Adverse Events Related to Excimer Laser Coronary Atherectomy: Analysis of the FDA MAUDE Database
Bansal A; Gupta S; Jain V; Tsutsui R; Reed GW; Puri R; Hedrick DP; Kanaa'N A; Khatri JJ; Kapadia SR; Kalra A
Cardiovascular Revascularization Medicine
2021
2021-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
journalArticle
<a href="http://doi.org/10.1016/j.carrev.2020.12.024" target="_blank" rel="noreferrer noopener">10.1016/j.carrev.2020.12.024</a>
Management of cardiogenic shock complicating acute myocardial infarction: A review.
Humans; Survival Rate/trends; Global Health; acute myocardial infarction; Disease Management; Percutaneous Coronary Intervention/methods; cardiogenic shock and management; Myocardial Infarction/complications/therapy; Shock Cardiogenic/etiology/mortality/therapy; Thrombolytic Therapy/methods
Despite advances in percutaneous coronary interventions and their widespread use, mortality in patients presenting with acute myocardial infarction (MI) complicated by cardiogenic shock (CS) has remained very high, and treatment options are limited. Limited evidences exist, supporting many of the routinely used therapies in treating these patients. In the present article, we discuss CS complicating MI in general and an update on the currently available treatment options, including inotropes and vasopressor, coronary revascularization, mechanical circulatory support devices, mechanical complications, and long-term outcomes.
Shah AH; Puri R; Kalra A
Clinical cardiology
2019
2019-04
© 2019 The Authors. Clinical Cardiology published by Wiley Periodicals, Inc.
journalArticle
<a href="http://doi.org/10.1002/clc.23168" target="_blank" rel="noreferrer noopener">10.1002/clc.23168</a>
PMID: 30815887
Coronary embolism: A systematic review.
BACKGROUND: Coronary embolism is a rare and potentially fatal phenomenon that occurs primarily in patients with valvular heart disease and atrial fibrillation. There is a lack of consensus regarding the diagnosis, treatment, and management of coronary embolism, leaving management at the discretion of the treating physician. Through this review, we aim to establish a better understanding of coronary embolism, and to identify treatment options - invasive and non-invasive - that may be used to manage coronary embolism. METHODS AND RESULTS: Our systematic review included 147 documented cases of coronary embolism from case reports and case series. The average age of our population was 54.2 ± 17.6 years. The most common causes of coronary embolism included infective endocarditis (22.4%), atrial fibrillation (17.0%), and prosthetic heart valve thrombosis (16.3%). Initial presentation was indistinguishable from an acute coronary syndrome (ACS) due to coronary atherosclerosis, and the diagnosis required a high level of suspicion and evaluation with angiography. Treatment strategies included, but were not limited to, thrombectomy, thrombolysis, balloon angioplasty and stent placement. Myocardial dysfunction on echocardiography was observed in over 80% of patients following coronary embolism. "Good outcomes" were reported in 68.7% of case reports and case series, with a mortality rate of 12.9%. CONCLUSION: Coronary embolism is an under-recognized etiology of myocardial infarction with the potential for significant morbidity and mortality. To improve outcomes, physicians should strive for early diagnosis and intervention based on the underlying etiology. Thrombectomy may be considered with the goal of rapid restoration of coronary flow.
Lacey MJ; Raza S; Rehman H; Puri R; Bhatt DL; Kalra A
Cardiovascular revascularization medicine : including molecular interventions
2020
2020-03
Copyright © 2019 Elsevier Inc. All rights reserved.
journalArticle
<a href="http://doi.org/10.1016/j.carrev.2019.05.012" target="_blank" rel="noreferrer noopener">10.1016/j.carrev.2019.05.012</a>
PMID: 31178350
Meta-analysis comparing outcomes in patients undergoing transcatheter aortic valve implantation with versus without percutaneous coronary intervention.
Humans; Treatment Outcome; Severity of Illness Index; Echocardiography; Coronary Angiography; Aortic Valve Stenosis/complications/diagnosis/surgery; Coronary Artery Disease/complications/diagnosis/surgery; Percutaneous Coronary Intervention/methods; Transcatheter Aortic Valve Replacement/methods
Patients having transcatheter aortic valve implantation (TAVI) routinely undergo coronary angiography before the procedure to define the coronary anatomy and to evaluate the extend of coronary artery disease (CAD). Whether percutaneous coronary intervention (PCI) prior/concomitant with TAVI confers any additional clinical benefit in patients with CAD remains unclear. Literature search was performed using Medline, Embase, Google Scholar, and Scopus from inception of these databases till April 2019. Included outcomes were 30-day all-cause mortality, stroke, myocardial infarction (MI), acute kidney injury, and 1-year mortality. The main summary estimate was random effects odds ratio (OR) with 95% confidence intervals (CIs). Eleven cohort studies enrolling 5,580 patients (mean age 82.4 years and 52.6% females) were included. Our study found no difference in effect estimates for 30-day all-cause mortality (OR 1.30 [0.85 to 1.98], p = 0.22, I(2) = 37.5%), stroke (OR 0.7 (0.36 to 1.45), p = 0.36, I(2) = 32.8%), MI (OR 2.71 [0.55 to 12.23], p = 0.22, I(2) = 41.3%), acute kidney injury (OR 0.7 [0.46 to 1.06], p = 0.08, I(2) = 14.4%) and 1-year all-cause mortality (OR 1.19 [0.92 to 1.52], p = 0.18, I(2) = 0.0%) in patients who underwent TAVI with and without PCI. In conclusion, our analysis indicates that PCI with TAVI in patients with severe aortic stenosis and concomitant CAD grants no additional clinical advantage in terms of patient important clinical outcomes. Further randomized studies are needed to better delineate the clinical practice for myocardial revascularization in patients receiving transcatheter therapy for aortic valve disease.
Lateef N; Khan MS; Deo VS; Yamani N; Riaz H; Virk HUH; Khan SU; Hedrick DP; Kanaan A; Reed GW; Krishnaswamy A; Puri R; Kapadia SR; Kalra A
The American journal of cardiology
2019
2019-12-01
Copyright © 2019 Elsevier Inc. All rights reserved.
journalArticle
<a href="http://doi.org/10.1016/j.amjcard.2019.08.024" target="_blank" rel="noreferrer noopener">10.1016/j.amjcard.2019.08.024</a>
PMID: 31575422