Deepak L Bhatt

..This study was designed to assess whether use of enoxaparin during percutaneous coronary intervention (PCI) increased bleeding compared with unfractionated heparin, in addition to background therapy with eptifibatide...

..Overall, clopidogrel plus aspirin was not significantly more effective than aspirin alone in reducing the rate of myocardial infarction, stroke, or death from cardiovascular causes. (ClinicalTrials.gov number, NCT00050817.)...

..g., glycoprotein IIb/IIIa inhibitors, aspirin, clopidogrel), and whether replacements for heparin, such as bivalirudin or enoxaparin, offer any advantages in terms of bleeding risk...

..Emboli protection devices are needed that will provide optimal procedural efficacy and cause minimal or no provocation ofembolization during use...

..This finding supports a pivotal role for inflammation in acute coronary syndromes. Importantly, this study suggests that in-hospital revascularization may mitigate some of the excess risk due to inflammation...

..This strategy appears to be reserved for patients without significant comorbidities and those cared for by cardiologists and is associated with a lower risk of in-hospital mortality...

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..Whether dual antiplatelet therapy is superior to aspirin monotherapy for high-risk primary prevention and secondary prevention is unknown...

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..We sought to characterize the risk factors and treatments of a diverse contemporary population of patients with atherothrombosis...

..To date, no single international database has characterized the atherosclerosis risk factor profile or treatment intensity of individuals with atherothrombosis...

..The results of the CHARISMA trial are expected to provide further information on the optimal management of patients with stable atherothrombosis with respect to both antiplatelet therapy and overall management...

..The purpose of this study was to determine the possible benefit of dual antiplatelet therapy in patients with prior myocardial infarction (MI), ischemic stroke, or symptomatic peripheral arterial disease (PAD)...

..New insights at the cellular and genomic levels will probably generate novel drugs to inhibit platelet function more effectively and safely than previously possible...

..We sought to determine whether peroxisome proliferator-activated receptor gamma agonists had any beneficial effect on patients with metabolic syndrome undergoing percutaneous coronary intervention (PCI)...

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..We sought to examine the clinical outcomes of patients treated with drug-eluting stents (DES) compared with bare-metal stents (BMS) during primary angioplasty for ST-segment elevation myocardial infarction (STEMI)...

..This study explored temporal trends in the use of aldosterone antagonist therapy among eligible patients with post-acute myocardial infarction (AMI) and reduced ejection fraction and characteristics associated with use in clinical practice...

..Clopidogrel pretreatment attenuated the periprocedural increase in CRP by 65% and was independently associated with an attenuation in the CRP increase in a multivariate model...

..3%, 7.5%, 8.1%, and 7.1%, respectively (p=0.71). The incidence of bleeding complications was 6.6%, 5.9%, 6.9%, and 7.3%, respectively (p=0.81). ACT did not independently predict either ischemic or hemorrhagic complications...

..In conclusion, for patients with ACS, atrial fibrillation and atrial flutter were most strongly associated with the use of triple therapy; however, this therapy was used less often than dual or single antiplatelet therapy...

..We sought to determine the frequency and time course of bleeding with DAPT in patients with established vascular disease or risk factors only; identify correlates of bleeding; and determine whether bleeding is associated with mortality...

..Although an early invasive strategy improves outcome in these patients, there are limited data on culprit-only, single-vessel (SV) percutaneous coronary intervention (PCI) or MV PCI in the NSTE ACS setting...

..Prior investigations to define ethnic-related differences in the risks, medical treatment, and outcomes of patients with peripheral arterial disease (PAD) have been limited...

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..92, 95% confidence interval 0.69 to 1.23, p = 0.59). In conclusion, adjunctive use of platelet GP IIb/IIIa inhibitors in saphenous vein graft PCI does not appear to be associated with less myonecrosis or improved survival...

..Angiography demonstrated thrombotic occlusion and severe underlying restenosis of the stent. To our knowledge, this is the latest bare metal stent thrombosis described in the world medical literature...

..There were no procedural deaths, myocardial infarctions, or strokes. Thus, among carefully selected patients, simultaneous bilateral carotid artery stenting is a promising, technically feasible option...

..Most studies have demonstrated similar outcomes and a more favourable safety profile supporting this change in practice patterns...

..Earlier studies indicate an inverse relationship between hospital volume and mortality after primary angioplasty for patients presenting with ST-segment elevation myocardial infarction (STEMI). However, contemporary data are lacking...

..aspirin alone in the prespecified 'asymptomatic' subgroup of CHARISMA, we investigated whether dual-antiplatelet therapy may be associated with adverse cardiovascular (CV) events in a primary prevention population...

..Aggressive efforts, such as drug-eluting stents to decrease the incidence of unstable angina due to bare metal ISR, are warranted...

..Conversely, if the benefits of DESs are attenuated in routine practice, many groups of patients treated with BMSs may have nearly comparable results...

..Compared with bare metal stents, sirolimus-eluting stents did not appear to increase the risk for thrombosis up to 13.5 months after coronary intervention (risk ratio 0.49, 95% confidence interval 0.22 to 1.12, p = 0.09)...

..Increased bleeding and greater requirements for blood transfusions were seen with clopidogrel. The addition of clopidogrel to aspirin represents a major advance in the treatment of acute coronary syndromes...

..Accordingly, our aim was to conduct a meta-analysis to assess the benefit and safety profile of drug-eluting stents in diabetic patients...

..Unlike surgical revascularization, symptomatic patients did not have a greater risk for stroke and death compared with asymptomatic patients after CAS with EPDs...

..However, there is a greater incidence of post-procedural bleeding complications among women...

..Several observational reports have documented both increased and decreased cardiac mortality or Q-wave myocardial infarction with drug-eluting stents compared with bare-metal stents...

..Other registries that compared patients with reduced and preserved EF did not analyze their data by sex. We sought to evaluate sex/EF differences in mortality and risk factors for survival in hospitalized patients with HF...

..Current data show conflicting results regarding safety and efficacy of drug-eluting stents (DES) versus bare-metal stents (BMS) for treating saphenous vein grafts (SVG). Our objective was to compare DES with BMS for SVG intervention...

..To quantify the impact of clopidogrel plus aspirin on the individual outcomes of death, myocardial infarction, or stroke in patients with established cardiovascular disease, or in patients with multiple risk factors for vascular disease...

..Coronary stent fracture is an underrecognized entity but has been reported more frequently in the drug-eluting stent (DES) era. Nevertheless, the clinical implications of coronary stent fracture remain unclear...

..Our aim was to assess the incidence of all-cause mortality in patients with anemia undergoing percutaneous coronary intervention (PCI) receiving drug-eluting stents (DES) or bare-metal stents (BMS)...

..Therefore, clopidogrel plus aspirin should replace ticlopidine plus aspirin as the standard antiplatelet regimen after stent deployment...

..CONCLUSION: Although baseline us-CRP and GFR are both independent predictors of long-term death after PCI, in concert, they impart a markedly exaggerated hazard of mortality...

..65; 95% CI, 0.42 to 0.99; P=0.045). CONCLUSIONS: In this large study cohort, statin therapy among PCI patients seems to be associated with a significant mortality advantage at early and intermediate-term follow-up...

..19, 95% CI 1.17-4.11, P = .015). CONCLUSIONS: In patients with recent coronary stent placement, reversible nuclear perfusion defects independently predicted risk of death or MI...

..This study sought to determine if the initiation of statin (HMG-CoA reductase inhibitor) therapy during acute coronary syndromes reduces long-term mortality and other adverse cardiac outcomes...

..The short-term and long-term safety and efficacy of paclitaxel versus sirolimus-overlapping drug-eluting stents (DES) is unknown. We sought to examine the clinical consequences of overlapping sirolimus versus paclitaxel DES...

..65 to 0.74, p < 0.0001). CONCLUSIONS: Managing non-ST-segment elevation acute coronary syndromes by early invasive therapy improves long-term survival and reduces late myocardial infarction and rehospitalization for unstable angina...

..5 or 3 had a statistically significant reduction in MACE (OR 0.36, 95% CI 0.14-0.87, P = .02). CONCLUSIONS: Compared with SVG-PCI without emboli protection, EPD significantly improved TMP and trended towards a reduction in MACE...

..Although more of this risk was seen with paclitaxel stents, it remains possible that sirolimus stents similarly increase the risk for late thrombosis compared with bare metal stents...

..Carotid artery stenting (CAS) prior to open-heart surgery may be a useful approach to minimise the risk of neurologic events in patients undergoing aortic valve replacement (AVR)...

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..Our purpose was to examine the incidence of all-cause mortality among drug-eluting stents (DES) and bare-metal stents (BMS) while adjusting for many confounding factors generally not considered in prior studies...

..The prevalence of emergency department (ED) platelet aspirin resistance in suspected acute coronary syndrome (ACS) is not described. Our purpose was to determine the prevalence of platelet aspirin resistance...

..The use of more refined agents in conjunction with a better understanding of their effects will further the ability to provide more optimized care on an individual basis...

..This article summarizes the major modifications to the ACS guidelines and highlights the clinical evidence prompting such changes...

..In all the studies, the benefit correlated with reductions in CRP...

..Diagnosis and appropriate management of metabolic syndrome are challenges as the presence of risk factors predates the coronary event...

..This article will explore the current role of and controversies in oral antiplatelet therapy after ACS and PCI...

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..This study investigated the risk of stent thrombosis associated with the use of paclitaxel-eluting stents (PES) compared to bare-metal stents (BMS)...

..This study sought to determine whether the use of a thrombectomy or embolic protection device during revascularization for acute myocardial infarction reduces mortality compared with percutaneous coronary intervention (PCI) alone...

..The benefit was at the cost of an increase in bleeding, however. This strategy may need to be tailored in centers that use a more aggressive treatment strategy of early angiography and revascularization...

..In this article, we review the benefits of clopidogrel as an antiplatelet agent and its role in the management of acute coronary syndromes and following percutaneous coronary intervention...

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..Further study is needed to investigate the mechanisms and potential genetic underpinnings behind this association...

..The FISH (femoral introducer sheath and hemostasis) device is novel in that the access sheath and closure component are incorporated onto the same system...

..Abdominal obesity is associated with metabolic abnormalities and increased risk of atherosclerotic cardiovascular disease. However, no obesity management strategy has demonstrated the ability to slow progression of coronary disease...

..In the absence of mechanical emboli protection, this procedure is associated with high incidence of death and nonfatal ischemic events...

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..The objective of this study was to characterize treatment patterns among patients with diabetes presenting with non-ST-segment elevation (NSTE) acute coronary syndromes (ACSs)...

..We sought to determine the prevalence, predictors, and outcomes of patients with NSTEMI and insignificant CAD...

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..Aspirin resistance can be assessed through platelet aggregometry testing, measurement of urinary thromboxane metabolites, and, possibly, genomic testing in the future...

..To determine whether clopidogrel with aspirin (C+ASA) will produce more potent platelet inhibition than aspirin alone (ASA) in patients after ischemic stroke, we conducted the Plavix Use for Treatment of Stroke trial...

..The purpose of this study was to evaluate the potential impact of clopidogrel and statin interaction in a randomized, placebo-controlled trial with long-term follow-up...

..High-risk groups in the CAPRIE and CURE studies would be expected to derive enhanced benefit from treatment with clopidogrel over that achieved by ASA...