Author Interviews, COVID -19 Coronavirus, Heart Disease / 12.04.2020 Interview with: Santiago Garcia, MD FACC Interventional Cardiologist, Minneapolis Heart Institute® Researcher, Minneapolis Heart Institute Foundation® What is the background for this study?  Response: We analyzed and quantified ST-segment elevation myocardial infarction (STEMI) activations for 9 high-volume (>100 primary percutaneous angioplasties per year) cardiac catheterization laboratories in the US. These centers represent different geographic areas and levels of COVID-19 exposure in the US. The data analyzed was from January 1, 2019 to March 31, 2020. Participating centers included 1-Minneapolis Heart Institute, Minneapolis, MN, 2- Beaumont Hospital Royal Oak, Royal Oak, MI, 3- The Christ Hospital, Cincinnati, OH, 4- Massachusetts General Hospital, Boston, MA, 5- UMass Memorial Medical Center, Worcester, MA, 6- Iowa Heart, Des Moines, IA, 7- Northwell Health Hospital, Manhasset, NY, 8- Prairie Cardiovascular, Springfield, IL, and 9- Swedish Medical Center, Seattle, WA. (more…)
AHA Journals, Author Interviews, Heart Disease / 16.01.2019 Interview with: JAY H. Traverse, MD, FACC, FAHA Director of Research Minneapolis Heart Institute Foundation Associate Professor of Medicine Cardiovascular Division University of Minnesota School of Medicine What is the background for this study? What are the main findings? Response: Reperfusion injury may contribute a significant amount to final infarct size in setting of ST-elevation myocardial infarction (STEMI). Several studies from Europe and Asia have suggested that modifying reperfusion with an angioplasty balloon of an occluded artery called postconditioning can reduce infarct size. However, not all studies show a benefit. We hypothesized that patient selection of STEMI patients could contribute to these inconsistent findings so we performed the first postconditioning study in the US sponsored by the NIH using the strictest enrollment criteria of any study to minimize factors that influence infarct size (ischemic time, collaterals, pre-infarction angina, TIMI 0 flow) designed to maximize the benefit of postconditioning to see if it can actually reduce infarct size. (more…)
Author Interviews, Heart Disease, JAMA / 27.10.2017 Interview with: Elad Asher, M.D, M.H.A Interventional Cardiologist, Director Intensive Cardiac Care Unit Deputy Director Heart Institute Assuta Ashdod Medical Center What is the background for this study? Response: Dual antiplatelet therapy represents the standard care for treating ST elevation myocardial infarction (STEMI) patients. Given the higher risk of peri-procedural thrombotic events in patients undergoing primary percutaneous coronary intervention (PPCI), there is a need to achieve inhibition of platelet aggregation (IPA) more promptly. Although chewing ticagrelor has been shown to be more efficient for IPA in stable coronary disease and in patients with acute coronary syndrome (ACS)/non-ST elevation myocardial infarction (NSETMI), there are no studies that have specifically assessed the efficacy and safety of chewing ticagrelor in STEMI patients. Therefore, the aim of our study was to investigate whether chewing ticagrelor (180mg) loading dose is associated with more favorable platelet inhibitory effects compared with the conventional way of swallowing whole tablets loading dose in STEMI patients undergoing PPCI. (more…)
Author Interviews, Heart Disease, JACC / 21.05.2017 Interview with: Dr. Ion S. Jovin, MD, ScD Associate Professor of Medicine at Virginia Commonwealth University Pauley Heart Center Director of the Cardiac Catheterization Laboratories and Site Director of the VCU Interventional Cardiology Fellowship Program at McGuire V.A. Medical Center Visiting Assistant Professor in the Department of Surgery/Cardiothoracic Surgery Yale University, New Haven, CT What is the background for this study? What are the main findings? Response: There is still uncertainty regarding the best anticoagulant for patients with acute ST-segment elevation myocardial infarction (STEMI) who undergo primary percutaneous coronary intervention (PCI) and especially PCI done via radial (as opposed to femoral) access. Our study compared outcomes of patients with STEMI treated with PCI done via radial access in the NCDR database who received one of the two main anticoagulants: bivalirudin and heparin. There is a large degree of variation in the use of the two anticoagulants in PCI and in primary PCI both within the United States but also in the world. We did not find a statistically significant difference between the outcomes of the two groups of patients, but we also found that a significant number of patients in both the heparin and in the bivalirudin group were also treated with additional medicines that inhibit platelet activation (glycoprotein IIb/IIIa inhibitors). (more…)
Author Interviews, Cleveland Clinic, Heart Disease, Kidney Disease / 01.05.2017 Interview with: Mohamed Khayata, MD Internal Medicine Resident PGY-3 Cleveland Clinic Akron General Akron, Ohio What is the background for this study? What are the main findings? Response: Previous studies showed that patients with ST-elevation myocardial infarction (STEMI) who had elevated creatinine and/or impaired creatinine clearance on presentation had higher short- and long-term mortality independent of other cardiovascular risk factors. We used the National Cardiovascular Database Registry to investigate the impact of creatinine levels at the time of presentation on the cardiovascular outcomes in patients who presented with STEMI. Our study showed that elevated creatinine levels correlated with higher incidence of atrial fibrillation, bleeding, heart failure, and cardiogenic shock during hospital stay after the percutaneous intervention. (more…)
Author Interviews, Heart Disease, JAMA / 01.03.2017 Interview with: Thomas Engstrøm  MD, PhD The Heart Center | Rigshospitalet | University of Copenhagen | Denmark Professor in cardiology | University of Lund | Sweden Adjunct professor in cardiology | University of Aalborg | Denmark What is the background for this study? What are the main findings? Response: Timely reperfusion by primary angioplasty (primary PCI) in patients with ST-elevation myocardial infarction is mandatory. However reperfusion it self can harm the myocardium - so called reperfusion injury. During a number of years ischemic postconditioning (iPOST) by repetitive interruptions of blood flow after reperfusion has been a promising technique to address reperfusion damage. The trial investigated the effect of iPOST in 1200 patients treated with primary PCI and in addition either iPOST or conventional angioplasty. (more…)