Category Archives: Heart Attack

Ad Hoc Angioplasty: The Patient Is On The Table

Cardiologist and patient in cath lab

Cardiologist talks to a patient “on the table” in cath lab

Something that is “on the table” is defined as an item that is “up for discussion.” And this week The Society for Cardiac Angiography and Interventions (SCAI) issued a consensus statement about the proper use of “ad hoc PCI” — and the patient was definitely on the table, up for discussion, part of the conversation.

Since we’re into definitions, ad hoc PCI is the scenario in which a diagnostic catheterization is followed in the same session by PCI (angioplasty and stents). And this is a common scenario: in New York State, for example, 80% of all angioplasties are done in the same session as the diagnostic angiogram, although the vast majority of these are emergency or primary angioplasties, where a patient in the midst of a heart attack (or close to it) is brought into the cath lab and the blockage is opened up, saving the heart muscle and possibly the patient’s life. Continue reading


Filed under COURAGE, FAME I / FAME II, FFR, Heart Attack, History, Optimal Medical Therapy, Patient Empowerment, Patients, Shared Decision-Making, Stent

The Question of Angioplasty in the Elderly

We just posted a report on the XIMA Trial which studied stents in octogenarians. The trial compared drug-eluting with bare-metal stents and the results are very interesting: while the trial didn’t find a difference in these two types of stents for the pre-specified composite endpoint of death, heart attack, revascularization, stroke and major bleeding…it did find significantly lower incidence of revascularization and heart attack in those patients who received the drug-eluting Xience stent.

But the real take-away from the XIMA Trial is that stenting and angioplasty in the elderly is safe and effective. Mortality from cardiac causes in this trial was 4% at one year, no matter which stent was used. Continue reading


Filed under Antiplatelet Medications, Bare Metal Stents, Clinical Trials / Studies, Drug-Eluting Stents, Heart Attack, Meetings & Conferences, Patients, Stent, Video

“Annual Report” of Stent Procedures Shows Big Increase in Wrist Angioplasty

Today’s report from the ACC CathPCI Registry data has some interesting statistics, among them a significant increase in the transradial approach, in which balloons and stents are directed to the heart via the radial artery in the wrist. As I’ve discussed for several years now, the radial approach is utilized much more outside of the U.S. — but it is catching on here…finally.

Dr. Sunil V. Rao

Dr. Sunil V. Rao

Four years ago we wrote about a study, authored by Dr. Sunil V. Rao, that also used data from the CathPCI registry for the years 2004-2007. (For more information, read my interview with Dr. Rao.) At that time Dr. Rao calculated the usage of transradial angioplasty in the U.S. at 1.32%.

Today’s report tabulates it at 6.9%: a five-fold increase!

Dr. Rao has been one of the main proponents of the transradial approach in the U.S., practicing it, teaching it, lecturing all over the country about it, and most recently co-directing a “Masters Course” in transradial at Duke. Continue reading


Filed under ACC, Heart Attack, Meetings & Conferences, Transradial Approach

TCT 2012 – Transcatheter Cardiovascular Therapeutics in Miami Beach

Miami Beach

The TCT will be held in Miami Beach, October 22-26, 2012

The Transcatheter Cardiovascular Therapeutics conference (TCT) is the largest U.S. meeting devoted to interventional cardiology (angioplasty, stents, and related procedures) and it starts next week. Organizers are predicting a new attendance record of over 12,000 cardiologists and associated healthcare professionals, as well as members of the device, imaging and pharmaceutical industries, venture capitalists, and press. Speaking of which, yes…I will be there and Angioplasty.Org will be reporting on late-breaking trials, new directions and innovative devices.

The annual  meeting is truly international: attendees will be traveling from 70 countries; in fact, this year more than two-thirds of the registrants hail from outside the United States. Continue reading

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Filed under Clinical Trials / Studies, Cost Effectiveness, FDA, Global Trends, Heart Attack, High Blood Pressure, Intravascular Guidance, Meetings & Conferences, Stent, Transradial Approach

Jerry “The King” Lawler Has Heart Attack (on the air) and Stents (not on the air)

Jerry Lawler

Jerry Lawler, announcing during a match in 2007 (courtesy Mshake3)

Jerry “The King’ Lawler, semi-retired professional wrestler, holder of 168 championships (reportedly) and commentator for WWE’s “Monday Night Raw” collapsed on September 10, during a live broadcast in Montreal, Canada.

62-year-old Lawler was having a heart attack.

EMTs performed CPR and defibrillated him (seven times, it is reported). He was revived and rushed to a Montreal hospital where he received an angioplasty with two stents. Continue reading

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Filed under Celebrity Patients, Heart Attack, Stent, Video

Patient Alert: Don’t Take NSAIDs After a Heart Attack

NSAID tabletsA study from Denmark of almost 100,000 patients over a 12-year period has concluded that:

The use of NSAIDs is associated with persistently increased coronary risk regardless of time elapsed after first-time MI. We advise long-term caution in using NSAIDs for patients after MI.

The study, published online before print in Circulation is titled, “Long-Term Cardiovascular Risk of NSAID Use According to Time Passed After First-Time Myocardial Infarction: A Nationwide Cohort Study.”  The researchers looked at the nationwide registries of hospitalization and drug dispensing from pharmacies in Denmark for the years 1997-2009 and calculated the incidence of death and heart attack associated with NSAID (Non-Steroidal Anti-Inflammatory Drug) use up to five years after a heart attack (in one-year increments). Continue reading


Filed under Heart Attack, Patient Alert, Patient Empowerment, Patients, Risk Factors

What We Can Learn from Tommy Lasorda’s “Mild” Heart Attack

Tommy Lasorda, photo by Phil Konstantin

Tommy Lasorda, photo by Phil Konstantin

Before he was Hall of Fame manager of the Los Angeles Dodgers, Tommy Lasorda was a scout and coach for the team. And part of his duties was to teach the rookies. So, in that tradition, there is a lesson in Tommy’s latest health scare: if you think you may be having a heart attack, get to the hospital ASAP, preferably a hospital that performs emergency angioplasty. Continue reading

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Filed under Celebrity Patients, Heart Attack, Video