Elective percutaneous coronary intervention fulfils many of the criteria needed of a clinical model of ischaemic preconditioning. But is this really a reflection of the laboratory phenomenon of ischaemic preconditioning?

S ince primary percutaneous coronary intervention (PCI) is the mainstay of reperfusion in acute myocardial infarction (AMI), and because AMI represents the most urgent situation for PCI, recommendations based on scientific evidence and expert experience would be useful for centres practising primary PCI or those looking to set up a primary PCI programme. With this in mind, a group of eight Euro...

INTRODUCTION AND OBJECTIVES A standardized protocol of emergent transfer for primary percutaneous coronary intervention for patients with ST elevation myocardial infarction, defined as the Infarction Code, was implemented in June 2009 in the Catalan regional health system. The objective of this study was to evaluate the impact of the new protocol on delay times, number of procedures and clinica...

Platelets play a central role in the pathogenesis of atherothrombosis. Thus, achieving platelet inhibition is an important part of managing patients that have experienced an atherothrombotic event. Dual antiplatelet therapy with clopidogrel plus aspirin has been shown to markedly reduce ischemic events in patients undergoing percutaneous coronary intervention (PCI) and stenting. Despite its pro...

T he introduction of the transradial approach has raised vascular access to a level of refinement unforeseen by the pioneers of cardiac catheterization, who relied on direct left ventricular puncture or transbronchial left atrial catheterization to make hemodynamic measurements in the 1950s (1). With the advent of percutaneous coronary intervention (PCI) in the late 1970s, interventional cardio...

BACKGROUND Thirty-day readmission after percutaneous coronary intervention (PCI) is common, costly, and linked to poor patient outcomes. Accordingly, facility-level 30-day readmission rates have been considered as a potential quality measure. However, it is unknown whether facility-level 30-day readmission rates are associated with facility-level mortality. We sought to determine the effect of ...

Dual oral antiplatelet therapy, aspirin plus thienopyridine, has permitted a rapid increase in the use of coronary intervention procedures. Clopidogrel is the thienopyridine of choice for dual antiplatelet therapy in patients treated with percutaneous coronary intervention. However, there are two issues with clopidogrel: (1) clopidogrel's antiplatelet activity is delayed because the drug needs ...

Time and time again, randomized clinical trials have demonstrated that what is conceptually logical and should be right is not always right. Randomized large clinical trials are often undertaken on the basis of this logical hypothesis. Very often, small clinical trials also show encouraging results.1,2 However, when large randomized clinical trials are performed, they not infrequently reveal ra...

For the acute myocardial infarction patient, percutaneous coronary intervention is clearly superior to thrombolysis for many clinical end points, yet widespread availability of PCI services is still far from being realised.

M a i n r e s u l t s Analysis was by intention to treat. The composite endpoint of any major coronary adverse outcome was lower in the homocysteine-lowering group than the placebo group, as was the need for repeated revascularization and repeated target lesion revascularization (Table). Adjustment for age, sex, and risk factors known to influence the need for repeated revascularization did not...