Successful Percutaneous Treatment of Coronary Artery Ectasia with Drug-Eluting Stent

Coronary artery ectasia is well-known but relatively uncommon finding with prevalence ranging from 1.2% to 5.3%. Coronary artery ectasia has been associated with atherosclerosis in approximately half of the cases. Here, we are presenting a case of male patient who experienced myocardial infarction and was diagnosed with coronary artery ectasia in proximal-mid junction of left anterior descending artery with stenotic lesion. The patient was successfully treated with percutaneous transluminal coronary angioplasty.

Clinical Performance of the Cobalt-Chromium Biodegradable Polymer Coated Sirolimus-Eluting Stent in an Unselected Real-World Population

OBJECTIVE: The primary objective of the S-CORE registry was to assess the safety and efficacy of the Supralimus-Core? sirolimus-eluting stent deployment for the treatment of coronary artery disease and event-free survival of patients treated with this coronary stent. METHODS: S-CORE Registry is an observational, single-arm, non-randomized, post-marketing surveillance multicenter registry in which 562 patients undergoing single or multi-vessel percutaneous coronary intervention were enrolled. The pre-specified primary outcome was the rate of major adverse cardiac events (MACE), defined as the composite of cardiac death, myocardial infarction (MI), target lesion revascularisation (TLR) and target vessel revascularisation (TVR) at 12-month post-procedure. Stent thrombosis (ST) served as the safety endpoint. RESULTS: A total of 640 lesions were treated in 562 enrolled patients (mean age 57.4 ± 10.7 years) with average stent length of 25.0 ± 9.0 mm. Stent delivery was successful in 99% cases. A total of 554 (98.6%) patients have been followed up to 12 months. The incidence of MACE at 30 days and 6 months was 7 (1.2%) and 12 (2.1%) respectively. The composite rate of MACE at a 12-month clinical follow-up was 19 (3.4%), consisting of 12 (2.1%) cardiac deaths, 0 (0%) MI, 6 (1.1%) TLR and 1 (0.2%) TVR. The long-term follow-up of this registry is going on to confirm safety and efficacy profiles. CONCLUSIONS: This multicenter registry demonstrated satisfactory safety and efficacy profiles, as evidenced by low rates of major adverse cardiac events up to 12 months, for the cobalt-chromium biodegradable polymer-based sirolimus-eluting Supralimus-Core? stent in a “real-world” setting.

Clinical Spectrum of Infective Endocarditis in a Tertiary Care Centre in Western India: A Prospective Study

OBJECTIVES: We examined the microbiological spectrum, clinical profile, echocardiographic features and in-hospital outcomes of patients with definitive IE. METHODS: A total of 75 consecutive cases of definitive infective endocarditis (IE), admitted between January 2011 and January 2013, were included in the study. This was a prospective study enrolling all the consecutive definitive cases of IE admitted at U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Ahmedabad, India. Only the patients who met the modified Duke’s definitive criteria for IE were included in the study. We compared enrolled patients clinicoepidemiologic features and outcomes to subjects in the west. RESULTS: The mean age was 27.46 ± 17.11 years with a male preponderance (2.26:1). The rheumatic heart disease (41.3%) was the commonest underlying disease followed by coronary heart disease (34.7%). The blood culture was positive in 40% of episodes with commonest organisms being staphylococci (16%) and streptococci (12%). Complications were cardiovascular in 40 (53.3%) cases (congestive heart failure in 42.7%, atrioventricular block in 6.7%), septic shock in 20 (26.7%), neurological in 23 (30.7%) (cerebrovascular stroke in 20%, central nervous system hemorrhage in 5.3%, encephalopathy in 5.3%) and renal failure in 20 (26.7%) of cases respectively. Only 12 (16%) patients underwent surgery for IE. The total in hospital mortality rate was 22 (29.3%). On multivariate analysis, congestive heart failure, renal failure, neurological abnormalities, age 20 years and septic shock were independent predictors of mortality. CONCLUSIONS: The spectrum of infective endocarditis is different in Indian population compared to the west and carries a substantial morbidity and mortality. The rheumatic heart disease is still the commonest underlying heart disease in our population. The culture positivity rates and surgery for infective endocarditis are unacceptably low. Early cardiac surgery may help to improve the outcomes of these patients.