Skip header and navigation

Refine By

   MORE

6 records – page 1 of 1.

Demographics, treatment and outcome of acute coronary syndromes: 17 years of experience in a specialized cardiac centre.

https://arctichealth.org/en/permalink/ahliterature170649
Source
Can J Cardiol. 2006 Feb;22(2):121-4
Publication Type
Article
Date
Feb-2006
Author
Jean-Pierre S Awaida
Jocelyn Dupuis
Pierre Théroux
Guy Pelletier
Michel Joyal
Pierre De Guise
Serge Doucet
Luc Bilodeau
Bernard Thibault
Jean-Francois Tanguay
Richard Gallo
Jean Grégoire
Philippe L L'Allier
Laurent Macle
Anil Nigam
Author Affiliation
Research Centre, Montreal Heart Institute, and Department of Medicine, University of Montreal, Quebec, Canada.
Source
Can J Cardiol. 2006 Feb;22(2):121-4
Date
Feb-2006
Language
English
Publication Type
Article
Keywords
Age Distribution
Angioplasty, Balloon, Coronary - statistics & numerical data
Cerebral Revascularization - statistics & numerical data
Coronary Care Units - statistics & numerical data
Coronary Disease - epidemiology - therapy
Demography
Female
Humans
Intra-Aortic Balloon Pumping - statistics & numerical data
Male
Middle Aged
Outcome Assessment (Health Care)
Prospective Studies
Quebec - epidemiology
Retrospective Studies
Sex Distribution
Stents - statistics & numerical data
Treatment Outcome
Abstract
Epidemiological information on patients with acute coronary syndromes managed in specialized cardiac centres is limited.
To report the evolution of demographics, treatment and outcome of patients admitted to a tertiary coronary care unit (CCU) over a 17-year period.
A prospective database of 18,719 patients admitted from April 1986 to March 2003 in a 21-bed CCU was analyzed.
From 1986 to 2003, the number of admissions increased from 937 to 1577 per year, while the length of stay declined from 7.5 to 3.5 days. The mean age increased from 58.4 to 63.4 years, and the proportion of men remained stable at approximately 70%. The use of coronary angiograms increased from 49.8% to 81.1% in all patients, while fibrinolysis dropped to 0.4%. In-hospital mortality decreased from 9% to 1.5%. The percentage of overall instrumentation (arterial line, central venous catheter, temporary pacemaker, Swan-Ganz catheter and intra-aortic balloon pump) decreased from 38% to 8.1%. From 1995 to 2003, the proportion of stenting during percutaneous transluminal coronary angioplasty increased dramatically from 0% to 86%. In the past five years, surgical revascularization has remained stable at approximately 20% of all admissions. The proportion of patients discharged with a noncoronary chest pain diagnosis has remained constant at approximately 4%.
There has been a tremendous increase in efficiency, with an approximate doubling of the admissions turnover rate in a tertiary CCU. Patients with acute coronary syndromes are stratified faster and treated more invasively. Therapeutic advances are reflected by an almost linear 0.5% per year decrease in in-hospital mortality.
Notes
Cites: Circulation. 2000 Nov 14;102(20 Suppl 4):IV2-IV1311080126
Cites: Lancet. 1999 Aug 28;354(9180):708-1510475181
Cites: J Am Coll Cardiol. 2002 Apr 3;39(7):1096-10311923031
Cites: Lancet. 2002 Sep 7;360(9335):743-5112241831
Cites: Circulation. 2003 Mar 25;107(11):1463-612654599
Cites: Circulation. 2003 Mar 25;107(11):1467-7012654600
Cites: Circulation. 2003 Mar 25;107(11):1471-212654601
Cites: Can J Cardiol. 2003 Aug;19(9):1033-912915930
Cites: Lancet. 2004 Feb 14;363(9408):502-314975607
Cites: Lancet. 2004 Feb 14;363(9408):511-714975612
Cites: Arch Intern Med. 2004 Apr 12;164(7):733-4015078642
Cites: Can J Cardiol. 2004 May 15;20(7):712-615197424
Cites: Chest. 1983 Sep;84(3):245-96884097
Cites: Chest. 1987 Oct;92(4):721-73652758
Cites: Chest. 1990 Dec;98(6):1331-52245670
Cites: N Engl J Med. 2001 Jun 21;344(25):1879-8711419424
PubMed ID
16485046 View in PubMed
Less detail

Differential 1-year clinical outcomes for ST-segment elevation myocardial infarction related to stent thrombosis or saphenous vein graft thrombosis.

https://arctichealth.org/en/permalink/ahliterature132581
Source
Catheter Cardiovasc Interv. 2013 Aug 1;82(2):193-200
Publication Type
Article
Date
Aug-1-2013
Author
Dabit Arzamendi
Hung Q Ly
Jean-François Tanguay
Sebastien Armero
Hasan Jilaihawi
Richard Gallo
Reda Ibrahim
Philippe L'Allier
Lucie Blondeau
Gilbert Gosselin
Jean Gregoire
Serge Doucet
Author Affiliation
Interventional Cardiology Division, Department of Medicine, Montreal Heart Institute, Université de Montréal, Montreal, Qc H1T 1C8, Canada.
Source
Catheter Cardiovasc Interv. 2013 Aug 1;82(2):193-200
Date
Aug-1-2013
Language
English
Publication Type
Article
Keywords
Aged
Chi-Square Distribution
Coronary Artery Bypass - adverse effects - mortality
Coronary Thrombosis - etiology - mortality - physiopathology - therapy
Female
Graft Occlusion, Vascular - etiology - mortality - physiopathology - therapy
Humans
Kaplan-Meier Estimate
Longitudinal Studies
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction - diagnosis - mortality - surgery - therapy
Percutaneous Coronary Intervention - adverse effects - instrumentation - mortality
Proportional Hazards Models
Prospective Studies
Quebec
Recurrence
Registries
Risk factors
Saphenous Vein - physiopathology - transplantation
Stents
Time Factors
Treatment Outcome
Vascular Patency
Venous Thrombosis - etiology - mortality - physiopathology - therapy
Abstract
Thrombosis of stents and of saphenous vein grafts (SVG) remains a severe complication of either revascularization techniques that often are present as ST elevation myocardial infarction (STEMI). The aim of this longitudinal cohort study was to compare the 1-year clinical outcomes among STEMI patients requiring primary PCI due to stent thrombosis and graft occlusion presenting with STEMI.
We prospectively collected data on all patients undergoing primary PCI at the Montreal Heart Institute between April 1, 2007 and March 30, 2008. Study patients were grouped according to the etiology of the STEMI: stent thrombosis, graft thrombosis, or atherosclerosis-related STEMIs (control group). The primary combined end-point, major adverse cardiac events (MACE), was defined as death, myocardial infarction, and target vessel revascularization within 12 months as primary end point. Of the 489 STEMI patients included in the study, 23 were due to stent thrombosis, 22 to graft thrombosis, and 444 in the control group. Stent and graft thromboses were associated with a higher MACE rates, 26.1 and 22.7%, respectively, compared to the control group, 9.3% (P = 0.004). Moreover, only stent thrombosis was associated with an increased risk of MACE (HR 2.57, confidence interval 95% 1.08-6.08.
Patients with stent thrombosis present with higher rate of reinfarction while graft thrombosis is associated with an increase in 1-year cardiac mortality. Using multivariate analysis, higher MACE rates were associated with stent thrombosis as compared to graft thrombosis.
Notes
Comment In: Catheter Cardiovasc Interv. 2013 Aug 1;82(2):201-223878031
PubMed ID
21805615 View in PubMed
Less detail

Effectiveness of risk-reducing salpingo-oophorectomy in preventing ovarian cancer in a high-risk French Canadian population.

https://arctichealth.org/en/permalink/ahliterature123040
Source
Int J Gynecol Cancer. 2012 Jul;22(6):974-8
Publication Type
Article
Date
Jul-2012
Author
Omar Moreira Bacha
Jean Gregoire
Katherine Grondin
Maria Isabel Edelweiss
Rachel Laframboise
Jacques Simard
Marie Plante
Author Affiliation
Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil. omarmbacha@terra.com.br
Source
Int J Gynecol Cancer. 2012 Jul;22(6):974-8
Date
Jul-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Canada - epidemiology
Female
Genes, BRCA1
Genes, BRCA2
Humans
Middle Aged
Ovarian Neoplasms - ethnology - genetics - prevention & control
Ovariectomy - statistics & numerical data
Ovary - pathology
Retrospective Studies
Salpingectomy - statistics & numerical data
Abstract
Women with germ line BRCA1 or BRCA2 mutations have a marked increased risk of breast and ovarian cancer compared with the general population, whereas risk-reducing salpingo-oophorectomy (RRSO) significantly lowers the incidence of these cancers. The objective of this study was to review the clinical and pathological characteristics of a French Canadian population undergoing RRSO. Surgical morbidity was also evaluated.
From December 1999 to December 2009, all women who underwent RRSO at our institution were identified. Medical records were retrospectively reviewed. Descriptive statistics, the Fischer exact test, and the Student t test were used for analysis.
During the study period, RRSO was performed on 119 women. Mean age at surgery was 49 years (35-72 years), and 63 patients (53%) were premenopausal. Sixty-two women (52%) had a history of in situ or invasive breast cancer. BRCA1 and BRCA2 mutations were present in 34 patients (29%) and 42 patients (35%), respectively, whereas 43 patients (36%) were considered to have an increased risk of breast and ovarian cancer, despite a personal genetic test, which was either negative (n = 23) or unknown because the patient declined genetic testing (n = 20). Most patients with a uterus in place had a complementary hysterectomy (65%). Six complications occurred (3 hematomas, 2 cardiac arrhythmias, and 1 cystotomy). In one patient (0.8%), a high-grade stage II ovarian cancer was discovered at the time of surgery. Fallopian tube atypias were identified on final pathology in 8 cases (6.7%). After a median follow-up of 22 months, 4 women (3.4%) developed breast cancer and one woman (0.8%) developed peritoneal cancer.
Risk-reducing salpingo-oophorectomy is highly effective in preventing ovarian, fallopian tube, and breast cancers in a high-risk French Canadian population; and the surgical morbidity is low.
PubMed ID
22740003 View in PubMed
Less detail

Feasibility of the PCI through 6F diagnostic catheters.

https://arctichealth.org/en/permalink/ahliterature165397
Source
Catheter Cardiovasc Interv. 2007 Feb 15;69(3):410-5
Publication Type
Article
Date
Feb-15-2007
Author
Pierre-Frédéric Keller
Gilbert Gosselin
Jean Grégoire
Antoine Guédès
Vitali Verin
Author Affiliation
Montreal Heart Institute, 5000 Belanger, Montreal, Quebec H1T 1C8, Canada.
Source
Catheter Cardiovasc Interv. 2007 Feb 15;69(3):410-5
Date
Feb-15-2007
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Angina Pectoris - radiography - therapy
Angioplasty, Balloon, Coronary - instrumentation
Blood Vessel Prosthesis Implantation
Canada
Cardiac Catheterization
Coronary Angiography
Coronary Disease - radiography - therapy
Equipment Design
Feasibility Studies
Female
Humans
Male
Middle Aged
Myocardial Infarction - radiography - therapy
Stents
Syndrome
Treatment Outcome
Abstract
The choice of guiding catheter for optimal back-up support is critical in order to achieve a successful PCI. Diagnostic 6 French (F) catheters have an internal lumen diameter as large as 5F guiding catheters. The aim of this study was to demonstrate for the first time the feasibility of performing PCI with Cordis 6F diagnostic catheters in selected coronary lesions.
32 coronary stents were implanted using 6F diagnostic catheters in 27 eligible patients at the Montreal Heart Institute. The inclusion criteria were TIMI angiographic score
PubMed ID
17265444 View in PubMed
Less detail

Treatment of bifurcation in-stent restenotic lesions with beta radiation using strontium 90 and sequential positioning pullback technique: procedural details and clinical outcomes.

https://arctichealth.org/en/permalink/ahliterature184236
Source
J Invasive Cardiol. 2003 Aug;15(8):469-73; quiz 474
Publication Type
Article
Date
Aug-2003
Author
Ricardo Costa
Michel Joyal
Francois Harel
Tim Fox
Ian Crocker
Andre Arsenault
Jean Gregoire
Raoul Bonan
Author Affiliation
Institut de Cardiologie de Montreal, 5000 Belanger Street, Montreal, QC H1T 1C8, Canada. raoul.bonan@mmic.net
Source
J Invasive Cardiol. 2003 Aug;15(8):469-73; quiz 474
Date
Aug-2003
Language
English
Publication Type
Article
Keywords
Angioplasty, Balloon - methods
Beta Particles - therapeutic use
Brachytherapy - methods
Canada
Coronary Angiography
Coronary Restenosis - radiography - therapy
Female
Follow-Up Studies
Humans
Iridium Radioisotopes - administration & dosage - therapeutic use
Male
Middle Aged
Prospective Studies
Radiometry
Stents
Strontium Radioisotopes - administration & dosage - therapeutic use
Treatment Outcome
Abstract
In-stent restenotic lesions have been problematic for many patients with the need for multiple repeat percutaneous coronary interventions (PCI). The need for repeat PCI has been significantly reduced in patients since the advent of vascular brachytherapy. In-stent restenosis resulting in bifurcation presents even more of a challenge. The use of radiation therapy for the treatment of this kind of lesion has not yet been reported. The purpose of this paper is to present five cases of radiation therapy in bifurcation in-stent restenotic lesions using the intraluminal beta radiation catheter delivery system (Beta-Cath System, Novoste Corporation, Norcross, Georgia).
We reviewed the database of patients enrolled in our Compassionate Use Registry between August 1999 and April 2002. The data is reported for 5 patients who received radiation in both branches of bifurcation lesions with the Beta-Cath catheter system.
The mean diameter of the vessels was 3.1 mm 0.5 mm. The dose administered was from 18.3 to 23 Gy, with an overlap of 3.3 to 10.3 mm; the hinge angle between the branches went from 43.3 to 65.4 . Angiographic follow-up was obtained at 6 months in 4 patients, with a single patient showing a focal (
PubMed ID
12890881 View in PubMed
Less detail

6 records – page 1 of 1.