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Circulation Ischemia Outcomes 
DAIC
MAY 16, 2024
milla1cf Thu, 05/16/2024 - 15:35 May 16, 2024 — A recent publication in the American Heart Association Circulation highlights a comprehensive investigation to assess the impact of revascularization strategies on the health-related quality of life (HRQoL) of patients suffering from chronic limb-threatening ischemia.
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Circulation: Cardiovascular Interventions
DECEMBER 28, 2023
Circulation: Cardiovascular Interventions, Ahead of Print. BACKGROUND:Lower-limb amputation rates in patients with chronic limb-threatening ischemia vary across the United States, with marked disparities in amputation rates by gender, race, and income status. Mean age, 76.6
Dr. Smith's ECG Blog
JANUARY 2, 2016
There may be ischemia present, but it is not evident on the ECG. In this paper, Dr. Birnbaum writes: "In patients with ACS without LVH, ST depression with negative T waves in the lateral leads is a sign of sub-endocardial ischemia and is an independent predictor of adverse outcome [11 – 13].
52 
Circulation: Cardiovascular Quality & Outcomes
FEBRUARY 26, 2025
Circulation: Cardiovascular Quality and Outcomes, Ahead of Print. Treatment effects are expressed as an odds ratio for a better health status outcome with an invasive versus conservative treatment strategy using Bayesian hierarchical proportional odds models. Diabetes was present in 28% and multivessel disease in 51%.
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Stroke Journal
JANUARY 4, 2024
These studies mainly concerned anterior circulation occlusions. All patients with a posterior circulation occlusion were included. Primary outcome was a shift toward better functional outcome on the modified Rankin Scale at 90 days. Our results are in line with the literature on the anterior circulation.
40 
Stroke: Vascular and Interventional Neurology
NOVEMBER 9, 2023
IntroductionIntracranial atherosclerotic disease (ICAD) is associated with up to 32% of posterior circulation strokes.1 5 However, most of the existing literature focuses on anterior circulation. Stroke: Vascular and Interventional Neurology, Volume 3, Issue S2 , November 1, 2023.
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Circulation: Cardiovascular Quality & Outcomes
FEBRUARY 26, 2025
Circulation: Cardiovascular Quality and Outcomes, Ahead of Print.
40 
DAIC
MAY 16, 2024
A new joint guideline from the American Heart Association (AHA), the American College of Cardiology (ACC) and nine other medical societies reports early diagnosis and treatment of peripheral artery disease is essential to improve outcomes and reduce amputation risk, heart attack, stroke and death for people with Peripheral Artery Disease (PAD).
Circulation
NOVEMBER 11, 2024
Circulation, Volume 150, Issue Suppl_1 , Page A4113494-A4113494, November 12, 2024. To elucidate this relationship, we investigated gut microbiota dynamics in response to immunosuppression and cell therapy in a nonhuman primate (NHP) cardiac ischemia/reperfusion (IR) model, with controlled genetic, dietary, and environmental factors.
40 
Journal of the American Heart Association
FEBRUARY 14, 2024
RUPP offspring also had increased circulating B cells, cytolytic natural killer cells, and increased circulating AT1‐AA, which were normalized with maternal rituximab treatment. Maternal blood and tissues were collected. Immune cells were measured via flow cytometry, and AT1‐AA was quantified using a contraction bioassay.
40 
Circulation
FEBRUARY 12, 2024
Circulation, Ahead of Print. The 2 coprimary outcomes were target lesion revascularization and myocardial infarction. Myocardial infarction did not significantly differ between guidance strategies (IVUS versus ICA: OR, 0.91 [95% CI, 0.70–1.19]; 1.19]; OCT versus ICA: OR, 0.87 [95% CI, 0.68–1.11];
67 
Circulation
NOVEMBER 11, 2024
Circulation, Volume 150, Issue Suppl_1 , Page ASu104-ASu104, November 12, 2024. Background:The incidence of cardiac arrest (CA) increases with age, leading to poorer neurological outcomes after the return of spontaneous circulation (ROSC) in the elderly.
40 
Stroke Journal
FEBRUARY 5, 2025
Growth Differentiation Factor 11 (GDF11), a member of the TGF- superfamily, is a circulating protein involved in cellular development and tissue repair. All six studies revealed consistent improvement of sensorimotor outcomes with rGDF11.
45 
Stroke Journal
FEBRUARY 1, 2024
Introduction:Recent randomized control trials suggested that mechanical thrombectomy (MT) was associated with good functional outcomes after acute ischemic stroke (AIS) due to large vessel occlusion (LVO) in patients presenting with low Alberta Stroke Program Early CT Score (ASPECTS) (defined as ASPECTS 2-5). with a score of 2, 17.7%
40 
Stroke Journal
FEBRUARY 1, 2024
Introduction:Despite comparable outcomes for different frontline techniques in mechanical thrombectomy (MT) for acute ischemic stroke (AIS), there are sparse data regarding if and when to switch techniques if the first pass is unsuccessful. 3.86, P = 0.002) and 90-day good clinical outcome (adjusted odds ratio 2.10, 95% CI: 1.15-3.85,
40 Circulation
NOVEMBER 11, 2024
Circulation, Volume 150, Issue Suppl_1 , Page A4147504-A4147504, November 12, 2024. There are discrepancies in the literature regarding whether vorapaxar alleviates ischemic outcomes and increases bleeding in patients with peripheral arterial disease (PAD).Purpose:The to 0.97, I2: 0%) compared to placebo. to 1.67, I2: 0%).Conclusion:In
Circulation
NOVEMBER 11, 2024
Circulation, Volume 150, Issue Suppl_1 , Page A4141224-A4141224, November 12, 2024. Background:Glycated albumin (GA) has been demonstrated to be associated with adverse outcomes in patients with acute coronary syndrome (ACS). years, and men accounted for 61.8%. The average GA level was 14.37 ± 2.42.
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Circulation
NOVEMBER 11, 2024
Circulation, Volume 150, Issue Suppl_1 , Page A4146032-A4146032, November 12, 2024. This systematic review aims to address this knowledge gap by evaluating the impact of routine stress testing in this specific patient population.Research Question:Does routine stress testing improve outcomes in diabetic patients with prior revascularization?
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Dr. Smith's ECG Blog
MARCH 9, 2013
For those who depend on echocardiogram to confirm the ECG findings of ischemia, this should be sobering. I have seen cases of Wellens' syndrome that were ignored because of either negative troponins or normal echo or both and the patient did not get an angiogram and had a bad outcome. Wellen's syndrome is a Reperfusion syndrome.
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Circulation: Cardiovascular Quality & Outcomes
JANUARY 8, 2024
Circulation: Cardiovascular Quality and Outcomes, Ahead of Print. for transient ischemia attack, 8.8% Background:Following regulatory approval, medical devices may be used “off-label.” female, 29.2%≥60 60 years old), which increased from 4.75 per 100 000 person-years in 2006 to 6.60 per 100 000 person-years in 2019.
Stroke: Vascular and Interventional Neurology
NOVEMBER 9, 2023
IntroductionMechanical thrombectomy (MT) has demonstrated a significant improvement in functional outcomes for patients with anterior circulation strokes and large‐vessel occlusion (LVO). Information was collected on demographic variables, medical history and clinical parameters.
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Stroke: Vascular and Interventional Neurology
JANUARY 26, 2024
BACKGROUNDSteroids have pleiotropic neuroprotective actions including the regulation of inflammation and apoptosis which may influence the effects of ischemia on neurons, glial cells, and blood vessels. Secondary outcomes include 90‐day functional independence (modified Rankin scale score, 0–2).
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DAIC
JANUARY 23, 2024
5 Over my career as a cardiovascular surgeon, as well as an immunologist, I have witnessed how current treatments for ASCVD have led to considerable improvements in outcomes, yet many patients remain vulnerable to life-threatening cardiac events.1,6 2019 Sep 10;140(11):e649-e650] [published correction appears in Circulation.
Circulation
JANUARY 18, 2024
Circulation, Ahead of Print. BACKGROUND:Cardiolipin is a mitochondrial-specific phospholipid that maintains integrity of the electron transport chain (ETC) and plays a central role in myocardial ischemia/reperfusion injury. Tafazzin is an enzyme that is required for cardiolipin maturation.
Dr. Smith's ECG Blog
JUNE 23, 2024
They shocked him twice before return of spontaneous circulation. This was interpreted by the treating clinicians as not showing any evidence of ischemia. When EMS arrived the patient was in ventricular fibrillation. He was intubated in the field and sedated upon arrival at the hospital.
118 
Circulation
NOVEMBER 11, 2024
Circulation, Volume 150, Issue Suppl_1 , Page A4138334-A4138334, November 12, 2024. Ischemic cardiomyopathy, a severe cardiac condition resulting from prolonged myocardial ischemia, is characterized by ventricular dilation, dysfunction, and an increased risk of life-threatening arrhythmias.
40 Stroke Journal
JANUARY 30, 2025
Collateral status is a well-documented marker of reperfusion and mortality in patients with large vessel occlusion (LVO) anterior circulation strokes, which account for approximately one-third of AIS. Modified Treatment in Cerebral Ischemia (mTICI) score was used to determine reperfusion status, with mTICI > 2b considered successful.
40 
Stroke Journal
JANUARY 30, 2025
Due to the rarity of iatrogenic CeAD, existing literature on management and outcomes is limited. Most cases are managed medically without significant clinical complications or long-term negative outcomes. Single or dual antiplatelet therapies remain preferred treatments, in line with current trends.
40 
Stroke Journal
FEBRUARY 1, 2024
Here, we investigate the association of middle cerebral artery(MCA) tortuosity on radiographic and functional outcome.Methods:The Analysis of Revascularization in Ischemic Stroke with EmboTrap II was utilized to identify patients with anterior circulation stroke. Good functional outcomes was defined as mRS0-2 on 90-day followup.
Circulation
OCTOBER 18, 2023
Circulation, Volume 148, Issue 24 , Page 1919-1928, December 12, 2023. The primary efficacy outcome was a composite of acute limb ischemia, major amputation of a vascular pathogenesis, myocardial infarction, ischemic stroke, or cardiovascular death. mg of rivaroxaban BID or matching placebo and 100 mg of aspirin daily.
DAIC
OCTOBER 16, 2024
16, 2024 — Sahajanand Medical Technologies (SMT) recently announced the publication of the COMPARE 60/80 HBR trial results in Circulation: Cardiovascular Interventions , a journal of The American Heart Association. tim.hodson Wed, 10/16/2024 - 09:00 Oct. Led by Dr. Pieter C. and 17.1%, respectively (P=0.02 for noninferiority).
52 Circulation
NOVEMBER 11, 2024
Circulation, Volume 150, Issue Suppl_1 , Page A4135092-A4135092, November 12, 2024. The outcome measure was peri-procedural complications defined as a composite of perioperative death, major bleeding, contrast nephropathy, myocardial infarction, ischemic stroke, and major amputation. and dialysis at 29.9%, respectively.
Circulation: Cardiovascular Imaging
NOVEMBER 20, 2023
Circulation: Cardiovascular Imaging, Volume 16, Issue 11 , Page e015800, November 1, 2023. Risk ratios (RRs) and mean differences with 95% CIs were computed for binary and continuous outcomes, respectively.RESULTS:Five randomized controlled trials with a total of 5727 patients were included, of whom 51.1%
40 
Dr. Smith's ECG Blog
AUGUST 9, 2019
Post by Smith and Meyers Sam Ghali ( [link] ) just asked me (Smith): "Steve, do left main coronary artery *occlusions* (actual ones with transmural ischemia) have ST Depression or ST Elevation in aVR?" That said, complete LM occlusion would be expected to have subepicardial ischemia (STE) in these myocardial territories: STE vector 1.
Dr. Smith's ECG Blog
AUGUST 9, 2024
Opioids associate with worse outcomes in myocardial infarction , probably because they eliminate the pain signal that informs the clinician of the urgency of revascularization. Possible mechanisms of ventricular arrhythmias elicited by ischemia followed by reperfusion. Circulation Research , 56 (2), 184–194. Do not treat AIVR.
107 
Dr. Smith's ECG Blog
OCTOBER 20, 2013
This ECG is diagnostic of diffuse subendocardial ischemia. The combination of sudden increased intracranial pressure with loss of spontaneous circulation results in near total loss of cerebral perfusion. Circulation 122:Abstract 101. The data was analyzed in relation to initial rhythm, outcomes and changes or delay in treatment.
Dr. Smith's ECG Blog
NOVEMBER 15, 2013
The ECG in the chart was read as "no obvious ST changes," (even though no previous ECG was available) and the formal read by the emergency physicians was: "ST deviation and moderated T-wave abnormality, consider lateral ischemia." Circulation 1991;84:1454-1455. Comment: most T-wave inversion is nonspecific, but not these ones!
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Dr. Smith's ECG Blog
NOVEMBER 15, 2023
This suggests further severe ischemia. Medical Therapy for Secondary Prevention and Long-Term Outcome in Patients With Myocardial Infarction With Nonobstructive Coronary Artery Disease. Circulation [Internet] 2017;135(16):1481–9. Circulation. Detailed coronary artery evaluation not performed. Downstream vasospasm?
Dr. Smith's ECG Blog
AUGUST 3, 2017
Computer read: "Non-specific ST abnormality, consider anterior subendocardial ischemia" There are very poor R-waves in V1-V4 suggesting old anterior MI. Firstly, subendocardial ischemia does not localize on 12-Lead ECG. But the real question at hand is: Are these precordial ST-depressions a result of subendocardial ischemia?
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Dr. S. Venkatesan MD
SEPTEMBER 23, 2024
So, we desperately required to break this inappropriate menace with evidence base like COURAGE, ISCHEMIA, BARI-2D, These studies tried to apply some breaks, but the force was weak and couldn’t abolish a pseudo-academic vice. Circ Cardiovasc Qual Outcomes. Something happened in 2018 , the ORBITA trial.It Come September 2024.
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Dr. Smith's ECG Blog
FEBRUARY 6, 2024
The ECG shows sinus tachycardia with RBBB and LAFB, without clear additional superimposed signs of ischemia. Atrial fibrillation is also a predictor of worse outcomes in this case (Alborzi). Circulation: Cardiovascular Imaging. Chest trauma was suspected on initial exam. Here is his initial ECG around 1330: What do you think?
115 
Dr. Smith's ECG Blog
JANUARY 3, 2022
2] Here there is no posterior ST elevation, but the anterior ST depression is also less—so it is dynamic, confirming acute ischemia. The absence of STE in V7-V9 is often due to resolution of ischemia, as seen by resolution of ST depression in V7-V9. non-occlusive ischemia) JAHA 2021 3. -- Meyers HP, Bracey A, Lee D, et al.
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Stroke: Vascular and Interventional Neurology
NOVEMBER 9, 2023
In his four months follow up clinic visit he had no further concerns of recurrent strokes or new symptoms.ResultsCarotid stump syndrome is a rare cause of cerebral and retinal ischemia; however, it must be considered in patients with recurrent ischemic strokes and chronic ipsilateral ICA occlusion.
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Dr. Smith's ECG Blog
JULY 31, 2018
Now you have ECG and troponin evidence of ischemia, AND ventricular dysrhythmia, which means this is NOT a stable ACS. It they are static, then they are not due to ischemia. This is better evidence for ischemia than any other data point. Circulation. Again, cath lab was not activated. What does this troponin level mean?
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