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Chalmers D, Fongheiser E, Compton N, Bland A, Neely B, Varghese V, Janech M, Velez J. Proteomic analysis reveals proteins associated exclusively with urinary muddy brown grannular casts. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00760-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Mikhail P, Howden N, Monjur M, Said C, Jeyaprakash P, Bland A, Collison D, McCartney P, Adamson C, Morrow A, Carrick D, McEntegart M, Ford T. Coronary perforation incidence and temporal trends (COPIT): systematic review and meta-analysis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Despite advancements in Percutaneous Coronary Intervention (PCI) technology and techniques, iatrogenic coronary artery perforation (CAP) remains a dreaded potential complication within the cardiac catheterisation laboratory. Data detailing the incidence of coronary perforation during PCI has previously been obtained from relatively small datasets. A swell of large data published in recent times provides invaluable information regarding PCI related CAP.
Purpose
COPIT is a systematic review and meta-analysis targeted at detailing the incidence, outcomes, etiology and treatment modalities of PCI related CAP including evaluation of temporal trends since the inception of PCI to contemporary practice. Additionally, COPIT provides hypothesis generating data regarding predictors of CAP during PCI.
Methods
A prospective systematic review and meta-analysis using MEDLINE and EMBASE via the OVID interface (PROSPERO ID: CRD42020207881) was performed according to the PRISMA guidelines. Identified relevant studies were used in a pre-specified sensitivity analysis to detail incidence, outcomes, etiology, treatment modalities and risk factors of PCI complicated by CAP. Studies limited to PCI in high risk populations only such as CTO-PCI or rotational atherectomy only were excluded.
Results
67 studies met eligibility criteria detailing 5,568,191 PCIs over a 38-year period (1982–2020). The pooled incidence of CAP was 0.39% (95% CI: 0.34–0.45%) with no change in incidence over that time. Approximately 1 in 5 perforations led to cardiac tamponade (21.1%). Ellis 3 perforations are increasing in frequency and account for 43% of all perforations. Mortality due to perforation occurs in 7.5% of all CAP (95% CI 6.7% - 8.4%) but has declined over the studied period. Meta-regression suggested that female gender, hypertension, chronic kidney disease and previous coronary bypass grafting were all associated with higher incidence of CAP. Coronary perforation was most frequently caused by distal wire exit (37%) followed by balloon dilation catheters (28%). Covered stents were used to treat 25% of perforations, with emergency cardiac surgery needed in 17%.
Conclusion
Coronary perforations occurs in approximately 1 in 250 all-comer PCI procedures. A tendency towards increase in coronary perforations is likely reflective of contemporary trends towards high pressure post-dilatation with 1:1 vessel sizing as well as an ageing population with increasingly complex, calcific coronary disease. However, reduction in CAP related mortality suggests earlier recognition and effective treatment with transcatheter techniques.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- P Mikhail
- Gosford Hospital , Gosford , Australia
| | - N Howden
- Gosford Hospital , Gosford , Australia
| | - M Monjur
- St George Hospital , Sydney , Australia
| | - C Said
- Gosford Hospital , Gosford , Australia
| | | | - A Bland
- Gosford Hospital , Gosford , Australia
| | - D Collison
- Golden Jubilee National Hospital , Glasgow , United Kingdom
| | - P McCartney
- University of Glasgow , Glasgow , United Kingdom
| | - C Adamson
- University of Glasgow , Glasgow , United Kingdom
| | - A Morrow
- University of Glasgow , Glasgow , United Kingdom
| | - D Carrick
- Hairmyres Hospital , East Kilbride , United Kingdom
| | - M McEntegart
- Columbia University , New York , United States of America
| | - T Ford
- Gosford Hospital , Gosford , Australia
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Chuah E, Meere W, Mikhail P, Howden N, Bland A, Spina R. Two Years Door-to-Balloon Times for ST-segment Elevation Myocardial Infarction in a New Regional 24/7 Primary Percutaneous Coronary Intervention Centre. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Bland A, Said C, Casinader S, Coote E, Parkinson M. 901 Thrombocytopenia Risk Following Glycoprotein IIB/IIIA Inhibitor use for ST-Elevation Myocardial Infarction (STEMI). Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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An N, Bland A, Lazarchick J, Li Z, Kraft A, Arthur J, Kang Y. Using Proteomics Analysis to Identify Novel Proteins in Marrow Niche Microenvironment That Contribute to the Enhanced Donor Cell Engraftment with Plerixafor Treatment. Biol Blood Marrow Transplant 2012. [DOI: 10.1016/j.bbmt.2011.12.499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Varghese SA, Taylor T, Bland A, D'Eugenio L, Arthur JM. 242 PROTEOMIC IDENTIFICATION OF PROTEIN BIOMARKERS DIFFERENTIATING ACUTE TUBULAR NECROSIS AND PRERENAL AZOTEMIA. J Investig Med 2004. [DOI: 10.1136/jim-52-suppl1-795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Ayiku H, Bland A, D'Engenio L, Arthur J, Raymond J, Turner J. 354 IDENTIFICATION OF SODIUM PROTON EXCHANGER (NHE-1) INTERACTING PROTEINS. J Investig Med 2004. [DOI: 10.1136/jim-52-suppl1-907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
This paper discusses how the Accident and Emergency Nursing Development Unit (NDU) in Dewsbury, UK, has developed the role of the emergency nurse practitioner. Each individual member of the Nursing Development Unit (NDU) contributed to this change in practice. Maintaining these contributions to practice development was as important as the practice itself. The NDU exists to support and facilitate a bottom-up approach. This paper will discuss the whole development process and will not therefore include all the details and results from what was a 2-year process.
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Affiliation(s)
- A Bland
- Dewsbury Accident and Emergency Nursing Development Unit, Dewsbury and District Hospital, UK
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