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  1. Article ; Online: Coronary Embolism in ST-Segment-Elevation Myocardial Infarction and Atrial Fibrillation: Not One Size Fits All.

    Abdelfattah, Omar M / Kumfa, Paul / Allencherril, Joseph

    Journal of the American Heart Association

    2024  Volume 13, Issue 10, Page(s) e035372

    MeSH term(s) Humans ; Atrial Fibrillation/complications ; Atrial Fibrillation/diagnosis ; ST Elevation Myocardial Infarction/diagnosis ; ST Elevation Myocardial Infarction/complications ; ST Elevation Myocardial Infarction/therapy ; Embolism/etiology ; Embolism/diagnosis ; Coronary Thrombosis/diagnostic imaging ; Coronary Thrombosis/etiology ; Coronary Thrombosis/complications ; Coronary Thrombosis/therapy ; Electrocardiography ; Risk Factors
    Language English
    Publishing date 2024-05-14
    Publishing country England
    Document type Journal Article ; Editorial ; Comment
    ZDB-ID 2653953-6
    ISSN 2047-9980 ; 2047-9980
    ISSN (online) 2047-9980
    ISSN 2047-9980
    DOI 10.1161/JAHA.124.035372
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Updates on Non-Statin LDL-Lowering Therapy.

    Abdulla, Amer / Shalaby, Mostafa / Kumfa, Paul / Raja, Muhammad / Allencherril, Joseph / Sharifeh, Tareq Abu

    Current cardiology reports

    2024  Volume 26, Issue 4, Page(s) 221–231

    Abstract: Purpose of review: There is ample evidence of the benefits and safety of low-density lipoprotein (LDL)-lowering therapies in the prevention of atherosclerotic cardiovascular disease. While statins remain the first-line agent for LDL reduction, several ... ...

    Abstract Purpose of review: There is ample evidence of the benefits and safety of low-density lipoprotein (LDL)-lowering therapies in the prevention of atherosclerotic cardiovascular disease. While statins remain the first-line agent for LDL reduction, several new therapies are now available. This narrative review provides an overview of currently available non-statin LDL-lowering agents, specifically mechanisms of action and data on efficacy and safety. It also discusses recommendations on their use in clinical practice.
    Recent findings: Ezetimibe, PCSK9 inhibitors, and bempedoic acid have proven safe and efficacious in reducing cardiovascular events in large randomized controlled trials. Inclisiran is a promising agent that suppresses PCSK9 mRNA translation and is currently under investigation in a large clinical outcomes randomized controlled trial assessing its effect on clinical outcomes. Expert consensus advocates for lower LDL targets in higher risk patients and escalation to or a combination of non-statin therapies as needed to achieve these goals.
    MeSH term(s) Humans ; Anticholesteremic Agents/therapeutic use ; Proprotein Convertase 9 ; Cholesterol, LDL ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects ; Ezetimibe/therapeutic use ; Cardiovascular Diseases/drug therapy ; Randomized Controlled Trials as Topic
    Chemical Substances Anticholesteremic Agents ; PCSK9 protein, human (EC 3.4.21.-) ; Proprotein Convertase 9 (EC 3.4.21.-) ; Cholesterol, LDL ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Ezetimibe (EOR26LQQ24)
    Language English
    Publishing date 2024-03-04
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2055373-0
    ISSN 1534-3170 ; 1523-3782
    ISSN (online) 1534-3170
    ISSN 1523-3782
    DOI 10.1007/s11886-024-02028-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5524: Show issues Location:
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  3. Article ; Online: Invasive Management for Non-ST-Segment-Elevation Myocardial Infarction and Chronic Kidney Disease: Does One Size Fit All?

    Elbadawi, Ayman / Elgendy, Islam Y / Kumfa, Paul

    Journal of the American Heart Association

    2022  , Page(s) e026390

    Language English
    Publishing date 2022-06-17
    Publishing country England
    Document type Editorial
    ZDB-ID 2653953-6
    ISSN 2047-9980 ; 2047-9980
    ISSN (online) 2047-9980
    ISSN 2047-9980
    DOI 10.1161/JAHA.122.026390
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Snaring Technique for Removal of Entrapped Coronary Guidewire in the Left Anterior Descending Artery.

    Thakker, Ravi A / Berbarie, Rafic F / Kumfa, Paul / Gilani, Syed

    Cardiology research

    2022  Volume 13, Issue 2, Page(s) 118–121

    Abstract: A 68-year-old female underwent coronary angiogram which was complicated by guidewire entrapment in a deployed left anterior descending (LAD) artery stent that extended into the aorta. Snare loop technique was utilized to retrieve the entrapped guidewire ... ...

    Abstract A 68-year-old female underwent coronary angiogram which was complicated by guidewire entrapment in a deployed left anterior descending (LAD) artery stent that extended into the aorta. Snare loop technique was utilized to retrieve the entrapped guidewire and LAD stent with successful deployment of a new stent. Snaring technique is a unique method for percutaneous extraction and can be utilized with whole stent removal along with the guidewire. This technique, as outlined in our case, can be a safe and effective approach.
    Language English
    Publishing date 2022-04-05
    Publishing country Canada
    Document type Case Reports
    ZDB-ID 2598593-0
    ISSN 1923-2837 ; 1923-2829
    ISSN (online) 1923-2837
    ISSN 1923-2829
    DOI 10.14740/cr1369
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Cerebral Embolic Protection in Transcatheter Aortic Valve Implantation Using the Sentinel Cerebral Protection System: A Systematic Review and Meta-Analysis.

    Harmouch, Wissam / Karnkowska, Barbara / Thakker, Ravi / Rasmussen, Peter / Shalaby, Mostafa / Khalife, Wissam / Alwash, Haider / Motiwala, Afaq / Kumfa, Paul / Gilani, Syed / Jneid, Hani / Rangasetty, Umamahesh

    Cardiology and therapy

    2024  Volume 13, Issue 2, Page(s) 299–314

    Abstract: Introduction: Transcatheter aortic valve implantation (TAVI) plays a vital role in patients with symptomatic aortic stenosis. Despite the mortality benefit of TAVI, embolic stroke remains a feared complication. As a result, transcatheter cerebral ... ...

    Abstract Introduction: Transcatheter aortic valve implantation (TAVI) plays a vital role in patients with symptomatic aortic stenosis. Despite the mortality benefit of TAVI, embolic stroke remains a feared complication. As a result, transcatheter cerebral embolic protection (TCEP) devices have been developed to reduce this risk. Given the ongoing debate of TCEP in TAVI, we performed a systematic review and meta-analysis of all randomized controlled trials to date to identify outcomes of periprocedural stroke using the Sentinel™ cerebral protection system (CPS).
    Methods: MEDLINE, Cochrane, and Scopus databases were utilized from inception until 12/2023. PRISMA criteria was utilized. Keywords included "cerebral embolic protection", "sentinel cerebral protection system", "transcatheter aortic valve implantation", and "transcatheter aortic valve replacement". Primary outcome was periprocedural stroke. Secondary outcomes included periprocedural disabling and non-disabling stroke, all-cause mortality, transient ischemic attack, delirium, acute kidney injury, vascular complications, bleeding, and pacemaker implantation. Risk ratios (RR) were measured via Mantel-Haenszel method with fixed analysis. Heterogeneity was assessed via chi-squared and Higgin's I
    Results: Four trials with 3528 patients were assessed. SAPIEN 3 was the most common bioprosthetic valve used. The average age was 79.4 years with 41.9% of the sample size being females. The most prevalent comorbidities were hypertension, diabetes mellitus, and coronary artery disease. There was no difference in periprocedural stroke in patients who underwent TAVI with the Sentinel™ CPS compared to no TCEP (RR 0.75, P = 0.12). Periprocedural disabling strokes were less likely in those who underwent TAVI with the Sentinel™ CPS compared to no TCEP (RR 0.41, P = 0.02) with a number needed to treat (NNT) of 123. All other outcomes did not reach statistical significance.
    Conclusions: In our analysis, there was no difference between TAVI with the Sentinel™ CPS compared to TAVI without TCEP in regard to risk of periprocedural stroke; however, it was associated with a decreased risk of periprocedural disabling stroke.
    Language English
    Publishing date 2024-02-10
    Publishing country England
    Document type Journal Article
    ZDB-ID 2700626-8
    ISSN 2193-6544 ; 2193-8261
    ISSN (online) 2193-6544
    ISSN 2193-8261
    DOI 10.1007/s40119-024-00359-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Safety of Transcatheter Aortic Valve Replacement in Patients with Aortic Aneurysm: A Propensity-Matched Analysis.

    Ugwu, Justin K / Ndulue, Jideofor K / Sherif, Khaled A / Alliu, Samson / Elbadawi, Ayman / Taskesen, Tuncay / Hussein, Doha / Ugwu Erugo, Judith N / Chatila, Khaled F / Almustafa, Ahmed / Khalife, Wissam I / Kumfa, Paul N

    Cardiology and therapy

    2022  Volume 11, Issue 1, Page(s) 143–154

    Abstract: Introduction: There is a paucity of data regarding the outcomes of transcatheter aortic valve replacement (TAVR) among patients with thoracic or abdominal aortic aneurysms (AA). Using the Nationwide Inpatient Sample (NIS) database, we explored the ... ...

    Abstract Introduction: There is a paucity of data regarding the outcomes of transcatheter aortic valve replacement (TAVR) among patients with thoracic or abdominal aortic aneurysms (AA). Using the Nationwide Inpatient Sample (NIS) database, we explored the safety of TAVR among patients with a diagnosis of AA.
    Methods: We queried the National Inpatient Sample database (2012-2017) for hospitalized patients undergoing TAVR, using ICD-9 and ICD-10 codes for endovascular TAVR. Reports show that > 95% of endovascular TAVR in the US is via transfemoral access, so our population are mostly patients undergoing transfemoral TAVR. Using propensity score matching, we compared the trends and outcomes of TAVR procedures among patients with versus without AA.
    Results: From a total sample of 29,517 individuals who had TAVR procedures between January 2012 and December 2017, 910 had a diagnosis of AA. In 774 matched-pair analysis, all-cause in-hospital mortality was similar in patients with and without AA OR 0.63 [(95% CI 0.28-1.43), p = 0.20]. The median length of stay was higher in patients with AA: 4 days (IQR 2.0-7.0) versus 3 days (IQR 2.0-6.0) p = 0.01. Risk of AKI [OR 1.01 (0.73-1.39), p = 0.87], heart block requiring pacemaker placement [OR 1.17 (0.81-1.69), p = 0.40], aortic dissection [OR 2.38 (0.41-13.75), p = 0.25], acute limb ischemia [OR 0.46 (0.18-1.16), p = 0.09], vascular complications [OR 0.80 (0.34-1.89), p = 0.53], post-op bleeding [OR 1.12 (0.81-1.57), p = 0.42], blood transfusion [OR 1.20 (0.84-1.70), p = 0.26], and stroke [OR 0.58 (0.24-1.39), p = 0.25] were similar in those with and without AA.
    Conclusions: Data from a large nationwide database demonstrated that patients with AA undergoing TAVR are associated with similar in-hospital outcomes compared with patients without AA.
    Language English
    Publishing date 2022-03-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 2700626-8
    ISSN 2193-6544 ; 2193-8261
    ISSN (online) 2193-6544
    ISSN 2193-8261
    DOI 10.1007/s40119-022-00258-6
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  7. Article ; Online: In-Hospital Outcomes of Chronic Total Occlusion Percutaneous Coronary Interventions in Heart failure patients.

    Albaeni, Aiham / Chatila, Khaled F / Thakker, Ravi A / Kumfa, Paul / Alwash, Haider / Elsherbiny, Ahmed / Gilani, Syed / Khalife, Wissam I / Jneid, Hani / Motiwala, Afaq

    Current problems in cardiology

    2022  Volume 48, Issue 2, Page(s) 101458

    Abstract: In-hospital outcomes of chronic total occlusion Percutaneous Coronary Interventions (CTO PCI) in heart failure patients has not been evaluated on a national base and was the focus of this investigation. We used the Nationwide Inpatient Sample database ... ...

    Abstract In-hospital outcomes of chronic total occlusion Percutaneous Coronary Interventions (CTO PCI) in heart failure patients has not been evaluated on a national base and was the focus of this investigation. We used the Nationwide Inpatient Sample database from 2008 to 2014 to identify adults with single vessel CTO PCI for stable ischemic heart disease (SIHD). Patients were divided into 3 groups: patients without heart failure, heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF). Clinical characteristics and in-hospital outcomes were studied using relevant statistics. Multiple logistic regression models were performed to assess in-hospital mortality, acute renal failure, and the use of mechanical support devices. Of 112,061 inpatients with SIHD from 2008 to 2014 undergoing CTO PCI, 21,185 (19%) had HFrEF and 3309 (3%) had HFpEF. Compared to patients without heart failure, HFrEF and HFpEF patients were older (mean age 69.2 vs 66.3, 70.3 vs 66.3 respectively, P < 0.001), had more comorbidities and higher acute in-hospital complications. HFrEF patients had higher adjusted in-hospital mortality [AOR 1.73, 95% CI (1.21-2.48)], acute renal failure [AOR 2.68, 95% CI (2.34-3.06)], and need for mechanical support [AOR 2.76, 95% CI (2.17-3.51)]. Compared to patients without heart failure, HFpEF patients had similar mortality and need for mechanical support, but higher incidence of acute renal failure. Older age was significantly associated with increased in-hospital mortality. chronic total occlusion PCI in patients with heart failure is associated with higher in-hospital morbidity and mortality and warrants further investigation to optimize health care delivery.
    Language English
    Publishing date 2022-10-17
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 441230-8
    ISSN 1535-6280 ; 0146-2806
    ISSN (online) 1535-6280
    ISSN 0146-2806
    DOI 10.1016/j.cpcardiol.2022.101458
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    Se 505: Show issues Location:
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    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

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  8. Article ; Online: National Trends of Percutaneous Coronary Intervention in Patients ≥70 Years of Age.

    Elbadawi, Ayman / Elgendy, Islam Y / Ha, Le Dung / Saad, Marwan / Mahmoud, Karim / Ogunbayo, Gbolahan O / Kumfa, Paul / Rangasetty, Umamahesh C / Gilani, Syed

    The American journal of cardiology

    2018  Volume 123, Issue 4, Page(s) 701–703

    MeSH term(s) Age Factors ; Aged ; Aged, 80 and over ; Coronary Artery Disease/mortality ; Coronary Artery Disease/surgery ; Databases, Factual ; Female ; Hospital Mortality ; Hospitalization/statistics & numerical data ; Humans ; Male ; Patient Selection ; Percutaneous Coronary Intervention/statistics & numerical data ; Practice Patterns, Physicians'/statistics & numerical data ; Procedures and Techniques Utilization ; Retrospective Studies ; Stents ; Treatment Outcome ; United States
    Language English
    Publishing date 2018-12-12
    Publishing country United States
    Document type Letter ; Observational Study
    ZDB-ID 80014-4
    ISSN 1879-1913 ; 0002-9149
    ISSN (online) 1879-1913
    ISSN 0002-9149
    DOI 10.1016/j.amjcard.2018.11.053
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    Ui IV Zs.73: Show issues Location:
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  9. Article: Fatal methadone intoxication in a child.

    Riascos, Roy / Kumfa, Paul / Rojas, Rafael / Cuellar, Hugo / Descartes, Fernando

    Emergency radiology

    2008  Volume 15, Issue 1, Page(s) 67–70

    Abstract: Methadone is an opiate used as part of the treatment for heroin abuse; it can be ingested orally. We present the lethal outcome of a 22-month-old child intoxicated after methadone ingestion. ...

    Abstract Methadone is an opiate used as part of the treatment for heroin abuse; it can be ingested orally. We present the lethal outcome of a 22-month-old child intoxicated after methadone ingestion.
    MeSH term(s) Brain/diagnostic imaging ; Brain/drug effects ; Fatal Outcome ; Humans ; Infant ; Male ; Methadone/poisoning ; Narcotics/poisoning ; Tomography, X-Ray Computed
    Chemical Substances Narcotics ; Methadone (UC6VBE7V1Z)
    Language English
    Publishing date 2008-01
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 1425144-9
    ISSN 1438-1435 ; 1070-3004
    ISSN (online) 1438-1435
    ISSN 1070-3004
    DOI 10.1007/s10140-007-0627-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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