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An Investigation on ECG-based Cardiological Diagnosis via Deep Learning Models
Published in Richard Jiang, Li Zhang, Hua-Liang Wei, Danny Crookes, Paul Chazot, Recent Advances in AI-enabled Automated Medical Diagnosis, 2022
Alex Meehan, Zhaonian Zhang, Bryan Williams, Richard Jiang
Acute Coronary Syndromes (ACS) are caused by an imbalance between the demand for oxygen and the blood flow. It may be caused by either an acute reduction of blood supply or an increase in demand that cannot be matched by the blood flow [4]. The main ACS are ST-elevation myocardial infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI), and unstable angina. These ACS are an important cause of morbidity and mortality in the UK and worldwide [6], with the World Health Organization estimating that 17.9 million people died from cardiovascular diseases in 2016 worldwide, representing 31% of all global deaths. Rapid and accurate diagnosis can dramatically improve patient outcomes, with treatments ranging from surgical interventions for the more acute cases to medications for less severe cases.
Investigator-driven randomized trials
Published in Yoshinobu Onuma, Patrick W.J.C. Serruys, Bioresorbable Scaffolds, 2017
Daniele Giacoppo, Roisin Colleran, Adnan Kastrati
Primary outcome measures at 24 months include cardiovascular death, nonfatal myocardial infarction, and unstable angina requiring unplanned hospitalization. Secondary outcome measures are all-cause death at 24 months, target vessel failure (composite of cardiovascular death, target vessel-related myocardial infarction, or target vessel revascularization) at 24 months, major adverse cardiovascular events (composite of all-cause death, any myocardial infarction, and any repeat revascularization), and the composite of death or myocardial infarction at 1, 6, 12, and 24 months; nonurgent revascularization procedures at 1, 6, 12, and 24 months; CCS anginal class [24] at 1, 6, 12, and 24 months; anti-anginal medication use at 1, 6, 12, and 24 months; and any cerebrovascular event at 1, 6, 12, and 24 months.
Cardiovascular system
Published in David A Lisle, Imaging for Students, 2012
Coronary artery disease is a diffuse disease of the coronary arteries characterized by atheromatous plaques. Plaques may cause stenosis of coronary arteries producing limitation of blood flow to the myocardium. During the development of atheromatous plaque, the external membranes of coronary arteries may expand outwards. As a result of this arterial remodelling phenomenon, significant coronary atherosclerosis may be present without narrowing of the vessel lumen (non-stenosing plaque). Rupture of atherosclerotic plaques with subsequent arterial thrombosis leads to acute cardiac events (acute cardiac syndrome), such as unstable angina, myocardial infarction and sudden death. Instability and rupture of atherosclerotic plaque is mediated by inflammatory factors, and may occur with stenosing or non-stenosing plaque.
Healthcare related aversion and care seeking patterns of female aviators in the United States
Published in Archives of Environmental & Occupational Health, 2022
William R. Hoffman, R. Daniel Barbera, James Aden, Matthew Bezzant, Aykut Uren
For various durations of both stable and unstable angina, female pilots were more likely than female non-pilots to delay seeking medical care due to concern for their career or hobby. Interestingly, pilots were more likely to wait longer when experiencing stable angina (chest pain only on exertion) compared to unstable angina (chest pain at rest). It is possible this trend is related to the perception that stable angina is a chronic medical condition while unstable angina is an acute emergency. Pilot healthcare seeking delay in an acute emergency (such as unstable angina) is concerning in that a true myocardial infarction requires immediate intervention and delayed care is associated with poorer outcomes.11 Care delay for chronic conditions (such as stable angina) is also worrisome in that early healthcare intervention may improve outcomes. Beyond the health of pilots, addressing this barrier could increase the safety of passengers and others in that a certain proportion of fatal aviation accidents each year are due to medical conditions not disclosed to an AME.9
Device profile of the Resolute Onyx Zotarolimus eluting coronary stent system for the treatment of coronary artery disease: overview of its safety and efficacy
Published in Expert Review of Medical Devices, 2020
Moritz Blum, Davide Cao, Roxana Mehran
A small single-arm study from Poland sought to assess short-term vascular healing after R-Onyx implantation by means of intravascular optical coherence tomography (OCT) [35]. A total of 15 patients who had received R-Onyx for treatment of a single de-novo coronary lesion were included. Eighty-six percent of patients underwent PCI for unstable angina. Patients presenting with MI were excluded. All patients underwent OCT at the time of index procedure and 30 days after PCI. An independent core lab assessed strut coverage of 15 stents in 378 OCT cross-sections, adding up to 3,661 struts in the final analysis. At 30-day follow-up, R-Onyx showed favorable vessel healing with 87.7% of the struts were covered by neointima and a median tissue thickness of 37.9 μm. In addition, rates of malapposed struts at baseline and 30 days were 4.3% and 5.7% (p = 0.417), indicating no stent recoil or significant late acquired malapposition.
Magmaris resorbable magnesium scaffold for the treatment of coronary heart disease: overview of its safety and efficacy
Published in Expert Review of Medical Devices, 2019
Johan Bennett, Quentin De Hemptinne, Keir McCutcheon
BIOSOLVE I was a prospective, multicenter, first-in-man trial designed to assess the safety and performance of the paclitaxel-eluting DREAMS scaffold [38]. Forty-six patients with de novo coronary artery disease and stable or unstable angina or silent ischemia were recruited. Patients were included if they had no more than two vessel disease with no more than one relatively simple lesion per vessel. Angiographic inclusion criteria were restricted to Type A and Type B lesions between 50% and 99% diameter stenosis that were no more than 12 mm in length in vessels between 3.0 and 3.5 mm in diameter. Exclusion criteria included target vessel thrombus, severe calcification, bifurcation lesions, ostial lesions and previous bypass grafts supplying the coronary bed distal to the target lesion. The primary endpoint was TLF at 6 and 12 months, which was defined as a composite of cardiac death, target vessel myocardial infarction, or clinically driven TLR. Secondary endpoints included LLL, percentage diameter stenosis, binary restenosis at 6 and 12 months, device success (defined as successful delivery of the scaffold to the target site with appropriate deployment and successful removal of the delivery system after scaffold release), procedural success (defined as device success plus residual stenosis <50% and the absence of ischemia driven major adverse cardiac events during the index admission), scaffold thrombosis rate, and cumulative rates of TLF at 1, 24 and 36 months. Patients were consecutively assigned to angiographic and IVUS follow-up at 6 months or 12 months. Serial OCT data was also available for seven of the patients in whom 5791 struts could be assessed.