Duane S. Pinto

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BACKGROUND It has been suggested that the survival benefit associated with primary percutaneous coronary intervention (PPCI) in ST-segment elevation myocardial infarction may be attenuated if door-to-balloon (DB) time is delayed by >1 hour beyond door-to-needle (DN) times for fibrinolytic therapy. Whereas DB times are rapid in randomized trials, they are(More)
BACKGROUND Stent thrombosis (ST) is a rare but devastating complication of coronary stent implantation, occurring in 0.5% to 1.9% of patients with bare metal stents. The incidence of ST with drug-eluting stents is less well studied, particularly among patients outside of clinical trials. METHODS AND RESULTS The aim of this study was to evaluate the(More)
OBJECTIVES The aim of this study was to evaluate the cost-effectiveness of transcatheter aortic valve replacement (TAVR) compared with surgical aortic valve replacement (AVR) for patients with severe aortic stenosis and high surgical risk. BACKGROUND TAVR is an alternative to AVR for patients with severe aortic stenosis and high surgical risk. METHODS(More)
BACKGROUND We investigated the relationship of stress technetium 99m sestamibi lung uptake with rest thallium 201 lung uptake and with indices of left ventricular (LV) dysfunction and severity of coronary artery disease (CAD) in patients with known or suspected CAD undergoing stress testing and cardiac catheterization. Stress Tc-99m sestamibi lung uptake(More)
OBJECTIVES The objectives of the study were to evaluate the effect of angiographic follow-up on revascularization rates in the TAXUS-IV trial and to determine whether the relative benefit of paclitaxel-eluting stent implantation compared with bare metal stent implantation was modified by angiographic follow-up. BACKGROUND Although several clinical trials(More)
Overt hyperglycemia has been associated with adverse clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI). The association of hypoglycemia and mild hyperglycemia with angiographic outcomes and the effect of clopidogrel on these outcomes have not been extensively evaluated. Patients with STEMI enrolled in the CLARITY-TIMI 28(More)
The effect of insulin therapy on adverse cardiovascular outcomes in diabetic patients has been debated and a reduced benefit in clinical restenosis outcomes after sirolimus stenting has been reported among diabetic patients requiring insulin therapy. We analyzed 297 diabetic patients receiving sirolimus-eluting stents, including 115 (39%) on insulin(More)
OBJECTIVES We hypothesized that impaired renal function would also be associated with poorer clinical outcomes among patients with ST-segment elevation myocardial infarction (STEMI) treated with fibrinolysis. BACKGROUND Previous studies have demonstrated that impaired renal function is associated with poorer clinical outcomes in the setting of unstable(More)
BACKGROUND Although randomized trials suggest that transfer for primary percutaneous coronary intervention (X-PCI) in ST-segment-elevation myocardial infarction is superior to onsite fibrinolytic therapy (O-FT), the generalizability of these findings to routine clinical practice is unclear because door-to-balloon (XDB) times are rapid in randomized trials(More)
BACKGROUND Great strides have been made in improving outcomes for patients with ST-elevation myocardial infarction (STEMI), predominately through initiatives focusing upon improving clinical processes "upstream" of percutaneous coronary intervention (PCI). The actual step-by-step mechanics of diagnostic angiography during STEMI and other aspects of the PCI(More)