As an initial management strategy in patients with stable coronary artery disease, PCI did not reduce the risk of death, myocardial infarction, or other major cardiovascular events when added to optimal medical therapy. (ClinicalTrials.gov number, NCT00007657 [ClinicalTrials.gov].).

These data establish that intravascular ultrasound is feasible and safe and yields luminal measurements that correlate generally with angiography. Differences between angiographic and ultrasound measures of lumen size in eccentric vessels probably reflect the dissimilar perspectives of tomographic and silhouette imaging techniques. Intravascular ultrasound provides detailed images of normal and abnormal wall morphology not previously possible in vivo.

We present polarization diagrams of the particle motions at the free surface of an isotropic half-space generated by incident shear waves from a local buried point source. The reflectivity technique is used to calculate synthetic seismograms from which the particle motions are plotted. The particle motions are examined over a range of epicentral distances in a uniform isotropic half-space for different source frequencies and polarization angles, and for different Poisson's ratios. The particle motions due to a curved wavefront possess different characteristics from those generated by plane wavefronts at corresponding incidence angles. A curved wavefront generates a local SP-phase: a P-headwave which propagates along the free surface, and arrives shortly before the direct S-wave. These two arrivals give rise to cruciform particle motions in the sagittal and horizontal planes, which could be misinterpreted as anisotropy-induced shear-wave splitting. An examination of the particle motion in the transverse plane, mutually orthogonal to the sagittal and horizontal planes, can be used to discriminate between isotropic and anisotropic interpretations. The amplitude of the SP-phase is enhanced when it propagates in a low-velocity surface layer overlying the source layer, and may then become the dominant phase on radial-component seismograms. The presence of even a single surface layer may introduce considerable complexity into the seismogram, and we examine the effects of layer thickness, velocity contrast, and source depth on the corresponding polarization diagrams. Reliable information on the source and propagation path characteristics of shear waves from a buried local point source can only be obtained from free-surface records if they are recorded within a very limited epicentral distance range.

Digoxin was associated with a significant increase in all-cause mortality in patients with AF after correcting for clinical characteristics and comorbidities, regardless of gender or of the presence or absence of HF. These findings call into question the widespread use of digoxin in patients with AF.

Shear wave splitting above small earthquakes in the Anza seismic gap on the San Jacinto fault, southern California, displays the effective anisotropy of vertical fluid-filled microcracks.The delays between the split shear waves increase significantly over the 3 years of available records at the only station with arrivals from a wide range of azimuths and angles of incidence.These changes can be modeled by increasing the aspect ratio ("bowing") of stressoriented microcracks, which is one of the expected elastic effects of an increase of stress on a rock mass containing a distribution of fluid-filled microcracks. This is the first time that temporal variations of shear wave splitting have been observed and suggests that shear wave splitting can be used to monitor the detailed changes in the buildup of stress before an earthquake.Res., 85, 6113-6156, 1980.

Changes in shear wave splitting are observed at KNW before and after the M = 6 North Palm Springs earthquake of July 8, 1986. KNW is a station of the Anza seismic network monitoring the Anza seismic gap on the San Jacinto fault, southern California. The gradual increase in the delays between the split shear waves over 3 years at KNW, reported by Peacock et al. (1988), ended in June 1986. The further 2 years of observations analyzed here show that the behavior of the delays changed abruptly near the time of the North Palm Springs earthquake, 33 km north of KNW. Peacock et al. demonstrated that the increase in delays could be simulated by increasing the aspect ratio of stress-aligned fluid-filled inclusions, and speculated that this increase might be the result of a build up of stress before an impending earthquake. The new data appear to confirm this speculation, but the temporal variations require a more complex interpretation, although they still suggest that the changes in shear wave splitting are caused by earthquake-induced stress changes to the fluid-filled inclusions throughout the rockmass. Central to our interpretation of temporal changes in shear wave splitting is the well established existence, throughout at least the uppermost 10 to 20 km of the crust, of small fluid-filled cracks, microcracks, and pores. The existence of such inclusions introduces a compliant quality to otherwise stiff crustal rock. We term these distributions of inclusions extensive dilatancy anisotropy or EDA, and the individual inclusions EDA cracks because, although they may include a wide range of shapes, many of the seismic properties can be simulated by distributions of thin parallel cracks. We present a further 2 years of data that splitting) than seismograms displayed as timeindicate that the shear wave splitting recorded series, and all the measurements of shear wave at KN• appears to change before and after the splitting in this paper are taken from polariza-M = 6 North Palm Springs (NPS) earthquake of tion diagrams. Figure 2 shows rotated seismo-July 8, 1986. Figure 1 shows a map of the Anza grams and horizontal polarization diagrams of a seismic network and location of the NPS earth-number of events. The positions of the arrowquake. The temporal changes display different heads marking the arrival times of the split behavior along different ray paths that place shear waves are those read from polarization constraints on the possible cause of the changes. diagrams. Many of the polarization diagrams in We speculate on how .these variations may be Figure 2 and throughout the data set display interpreted in terms of stress-induced modific-classic patterns of shear wave splitting familiar ations to the cracked rockmass. from synthetic modelling [Crampin. 1978; Crampin and Booth, 1985], so that the analysis is Crampin, S., Seismic wave propagation through a cracked EH9 3LA, Scotland. solid: polarization as a possible dilatancy diag-J.B. Fletcher, U.S. Geological Survey, 345 Middlefield nostic, Geophys. •. R. /ts tr. Soc., 53, 46...

Percutaneous coronary intervention is an alternative to CABG for patients with medically refractory myocardial ischemia and a high risk of adverse outcomes with CABG.

In a cohort of patients treated with OMT, anatomic burden was a consistent predictor of death, MI, and NSTE-ACS, whereas ischemic burden was not. Importantly, neither determination, even in combination, identified a patient profile benefiting preferentially from an invasive therapeutic strategy. (Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation [COURAGE]; NCT00007657).