No abstract

PFO closure did not meet the primary endpoint of reduction in responder rate in patients with frequent migraine. (Prospective, Randomized Investigation to Evaluate Incidence of Headache Reduction in Subjects With Migraine and PFO Using the AMPLATZER PFO Occluder to Medical Management [PREMIUM]; NCT00355056).

In STEMI patients undergoing primary PCI, the radial approach is associated with favorable outcomes and should be the preferred approach for experienced radial operators.

Background Takotsubo (or stress-induced) cardiomyopathy is characterized by transient left ventricular systolic dysfunction. Recent trends in patient volume, characteristics and outcomes in the United States are unknown. Methods Using 2007–2012 National Inpatient Sample data, we identified 22,005 adults (≥18 years) with a primary and 31,942 adults with a secondary discharge diagnosis of takotsubo cardiomyopathy (ICD-9 code 429.83) who underwent diagnostic coronary angiography. Results During 2007–2012, the incidence of takotsubo cardiomyopathy increased over 3-fold: 52/million discharges in 2007 to 178/million in 2012 (P < 0.001). We found a temporal increase in the prevalence of cardiac arrest, cardiogenic shock, cardiovascular risk factors (diabetes, hypertension) and psychiatric disorders (P trend<0.0001 for all). In-hospital mortality was 1.1% and remained unchanged over this period (P=0.22). Compared to the primary diagnosis group, mortality in the secondary diagnosis group was higher (1.1% vs. 3.2%), and was associated with higher incidence of cardiogenic shock, cardiac arrest and respiratory failure. Men represent 8% of patients in the primary diagnosis group and 12% in the secondary group. In both groups men had a higher incidence of shock, cardiac arrest and respiratory failure. While their mortality was higher than women in the primary group (3.0% vs. 0.9%; adjusted odds ratio [OR] 3.85; 1.74 – 8.51), it was comparable in the secondary group (4.8% vs. 3.0%). Conclusions We found a marked increase in the hospitalization for takotsubo cardiomyopathy in the U.S. in recent years, suggesting higher incidence than prior reports. Although outcomes have remained favorable, there is an increasing burden of cardiovascular and psychiatric disorders in this population with growing cost of care. Risk of mortality is higher in men and in patients with underlying critical illness. The excess mortality in these groups appears to be mediated by greater severity of disease.

Background-Assessment of gene expression in peripheral blood may provide a noninvasive screening test for allograft rejection. We hypothesized that changes in peripheral blood expression profiles would correlate with biopsy-proven rejection and would resolve after treatment of rejection episodes. Methods and Results-We performed a case-control study nested within a cohort of 189 cardiac transplant patients who had blood samples obtained during endomyocardial biopsy (EMB). Using Affymetrix HU133A microarrays, we analyzed whole-blood expression profiles from 3 groups: (1) control samples with negative EMB (nϭ7); (2)