The safety and efficacy of treating recently stented patients on combination antiplatelet therapy with warfarin for clinical indications in unknown. Therefore, we examined the use of warfarin in a population of patients with myocardial infarction (MI) treated with coronary stenting. We performed a retrospective analysis comparing patients who underwent successful coronary stenting for acute MI and were discharged on either warfarin and combination platelet therapy for clinical indications or combination antiplatelet therapy alone. There was a nonsignificant trend toward reinfarction at 6 and 12 months in warfarin-treated patients. Warfarin-treated patients had significantly higher rates of transfusion compared to nonwarfarin-treated patients at 12 months (21% vs 0%, P=0.028). There were no significant predictors of reinfarction in 6 and 12 months in multivariate analysis. These data demonstrate that warfarin anticoagulation, in combination with successful coronary stenting for acute MI and antiplatelet therapy, does not reduce risk of reinfarction but is associated with increased rates of transfusion.

Haploid sporidia of the dimorphic phytopathogen Ustilago maydis (D.C.) Corda reproduce by budding once each cell cycle. Homogeneous log-phase sporidial cultures were generated by serial passage in liquid culture, and the growth characteristics and percentages of budded cells were determined for the cultures. The characteristics of budding were determined for individual cells by light and electron microscopy. Buds emerged only from the poles of mother cells, and cells could select either a previously used bud site, or a new bud site, each cycle. Time-lapse photomicroscopy indicated that, on solid medium, the first two buds emerged from new cells at a point distal to the site of attachment to the mother cell. In subsequent cell cycles, the buds tended to emerge from alternate poles of the mother cell. The cells used multiple bud sites at each pole. In addition, transmission and scanning electron microscopy revealed a series of annulations (bud scars) at the base of some buds, indicating that cells also used the same budding site many times. This versatility in selecting bud sites indicates that budding likely depends on complex regulatory pathways for determining cellular polarity. Key words: Ustilago maydis, bud, polarity, cell cycle, morphogenesis, yeast.

Contemporary PCI patients have better procedural outcomes and fewer in-hospital adverse events than patient treated before the availability of stents. However, recanalization of total occlusions and avoiding no-reflow will have the most impact on future PCI success.

Morbid obesity is increasing in prevalence among patients undergoing PCI and is associated with a higher risk of mortality and morbidity. These epidemiological changes have important implications for technical considerations of cardiac catheterization, design of the catheterization lab to accommodate these patients, and most importantly, for societal effort toward prevention of obesity.

LVSD occurs in a minority of patients despite successful mechanical reperfusion and occurred independent of procedural, angiographic variables, target vessel revascularization, reinfarction, and combined MACE. Infarct size (determined by peak CPK) and high baseline ejection fraction predicted development of LVSD at 6 months. LVSD in this population likely occurred by negative left ventricular remodeling.