Comparison of arterial blood pressure measurements and hypertension scores obtained by use of three indirect easurement devices in hospitalized dogs

Objective—To evaluate the agreement of blood pressure measurements and hypertension scores obtained by use of 3 ndirect arterial blood pressure measurement devices in hospitalized dogs. Design—Diagnostic test evaluation. Animals—29 client-owned dogs. Procedures—5 to 7 consecutive blood pressure readings were obtained from each dog on each of 3 occasions with a Doppler ultrasonic flow detector, a standard oscillometric device (STO), and a high-definition oscillometric device (HDO). Results—When the individual sets of 5 to 7 readings were evaluated, the coefficient of variation for systolic arterial blood pressure (SAP) exceeded 20% for 0% (Doppler), 11% (STO), and 28% (HDO) of the sets of readings. After readings that exceeded a 20% coefficient of variation were discarded, repeatability was within 25 (Doppler), 37 (STO), and 39 (HDO) mm Hg for SAP. Correlation of mean values among the devices was between 0.47 and 0.63. Compared with Doppler readings, STO underestimated and HDO overestimated SAP. Limits of agreement between mean readings of any 2 devices were wide. With the hypertension scale used to score SAP, the intraclass correlation of scores was 0.48. Linear-weighted inter-rater reliability between scores was 0.40 (Doppler vs STO), 0.38 (Doppler vs HDO), and 0.29 (STO vs HDO). Conclusions and Clinical Relevance—Results of this study suggested that no meaningful clinical comparison can be made between blood pressure readings obtained from the same dog with different indirect blood pressure measurement devices

Clinical results of two year dual antiplatelet therapy after primary percutaneous coronary intervention with paclitaxel-eluting stents: a single centre study

Aims: The long-term outcome of extended dual antiplatelet therapy after percutaneous coronary intervention (PCI) is unexplored. The purpose of the study was to evaluate the 2 year safety and efficacy of continuous dual antiplatelet treatment in patients undergoing primary PCI with paclitaxel-eluting stent (PES) for acute ST segment elevation myocardial infarction (STEMI).Methods and results: A series of 145 consecutive patients with STEMI underwent primary PCI with PES. All patients received intracoronary high dose bolus and 24 hours i.v. infusion of tirofiban and were then treated with dual anti-aggregation up to 2 years. The incidence of major adverse cardiac events (MACE) was evaluated at 1 month, 1 year, and 2 years during the follow-up period. Overall, the rate of cumulative MACE detected at follow-up was 2.7%, with a 1.4% incidence of mortality and a 0.7% need for target vessel revascularisation. No major bleeding occurred during follow-up (95% C.I. 0-2.6%). Safety analysis revealed that minor bleeding occurred in 5 patients (3.4%) at the time of PCI, and that thrombocytopenia developed in 3 patients (2.1%) with the extended clopidogrel course. During the 2 year follow-up, in-stent thrombosis was seen in only 1 patient who stopped drug treatment against medical advice, but did not occur in patients who remained on dual antiplatelet therapy.Conclusions: This study shows in a 'real world' scenario that sustained dual antiplatelet therapy following primary PCI with PES in patients with STEMI is associated with very good 2 year clinical results