Percutaneous Coronary Interventions in Stable and Acute Coronary Syndromes: Stent technology, lesion complexity and clinical outcome

__Abstract__ Percutaneous coronary intervention (PCI) has brought a major revolution in the way we manage coronary artery disease. Since the first intervention by Andreas Grüntzig in 1977, development of the technology has been relentless and today PCI has been established as one of the major pillars of treatment of coronary heart disease alongside its medical and surgical solutions. Stent implantation during PCI has given the needed edge to PCI, not only in restoring coronary flow but moreover in maintaining it. The aim of this thesis were to : 1. Determine the long term outcome of drug eluting stent implantation compared to bare metal stents in the general PCI population and explore clinical benefits of newer generation drug eluting stents. 2. Examine the clinical outcome of drug eluting stents in patient populations prone to aggressive coronary artery disease. 3. Analyse determinants and prognostic value of myocardial no reflow after stenting in acute myocardial infarction. 4. Utilize OCT to gain further insights into intra coronary thrombus and the effects for stenting and thrombectomy in patients with STEMI. 5. Establish the usefulness of the Syntax score in risk stratification of patients presenting with ST elevation myocardial infarction. 6. Assess the outcome of drug-eluting stent implantation in bypass grafts and evaluate a dedicated stent developed for bifurcation stenting including that of the left main stem

The influence of optimal medical treatment on the 'obesity paradox', body mass index and long-term mortality in patients treated with percutaneous coronary intervention: A prospective cohort study

Objective: To assess whether the obesity paradox persists in the long term and to study the effect of optimal medical treatment on this phenomenon. Design: A retrospective cohort study. Setting: A tertiary care centre in Rotterdam. Participants: From January 2000 to December 2005, 6332 patients undergoing percutaneous coronary intervention for coronary artery disease were categorised into underweight (body mass index (BMI)30). Primary outcome measure: Mortality. Secondary outcome measures: Cardiac death and non-fatal myocardial infarction. Results: Optimal medical treatment was more common in obese patients as compared with normal weight patients (85% vs 76%; p<0.001). At a mean of 6.1 years, overweight and obese patients had a lower risk of all-cause mortality (HR: 0.75, 95% CI 0.66 to 0.86 and HR: 0.72, 95% CI 0.60 to 0.87, respectively). After adjusting for OMT in the multivariate analysis, BMI did not remain an independent predictor of longterm mortality (HR: 0.90, 95% CI 0.72 to 1.12 and HR: 1.07, 95% CI: 0.80 to 1.43, respectively). Conclusion: BMI is inversely related to long-term mortality in patients treated with percutaneous coronary intervention. Patients with a normal BMI are on suboptimal medical treatment when compared with those with a high BMI. A more optimal medical treatment in the obese group may explain the observed improved outcome in these patients

Mapping our Universe in 3D with MITEoR

Mapping our universe in 3D by imaging the redshifted 21 cm line from neutral hydrogen has the potential to overtake the cosmic microwave background as our most powerful cosmological probe, because it can map a much larger volume of our Universe, shedding new light on the epoch of reionization, inflation, dark matter, dark energy, and neutrino masses. We report on MITEoR, a pathfinder low-frequency radio interferometer whose goal is to test technologies that greatly reduce the cost of such 3D mapping for a given sensitivity. MITEoR accomplishes this by using massive baseline redundancy both to enable automated precision calibration and to cut the correlator cost scaling from N^2 to NlogN, where N is the number of antennas. The success of MITEoR with its 64 dual-polarization elements bodes well for the more ambitious HERA project, which would incorporate many identical or similar technologies using an order of magnitude more antennas, each with dramatically larger collecting area.Comment: To be published in proceedings of 2013 IEEE International Symposium on Phased Array Systems & Technolog