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Coronary Artery Disease: HELP
Articles by Stephen R. Ramee
Based on 5 articles published since 2010
(Why 5 articles?)

Between 2010 and 2020, Stephen Ramee wrote the following 5 articles about Coronary Artery Disease.
+ Citations + Abstracts
1 Guideline The Rationale for Performance of Coronary Angiography and Stenting Before Transcatheter Aortic Valve Replacement: From the Interventional Section Leadership Council of the American College of Cardiology. 2016

Ramee, Stephen / Anwaruddin, Saif / Kumar, Gautam / Piana, Robert N / Babaliaros, Vasilis / Rab, Tanveer / Klein, Lloyd W / Anonymous10330889 / Anonymous10340889. ·Ochsner Medical Center, New Orleans, Louisiana. · Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania. · Emory University/Atlanta VA Medical Center, Atlanta, Georgia. · Vanderbilt University Medical Center, Nashville, Tennessee. · Emory University School of Medicine, Atlanta, Georgia. · Rush Medical College, Chicago, Illinois. Electronic address: lloydklein@comcast.net. ·JACC Cardiovasc Interv · Pubmed #27931592.

ABSTRACT: Transcatheter aortic valve replacement (TAVR) is an effective, nonsurgical treatment option for patients with severe aortic stenosis. The optimal treatment strategy for treating concomitant coronary artery disease (CAD) has not been tested prospectively in a randomized clinical trial. Nevertheless, it is standard practice in the United States to perform coronary angiography and percutaneous coronary intervention for significant CAD at least 1 month before TAVR. All existing clinical trials were designed using this strategy. Therefore, it is wrong to extrapolate current American College of Cardiology/American Heart Association Appropriate Use Criteria against invasive procedures in asymptomatic patients to the TAVR population when evaluating the quality of care by cardiologists or hospitals. In this statement from the Interventional Section Leadership Council of the ACC, it is recommended that percutaneous coronary intervention should be considered in all patients with significant proximal coronary stenosis in major coronary arteries before TAVR, even though the indication is not covered in current guidelines.

2 Article The Unknown Association of PPIs With Chest Pain in Patients With Known, Treated Coronary Artery Disease-A Diagnostic Dilemma. 2016

Javed, Fahad / Ramee, Stephen. · ·Curr Probl Cardiol · Pubmed #27908388.

ABSTRACT: Patients with coronary artery disease (CAD) are destined to lifelong antiplatelet therapy in form of aspirin (acetylsalicylic acid) alone, or in combination with other P2Y2 inhibitors. Proton pump inhibitors (PPIs) are the preferred agents for the treatment and prophylaxis of gastrointestinal injury associated with nonsteroidal anti-inflammatory drug or acetylsalicylic acid or both,

3 Article Factors related to a clinically silent peri-procedural drop in hemoglobin with coronary and peripheral vascular interventions. 2011

Jaffery, Zehra / White, Christopher J / Collins, Tyrone J / Grise, Mark A / Jenkins, J Stephen / McMullan, Paul W / Patel, Rajan A / Reilly, John P / Thornton, Stanley N / Ramee, Stephen R. ·Department of Cardiology, Ochsner Heart and Vascular Institute, John Ochsner Clinic Foundation, New Orleans, LA, USA. zjaffery@ochsner.org ·Vasc Med · Pubmed #22003001.

ABSTRACT: Clinically evident and subclinical peri-procedural bleeding following interventional therapies are associated with adverse cardiovascular outcomes. The risk factors for clinically evident bleeding have been well described. Despite the well-documented association of adverse outcomes for patients with a subclinical peri-procedural hemoglobin drop, the clinical predictors have not yet been defined. We identified 1176 consecutive patients with a subclinical drop in hemoglobin (fall of ≥ 1 g/dl in patients without clinical bleeding) following percutaneous coronary interventions (PCI) and peripheral vascular interventions (PVI). Multivariate logistic regression analysis was performed. A subclinical peri-procedural hemoglobin drop ≥ 1 g/dl was identified in 41% (400/972) of PCI and in 49% (213/435) of PVI. More than one access site predicted a higher risk of a subclinical drop in hemoglobin in both groups. A body mass index ≥ 30 predicted a lower risk of a subclinical drop in hemoglobin in both groups. For PCI, creatinine clearance < 60 ml/min was associated with a higher risk of a subclinical drop in hemoglobin. In conclusion, clinically silent peri-procedural hemoglobin fall ≥ 1 g/dl is common in patients undergoing both coronary and peripheral percutaneous intervention. Predictors identified in our study will need prospective validation.

4 Article Outcomes of unselected recipients of sirolimus-eluting stents: the Cypher stent U.S. post-marketing surveillance registry. 2010

Bezerra, Hiram / Perin, Emerson / Berger, Peter / Block, Peter / Ramee, Stephen / Katz, Stanley / Kellet, Mirle / Dippel, Eric / Schaer, Gary / Britto, Suzanne / Cohen, Sidney / Costa, Marco. ·University Hospitals Case Medical Center, Cardiovascular Dept., Cleveland, OH 44106-6031, USA. ·J Invasive Cardiol · Pubmed #20124586.

ABSTRACT: OBJECTIVE: To examine the 1-year safety and clinical outcomes associated with the post-marketing early unselected use of sirolimus-eluting stents (SES) in the United States. BACKGROUND: The safety and effectiveness of SES has been assessed in selected patients enrolled in pivotal randomized trials. This PMS registry was initiated to examine the safety and effectiveness of SES in an unselected population. METHODS: Consecutive patients who underwent implantation of > or = 1 SES at 38 participating U.S. centers were enrolled in this registry. Results were compared according to "off-" versus "on-label" use of SES. Multivariate regression analyses were carried out in search of predictors of 1- year MACE and stent thrombosis. RESULTS: The mean age of the 2,067 patients (3,367 treated lesions) was 63.7 years. The 12-month follow up was completed by 1,964 patients (95%). SES were implanted for "offlabel" indications in 1,173 patients (57%). The 12-month rates of MACE and TLR in that subgroup were 9.2% and 6.2% (p < 0.001 vs. "on-label" indications). Rate of definite/probable stent thrombosis was 1.6% ("off-label") vs. 0.6% ("on-label"), p = 0.026. The rates of MACE, TLR and stent thrombosis in 640 diabetics (31%) were 9.4%, 5.8% and 1.3% (p = 0.021, NS and NS vs. non-diabetics, respectively). Number of lesions, insulin-dependent diabetes and unstable angina were predictors of stent thrombosis. CONCLUSIONS: The "off-label" use of SES was associated with higher 1-year cumulative rates of MACE than "on-label" indications, although rates were similar to those seen in historical premarketing randomized trials. None of the "off-label" indications were independent predictors of MACE or stent thrombosis.

5 Unspecified Anomalous right coronary artery: a case report. 2014

Keswani, Amit N / Dann, Kristen / Ramee, Stephen. ·John Ochsner Heart and Vascular Institute, Ochsner Clinic Foundation, New Orleans, LA. ·Ochsner J · Pubmed #24940145.

ABSTRACT: BACKGROUND: Anomalous coronary arteries (ACAs) are rare but potentially life-threatening abnormalities of coronary circulation. Most variations are benign; however, some may lead to myocardial ischemia and/or sudden cardiac arrest. CASE REPORT: We present the case of a patient with a significant medical history of hypertension, hyperlipidemia, type 2 diabetes, obesity, and gastroesophageal reflux disease who presented to the emergency department with atypical chest pain. She underwent a cardiac catheterization that showed an anomalous right coronary artery originating near the anterior left coronary artery sinus and coursing between the pulmonary artery and aorta. The patient was deemed a poor surgical candidate, was discharged home on medical management with beta blocker therapy, and was instructed to restrict her physical activity. CONCLUSION: Treatment of significant anomalies should be guided by the nature of the anomalous vessel. Symptomatic patients with ACAs have 3 treatment options: medical management, coronary angioplasty and stent deployment, or surgical correction. These treatment options remain controversial. Some clinicians advocate revascularization, but the long-term benefits of revascularization therapies have not yet been demonstrated.