Hiroyuki Jinnouchi

Peri-procedural myocardial infarction is all the same?

Peri-procedural MI is one of the important complications after percutaneous coronary intervention (PCI). In general, the incidence of peri-procedural MI was reported as 2% to 30 %, which depends on the definitions of peri-procedural MI (1).

Transient Retinopathy in Acute Aortic Dissection

PURPOSE To explore the occurrence of transient retinopathy and its prognostic importance in patients with acute aortic dissection (AAD). DESIGN Prospective, observational study. PARTICIPANTS Sixty-four patients with Stanford type B AAD were treated with conservative medical therapy. METHODS Retinopathy findings, such as cotton-wool spots and hemorrhage, were examined. Fundus photography was performed on hospital days 9 to 14 and after 2 or 3 months. The association between the appearance of retinopathy and the subsequent cardio-cerebrovascular events was investigated. MAIN OUTCOME MEASURES The primary outcomes included the incidence of retinopathy and subsequent adverse cardio-cerebrovascular events. RESULTS Retinopathy was detected in 55% (35 of 64) of patients (cotton-wool spots alone, n = 31; dot hemorrhage alone, n = 1; and both, n = 3). These findings disappeared in all 12 patients who underwent follow-up fundus examinations. In the multivariate analysis, a history of hypertension and higher peak C-reactive protein level were independently associated with retinopathy. At a median follow-up of 911 days, adverse cardio-cerebrovascular events were reported in 11 patients, of whom those with retinopathy experienced adverse events significantly more frequently than those without retinopathy (P = 0.045). CONCLUSIONS Retinopathy occurred frequently in patients with AAD. This retinopathy was associated with a history of hypertension and higher peak C-reactive protein levels and was an important predictive factor for adverse cardio-cerebrovascular outcomes.