CT and Contrast-Induced Nephrophathy (CIN)
|
|
- Myles Sharp
- 5 years ago
- Views:
Transcription
1 CT and Contrast-Induced Nephrophathy (CIN) Philipp A Kaufmann, MD Professor and Director of Cardiac Imaging University Hospital Zurich, Switzerland DISCLOSURE: Institutional Research contract with GE
2 CIN controversy CIN is a subgruop of acute kidney injury (AKIN) Almost everything about CIN is subject to debate, including its definition methods for measuring the condition causative agents the mechanism for damage the best means of prevention, and its true effect on mortality rates
3 CIN: definition Common definition: Serum creatinine increase 25% and/or 44 μmol/l = 0.5 mg/dl or more from baseline after contrast material exposure In different trials only parts of the definition were used The time point serum creatinin increase measurement was not standardized
4 CIN background Contrast-induced nephropathy (CIN) was first recognized more than 50 years ago. Bartels E, Brun GC, Gammeltof A, Gjorup LA. Acute anuria following intravenous pyelography in a patient with myelomatosis. Acta Med Scand. 1954;150: Contrast media have changed over time to become increasingly safe and well tolerated, but the indications for use of contrast media have greatly expanded. There are now more than 25,000 CT scanners worldwide.
5 CIN background The number of CT examinations performed annually has increased as improvements in technology have created new indications for CT and CT angiography. In the United States alone, 50 million CT procedures are performed annually, and approximately 50% of CT examinations use contrast. Cardiac catheterization and percutaneous coronary intervention (PCI) increased 390% between 1979 and 2002 (further increase occuring now)
6 CIN impact on outcome From AM et al. Mayo Clin Proc. 2008;83(10):
7 CIN impact on outcome Twofold-to-fivefold increase in mortality while patients are in the hospital, mostly related to an increase in adverse cardiac events. Hospital resource consumption is increased. Hospital lengths of stay increase by 5-10 days. Use of dialysis facilities increases 10% to 15%. Long-term mortality (at 1 year) also increases threefold. If dialysis required: In-hosp mortality up to 35%.
8 CIN is a predictable event Occurring immediately after exposure to contrast media (both iodinated contrast and gadolinium compounds) in vulnerable individuals. Its incidence is 10% to 50% in susceptible individuals receiving cardiac angiography, rising in parallel with the baseline serum creatinine level. The incidence for CT studies is less clear.
9 CIN facts But the minority is a CT coronary angiography! Nash K et al. Am J Kidney Dis. 2002;39:
10 CIN in cath pts (n=1 196)
11 CIN risk factors D. mellitus+renal failure, oral antidiabetics (metformin) Renal disease or solitary kidney disease Aged 70 years or older Sepsis or acute hypotension Cardiovascular disease Organ transplant Nephrotoxic drugs (e.g. nonsteroidal anti-inflammatory drugs, chemotherapy) Human immunodeficiency syndrome or acquired immunodeficiency syndrome
12 CIN: how big is the problem? Risk of CIN lower than 2% in general population. Highest for for patients who have impaired renal function in combination with diabetes. The estimated GFR, using serum creatinine measurements, is thought to be more accurate than serum creatinine level alone for measuring risk for CIN. GFR 60 to 30 ml/min: 10% to 20% risk of CIN GFR <30 ml/min: 40% to 50% risk of CIN
13 From cath to CT: differential impact Intra-arterial CM application may be more toxic. Multiple bolus injection of CM in the cath as opposed to one bolus in CT coronary angiography may have molre adverse impact. Patients undergoing CT coronary angiography are younger, have much less concomitant disease.
14 CIN: Impact of different CM
15 Pugliese F, RAD Magazine 2008
16 Pugliese F, RAD Magazine 2008
17 Differences between 5 PCI studies Aspelin et al. N Engl J Med. 2003; Jo et al. J Am Coll Cardiol. 2006; Solomon RJ et al. Circ. 2007; Nie et al. Catheter Cardiovasc Int. 2008; Wessely R et al. ACC 2008 abstract.
18 CIN- Incidence in 5 PCI studies Aspelin et al. N Engl J Med. 2003; Jo et al. J Am Coll Cardiol. 2006; Solomon RJ et al. Circ. 2007; Nie et al. Catheter Cardiovasc Int. 2008; Wessely R et al. ACC 2008 abstract.
19 CIN in CCTA
20 CIN and coronary CT angiography (CCTA) Most of the CIN risk factors are rare in CCTA, as mainly used for CAD rule out or coron. anomalies in younger patients decreased GFR unlikely nephrotoxic drugs rare iv is less nephrotoxic than ic/ia where bolus reaches kidney almost undiluted CM bolus much smaller than in cath
21 CM bolus in CT much lower than in cath Pazhenkottil et al. In J Card Imag 2010;26:
22 1997
23 Procedure related CIN Cardiac cath CT overall Periph. cath ERCP Pulmon. angio Cholangiography Renal angiography For CT angio only few individual cases have been observed Nash K et al. Am J Kidney Dis. 2002;39:
24 CIN: Strategies of prevention Fischman & Reddan. Acta Radiol 2008
25 Fischman & Reddan. Acta Radiol 2008
26
27 If you image, image gently! Non-invasively Low CM Low radiation (1-2m Sv) Be diagnostic! Be evidence-based:
28
29 Husmann et al. Eur Heart J 2008;29: msv
30 Kaufmann, Knuuti EHJ 2010
31 A L A R A!
32
33
34 If you image, image gently! Non-invasively Low CM Low radiation (1-2m Sv) Be diagnostic! Be evidence-based: Choose low-dose CT-angiography!
Safety of contrast agents CT / MR / Echo
International Conference on Integrated Medical Imaging in Cardiovascular Diseases (IMIC 2013, IAEA) Safety of contrast agents CT / MR / Echo Philipp A Kaufmann, MD Professor and Director of Cardiac Imaging
More information16/05/2018 NEFROPATIA DA MEZZO DI CONTRASTO: ANCORA UNA VECCHIA NEMICA?
16/05/2018 NEFROPATIA DA MEZZO DI CONTRASTO: ANCORA UNA VECCHIA NEMICA? Dott. Andrea Boccatonda Università degli Studi G. d Annunzio Chieti Chi di voi non ha mai discusso con un radiologo per eseguire
More informationMinimizing the Renal Toxicity of Iodinated Contrast
Minimizing the Renal Toxicity of Iodinated Contrast Peter A. McCullough, MD, MPH, FACC, FACP, FAHA, FCCP Chief Academic and Scientific Officer St. John Providence Health System Detroit, MI USA Outline
More informationContrast-Induced Nephropathy: Evidenced Based Prevention
Contrast-Induced Nephropathy: Evidenced Based Prevention Michael J Cowley, MD, FSCAI Nothing to disclose Contrast-Induced Nephropathy (CIN) Definitions New onset or worsening of renal function after contrast
More informationOptimal Use of Iodinated Contrast Media In Oncology Patients. Focus on CI-AKI & cancer patient management
Optimal Use of Iodinated Contrast Media In Oncology Patients Focus on CI-AKI & cancer patient management Dr. Saritha Nair Manager-Medical Affairs-India & South Asia GE Healthcare Context Cancer patients
More informationCATH LAB SYMPOSIUM 2010
CATH LAB SYMPOSIUM 2010 Low resistance system High Pressure in Capillaries to filter plasma RBF: 1.2-1.3 L/min (25% of C.O.) Low AV difference ( shunt ) Kidney: 14 ml O2/L blood Brain: 62 ml O2/L blood
More informationContrast Induced Nephropathy
Contrast Induced Nephropathy O CIAKI refers to an abrupt deterioration in renal function associated with the administration of iodinated contrast media O CIAKI is characterized by an acute (within 48 hours)
More informationProtocol for iv. iodine and gadolinium contrast studies
Protocol for iv. iodine and gadolinium contrast studies Royal College of Radiologists Standard The individual administering the contrast agent must ensure that the patient understands that it is to be
More informationPrevention of Contrast induced Nephropathy
55 th Annual Scientific Meeting of The Korean Society of Cardiology 11:50 12:10 Message from Nephrologists Dec 03, 2011 Prevention of Contrast induced Nephropathy Soo Wan Kim, MD, PhD Department of Internal
More informationCTA in acute stroke assessment
CTA in acute stroke assessment Assumptions: It is more efficient to cancel an unnecessary CTA than to order a CTA after the fact It is more efficient to make 1 trip to the CT scanner Even if no LVO, CTA
More informationSAFETY IN THE CATH LAB How to Minimise Contrast Toxicity
SAFETY IN THE CATH LAB How to Minimise Contrast Toxicity Dr. Vijay Kunadian MBBS, MD, MRCP Senior Lecturer and Consultant Interventional Cardiologist Institute of Cellular Medicine, Faculty of Medical
More informationA Paradigm Shift in Contrast-Induced Acute Kidney Injury (CI-AKI) Prevention
CE Mark US: Investigational device. Limited by Federal Law to investigational use only. A Paradigm Shift in Contrast-Induced Acute Kidney Injury (CI-AKI) Prevention 1 ED00092 Rev. A Clinical Problem 2
More informationDoreen P. Foley MS RN ANP-C Doctor of Nursing Practice Program Chamberlain College of Nursing
Doreen P. Foley MS RN ANP-C Doctor of Nursing Practice Program Chamberlain College of Nursing This program has been developed solely for the purposes of describing the level of nurse practitioner (NP)
More informationAcute Coronary Syndrome (ACS) Patients with Chronic Kidney Disease being considered for Cardiac Catheterization. PROVINCIAL PROTOCOL March 2015
Acute Coronary Syndrome (ACS) Patients with Chronic Kidney Disease being considered for Cardiac Catheterization PROVINCIAL PROTOCOL March 2015 Contents Introduction.......................1 Assessing kidney
More informationEVALUATION OF THE ROLE OF NEPHROTOXIC DRUGS IN CONTRAST INDUCED
EVALUATION OF THE ROLE OF NEPHROTOXIC DRUGS IN CONTRAST INDUCED NEPHROPATHY (CIN) Dr. SIRISHA.A POST GRADUATE KAMINENI INSTITUTE OF MEDICAL SCIENCES NARKETPALLY, TELANGANA INTRODUCTION Contrast-induced
More informationPatient referral for elective coronary angiography: challenging the current strategy
Patient referral for elective coronary angiography: challenging the current strategy M. Santos, A. Ferreira, A. P. Sousa, J. Brito, R. Calé, L. Raposo, P. Gonçalves, R. Teles, M. Almeida, M. Mendes Cardiology
More informationCorrespondence should be addressed to Lantam Sonhaye;
Radiology Research and Practice Volume 2015, Article ID 805786, 4 pages http://dx.doi.org/10.1155/2015/805786 Research Article Intravenous Contrast Medium Administration for Computed Tomography Scan in
More information2/20/2013. Why use imaging in CV prevention? Update on coronary CTA in 2013 Coronary CTA for 1 0 prevention: pros and cons Are we there yet?
Evolving Role of Coronary CTA in Primary Cardiovascular Disease Prevention: Are We There Yet? Ron Blankstein, M.D., F.A.C.C. Co-Director, Cardiovascular Imaging Training Program Associate Physician, Preventive
More informationSYNTAX III REVOLUTION Trial Press briefing conference. Prof. Patrick W. Serruys MD, PhD Principal Investigator Imperial College of London
SYNTAX III REVOLUTION Trial Press briefing conference Prof. Patrick W. Serruys MD, PhD Principal Investigator Imperial College of London Title: Coronary Computed Tomography Angiography for Heart Team Decision-making
More informationVersion 4.4. Institutional Outcomes Report 2014Q3. National Outcomes Report Aggregation Date: Jan 12, :59:59 PM
Version 4.4 Institutional Outcomes Report 2014Q3 National Outcomes Report 999997 Aggregation Date: Jan 12, 2015 11:59:59 PM Publish Date: Jan 29, 2015 If User desires to publish or otherwise distribute
More informationThe 2016 NASCI Keynote: Trends in Utilization of Cardiac Imaging: The Coronary CTA Conundrum. David C. Levin, M.D.
The 2016 NASCI Keynote: Trends in Utilization of Cardiac Imaging: The Coronary CTA Conundrum David C. Levin, M.D. October 16, 2016 MPI Utilization Rates/1000[includes PET] total radiologists 2014 total
More informationLow-Dose Computed Tomography Coronary Angiography With Prospective Electrocardiogram Triggering
Journal of the American College of Cardiology Vol. 57, No. 3, 2011 2011 by the American College of Cardiology Foundation ISSN 0735-1097/$36.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2010.08.634
More informationNovel Risk Markers in ACS (Hyperglycemia, Anemia, GFR)
Novel Risk Markers in ACS (Hyperglycemia, Anemia, GFR) Shaul Atar, MD Department of Cardiology Faculty of Medicine of the Galilee Western Galilee Medical Center, Nahariya, Israel TIMI Risk Score Age 65
More informationDONOR CORONARY ANGIOGRAPHY PROTOCOL
Guidance Document DONOR CORONARY ANGIOGRAPHY PROTOCOL ATCA-TSANZ Guidelines 002/2015 Version 1.0, 27 March 2015 1 Table of Contents 1 Purpose 2 Preamble Introduction 4 Donor Heart Allocation protocol 4
More informationMortality Associated With Nephropathy After Radiographic Contrast Exposure
ORIGINAL ARTICLE MORTALITY ASSOCIATED WITH NEPHROPATHY AFTER RADIOGRAPHIC CONTRAST EXPOSURE Mortality Associated With Nephropathy After Radiographic Contrast Exposure AARON M. FROM, MD; BRIAN J. BARTHOLMAI,
More informationClinical Lessons from BMC2-PCI
Clinical Lessons from BMC2-PCI The Blue Cross Blue Shield of Michigan Cardiovascular Consortium Hitinder Gurm, M.D. University of Michigan Overview 32 papers since inception 10 papers published this year
More informationHorizon Scanning Technology Summary. Magnetic resonance angiography (MRA) imaging for the detection of coronary artery disease
Horizon Scanning Technology Summary National Horizon Scanning Centre Magnetic resonance angiography (MRA) imaging for the detection of coronary artery disease April 2007 This technology summary is based
More informationNoninvasive cardiac imaging refers
CARDIOLOGY PATIENT PAGE Introduction to Noninvasive Cardiac Imaging Ron Blankstein, MD Noninvasive cardiac imaging refers to a combination of methods that can be used to obtain images related to the structure
More informationWith increased use of contrast media (CM), interest in
ORIGINAL RESEARCH S. Langner S. Stumpe M. Kirsch M. Petrik N. Hosten No Increased Risk for Contrast-Induced Nephropathy after Multiple CT Perfusion Studies of the Brain with a Nonionic, Dimeric, Iso-Osmolal
More informationComputer Aided Detection and Diagnosis: Cardiac Imaging Applications
Computer Aided Detection and Diagnosis: Cardiac Imaging Applications U. Joseph Schoepf, MD, FAHA, FSCBT MR, FSCCT Professor of Radiology, Medicine, and Pediatrics Director of Cardiovascular Imaging Disclosures
More informationA Light in the Dark: Cardiac MRI and Risk Mitigation. J. Ronald Mikolich MD Professor of Internal Medicine Northeast Ohio Medical University (NEOMED)
A Light in the Dark: Cardiac MRI and Risk Mitigation J. Ronald Mikolich MD Professor of Internal Medicine Northeast Ohio Medical University (NEOMED) Dr. Mikolich has NO financial disclosures relative to
More informationLife After CORAL: What Did CORAL Prove? David Paul Slovut, MD, PhD Co-director TAVR, Dir of Advanced Intervention
Life After CORAL: What Did CORAL Prove? David Paul Slovut, MD, PhD Co-director TAVR, Dir of Advanced Intervention No Relationships to Disclose The Need for Modern Renal Trials Increased rate of RAS diagnosis
More informationCurrent and Future Imaging Trends in Risk Stratification for CAD
Current and Future Imaging Trends in Risk Stratification for CAD Brian P. Griffin, MD FACC Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Disclosures: None Introduction
More informationKavitha Yaddanapudi Stony brook University New York
Kavitha Yaddanapudi Stony brook University New York 8 million ER visits a year for chest pain 2-10% have Acute coronary syndrome (ACS) Coronary CTA(CCTA) -safe alternative to standard of care (SOC) and
More informationThe patient with 30 min chest pain presenting at the ER two hours after onset of symptoms. Professor Christian Mueller
The patient with 30 min chest pain presenting at the ER two hours after onset of symptoms Professor Christian Mueller Disclosures Swiss National Science Foundation.... Research support / travel support
More informationResearch Article Changes in Renal Function in Elderly Patients Following Intravenous Iodinated Contrast Administration: A Retrospective Study
Radiology Research and Practice, Article ID 459583, 4 pages http://dx.doi.org/10.1155/2014/459583 Research Article Changes in Renal Function in Elderly Patients Following Intravenous Iodinated Contrast
More informationThe PRESERVE trial: does it guide prevention strategies for post angiography acute kidney injury?
Editorial Page 1 of 7 The PRESERVE trial: does it guide prevention strategies for post angiography acute kidney injury? Richard Solomon Larner College of Medicine, University of Vermont, Burlington, VT,
More informationIschemic Mitral Valve Disease: Repair, Replace or Ignore?
Ischemic Mitral Valve Disease: Repair, Replace or Ignore? Fabio B. Jatene Full Professor of Cardiovascular Surgery, Medical School, University of São Paulo, Brazil DISCLOSURE I have no financial relationship
More informationOptimal testing for coronary artery disease in symptomatic and asymptomatic patients
Optimal testing for coronary artery disease in symptomatic and asymptomatic patients Alexandre C Ferreira, MD Clinical Chief of Cardiology Jackson Health System Director, Interventional Cardiology Training
More informationThe Who, How and When of Advanced Heart Failure Therapies. Disclosures. What is Advanced Heart Failure?
The Who, How and When of Advanced Heart Failure Therapies 9 th Annual Dartmouth Conference on Advances in Heart Failure Therapies Dartmouth-Hitchcock Medical Center Lebanon, NH May 20, 2013 Joseph G. Rogers,
More informationRadial Artery Access Improving Outcomes and Decreasing Costs
Howard A. Cohen, MD, FACC, FSCAI Director, Division of Cardiac Intervention Co-Director, Cardiac Catheterization Laboratories Lenox Hill Heart & Vascular Institute Institute DISCLOSURE Nothing to disclose
More informationOptimal Imaging Technique Prior to TAVI -Echocardiography-
2014 KSC meeting Optimal Imaging Technique Prior to TAVI -Echocardiography- Geu-Ru Hong, M.D. Ph D Associate Professor of Medicine Division of Cardiology, Severance Cardiovascular Hospital Yonsei University
More informationLow-dose and High-resolution Cardiac Imaging with Revolution CT
GE Healthcare Case study Low-dose and High-resolution Cardiac Imaging with Revolution CT Prof. Philipp A. Kaufmann, M.D. Ronny R. Buechel, M.D. Fran Mikulicic, M.D. Dominik C. Benz, M.D. University of
More informationN-acetylcysteine in the prevention of contrast agent-induced nephrotoxicity in patients undergoing computed tomography studies
RESEARCH REPORT N-acetylcysteine in the prevention of contrast agent-induced nephrotoxicity in patients undergoing computed tomography studies Hossein Khalili, Simin Dashti-Khavidaki, Hamed Tabifar, Nasrin
More informationHybrid cardiac imaging Advantages, limitations, clinical scenarios and perspectives for the future
Hybrid cardiac imaging Advantages, limitations, clinical scenarios and perspectives for the future Prof. Juhani Knuuti, MD, FESC Turku, Finland Disclosure: Juhani Knuuti, M.D. Juhani Knuuti, M.D. has financial
More informationMultisclice CT in combination with functional imaging for CAD. Temporal Resolution. Spatial Resolution. Temporal resolution = ½ of the rotation time
Multisclice CT in combination with functional imaging for CAD Prof. Juhani Knuuti, MD, FESC Turku University Hospital and University of Turku Turku, Finland MSCT and functional imaging for CAD Practical
More informationNephrogram type. Days between first and second NCCT
Supplemental Table 1. Characteristics of patients with multiple unenhanced CT scans number Contrastenhanced procedure Pre-CE exam egfr present at first NCCT type Days between first and second NCCT present
More informationPresenter Disclosure Information
Presenter Disclosure Information Name: Giora Weisz, MD Within the past 12 months, the presenter or their spouse/partner have had a financial interest/arrangement or affiliation with the organization ion
More informationFractional Flow Reserve from Coronary CT Angiography (and some neat CT images)
Fractional Flow Reserve from Coronary CT Angiography (and some neat CT images) Victor Cheng, M.D. Director, Cardiovascular CT Oklahoma Heart Institute 1 Disclosures Tornadoes scare me 2 Treating CAD Fixing
More informationIntravascular Ultrasound in the Treatment of Complex Aortic Pathologies. Naixin Kang, M.D. Vascular Surgery Fellow April 26 th, 2018
Intravascular Ultrasound in the Treatment of Complex Aortic Pathologies Naixin Kang, M.D. Vascular Surgery Fellow April 26 th, 2018 DISCLOSURES Nothing To Disclose 2 ENDOVASCULAR AORTIC INTERVENTION Improved
More informationAcute Coronary Syndrome. Cindy Baker, MD FACC Director Peripheral Vascular Interventions Division of Cardiovascular Medicine
Acute Coronary Syndrome Cindy Baker, MD FACC Director Peripheral Vascular Interventions Division of Cardiovascular Medicine Topics Timing is everything So many drugs to choose from What s a MINOCA? 2 Acute
More informationNew Stable Chest Pain Guidance in the UK NICE to have, difficult to implement
New Stable Chest Pain Guidance in the UK NICE to have, difficult to implement Dr Tim Fairbairn MBChB, MRCP, PhD Consultant Imaging Cardiologist Liverpool Heart and Chest Hospital, United Kingdom 2010 Risk
More informationFollow-up of patients with contrast-induced nephropathy
http://www.kidney-international.org & 2006 International Society of Nephrology Follow-up of patients with contrast-induced nephropathy R Solomon 1 and B Barrett 2 1 Fletcher Allen Health Care, University
More informationCT FFR: Are you ready to totally change the way you diagnose Coronary Artery Disease?
CT FFR: Are you ready to totally change the way you diagnose Coronary Artery Disease? Madan Mohan MD MRCP FACC CQO, Division of Cardiovascular Medicine University Hospitals Case Medical Center Assistant
More informationCT or PET/CT for coronary artery disease
CT or PET/CT for coronary artery disease Rotterdam 2012 Juhani Knuuti, MD, PhD, FESC Turku PET Centre University of Turku Turku, Finland Juhani.knuuti@utu.fi Turku PET Centre University of Turku Åbo Akademi
More informationMædica - a Journal of Clinical Medicine
MAEDICA a Journal of Clinical Medicine 2013; 8(2): 103-107 Mædica - a Journal of Clinical Medicine ORIGINAL PAPERS Early Clinical Outcomes of Primary Percutaneous Coronary Intervention in Bharatpur, Nepal
More informationEvidence for Everyone: Expanding the Reach of Health Technology Assessment 2016 CADTH Symposium, April 10-12, Shaw Centre, Ottawa
Dr. Ross Davies President Dr. Benjamin Chow Vice-President Dr. Jonathan Leipsic Secretary/Treasurer Office 222 Queen Street Suite 1403 Ottawa, ON K1P 5V9 www.ccs.ca/ nuclear_ct@ccs.ca Evidence for Everyone:
More informationPhysician Self-referral and Health Care Utilization. Rita F. Redberg, MD, MSc Professor of Medicine UCSF Medical Center
Physician Self-referral and Health Care Utilization Rita F. Redberg, MD, MSc Professor of Medicine UCSF Medical Center Physician self-referral why should we care? Extent of occurrences Impact of physician
More informationMultimodality Imaging in Spontaneous Coronary Artery Dissection in the Peripartum Period
Multimodality Imaging in Spontaneous Coronary Artery Dissection in the Peripartum Period Marysia Tweet, MD NASCI Annual Meeting October 18 th, 2016 2016 MFMER slide-1 DISCLOSURE No relevant financial relationship(s)
More informationTAVR y Enfermedad Coronaria. Mauricio G. Cohen, MD, FACC, FSCAI Director, Cardiac Catheterization Lab Associate Professor of Medicine
TAVR y Enfermedad Coronaria Mauricio G. Cohen, MD, FACC, FSCAI Director, Cardiac Catheterization Lab Associate Professor of Medicine CAD and AS Similar Pathological Processes CAD in TAVR Patients (n=390)
More informationOut-of-hospital Cardiac Arrest. Franz R. Eberli MD, FESC, FAHA Cardiology Triemli Hospital Zurich, Switzerland
Out-of-hospital Cardiac Arrest Franz R. Eberli MD, FESC, FAHA Cardiology Triemli Hospital Zurich, Switzerland Conflict of Interest I have no conflict of interest to disclose regarding this presentation.
More informationCardiothoracic Department October 9, Deborah Winters, RN BSN Clinical Excellence
Cardiothoracic Department October 9, 2013 Deborah Winters, RN BSN Clinical Excellence Quarterly Executive Summary CathPCI Registry PCI Performance Measures PCI Process/Outcome Metrics Diagnostic Cath Process/Outcome
More informationDetection Of Functional Significance of Coronary Stenoses Using Dynamic. Values Of Myocardial Blood Flow And Coronary Flow Reserve
The 2nd International Symposium on Physics, Engineering and Technologies for Biomedicine Volume 2018 Conference Paper Detection Of Functional Significance of Coronary Stenoses Using Dynamic 13 N-Ammonia
More informationCulprit PCI vs MultiVessel PCI for Acute Myocardial Infarction
Culprit PCI vs MultiVessel PCI for Acute Myocardial Infarction Dipti Itchhaporia, MD, FACC, FESC Trustee, American College of Cardiology Director of Disease Management, Hoag Hospital Robert and Georgia
More informationCombining Coronary Artery Calcium Scanning with SPECT/PET Myocardial Perfusion Imaging
Combining Coronary Artery Calcium Scanning with SPECT/PET Myocardial Perfusion Imaging Daniel S. Berman, MD Director, Cardiac Imaging Cedars-Sinai Heart Institute Professor of Medicine and Imaging Cedars-Sinai
More informationNew Technologies for Cardiac CT. Geoffrey D. Rubin, MD, MBA, FACR, FNASCI Duke University
1996 New Technologies for Cardiac CT Geoffrey D. Rubin, MD, MBA, FACR, FNASCI Duke University New Technology The Long View Levels of Efficacy Endpoint Examples 1: Technical Imaging resolution 2: Diagnostic
More informationAcute Kidney Injury in Trauma. David Lee Skinner MBChB FCS(SA) Trauma Unit Inkosi Albert Luthuli Central Hospital KwaZulu Natal South Africa
Acute Kidney Injury in Trauma David Lee Skinner MBChB FCS(SA) Trauma Unit Inkosi Albert Luthuli Central Hospital KwaZulu Natal South Africa Acute Kidney Injury Acute Renal Failure RIFLE & AKIN RIFLE criteria
More informationPro-enkephalin and Renal Disease. Alan H. Wu, Ph.D. University of California, San Francisco 12 th Annual UCSD Biomarkers of Cardiac Disease
Pro-enkephalin and Renal Disease Alan H. Wu, Ph.D. University of California, San Francisco 12 th Annual UCSD Biomarkers of Cardiac Disease The presenter has received relevant grants and /or consulting
More informationStress only Perfusion Imaging
European Society of Cardiology Annual meeting, 2010, Stockholm, Sweden Stress only Perfusion Imaging Oliver Gaemperli, MD Cardiovascular Center, University Hospital Zurich, Switzerland Male patient, 48
More informationFFR Incorporating & Expanding it s use in Clinical Practice
FFR Incorporating & Expanding it s use in Clinical Practice Suleiman Kharabsheh, MD Consultant Invasive Cardiology Assistant professor, Alfaisal Univ. KFHI - KFSHRC Concept of FFR Maximum flow down a vessel
More informationThe Emerging Role of Cardiac CT in Cardiovascular Imaging. Anthony Gemignani, MD Vermont Cardiac Network April 28, 2016
The Emerging Role of Cardiac CT in Cardiovascular Imaging Anthony Gemignani, MD Vermont Cardiac Network April 28, 2016 Conflict Disclosures I have no significant financial relationship with any companies
More informationOverview. Health and economic burden of coronary artery disease (CAD) Pitfalls in care of patients suspected of having CAD
Quality Challenges and Pitfalls in the Evaluation of Patients with Suspected Heart Disease Joseph A. Ladapo, MD, PhD Assistant Professor of Medicine Department of Population Health NYU School of Medicine
More informationDECLARATION OF CONFLICT OF INTEREST. Research grants: Sanofi-Aventis
DECLARATION OF CONFLICT OF INTEREST Research grants: Sanofi-Aventis Invasive management after cardiac arrest Nikolaos I Nikolaou FESC, FERC Athens, Greece Survival (%) Survival from Out of Hospital Cardiac
More informationof developing contrast -induced
Original Article Singapore Med 1 2009, 50 (3) : 250 Diabetic patients with normal baseline renal function are at increased risk of developing contrast -induced nephropathy post-percutaneous coronary intervention
More informationFractional Flow Reserve: Basics, FAME 1, FAME 2. William F. Fearon, MD Associate Professor Stanford University Medical Center
Fractional Flow Reserve: Basics, FAME 1, FAME 2 William F. Fearon, MD Associate Professor Stanford University Medical Center Conflict of Interest Advisory Board for HeartFlow Research grant from St. Jude
More informationHigh Risk PCI for Heart Failure
High Risk PCI for Heart Failure Ray Matthews MD Professor of Clinical Medicine Chief, Division of Cardiovascular Medicine University of Southern California Los Angeles, California Disclosures Abiomed Research
More informationComputed Tomography of the Coronary Arteries
Cardiology Update DAVOS 2011 Computed Tomography of the Coronary Arteries Anders Persson M.D., Ph.D Director, Assoc. Professor Center for Medical Image Science and Visualization Linköping University SWEDEN
More informationEvaluating the Efficacy of Single Daily Dose of 1200mg of N-Acetyl-Cysteine in Preventing Contrast Agent-Associated Nephrotoxicity
ISPUB.COM The Internet Journal of Internal Medicine Volume 6 Number 1 Evaluating the Efficacy of Single Daily Dose of 1200mg of N-Acetyl-Cysteine in Preventing Contrast Agent-Associated Nephrotoxicity
More informationCoronary Artery Manifestations of Fibromuscular Dysplasia: Infrequent and Easily Missed
Coronary Artery Manifestations of Fibromuscular Dysplasia: Infrequent and Easily Missed Jeffrey W Olin, D.O., F.A.C.C., F.A.H.A. Professor of Medicine (Cardiology) Director of Vascular Medicine & Vascular
More informationEvidence-Based Management of CAD: Last Decade Trials and Updated Guidelines
Evidence-Based Management of CAD: Last Decade Trials and Updated Guidelines Enrico Ferrari, MD Cardiac Surgery Unit Cardiocentro Ticino Foundation Lugano, Switzerland Conflict of Interests No conflict
More informationRenal artery stenosis
Renal artery stenosis Dr. Alexander Woywodt Consultant Renal Physician, Royal Preston Hospital Preston, 31.10.2007 Menu anatomy of the renal arteries diseases of the large renal arteries atherosclerotic
More informationRenal Artery Stenting
Renal Artery Stenting J.P. Reilly, MD, FSCAI Ochsner Medical Center Speaker s bureau: Astra Zeneca and Lilly/Diachi Sankyo Prevalence of RAS is high in cath population. Renal artery intervention can help
More informationScreening and early recognition of CKD. John Ngigi (FISN) Kidney specialist
Screening and early recognition of CKD John Ngigi (FISN) Kidney specialist screening Why? Who? When? How? Primary diagnosis for patients who start dialysis Other 10% Glomerulonephritis 13% No. of dialysis
More informationNew Jersey Cardiac Catheterization Data Registry, Version 2.0 (Please report data only for patients 16 years or older.)
A. ADMINISTRATIVE New Jersey Cardiac Catheterization Data Registry, Version 2.0 (Please report data only for patients 16 years or older.) 1. Facility Code: 2. Facility Name: 3. Procedure Type (Choose only
More informationPearls in Acute Heart Failure Management
Pearls in Acute Heart Failure Management Best Practices Juan M. Aranda Jr., M.D. Professor of Medicine Medical Director of Heart Failure/ Transplant Program University of Florida College of Medicine Disclosures:
More informationCardiovascular Disease in CKD. Parham Eftekhari, D.O., M.Sc. Assistant Clinical Professor Medicine NSUCOM / Broward General Medical Center
Cardiovascular Disease in CKD Parham Eftekhari, D.O., M.Sc. Assistant Clinical Professor Medicine NSUCOM / Broward General Medical Center Objectives Describe prevalence for cardiovascular disease in CKD
More informationCIPG Transcatheter Aortic Valve Replacement- When Is Less, More?
CIPG 2013 Transcatheter Aortic Valve Replacement- When Is Less, More? James D. Rossen, M.D. Professor of Medicine and Neurosurgery Director, Cardiac Catheterization Laboratory and Interventional Cardiology
More informationWhich Test When? Avoid the Stress of Stress Testing. Marc Newell, MD, FACC, FSCCT Minneapolis Heart Institute
Which Test When? Avoid the Stress of Stress Testing Marc Newell, MD, FACC, FSCCT Minneapolis Heart Institute Outline Understand the importance of coronary artery disease assessment Understand the basics
More informationCardiotoxicity: The View of the Cardiologist
Cardiotoxicity: The View of the Cardiologist Dr. Yael Peled, Cardio-Oncology Interactions: 1.Cardiotoxicity following chemotherapy 2. Co existence of cancer and CVD Aging & common risk factors cardiac
More informationWORSENING OF RENAL FUNCTION AFTER RAS INHIBITION IN DECOMPENSATED HEART FAILURE: CLINICAL IMPLICATIONS
WORSENING OF RENAL FUNCTION AFTER RAS INHIBITION IN DECOMPENSATED HEART FAILURE: CLINICAL IMPLICATIONS George Bakris, MD, FASH, FAHA, FASN Professor of Medicine Director, Comprehensive Hypertension Center
More informationCompetency Portfolio for the Diploma in Adult Interventional Cardiology
Competency Portfolio for the Diploma in Adult Interventional Cardiology For Candidates to Complete 2013 VERSION 2.1 This portfolio applies to those who begin training on or after July 1 st, 2013. DEFINITION
More informationThe Latest on CT Fractional Flow Reserve. Dimitris Mitsouras, Ph.D.
The Latest on CT Fractional Flow Reserve Dimitris Mitsouras, Ph.D. Assistant Professor of Radiology Harvard Medical School Director, Applied Imaging Science Lab Brigham and Women s Hospital Disclosures
More informationOriginal Article INTRODUCTION
Original Article Defining the at risk patients for contrast induced nephropathy after coronary angiography; 24-h urine creatinine versus Cockcroft-Gault equation or serum creatinine level Ahmadreza Assareh,
More informationComplicanze durante TAVI. Brambilla Nedy IRCCS Policlinico San Donato
Complicanze durante TAVI Brambilla Nedy IRCCS Policlinico San Donato 0 2 4 6 9 11 14 16 22 26 31 33 37 43 52 61 69 78 87 93 106 113 121 151 171 186 201 225 267 283 294 311 349 502 515 709 1007 Number of
More informationΔΙΑΒΗΤΗΣ ΚΑΙ ΣΙΩΠΗΡΗ ΙΣΧΑΙΜΙΑ. Δρ. ΛΑΦΑΡΑΣ ΧΡΗΣΤΟΣ
ΔΙΑΒΗΤΗΣ ΚΑΙ ΣΙΩΠΗΡΗ ΙΣΧΑΙΜΙΑ Δρ. ΛΑΦΑΡΑΣ ΧΡΗΣΤΟΣ Διευθυντής Καρδιολογικού Τμήματος, Α.Ν.Θ Θεαγένειο, Θεσσαλονίκη ΔΕΚΕΜΒΡΙΟΣ 2015 Introduction The incidence of diabetes mellitus is increasing globally.
More informationThe Incidence of Contrast Induced Nephropathy in Trauma Patients.
The Incidence of Contrast Induced Nephropathy in Trauma Patients. Item Type Thesis Authors Cordeiro, Samuel Publisher The University of Arizona. Rights Copyright is held by the author. Digital access to
More informationPurpose. Methods and Materials
Comparison of iterative and filtered back-projection image reconstruction techniques: evaluation of heavily calcified vessels with coronary CT angiography Poster No.: C-1644 Congress: ECR 2011 Type: Scientific
More informationMetformin appears to be a useful therapeutic option for physicians wishing to use drug therapy to control blood glucose levels. 3
VI.2 VI.2.1 Elements for a Public Summary Overview of disease epidemiology Type 2 diabetes mellitus Rates of diabetes are increasing worldwide. The International Diabetes Federation predicts that the number
More informationIndication, Timing, Assessment and Update on TAVI
Indication, Timing, Assessment and Update on TAVI Swedish Heart and Vascular Institute Ming Zhang MD PhD Interventional Cardiology Structure Heart Disease Conflict of Interest None Starr- Edwards Mechanical
More information9/28/2011 CARDIAC CATHETERIZATION CODING DISCLAIMER AGENDA CATRENA SMITH, CCS, CCS-P, CPC, PCS. 1. Cardiac Catheterization s defined
CARDIAC CATHETERIZATION CODING CATRENA SMITH, CCS, CCS-P, CPC, PCS PRESIDENT, ACCESS QUALITY CODING & CONSULTING, LLC 1 DISCLAIMER This material is provided to assist in education for coders. Every attempt
More information