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Introduction: To evaluate the efficacy/safety profile of the Abluminus DES+ over 2-years follow-up in the "real-world" scenario in diabetics as compared to non-diabetics. Methods: In prospective, all-comers, open-label registry conducted at 31 sites, patients were analyzed for 1 & 2-year outcomes with the primary endpoint defined as 3P-MACE of CV death, target vesselrelated myocardial infarction (TV-MI), ischemia-driven target lesion revascularization (TLR)/target vessel revascularization (TVR) apart from Stent thrombosis (ST). Results: Of 2500 patients of PCI with 3286 Abluminus-DES+, 1641 (65.64%) were non-diabetics while 859 (34.36%) were diabetics. The 3-P MACE for the cohort at 1 & 2 years were 2.9%, and 3.16%; TLR/ TVR - 1.4% at both the intervals for 2493 patients at 2 years. follow-up. TV-MI & ST were 0.36% and 0.56% at 1st and 2nd year respectively. The 3P-MACE was lower in non-diabetics at 1 & 2 years (2.3% vs 4.2%; 2.4% vs 4.7% respectively). For components of MACE, CV mortality (0.9 vs 1.9% at 1 yr ; 1.0 vs 2.1% at 2 years) was significant (P < 0.05) while TLR (1.1 vs 1.9% at 1 yr. & 1.1 vs 2.1% at 2 yrs.) and TV-MI (0.9 vs 1.9% at 1 yr. & 1 vs 2.1% at 2 years) were similar for diabetics and non-diabetics so was ST (P > 0.05). Conclusion: Abluminus-DES+ showed excellent 2-year safety and efficacy with low 3-P MACE which was higher in diabetics driven by higher CV death but similar TLR, TV-MI and ST. [ABSTRACT FROM AUTHOR]

We are reporting the case of a middle aged female who presented with an acute anterior wall myocardial infarction on the thirteenth day of menstrual cycle (the timing of peak estrogen surge during a menstrual cycle of average duration). The patient was thrombolysed initially. Subsequent to the initial resolution of the symptoms immediately after lysis, the patient developed recurrence of symptoms and ECG showed the occurrence of re-infarction. The angiogram revealed a spontaneous multi-vessel dissection involving left main, left anterior descending (LAD) artery and left circumflex artery extending from the left main downwards without any obvious predisposition. The arteries were laden with thrombus and percutaneous intervention was initially impossible. The patient was given an infusion of abciximab following the thrombus burden reduced enabling an intervention. The patient underwent successful stenting from LMCA to LAD and has been asymptomatic and has maintained stent patency at 3 months of follow up. The correlation of spontaneous coronary artery dissection with mid-menstrual estrogen surge has never been discussed previously and is an important consideration in management of young females who present with idiopathic coronary syndrome and illustrates the role of diagnostic angiogram before the administration of thrombolytic therapy in such cases. [ABSTRACT FROM AUTHOR]

Syphilis is known to affect the cardiovascular system in multiple ways but the occurrence of coronary artery aneurysm secondary to syphilitic disease process has never been previously described. We are presenting an interesting case report of a 54 year old female who presented to us with an evolved anterior wall myocardial infarction and coronary angiogram revealed a large thrombus containing aneurysm in the left anterior descending artery. The blood work up of the patient revealed that her VDRL test was positive which was confirmed by TPHA test. The patient decided for conservative medical management. The absence of evidence of atherosclerotic involvement of the same artery in the vicinity of the aneurysm and the other arteries creates a high likelihood of the aneurysm being related to the syphilitic disease process. Although the occurrence of atherosclerotic aneurysm cannot be ruled out completely, and only excision biopsy performed during surgical correction could have provided definitive association of the aneurysm with the syphilitic disease process but with the patient having opted for conservative management so this could not have been possible. Aneurysmal involvement of the coronary arteries due to syphilis has never been reported previously and could be a potentially life threatening complication of the disease and thereby merits a mention. [ABSTRACT FROM AUTHOR]