Search

Introduction: Spontaneous coronary artery dissection (SCAD) is a nonatherosclerotic cause of myocardial infarction. Migraine headache has been reported to be common among patients with SCAD, but the degree of migraine-related disability has not been quantified. Methods: Clinical data and headache variables were obtained from the baseline assessment of the prospective, multicenter iSCAD Registry. Migraine-related disability was quantified using the self-reported Migraine Disability Assessment (MIDAS). Demographic, clinical, psychosocial, and medical characteristics from data entry forms were compared between patients with and without migraine. Results: Of the 773 patients with available data, 46% reported previous or current migraines. Those with migraines were more likely to be women (96.9% vs 90.3%, p = 0.0003). The presence of underlying carotid fibromuscular dysplasia was associated with migraine (35% vs 27%, p = 0.0175). There was not a significant association with carotid artery dissection and migraine. Current migraine frequency was less than monthly (58%), monthly (24%), weekly (16%), and daily (3%). Triptan use was reported in 32.5% of patients, and 17.5% used daily migraine prophylactic medications. Using the MIDAS to quantify disability related to migraine, 60.2% reported little or no disability, 14.4% mild, 12.7% moderate, and 12.7% severe. The mean MIDAS score was 9.9 (mild to moderate disability). Patients with SCAD had higher rates of depression and anxiety (28.2% vs 17.7% [ p = 0.0004] and 35.3% vs 26.7% [ p = 0.0099], respectively). Conclusions: Migraines are common, frequent, and a source of disability in patients with SCAD. The association between female sex, anxiety, and depression may provide some insight for potential treatment modalities. [ABSTRACT FROM AUTHOR]

This study was sponsored by CSL Behring and performed in collaboration with the Baim Institute. The Food and Drug Administration Amendments Act of 2007 (FDAAA) mandated the submission of clinical trial information to the ClinicalTrials.gov online repository. To investigate the trends and characteristics of cardiovascular (CV) clinical trials following the enactment of FDAAA. In this analysis, studies that were registered in the ClinicalTrials.gov database between 2008 and 2022, involved ≥1 intervention, and investigated ≥1 CV condition were eligible for inclusion. Relevant trials were identified and categorized using Medical Subject Heading descriptors generated by the National Library of Medicine algorithm. The two-sided Cochran–Armitage test was used to evaluate the annual trends. From a total of 390,887 studies, we identified 30,948 CV trials for inclusion. Generally, there was an ascending trend in the number of trials over time, with 1,609 trials registered in 2008 and 2,511 in 2022 (Figure, Panel A). The size of the trials varied; the majority of trials (61.2%) enrolled ≤100 participants, 33.3% enrolled 101–1,000 participants, 4.4% enrolled 1,001–5,000 participants, and only 1.2% studies were classified as mega-trials with >5,000 participants. Most trials followed participants for 13–60 months (63.5%), with study durations of ≤12 months or >60 months only reported in 27.6% and 9.0% of studies, respectively. The number of pharmacological intervention trials (Figure, Panel B) and trials targeting myocardial ischemia, arterial occlusive diseases, and hypertension (Figure, Panel C) tended to decrease over time, whereas trials targeting cerebrovascular disorders exhibited an ascending trend. Over the past 15 years, the landscape of CV trials has been continuously expanding. During this period there has been a shift in research emphasis towards non-pharmacological interventions and cerebrovascular disorders. [ABSTRACT FROM AUTHOR]

Objectives: The objective of the European Multicenter Registry to Assess Outcomes in coronary artery bypass grafting (CABG) patients (DuraGraft Registry) was to determine clinical outcomes and quality of life (QoL) after contemporary CABG that included isolated CABG and combined CABG/valve procedures, using an endothelial damage inhibitor (DuraGraft) intraoperatively for conduit preservation. Here, we report outcomes in the patient cohort undergoing isolated CABG., Methods: The primary outcome was the composite of all-cause death, myocardial infarction (MI), or repeat revascularization (RR) [major adverse cardiac events (MACE)] at 1 year. Secondary outcomes included the composite of all-cause death, MI, RR, or stroke [major adverse cardiac and cerebrovascular events (MACCE)], and QoL. QoL was assessed with the EuroQol-5 Dimension questionnaire. Independent risk factors for MACE at 1 year were determined using Cox regression analysis., Results: A total of 2532 patients (mean age, 67.4±9.2 years; 82.5% male) underwent isolated CABG. The median EuroScore II was 1.4 [interquartile range (IQR), 0.9-2.3]. MACE and MACCE rates at 1 year were 6.6% and 7.8%, respectively. The rates of all-cause death, MI, RR, and stroke were 4.4, 2.0, 2.2, and 1.9%, respectively. The 30-day mortality rate was 2.3%. Age, extracardiac arteriopathy, left ventricular ejection fraction less than 50%, critical operative state, and left main disease were independent risk factors for MACE. QoL index values improved from 0.84 [IQR, 0.72-0.92] at baseline to 0.92 [IQR, 0.82-1.00] at 1 year ( P <0.0001)., Conclusion: Contemporary European patients undergoing isolated CABG have a low 1-year clinical event rate and an improved QoL., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)