Integris Health (stylized INTEGRIS Health) is an American 501(c)3 not-for-profit organization which manages health care facilities in the state of Oklahoma. Through affiliates Integris Health Inc. operates 16 hospitals and has health providers in 49 Oklahoma towns and cities. The Integris facilities include hospitals, rehabilitation centers, physician clinics, pharmacies, mental health facilities, independent living centers, and home health agencies, located throughout Oklahoma.
Cardiac CT angiography (CCTA) has become a mainstream and integral part of many cardiology practices based on a vast base of literature supporting and validating its clinical utility. It is now recommended as a first-line test for the evaluation of chest pain according to the American Heart Association (AHA) and the American College of Cardiology (ACC). As the technology continues to advance, coronary imaging has improved in stride. Unfortunately, despite an arsenal of tests available to detect clinically significant coronary artery disease, many people continue to suffer acute myocardial infarction (MI) and other acute coronary syndromes, leading to significant morbidity and mortality due to unstable coronary artery disease (CAD). These unstable, “vulnerable” or high-risk plaques (HRP) continue to plague cardiologists across the globe. The ability to identify HRP has been a step in the right direction increasing more aggressive therapy. A large body of evidence supporting the utility of CCTA in plaque imaging has emerged and has defined characteristics of HRPs and their relationship to future coronary events. The potential of CCTA plaque imaging exists to not only identify HRP that can lead to more aggressive therapy, but to observe the transformation to stable plaque through follow-up CCTA imaging.
Background Percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) lesions involves greater technical challenges than PCI for non-CTO lesions. Its outcomes in modern practice remain only partially understood. We aimed to evaluate temporal trends and 30-day outcomes in patients undergoing CTO PCI. Methods Using the TriNetX research database, adult patients undergoing PCI for CTO versus non-CTO lesions between January 2014 and November 2025 were propensity score-matched within predefined time frames (2014-2017, 2018-2021, and 2022-November 2025). Outcomes included 30-day all-cause mortality, ischemic stroke, coronary artery bypass graft (CABG), and pericardiocentesis, with temporal trends assessed among CTO PCI patients. Results After matching, there was no significant difference in 30-day mortality (0.72% vs 0.71%) or ischemic stroke (1.64% vs 1.55%) between CTO PCI and non-CTO PCI. CTO PCI was consistently associated with a higher 30-day incidence of CABG compared with non-CTO PCI across all time frames (2014-2017: hazard ratio [HR], 2.54; 95% CI, 1.57-4.12; 2018-2021: HR, 4.22; 95% CI, 2.18-8.14; 2022-November 2025: HR, 3.13; 95% CI, 1.87-5.25), with absolute rates of 0.91% vs 0.28%, respectively, without a statistically significant temporal trend. Pericardiocentesis occurred more frequently after CTO than non-CTO PCI (0.20% vs 0.09%). Conclusions Over more than a decade, there were no significant differences in mortality or ischemic stroke between CTO PCI and non-CTO PCI. CTO PCI was associated with a higher incidence of pericardiocentesis and CABG, although absolute event rates were low and without an observed impact on 30-day mortality.
Utilization of a blood pump to aid in circulating a patient’s blood, otherwise known as mechanical circulatory support, is an effective and often life-saving treatment for cardiac/pulmonary failure patients, yet adverse events remain a common complication often attributed to mechanical trauma inflicted on blood components. This work specifically focuses on erythrocyte-derived extracellular vesicles (ErEVs) as a marker of this mechanical trauma as they are elevated in patients with blood pumps and have been tied to adverse events. Despite this, ErEVs are typically neglected during device development which usually includes testing with animal blood, most commonly porcine and bovine. Flow cytometry was employed to monitor ErEVs generated during a 6 h perfusion of porcine or bovine red blood cells (RBCs) in a blood circulatory loop with the CentriMag blood pump. Successful measurement meant overcoming limitations in suitable stains for the RBCs and ErEVs of the two species. Between the two species, 12 different antibodies and dyes were evaluated, including multiple glycophorin A clones, the typical human erythrocyte antigen. Only CD46 and carboxyfluorescein succinimidyl ester (CFSE) were found to successfully and reliably label porcine and bovine RBCs, respectively. With these stains, statistically significant increases for both porcine and bovine ErEVs with perfusion time were observed. Bovine erythrocytes produced significantly more ErEVs than porcine, indicating they are more sensitive to mechanical trauma and could be useful in early-stage device development. The utility of CD46 and CFSE used for porcine and bovine ErEV detection was demonstrated for in vitro pump testing with implications for physiological and pathological research with these animals.
Metabolic bariatric surgery (MBS) effectively lowers the risk of cardiovascular (CV) events in individuals with obesity, however, its application in those with pre-existing CV disease has been limited due to concerns about perioperative outcomes. This study evaluates the effectiveness and safety of bariatric surgery in reducing CV risk in people with pre-existing CV disease. We carried out an extensive search on PubMed, Google Scholar, Science Direct, and Clinicaltrial.gov from their inception until February 2025. Key outcomes included reductions in all-cause mortality (ACM), major adverse CV events (MACE), myocardial infarction (MI), and cerebrovascular events in people with and without prior CV disease undergoing bariatric surgery. Data were combined using a random-effects model and displayed as hazard ratios (HR) along with 95
