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pci in stable angina

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https://www.readbyqxmd.com/read/29785878/five-year-outcomes-with-pci-guided-by-fractional-flow-reserve
#1
Panagiotis Xaplanteris, Stephane Fournier, Nico H J Pijls, William F Fearon, Emanuele Barbato, Pim A L Tonino, Thomas Engstrøm, Stefan Kääb, Jan-Henk Dambrink, Gilles Rioufol, Gabor G Toth, Zsolt Piroth, Nils Witt, Ole Fröbert, Petr Kala, Axel Linke, Nicola Jagic, Martin Mates, Kreton Mavromatis, Habib Samady, Anand Irimpen, Keith Oldroyd, Gianluca Campo, Martina Rothenbühler, Peter Jüni, Bernard De Bruyne
Background We hypothesized that fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) would be superior to medical therapy as initial treatment in patients with stable coronary artery disease. Methods Among 1220 patients with angiographically significant stenoses, those in whom at least one stenosis was hemodynamically significant (FFR, ≤0.80) were randomly assigned to FFR-guided PCI plus medical therapy or to medical therapy alone. Patients in whom all stenoses had an FFR of more than 0...
May 22, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29780640/plasma-chemerin-levels-are-increased-in-st-elevation-myocardial-infarction-patients-with-high-thrombus-burden
#2
Ahmet Hakan Ateş, Uğur Arslan, Aytekin Aksakal, Ahmet Yanık, Metin Özdemir, Selim Kul
Objective: To investigate plasma chemerin levels in ST elevation myocardial infarction (STEMI) patients and find out possible relationships between plasma chemerin levels and angiographic characteristics. Patients and Methods: Ninety-seven consecutive patients who presented with STEMI and underwent primary percutaneous coronary intervention (PCI) with coronary stents were enrolled, and 30 age- and sex-matched patients with stable angina pectoris who underwent coronary angiography formed the control group...
2018: Cardiology Research and Practice
https://www.readbyqxmd.com/read/29778671/international-study-of-comparative-health-effectiveness-with-medical-and-invasive-approaches-ischemia-trial-rationale-and-design
#3
David J Maron, Judith S Hochman, Sean M O'Brien, Harmony R Reynolds, William E Boden, Gregg W Stone, Sripal Bangalore, John A Spertus, Daniel B Mark, Karen P Alexander, Leslee Shaw, Jeffrey S Berger, T Bruce Ferguson, David O Williams, Robert A Harrington, Yves Rosenberg
BACKGROUND: Prior trials comparing a strategy of optimal medical therapy with or without revascularization have not shown that revascularization reduces cardiovascular events in patients with stable ischemic heart disease (SIHD). However, those trials only included participants in whom coronary anatomy was known prior to randomization and did not include sufficient numbers of participants with significant ischemia. It remains unknown whether a routine invasive approach offers incremental value over a conservative approach with catheterization reserved for failure of medical therapy in patients with moderate or severe ischemia...
April 21, 2018: American Heart Journal
https://www.readbyqxmd.com/read/29772387/validation-of-the-seattle-angina-questionnaire-in-women-with-ischemic-heart-disease
#4
Krishna K Patel, Suzanne V Arnold, Paul S Chan, Yuanyuan Tang, Philip G Jones, Jianping Guo, Donna M Buchanan, Mohammed Qintar, Carole Decker, David A Morrow, John A Spertus
BACKGROUND: Although the Seattle Angina Questionnaire (SAQ) has been widely used to assess disease-specific health status in patients with ischemic heart disease, it was originally developed in a predominantly male population and its validity in women has been questioned. METHODS: Using data from 8892 men and 4013 women across 2 multicenter trials and 5 registries, we assessed the construct validity, test-retest reliability, responsiveness to clinical change, and predictive validity of the SAQ Summary Score (SS) and its 5 subdomains (Physical Limitation (PL), Anginal Stability (AS), Angina Frequency (AF), Treatment Satisfaction (TS), and Quality of Life (QoL)) separately in men and women...
April 21, 2018: American Heart Journal
https://www.readbyqxmd.com/read/29768313/the-incidence-of-myocardial-injury-after-loading-doses-of-clopidogrel-versus-prasugrel-in-the-candidates-for-percutaneous-coronary-intervention-a-randomized-controlled-trial
#5
Reza Rahmani, Laya Jiriaee, Zahra Jiriaee, Akbar Shafiee, Amir Farhang Zand Parsa
INTRODUCTION: Prevention of myocardial injury is an essential issue in percutaneous coronary intervention (PCI). We compared the incidence of myocardial injury after loading doses of clopidogrel versus prasugrel in the candidates for PCI. METHODS: In this randomized-controlled clinical trial, we enrolled 88 stable angina patients, candidate for PCI. Patients received either prasugrel (60 mg orally) (n = 42) or clopidogrel (600 mg orally) (n = 46). Serum levels of creatine phosphokinase muscle-brain type, cardiac troponin I, and high sensitive C-reactive protein were measured at baseline and 6 and 12 hours postprocedural...
June 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29764706/atrial-fibrillation-and-ischemic-events-with-rivaroxaban-in-patients-with-stable-coronary-artery-disease-afire-protocol-for-a-multicenter-prospective-randomized-open-label-parallel-group-study
#6
Satoshi Yasuda, Koichi Kaikita, Hisao Ogawa, Masaharu Akao, Junya Ako, Tetsuya Matoba, Masato Nakamura, Katsumi Miyauchi, Nobuhisa Hagiwara, Kazuo Kimura, Atsushi Hirayama, Kunihiko Matsui
BACKGROUND: In atrial fibrillation (AF) patients with coronary artery disease (CAD), anticoagulants are commonly used in combination with antiplatelet drugs. However, dual therapy can increase the risk of bleeding, and the potential therapeutic benefits must be weighed against this. Therefore, it is recommended that dual therapy is only used for a limited time, and that monotherapy with anticoagulants should start from 1 year after percutaneous coronary intervention (PCI). However, there is a lack of evidence on the use of monotherapy, in particular with direct oral anticoagulants, in this group of patients...
May 2, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29752388/predicting-the-benefits-of-percutaneous-coronary-intervention-on-1-year-angina-and-quality-of-life-in-stable-ischemic-heart-disease-risk-models-from-the-courage-trial-clinical-outcomes-utilizing-revascularization-and-aggressive-drug-evaluation
#7
Zugui Zhang, Philip Jones, William S Weintraub, G B John Mancini, Steven Sedlis, David J Maron, Koon Teo, Pamela Hartigan, William Kostuk, Daniel Berman, William E Boden, John A Spertus
BACKGROUND: Percutaneous coronary intervention (PCI) is a therapy to reduce angina and improve quality of life in patients with stable ischemic heart disease. However, it is unclear whether the quality of life after PCI is more dependent on the PCI or other patient-related factors. To address this question, we created models to predict angina and quality of life 1 year after PCI and medical therapy. METHODS AND RESULTS: Using data from the 2287 stable ischemic heart disease patients randomized in the COURAGE trial (Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation) to PCI plus optimal medical therapy (OMT) versus OMT alone, we built prediction models for 1-year Seattle Angina Questionnaire angina frequency, physical limitation, and quality of life scores, both as continuous outcomes and categorized by clinically desirable states, using multivariable techniques...
May 2018: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29735587/high-dose-versus-low-dose-pitavastatin-in-japanese-patients-with-stable-coronary-artery-disease-real-cad-a-randomized-superiority-trial
#8
Isao Taguchi, Satoshi Iimuro, Hiroshi Iwata, Hiroaki Takashima, Mitsuru Abe, Eisuke Amiya, Takanori Ogawa, Yukio Ozaki, Ichiro Sakuma, Yoshihisa Nakagawa, Kiyoshi Hibi, Takafumi Hiro, Yoshihiro Fukumoto, Seiji Hokimoto, Katsumi Miyauchi, Tsutomu Yamazaki, Hiroshi Ito, Yutaka Otsuji, Kazuo Kimura, Jun Takahashi, Atsushi Hirayama, Hiroyoshi Yokoi, Kazuo Kitagawa, Takao Urabe, Yasushi Okada, Yasuo Terayama, Kazunori Toyoda, Takehiko Nagao, Masayasu Matsumoto, Yasuo Ohashi, Tetsuji Kaneko, Retsu Fujita, Hiroshi Ohtsu, Hisao Ogawa, Hiroyuki Daida, Hiroaki Shimokawa, Yasushi Saito, Takeshi Kimura, Teruo Inoue, Masunori Matsuzaki, Ryozo Nagai
BACKGROUND: Current guidelines call for high-intensity statin therapy in patients with cardiovascular disease on the basis of several previous "more versus less statins" trials. However, no clear evidence for more versus less statins has been established in an Asian population. METHODS: In this prospective, multicenter, randomized, open-label, blinded end point study, 13 054 Japanese patients with stable coronary artery disease who achieved low-density lipoprotein cholesterol (LDL-C) <120 mg/dL during a run-in period (pitavastatin 1 mg/d) were randomized in a 1-to-1 fashion to high-dose (pitavastatin 4 mg/d; n=6526) or low-dose (pitavastatin 1 mg/d; n=6528) statin therapy...
May 8, 2018: Circulation
https://www.readbyqxmd.com/read/29722796/a-randomized-multicentre-trial-to-compare-revascularization-with-optimal-medical-therapy-for-the-treatment-of-chronic-total-coronary-occlusions
#9
Gerald S Werner, Victoria Martin-Yuste, David Hildick-Smith, Nicolas Boudou, Georgios Sianos, Valery Gelev, Jose Ramon Rumoroso, Andrejs Erglis, Evald Høj Christiansen, Javier Escaned, Carlo di Mario, Thomas Hovasse, Luis Teruel, Alexander Bufe, Bernward Lauer, Kris Bogaerts, Javier Goicolea, James C Spratt, Anthony H Gershlick, Alfredo R Galassi, Yves Louvard
Aims: The clinical value of percutaneous coronary intervention (PCI) for chronic coronary total occlusions (CTOs) is not established by randomized trials. This study should compare the benefit of PCI vs. optimal medical therapy (OMT) on the health status in patients with at least one CTO. Method and results: Three hundred and ninety-six patients were enrolled in a prospective randomized, multicentre, open-label, and controlled clinical trial to compare the treatment by PCI with OMT with a 2:1 randomization ratio...
May 2, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29716756/coronary-microvascular-dysfunction-in-patients-with-stable-coronary-artery-disease-the-ce-marc-2-coronary-physiology-sub-study
#10
David Corcoran, Robin Young, David Adlam, Alex McConnachie, Kenneth Mangion, David Ripley, David Cairns, Julia Brown, Chiara Bucciarelli-Ducci, Andreas Baumbach, Rajesh Kharbanda, Keith G Oldroyd, Gerry P McCann, John P Greenwood, Colin Berry
BACKGROUND: In patients with angina undergoing invasive management, no obstructive coronary artery disease (NOCAD) is a common finding, and angina may persist following percutaneous coronary intervention (PCI). Coronary microvascular dysfunction may be relevant. We aimed to assess the proportion of patients presenting with suspected CAD who had coronary microvascular dysfunction. METHODS: Clinical Evaluation of Magnetic Resonance Imaging in Coronary Heart Disease 2 (CE-MARC 2) was a prospective multicenter randomised controlled trial of functional imaging versus guideline-based management in patients with suspected CAD...
April 19, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29685691/mid-term-clinical-outcomes-after-bailout-drug-eluting-stenting-for-suboptimal-drug-coated-balloon-results-insights-from-a-milan-registry
#11
Satoru Mitomo, Richard J Jabbour, Antonio Mangieri, Marco Ancona, Damiano Regazzoli, Akihito Tanaka, Francesco Giannini, Mauro Carlino, Matteo Montorfano, Alaide Chieffo, Azeem Latib, Antonio Colombo
BACKGROUND: Drug-coated balloon (DCB) is an alternative to drug-eluting stent (DES) for the treatment of small vessel or in-stent restenosis (ISR) lesions, with bailout stenting reserved for poor results after DCB inflation (residual stenosis or dissection). Data regarding bailout stenting with DES are limited. The aim of this study was to evaluate clinical outcomes after bailout stenting with DES for suboptimal DCB results. METHODS: From June 2009 to December 2015, patients who underwent bailout DES implantation for suboptimal results after DCB (residual stenosis > 30% or type C-F dissection) in 2 high-volume centers in Italy were analyzed...
April 13, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29669963/protective-effect-of-remote-ischemic-preconditioning-on-myocardial-damage-after-percutaneous-coronary-intervention-in-stable-angina-patients-with-complex-coronary-lesions-subanalysis-of-a-randomized-controlled-trial
#12
Kentaro Ejiri, Toru Miyoshi, Kunihisa Kohno, Makoto Nakahama, Masayuki Doi, Mitsuru Munemasa, Masaaki Murakami, Atsushi Takaishi, Kazufumi Nakamura, Hiroshi Ito
BACKGROUND: The effect of remote ischemic preconditioning (RIPC) on periprocedural myocardial damage (pMD) in patients undergoing percutaneous coronary intervention (PCI) is controversial. The aim of this study was to investigate the effect of RIPC or intravenous nicorandil on pMD following elective PCI in a subgroup of patients with complex coronary lesions from a multicenter randomized controlled trial.Methods and Results:Patients with stable angina who underwent elective PCI were assigned to 3 groups: control, upper-limb RIPC or intravenous nicorandil...
April 18, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29669787/rediscovering-the-orbit-of-pci-after-orbita
#13
Deepak L Bhatt, Bernard J Gersh, Ph Gabriel Steg, Robert A Harrington, Stephan Windecker
The publication of the Objective Randomised Blinded Investigation with Optimal Medical Therapy of Angioplasty in Stable Angina (ORBITA) trial generated an immense amount of discussion, debate, and controversy.1 The editorialists posed in their title whether the ORBITA trial is the "Last nail in the coffin for PCI in stable angina?"2 The ensuing press coverage has been extensive, though mostly one-sided and largely following the negative tone set by the editorial. The exchange on social media has been at times vitriolic, both pro and con - the number of Tweets of the article (1716 as of February 25, 2018) now exceeds the number of patients enrolled by over seven-fold...
April 18, 2018: Circulation
https://www.readbyqxmd.com/read/29664030/do-practice-gaps-exist-in-evidence-based-medication-prescription-at-hospital-discharge-in-patients-undergoing-coronary-artery-bypass-surgery-coronary-angioplasty
#14
Pradeep Pereira, Aditya Kapoor, Archana Sinha, Surendra K Agarwal, Shantanu Pande, Roopali Khanna, Nilesh Srivastava, Sudeep Kumar, Naveen Garg, Satyendra Tewari, Pravin Goel
Background & objectives: Prescription patterns of guideline-directed medical therapy (GDMT) after coronary artery bypass surgery [coronary artery bypass graft (CABG)] and percutaneous coronary intervention (PCI) at hospital discharge are often not optimal. In view of scarce data from the developing world, a retrospective analysis of medication advice to patients following CABG and PCI was conducted. Methods: Records of 5948 patients (post-PCI: 5152, post-CABG: 796) who underwent revascularization from 2010 to 2014 at a single tertiary care centre in north India were analyzed...
December 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/29643278/absolute-myocardial-blood-flow-after-elective-percutaneous-coronary-intervention-evaluated-on-phase-contrast-cine-cardiovascular-magnetic-resonance-imaging
#15
Rikuta Hamaya, Akinori Sugano, Yoshihisa Kanaji, Tadashi Fukuda, Yoshinori Kanno, Taishi Yonetsu, Eisuke Usui, Masahiro Hoshino, Masahiro Hada, Hiroaki Ohya, Yohei Sumino, Haruhito Yuki, Tadashi Murai, Tetsumin Lee, Tsunekazu Kakuta
BACKGROUND: Few studies have documented changes in myocardial blood flow (MBF) after percutaneous coronary intervention (PCI). Phase-contrast cine cardiovascular MRI (PC-CCMR) of the coronary sinus (CS) is a promising approach to quantify MBF. The aim of this study was to quantify CS flow (CSF) on PC-CCMR as a measure of volumetric MBF before and after elective PCI.Methods and Results:We prospectively studied 34 patients with stable angina undergoing elective PCI for a single de novo lesion...
April 12, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29627899/influence-of-visual-functional-mismatch-on-coronary-flow-profiles-after-percutaneous-coronary-intervention-a-propensity-score-matched-analysis
#16
Masahiro Hoshino, Taishi Yonetsu, Tadashi Murai, Yoshihisa Kanaji, Eisuke Usui, Masahiro Hada, Rikuta Hamaya, Yoshinori Kanno, Tetsumin Lee, Tsunekazu Kakuta
The aims of this study are to clarify whether discrepancies between angiographic and fractional flow reserve (FFR) measurements (visual-functional mismatch) influence coronary flow profiles after percutaneous coronary intervention. While current guidelines FFR-guided revascularization, clinical practice most commonly relies on angiographic evaluation, which may under- or over-estimate the functional relevance of the lesion. Our retrospective analysis involved 274 vessels from 264 patients with stable angina pectoris who underwent FFR, index of microvascular resistance, and coronary flow reserve (CFR) measurements before and after PCI...
April 7, 2018: Heart and Vessels
https://www.readbyqxmd.com/read/29626151/metabolomic-profiling-in-acute-st-segment-elevation-myocardial-infarction-identifies-succinate-as-an-early-marker-of-human-ischemia-reperfusion-injury
#17
Matthias Kohlhauer, Sam Dawkins, Ana S H Costa, Regent Lee, Timothy Young, Victoria R Pell, Robin P Choudhury, Adrian P Banning, Rajesh K Kharbanda, Kourosh Saeb-Parsy, Michael P Murphy, Christian Frezza, Thomas Krieg, Keith M Channon
BACKGROUND: Ischemia-reperfusion injury following ST-segment-elevation myocardial infarction (STEMI) is a leading determinant of clinical outcome. In experimental models of myocardial ischemia, succinate accumulation leading to mitochondrial dysfunction is a major cause of ischemia-reperfusion injury; however, the potential importance and specificity of myocardial succinate accumulation in human STEMI is unknown. We sought to identify the metabolites released from the heart in patients undergoing primary percutaneous coronary intervention for emergency treatment of STEMI...
April 6, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29617004/impact-of-chronic-kidney-disease-on-cardiovascular-and-renal-events-in-patients-undergoing-percutaneous-coronary-intervention-with-everolimus-eluting-stent-risk-stratification-with-c-reactive-protein
#18
Kazuhiro Dan, Toru Miyoshi, Makoto Nakahama, Tomofumi Mizuno, Kenzo Kagawa, Yoichiro Naito, Satoshi Kawada, Hiroshi Ito
BACKGROUND: Chronic kidney disease (CKD) and inflammation play critical roles in atherosclerosis. There is limited evidence regarding the relationship between CKD and patients receiving second-generation drug-eluting stents for coronary artery disease. OBJECTIVE: This study aimed to investigate the effect of CKD on cardiovascular and renal events in patients undergoing percutaneous coronary intervention (PCI) with everolimus-eluting stents (EES). METHODS: We analyzed 504 consecutive patients with stable angina pectoris and significant coronary artery stenosis treated with EES...
2018: Cardiorenal Medicine
https://www.readbyqxmd.com/read/29607427/urban-legend-or-real-fact-coronary-artery-size-varies-with-demographics
#19
Mustafa Adem Tatlisu, Murat Sargin, Adnan Kaya, Ahmet Ilker Tekkesin, Zekeriya Nurkalem, Serap Aykut Aka
OBJECTIVE: This study aimed to determine the relationship between the diameter of coronary artery stents and age, gender, diabetes mellitus (DM), left ventricular ejection fraction (LVEF), renal dysfunction, and the clinical presentation of myocardial ischemia in the cohort of patients with implanted stents in coronary arteries with severe stenotic lesions. METHODS: This study included 2256 patients (mean age, 59.3±10.9 years; men, 62%) who underwent percutaneous coronary intervention (PCI)...
2018: Northern Clinics of Istanbul
https://www.readbyqxmd.com/read/29568240/differential-impact-of-diabetes-mellitus-on-antiplatelet-effects-of-prasugrel-and-clopidogrel
#20
Satoshi Niijima, Tsukasa Ohmori, Kazuomi Kario
Background: Although prasugrel exerts stronger antiplatelet effects compared with clopidogrel, the factors affecting platelet reactivity under prasugrel have not been fully determined. This study aimed to find the novel mechanistic differences between two thienopyridines and identify the factor that influence platelet reactivity to each drug. Methods: Forty patients with stable angina who underwent elective percutaneous coronary intervention were randomly assigned to receive either prasugrel (20 mg) or clopidogrel (300 mg) as a loading dose...
2018: Thrombosis Journal
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