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https://www.readbyqxmd.com/read/29776573/duration-of-dual-antiplatelet-therapy-and-outcome-in-patients-with-acute-coronary-syndrome-undergoing-percutaneous-revascularization-a-meta-analysis-of-11-randomized-trials
#1
Monica Verdoia, Elvin Khedi, Claudia Ceccon, Harry Suryapranata, Giuseppe De Luca
BACKGROUND: Acute coronary syndromes (ACS) represent a context of higher thrombotic risk, where larger advantages have been achieved by the administration of dual antiplatelet therapy (DAPT). However, the indication of 1 year DAPT after coronary angioplasty for ACS has been supported by an outdated randomized trial (PCI-CURE). In addition, the initial fear of late thrombotic events emerged with first generation drug-eluting stents (DES), that suggested the need of a prolonged DAPT prescription, has been completely overcome by the recent technological evolution of DES, that have shown faster re-endothelization and lower rates of late thrombotic complications...
August 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29768318/angiographic-characteristics-of-st-elevation-myocardial-infarction-patients-with-infarct-related-coronary-artery-ectasia-undergoing-primary-percutaneous-coronary-intervention
#2
Babak Geraiely, Mojtaba Salarifar, Mohammad Alidoosti, Seyedeh Hamideh Mortazavi
Coronary ectasia accounts for 0.3%-4.9% of patients undergoing coronary angiography. We conducted the present study to evaluate the angiographic characteristics of ST-elevation myocardial infarction (STEMI) patients with infarct-related coronary artery ectasia (IRAE) undergoing primary percutaneous coronary intervention. We evaluated 667 STEMI patients who were divided into 2 groups of IRAE (n = 81) and non-IRAE (n = 568). Preprocedural thrombolysis in myocardial infarction (TIMI) flow grade, postprocedural TIMI flow grade, thrombus burden grade, and TIMI frame count were then evaluated...
June 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29768315/angiography-guided-multivessel-percutaneous-coronary-intervention-versus-ischemia-guided-percutaneous-coronary-intervention-versus-medical-therapy-in-the-management-of-significant-disease-in-non-infarct-related-arteries-in-st-elevation-myocardial-infarction
#3
Dhanuka Perera, Tom Crake, Victor Lee
BACKGROUND: In ST-elevation myocardial infarction (STEMI) patients with multivessel (MV) disease, after primary percutaneous coronary intervention (PCI), emerging evidence suggests that significant disease in non-infarct-related coronary arteries (IRAs) should be routinely stented. Whether this procedure should be guided by angiography alone or ischemia testing is unclear. METHODS: All STEMI patients treated with primary PCI between January 1, 2005, and December 31, 2012, at a tertiary cardiology center were reviewed retrospectively...
June 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29765531/comparison-of-coronary-artery-bypass-grafting-and-percutaneous-coronary-intervention-in-patients-with-heart-failure-with-reduced-ejection-fraction-and-multivessel-coronary-artery-disease
#4
Michał Hawranek, Michal O Zembala, Mariusz Gasior, Tomasz Hrapkowicz, Łukasz Pyka, Daniel Cieśla, Marian Zembala
Aims: To compare coronary artery bypass grafting (CABG) with percutaneous coronary interventions (PCI) in patients with heart failure with reduced ejection fraction (HFrEF) and multivessel coronary artery disease. Methods: 1213 patients were selected from institutional databases, 761 and 452 in CABG and PCI group respectively. Only the subjects with left ventricle ejection fraction ≤ 35% and multivessel coronary artery disease were included to the study. The primary outcome measure was long-term all-cause death, the secondary outcomes were recurrent myocardial infarction, urgent repeat revascularization and stroke...
April 20, 2018: Oncotarget
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
#5
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/29764035/-relationship-between-hyperuricemia-and-prognosis-in-patients-with-heart-failure-of-coronary-heart-disease-after-revascularization
#6
D Peng, S P Wang, D H Zhao, Q C Fan, J Shu, J H Liu
Objective: To explore the effect of hyperuricemia on prognosis in patients with heart failure of coronary heart disease (CHD) after revascularization. Methods: A single-center retrospective study of all subjects who underwent percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) as revascularization for CHD at Beijing Anzhen Hospital, Capital Medical University, between January 2005 and December 2014 was performed.Patients were divided into two groups by with or without hyperuricemia...
May 8, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29755631/anomalous-coronary-artery-from-the-opposite-sinus-acaos-technical-challenges-during-percutaneous-coronary-intervention
#7
Santosh Kumar Sinha, Mahmodula Razi, Anupam Mahrotra, Puneet Aggarwal, Anupam Singh, Lokendra Rekwal, Sunil Tripathi, Nishant Kumar Abhishekh, Vinay Krishna
Anomalies of the coronary arteries are reported in 1-2% of patients among diagnostic angiogram. Ectopic origin of right coronary artery (RCA) from opposite sinus is one of the most common and they are mainly benign, but at times may be malignant. We report a case of a 69-year-old male who underwent early invasive percutaneous coronary intervention for non-ST-segment elevation myocardial infarction (NSTEMI) where RCA arising from left sinus at the root of left main artery was culprit and various technical challenges were encountered while intervening in form of cannulation to tracking of hardwares...
April 2018: Cardiology Research
https://www.readbyqxmd.com/read/29754669/comparison-of-fractional-flow-reserve-and-intravascular-ultrasound-guided-intervention-strategy-for-clinical-outcomes-in-patients-with-intermediate-stenosis-flavour-rationale-and-design-of-a-randomized-clinical-trial
#8
Jeehoon Kang, Bon-Kwon Koo, Xinyang Hu, Joo Myung Lee, Joo-Yong Hahn, Hyoung-Mo Yang, Eun-Seok Shin, Chang-Wook Nam, Joon-Hyung Doh, Bong-Ki Lee, Chul Ahn, JianAn Wang, Seung-Jae Tahk
BACKGROUND: Coronary angiography has limitations in defining the ischemia-causing stenotic lesion, especially in cases with intermediate coronary stenosis. Fractional flow reserve (FFR) is a current standard method to define the presence of ischemia, and intravascular ultrasound (IVUS) is the most commonly used invasive imaging tool that can provide the lesion geometry and can provide the information on plaque vulnerability. The primary aim of this study is to compare the safety and efficacy of FFR-guided and IVUS-guided percutaneous coronary intervention (PCI) strategies in patients with intermediate coronary stenosis...
May 2018: American Heart Journal
https://www.readbyqxmd.com/read/29753563/critical-appraisal-of-the-2018-acc-scientific-sessions-late-breaking-trials-from-a-statistician-s-perspective
#9
REVIEW
Stuart J Pocock, Tim J Collier
The late-breaking clinical trials presentations at the American College of Cardiology Scientific Sessions in March 2018 are an important contribution to the field of cardiology. This paper presents a constructive critical appraisal of 7 key studies: ODYSSEY OUTCOMES (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab), VEST (Vest Prevention of Early Sudden Death Trial), SECURE-PCI (Statins Evaluation in Coronary Procedures and Revascularization), TREAT (Ticagrelor in Patients with ST-Elevation Myocardial Infarction treated with Pharmacological Thrombolysis), POISE (PeriOperative ISchemic Evaluation), SMART-DATE (Safety of 6-Month Duration of Dual Antiplatelet Therapy After Percutaneous Coronary Intervention in Patients With Acute Coronary Syndrome), and CVD-REAL 2 (Comparative Effectiveness of Cardiovascular Outcomes in New Users of SGLT-2 Inhibitors)...
May 7, 2018: Journal of the American College 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
#10
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/29751955/outcomes-in-patients-with-diabetes-mellitus-according-to-insulin-treatment-after-percutaneous-coronary-intervention-in-the-second-generation-drug-eluting-stent-era
#11
Seung-Hoon Pi, Tae-Min Rhee, Joo Myung Lee, Doyeon Hwang, Jonghanne Park, Taek Kyu Park, Jeong Hoon Yang, Young Bin Song, Jin-Ho Choi, Joo-Yong Hahn, Byung Jin Kim, Bum Soo Kim, Hyeon-Cheol Gwon, Seung-Hyuk Choi
Limited data exist regarding the clinical outcomes of patients with diabetes mellitus (DM) after percutaneous coronary intervention (PCI) using second-generation drug-eluting stents (DES), especially according to DM treatment. The purpose of this study was to compare clinical outcomes among patients without DM, with non-insulin-treated DM (non-ITDM), and with ITDM after PCI using second-generation DES. We analyzed 4,812 consecutive patients who underwent PCI using second-generation DES. Primary outcomes were patient-oriented composite outcome (a composite of all-cause mortality, any myocardial infarction, and any revascularization) at 3 years...
April 18, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29749621/the-short-and-long-term-outcomes-of-percutaneous-intervention-with-drug-eluting-stent-vs-bare-metal-stent-in-saphenous-vein-graft-disease-an-updated-meta-analysis-of-all-randomized-clinical-trials
#12
REVIEW
Babikir Kheiri, Mohammed Osman, Ahmed Abdalla, Sahar Ahmed, Ghassan Bachuwa, Mustafa Hassan
The use of drug-eluting stents (DES) vs bare-metal stents (BMS) in saphenous vein graft (SVG) lesions remains controversial. We conducted a meta-analysis of all randomized clinical trials comparing the outcomes of DES with BMS in SVG percutaneous coronary interventions. A search of PubMed, Embase, the Cochrane Register of Controlled Trials, and Clinicaltrials.gov was performed for all randomized clinical trials. We evaluated the short- and long-term clinical outcomes of the following: all-cause mortality, major adverse cardiovascular events (MACE), definite/probable stent thrombosis, target lesion revascularization (TLR), and target-vessel revascularization (TVR)...
May 11, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29748219/frequency-reasons-and-impact-of-premature-ticagrelor-discontinuation-in-patients-undergoing-coronary-revascularization-in-routine-clinical-practice-results-from-the-bern-percutaneous-coronary-intervention-registry
#13
Thomas Zanchin, Fabrice Temperli, Alexios Karagiannis, Christian Zanchin, Markus Räsänen, Konstantinos C Koskinas, Stefan Stortecky, Lukas Hunziker, Fabien Praz, Stefan Blöchlinger, Christina Moro, Aris Moschovitis, Christian Seiler, Michael Billinger, Dik Heg, Thomas Pilgrim, Marco Valgimigli, Stephan Windecker, Lorenz Räber
BACKGROUND: Although ticagrelor has improved clinical outcomes among patients with acute coronary syndrome compared with clopidogrel, adherence to this new antiplatelet agent in real-world practice has not been fully investigated. METHODS AND RESULTS: Between November 2011 and June 2014, 1278 of 4831 consecutive patients (26.5%) undergoing percutaneous coronary intervention at a tertiary care center were treated with ticagrelor. Premature ticagrelor cessation was categorized into (1) change, when ticagrelor was replaced by prasugrel; (2) de-escalation, when ticagrelor was replaced by clopidogrel; and (3) premature discontinuation, when ticagrelor was discontinued without P2Y12 inhibitor replacement...
May 2018: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29747913/complete-revascularization-during-primary-percutaneous-coronary-intervention-reduces-death-and-myocardial-infarction-in-patients-with-multivessel-disease-meta-analysis-and-meta-regression-of-randomized-trials
#14
Vincenzo Pasceri, Giuseppe Patti, Francesco Pelliccia, Carlo Gaudio, Giulio Speciale, Roxana Mehran, George D Dangas
OBJECTIVES: The aim of this study was to compare complete revascularization with a culprit-only strategy in patients presenting with ST-segment elevation myocardial infarction (MI) and multivessel disease by a meta-analysis of randomized trials. BACKGROUND: Although several trials have compared complete with culprit-only revascularization in ST-segment elevation MI, it remains unclear whether complete revascularization may lead to improvement in hard endpoints (death and MI)...
May 14, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29747912/defining-staged-procedures-for-percutaneous-coronary-intervention-trials-a-guidance-document
#15
REVIEW
Ernest Spitzer, Eugène McFadden, Pascal Vranckx, Ton de Vries, Ben Ren, Carlos Collet, Yoshinobu Onuma, Hector M Garcia-Garcia, Renato D Lopes, Gregg W Stone, Donald E Cutlip, Patrick W Serruys
Patients in coronary intervention trials may require more than 1 procedure to complete the intended revascularization strategy. However, these staged interventions are not consistently defined. Standardized definitions are needed to allow meaningful comparisons of this outcome among trials. This document provides guidance on relevant parameters involving staged procedures, including minimum data collection and consistent classification of coronary procedures initially identified as staged; the aim is to achieve consistency among clinical trialists, sponsors, health authorities, and regulators...
May 14, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29747859/comparison-of-long-term-mortality-in-patients-with-previous-coronary-artery-bypass-grafting-who-underwent-percutaneous-coronary-intervention-with-versus-without-optimal-medical-therapy
#16
Yuichi Nakamura, Yasuhide Asaumi, Tadayoshi Miyagi, Michikazu Nakai, Kunihiro Nishimura, Hiroki Sugane, Hideo Matama, Yu Kataoka, Yoshihiro Miyamoto, Yasuchika Takeishi, Teruo Noguchi, Satoshi Yasuda
Although current guidelines have highlighted the importance of evidence-based optimal medical therapy (OMT) in patients with previous coronary artery bypass grafting (CABG), the effect of OMT on post-CABG patients requiring secondary coronary revascularization on prognosis remains unknown. We sought to examine the impact of OMT on post-CABG patients who underwent percutaneous coronary intervention (PCI) as secondary revascularization. A total of 632 consecutive post-CABG patients who underwent PCI between 2001 and 2013 at our hospital (84% men, median age 71 years) were divided into 2 groups: patients who were discharged with OMT and patients who were discharged without OMT (non-OMT)...
April 12, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29747321/-prognostic-value-of-syntax-score-on-1-year-outcome-in-patients-underwent-percutaneous-coronary-intervention
#17
J Wang, C D Guan, J S Yuan, R L Gao, B Xu, S B Qiao
Objective: To investigate the prognostic value of SYNTAX score on 1 year outcome in coronary heart disease patients underwent percutaneous coronary intervention(PCI). Methods: The present study (PANDA Ⅲ trial) was a perspective, multi-center, randomized controlled trial. Between December 2013 and August 2014, 2 348 patients who underwent PCI from 46 centers were enrolled. SYNTAX score was calculated from all patients. Patients were divided into 3 groups based on SYNTAX score: lower risk group (SYNTAX score≤22, 1 777 patients), intermediate risk group (SYNTAX score 23-32, 412 patients), and higher risk group (SYNTAX score≥33, 159 patients)...
April 24, 2018: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/29745969/comparison-of-short-term-clinical-outcomes-between-resolute-onyx-zotarolimus-eluting-stents-and-everolimus-eluting-stent-in-patients-with-acute-myocardial-infarction-results-from-the-korea-acute-myocardial-infarction-registry-kamir
#18
Yongcheol Kim, Sung Sik Oh, Myung Ho Jeong, Youngkeun Ahn, Ju Han Kim, Young Joon Hong, Doo Sun Sim, Min Chul Kim, Hyo-Soo Kim, Kyeong Ho Yun, Seok Kyu Oh, Chong Jin Kim, Myeong Chan Cho
BACKGROUND: There are few studies which compare the efficacy and safety of the Resolute Onyx zotarolimus-eluting stent (O-ZES) and everolimus-eluting stent (EES) in patients with acute myocardial infarction (AMI). Therefore, the present study aimed to compare clinical outcomes of O-ZES and EES in patients with AMI undergoing successful percutaneous coronary intervention (PCI). METHODS: From January 2016 to December 2016, the Korea Acute Myocardial Infarction Registry (KAMIR) enrolled 3,364 consecutive patients...
May 10, 2018: Cardiology Journal
https://www.readbyqxmd.com/read/29743902/early-and-long-term-outcomes-of-complete-revascularization-with-percutaneous-coronary-intervention-in-patients-with-multivessel-coronary-artery-disease-presenting-with-non-st-segment-elevation-acute-coronary-syndromes
#19
Michał Hawranek, Piotr Desperak, Paweł Gąsior, Aneta Desperak, Andrzej Lekston, Mariusz Gąsior
Introduction: The clinical significance of complete revascularization with percutaneous coronary intervention (CR-PCI) in patients with non-ST-segment acute coronary syndrome (NSTE-ACS) remains uncertain. Aim: To evaluate the impact of CR-PCI during index hospitalization on short and long-term incidence of death and composite endpoint among patients with multivessel coronary artery disease (CAD) presenting with NSTE-ACS. Material and methods: We analyzed consecutive data of 1,592 patients with multivessel CAD from 2006 to 2014...
2018: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
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
#20
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
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