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https://www.readbyqxmd.com/read/28780509/rehospitalizations-following-primary-percutaneous-coronary-intervention-in-patients-with-st-elevation-myocardial-infarction-results-from-a-multi-center-randomized-trial
#1
Ernest Spitzer, Martina Frei, Serge Zaugg, Susanne Hadorn, Henning Kelbaek, Miodrag Ostojic, Andreas Baumbach, David Tüller, Marco Roffi, Thomas Engstrom, Giovanni Pedrazzini, Vladan Vukcevic, Michael Magro, Ran Kornowski, Thomas F Lüscher, Clemens von Birgelen, Dik Heg, Stephan Windecker, Lorenz Räber
BACKGROUND: Rehospitalizations (RHs) after ST-elevation myocardial infarction carry a high economic burden and may deteriorate quality of life. Characterizing patients at higher risk may allow the design of preventive measures. We studied the frequency, reasons, and predictors for unplanned cardiac and noncardiac RHs in ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention. METHODS AND RESULTS: In this post-hoc analysis of the COMFORTABLE AMI (Comparison of Biolimus Eluted From an Erodible Stent Coating With Bare Metal Stents in Acute ST-Elevation Myocardial Infarction; NCT00962416) trial including 1137 patients, unplanned cardiac and noncardiac RHs occurred in 133 (11...
August 5, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28728654/comparison-of-stenting-versus-bypass-surgery-according-to-the-completeness-of-revascularization-in-severe-coronary-artery-disease-patient-level-pooled-analysis-of-the-syntax-precombat-and-best-trials
#2
Jung-Min Ahn, Duk-Woo Park, Cheol Whan Lee, Mineok Chang, Rafael Cavalcante, Yohei Sotomi, Yoshinobu Onuma, Erhan Tenekecioglu, Minkyu Han, Pil Hyung Lee, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Seong-Wook Park, Patrick W Serruys, Seung-Jung Park
OBJECTIVES: The aim of this study was to compare long-term survival between patients with severe coronary artery disease undergoing coronary artery bypass grafting (CABG) and those undergoing percutaneous coronary intervention (PCI) achieving complete revascularization (CR) or incomplete revascularization. BACKGROUND: The importance of CR in decision making regarding revascularization strategy in patients with severe coronary artery disease is unknown. METHODS: Data were pooled from the SYNTAX (Synergy Between PCI With Taxus and Cardiac Surgery), PRECOMBAT (Premier of Randomized Comparison of Bypass Surgery Versus Angioplasty Using Sirolimus-Eluting Stent in Patients With Left Main Coronary Artery Disease), and BEST (Randomized Comparison of Coronary Artery Bypass Surgery and Everolimus-Eluting Stent Implantation in the Treatment of Patients With Multivessel Coronary Artery Disease) trials...
July 24, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28664479/comparison-of-syntax-score-and-syntax-score-ii-to-predict-no-reflow-phenomenon-in-patients-with-st-segment-elevation-myocardial-infarction
#3
Mahmut Yesin, Metin Çağdaş, Macit Kalçık, Mahmut Uluganyan, Süleyman Çağan Efe, İbrahim Rencüzoğulları, Yavuz Karabağ, Mustafa Ozan Gürsoy, Süleyman Karakoyun
Even though the relationship between syntax score (SS) and coronary no-reflow phenomenon has been studied, the relation between SS and syntax score II (SS II) in patients with no-reflow phenomenon is unknown. We aimed to define the relationship between coronary no-reflow phenomenon and SS II as compared with SS. This study enrolled 193 patients undergoing primary percutaneous coronary intervention for ST elevation myocardial infarction in whom 42 patients developed the no-reflow phenomenon. SS and SS II were calculated in all patients...
June 29, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28660768/comparison-of-peri-and-post-procedural-complications-in-patients-undergoing-revascularisation-of-coronary-artery-multivessel-disease-by-coronary-artery-bypass-grafting-or-protected-percutaneous-coronary-intervention-with-the-impella-2-5-device
#4
Tobias Becher, Stefan Baumann, Frederik Eder, Simon Perschka, Dirk Loßnitzer, Christian Fastner, Michael Behnes, Christina Doesch, Martin Borggrefe, Ibrahim Akin
BACKGROUND: While coronary artery bypass grafting remains the standard treatment of complex multivessel coronary artery disease, the advent of peripheral ventricular assist devices has enhanced the safety of percutaneous coronary intervention. We therefore evaluated the safety in terms of inhospital outcome comparing protected high-risk percutaneous coronary intervention with the Impella 2.5 device and coronary artery bypass grafting in patients with complex multivessel coronary artery disease...
June 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28532984/prognostic-impact-of-residual-syntax-score-in-patients-with-st-elevation-myocardial-infarction-and-multivessel-disease-analysis-of-an-8-year-all-comers-registry
#5
Carlos Galvão Braga, Ana Belén Cid-Alvarez, Alfredo Redondo Diéguez, Belén Alvarez Alvarez, Diego López Otero, Raymundo Ocaranza Sánchez, Xoan Sanmartin Pena, Violeta González Salvado, Ramiro Trillo-Nouche, José R González-Juanatey
BACKGROUND: The residual SYNTAX score (rSS) was designed and validated to quantify the burden of residual coronary artery disease after percutaneous coronary intervention (PCI). The aim of this study was to assess the prognostic impact of rSS in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease undergoing primary-PCI. METHODS: This retrospective cohort study included 1499 consecutive patients with STEMI who underwent primary-PCI between January 2008 and December 2015...
September 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28442067/meta-analysis-of-percutaneous-coronary-intervention-versus-coronary-artery-bypass-grafting-in-left-main-coronary-artery-disease
#6
REVIEW
Abdur R Khan, Harsh Golwala, Avnish Tripathi, Haris Riaz, Arnav Kumar, Michael P Flaherty, Deepak L Bhatt
Despite the increase in use of percutaneous coronary intervention (PCI) in left main coronary disease, its efficacy compared with coronary artery bypass grafting (CABG) is unclear. We performed a meta-analysis of randomized controlled trials to assess the optimal revascularization strategy. Our search yielded 8 studies reporting relevant outcomes that were pooled using the inverse variance method, and the hazard ratio (HR) was calculated. The primary outcome was all-cause mortality, myocardial infarction (MI), or stroke (major adverse cardiac events [MACE]), and the secondary outcome was death/MI/stroke/repeat revascularization (expanded MACE)...
June 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28400034/association-of-syntax-score-with-short-term-outcomes-among-acute-st-elevation-myocardial-infarction-patients-undergoing-primary-pci
#7
Sarita Choudhary
OBJECTIVE: Syntax score (SX) has emerged as a reproducible angiographic tool to quantify the extent of coronary artery disease based on location and complexity of each lesion. It has been shown to predict long-term clinical outcomes in patients with left main or multi-vessel disease and recently also in ST-segment elevation myocardial infarction undergoing primary PCI. The aim of this study was to evaluate whether the syntax score is associated with short-term cardiovascular outcomes in patients treated with primary percutaneous coronary intervention (PCI) for acute ST-segment elevation myocardial infarction (STEMI)...
April 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28373177/glycemic-control-status-after-percutaneous-coronary-intervention-and-long-term-clinical-outcomes-in-patients-with-type-2-diabetes-mellitus
#8
Jin Kyung Hwang, Seung Hwa Lee, Young Bin Song, Joonghyun Ahn, Keumhee Carriere, Mi Ja Jang, Taek Kyu Park, Seung-Hyuk Choi, Jeong Hoon Yang, Jin-Ho Choi, Sang Hoon Lee, Hyeon-Cheol Gwon, Joo-Yong Hahn
BACKGROUND: Data on the association between glycemic control after percutaneous coronary intervention and clinical outcomes are limited and controversial in diabetic patients. METHODS AND RESULTS: We studied 980 patients with type 2 diabetes mellitus undergoing percutaneous coronary intervention using drug-eluting stents. Based on 2-year glycosylated hemoglobin A (HbA1c) levels, we divided patients into 2 groups of HbA1c<7.0 (n=489) and HbA1c≥7.0 (n=491). Propensity score-matched analysis was performed in 322 pairs...
April 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28329291/coronary-artery-bypass-graft-surgery-versus-drug-eluting-stent-implantation-for-high-surgical-risk-patients-with-left-main-or-multivessel-coronary-artery-disease
#9
Mineok Chang, Cheol Whan Lee, Jung-Min Ahn, Rafael Cavalcante, Yohei Sotomi, Yoshinobu Onuma, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Seong-Wook Park, Patrick W Serruys, Seung-Jung Park
OBJECTIVES: There are limited data comparing long-term outcomes of coronary artery bypass graft surgery (CABG) and percutaneous coronary intervention (PCI) with drug-eluting stents (DES) in patients with high surgical risk. We evaluated 5-year outcomes following CABG versus PCI with DES in 598 patients with left main or multivessel coronary artery disease (CAD) and a high surgical risk [EuroSCORE (European system for cardiac operative risk evaluation) ≥ 6]. METHODS: Databases were merged from the BEST, PRECOMBAT and SYNTAX trials...
May 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28315564/clinical-risk-scores-predict-procedural-complications-of-primary-percutaneous-coronary-intervention
#10
László Hadadi, Razvan Constantin Şerban, Alina Scridon, Ioana Şuş, Éva Katalin Lakatos, Zoltán Demjén, Dan Dobreanu
OBJECTIVE: The predictive value of five risk score models containing clinical (PAMI-PMS, GRACE-GRS, and modified ACEF-ACEFm-scores), angiographic SYNTAX score (SXS) and combined Clinical SYNTAX score (CSS) variables were evaluated for the incidence of three procedural complications of primary percutaneous coronary intervention (pPCI): iatrogenic coronary artery dissection, angiographically visible distal embolization and angiographic no-reflow phenomenon. METHODS: The mentioned scores and the incidence of procedural complications were retrospectively analyzed in 399 consecutive patients with acute ST-elevation myocardial infarction who underwent pPCI...
April 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28219920/impact-of-coronary-artery-disease-severity-assessed-with-the-syntax-score-on-outcomes-following-transcatheter-aortic-valve-replacement
#11
Jean-Michel Paradis, Jonathon M White, Philippe Généreux, Marina Urena, Darshan Doshi, Tamim Nazif, Rebecca Hahn, Isaac George, Omar Khalique, Kishore Harjai, Laura Lasalle, Benoit M Labbé, Robert DeLarochellière, Daniel Doyle, Éric Dumont, Siamak Mohammadi, Martin B Leon, Josep Rodés-Cabau, Susheel Kodali
BACKGROUND: The influence of coronary artery disease (CAD) on clinical and echocardiographic outcomes after transcatheter aortic valve replacement (TAVR) is still controversial. We sought to evaluate the impact of CAD severity as measured by the SYNTAX score (SS) on patients undergoing TAVR. METHODS AND RESULTS: A total of 377 patients who underwent TAVR in 2 high-volume centers in North America were included in our retrospective analysis. A blinded angiographic core laboratory calculated the SS on all available coronary angiograms with the use of quantitative coronary analysis...
February 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28211603/impact-of-six-versus-12-months-of-dual-antiplatelet-therapy-in-patients-with-drug-eluting-stent-implantation-after-risk-stratification-with-the-residual-syntax-score-results-from-a-secondary-analysis-of-the-i-love-it-2-trial
#12
RANDOMIZED CONTROLLED TRIAL
Miaohan Qiu, Yi Li, Jing Li, Kai Xu, Quanmin Jing, Shaohong Dong, Zhe Jin, Pitian Zhao, Bo Xu, Yaling Han
BACKGROUND: The optimal duration of dual antiplatelet therapy (DAPT) after drug-eluting stent (DES) implantation remains undetermined, especially for those at high risk of cardiac events postprocedure. OBJECTIVES: This study was aimed to investigate the impact of 6 versus 12 months of DAPT after DES implantation based on risk stratification with the residual SYNTAX score (rSS). METHODS: A total of 2737 patients in the I-LOVE-IT 2 trial were grouped according to rSS status (low rSS [rSS = 0, n = 1474] versus high rSS [rSS > 0, n = 1263]) and DAPT duration (6 months vs...
March 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28126156/syntax-score-and-long-term%C3%A2-outcomes-the-bari-2d-trial
#13
COMPARATIVE STUDY
Fumiaki Ikeno, Maria Mori Brooks, Kaori Nakagawa, Min-Kyu Kim, Hideaki Kaneda, Yoshiaki Mitsutake, Helen A Vlachos, Leonard Schwartz, Robert L Frye, Sheryl F Kelsey, Katsuhisa Waseda, Mark A Hlatky
BACKGROUND: The extent of coronary disease affects clinical outcomes and may predict the effectiveness of coronary revascularization with either coronary artery bypass graft (CABG) surgery or percutaneous coronary intervention (PCI). The SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) score quantifies the extent of coronary disease. OBJECTIVES: This study sought to determine whether SYNTAX scores predicted outcomes and the effectiveness of coronary revascularization compared with medical therapy in the BARI-2D (Bypass Angioplasty Revascularization Investigation 2 Diabetes) trial...
January 31, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28081585/drug-eluting-stent-placement-versus-coronary-artery-bypass-surgery-for-unprotected-left-main-coronary-artery-disease-a-meta-analysis-of-randomized-controlled-trials
#14
REVIEW
Sunil Upadhaya, Ramkaji Baniya, Seetharamprasad Madala, Suresh Kumar Subedi, Jahangir Khan, Ravi Kanth Velagapudi, Ghassan Bachuwa
BACKGROUND: Coronary artery bypass grafting (CABG) is the standard of care for treating left main coronary lesions. However, recently published randomized controlled trials (RCT) have shown conflicting results. We sought to compare clinical outcomes of percutaneous coronary intervention (PCI) with drug-eluting stent placement to CABG using a meta-analysis of randomized controlled trials. METHODS: A systemic search of Pubmed, Scopus, Cochrane library, and Clinicaltrials...
February 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28041714/comparison-of-prognostic-risk-scores-after-successful-primary-percutaneous-coronary-intervention
#15
Andreas Synetos, George Georgiopoulos, Voula Pylarinou, Konstantinos Toutouzas, Katerina Maniou, Maria Drakopoulou, Panagiotis Tolis, Antonios Karanasos, Aggelos Papanikolaou, George Latsios, Eleftherios Tsiamis, Dimitrios Tousoulis
BACKGROUND: The aim of this study was to compare the predictive ability of clinical risk scores (ACEF, EuroSCORE and EuroSCORE II) to angiographic (SYNTAX score) and combined risk scores (Global Risk Score and Clinical SXscore) towards cardiovascular death and/or major adverse cardiac events (MACE) in patients with ST-segment elevation acute myocardial infarction (STEMI) managed with primary percutaneous coronary intervention (pPCI). METHODS: A total of 685 patients successfully treated with pPCI were evaluated and the risk scores were calculated...
March 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27973327/baseline-and-residual-syntax-score-in-predicting-outcomes-after-acute-infarct-angioplasty
#16
Yash Singbal, Michael Fryer, Paul Garrahy, Richard Lim
AIMS: To explore the utility of baseline SYNTAX Score (bSS) and residual SYNTAX Score (rSS) in predicting 12-month outcomes after primary percutaneous coronary intervention (PPCI). METHODS AND RESULTS: 590 all-comers with acute STEMI presenting for PPCI over a 2-year period were identified. Of these, 173 were excluded because of unsuitability for SYNTAX score calculation for this study. Two experienced observers calculated the bSS and rSS. Mortality data were sourced from the government registry...
December 15, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27842548/infarct-size-following-complete-revascularization-in-patients-presenting-with-stemi-a-comparison-of-immediate-and-staged-in-hospital-non-infarct-related-artery-pci-subgroups-in-the-cvlprit-study
#17
Jamal N Khan, Sheraz A Nazir, John P Greenwood, Miles Dalby, Nick Curzen, Simon Hetherington, Damian J Kelly, Daniel Blackman, Arne Ring, Charles Peebles, Joyce Wong, Thiagarajah Sasikaran, Marcus Flather, Howard Swanton, Anthony H Gershlick, Gerry P McCann
BACKGROUND: The CvLPRIT study showed a trend for improved clinical outcomes in the complete revascularisation (CR) group in those treated with an immediate, as opposed to staged in-hospital approach in patients with multivessel coronary disease undergoing primary percutaneous intervention (PPCI). We aimed to assess infarct size and left ventricular function in patients undergoing immediate compared with staged CR for multivessel disease at PPCI. METHODS: The Cardiovascular Magnetic Resonance (CMR) substudy of CvLPRIT was a multicentre, prospective, randomized, open label, blinded endpoint trial in PPCI patients with multivessel disease...
November 9, 2016: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/27823681/a-comparison-of-reduced-dose-prasugrel-and-standard-dose-clopidogrel-in-elderly-patients-with-acute-coronary-syndromes-undergoing-early-percutaneous-revascularization-design-and-rationale-of-the-randomized-elderly-acs-2-study
#18
RANDOMIZED CONTROLLED TRIAL
Luca A Ferri, Nuccia Morici, Daniele Grosseto, Giovanni Tortorella, Irene Bossi, Paolo Sganzerla, Michele Cacucci, Girolamo Sibilio, Stefano Tondi, Anna Toso, Maurizio Ferrario, Nicola Gandolfo, Amelia Ravera, Matteo Mariani, Elena Corrada, Leonardo Di Ascenzo, Anna Sonia Petronio, Claudio Cavallini, Nadia Moffa, Stefano De Servi, Stefano Savonitto
BACKGROUND: Elderly patients display higher on clopidogrel platelet reactivity as compared with younger patients. Treatment with prasugrel 5mg has been shown to provide more predictable and homogenous antiplatelet effect, as compared with clopidogrel, suggesting the possibility of reducing ischemic events after an acute coronary syndrome (ACS) without increasing bleeding. STUDY DESIGN: The Elderly-ACS 2 study is a multicenter, randomized, parallel-group, open-label trial designed to demonstrate the superiority of a strategy of dual antiplatelet treatment using a reduced 5-mg daily dose of prasugrel over a standard strategy with a daily clopidogrel dose of 75mg in patients older than 74years with ACS (either ST- or non-ST-elevation myocardial infarction) undergoing early percutaneous revascularization...
November 2016: American Heart Journal
https://www.readbyqxmd.com/read/27797291/everolimus-eluting-stents-or-bypass-surgery-for-left-main-coronary-artery-disease
#19
RANDOMIZED CONTROLLED TRIAL
Gregg W Stone, Joseph F Sabik, Patrick W Serruys, Charles A Simonton, Philippe Généreux, John Puskas, David E Kandzari, Marie-Claude Morice, Nicholas Lembo, W Morris Brown, David P Taggart, Adrian Banning, Béla Merkely, Ferenc Horkay, Piet W Boonstra, Ad J van Boven, Imre Ungi, Gabor Bogáts, Samer Mansour, Nicolas Noiseux, Manel Sabaté, José Pomar, Mark Hickey, Anthony Gershlick, Pawel Buszman, Andrzej Bochenek, Erick Schampaert, Pierre Pagé, Ovidiu Dressler, Ioanna Kosmidou, Roxana Mehran, Stuart J Pocock, A Pieter Kappetein
BACKGROUND: Patients with obstructive left main coronary artery disease are usually treated with coronary-artery bypass grafting (CABG). Randomized trials have suggested that drug-eluting stents may be an acceptable alternative to CABG in selected patients with left main coronary disease. METHODS: We randomly assigned 1905 eligible patients with left main coronary artery disease of low or intermediate anatomical complexity to undergo either percutaneous coronary intervention (PCI) with fluoropolymer-based cobalt-chromium everolimus-eluting stents (PCI group, 948 patients) or CABG (CABG group, 957 patients)...
December 8, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27784884/second-vs-first-generation-drug-eluting-stents-in-complex-lesions-subsets-3-years-follow-up-of-eraci-iv-study
#20
Alfredo E Rodriguez, Omar Santaera, Miguel Larribau, Ricardo Sarmiento, Carlos Haiek, Juan F Del Pozo, Hernan Pavlovsky, Alfredo M Rodriguez-Granillo
BACKGROUND: Although percutaneous coronary intervention (PCI) with first-generation drug-eluting stents (DES-1) did not show a benefit in terms of death rate and myocardial infarction (MI) compared to bypass surgery (coronary artery bypass graft [CABG]), DES platforms have seen a remarkable improvement in the last few years, and a significant increase in their safety and efficacy was observed in randomized controlled trials and observational studies in comparison with DES-1 in patients with coronary artery disease (CAD)...
February 2017: Minerva Cardioangiologica
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