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Ajay Kirtane

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https://www.readbyqxmd.com/read/28521919/intravascular-ultrasound-analysis-of-intraplaque-versus-subintimal-tracking-in-percutaneous-intervention-for-coronary-chronic-total-occlusions-and-association-with-procedural-outcomes
#1
Lei Song, Akiko Maehara, Matthew T Finn, Sanjog Kalra, Jeffrey W Moses, Manish A Parikh, Ajay J Kirtane, Michael B Collins, Tamim M Nazif, Khady N Fall, Raja Hatem, Ming Liao, Tiffany Kim, Philip Green, Ziad A Ali, Candido Batres, Martin B Leon, Gary S Mintz, Dimitri Karmpaliotis
OBJECTIVES: Using intravascular ultrasound (IVUS), the authors compared outcomes by observed wire position (intraplaque vs. subintimal) achieved during successful chronic total occlusion (CTO) lesion treatment. BACKGROUND: Recent successes in CTO percutaneous coronary intervention (PCI) have used both intraluminal and subintimal wire tracking to improve procedural success. IVUS may be used to determine the course of wire tracking after crossing a CTO. METHODS: From March 2014 to March 2016, data were collected into a single-center database from 219 patients undergoing CTO PCI with concomitant IVUS imaging...
May 22, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28499595/impact-of-calcium-on-chronic-total-occlusion-percutaneous-coronary-interventions
#2
Judit Karacsonyi, Dimitri Karmpaliotis, Khaldoon Alaswad, Farouc A Jaffer, Robert W Yeh, Mitul Patel, Ehtisham Mahmud, William Lombardi, Michael R Wyman, Anthony Doing, Jeffrey W Moses, Ajay Kirtane, Manish Parikh, Ziad Ali, David Kandzari, Nicholas Lembo, Santiago Garcia, Barbara A Danek, Aris Karatasakis, Erica Resendes, Pratik Kalsaria, Bavana V Rangan, Imre Ungi, Craig A Thompson, Subhash Banerjee, Emmanouil S Brilakis
We sought to examine the impact of calcific deposits on the outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). The outcomes of 1,476 consecutive CTO PCIs performed in 1,453 patients (65.5 ± 10 years, 85% male) between 2012 and 2016 at 11 US centers were evaluated. Moderate or severe quantity of calcium was present in 58% of target lesions. Calcified lesions were more tortuous and more likely to have proximal cap ambiguity and interventional collaterals. PCI of moderately/severely calcified CTOs more often required use of the retrograde approach (54% vs 30%, p <0...
April 13, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28495896/percutaneous-coronary-intervention-of-saphenous-vein-graft
#3
Björn Redfors, Philippe Généreux, Bernhard Witzenbichler, Thomas McAndrew, Jamie Diamond, Xin Huang, Akiko Maehara, Giora Weisz, Roxana Mehran, Ajay J Kirtane, Gregg W Stone
BACKGROUND: Percutaneous coronary intervention (PCI) of saphenous vein grafts (SVGs) has historically been associated with a high risk of adverse ischemic events, but there is a paucity of contemporary data on the second-generation drug-eluting stent use within SVG, and the relative importance of high platelet reactivity (HPR) in SVG PCI versus native lesion PCI is unknown. We studied ischemic and bleeding events after SVG PCI and their association with HPR. METHODS AND RESULTS: Subjects in the prospective, multicenter ADAPT-DES study (Assessment of Dual Antiplatelet Therapy With Drug-Eluting Stents) were stratified according to whether they had PCI of an SVG or a non-SVG lesion...
May 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28467527/association-of-transcatheter-aortic-valve-replacement-with-30-day-renal-function-and-1-year-outcomes-among-patients-presenting-with-compromised-baseline-renal-function-experience-from-the-partner-1-trial-and-registry
#4
Nirat Beohar, Darshan Doshi, Vinod Thourani, Hanna Jensen, Susheel Kodali, Feifan Zhang, Yiran Zhang, Charles Davidson, Patrick McCarthy, Michael Mack, Samir Kapadia, Martin Leon, Ajay Kirtane
Importance: The frequency of baseline renal impairment among high-risk and inoperable patients with severe aortic stenosis undergoing a transcatheter aortic valve replacement (TAVR) and the effect of TAVR on subsequent renal function are, to our knowledge, unknown. Objective: To determine the effect of TAVR among patients with baseline renal impairment. Design, Setting, and Participants: This substudy of patients with baseline renal impairment (estimated glomerular filtration rate [eGFR] ≤ 60 mL/min) and paired baseline and 30-day measures of renal function undergoing TAVR in the PARTNER 1 trial and continued access registries was conducted in 25 centers in the United States and Canada...
May 3, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28422817/incidence-and-implications-of-left-ventricular-distention-during-venoarterial-extracorporeal-membrane-oxygenation-support
#5
Lauren K Truby, Koji Takeda, Christine Mauro, Melana Yuzefpolskaya, Arthur R Garan, Ajay J Kirtane, Veli K Topkara, Darryl Abrams, Daniel Brodie, Paolo C Colombo, Yoshifumi Naka, Hiroo Takayama
Left ventricular distention (LVD) during venoarterial extracorporeal membrane oxygenation (VA-ECMO) support is increasingly recognized but seldom reported in the literature. The current study defined LVD as not present (LVD-); subclinical (LVD+, evidence of pulmonary edema on chest radiograph AND pulmonary artery diastolic blood pressure greater than 25 mm Hg within the first 2 hours of intensive care unit admission); or clinical (LVD++, need for decompression of the left ventricle immediately following VA-ECMO initiation)...
May 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28407050/infarct-size-left-ventricular-function-and-prognosis-in-women-compared-to-men-after-primary-percutaneous-coronary-intervention-in-st-segment-elevation-myocardial-infarction-results-from-an-individual-patient-level-pooled-analysis-of-10-randomized-trials
#6
Ioanna Kosmidou, Björn Redfors, Harry P Selker, Holger Thiele, Manesh R Patel, James E Udelson, E Magnus Ohman, Ingo Eitel, Christopher B Granger, Akiko Maehara, Ajay Kirtane, Philippe Généreux, Paul L Jenkins, Ori Ben-Yehuda, Gary S Mintz, Gregg W Stone
Aim: Studies have reported less favourable outcomes in women compared with men after primary percutaneous coronary intervention (PCI) in ST-segment elevation myocardial infarction (STEMI). Whether sex-specific differences in the magnitude or prognostic impact of infarct size or post-infarction cardiac function explain this finding is unknown. Methods and results: We pooled patient-level data from 10 randomized primary PCI trials in which infarct size was measured within 1 month (median 4 days) by either cardiac magnetic resonance imaging or technetium-99m sestamibi single-photon emission computed tomography...
April 12, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28320686/characteristics-of-early-versus-late-in-stent-restenosis-in-second-generation-drug-eluting-stents-an-optical-coherence-tomography-study
#7
Lei Song, Gary S Mintz, Dong Yin, Myong Hwa Yamamoto, Chee Yang Chin, Mitsuaki Matsumura, Ajay J Kirtane, Manish A Parikh, Jeffrey W Moses, Ziad A Ali, Richard A Shlofmitz, Akiko Maehara
AIMS: In-stent restenosis (ISR) is an important cause of DES failure and target vessel revascularization. We evaluated differences between early and late-presenting restenosis in second-generation drug-eluting stents (DES) using optical coherence tomography (OCT). METHODS AND RESULTS: Overall, 171 cases of second-generation DES ISR with a follow-up OCT minimum lumen area <3.0mm2 were included; 33.3% of patients (n=57) had early ISR; and 67.7% (n=114) had late ISR (duration from stent implantation >1 year)...
March 21, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28315573/mortality-length-of-stay-and-cost-implications-of-procedural-bleeding-after-percutaneous-interventions-using-large-bore-catheters
#8
Björn Redfors, Brendan M Watson, Thomas McAndrew, Emilie Palisaitis, Dominic P Francese, Mehdi Razavi, Jordan Safirstein, Roxana Mehran, Ajay J Kirtane, Philippe Généreux
Importance: Bleeding complications after percutaneous transcatheter interventions that used large-bore catheters are frequent and associated with high mortality and morbidity. Objective: To describe the incidence of bleeding complications among patients undergoing contemporary endovascular interventions involving large-bore catheters and its association with in-hospital mortality, length of stay, and health care cost. Design, Setting, and Participants: This retrospective cohort study analyzed all 17 672 patients from the Healthcare Cost and Utilization Project's National Inpatient Sample database who were recorded as having undergone a transcatheter aortic valve replacement (n = 3223), an endovascular aneurysm repair (n = 12 633), or a percutaneous left ventricular assist device implant (n = 1816) between January 1, 2012, and December 31, 2013...
March 18, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28296639/impact-of-chronic-total-occlusions-on-revascularization-scores-and-outcome-prediction
#9
Björn Redfors, Tullio Palmerini, Adriano Caixeta, Girma Minalu Ayele, Dominic P Francese, Roxana Mehran, Emmanouil S Brilakis, Ajay J Kirtane, Dimitri Karmpaliotis, Gregg W Stone, Philippe Généreux
OBJECTIVES: To evaluate the contribution of chronic total occlusion (CTO)-related SYNTAX score (SS) to the overall SS for patients with CTO and compare the traditional SS to a simplified variant. The SS algorithm assigns CTO lesions a greater weight (5× points) than non-CTO lesions (50% to <100% diameter stenosis; 2× points). METHODS: We calculated the SS and the simplified SS (2× points also to CTO lesions) for 4356 patients from the angiographic substudy of the Acute Catheterization and Urgent Intervention Triage StrategY (ACUITY) trial...
April 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28288963/platelet-reactivity-and-clinical-outcomes-after-coronary-artery-implantation-of-drug-eluting-stents-in-subjects-with-peripheral-arterial-disease-analysis-from-the-adapt-des-study-assessment-of-dual-antiplatelet-therapy-with-drug-eluting-stents
#10
Rajesh Gupta, Ajay J Kirtane, M Ozgu Ozan, Bernhard Witzenbichler, Michael J Rinaldi, D Christopher Metzger, Giora Weisz, Thomas D Stuckey, Bruce R Brodie, Roxana Mehran, Ori Ben-Yehuda, Gregg W Stone
BACKGROUND: Patients with peripheral arterial disease (PAD) have high rates of adverse cardiovascular events after percutaneous coronary intervention and may additionally have heightened platelet reactivity. This study assessed the relationship between platelet reactivity and clinical outcomes after percutaneous coronary interventions among subjects with and without PAD. METHODS AND RESULTS: ADAPT-DES (Assessment of Dual Antiplatelet Therapy With Drug-Eluting Stents) was a prospective, multicenter registry of patients treated with coronary drug-eluting stents...
March 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28281026/neoatherosclerosis-assessed-with-optical-coherence-tomography-in-restenotic-bare-metal-and-first-and-second-generation-drug-eluting-stents
#11
Lei Song, Gary S Mintz, Dong Yin, Myong Hwa Yamamoto, Chee Yang Chin, Mitsuaki Matsumura, Khady Fall, Ajay J Kirtane, Manish A Parikh, Jeffrey W Moses, Ziad A Ali, Richard A Shlofmitz, Akiko Maehara
Although reported in bare metal stents (BMS) and first-generation drug-eluting stents (DES), little is known about neoatherosclerosis in second-generation DES. We used optical coherence tomography to evaluate neoatherosclerosis among different stent generations. Overall, 274 in-stent restenosis (ISR) lesions (duration from implantation 56.9 ± 47.2 months) in 274 patients were assessed for the presence of neoatherosclerosis. Neoatherosclerosis was identified in 38.7% of lesions (106/274): 23.0% second-generation DES (38/165), 65...
March 9, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28273300/one-year-follow-up-of-the-european-ambulance-acute-coronary-syndrome-angiography-trial
#12
Ajay J Kirtane, Robert A Harrington
No abstract text is available yet for this article.
March 8, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28249084/effect-of-short-procedural-duration-with-bivalirudin-on-increased-risk-of-acute-stent-thrombosis-in-patients-with-stemi-a-secondary-analysis-of-the-horizons-ami-randomized-clinical-trial
#13
Hector Tamez, Duane S Pinto, Ajay J Kirtane, Claire Litherland, Robert W Yeh, George D Dangas, Roxana Mehran, Efthymios N Deliargyris, Guillermo Ortiz, C Michael Gibson, Gregg W Stone
Importance: Bivalirudin has been associated with reduced bleeding and mortality during primary percutaneous coronary intervention for ST-segment elevation myocardial infarction (STEMI). However, increased rates of acute stent thrombosis (AST) have been noted when bivalirudin is discontinued at the end of the procedure, which is perhaps related to this medication's short half-life. Objectives: To evaluate the clinical effect of procedure duration on AST when either bivalirudin or heparin plus glycoprotein IIb/IIIa receptor inhibitor (GPI) is used...
March 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28240675/impact-of-chronic-statin-therapy-on-clinical-presentation-and-underlying-lesion-morphology-in-patients-undergoing-percutaneous-intervention-an-adapt-des-ivus-substudy
#14
Tadayuki Kadohira, Gary S Mintz, Cristiano F Souza, Bernhard Witzenbichler, D Christopher Metzger, Michael J Rinaldi, Ernest L Mazzaferri, Peter L Duffy, Giora Weisz, Thomas D Stuckey, Bruce R Brodie, Aaron Crowley, Ajay J Kirtane, Gregg W Stone, Akiko Maehara
OBJECTIVE: Previous intravascular ultrasound (IVUS) studies have not established a relationship between chronic statin use and plaque morphology and composition in patients undergoing percutaneous coronary intervention (PCI). We sought to use pre-PCI grayscale and virtual histology (VH)-IVUS to assess plaque morphology and composition in patients treated with chronic statin therapy compared with patients who were not taking statins before admission and PCI. METHODS: In a prespecified substudy of the Assessment of Dual AntiPlatelet Therapy with Drug-Eluting Stents study, pre-PCI grayscale and VH-IVUS were performed in 780 patients with 916 culprit and 765 nonculprit lesions...
May 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28195937/an-updated-protocol-for-evaluating-chest-pain-and-managing-acute-coronary-syndromes
#15
Christopher R Kelly, Ajay J Kirtane, Jennifer Stant, Gregg W Stone, Robert M Minutello, S Chiu Wong, Honeyleen Manuzon, Roxanne Gerow-Smith, Nancy Kelley, LeRoy E Rabbani
Clinical pathways can optimize care both across and within institutions, but regular updates to these pathways based on new clinical trials, professional guidelines, and Food and Drug Administration approvals are essential. Herein we describe the most recent revisions to the New York-Presbyterian Hospital (Columbia University Medical Center and Weill Cornell Medical Center) clinical pathway for acute coronary syndromes and chest pain, which incorporates novel data regarding the timing and administration of P2Y12 inhibition (including the intravenous P2Y12 inhibitor cangrelor) and the appropriateness of prolonged (>1 year) dual antiplatelet therapy for the secondary prevention of ischemic events...
March 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28193677/sex-differences-in-the-clinical-impact-of-high-platelet-reactivity-after-percutaneous-coronary-intervention-with-drug-eluting-stents-results-from-the-adapt-des-study-assessment-of-dual-antiplatelet-therapy-with-drug-eluting-stents
#16
Jennifer Yu, Roxana Mehran, Usman Baber, Sze-Yuan Ooi, Bernhard Witzenbichler, Giora Weisz, Michael J Rinaldi, Franz-Josef Neumann, D Christopher Metzger, Timothy D Henry, David A Cox, Peter L Duffy, Ernest L Mazzaferri, Bruce R Brodie, Thomas D Stuckey, Akiko Maehara, Ke Xu, Ori Ben-Yehuda, Ajay J Kirtane, Gregg W Stone
BACKGROUND: Sex differences in the outcomes after percutaneous coronary intervention with drug-eluting stents and in the response to clopidogrel therapy have been reported; however, the differential risk of high platelet reactivity (HPR) on clopidogrel in women versus men is unknown. METHODS AND RESULTS: We compared 8448 patients enrolled in the ADAPT-DES study (Assessment of Dual Antiplatelet Therapy With Drug-Eluting Stents) according to sex and the presence/absence of HPR on clopidogrel (defined as P2Y12 reactivity units >208)...
February 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28169091/predictors-of-excess-patient-radiation-exposure-during-chronic-total-occlusion-coronary-intervention-insights-from-a-contemporary-multicentre-registry
#17
Georgios E Christakopoulos, Georgios Christopoulos, Dimitri Karmpaliotis, Khaldoon Alaswad, Robert W Yeh, Farouc A Jaffer, Michael R Wyman, William L Lombardi, Muhammad Nauman J Tarar, J Aaron Grantham, David E Kandzari, Nicholas Lembo, Jeffrey W Moses, Ajay J Kirtane, Manish Parikh, Philip Green, Matthew Finn, Santiago Garcia, Anthony H Doing, Raja Hatem, Craig A Thompson, Subhash Banerjee, Emmanouil S Brilakis
BACKGROUND: High patient radiation dose during chronic total occlusion (CTO) percutaneous coronary intervention (PCI) might lead to procedural failure and radiation skin injury. METHODS: We examined the association between several clinical and angiographic variables on patient air kerma (AK) radiation dose among 748 consecutive CTO PCIs performed at 9 experienced US centres between May 2012 and May 2015. RESULTS: The mean age was 65 ± 10 years, 87% of patients were men, and 35% had previous coronary artery bypass graft surgery (CABG)...
April 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28114641/the-importance-of-long-term-follow-up-within-randomized-clinical-trials-of-cardiovascular-devices
#18
Ajay J Kirtane, Robert O Bonow
No abstract text is available yet for this article.
March 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28104208/first-in-human-evaluation-of-a-novel%C3%A2-polymer-free-drug-filled-stent-angiographic-ivus-oct-and-clinical-outcomes-from%C3%A2-the%C3%A2-revelution-study
#19
Stephen G Worthley, Alexandre Abizaid, Ajay J Kirtane, Daniel I Simon, Stephan Windecker, Sandeep Brar, Ian T Meredith, Sharad Shetty, Ajay Sinhal, Alexandra Popma Almonacid, Daniel Chamié, Akiko Maehara, Gregg W Stone
OBJECTIVES: This study sought to assess the safety and effectiveness of the drug-filled stent (DFS) (Medtronic, Santa Rosa, California) in the treatment of patients with coronary artery disease. BACKGROUND: Polymer-free drug-eluting stents have the potential to improve clinical outcomes and facilitate shorter durations of dual antiplatelet therapy. The polymer-free DFS is made from a trilayered continuous wire with an outer cobalt chromium layer, a middle tantalum layer, and an inner lumen coated with sirolimus...
January 23, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28092294/outcomes-of-a-combined-approach-of-percutaneous-coronary-revascularization-and-cardiac-valve-surgery
#20
REVIEW
Orlando Santana, Sandeep Singla, Christos G Mihos, Andrés M Pineda, Gregg W Stone, Paul A Kurlansky, Isaac George, Ajay J Kirtane, Craig R Smith, Nirat Beohar
A subset of patients requiring coronary revascularization and valve surgery may benefit from a combined approach of percutaneous coronary intervention (PCI) and valve surgery, as opposed to the standard median sternotomy approach of combined coronary artery bypass and valve surgery. To evaluate its potential benefits and limitations, a literature search was performed using PubMed, EMBASE, Ovid, and the Cochrane library, through March 2016 to identify all studies involving a combined approach of PCI and valve surgery in patients with coronary artery and valvular disease...
January 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
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