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https://www.readbyqxmd.com/read/29780241/patient-and-physician-preferences-for-attributes-of-coronary-revascularization
#1
Carlos Alberto da Silva Magliano, Andrea Liborio Monteiro, Bernardo Rangel Tura, Claudia Silvia Rocha Oliveira, Amanda Rebeca de Oliveira Rebelo, Claudia Cristina de Aguiar Pereira
Background: Patients with a diagnosis of coronary artery disease (CAD) may face important decisions regarding treatment options, with the "right choice" depending on the relative weights of risks and benefits. Studies performed as discrete choice experiments are used to estimate these weights, and attribute selection is an essential step in the design of these studies. Attributes not included in the design cannot be analyzed. In this study, we aimed to elicit, rank, and rate attributes that may be considered important to patients and physicians who must choose between angioplasty and surgery for coronary revascularization...
2018: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29778734/association-between-maximal-activated-clotting-time-and-major-bleeding-complications-during-transradial-and-transfemoral-percutaneous-coronary-intervention
#2
David W Louis, Kevin Kennedy, Fabio V Lima, Samir Pancholy, J Dawn Abbott, Paul Gordon, Herbert D Aronow
OBJECTIVES: This study sought to determine whether higher maximal activated clotting time (ACT) during transradial (TR) percutaneous coronary intervention (PCI) is associated with greater bleeding risk. BACKGROUND: Higher maximal ACT during transfemoral (TF) PCI has been associated with a greater bleeding risk. It is unclear whether this relationship exists in the setting of TR PCI. METHODS: Among 14,637 patients undergoing TR or TF PCI with unfractionated heparin monotherapy, the study related maximal ACT to the risk of major bleeding...
May 11, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29778726/incidence-determinants-and-outcomes-of-left-and-right-radial-access-use-in-patients-undergoing-percutaneous-coronary-intervention-in-the-united-kingdom-a-national-perspective-using-the-bcis-dataset
#3
Muhammad Rashid, Claire Lawson, Jessica Potts, Evangelos Kontopantelis, Chun Shing Kwok, Olivier F Bertrand, Ahmad Shoaib, Peter Ludman, Tim Kinnaird, Mark de Belder, James Nolan, Mamas Mamas
OBJECTIVES: The authors sought to determine the relationships between left radial access (LRA) or right radial access (RRA) and clinical outcomes using the British Cardiovascular Intervention Society (BCIS) database. BACKGROUND: LRA has been shown to offer procedural advantages over RRA in percutaneous coronary intervention (PCI) although few data exist from a national perspective around its use and association with clinical outcomes. METHODS: The authors investigated the relationship between use of LRA or RRA and clinical outcomes of in-hospital or 30-day mortality, major adverse cardiovascular events, in-hospital stroke, and major bleeding complications in patients undergoing PCI between 2007 and 2014...
May 11, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29778671/international-study-of-comparative-health-effectiveness-with-medical-and-invasive-approaches-ischemia-trial-rationale-and-design
#4
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/29777510/clopidogrel-pharmacogenetics-in-iranian-patients-undergoing-percutaneous-coronary-intervention
#5
Nejat Mahdieh, Ahmad Rabbani, Ata Firouzi, Ali Zahedmehr, Maryam Hoseinimoghaddam, Sedigheh Saeidi, Hamidreza Sanati, Hosseinali Basiri, Feridoun Noohi, Bahareh Rabbani, Majid Maleki
Clopidogrel is used in patients with coronary syndromes and at risk of thrombotic events or receiving percutaneous coronary intervention (PCI) for reducing heart attack and stroke. Here we present genotype and phenotype study of Iranian patients undergoing PCI treated with clopidogrel during a 6-month period of follow-up; common variants of CYP2C19, CYP3A5, CYP3A4, and ABCB1 genes were determined as well as the patients' cardiovascular outcomes to find out the effect of these variants individually and in combination...
May 18, 2018: Cardiovascular Toxicology
https://www.readbyqxmd.com/read/29769167/impact-of-sex-on-comparative-outcomes-of-bivalirudin-versus-unfractionated-heparin-in-patients-with-acute-coronary-syndromes-undergoing-invasive-management-a-pre-specified-analysis-of-the-matrix-trial
#6
Giuseppe Gargiulo, Bruno R da Costa, Enrico Frigoli, Cataldo Palmieri, Marco Stefano Nazzaro, Camillo Falcone, Armando Liso, Carlo Vigna, Fabio Abate, Marco Comeglio, Roberto Diletti, Gabriele Gabrielli, Emilio Di Lorenzo, Pietro Mazzarotto, Marco Zimarino, Claudio Moretti, Antonio Colombo, Carlo Penzo, Giampaolo Pasquetto, Salvatore Brugaletta, Fabio Ferrari, Gavino Casu, Vincenzo Guiducci, Antonio Dellavalle, Francesco Liistro, Ciro Mauro, Arnoud W J Van't Hof, Elmir Omerovic, Salvatore Curello, Jose Maria de la Torre Hernandez, Stefano De Servi, Flavia Belloni, Stephan Windecker, Marco Valgimigli
AIMS: To assess whether bivalirudin compared with unfractionated heparin (UFH) is associated with consistent outcomes in male and female patients with acute coronary syndrome (ACS) undergoing invasive management. METHODS AND RESULTS: In the MATRIX program,7213 patients were randomized to bivalirudin or UFH.Patients in bivalirudin group were subsequently assigned to receive or not to receive a post-PCI infusion.The 30-day coprimary outcomes were major adverse cardiovascular and cerebrovascular events (MACE),defined as death,myocardial infarction,or stroke,and net adverse clinical events (NACE),defined as MACE or major bleeding...
May 15, 2018: EuroIntervention
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
#7
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
#8
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/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
#9
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/29747915/prognostic-and-practical-validation-of-current-definitions-of-myocardial-infarction-associated-with-percutaneous-coronary-intervention
#10
Pierluigi Tricoci, L Kristin Newby, Robert M Clare, Sergio Leonardi, C Michael Gibson, Robert P Giugliano, Paul W Armstrong, Frans Van de Werf, Gilles Montalescot, David J Moliterno, Claes Held, Philip E Aylward, Lars Wallentin, Robert A Harrington, Eugene Braunwald, Kenneth W Mahaffey, Harvey D White
OBJECTIVES: In 13,038 patients with non-ST-segment elevation acute coronary syndrome undergoing index percutaneous coronary intervention (PCI) in the EARLY ACS (Early Glycoprotein IIb/IIIa Inhibition in Non-ST-Segment Elevation Acute Coronary Syndrome) and TRACER (Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome) trials, the relationship between PCI-related myocardial infarction (MI) and 1-year mortality was assessed. BACKGROUND: The definition of PCI-related MI is controversial...
May 14, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29743903/novel-predictors-of-outcome-after-coronary-angioplasty-with-rotational-atherectomy-not-only-low-ejection-fraction-and-clinical-parameters-matter
#11
Piotr Kübler, Wojciech Zimoch, Michał Kosowski, Brunon Tomasiewicz, Oscar Rakotoarison, Artur Telichowski, Krzysztof Reczuch
Introduction: Most established risk factors after rotational atherectomy (RA) of heavily fibro-calcified lesions are associated with patients' general risk and clinical related factors and are not specific for either coronary and culprit lesion anatomy or the RA procedure. Aim: To assess novel predictors of poor outcome after percutaneous coronary intervention using RA in an all-comers population. Material and methods: A total of 207 consecutive patients after RA were included in a single-center observational study...
2018: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
https://www.readbyqxmd.com/read/29742731/associations-of-common-variants-at-aldh2-gene-and-the-risk-of-stroke-in-patients-with-coronary-artery-diseases-undergoing-percutaneous-coronary-intervention
#12
Ling You, Chenze Li, Jinzhao Zhao, Dao Wen Wang, Wei Cui
Limited data are available about the role of common variants at the aldehyde dehydrogenase 2 gene (ALDH2) on the clinical outcome in Chinese patients with coronary heart disease (CHD) undergoing percutaneous coronary intervention (PCI). In the present study, a total of 1089 patients were consecutively enrolled from January 2012 and July 2013. Six common variants at ALDH2 gene, including rs2339840, rs4648328, rs4767939, rs11066028, rs16941669, and rs671, were selected to test the associations of those polymorphisms with the cardiovascular outcome in patients with CHD after PCI...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29740755/optimal-antithrombotic-treatment-of-patients-with-atrial-fibrillation-undergoing-percutaneous-coronary-intervention-triple-therapy-is-too-much
#13
REVIEW
M S Jacobs, R G Tieleman
Patients with atrial fibrillation who undergo a coronary intervention are eligible for both anticoagulation and (dual) antiplatelet therapy ((D)APT). An optimal balance has to be found to reduce the thromboembolic risk (i.e. stroke, systemic embolism and myocardial infarction) and to minimise the increased risk of bleeding with concomitant use of an anticoagulant and (D)APT. Owing to a lack of evidence, the guideline recommendations are predominantly based on expert opinion. Current evidence indicates that the combination of a non-vitamin K oral anticoagulant (NOAC) and clopidogrel is safer than vitamin-K oral antagonists plus DAPT, which increases the risk of bleeding, without clear advantages in regard to efficacy...
May 8, 2018: Netherlands Heart Journal
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
#14
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/29731024/the-potential-effects-of-new-stent-platforms-for-coronary-revascularization-in-patients-with-diabetes
#15
REVIEW
Gustavo S Guandalini, Sripal Bangalore
Coronary artery disease in patients with diabetes mellitus (DM) is characterized by extensive atherosclerosis, longer lesions, and diffuse distal disease. Consequently, these patients have worse outcomes after coronary revascularization, regardless of the modality used. Traditionally, coronary artery bypass grafting (CABG) has been regarded as more effective than percutaneous coronary intervention (PCI) in patients with DM, likely because of more complete revascularization and protection against disease progression in the bypass segment...
May 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29724974/comparison-of-the-transradial-and-transfemoral-approach-in-treatment-of-chronic-total-occlusions-with-similar-lesion-characteristics
#16
Mustafa Ahmet Huyut, Aylin Hatice Yamaç
OBJECTIVE: There is limited data on the efficacy and the safety of the transradial approach (TRA) for percutaneous coronary intervention (PCI) of chronic total occlusion (CTO), particularly in comparison with the transfemoral approach (TFA) in lesions with similar complexity. METHODS: We included 358 patients, who underwent elective CTO PCI between January 2012 and August 2017 and compared the radial (179 patients) and femoral (179 patients) approaches. The J-CTO score was similar in both groups (TRA, 2...
May 2018: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/29720092/post-percutaneous-coronary-interventional-adverse-cardiovascular-outcomes-and-bleeding-events-observed-with-prasugrel-versus-clopidogrel-direct-comparison-through-a-meta-analysis
#17
Pravesh Kumar Bundhun, Feng Huang
BACKGROUND: Due to limitations associated with clopidogrel following percutaneous coronary intervention (PCI), other newer oral anti-platelet agents are being studied. We aimed to systematically carry out a direct comparison of outcomes observed with prasugrel versus clopidogrel following PCI. METHODS: Common online searched databases (The Cochrane library, EMBASE, MEDLINE and Google scholar) were used to retrieve relevant publications. Primary endpoints were the adverse cardiovascular outcomes...
May 2, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29718158/management-of-left-main-disease-an-update
#18
Jean Fajadet, Davide Capodanno, Gregg W Stone
A severe narrowing of the left main coronary artery (LMCA), usually due to atherosclerosis, jeopardizes a large area of myocardium and increases the risk of major adverse cardiac events. Management strategies for LMCA disease include coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI). In general, PCI offers more rapid recovery and a lower early adverse event rate, whereas CABG offers a more durable procedure. The largest of six LMCA trials comparing PCI with CABG recently reported that in patients with site-reported low or intermediate anatomical complexity PCI was non-inferior to CABG with respect to the composite of death, stroke, or myocardial infarction at 3 years...
April 30, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29703065/association-of-obstructive-sleep-apnea-with-cardiovascular-outcomes-after-percutaneous-coronary-intervention-a-systematic-review-and-meta-analysis
#19
Xiao Wang, Jing-Yao Fan, Ying Zhang, Shao-Ping Nie, Yong-Xiang Wei
The relationship between obstructive sleep apnea (OSA) and adverse cardiovascular outcomes in patients undergoing percutaneous coronary intervention (PCI) remains unclear. We performed a systematic review and meta-analysis to assess the impact of OSA on subsequent cardiovascular events after PCI.We searched the PubMed, EMBASE, and Cochrane library from their inceptions to August 5, 2017. We included cohort studies that described the association between OSA (based on apnea-hypopnea index) and cardiovascular outcomes after PCI with stenting...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29699618/cerebrovascular-events-after-cardiovascular-procedures-risk-factors-recognition-and-prevention-strategies
#20
REVIEW
Jasneet K Devgun, Sajjad Gul, Divyanshu Mohananey, Brandon M Jones, M Shazam Hussain, Yash Jobanputra, Arnav Kumar, Lars G Svensson, E Murat Tuzcu, Samir R Kapadia
Stroke has long been a devastating complication of any cardiovascular procedure that unfavorably affects survival and quality of life. Over time, strategies have been developed to substantially reduce the incidence of stroke after traditional cardiovascular procedures such as coronary artery bypass grafting, isolated valve surgery, and carotid endarterectomy. Subsequently, with the advent of minimally invasive technologies including percutaneous coronary intervention, carotid artery stenting, and transcatheter valve therapies, operators were faced with a new host of procedural risk factors, and efforts again turned toward identifying novel ways to reduce the risk of stroke...
May 1, 2018: Journal of the American College of Cardiology
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