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GMG Interventional

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440 papers 25 to 100 followers Papers related to PCI therapy for CAD
By Gregory Gustafson Interventional Cardiologist
https://www.readbyqxmd.com/read/29097450/clinical-outcomes-and-cost-effectiveness-of-fractional-flow-reserve-guided-percutaneous-coronary-intervention-in-patients-with-stable-coronary-artery-disease-three-year-follow-up-of-the-fame-2-trial-fractional-flow-reserve-versus-angiography-for-multivessel
#1
William F Fearon, Takeshi Nishi, Bernard De Bruyne, Derek B Boothroyd, Emanuele Barbato, Pim Tonino, Peter Jüni, Nico H J Pijls, Mark A Hlatky
BACKGROUND : Previous studies found that percutaneous coronary intervention (PCI) does not improve outcome compared with medical therapy (MT) in patients with stable coronary artery disease, but PCI was guided by angiography alone. FAME 2 trial (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation) compared PCI guided by fractional flow reserve with best MT in patients with stable coronary artery disease to assess clinical outcomes and cost-effectiveness. METHODS : A total of 888 patients with stable single-vessel or multivessel coronary artery disease with reduced fractional flow reserve were randomly assigned to PCI plus MT (n=447) or MT alone (n=441)...
November 2, 2017: Circulation
https://www.readbyqxmd.com/read/29146627/single-session-versus-staged-procedures-for-elective-multivessel-percutaneous-coronary-intervention
#2
Toshiaki Toyota, Takeshi Morimoto, Hiroki Shiomi, Kyohei Yamaji, Kenji Ando, Koh Ono, Satoshi Shizuta, Naritatsu Saito, Takao Kato, Shuichiro Kaji, Yutaka Furukawa, Yoshihisa Nakagawa, Kazushige Kadota, Minoru Horie, Takeshi Kimura
OBJECTIVES: To clarify the effect of single-session multivessel percutaneous coronary intervention (PCI) strategy relative to the staged multivessel strategy on clinical outcomes in patients with stable coronary artery disease (CAD) or non-ST-elevation acute coronary syndrome. METHODS: In the Coronary REvascularisation Demonstrating Outcome Study in Kyoto PCI/coronary artery bypass grafting registry cohort-2, there were 2018 patients who underwent elective multivessel PCI...
November 16, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29130810/outcomes-after-angiography-with-sodium-bicarbonate-and-acetylcysteine
#3
Steven D Weisbord, Martin Gallagher, Hani Jneid, Santiago Garcia, Alan Cass, Soe-Soe Thwin, Todd A Conner, Glenn M Chertow, Deepak L Bhatt, Kendrick Shunk, Chirag R Parikh, Edward O McFalls, Mary Brophy, Ryan Ferguson, Hongsheng Wu, Maria Androsenko, John Myles, James Kaufman, Paul M Palevsky
Background Intravenous sodium bicarbonate and oral acetylcysteine are widely used to prevent acute kidney injury and associated adverse outcomes after angiography without definitive evidence of their efficacy. Methods Using a 2-by-2 factorial design, we randomly assigned 5177 patients at high risk for renal complications who were scheduled for angiography to receive intravenous 1.26% sodium bicarbonate or intravenous 0.9% sodium chloride and 5 days of oral acetylcysteine or oral placebo; of these patients, 4993 were included in the modified intention-to-treat analysis...
November 12, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29130567/treatment-strategies-in-coronary-microvascular-dysfunction-a-systematic-review-of-interventional-studies
#4
Hannah E Suhrs, Marie M Michelsen, Eva Prescott
Coronary microvascular dysfunction has been associated with a wide spectrum of diseases and conditions, and it has proven to be a strong prognostic marker of morbidity and mortality. Despite increased attention guideline-based treatment recommendations are lacking. We performed a systematic review of pharmacological and non-pharmacological interventions to improve coronary perfusion, assessed by intracoronary Doppler, transthoracic Doppler echocardiography, positron emission tomography, cardiac magnetic resonance imaging, transthoracic contrast perfusion echocardiography and dilution techniques...
November 11, 2017: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
https://www.readbyqxmd.com/read/29083953/pci-strategies-in-patients-with-acute-myocardial-infarction-and-cardiogenic-shock
#5
RANDOMIZED CONTROLLED TRIAL
Holger Thiele, Ibrahim Akin, Marcus Sandri, Georg Fuernau, Suzanne de Waha, Roza Meyer-Saraei, Peter Nordbeck, Tobias Geisler, Ulf Landmesser, Carsten Skurk, Andreas Fach, Harald Lapp, Jan J Piek, Marko Noc, Tomaž Goslar, Stephan B Felix, Lars S Maier, Janina Stepinska, Keith Oldroyd, Pranas Serpytis, Gilles Montalescot, Olivier Barthelemy, Kurt Huber, Stephan Windecker, Stefano Savonitto, Patrizia Torremante, Christiaan Vrints, Steffen Schneider, Steffen Desch, Uwe Zeymer
BACKGROUND: In patients who have acute myocardial infarction with cardiogenic shock, early revascularization of the culprit artery by means of percutaneous coronary intervention (PCI) improves outcomes. However, the majority of patients with cardiogenic shock have multivessel disease, and whether PCI should be performed immediately for stenoses in nonculprit arteries is controversial. METHODS: In this multicenter trial, we randomly assigned 706 patients who had multivessel disease, acute myocardial infarction, and cardiogenic shock to one of two initial revascularization strategies: either PCI of the culprit lesion only, with the option of staged revascularization of nonculprit lesions, or immediate multivessel PCI...
December 21, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28007201/incidence-characteristics-predictors-and%C3%A2-outcomes-of-repeat-revascularization-after-percutaneous-coronary-intervention-and-coronary-artery-bypass-grafting-the-syntax-trial-at-5-years
#6
RANDOMIZED CONTROLLED TRIAL
Catalina A Parasca, Stuart J Head, Milan Milojevic, Michael J Mack, Patrick W Serruys, Marie-Claude Morice, Friedrich W Mohr, Ted E Feldman, Antonio Colombo, Keith D Dawkins, David R Holmes, Pieter A Kappetein
OBJECTIVES: The study sought to determine the incidence, predictors, characteristics, and outcomes of repeat revascularization during 5-year follow-up of the SYNTAX (Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery) trial. BACKGROUND: Limited in-depth long-term data on repeat revascularization are available from randomized trials comparing percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). METHODS: Incidence and timing of repeat revascularization and its relation to the long-term composite safety endpoint of death, stroke, and myocardial infarction were analyzed in the SYNTAX trial (n = 1,800) using Kaplan-Meier analysis...
December 26, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28057282/culprit-vessel-versus-multivessel-versus-in-hospital-staged-intervention-for-patients-with-st-segment-elevation-myocardial%C3%A2-infarction-and-multivessel-disease-stratified-analyses-in-high-risk-patient-groups-and-anatomic%C3%A2-subsets-of-nonculprit-disease
#7
COMPARATIVE STUDY
M Bilal Iqbal, Imad J Nadra, Lillian Ding, Anthony Fung, Eve Aymong, Albert W Chan, Steven Hodge, Anthony Della Siega, Simon D Robinson
OBJECTIVES: This study evaluated revascularization strategies for patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease. BACKGROUND: In patients with STEMI and multivessel disease, it is unclear whether multivessel intervention (MVI), culprit vessel intervention (CVI) only (CVI-O) or CVI with staged revascularization (CVI-S) is associated with improved outcomes. Whether MVI at primary percutaneous coronary intervention may benefit specific patient groups is unclear...
January 9, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28606950/pathophysiology-of-takotsubo-syndrome
#8
REVIEW
Francesco Pelliccia, Juan Carlos Kaski, Filippo Crea, Paolo G Camici
Originally described by Japanese authors in the 1990s, Takotsubo syndrome (TTS) generally presents as an acute myocardial infarction characterized by severe left ventricular dysfunction. TTS, however, differs from an acute coronary syndrome because patients have generally a normal coronary angiogram and left ventricular dysfunction, which extends beyond the territory subtended by a single coronary artery and recovers within days or weeks. The prognosis was initially thought to be benign, but subsequent studies have demonstrated that both short-term mortality and long-term mortality are higher than previously recognized...
June 13, 2017: Circulation
https://www.readbyqxmd.com/read/28622945/safety-of-intracoronary-provocative-testing-for-the-diagnosis-of-coronary-artery-spasm
#9
Giuseppe Ciliberti, Sreenivasa Rao Kondapally Seshasai, Giuseppe Ambrosio, Juan Carlos Kaski
AIMS: Systematic review of literature to evaluate safety of intracoronary (i.c.) pharmacologic testing with acetylcholine (ACh), or ergonovine (ERGO), to induce coronary artery spasm. METHODS AND RESULTS: Review of all relevant publications using MEDLINE and EMBASE databases yielded 10 publications, totalling 9,444 patients. Prevalence of provoked spasm varied from 2.3% to 54.7% of patients tested in the selected studies. The wide variability in prevalence was due to heterogeneity of study populations and provocation protocols...
October 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28864442/integrated-non-invasive-physiological-assessment-of-coronary-circulatory-function-and-impact-on-cardiovascular-mortality-in-patients-with-stable-coronary-artery-disease
#10
Ankur Gupta, Viviany R Taqueti, Tim P van de Hoef, Navkaranbir S Bajaj, Paco E Bravo, Venkatesh L Murthy, Michael T Osborne, Sara B Seidelmann, Tomas S Vita, Courtney F Bibbo, Meagan Harrington, Jon Hainer, Ornella Rimoldi, Sharmila Dorbala, Deepak L Bhatt, Ron Blankstein, Paolo G Camici, Marcelo F Di Carli
Background -It is suggested that the integration of maximal myocardial blood flow (MBF) and coronary flow reserve (CFR), termed coronary flow capacity, allows comprehensive evaluation of patients with known or suspected stable coronary artery disease. As management decisions are predicated on clinical risk, we sought to determine the independent and integrated value of maximal MBF and CFR for predicting cardiovascular death. Methods -MBF and CFR were quantified in 4,029 consecutive patients (median age 66 years, 50...
September 1, 2017: Circulation
https://www.readbyqxmd.com/read/28007133/high-sensitivity-cardiac-troponin-statin%C3%A2-therapy-and-risk-of-coronary%C3%A2-heart%C3%A2-disease
#11
RANDOMIZED CONTROLLED TRIAL
Ian Ford, Anoop S V Shah, Ruiqi Zhang, David A McAllister, Fiona E Strachan, Muriel Caslake, David E Newby, Chris J Packard, Nicholas L Mills
BACKGROUND: Cardiac troponin is an independent predictor of cardiovascular mortality in individuals without symptoms or signs of cardiovascular disease. The mechanisms for this association are uncertain, and a role for troponin testing in the prevention of coronary heart disease has yet to be established. OBJECTIVES: This study sought to determine whether troponin concentration could predict coronary events, be modified by statins, and reflect response to therapy in a primary prevention population...
December 27, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28618904/antiplatelet-and-antithrombotic-treatment-for-secondary-prevention-in-ischaemic-heart-disease
#12
Maddalena Lettino, Sergio Leonardi, Elia De Maria, Sigrun Halvorsen
Platelets play a key role in the pathogenesis of acute coronary syndromes and this is why antiplatelet drugs are essential, both in the acute phase and in the long-term follow-up in preventing recurrent myocardial infarction, stroke and cardiovascular death. Aspirin is the most used agent and still remains the first choice drug for lifelong administration in secondary prevention after myocardial infarction. Dual antiplatelet therapy, targeting more than one pathway of platelet activation, has significantly improved the outcome of patients with acute coronary syndromes despite an increased risk of bleeding complications...
June 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28701487/differential-event-rates-and-independent-predictors-of-long-term-major-cardiovascular-events-and-death-in-5795-patients-with-unprotected-left-main-coronary-artery-disease-treated-with-stents-bypass-surgery-or-medication-insights-from-a-large-international-multicenter
#13
Se Hun Kang, Jung-Min Ahn, Cheol Hyun Lee, Pil Hyung Lee, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Duk-Woo Park, Seung-Jung Park
BACKGROUND: Identifying predictive factors for major cardiovascular events and death in patients with unprotected left main coronary artery disease is of great clinical value for risk stratification and possible guidance for tailored preventive strategies. METHODS AND RESULTS: The Interventional Research Incorporation Society-Left MAIN Revascularization registry included 5795 patients with unprotected left main coronary artery disease (percutaneous coronary intervention, n=2850; coronary-artery bypass grafting, n=2337; medication alone, n=608)...
July 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28639567/spontaneous-coronary-artery-dissection-as-a-cause-of-acute-myocardial-infarction-in-young-female-population-a-single-center-study
#14
Pei-Na Meng, Chen Xu, Wei You, Zhi-Ming Wu, Du-Jiang Xie, Hang Zhang, Chang Pan, Fei Ye
BACKGROUND: Spontaneous coronary artery dissection (SCAD) is a nonatherosclerotic but a rare and extremely dangerous clinical entity, it has a high prevalence in young female population with acute myocardial infarction (AMI). The previous reports were restricted to other countries' population, but rare in China. Hence, this study aimed to focus on the characteristics of SCAD as a cause of young female AMI population in Jiangsu, China. METHODS: This study enrolled young female AMI patients aged ≤50 years who underwent coronary angiography (CAG) and intracoronary imaging in our center between January 2013 and December 2016...
July 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28317428/fractional-flow-reserve-guided-multivessel-angioplasty-in-myocardial-infarction
#15
RANDOMIZED CONTROLLED TRIAL
Pieter C Smits, Mohamed Abdel-Wahab, Franz-Josef Neumann, Bianca M Boxma-de Klerk, Ketil Lunde, Carl E Schotborgh, Zsolt Piroth, David Horak, Adrian Wlodarczak, Paul J Ong, Rainer Hambrecht, Oskar Angerås, Gert Richardt, Elmir Omerovic
BACKGROUND: In patients with ST-segment elevation myocardial infarction (STEMI), the use of percutaneous coronary intervention (PCI) to restore blood flow in an infarct-related coronary artery improves outcomes. The use of PCI in non-infarct-related coronary arteries remains controversial. METHODS: We randomly assigned 885 patients with STEMI and multivessel disease who had undergone primary PCI of an infarct-related coronary artery in a 1:2 ratio to undergo complete revascularization of non-infarct-related coronary arteries guided by fractional flow reserve (FFR) (295 patients) or to undergo no revascularization of non-infarct-related coronary arteries (590 patients)...
March 30, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28628711/antiplatelet-therapy-in-patients-with-coronary-stents-undergoing-elective-noncardiac-surgery-continue-stop-or-something-in-between
#16
Christopher P Childers, Melinda Maggard-Gibbons, Paul G Shekelle
No abstract text is available yet for this article.
July 11, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28530674/fifteen-new-risk-loci-for-coronary-artery-disease-highlight-arterial-wall-specific-mechanisms
#17
Joanna M M Howson, Wei Zhao, Daniel R Barnes, Weang-Kee Ho, Robin Young, Dirk S Paul, Lindsay L Waite, Daniel F Freitag, Eric B Fauman, Elias L Salfati, Benjamin B Sun, John D Eicher, Andrew D Johnson, Wayne H H Sheu, Sune F Nielsen, Wei-Yu Lin, Praveen Surendran, Anders Malarstig, Jemma B Wilk, Anne Tybjærg-Hansen, Katrine L Rasmussen, Pia R Kamstrup, Panos Deloukas, Jeanette Erdmann, Sekar Kathiresan, Nilesh J Samani, Heribert Schunkert, Hugh Watkins, Ron Do, Daniel J Rader, Julie A Johnson, Stanley L Hazen, Arshed A Quyyumi, John A Spertus, Carl J Pepine, Nora Franceschini, Anne Justice, Alex P Reiner, Steven Buyske, Lucia A Hindorff, Cara L Carty, Kari E North, Charles Kooperberg, Eric Boerwinkle, Kristin Young, Mariaelisa Graff, Ulrike Peters, Devin Absher, Chao A Hsiung, Wen-Jane Lee, Kent D Taylor, Ying-Hsiang Chen, I-Te Lee, Xiuqing Guo, Ren-Hua Chung, Yi-Jen Hung, Jerome I Rotter, Jyh-Ming J Juang, Thomas Quertermous, Tzung-Dau Wang, Asif Rasheed, Philippe Frossard, Dewan S Alam, Abdulla Al Shafi Majumder, Emanuele Di Angelantonio, Rajiv Chowdhury, Yii-Der Ida Chen, Børge G Nordestgaard, Themistocles L Assimes, John Danesh, Adam S Butterworth, Danish Saleheen
Coronary artery disease (CAD) is a leading cause of morbidity and mortality worldwide. Although 58 genomic regions have been associated with CAD thus far, most of the heritability is unexplained, indicating that additional susceptibility loci await identification. An efficient discovery strategy may be larger-scale evaluation of promising associations suggested by genome-wide association studies (GWAS). Hence, we genotyped 56,309 participants using a targeted gene array derived from earlier GWAS results and performed meta-analysis of results with 194,427 participants previously genotyped, totaling 88,192 CAD cases and 162,544 controls...
July 2017: Nature Genetics
https://www.readbyqxmd.com/read/28622955/age-specific-risks-severity-time-course-and-outcome-of-bleeding-on-long-term-antiplatelet-treatment-after-vascular-events-a-population-based-cohort-study
#18
Linxin Li, Olivia C Geraghty, Ziyah Mehta, Peter M Rothwell
BACKGROUND: Lifelong antiplatelet treatment is recommended after ischaemic vascular events, on the basis of trials done mainly in patients younger than 75 years. Upper gastrointestinal bleeding is a serious complication, but had low case fatality in trials of aspirin and is not generally thought to cause long-term disability. Consequently, although co-prescription of proton-pump inhibitors (PPIs) reduces upper gastrointestinal bleeds by 70-90%, uptake is low and guidelines are conflicting...
July 29, 2017: Lancet
https://www.readbyqxmd.com/read/28605530/transapical-implantation-of-a-transcatheter-aortic-valve-prosthesis-into-a-mitral-annuloplasty-ring-guided-by-real-time-three-dimensional-cardiac-computed-tomography-fluoroscopy-fusion-imaging
#19
Eberhard Schulz, Alexander Tamm, Walter Kasper-König, Andres Beiras-Fernandez, Christian Friedrich Vahl, Thomas Münzel, Ralph Stephan von Bardeleben
No abstract text is available yet for this article.
June 12, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28449776/incident-myocardial-infarction-and-very-late-stent-thrombosis-in-outpatients-with%C3%A2-stable-coronary-artery-disease
#20
MULTICENTER STUDY
Gilles Lemesle, Olivier Tricot, Thibaud Meurice, Robert Lallemant, Maxence Delomez, Octave Equine, Nicolas Lamblin, Christophe Bauters
BACKGROUND: Current data are lacking for incidence, correlates, and prognosis associated with incident myocardial infarction (MI) in patients with stable coronary artery disease (CAD). Furthermore, the contribution of very late stent thrombosis (VLST) to these events remains poorly understood. OBJECTIVES: This study aimed to analyze the residual risk of MI, together with relevant associated factors, and related mortality in stable CAD outpatients. METHODS: The multicenter CORONOR (Suivi d'une cohorte de patients COROnariens stables en region NORd-Pas-de-Calais) study enrolled 4,184 unselected outpatients with stable CAD (i...
May 2, 2017: Journal of the American College of Cardiology
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