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GMG Interventional

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410 papers 25 to 100 followers Papers related to PCI therapy for CAD
By Gregory Gustafson Interventional Cardiologist
https://www.readbyqxmd.com/read/27785906/functional-assessment-of-anomalous-right-coronary-artery-using-fractional-flow-reserve-an-innovative-modality-to-guide-patient-management
#1
Amber N Boler, Anthony A Hilliard, Brent M Gordon
Anomalous origin of a coronary artery is a recognized cause of sudden cardiac death (SCD). To date, there is no standard test to predict which patients are at increased risk for SCD. Fractional flow reserve (FFR) is an invasive technique used to qualify focal obstructive coronary lesions. We present a case where FFR was used to guide therapy in a young patient with anomalous right coronary artery (ARCA) when standard noninvasive testing showed ischemic discrepancy. © 2016 Wiley Periodicals, Inc.
February 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27822931/clinical-outcomes-in-patients-with-deferred-coronary-lesions-according-to-disease-severity-assessed-by-fractional-flow-reserve
#2
Ki Bum Won, Chang Wook Nam, Yun Kyeong Cho, Hyuck Jun Yoon, Hyoung Seob Park, Hyungseop Kim, Seongwook Han, Seung Ho Hur, Yoon Nyun Kim, Sang Hyun Park, Jung Kyu Han, Bon Kwon Koo, Hyo Soo Kim, Joon Hyung Doh, Sung Yun Lee, Hyoung Mo Yang, Hong Seok Lim, Myeong Ho Yoon, Seung Jea Tahk, Kwon Bae Kim
Data on the clinical outcomes in deferred coronary lesions according to functional severity have been limited. This study evaluated the clinical outcomes of deferred lesions according to fractional flow reserve (FFR) grade using Korean FFR registry data. Among 1,294 patients and 1,628 lesions in Korean FFR registry, 665 patients with 781 deferred lesions were included in this study. All participants were consecutively categorized into 4 groups according to FFR; group 1: ≥ 0.96 (n = 56), group 2: 0.86-0.95 (n = 330), group 3: 0...
December 2016: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27884241/a-prospective-natural-history-study-of%C3%A2-coronary-atherosclerosis-using-fractional-flow-reserve
#3
Emanuele Barbato, Gabor G Toth, Nils P Johnson, Nico H J Pijls, William F Fearon, Pim A L Tonino, Nick Curzen, Zsolt Piroth, Gilles Rioufol, Peter Jüni, Bernard De Bruyne
BACKGROUND: In patients with coronary artery disease, clinical outcome depends on the extent of reversible myocardial ischemia. Whether the outcome also depends on the severity of the stenosis as determined by fractional flow reserve (FFR) remains unknown. OBJECTIVES: This study sought to investigate the relationship between FFR values and vessel-related clinical outcome. METHODS: We prospectively studied major adverse cardiovascular events (MACE) at 2 years in 607 patients in whom all stenoses were assessed by FFR and who were treated with medical therapy alone...
November 29, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27969970/tct-597-why-does-thin-cap-fibroatheroma-cluster-in-the-proximal-segment-in-left-anterior-coronary-artery-but-are-evenly-distributed-throughout-the-entire-right-coronary-artery-results-from-computational-fluid-dynamics-simulation-by-ct-ffr
#4
Takayoshi Toba, Gilwoo Choi, Kenzo Uzu, Toshiro Shinke, Bon-Kwon Koo, Charles Taylor, Hiromasa Otake
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27973333/reliability-of-physiological-assessment-of-coronary-stenosis-severity-using-intracoronary-pressure-techniques-a-comprehensive-analysis-from-a-large-cohort-of-consecutive-intermediate-coronary-lesions
#5
Fernando Rivero, Javier Cuesta, Teresa Bastante, Amparo Benedicto, Cristina Fernández-Pérez, Paula Antuña, Marcos García-Guimaraes, Fernando Alfonso
AIM: We sought to assess the reliability of the most frequently used intracoronary physiologic indexes (including intravenous adenosine-FFR [IV- FFR], intracoronary low-dose-adenosine FFR [IC-LD-FFR], intracoronary high- dose-adenosine FFR [IC-HD-FFR], Pd/Pa and iFR). We also sought to analyze factors affecting their reproducibility in a real world patient population. METHODS AND RESULTS: A total of 91 lesions in 86 consecutive patients were included. Measurements of all physiological indexes were repeated within a systematic standardized prospective protocol...
December 15, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27979031/clinical-value-of-post-percutaneous-coronary-intervention-fractional-flow-reserve-value-a-systematic-review-and-meta-analysis
#6
REVIEW
Goran Rimac, William F Fearon, Bernard De Bruyne, Fumiaki Ikeno, Hitoshi Matsuo, Zsolt Piroth, Olivier Costerousse, Olivier F Bertrand
BACKGROUND: Fractional flow reserve (FFR) prior to percutaneous coronary intervention (PCI) is useful to guide treatment. Whether post-PCI FFR assessment might have clinical impact is controversial. The aim of this study is to evaluate the range of post-PCI FFR values and analyze the relationship between post-PCI FFR and clinical outcomes. METHODS: We systematically searched the PubMed, EMBASE, and Cochrane Library databases with cross-referencing of articles reporting post-PCI FFR and correlating post-PCI FFR values and clinical outcomes...
January 2017: American Heart Journal
https://www.readbyqxmd.com/read/27982159/comparative-study-between-perfusion-changes-and-positive-findings-on-coronary-flow-reserve
#7
Costantino Roberto Frack Costantini, Jose Antonio Ramires, Costantino Ortiz Costantini, Marcos Antonio Denk, Sergio Gustavo Tarbine, Marcelo de Freitas Santos, Daniel Aníbal Zanuttini, Carmen Weigert Silveira, Admar Moraes de Souza, Rafael Michel de Macedo
BACKGROUND: Functional assessment of coronary artery obstruction is used in cardiology practice to correlate anatomic obstructions with flow decrease. Among such assessments, the study of the coronary fractional flow reserve (FFR) has become the most widely used. OBJECTIVE: To evaluate the correlation between FFR and findings of ischemia obtained by noninvasive methods including stress echocardiography and nuclear medicine and the presence of critical coronary artery obstruction...
January 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/27998839/ffr-result-post-pci-is-suboptimal-in-long-diffuse-coronary-artery-disease
#8
Arvydas Baranauskas, Aaron Peace, Aleksandras Kibarskis, Joanne Shannon, Vytautas Abraitis, Vilhelmas Bajoras, Valdas Bilkis, Audrius Aidietis, Aleksandras Laucevicius, Giedrius Davidavicius
AIMS: The aim of this study was to evaluate the functional result immediately post PCI and at nine-month follow-up, and to ascertain how often a functionally optimal result of >0.95 can be achieved in long coronary lesions treated with long second- or newer-generation DES. METHODS AND RESULTS: Patients receiving DES measuring ≥30 mm with FFR value ≤0.8 were included in the study. Stent length was defined as long (30 to 49 mm; L-DES) and ultra-long (≥50 mm; UL-DES)...
December 20, 2016: EuroIntervention
https://www.readbyqxmd.com/read/28025191/fractional-flow-reserve-to-guide-and-to-assess-coronary-artery-bypass-grafting
#9
REVIEW
Mariano Pellicano, Bernard De Bruyne, Gabor G Toth, Filip Casselman, William Wijns, Emanuele Barbato
The aim of this review is to highlight the role of invasive functional evaluation in patients in whom coronary artery bypass graft (CABG) is indicated, and to examine the clinical evidence available in favour of fractional flow reserve (FFR) adoption in these patients, outline appropriate use, as well as point out potential pitfalls. FFR after CABG will also be reviewed, highlighting its correct interpretation and adoption when applied to both native coronary arteries and bypass grafts. Practice European guidelines support the use of FFR to complement coronary angiography with the highest degree of recommendation (Class IA) for the assessment of coronary stenosis before undertaking myocardial revascularization when previous non-invasive functional evaluation is unavailable or not conclusive...
December 23, 2016: European Heart Journal
https://www.readbyqxmd.com/read/28040284/outcome-of-coronary-lesions-with-deferred-revascularization-due-to-negative-fractional-flow-reserve-in-subjects-with-acute-coronary-syndrome
#10
Andrea Picchi, Antonio Maria Leone, Filippo Zilio, Enrico Cerrato, Fabrizio D'Ascenzo, Massimo Fineschi, Stefano Rigattieri, Marco Ferlini, Matteo Cameli, Paolo Calabria, Alberto Cresti, Ugo Limbruno
OBJECTIVE: Revascularization of functionally non-significant stenoses in patients with stable coronary artery disease can safely be deferred as rate of adverse cardiovascular events is low. It is not clear whether fractional flow reserve (FFR) is just as accurate in acute coronary syndromes (ACS). The aim of this study is to assess the outcome of coronary lesions whose revascularization was deferred based on negative FFR values in subjects with ACS. METHODS: Patients with acute coronary syndrome and showing at least one coronary stenosis whose revascularization was deferred based on FFR value >0...
March 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28134124/the-impact-of-microvascular-resistance-on-the-discordance-between-anatomical-and-functional-evaluations-of-intermediate-coronary-disease
#11
Kyoung-Woo Seo, Hong-Seok Lim, Myeong-Ho Yoon, Seung-Jea Tahk, So-Yeon Choi, Byoung-Joo Choi, Hyoung-Mo Yang, Joon-Han Shin, Gyo-Seung Hwang, Jin-Sun Park, XiongJie Jin
AIMS: In intermediate coronary artery disease, discordance between anatomical and functional assessments persists and the diagnostic accuracy of an anatomical evaluation is not satisfactory for determining functional significance. We evaluated the impact of microvascular resistance on 'anatomical-functional discordance'. METHODS AND RESULTS: In 97 intermediate coronary lesions of 83 patients, minimum lumen area (MLA), fractional flow reserve (FFR), ∆(Pd/Pa-FFR), and hyperaemic microvascular resistance index (hMVRI) were measured using intravascular ultrasound and intracoronary dual pressure and Doppler sensor-tipped guidewire...
January 31, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28228427/myocardial-infarction-risk-after-discontinuation-of-thienopyridine-therapy-in-the-randomized-dapt-study
#12
Ada C Stefanescu Schmidt, Dean J Kereiakes, Donald E Cutlip, Robert W Yeh, Ralph B D'Agostino, Joseph M Massaro, Wen-Hua Hsieh, Laura Mauri
Background -Thienopyridine plus aspirin beyond one year after coronary stenting (PCI) reduces myocardial infarction (MI) risk and increases bleeding risk compared with aspirin alone. The hazard associated with late thienopyridine discontinuation and risk factors for MI after discontinuation are poorly defined. Methods -In the Dual Antiplatelet Therapy (DAPT) Study, after PCI and 12 months of thienopyridine (clopidogrel or prasugrel) plus aspirin, eligible patients remained on aspirin and were randomized to continued thienopyridine vs...
February 22, 2017: Circulation
https://www.readbyqxmd.com/read/27797298/treatment-of-left-main-coronary-artery-disease
#13
LETTER
Eugene Braunwald
No abstract text is available yet for this article.
December 8, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27609250/survival-after-varying-revascularization-strategies-in-patients-with-st-segment-elevation-myocardial-infarction-and-multivessel-coronary-artery-disease-a-pairwise-and-network-meta-analysis
#14
Giuseppe Tarantini, Gianpiero D'Amico, Sorin J Brener, Paola Tellaroli, Marco Basile, Alessandro Schiavo, Marco Mojoli, Chiara Fraccaro, Alfredo Marchese, Giuseppe Musumeci, Gregg W Stone
OBJECTIVES: The authors conducted a systematic pairwise and network meta-analysis to assess optimal treatment strategies in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease (MV-CAD) undergoing primary percutaneous coronary intervention (PCI). BACKGROUND: Patients with STEMI and MV-CAD have a worse prognosis than those with single-vessel CAD. The optimal revascularization strategy for these patients is uncertain...
September 12, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27840336/ticagrelor-compared-with-clopidogrel-in-patients-with-prior-lower-extremity-revascularization-for-peripheral-artery-disease
#15
W Schuyler Jones, Iris Baumgartner, William R Hiatt, Gretchen Heizer, Michael S Conte, Christopher J White, Jeffrey S Berger, Peter Held, Brian G Katona, Kenneth W Mahaffey, Lars Norgren, Juuso Blomster, Marcus Millegård, Craig Reist, Manesh R Patel, F Gerry R Fowkes
BACKGROUND: In patients with symptomatic peripheral artery disease with a history of limb revascularization, the optimal antithrombotic regimen for long-term management is unknown. METHODS: The EUCLID trial (Examining Use of Ticagrelor In PAD) randomized 13 885 patients with peripheral artery disease to treatment with ticagrelor 90 mg twice daily or clopidogrel 75 mg daily. Patients were enrolled based on an abnormal ankle-brachial index ≤0.80 or a previous lower extremity revascularization...
January 17, 2017: Circulation
https://www.readbyqxmd.com/read/27821423/where-is-the-culprit-lesion
#16
Antoni Bayés de Luna, Miguel Fiol-Sala
No abstract text is available yet for this article.
November 8, 2016: Circulation
https://www.readbyqxmd.com/read/27771985/five-year-outcomes-after-off-pump-or-on-pump-coronary-artery-bypass-grafting
#17
RANDOMIZED CONTROLLED TRIAL
André Lamy, P J Devereaux, Dorairaj Prabhakaran, David P Taggart, Shengshou Hu, Zbynek Straka, Leopoldo S Piegas, Alvaro Avezum, Ahmet R Akar, Fernando Lanas Zanetti, Anil R Jain, Nicolas Noiseux, Chandrasekar Padmanabhan, Juan-Carlos Bahamondes, Richard J Novick, Liang Tao, Pablo A Olavegogeascoechea, Balram Airan, Toomas-Andres Sulling, Richard P Whitlock, Yongning Ou, Peggy Gao, Shirley Pettit, Salim Yusuf
Background We previously reported that there was no significant difference at 30 days or at 1 year in the rate of the composite outcome of death, stroke, myocardial infarction, or renal failure between patients who underwent coronary-artery bypass grafting (CABG) performed with a beating-heart technique (off-pump) and those who underwent CABG performed with cardiopulmonary bypass (on-pump). We now report the results at 5 years (the end of the trial). Methods A total of 4752 patients (from 19 countries) who had coronary artery disease were randomly assigned to undergo off-pump or on-pump CABG...
December 15, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27663770/association-of-cyp2c19-variants-and-epoxyeicosatrienoic-acids-on-patients-with-microvascular-angina
#18
Tomonori Akasaka, Daisuke Sueta, Yuichiro Arima, Noriaki Tabata, Seiji Takashio, Yasuhiro Izumiya, Eiichiro Yamamoto, Megumi Yamamuro, Kenichi Tsujita, Sunao Kojima, Koichi Kaikita, Ayami Kajiwara, Kazunori Morita, Kentaro Oniki, Junji Saruwatari, Kazuko Nakagawa, Yasuhiro Ogata, Kunihiko Matsui, Seiji Hokimoto
Categorization as a cytochrome P450 (CYP) 2C19 poor metabolizer (PM) is reported to be an independent risk factor for cardiovascular disease. Epoxyeicosatrienoic acids (EETs) are metabolites of arachidonic acid by CYP2C19 epoxygenases and anti-inflammatory properties, especially in microvascular tissues. We examined the association of CYP2C19 polymorphisms and EETs on microvascular angina (MVA) caused by coronary microvascular dysfunction. We examined CYP2C19 genotypes in patients with MVA (n = 71) and healthy subjects as control (n = 71)...
December 1, 2016: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/27694191/plasma-concentration-of-serotonin-is-a-novel-biomarker-for-coronary-microvascular-dysfunction-in-patients-with-suspected-angina-and-unobstructive-coronary-arteries
#19
Yuji Odaka, Jun Takahashi, Ryuji Tsuburaya, Kensuke Nishimiya, Kiyotaka Hao, Yasuharu Matsumoto, Kenta Ito, Yasuhiko Sakata, Satoshi Miyata, Daisuke Manita, Yuji Hirowatari, Hiroaki Shimokawa
AIMS: Although the importance of coronary microvascular dysfunction (CMD) has been emerging, reliable biomarkers for CMD remain to be developed. We examined the potential usefulness of plasma concentration of serotonin to diagnose CMD in patients with suspected angina and unobstructive coronary arteries. METHODS AND RESULTS: We enrolled 198 consecutive patients (M/F 116/82, 60.2 ± 13.3 years old) who underwent acetylcholine provocation test and measured plasma serotonin concentration...
October 2, 2016: European Heart Journal
https://www.readbyqxmd.com/read/26981290/tender-endothelium-syndrome-combination-of-hypotension-bradycardia-contrast-induced-chest-pain-and-microvascular-angina
#20
Shivesh Goberdhan, Soon Kwang Chiew, Jaffer Syed
Hypotension, bradycardia, and contrast induced chest pain are potential complications of cardiac catheterization and coronary angiography. Catheter-induced coronary spasm has been occasionally demonstrated, but its relationship to spontaneous coronary spasm is unclear. We describe a 64-year-old female who underwent coronary artery bypass surgery in 1998 on the basis of an angiographic diagnosis of severe left main disease, who recently presented with increasingly frequent typical angina. Repeat coronary angiography was immediately complicated by severe chest pain, hypotension, and bradycardia but demonstrated only mild disease of the left main artery and entire coronary tree with complete occlusion of her prior grafts...
2016: Case Reports in Cardiology
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