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GMG Interventional

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419 papers 25 to 100 followers Papers related to PCI therapy for CAD
By Gregory Gustafson Interventional Cardiologist
https://www.readbyqxmd.com/read/28487152/effects-of-ticagrelor-on-neointimal-hyperplasia-and-endothelial-function-compared-with-clopidogrel-and-prasugrel-in-a-porcine-coronary-stent-restenosis-model
#1
Hyun Kuk Kim, Myung Ho Jeong, Kyung Seob Lim, Jung Ha Kim, Han Chul Lim, Min Chul Kim, Young Joon Hong, Sung Soo Kim, Keun-Ho Park, Kyoung-Sig Chang
BACKGROUND: Several investigations have been conducted to evaluate the off-target effects of ticagrelor. The aim of the present study was to evaluate the off-target effects of ticagrelor such as neointimal formation and endothelial function after drug-eluting stent implantation in a porcine restenosis model. METHODS: A total of 30 pigs were randomly allocated based on the following P2Y12 inhibitor: (1) clopidogrel 300mg loading plus 75mg maintenance (n=10); (2) prasugrel 60mg loading plus 10mg maintenance (n=10); (3) ticagrelor 180mg loading plus 180mg maintenance (n=10)...
May 3, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28454806/assessing-micro-vascular-resistances-via-imr-to-predict-outcome-in-stemi-patients-with-multivessel-disease-undergoing-primary-pci-amicro-rationale-and-design-of-a-prospective-multicenter-clinical-trial
#2
Massimo Fineschi, Edoardo Verna, Giuseppe Mezzapelle, Davide Bartolini, Giovanni Turiano, Antonio Manari, Katia Lucarelli, Lucia Uguccioni, Alessandra Repetto, Giuseppe Tarantini
BACKGROUND: In STEMI patients treated with primary percutaneous coronary angioplasty (PPCI) the evaluation of coronary microcirculatory resistance index (IMR) predict the extent of microvascular damage and left ventricular (LV) remodeling. However, the impact of IMR on the clinical outcome after PPCI in patients with multivessel disease (MVD) remains unsettled. AIM: We designed a prospective multicenter controlled clinical trial to evaluate the prognostic value of IMR in terms of clinical outcome and left ventricular remodeling in STEMI patients with MVD undergoing PPCI...
May 2017: American Heart Journal
https://www.readbyqxmd.com/read/28454829/design-and-rationale-of-the-compare-acute-trial-fractional-flow-reserve-guided-primary-multivessel-percutaneous-coronary-intervention-to-improve-guideline-indexed-actual-standard-of-care-for-treatment-of-st-elevation-myocardial-infarction-in-patients-with-multivessel
#3
Pieter C Smits, Amira Assaf, Gert Richardt, Elmir Omerovic, Mohamed Abdel-Wahab, Franz-Joseph Neumann
What the best strategy is for nonculprit lesions in ST-elevation myocardial infarction (STEMI) patients presenting with multivessel disease remains a clinical dilemma. Based on recent clinical studies suggesting that complete revascularization in the acute phase is beneficial, the European Society of Cardiology and American College of Cardiology/American Heart Association guidelines have been recently changed from class 3 discouragement to a class 2B recommendation concerning the treatment of the nonculprit lesions in the acute index procedure...
April 2017: American Heart Journal
https://www.readbyqxmd.com/read/28456699/cutoff-value-and-long-term-prediction-of%C3%A2-clinical-events-by-ffr-measured-immediately-after-implantation-of-a-drug-eluting-stent-in-patients-with-coronary-artery-disease-1-to-3-year-results-from-the-dkcrush-vii-registry-study
#4
Sui-Ji Li, Zhen Ge, Jing Kan, Jun-Jie Zhang, Fei Ye, Tak W Kwan, Teguh Santoso, Song Yang, Imad Sheiban, Xue-Song Qian, Nai-Liang Tian, Tanveer S Rab, Ling Tao, Shao-Liang Chen
OBJECTIVES: This study aimed to investigate the cutoff of post-drug-eluting stent (DES) fractional flow reserve (FFR) for prediction of 1- to 3-year target vessel failure (TVF). BACKGROUND: FFR immediately after a DES implantation correlates with clinical events. However, the cutoff of post-DES FFR for predicting long-term clinical events remains understudied. METHODS: Between May 2012 and September 2013, a total of 1,476 patients who had FFR <0...
April 22, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28475383/fractional-flow-reserve-in-2017-current-data-and-everyday-practice
#5
J J Coughlan, Colin MacDonnell, Samer Arnous, Thomas J Kiernan
Fractional Flow Reserve (FFR) is an objective physiological index utilized in coronary angiography. It expresses the blood flow in the presence of a coronary artery stenosis as a fraction of the normal blood flow and gives information regarding the functional significance of the lesion. FFR guided percutaneous coronary intervention (PCI) has been shown to be superior to angiography guided PCI in several trials and registries. In addition, it appears that the use of FFR may also be preferable from an economic perspective...
May 5, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28457806/detection-of-spontaneous-coronary-artery-spasm-with-optical-coherence-tomography-in-a-patient-with-acute-coronary-syndrome
#6
HanyTawfik Fathelbab, Santiago Jesús Camacho Freire, Javier León Jiménez, Rosa Cardenal Piris, Antonio Enrique Gómez Menchero, Jessica Roa Garrido, José Francisco Díaz Fernández
We present 2 illustrative cases of acute coronary syndrome and spontaneous coronary artery spasm evaluated by optical coherence tomography. Different spasm patterns were showed by optical coherence tomography (OCT), according to whether there were underlying atherosclerotic plaques or not.
February 20, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28461799/phasic-compression-of-left-circumflex-coronary-artery-during-atrial-systole
#7
Edward Samuel Roberto, Ajay Agarwal
Phasic coronary artery compression is typically associated with spasm or myocardial bridging. Compression caused by acquired anatomic changes to the surrounding heart chambers has been reported only infrequently. We present a possibly unique case of phasic compression of the proximal left circumflex coronary artery during atrial contraction in association with a dilated left atrium. A 55-year-old man with multiple cardiac risk factors presented with worsening exertional dyspnea. An electrocardiogram and echocardiogram revealed marked left atrial dilation and a left ventricular ejection fraction of 0...
April 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28476516/effects-of-neuropeptide-y-on-coronary-artery-vasomotion-in-patients-with-microvascular-angina
#8
Giuseppe M C Rosano, Dimitris Tousoulis, Eugene McFadden, John Clarke, Graham J Davies, Juan Carlos Kaski
BACKGROUND: Patients with microvascular angina (exertional angina, positive exercise tests and normal coronary arteriograms) usually have a reduced coronary blood flow reserve. Neuropeptide Y (NPY) is a potent endogenous vasoconstrictor involved in modulation of coronary vasomotor tone and may play a role in microvascular angina. METHODS: We compared the effects of NPY (0.2-1.0pmol/kg, intracoronary) on the vasomotor response of proximal and distal segments of the coronary arteries in 7 patients with microvascular angina, 9 with chronic stable angina, and 9 control individuals...
March 16, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28420802/clinical-decision-making-for-the-hemodynamic-gray-zone-ffr-0-75-0-80-and-long-term-outcomes
#9
Shiv Kumar Agarwal, Srikanth Kasula, Mohan M Edupuganti, Sameer Raina, Fnu Shailesh, Ahmed Almomani, Jason J Payne, Naga V Pothineni, Barry F Uretsky, Abdul Hakeem
BACKGROUND: Fractional flow reserve (FFR) value between 0.75 and 0.80 is considered the "gray zone" and outcomes data relative to treatment strategy (revascularization vs medical therapy alone [deferral]) are limited for this group. METHODS AND RESULTS: A total of 238 patients (64.3 ± 8.6 years; 97% male; 45% diabetic) with gray-zone FFR were followed for the primary endpoint of major adverse cardiovascular event (MACE), defined as a composite of death, myocardial infarction (MI), and target-vessel revascularization...
April 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/27785906/functional-assessment-of-anomalous-right-coronary-artery-using-fractional-flow-reserve-an-innovative-modality-to-guide-patient-management
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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