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ESTUDIOS


01 agosto 2015

JACC. Duration of Dual Antiplatelet Therapy After Coronary Stenting. A Review of the Evidence

Gilles Montalescot, MD, PhD∗; David Brieger, MBBS, MMed, PhD†; Anthony J. Dalby, MB, ChB‡; Seung-Jung Park, MD, PhD§; Roxana Mehran, MD‖

The duration of dual antiplatelet therapy (DAPT) after coronary stenting has been evaluated in randomized studies with apparently conflicting results. Although longer exposure associates with more bleeding complications, late stent thrombosis (ST) and myocardial infarction are reduced. In addition, as new drug-eluting stents carry a lower risk of ST compared with the first-generation drug-eluting stents and possibly even bare-metal stents, a shift toward better protection from ST may have an effect on the duration and intensity of DAPT. Whether the duration of DAPT should be shorter or longer than the currently recommended 6 to 12 months is analyzed in this review, drawing on lessons from the most recent studies.

01 septiembre 2015

JACC. 2-Year Outcomes After Iliofemoral Self-Expanding Transcatheter Aortic Valve Replacement in Patients With Severe Aortic Stenosis Deemed Extreme Risk for Surgery

Steven J. Yakubov, MD∗; David H. Adams, MD†; Daniel R. Watson, MD∗; Michael J. Reardon, MD‡; Neal S. Kleiman, MD‡; David Heimansohn, MD§; James Hermiller, Jr., MD§; G. Chad Hughes, MD‖; J. Kevin Harrison, MD‖; Joseph Coselli, MD¶; Jose Diez, MD¶; Theodore Schreiber, MD#; Thomas G. Gleason, MD∗∗; John Conte, MD††; G. Michael Deeb, MD‡‡; Jian Huang, MD§§; Jae Oh, MD‖‖; Timothy Byrne, MD¶¶; Michael Caskey, MD¶¶; Jeffrey J. Popma, MD##

Background: We reported favorable 1-year outcomes in patients unsuitable for surgery who underwent self-expanding transcatheter aortic valve replacement (TAVR) compared with an objective performance goal. Longer-term outcomes in these patients are not known.

22 julio 2016

JOURNAL OF THE AMERICAN HEART ASSOCIATION. Interventional Cardiology. Prolonged High‐Dose Bivalirudin Infusion Reduces Major Bleeding Without Increasing Stent Thrombosis in Patients Undergoing Primary Percutaneous Coronary Intervention: Novel Insights From an Updated Meta‐Analysis

Gregor Fahrni, MD1,†; Mathias Wolfrum, MD1,†; Giovanni Luigi De Maria, MD1; Adrian P. Banning, MD, MBBS1; Umberto Benedetto, MD, PhD2; Rajesh K. Kharbanda, MD, PhD*,1

Backgroun: The optimal antithrombotic therapy in patients with ST‐segment‐elevation myocardial infarction undergoing primary percutaneous coronary intervention (PCI) remains a matter of debate. This updated meta‐analysis investigated the impact of (1) bivalirudin (with and without prolonged infusion) and (2) prolonged PCI‐dose (1.75 mg/hg per hour) bivalirudin infusion compared with conventional antithrombotic therapy on clinical outcomes in patients undergoing primary PCI.

30 junio 2016

JOURNAL OF THE AMERICAN HEART ASSOCIATION. Interventional Cardiology. Effect of Varying Hemodynamic and Vascular Conditions on Fractional Flow Reserve: An In Vitro Study

Kranthi K. Kolli, PhD1; James K. Min, MD1,2; Seongmin Ha, BS1; Hilary Soohoo, BS1; Guanglei Xiong, PhD*,1

Background: The aim of this study was to investigate the impact of varying hemodynamic conditions on fractional flow reserve (ratio of pressure distal [Pd] and proximal [Pa] to stenosis under hyperemia) in an in vitro setting. Failure to achieve maximal hyperemia and the choice of hyperemic agents may have differential effects on coronary hemodynamics and, consequently, on the determination of fractional flow reserve.

06 julio 2016

JOURNAL OF THE AMERICAN HEART ASSOCIATION. Kidney in Cardiovascular Disease. Acute Kidney Injury Definition and In‐Hospital Mortality in Patients Undergoing Primary Percutaneous Coronary Intervention for ST‐Segment Elevation Myocardial Infarction

Giancarlo Marenzi, MD*,1; Nicola Cosentino, MD1; Marco Moltrasio, MD1; Mara Rubino, MD1; Gabriele Crimi, MD2; Stefano Buratti, MD2; Marco Grazi, MD1; Valentina Milazzo, MD1; Alberto Somaschini, MD2,3; Rita Camporotondo, MD2; Stefano Cornara, MD2,3; Monica De Metrio, MD1; Alice Bonomi, MSc1; Fabrizio Veglia, PhD1; Gaetano M. De Ferrari, MD2,3; Antonio L. Bartorelli, MD, FACC1

Background: Acute kidney injury (AKI) has been associated with increased mortality in ST‐segment elevation myocardial infarction. We compared the mortality predictive accuracy of the 3 AKI definitions used most widely for patients with ST‐segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.

20 agosto 2016

JOURNAL OF THE AMERICAN HEART ASSOCIATION. Interventional Cardiology. Use of Intravascular Imaging During Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From a Contemporary Multicenter Registry

Judit Karacsonyi, MD1,2; Khaldoon Alaswad, MD3; Farouc A. Jaffer, MD, PhD4; Robert W. Yeh, MD5; Mitul Patel, MD6; John Bahadorani, MD6; Aris Karatasakis, MD1; Barbara A. Danek, MD1; Anthony Doing, MD7; J. Aaron Grantham, MD8; Dimitri Karmpaliotis, MD9; Jeffrey W. Moses, MD9; Ajay Kirtane, MD9; Manish Parikh, MD9; Ziad Ali, MD9; William L. Lombardi, MD10; David E. Kandzari, MD11; Nicholas Lembo, MD11; Santiago Garcia, MD12; Michael R. Wyman, MD13; Aya Alame, BA1; Phuong‐Khanh J. Nguyen‐Trong, MD1; Erica Resendes, MS1; Pratik Kalsaria, MS1; Bavana V. Rangan, BDS, MPH1; Imre Ungi, MD2; Craig A. Thompson, MD, MMSc14; Subhash Banerjee, MD1; Emmanouil S. Brilakis, MD, PhD*,1

Background: Intravascular imaging can facilitate chronic total occlusion (CTO) percutaneous coronary intervention.

08 agosto 2016

JOURNAL OF THE AMERICAN HEART ASSOCIATION. Congenital Heart Disease. Surgical Valvotomy Versus Balloon Valvuloplasty for Congenital Aortic Valve Stenosis: A Systematic Review and Meta‐Analysis

Garick D. Hill, MD, MS*,1; Salil Ginde, MD1; Rodrigo Rios, MD1; Peter C. Frommelt, MD1; Kevin D. Hill, MD, MS2

Background: Optimal initial treatment for congenital aortic valve stenosis in children remains unclear between balloon aortic valvuloplasty (BAV) and surgical aortic valvotomy (SAV).

28 julio 2016

JOURNAL OF THE AMERICAN HEART ASSOCIATION. Cardiovascular Surgery. Is Mitral Valve Repair Superior to Mitral Valve Replacement in Elderly Patients? Comparison of Short‐ and Long‐Term Outcomes in a Propensity‐Matched Cohort

Miriam Silaschi, MD1; Sanjay Chaubey, PhD1; Omar Aldalati, MD1; Habib Khan, MBBS1; Mohammed Mohsin Uzzaman1; Mrinal Singh1; Max Baghai, PhD1; Ranjit Deshpande, FRCS1; Olaf Wendler, MD, PhD, FRCS*,1

Background: Because of demographic changes, a growing number of elderly patients present with mitral valve (MV) disease. Although mitral valve repair (MV‐repair) is the “gold standard” treatment for MV disease, in elderly patients, there is controversy about whether MV‐repair is superior to mitral valve replacement. We reviewed results after MV surgery in elderly patients treated over the past 20 years.

15 junio 2016

JOURNAL OF THE AMERICAN HEART ASSOCIATION. Coronary Heart Disease. Impact of Sleep‐Disordered Breathing on Long‐Term Outcomes in Patients With Acute Coronary Syndrome Who Have Undergone Primary Percutaneous Coronary Intervention

Toru Mazaki, MD*,1; Takatoshi Kasai, MD, PhD2,3; Hiroyoshi Yokoi, MD4; Shoichi Kuramitsu, MD5; Kyohei Yamaji, MD, PhD5; Takashi Morinaga, MD5; Hisaki Masuda, MD5; Shinichi Shirai, MD5; Kenji Ando, MD5

Background: Sleep‐disordered breathing (SDB) has been recognized as an important risk factor for cardiovascular diseases; however, the impact of SDB on long‐term outcomes in patients with acute coronary syndrome has not been fully evaluated.

13 junio 2016

JOURNAL OF THE AMERICAN HEART ASSOCIATION. Epidemiology. Relationship Between Arterial Access and Outcomes in ST‐Elevation Myocardial Infarction With a Pharmacoinvasive Versus Primary Percutaneous Coronary Intervention Strategy: Insights From the STrategic Reperfusion Early After Myocardial Infarction (STREAM) Study

Jay Shavadia, MD1; Robert Welsh, MD1; Anthony Gershlick, MD2; Yinggan Zheng, MA, MEd1; Kurt Huber, MD3; Sigrun Halvorsen, MD4; Phillipe G. Steg, MD5; Frans Van de Werf, MD, PhD6; Paul W. Armstrong, MD*,1,

Background: The effectiveness of radial access (RA) in ST‐elevation myocardial infarction (STEMI) has been predominantly established in primary percutaneous coronary intervention (pPCI) with limited exploration of this issue in the early postfibrinolytic patient. The purpose of this study was to compare the effectiveness and safety of RA versus femoral (FA) access in STEMI undergoing either a pharmacoinvasive (PI) strategy or pPCI.

27 mayo 2016

JOURNAL OF THE AMERICAN HEART ASSOCIATION. Interventional Cardiology. Excessively High Hydration Volume May Not Be Associated With Decreased Risk of Contrast‐Induced Acute Kidney Injury After Percutaneous Coronary Intervention in Patients With Renal Insufficiency

Yong Liu, MD1,†; Hualong Li, MD1,†; Shiqun Chen, MS1,2,†; Jiyan Chen, MD, FACC, FESC*,1; Ning Tan, MD, FACC, FESC*,1; Yingling Zhou, MD1; Yuanhui Liu, MD1; Piao Ye, MD1; Peng Ran, MD1; Chongyang Duan, MS2; Pingyan Chen, MS*,2

Background: No well‐defined protocols currently exist regarding the optimal rate and duration of normal saline administration to prevent contrast‐induced acute kidney injury (CI‐AKI) in patients with renal insufficiency.

31 mayo 2016

JOURNAL OF THE AMERICAN HEART ASSOCIATION. Interventional Cardiology. Impact of Center Experience on Patient Radiation Exposure During Transradial Coronary Angiography and Percutaneous Intervention: A Patient‐Level, International, Collaborative, Multi‐Center Analysis

Trevor Simard, MD1,†; Benjamin Hibbert, MD, PhD1,†; Madhu K. Natarajan, MD, MSc2; Mathew Mercuri, PhD2,3; Simon L. Hetherington, MD4; Robert Wright, MD5; Ronak Delewi, MD, PhD6; Jan J. Piek, MD, PhD6; Ralf Lehmann, MD7; Zoltán Ruzsa, MD, PhD8; Helmut W. Lange, MD9; Håkan Geijer, MD, PhD10; Michael Sandborg, PhD11; Vinay Kansal, BHSc12; Jordan Bernick, MSc13; Pietro Di Santo, MD1; Ali Pourdjabbar, MD, MSc1; F. Daniel Ramirez, MD1; Benjamin J. W. Chow, MD1; Aun Yeong Chong, MD1; Marino Labinaz, MD1; Michel R. Le May, MD1; Edward R. O´Brien, MD14; George A. Wells, PhD13; Derek So, MD*,1

Background: The adoption of the transradial (TR) approach over the traditional transfemoral (TF) approach has been hampered by concerns of increased radiation exposure—a subject of considerable debate within the field. We performed a patient‐level, multi‐center analysis to definitively address the impact of TR access on radiation exposure.

10 junio 2016

JOURNAL OF THE AMERICAN HEART ASSOCIATION. Interventional Cardiology. Value of Image Fusion in Coronary Angiography for the Detection of Coronary Artery Bypass Grafts

Julien Plessis, MD*,1; Karine Warin Fresse, MD1; Zachary Cahouch, MD1; Thibaut Manigold, MD1; Vincent Letocart, MD1; Laurianne Le Gloan, MD1; Béatrice Guyomarch, MS1; Patrice Guerin, MD, PhD1

Background: Coronary angiography is more complex in patients with coronary artery bypass grafts (CABG). Image fusion is a new technology that allows the overlay of a computed tomography (CT) three‐dimension (3D) model with fluoroscopic images in real time.

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