21 mayo 2014

EUROPEAN HEART JOURNAL. Bivalirudin is superior to heparins alone with bailout GP IIb/IIIa inhibitors in patients with ST-segment elevation myocardial infarction transported emergently for primary percutaneous coronary intervention: a pre-specified analysis from the EUROMAX trial

Francesco Maisano, MD∗; Olaf Franzen, MD†; Stephan Baldus, MD‡; Ulrich Schäfer, MD§; Jörg Hausleiter, MD‖; Christian Butter, MD¶; Gian Paolo Ussia, MD#; Horst Sievert, MD††; Gert Richardt, MD‡‡; Julian D. Widder, MD§§; Tiziano Moccetti, MD‖‖; Wolfgang Schillinger, MD¶¶

Aims: In the HORIZONS trial, in-hospital treatment with bivalirudin reduced bleeding and mortality in primary percutaneous coronary intervention (PCI) compared with heparin and routine glycoprotein IIb/IIIa inhibitors (GPI). It is unknown whether this advantage of bivalirudin is observed in comparison with heparins only with GPI used as bailout.

01 septiembre 2013

JACC. Pulmonary Artery Denervation to Treat Pulmonary Arterial Hypertension

Shao-Liang Chen, MD∗; Feng-Fu Zhang, MD∗; Jing Xu, MD∗; Du-Jiang Xie, MD∗; Ling Zhou, MD∗; Thach Nguyen, MD‡; Gregg W. Stone, MD§

Objectives: This study was designed to test the safety and efficacy of pulmonary artery (PA) denervation (PADN) for patients with idiopathic PA hypertension (IPAH) not responding optimally to medical therapy.

01 septiembre 2013

JACC. Disease Prevalence and Number of Candidates for Transcatheter Aortic Valve Replacement: A Meta-Analysis and Modeling Study

Ruben L.J. Osnabrugge, MS∗; Darren Mylotte, MD†; Stuart J. Head, MS∗; Nicolas M. Van Mieghem, MD§; Vuyisile T. Nkomo, MD, MPH‖; Corinne M. LeReun, MS¶; Ad J.J.C. Bogers, MD, PhD∗; Nicolo Piazza, MD, PhD†; A. Pieter Kappetein, MD, PhD∗

Objectives: The purpose of this study was to evaluate the prevalence of aortic stenosis (AS) in the elderly and to estimate the current and future number of candidates for transcatheter aortic valve replacement (TAVR).

01 septiembre 2013

JACC. Coarctation of the Aorta. Lifelong Surveillance Is Mandatory Following Surgical Repair

Morgan L. Brown, MD, PhD∗; Harold M. Burkhart, MD∗; Heidi M. Connolly, MD†; Joseph A. Dearani, MD∗; Frank Cetta, MD†; Zhuo Li, MS§; William C. Oliver‖; Carole A. Warnes, MD†; Hartzell V. Schaff, MD∗

Objectives: The objective of our study was to review the long-term outcomes of patients undergoing surgical repair of aortic coarctation.

06 agosto 2013

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Pharmacology. Antianginal Therapy Before Percutaneous Coronary Intervention

William B. Borden, MD, John A. Spertus, MD, MPH, Alvin I. Mushlin, MD, ScM, Matthew T. Roe, MD, MHS, Lisa A. McCoy, MS and Rita F. Redberg, MD, MSc

Background: The regional variability of percutaneous coronary intervention (PCI) rates may be explained by variations in the medical treatment of stable coronary artery disease. We sought to determine whether greater regional use of antianginal medications in PCI patients is associated with lower regional rates of PCI.

13 agosto 2013

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Pharmacology. Triple Antithrombotic Therapy Is the Independent Predictor for the Occurrence of Major Bleeding Complications

Yoshihisa Naruse, MD, Akira Sato, MD, Tomoya Hoshi, MD, Noriyuki Takeyasu, MD, Yuki Kakefuda, MD, Mayu Ishibashi, MD, Masako Misaki, MD, Daisuke Abe, MD and Kazutaka Aonuma, MD Ibaraki Cardiovascular Assessment Study (ICAS) Registry

Background: Triple antithrombotic therapy increases the risk of bleeding events in patients undergoing percutaneous coronary intervention. However, it remains unclear whether good control of percent time in therapeutic range is associated with reduced occurrence of bleeding complications in patients undergoing triple antithrombotic therapy.

06 agosto 2013

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Pharmacology. Effects of Endothelial Dysfunction on Residual Platelet Aggregability After Dual Antiplatelet Therapy With Aspirin and Clopidogrel in Patients With Stable Coronary Artery Disease

Koichiro Fujisue, MD, Seigo Sugiyama, MD, PhD, Takamichi Ono, MD, PhD, Yasushi Matsuzawa, MD, PhD, Eiichi Akiyama, MD, Koichi Sugamura, MD, PhD, Junichi Matsubara, MD, PhD, Hirofumi Kurokawa, MD, Koichi Kaikita, MD, PhD, Satomi Iwashita, MT, Hitoshi Sumida, MD, PhD, Seiji Hokimoto, MD, PhD, Kentaro Oniki, MS, Kazuko Nakagawa, MD, PhD, Kunihiko Matsui, MD, MPH and Hisao Ogawa, MD, PhD

Background: Dual antiplatelet therapy with aspirin and clopidogrel is widely used in patients with coronary stents. High residual platelet reactivity (high RPR) after dual antiplatelet therapy is associated with increased cardiovascular events. Endothelial function could affect platelet reactivity in vivo. We hypothesized that endothelial dysfunction could be associated with high RPR after dual antiplatelet therapy in patients with stable coronary artery disease.

13 agosto 2013

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Congenital Heart Disease. Outcomes After Primary Transcatheter Therapy in Infants and Young Children With Severe Bilateral Peripheral Pulmonary Artery Stenosis

Jonathan W. Cunningham, BA, Doff B. McElhinney, MD, Kimberlee Gauvreau, DSc, Lisa Bergersen, MD, Ronald V. Lacro, MD, Audrey C. Marshall, MD, Leslie Smoot, MD and James E. Lock, MD

Background: Angioplasty and stent implantation have become accepted therapies for isolated peripheral pulmonary stenosis, and have been shown to increase vessel diameter and reduce right ventricular (RV) pressure acutely in patients with pulmonary artery (PA) stenosis. The purpose of this study was to assess long-term outcomes after primary transcatheter therapy for peripheral pulmonary stenosis.

13 agosto 2013

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Structural Heart Disease. Aortic Regurgitation and Left Ventricular Remodeling After Transcatheter Aortic Valve Implantation

Constanze Merten, MD, Hans-Wilko Beurich, MD, Dirk Zachow, MD, Ahmad E. Mostafa, MD, Volker Geist, MD, Ralph Toelg, MD, Gert Richardt, MD and Mohamed Abdel-Wahab, MD

Background: Aortic regurgitation (AR) after transcatheter aortic valve implantation (TAVI) has been associated with poor outcomes, but little is known about how it evolves over time. We evaluated left ventricular (LV) function, remodeling, and the occurrence and evolution of AR after TAVI by using cardiac MRI.

01 agosto 2014

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Microvasculature. Small Vessels With Large Impact

Habib Samady, MD and Olivia Y. Hung, MD, PhD

Hemodynamic measurements in vivo during heart catheterization are increasingly used to drive clinical decision making in the cardiac catheterization laboratory.1 Coronary flow velocity reserve (CFVR), also referred to as coronary flow reserve, was introduced in the 1970s and was one of the first hemodynamic measurements which could be applied clinically to help evaluate these lesions.2 Moreover, the development of Doppler-tipped guide wires allowed CFVR measurements to be readily obtained. CFVR is defined as the ratio of steady-state hyperemic average peak velocity to resting average peak velocity for the artery of interest (target vessel). The concept is based on observations that increased oxygen demand is met under physiological conditions through a 4 to 5 fold increase in myocardial blood flow caused by autoregulation, and that the degree of epicardial or microvascular resistance can be determined by the ratio of hyperemic to resting blood flow. Although invasively measured CFVR is considered the gold standard, CFVR can also be measured by noninvasive imaging modalities, such as positron emission tomography, single-photon emission computerized tomography, transthoracic Doppler or myocardial contrast echocardiography, or cardiac MRI.

30 julio 2013

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Hemodynamics. Impaired Coronary Autoregulation Is Associated With Long-term Fatal Events in Patients With Stable Coronary Artery Disease

Tim P. van de Hoef, MD, Matthijs Bax, MD, Peter Damman, MD, Ronak Delewi, MD, Mariëlla E.C.J. Hassell, MD, Martijn A. Piek, Steven A.J. Chamuleau, MD, PhD, Michiel Voskuil, MD, PhD, Berthe L.F. van Eck-Smit, MD, PhD, Hein J. Verberne, MD, PhD, José P.S. Henriques, MD, PhD, Karel T. Koch, MD, PhD, Robbert J. de Winter, MD, PhD, Jan G.P. Tijssen, PhD, Jan J. Piek, MD, PhD and Martijn Meuwissen, MD, PhD

Background: Abnormalities in the coronary microcirculation are increasingly recognized as an elementary component of ischemic heart disease, which can be accurately assessed by coronary flow velocity reserve in reference vessels (refCFVR). We studied the prognostic value of refCFVR for long-term mortality in patients with stable coronary artery disease.

13 agosto 2013

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Cardiac Catheterization. Adoption of Transradial Percutaneous Coronary Intervention and Outcomes According to Center Radial Volume in the Veterans Affairs Healthcare System

Antonio Gutierrez, MD, MSc, Thomas T. Tsai, MD, MSc, Maggie A. Stanislawski, MSc, Mladen Vidovich, MD, Christopher L. Bryson, MD, MS, Deepak L. Bhatt, MD, MPH, Gary K. Grunwald, PhD, John Rumsfeld, MD, PhD and Sunil V. Rao, MD

Background: Studies examining the association between radial approach and post–percutaneous coronary intervention (PCI) bleeding and mortality have reached conflicting conclusions. There are no current data about the use and outcomes of transradial PCI (r-PCI) in the Veterans Affairs system.

06 agosto 2013

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Cardiac Catheterization. Comparison of Bivalirudin and Radial Access Across a Spectrum of Preprocedural Risk of Bleeding in Percutaneous Coronary Intervention

Dmitri V. Baklanov, MD, Sunghee Kim, PhD, Steven P. Marso, MD, Sumeet Subherwal, MD and Sunil V. Rao, MD

Background: Bleeding is a common, noncardiac, preventable complication of percutaneous coronary intervention. We compared the relative safety of radial access and bivalirudin in percutaneous coronary intervention.

23 julio 2013

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Cardiac Catheterization. Prognostic Value of Access and Non–Access Sites Bleeding After Percutaneous Coronary Intervention

Gjin Ndrepepa, MD, Franz-Josef Neumann, MD, Gert Richardt, MD, Stefanie Schulz, MD, Ralph Tölg, MD, Kiril M. Stoyanov, Michael Gick, MD, Tareq Ibrahim, MD, Katrin Anette Fiedler, MD, Peter B. Berger, MD, Karl-Ludwig Laugwitz, MD and Adnan Kastrati, MD

Background: Little is known about the impact of bleeding site on mortality after percutaneous coronary intervention. The aim of this study was to assess the impact of access and non–access site bleeding within 30 days after percutaneous coronary intervention on mortality.

30 julio 2013

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Cardiac Catheterization. Incidence and Clinical Impact of Stroke Complicating Percutaneous Coronary Intervention

Nicolas Werner, MD, Timm Bauer, MD, Matthias Hochadel, PhD, Ralf Zahn, MD, Franz Weidinger, MD, Jean Marco, MD, Christian Hamm, MD, Anselm K. Gitt, MD and Uwe Zeymer, MD

Background: Stroke is a rare but serious complication of percutaneous coronary interventions (PCIs). So far, scant information is available about the incidence and outcome of patients developing stroke after PCI for stable angina or acute coronary syndrome (ACS) in daily clinical practice in Europe today.