30 julio 2013

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Cardiac Catheterization. Impact of Stent Surface on Thrombogenicity and Vascular Healing

Michael J. Eppihimer, PhD, Natalia Sushkova, MD, Jessica L. Grimsby, PhD, Natalia Efimova, BS, Wang Kai, PhD, Steve Larson, BS, Bruce Forsyth, PhD, Barbara A. Huibregtse, DVM, Keith D. Dawkins, MD, Gregory J. Wilson, MD and Juan F. Granada, MD

Background: Emerging drug-eluting stent technologies are evolving toward the elimination of polymeric component used as the method for modulating drug delivery. Although this technological approach seems to be biologically appealing, the impact of durable polymers and metallic stent surfaces on vascular healing remains unclear. In the present study, we aimed to compare the independent effect of a durable polymer and a metallic stent surface on thrombogenicity and endothelial cell coverage using different in vitro and in vivo experimental models.

06 agosto 2013

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Myocardial Infarction. Outcomes With Various Drug-Eluting or Bare Metal Stents in Patients With ST-Segment–Elevation Myocardial Infarction

Sripal Bangalore, MD, MHA, Nicholas Amoroso, MD, Mario Fusaro, MD, Sunil Kumar, MD and Frederick Feit, MD

Background: The efficacy and safety of drug-eluting stents (DES) in patients with ST-segment–elevation myocardial infarction (STEMI) is controversial. Consequently, DES implantation has a class IIa indication in the American College of Cardiology/American Heart Association and the European Society of Cardiology STEMI guidelines.

13 agosto 2013

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Myocardial Infarction Timing of Mortality After Severe Bleeding and Recurrent Myocardial Infarction in Patients With ST-Segment–Elevation Myocardial Infarction

Wouter J. Kikkert, MD, Aeilko H. Zwinderman, PhD, Marije M. Vis, MD, PhD, Jan Baan Jr, MD, PhD, Karel T. Koch, MD, PhD, Ron J. Peters, MD, PhD, Robbert J. de Winter, MD, PhD, Jan J. Piek, MD, PhD, Jan G.P. Tijssen, PhD and José P.S. Henriques, MD, PhD

Background: The prognosis of initial survivors of ST-segment–elevation myocardial infarction (STEMI) is affected by both recurrent myocardial infarction (MI) and severe bleeding. The aim of the current study was to investigate how mortality is affected in time after bleeding and recurrent MI.

01 octubre 2014

CANADIAN JOURNAL OF CARDIOLOGY. Monitoring Wait Times for Transcatheter Aortic Valve Implantation: A Need for National Benchmarks

Sandra Lauck, RN, PhD, Dion Stub, MD, PhD, John Webb, MD

Aortic stenosis is the most common valvular heart disease in developed countries; its impact on public health and health care resources is expected to become increasingly significant as the population ages.1 The rapid emergence of transcatheter aortic valve implantation (TAVI) as the recommended or preferred therapy for many patients with aortic stenosis is challenging clinicians, administrators, and policy makers to ensure adherence to evidence-based indications and access to services within safe and appropriate times. Recently, the findings of the CoreValve US Pivotal Trial demonstrated a significant reduction in mortality and morbidity in high-risk patients who had TAVI compared with a randomized surgical cohort2; this further confirmed the findings of the Placement of Aortic Transcatheter Valves (PARTNER) study, which showed a 20% absolute risk reduction in 1-year mortality in inoperable patients, noninferior outcomes in high-risk surgical candidates, and a significantly lower procedural mortality in even higher risk patients who underwent transfemoral TAVI rather than surgery.3, 4 Clinical trials are currently under way to examine the role of newer improved devices in patients at lower surgical risk. Outcomes with TAVI continue to improve and indications will likely broaden. This paradigm shift in the management of valvular heart disease is creating significant new pressures on clinical resources and casts questions regarding how to best monitor patient access, support health care planning, and inform funding models.

01 septiembre 2013

CANADIAN JOURNAL OF CARDIOLOGY. Spontaneous Coronary Artery Dissection

Jacqueline Saw, MD

Abstract: Spontaneous coronary artery dissection (SCAD) is an infrequent condition that is underdiagnosed. There is a predilection for young women without traditional cardiovascular risk factors, and it is increasingly diagnosed in women who are not peripartum. We discovered an association between SCAD and fibromuscular dysplasia (FMD), in which most women with nonatherosclerotic SCAD were found to have FMD in another vascular territory. We suspect that these seemingly healthy patients have underlying coronary FMD that predisposed them to coronary dissection. Medical treatment of SCAD includes antiplatelet therapy and β-blockade. Revascularization of SCAD patients might be challenging, and the recommendation for stenting or surgery depends on their clinical status and the dissected coronary anatomy. The long-term outcome of patients who survived their SCAD event is generally good, however, they are at risk for recurrent dissection and major cardiovascular events, and thus should be closely monitored by cardiovascular specialists. This review summarizes the epidemiology, associated etiology, diagnosis, management, and outcome of patients with SCAD.

01 septiembre 2013

CANADIAN JOURNAL OF CARDIOLOGY. Guiding Coronary Artery Intervention: One Technology to Rule Them All and in the Darkness Bind Them

Gary S. Mintz, MD

Although he died before Andreas Gruentzig performed the first coronary angioplasty, Tolkien´s words apply to the current state of imaging in the catheterization laboratory. On one hand, most interventional cardiologists cling to coronary angiography as the only imaging technology that is necessary, ignoring its limitations. On the other hand, manufacturers and devotees of intravascular imaging and physiology continue to search for the 1 technique that will answer all questions that cannot be answered by angiography.

01 septiembre 2014

AMERICAN HEART JOURNAL. Suboptimal risk factor control in patients undergoing elective coronary or peripheral percutaneous intervention

Lisa Tully, MD, Eugenia Gianos, MD, Anish Vani, BS, Yu Guo, MA, Revathi Balakrishnan, MD, Arthur Schwartzbard, MD, James Slater, MD, Richard Stein, MD, James Underberg, MD, Howard Weintraub, MD, Edward Fisher, MD, Jeffrey S. Berger, MD, MS

Background: The American Heart Association recommends targeting 7 cardiovascular (CV) health metrics to reduce morbidity and mortality. Control of these targets in patients undergoing CV intervention is uncertain.

01 septiembre 2014

AMERICAN HEART JOURNAL. Spironolactone lowers the rate of repeat revascularization in acute myocardial infarction patients treated with percutaneous coronary intervention

Pil Sang Song, MDd, Dong-Kie Kim, MDd, Guang-Won Seo, MD, Ki-Hun Kim, MD, Sang-Hoon Seol, MD, PhD, Jeong Hoon Yang, MD, Joo-Yong Hahn, MD, PhD, Seung-Hyuk Choi, MD, PhD, Jin-Ho Choi, MD, PhD, Hyeon-Cheol Gwon, MD, PhD, Youngkeun Ahn, MD, PhD, Myung Ho Jeong, MD, PhD, Young Bin Song, MD, PhD, Doo-Il Kim, MD, PhD, Other Korea Acute Myocardial Infarction Registry Investigators

Background: We sought to assess the effect of the aldosterone receptor blocker, spironolactone, on 1-year clinical outcomes in all-comers with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention.

01 septiembre 2014

AMERICAN HEART JOURNAL. Temporal trends in the use of intraaortic balloon pump associated with percutaneous coronary intervention in the United States, 1998-2008

Hiren Patel, MD, Anupama Shivaraju, MD, Gregg C. Fonarow, MD, Hui Xie, PhD, Weihua Gao, PhD, Adhir R. Shroff, MD, Mladen I. Vidovich, MD

Background: With conflicting evidence regarding the usefulness of intraaortic balloon pump (IABP), reports of IABP use in the United States have been inconsistent. Our objective was to examine trends in IABP usage in percutaneous coronary intervention (PCI) in the United States and to evaluate the association of IABP use with mortality.

30 julio 2013

CIRCULATION. Coronary Heart Disease. Stent Thrombosis With Ticagrelor Versus Clopidogrel in Patients With Acute Coronary Syndromes

P. Gabriel Steg, MD; Robert A. Harrington, MD; Håkan Emanuelsson, MD; Hugo A. Katus, MD; Kenneth W. Mahaffey, MD; Bernhard Meier, MD; Robert F. Storey, MD, DM; Daniel M. Wojdyla, MS; Basil S. Lewis, MD; Gerald Maurer, MD; Lars Wallentin, MD, PhD; Stefan K. James, MD, PhD; for the PLATO Study Group

Background: We aimed to describe the effects of ticagrelor versus clopidogrel on stent thrombosis in the Platelet Inhibition and Patient Outcomes (PLATO) trial.

15 julio 2013

CIRCULATION. Coronary Heart Disease. Rosiglitazone and Outcomes for Patients With Diabetes Mellitus and Coronary Artery Disease in the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) Trial

Richard G. Bach, MD; Maria Mori Brooks, PhD; Manuel Lombardero, MS; Saul Genuth, MD; Thomas W. Donner, MD; Alan Garber, MD, PhD; Laurence Kennedy, MD; E. Scott Monrad, MD; Rodica Pop-Busui, MD, PhD; Sheryl F. Kelsey, PhD; Robert L. Frye, MD; for the BARI 2D Investigators

Background: Rosiglitazone improves glycemic control for patients with type 2 diabetes mellitus, but there remains controversy regarding an observed association with cardiovascular hazard. The cardiovascular effects of rosiglitazone for patients with coronary artery disease remain unknown.

02 julio 2013

CIRCULATION. Interventional Cardiology. Vascular Injury Involves the Overoxidation of Peroxiredoxin Type II and Is Recovered by the Peroxiredoxin Activity Mimetic That Induces Reendothelialization

Dong Hoon Kang, PhD; Doo Jae Lee, PhD; Jiran Kim, MS; Joo Young Lee, PhD; Hyun-Woo Kim, PhD; Kihwan Kwon, MD, PhD; W. Robert Taylor, MD; Hanjoong Jo, PhD; Sang Won Kang, PhD

Background: Typical 2-Cys peroxiredoxin (Prx) is inactivated by overoxidation of the peroxidatic cysteine residue under oxidative stress. However, the significance in the context of vascular disease is unknown.

30 septiembre 2014

CIRCULATION. Contemporary Reviews in Cardiovascular Medicine. Repair of the Regurgitant Bicuspid or Tricuspid Aortic Valve

Fabian A. Kari, MD; Matthias Siepe, MD; Hans-Hinrich Sievers, MD; Friedhelm Beyersdorf, MD

Introduction: The treatment of severe aortic valve regurgitation (AR) has been moving ahead quickly and has undergone a fundamental transition over the past few decades. Mechanical or bioprosthetic aortic valve replacement has been the standard of care for many years for most types of AR. Although still restricted to patients with well-defined pathological aortic valve and root anatomy, the number of accepted indications for reconstructive aortic valve surgery is growing.

30 septiembre 2014

CIRCULATION. New Drugs and Technologies. Overview of the 2013 Food and Drug Administration Circulatory System Devices Panel Meeting on the MitraClip Delivery System

Sa´ar Minha, MD; Rebecca Torguson, MPH; Ron Waksman, MD

Introduction: The MitraClip system (MCS; Abbott Vascular, Santa Clara, CA) is a percutaneously delivered device aimed at reducing severe mitral valve regurgitation (MR) by approximating the mitral valve leaflets. The device is introduced through the femoral vein and advanced into the left atrium through a transseptal puncture. With echocardiographic guidance, the MitraClip is permanently placed in a fashion that approximates the anterior and posterior leaflets as seen in the surgical technique by Alfieri and De Bonis,1 although it should be noted that this technique includes mitral annuloplasty as an essential component. After being in development for more than a decade, the MCS was approved for commercial use in Europe in 20082 and is recommended by the European Society of Cardiology for use in patients with symptomatic severe MR who are determined to be inoperable or at high surgical risk by a heart team and who have a life expectancy >1 year (recommendation Class IIb, Level of Evidence C).3 The MitraClip is currently approved for use in >40 countries with >8000 patients having been treated with this device, most of whom are at high surgical risk

28 junio 2013

CIRCULATION. Congenital Heart Disease. Association Between Maternal Chronic Conditions and Congenital Heart Defects

Shiliang Liu, MD, PhD; K.S. Joseph, MD, PhD; Sarka Lisonkova, MD, PhD; Jocelyn Rouleau; Michiel Van den Hof, MD; Reg Sauve, MD, MPH; Michael S. Kramer, MD; for the Canadian Perinatal Surveillance System (Public Health Agency of Canada)

Background: This study quantifies the association between maternal medical conditions/illnesses and congenital heart defects (CHDs) among infants.