01 julio 2013

JACC. Optimized Prognostic Score for Coronary Computed Tomographic Angiography. Results From the CONFIRM Registry (COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter Registry)

Martin Hadamitzky, MD∗; Stephan Achenbach, MD†; Mouaz Al-Mallah, MD, MSc‡; Daniel Berman, MD§; Matthew Budoff, MD⋮; Filippo Cademartiri, MD, PhD¶; Tracy Callister, MD∗∗; Hyuk-Jae Chang, MD, PhD††; Victor Cheng, MD§; Kavitha Chinnaiyan, MD‡‡; Benjamin J.W. Chow, MD§§; Ricardo Cury, MD⋮⋮; Augustin Delago, MD¶¶; Allison Dunning, MS##; Gudrun Feuchtner, MD∗∗∗; Millie Gomez, MD†††; Philipp Kaufmann, MD‡‡‡; Yong-Jin Kim, MD§§§; Jonathon Leipsic, MD⋮⋮⋮; Fay Y. Lin, MD¶¶¶; Erica Maffei, MD¶; James K. Min, MD§; Gil Raff, MD‡‡; Leslee J. Shaw, PhD###; Todd C. Villines, MD∗∗∗∗; Jörg Hausleiter, MD††††

Objectives: The aim of this study was to analyze the predictive value of coronary computed tomography angiography (CCTA) and to model and validate an optimized score for prognosis of 2-year survival on the basis of a patient population with suspected coronary artery disease (CAD).

01 julio 2013

JACC. Same-Day Discharge After Percutaneous Coronary Intervention

Kimberly M. Brayton, MD, JD∗; Vishal G. Patel, MD†; Christopher Stave, MLS∗; James A. de Lemos, MD†; Dharam J. Kumbhani, MD, SM†

Objectives: This study sought to assess the safety of same-day discharge in patients undergoing percutaneous coronary intervention (PCI).

01 julio 2013

JACC. Reduction of Stent Thrombosis in Patients With Acute Coronary Syndromes Treated With Rivaroxaban in ATLAS-ACS 2 TIMI 51

C. Michael Gibson, MD∗; Anjan K. Chakrabarti, MD∗; Jessica Mega, MD, MPH†; Christophe Bode, MD‡; Jean-Pierre Bassand, MD§; Freek W.A. Verheugt, MD, PhD⋮; Deepak L. Bhatt, MD, MPH†; Shinya Goto, MD#; Marc Cohen, MD∗∗; Satishkumar Mohanavelu, MS†; Paul Burton, MD††; Gregg Stone, MD‡‡; Eugene Braunwald, MD†

Objectives: The aim of this study was to determine if rivaroxaban is associated with a reduction in stent thrombosis among patients with acute coronary syndromes (ACS) in the ATLAS-ACS 2 TIMI 51 (Anti-Xa Therapy to Lower Cardiovascular Events in Addition to Standard Therapy in Subjects With Acute Coronary Syndrome—Thrombolysis in Myocardial Infarction 51) trial.

01 julio 2014

JACC. 4-Year Results of a Randomized Controlled Trial of Percutaneous Repair Versus Surgery for Mitral Regurgitation

Laura Mauri, MD∗; Elyse Foster, MD‡; Donald D. Glower, MD§; Patricia Apruzzese, MS†; Joseph M. Massaro, PhD†; Howard C. Herrmann, MD¶; James Hermiller, MD#; William Gray, MD∗∗; Andrew Wang, MD‡; Wesley R. Pedersen, MD††; Tanvir Bajwa, MD‡‡; John Lasala, MD, PhD§§; Reginald Low, MD⋮⋮; Paul Grayburn, MD¶¶; Ted Feldman, MD##

Objectives: This study sought to evaluate 4-year outcomes of percutaneous repair versus surgery for mitral regurgitation.

01 julio 2013

JACC. Severe Aortic Stenosis and Coronary Artery Disease—Implications for Management in the Transcatheter Aortic Valve Replacement Era

Sachin S. Goel, MD∗; Mobolaji Ige, MD†; E. Murat Tuzcu, MD∗; Stephen G. Ellis, MD∗; William J. Stewart, MD∗; Lars G. Svensson, MD, PhD‡; Bruce W. Lytle, MD‡; Samir R. Kapadia, MD∗

Management of coronary artery disease (CAD) in patients with severe aortic stenosis (AS) referred for transcatheter aortic valve replacement (TAVR) is posing challenges. Due to limited and heterogeneous data on the prevalence and clinical impact of CAD on the outcomes of TAVR and the management strategies for CAD in patients undergoing TAVR, we performed a comprehensive review of the literature. Significant CAD is present in 40% to 75% of patients undergoing TAVR. The impact of CAD on outcomes after TAVR remains understudied. Based on existing data, not all patients require revascularization before TAVR. Percutaneous coronary intervention (PCI) should be considered for severely stenotic lesions in proximal coronaries that subtend a large area of myocardium at risk. Ongoing studies randomizing patients to surgical or percutaneous management strategies for severe AS will help provide valuable data regarding the impact of CAD on TAVR outcomes, the role of PCI, and its timing in relation to TAVR.

01 julio 2013

JACC. Evaluation and Management of Paravalvular Aortic Regurgitation After Transcatheter Aortic Valve Replacement

Jan-Malte Sinning, MD∗; Mariuca Vasa-Nicotera, MD∗; Derek Chin, MD†; Christoph Hammerstingl, MD∗; Alexander Ghanem, MD∗; Johan Bence, MD†; Jan Kovac, MD†; Eberhard Grube, MD∗; Georg Nickenig, MD∗; Nikos Werner, MD∗

Abstract: Paravalvular aortic regurgitation (PAR) negatively affects the prognosis after transcatheter aortic valve replacement (TAVR) with dramatically increased morbidity and mortality in patients with more than mild PAR. Because transcatheter heart valves are implanted in a sutureless fashion using oversizing to anchor the prosthesis stent frame at the level of the virtual aortic annulus, stent frame underexpansion due to heavily calcified cusps, suboptimal placement of the prosthesis, and/or annulus-prosthesis-size mismatch due to malsizing can contribute to paravalvular leakage. In contrast to open heart surgery, TAVR does not offer the opportunity to measure the aortic annulus under direct vision during the procedure. Therefore, the dilemma before each TAVR procedure is the appropriate sizing of the dimensions of the aortic annulus and to choose not only the size but also the transcatheter heart valve type (self-expanding vs. balloon-expandable) that fits the given anatomy best. Because precise echocardiographic quantification of PAR in patients with TAVR remains challenging especially in the acute implantation situation, a multimodal approach for the evaluation of PAR with the use of hemodynamic measurements and imaging modalities is imperative to precisely quantify the severity of aortic regurgitation immediately after valve implantation and to identify patients who will benefit from corrective measures such as post-dilation or valve-in-valve implantation. Every measure has to be taken to prevent or reduce PAR to provide a satisfying long-term clinical outcome.

01 julio 2013

JACC. Long-Term Results After Simple Versus Complex Stenting of Coronary Artery Bifurcation Lesions

Michael Maeng, MD∗; Niels R. Holm, MD∗; Andrejs Erglis, MD†; Indulis Kumsars, MD†; Matti Niemelä, MD‡; Kari Kervinen, MD‡; Jan S. Jensen, MD§; Anders Galløe, MD§; Terje K. Steigen, MD⋮; Rune Wiseth, MD¶; Inga Narbute, MD†; Pål Gunnes, MD#; Jan Mannsverk, MD∗∗; Oliver Meyerdierks, MD††; Svein Rotevatn, MD‡‡; Kjell Nikus, MD§§; Saila Vikman, MD‡‡; Jan Ravkilde, MD⋮⋮; Stefan James, MD¶¶; Jens Aarøe, MD⋮⋮; Antti Ylitalo, MD##; Steffen Helqvist, MD∗∗∗; Iwar Sjögren, MD†††; Per Thayssen, MD‡‡‡; Kari Virtanen, MD§§§; Mikko Puhakka, MD⋮⋮⋮; Juhani Airaksinen, MD¶¶¶; Evald H. Christiansen, MD∗; Jens F. Lassen, MD∗; Leif Thuesen, MD∗

Objectives: This study sought to report the 5-year follow-up results of the Nordic Bifurcation Study.

01 julio 2013

JACC. Patent Foramen Ovale, Subclinical Cerebrovascular Disease, and Ischemic Stroke in a Population-Based Cohort

Marco R. Di Tullio, MD∗; Zhezhen Jin, PhD†; Cesare Russo, MD∗; Mitchell S.V. Elkind, MD, MS‡; Tatjana Rundek, MD, PhD§; Mitsuhiro Yoshita, MD, PhD⋮; Charles DeCarli, MD⋮; Clinton B. Wright, MD, MS§; Shunichi Homma, MD∗; Ralph L. Sacco, MD, MS§

Objectives: The purpose of this study was to evaluate the relationship between patent foramen ovale (PFO), ischemic stroke, and subclinical cerebrovascular disease in the general population.

01 julio 2013

JACC. Percutaneous Left Atrial Appendage Closure With the AMPLATZER Cardiac Plug Device in Patients With Nonvalvular Atrial Fibrillation and Contraindications to Anticoagulation Therapy

Marina Urena, MD∗; Josep Rodés-Cabau, MD∗; Xavier Freixa, MD†; Jacqueline Saw, MD‡; John G. Webb, MD§; Mélanie Freeman, MD§; Eric Horlick, MD⋮; Mark Osten, MD⋮; Albert Chan, MD¶; Jean-Francois Marquis, MD#; Jean Champagne, MD∗; Réda Ibrahim, MD†

Objectives: The aim of this study was to evaluate the results associated with left atrial appendage closure (LAAC) with the AMPLATZER Cardiac Plug (ACP) (St. Jude Medical, Minneapolis, Minnesota) in patients with nonvalvular atrial fibrillation and absolute contraindications to anticoagulation therapy.

01 julio 2013

JACC. Percutaneous Left Atrial Appendage Suture Ligation Using the LARIAT Device in Patients With Atrial Fibrillation

Krzysztof Bartus, MD, PhD⁎; Frederick T. Han, MD†; Jacek Bednarek, MD, PhD‡; Jacek Myc, MD, PhD⁎; Boguslaw Kapelak, MD, PhD⁎; Jerzy Sadowski, MD, PhD⁎; Jacek Lelakowski, MD, PhD‡; Stanislaw Bartus, MD, PhD⁎; Steven J. Yakubov, MD§; Randall J. Lee, MD, PhD†

Objectives: The purpose of the study was to determine the efficacy and safety of left atrial appendage (LAA) closure via a percutaneous LAA ligation approach.

01 julio 2013

JACC. Biodegradable Polymer Biolimus-Eluting Stent Versus Durable Polymer Everolimus-Eluting Stent

Masahiro Natsuaki, MD∗; Ken Kozuma, MD†; Takeshi Morimoto, MD‡; Kazushige Kadota, MD§; Toshiya Muramatsu, MD⋮; Yoshihisa Nakagawa, MD¶; Takashi Akasaka, MD#; Keiichi Igarashi, MD∗∗; Kengo Tanabe, MD††; Yoshihiro Morino, MD‡‡; Tetsuya Ishikawa, MD§§; Hideo Nishikawa, MD⋮⋮; Masaki Awata, MD¶¶; Mitsuru Abe, MD##; Hisayuki Okada, MD∗∗∗; Yoshiki Takatsu, MD†††; Nobuhiko Ogata, MD‡‡‡; Kazuo Kimura, MD§§§; Kazushi Urasawa, MD⋮⋮⋮; Yasuhiro Tarutani, MD¶¶¶; Nobuo Shiode, MD###; Takeshi Kimura, MD∗

Objectives: NEXT (NOBORI Biolimus-Eluting Versus XIENCE/PROMUS Everolimus-Eluting Stent Trial) was designed for evaluating the noninferiority of a biolimus-eluting stent (BES) relative to an everolimus-eluting stent (EES) in terms of target lesion revascularization (TLR) at 1 year.

01 julio 2013

JACC. Transcatheter Aortic Valve Replacement in Europe. Adoption Trends and Factors Influencing Device Utilization

Darren Mylotte, MD∗; Ruben L.J. Osnabrugge, MSc‡; Stephan Windecker, MD§; Thierry Lefèvre, MD⋮; Peter de Jaegere, MD, PhD‡; Raban Jeger, MD¶; Peter Wenaweser, MD§; Francesco Maisano, MD#; Neil Moat, MD∗∗; Lars Søndergaard, MD††; Johan Bosmans, PhD‡‡; Rui C. Teles, MD§§; Giuseppe Martucci, MD∗; Ganesh Manoharan, MD⋮⋮; Eulogio Garcia, MD¶¶; Nicolas M. Van Mieghem, MD‡; A. Pieter Kappetein, MD, PhD‡; Patrick W. Serruys, MD, PhD‡; Ruediger Lange, MD, PhD##; Nicolo Piazza, MD, PhD∗

Objectives: The authors sought to examine the adoption of transcatheter aortic valve replacement (TAVR) in Western Europe and investigate factors that may influence the heterogeneous use of this therapy.

01 julio 2013

JACC. Effectiveness of Renal Denervation Therapy for Resistant Hypertension. A Systematic Review and Meta-Analysis

Mark I. Davis, MD∗; Kristian B. Filion, PhD†; David Zhang∗; Mark J. Eisenberg, MD, MPH∗; Jonathan Afilalo, MD, MSc∗; Ernesto L. Schiffrin, MD, PhD∗; Dominique Joyal, MD∗

Objectives: This study sought to determine the current effectiveness and safety of sympathetic renal denervation (RDN) for resistant hypertension.

01 julio 2013

JACC. Cardiac Troponin After Percutaneous Coronary Intervention and 1-Year Mortality in Non–ST-Segment Elevation Acute Coronary Syndrome Using Systematic Evaluation of Biomarker Trends

Pierluigi Tricoci, MD, MHS, PhD∗; Sergio Leonardi, MD, MHS†; Jennifer White, MS∗; Harvey D. White, MB, ChB, DSc‡; Paul W. Armstrong, MD§; Gilles Montalescot, MD⋮; Robert P. Giugliano, MD, SM¶; C. Michael Gibson, MD#; Frans Van de Werf, MD∗∗; Robert M. Califf, MD∗; Robert A. Harrington, MD††; Eugene Braunwald, MD¶; Kenneth W. Mahaffey, MD∗; L. Kristin Newby, MD, MHS∗

Objectives: This study sought to review cardiac troponin (cTn) trends during non–ST-segment elevation acute coronary syndrome (NSTE ACS) in patients undergoing percutaneous coronary intervention (PCI) in the EARLY ACS (Early Glycoprotein IIb/IIIa Inhibition in Non–ST-Segment Elevation Acute Coronary Syndromes) and SYNERGY (Superior Yield of the New Strategy of Enoxaparin, Revascularization and Glycoprotein IIb/IIIa Inhibitors) studies and to study the relationship between post-PCI cTn and mortality.

01 junio 2013

CIRCULATION. Hypertension. Ambulatory Blood Pressure Changes After Renal Sympathetic Denervation in Patients With Resistant Hypertension

Felix Mahfoud, MD; Christian Ukena, MD; Roland E. Schmieder, MD; Bodo Cremers, MD; Lars C. Rump, MD; Oliver Vonend, MD; Joachim Weil, MD; Martin Schmidt, MD; Uta C. Hoppe, MD; Thomas Zeller, MD; Axel Bauer, MD; Christian Ott, MD; Erwin Blessing, MD; Paul A. Sobotka, MD; Henry Krum, MBBS, PhD; Markus Schlaich, MD; Murray Esler, MBBS, PhD, FRACP; Michael Böhm, MD

Background: Catheter-based renal sympathetic denervation (RDN) reduces office blood pressure (BP) in patients with resistant hypertension according to office BP. Less is known about the effect of RDN on 24-hour BP measured by ambulatory BP monitoring and correlates of response in individuals with true or pseudoresistant hypertension.