01 junio 2013

CIRCULATION. Interventional Cardiology. Quantification of Incomplete Revascularization and its Association With Five-Year Mortality in the Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery (SYNTAX) Trial Validation of the Residual SYNTAX Score

Vasim Farooq, MBChB, MRCP; Patrick W. Serruys, MD, PhD; Christos V. Bourantas, MD; Yaojun Zhang, MD; Takashi Muramatsu, MD; Ted Feldman, MD; David R. Holmes, MD; Michael Mack, MD; Marie Claude Morice, MD; Elisabeth Ståhle, MD; Antonio Colombo, MD; Ton de Vries, MSc; Marie-angèle Morel, BSc; Keith D. Dawkins, MD; Arie-Pieter Kappetein, MD, PhD; Friedrich W. Mohr, MD

Background: The residual Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery (SYNTAX) Score is an objective measure of the degree and complexity of residual stenosis after percutaneous coronary intervention (PCI).

01 junio 2013

CIRCULATION. Stroke. The Long-Term Multicenter Observational Study of Dabigatran Treatment in Patients With Atrial Fibrillation (RELY-ABLE) Study

Stuart J. Connolly, MD; Lars Wallentin, MD, PhD; Michael D. Ezekowitz, MB, ChB, DPhil; John Eikelboom, MD; Jonas Oldgren, MD, PhD; Paul A. Reilly, PhD; Martina Brueckmann, MD; Janice Pogue, PhD; Marco Alings, MD, PhD; John V. Amerena, MB, BS; Alvaro Avezum, MD, PhD; Iris Baumgartner, MD; Andrzej J. Budaj, MD, PhD; Jyh-Hong Chen, MD, PhD; Antonio L. Dans, MD, MDc; Harald Darius, MD, PhD; Giuseppe Di Pasquale, MD; Jorge Ferreira, MD; Greg C. Flaker, MD; Marcus D. Flather, MD; Maria Grazia Franzosi, PhD; Sergey P. Golitsyn, MD, PhD; David A. Halon, MB, ChB; Hein Heidbuchel, MD, PhD; Stefan H. Hohnloser, MD; Kurt Huber, MD; Petr Jansky, MD; Gabriel Kamensky, PhD; Matyas Keltai, MD; Sung Soon Kim, MD; Chu-Pak Lau, MD, PhD; Jean-Yves Le Heuzey, PhD; Basil S. Lewis, MD, FRCP; Lisheng Liu, MD, PhD; John Nanas, MD; Razali Omar, MD; Prem Pais, MD, PhD; Knud E. Pedersen, MD; Leopoldo S. Piegas, MD, PhD; Dimitar Raev, MD; Pal J. Smith, MD; Mario Talajic, MD; Ru San Tan, MB, BS; Supachai Tanomsup, MD; Lauri Toivonen, MD, PhD; Dragos Vinereanu, MD, PhD, FESC; Denis Xavier, MD; Jun Zhu, MD; Susan Q. Wang, PhD; Christine O. Duffy, MSHS; Ellison Themeles, BA; Salim Yusuf, MBBS, DPhil

Background: During follow-up of between 1 and 3 years in the Randomized Evaluation of Long-term Anticoagulation Therapy (RE-LY) trial, 2 doses of dabigatran etexilate were shown to be effective and safe for the prevention of stroke or systemic embolism in patients with atrial fibrillation. There is a need for longer-term follow-up of patients on dabigatran and for further data comparing the 2 dabigatran doses.

01 junio 2013

CIRCULATION. Valvular Heart Disease. Anatomical and Procedural Features Associated With Aortic Root Rupture During Balloon-Expandable Transcatheter Aortic Valve Replacement

Marco Barbanti, MD; Tae-Hyun Yang, MD; Josep Rodès Cabau, MD; Corrado Tamburino, MD; David A. Wood, MD; Hasan Jilaihawi, MD; Phillip Blanke, MD; Raj R. Makkar, MD; Azeem Latib, MD; Antonio Colombo, MD; Giuseppe Tarantini, MD; Rekha Raju, MD; Ronald K. Binder, MD; Giang Nguyen, MD; Melanie Freeman, MD; Henrique B. Ribeiro, MD; Samir Kapadia, MD; James Min, MD; Gudrun Feuchtner, MD; Ronen Gurtvich, MD; Faisal Alqoofi, MD; Marc Pelletier, MD; Gian Paolo Ussia, MD; Massimo Napodano, MD; Fabio Sandoli de Brito Jr, MD; Susheel Kodali, MD; Bjarne L. Norgaard, MD; Nicolaj C. Hansson, MD; Gregor Pache, MD; Sergio J. Canovas, MD; Hongbin Zhang, PhD; Martin B. Leon, MD; John G. Webb, MD; Jonathon Leipsic, MD

Background: Aortic root rupture is a major concern with balloon-expandable transcatheter aortic valve replacement (TAVR). We sought to identify predictors of aortic root rupture during balloon-expandable TAVR by using multidetector computed tomography.

01 junio 2013

CIRCULATION. Coronary Heart Disease. Mechanically Unloading the Left Ventricle Before Coronary Reperfusion Reduces Left Ventricular Wall Stress and Myocardial Infarct Size

Navin K. Kapur, MD; Vikram Paruchuri, MD; Jose Angel Urbano-Morales, MD; Emily E. Mackey, BSc; Gerard H. Daly, MD; Xiaoying Qiao, PhD; Natesa Pandian, MD; George Perides, PhD; Richard H. Karas, MD, PhD

Background: Ischemia/reperfusion injury worsens infarct size, a major determinant of morbidity and mortality after acute myocardial infarction (MI). We tested the hypothesis that reducing left ventricular wall stress with a percutaneous left atrial-to-femoral artery centrifugal bypass system while delaying coronary reperfusion limits myocardial injury in a model of acute MI.

01 julio 2014

THE AMERICAN JOURNAL OF CARDIOLOGY. Impact of Albuminuria on the Incidence of Periprocedural Myocardial Injury in Patients Undergoing Elective Coronary Stent Implantation

Naohiro Osugi, MD, Susumu Suzuki, MD, Hideki Ishii, MD, PhD, Yoshinari Yasuda, MD, PhD, Yohei Shibata, MD, Yosuke Tatami, MD, Tomoyuki Ota, MD, Yoshihiro Kawamura, MD, Satoshi Okumura, MD, Akihito Tanaka, MD, Yosuke Inoue, MD, Seiichi Matsuo, MD, PhD, Toyoaki Murohara, MD, PhD

Albuminuria has traditionally been associated with an elevated risk of cardiovascular events. However, few studies have examined the potential relation between albuminuria and periprocedural risk in percutaneous coronary intervention (PCI). The aim of this study was to evaluate the impact of albuminuria on the incidence of periprocedural myocardial injury (PMI) in patients who underwent PCI. The study included 252 consecutive patients who underwent PCI. The incidence of PMI was significantly higher in patients with albuminuria than in those with normoalbuminuria (31.9% vs 43.3%, respectively, p = 0.014). Even after adjustment for confounders, the presence of albuminuria predicted PMI (odds ratio 2.07, 95% confidence interval 1.08 to 3.97, p = 0.029). Furthermore, patients with albuminuria and preserved estimated glomerular filtration rate had a 4.2-fold higher risk for PMI than did patients with normoalbuminuria and preserved estimated glomerular filtration rate. In conclusion, albuminuria was a strong predictor of PMI in patients who underwent PCI.

01 julio 2014

THE AMERICAN JOURNAL OF CARDIOLOGY. Anticoagulant and Antiplatelet Therapy in Patients With Atrial Fibrillation Undergoing Percutaneous Coronary Intervention

Koji Goto, MD, Kentaro Nakai, MD, Satoshi Shizuta, MD, Takeshi Morimoto, MD, Hiroki Shiomi, MD, Masahiro Natsuaki, MD, Mitsuhiko Yahata, MD, Chihiro Ota, MD, Koh Ono, MD, Takeru Makiyama, MD, Yoshihisa Nakagawa, MD, Yutaka Furukawa, MD, Kazushige Kadota, MD, Yoshiki Takatsu, MD, Takashi Tamura, MD, Akinori Takizawa, MD, Tsukasa Inada, MD, Osamu Doi, MD, Ryuji Nohara, MD, Mitsuo Matsuda, MD, Teruki Takeda, MD, Masayuki Kato, MD, Manabu Shirotani, MD, Hiroshi Eizawa, MD, Katsuhisa Ishii, MD, Jong-Dae Lee, MD, Masaaki Takahashi, MD, Minoru Horie, MD, Mamoru Takahashi, MD, Shinji Miki, MD, Takeshi Aoyama, MD, Satoru Suwa, MD, Shuichi Hamasaki, MD, Hisao Ogawa, MD, Kazuaki Mitsudo, MD, Masakiyo Nobuyoshi, MD, Toru Kita, MD, Takeshi Kimura, MD, CREDO-Kyoto Registry Cohort-2 Investigators

The prevalence, intensity, safety, and efficacy of oral anticoagulation (OAC) in addition to dual antiplatelet therapy (DAPT) in “real-world” patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) have not yet been fully evaluated. In the Coronary REvascularization Demonstrating Outcome Study in Kyoto registry cohort-2, a total of 1,057 patients with AF (8.3%) were identified among 12,716 patients undergoing first PCI. Cumulative 5-year incidence of stroke was higher in patients with AF than in no-AF patients (12.8% vs 5.8%, p <0.0001). Although most patients with AF had CHADS2 score ≥2 (75.2%), only 506 patients (47.9%) received OAC with warfarin at hospital discharge. Cumulative 5-year incidence of stroke in the OAC group was not different from that in the no-OAC group (13.8% vs 11.8%, p = 0.49). Time in therapeutic range (TTR) was only 52.6% with an international normalized ratio of 1.6 to 2.6, and only 154 of 409 patients (37.7%) with international normalized ratio data had TTR ≥65%. Cumulative 5-year incidence of stroke in patients with TTR ≥65% was markedly lower than that in patients with TTR <65% (6.9% vs 15.1%, p = 0.01). In a 4-month landmark analysis in the OAC group, there was a trend for higher cumulative incidences of stroke and major bleeding in the on-DAPT (n = 286) than in the off-DAPT (n = 173) groups (15.1% vs 6.7%, p = 0.052 and 14.7% vs 8.7%, p = 0.10, respectively). In conclusion, OAC was underused and its intensity was mostly suboptimal in real-world patients with AF undergoing PCI, which lead to inadequate stroke prevention. Long-term DAPT in patients receiving OAC did not reduce stroke incidence.

01 julio 2014

AMERICAN HEART JOURNAL. Extent of coronary artery disease and outcomes after ticagrelor administration in patients with an acute coronary syndrome: Insights from the PLATelet inhibition and patient Outcomes (PLATO) trial

Anna Kotsia, MD, Emmanouil S. Brilakis, MD, PhD, Claes Held, MD, PhD, Christopher Cannon, MD, Gabriel P. Steg, MD, Bernhard Meier, MD, Frank Cools, MD, Marc J. Claeys, MD, PhD, Jan H. Cornel, MD, PhD, Philip Aylward, BM, BCh, PhD, Basil S. Lewis, MD, Douglas Weaver, MD, Gunnar Brandrup-Wognsen, MD, PhD, Susanna R. Stevens, MSc, Anders Himmelmann, MD, PhD, Lars Wallentin, MD, PhD, Stefan K. James, MD, PhD

Background: Extensive coronary artery disease (CAD) is associated with higher risk. In this substudy of the PLATO trial, we examined the effects of randomized treatment on outcome events and safety in relation to the extent of CAD.

08 febrero 2013

EUROPEAN HEART JOURNAL. Safety and efficacy of a novel hyperaemic agent, intracoronary nicorandil, for invasive physiological assessments in the cardiac catheterization laboratory

Ho-Jun Jang1, Bon-Kwon Koo1,*, Hee-Sun Lee1, Jun-Bean Park1, Ji-Hyun Kim2, Myung-Ki Seo1, Han-Mo Yang1, Kyung-Woo Park1, Chang-Wook Nam3, Joon-Hyung Doh4 and Hyo-Soo Kim1

Aims: Maximal hyperaemia is a key element of invasive physiological studies and adenosine is the most commonly used agent. However, infusion of adenosine requires additional venous access and can cause chest discomfort, bronchial hyper-reactivity, and atrioventricular conduction block. The aim of this study was to evaluate the feasibility and efficacy of intracoronary (IC) nicorandil as a novel hyperaemic agent for invasive physiological studies.

20 junio 2013

EUROPEAN HEART JOURNAL. Effects of renal denervation with a standard irrigated cardiac ablation catheter on blood pressure and renal function in patients with chronic kidney disease and resistant hypertension

Márcio Galindo Kiuchi1,2, George Luiz Marques Maia2, Maria Angela Magalhães de Queiroz Carreira2, Tetsuaki Kiuchi2, Shaojie Chen3, Bruno Rustum Andrea4, Miguel Luis Graciano1 and Jocemir Ronaldo Lugon1,5,*

Aims: Evaluation of the safety and efficacy of renal denervation with a standard irrigated cardiac ablation catheter (SICAC) in chronic kidney disease (CKD) patients with refractory hypertension.

19 junio 2013

EUROPEAN HEART JOURNAL. Safety and efficacy of a multi-electrode renal sympathetic denervation system in resistant hypertension: the EnligHTN I trial

Stephen G. Worthley1,*, Costas P. Tsioufis2, Matthew I. Worthley1, Ajay Sinhal3, Derek P. Chew3, Ian T. Meredith4, Yuvi Malaiapan4 and Vasilios Papademetriou2,5

Aims: Catheter-based renal artery sympathetic denervation has emerged as a novel therapy for treatment of patients with drug-resistant hypertension. Initial studies were performed using a single electrode radiofrequency catheter, but recent advances in catheter design have allowed the development of multi-electrode systems that can deliver lesions with a pre-determined pattern. This study was designed to evaluate the safety and efficacy of the EnligHTN™ multi-electrode system.

14 junio 2013

EUROPEAN HEART JOURNAL. 2013 ESH/ESC Guidelines for the management of arterial hypertension. The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC)

Authors/Task Force Members, Giuseppe Mancia, (Chairperson) (Italy)*, Robert Fagard, (Chairperson) (Belgium)*, Krzysztof Narkiewicz, (Section co-ordinator) (Poland), Josep Redon, (Section co-ordinator) (Spain), Alberto Zanchetti, (Section co-ordinator) (Italy), Michael Böhm, (Germany), Thierry Christiaens, (Belgium), Renata Cifkova, (Czech Republic), Guy De Backer, (Belgium), Anna Dominiczak, (UK), Maurizio Galderisi, (Italy), Diederick E. Grobbee, (Netherlands), Tiny Jaarsma, (Sweden), Paulus Kirchhof, (Germany/UK), Sverre E. Kjeldsen, (Norway), Stéphane Laurent, (France), Athanasios J. Manolis, (Greece), Peter M. Nilsson, (Sweden), Luis Miguel Ruilope, (Spain), Roland E. Schmieder, (Germany), Per Anton Sirnes, (Norway), Peter Sleight, (UK), Margus Viigimaa, (Estonia), Bernard Waeber, (Switzerland) and Faiez Zannad, (France)

The 2013 guidelines on hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC) follow the guidelines jointly issued by the two societies in 2003 and 2007.1,2 Publication of a new document 6 years after the previous one was felt to be timely because, over this period, important studies have been conducted and many new results have been published on both the diagnosis and treatment of individuals with an elevated blood pressure (BP), making refinements, modifications and expansion of the previous recommendations necessary.

04 junio 2014

EUROPEAN HEART JOURNAL. Catheter-based renal denervation for treatment of patients with treatment-resistant hypertension: 36 month results from the SYMPLICITY HTN-2 randomized clinical trial

Murray D. Esler1,*, Michael Böhm2, Horst Sievert3, Christian L. Rump4, Roland E. Schmieder5, Henry Krum6, Felix Mahfoud2 and Markus P. Schlaich1

Aim: The aim of this study was to determine long-term results of renal artery denervation for treatment of treatment-resistant hypertension in the SYMPLICITY HTN-2 study.

13 marzo 2013

EUROPEAN HEART JOURNAL. Clinical outcomes of patients with estimated low or intermediate surgical risk undergoing transcatheter aortic valve implantation

Peter Wenaweser1,†,*, Stefan Stortecky1,†, Sarah Schwander1, Dik Heg2, Christoph Huber3, Thomas Pilgrim1, Steffen Gloekler1, Crochan J. O´Sullivan1, Bernhard Meier1, Peter Jüni2, Thierry Carrel3 and Stephan Windecker1,2

Aims: Transcatheter aortic valve implantation (TAVI) is an established treatment alternative to surgical aortic valve replacement in high-risk and inoperable patients and outcomes among patients with estimated low or intermediate risk remain to be determined. The aim of this study was to assess clinical outcomes among patients with estimated low or intermediate surgical risk undergoing TAVI.

01 junio 2013

JACC: CARDIOVASCULAR INTERVENTIONS. Sex Differences in the Visual-Functional Mismatch Between Coronary Angiography or Intravascular Ultrasound Versus Fractional Flow Reserve

Soo-Jin Kang, MD, PhD∗; Jung-Min Ahn, MD∗; Seungbong Han, PhD†; Jong-Young Lee, MD∗; Won-Jang Kim, MD∗; Duk-Woo Park, MD, PhD∗; Seung-Whan Lee, MD, PhD∗; Young-Hak Kim, MD, PhD∗; Cheol Whan Lee, MD, PhD∗; Seong-Wook Park, MD, PhD∗; Gary S. Mintz, MD‡; Seung-Jung Park, MD, PhD∗

Objectives: This study sought to assess differences in visual-functional mismatches between men and women.

01 junio 2013

JACC: CARDIOVASCULAR INTERVENTIONS. Serial Morphological and Functional Assessment of Drug-Eluting Balloon for In-Stent Restenotic Lesions. Mechanisms of Action Evaluated With Angiography, Optical Coherence Tomography, and Fractional Flow Reserve

Pierfrancesco Agostoni, MD, PhD; Anouar Belkacemi, MD; Michiel Voskuil, MD, PhD; Hendrik M. Nathoe, MD, PhD; Pieter A. Doevendans, MD, PhD; Pieter R. Stella, MD, PhD

Objectives: This study sought to elucidate the underlying mechanism through which drug-eluting balloons (DEB) restore coronary blood flow, by assessing the coronary vessel before, immediately after, and at 6-month follow-up with angiography, optical coherence tomography (OCT), and fractional flow reserve (FFR).