01 abril 2013

JACC. Colchicine Treatment for the Prevention of Bare-Metal Stent Restenosis in Diabetic Patients

Spyridon Deftereos, MD⁎; Georgios Giannopoulos, MD⁎; Konstantinos Raisakis, MD⁎; Charalambos Kossyvakis, MD⁎; Andreas Kaoukis, MD⁎; Vasiliki Panagopoulou, MD⁎; Metaxia Driva, MD⁎; George Hahalis, MD‡; Vlasios Pyrgakis, MD⁎; Dimitrios Alexopoulos, MD‡; Antonis S. Manolis, MD§; Christodoulos Stefanadis, MD∥; Michael W. Cleman, MD†

Objectives: This study sought to test the hypothesis that colchicine treatment after percutaneous coronary intervention (PCI) can lead to a decrease in in-stent restenosis (ISR).

01 abril 2013

JACC. Association Between Advanced Age and Vascular Disease in Different Arterial Territories. A Population Database of Over 3.6 Million Subjects

Nazir Savji, MA⁎; Caron B. Rockman, MD†; Adam H. Skolnick, MD⁎; Yu Guo, MA‡; Mark A. Adelman, MD†; Thomas Riles, MD†; Jeffrey S. Berger, MD, MS⁎

Objectives: This study sought to determine the relationship between vascular disease in different arterial territories and advanced age.

01 abril 2013

JACC. 5-Year Experience With Transcatheter Transapical Mitral Valve-in-Valve Implantation for Bioprosthetic Valve Dysfunction

Anson Cheung, MD; John G. Webb, MD; Marco Barbanti, MD; Melanie Freeman, MD; Ronald K. Binder, MD; Christopher Thompson, MD; David A. Wood, MD; Jian Ye, MD

Objectives: The study sought to describe the authors´ experience with mitral transapical transcatheter valve-in-valve implantation (TVIV).

01 abril 2013

JACC. Sex Differences in Presentation and Outcome Among Patients With Type 2 Diabetes and Coronary Artery Disease Treated With Contemporary Medical Therapy With or Without Prompt Revascularization. A Report From the BARI 2D Trial (Bypass Angioplasty Revascularization Investigation 2 Diabetes)

Jacqueline E. Tamis-Holland, MD⁎; Jiang Lu, MS†; Mary Korytkowski, MD†; Michelle Magee, MD‡; William J. Rogers, MD§; Neuza Lopes, MD∥; Lisa Mighton, RN¶; Alice K. Jacobs, MD#

Objectives: This study evaluated differences in outcome among women and men enrolled in the BARI 2D (Bypass Angioplasty Revascularization Investigation 2 Diabetes) trial.

01 abril 2013

JACC. Quality of Life Assessment in the Randomized PROTECT AF (Percutaneous Closure of the Left Atrial Appendage Versus Warfarin Therapy for Prevention of Stroke in Patients With Atrial Fibrillation) Trial of Patients at Risk for Stroke With Nonvalvular Atrial Fibrillation

Oluseun Alli, MD⁎; Shepal Doshi, MD†; Saibal Kar, MD‡; Vivek Reddy, MD§; Horst Sievert, MD∥; Chris Mullin¶; Vijay Swarup, MD#; Brian Whisenant, MD⁎⁎; David Holmes, MD††

Objectives: This study sought to assess quality of life parameters in a subset of patients enrolled in the PROTECT AF (Percutaneous Closure of the Left Atrial Appendage Versus Warfarin Therapy for Prevention of Stroke in Patients With Atrial Fibrillation) trial.

01 abril 2013

JACC. Invasive Hemodynamic Characteristics of Low Gradient Severe Aortic Stenosis Despite Preserved Ejection Fraction

Juliane Lauten, MD⁎; Christian Rost, MD⁎; Ole A. Breithardt, MD, PhD⁎; Christian Seligmann, MD, PhD⁎; Lutz Klinghammer, MD⁎; Werner G. Daniel, MD, PhD⁎; Frank A. Flachskampf, MD, PhD†

Objectives: The study sought to compare echocardiographic with invasive hemodynamic data in patients with “paradoxic” aortic stenosis and in patients with conventionally defined severe aortic stenosis.

01 mayo 2013

JACC. Standardized Cardiovascular Data for Clinical Research, Registries, and Patient Care. A Report From the Data Standards Workgroup of the National Cardiovascular Research Infrastructure Project

H. Vernon Anderson, MD⁎; William S. Weintraub, MD†; Martha J. Radford, MD‡; Mark S. Kremers, MD§; Matthew T. Roe, MD, MHS‖; Richard E. Shaw, PhD¶; Dana M. Pinchotti, BS#; James E. Tcheng, MD‖

Relatively little attention has been focused on standardization of data exchange in clinical research studies and patient care activities. Both are usually managed locally using separate and generally incompatible data systems at individual hospitals or clinics. In the past decade there have been nascent efforts to create data standards for clinical research and patient care data, and to some extent these are helpful in providing a degree of uniformity. Nonetheless, these data standards generally have not been converted into accepted computer-based language structures that could permit reliable data exchange across computer networks. The National Cardiovascular Research Infrastructure (NCRI) project was initiated with a major objective of creating a model framework for standard data exchange in all clinical research, clinical registry, and patient care environments, including all electronic health records. The goal is complete syntactic and semantic interoperability. A Data Standards Workgroup was established to create or identify and then harmonize clinical definitions for a base set of standardized cardiovascular data elements that could be used in this network infrastructure. Recognizing the need for continuity with prior efforts, the Workgroup examined existing data standards sources. A basic set of 353 elements was selected. The NCRI staff then collaborated with the 2 major technical standards organizations in health care, the Clinical Data Interchange Standards Consortium and Health Level Seven International, as well as with staff from the National Cancer Institute Enterprise Vocabulary Services. Modeling and mapping were performed to represent (instantiate) the data elements in appropriate technical computer language structures for endorsement as an accepted data standard for public access and use. Fully implemented, these elements will facilitate clinical research, registry reporting, administrative reporting and regulatory compliance, and patient care.

01 mayo 2013

JACC. Endovascular Repair of Ascending Aortic Dissection. A Novel Treatment Option for Patients Judged Unfit for Direct Surgical Repair

Qingsheng Lu, MD; Jiaxuan Feng, MD; Jian Zhou, MD; Zhiqing Zhao, MD; Junmin Bao, MD; Rui Feng, MD; Liangxi Yuan, MD; Xiang Feng, MD; Lefeng Qu, MD; Yifei Pei, MD; Zhijun Mei, MD; Zaiping Jing, MD, PhD

Objectives: This paper sought to report the outcomes of patients who are considered unfit for urgent surgical repair of ascending aortic dissections (AADs) who were treated using a novel endovascular repair strategy.

01 mayo 2013

JACC. Renoprotective Effect of Remote Ischemic Post-Conditioning by Intermittent Balloon Inflations in Patients Undergoing Percutaneous Coronary Intervention

Spyridon Deftereos, MD⁎; Georgios Giannopoulos, MD⁎; Vasileios Tzalamouras, MD⁎; Konstantinos Raisakis, MD⁎; Charalambos Kossyvakis, MD⁎; Andreas Kaoukis, MD⁎; Vasiliki Panagopoulou, MD⁎; Sofia Karageorgiou⁎; Dimitrios Avramides, MD⁎; Konstantinos Toutouzas, MD‡; George Hahalis, MD§; Vlassios Pyrgakis, MD⁎; Antonis S. Manolis, MD∥; Dimitrios Alexopoulos, MD§; Christodoulos Stefanadis, MD‡; Michael W. Cleman, MD†

Objectives: The aim of the present study was to assess the efficacy of remote ischemic post-conditioning (RIPC) by repeated intermittent balloon inflations in preventing acute kidney injury (AKI) in patients with a non–ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention (PCI).

01 mayo 2013

JACC. Evaluation of Ranolazine in Patients With Type 2 Diabetes Mellitus and Chronic Stable Angina. Results From the TERISA Randomized Clinical Trial (Type 2 Diabetes Evaluation of Ranolazine in Subjects With Chronic Stable Angina)

Mikhail Kosiborod, MD⁎; Suzanne V. Arnold, MD, MHA⁎; John A. Spertus, MD, MPH⁎; Darren K. McGuire, MD, MHSC‡; Yan Li, PhD⁎; Patrick Yue, MD§; Ori Ben-Yehuda, MD§; Amos Katz, MD∥; Philip G. Jones, MS⁎; Ann Olmsted, PhD§; Luiz Belardinelli, MD§; Bernard R. Chaitman, MD¶

Objectives: This study sought to examine the efficacy of ranolazine versus placebo on weekly angina frequency and sublingual nitroglycerin use in subjects with type 2 diabetes mellitus, coronary artery disease (CAD), and chronic stable angina who remain symptomatic despite treatment with up to 2 antianginal agents.

01 mayo 2013

JACC. Triple Therapy With Aspirin, Prasugrel, and Vitamin K Antagonists in Patients With Drug-Eluting Stent Implantation and an Indication for Oral Anticoagulation

Nikolaus Sarafoff, MD⁎; Amadea Martischnig, MD†; Jill Wealer, MS†; Katharina Mayer, MD†; Julinda Mehilli, MD⁎; Dirk Sibbing, MD⁎; Adnan Kastrati, MD†

Objectives: This study sought to evaluate whether prasugrel may serve as an alternative to clopidogrel in patients with triple therapy.

01 mayo 2013

JACC. Patterns of Use and Comparative Effectiveness of Bleeding Avoidance Strategies in Men and Women Following Percutaneous Coronary Interventions. An Observational Study From the National Cardiovascular Data Registry

Stacie L. Daugherty, MD, MSPH⁎; Lauren E. Thompson, MD†; Sunghee Kim, PhD‡; Sunil V. Rao, MD‡; Sumeet Subherwal, MD, MBA‡; Thomas T. Tsai, MD, MSc⁎; John C. Messenger, MD⁎; Frederick A. Masoudi, MD, MSPH⁎

Objectives: This study sought to compared the use and effectiveness of bleeding avoidance strategies (BAS) by sex.

01 mayo 2013

JACC. Noninvasive Renal Sympathetic Denervation by Extracorporeal High-Intensity Focused Ultrasound in a Pre-Clinical Canine Model

Qifeng Wang, MM⁎; Rui Guo, MD, PhD†; Shunkang Rong, MD⁎; Gang Yang, MD, PhD⁎; Que Zhu, MD, PhD⁎; Yonghong Jiang, MD⁎; Changming Deng, MD⁎; Dichuan Liu, MD⁎; Qi Zhou, MD, PhD⁎; Qi Wu, MD, PhD⁎; Shunhe Wang, MD§; Jun Qian, MM⁎; Qi Wang, MS‡; Han Lei, MD†; Tong-Chuan He, MD, PhD∥; Zhibiao Wang, MD, PhD‡; Jing Huang, MD⁎

Objectives: This study investigated the feasibility of noninvasive renal sympathetic denervation (RSD) by using the novel approach of extracorporeal high-intensity focused ultrasound (HIFU).

01 marzo 2014

THE AMERICAN JOURNAL OF CARDIOLOGY. Influence of the Extent of Coronary Atherosclerotic Disease on ST-Segment Changes Induced by ST Elevation Myocardial Infarction

Francisco J. Noriega, MD, Miquel Vives-Borrás, MD, Eduard Solé-González, MD, Joan García-Picart, MD, Dabit Arzamendi, MD, Juan Cinca, MD, PhD

The accuracy of the admission electrocardiogram (ECG) in predicting the site of acute coronary artery occlusion in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease is not well known. This study aimed to assess whether the presence of multivessel coronary artery disease (CAD) modifies the artery-related ST-segment changes in patients with acute coronary artery occlusion. We reviewed the admission ECG, clinical records, and coronary angiography of 289 patients with STEMI caused by acute occlusion of left anterior descending (LAD; n = 140), right (n = 118), or left circumflex (LCx; n = 31) coronary arteries. All patients underwent primary percutaneous coronary reperfusion during the first 12 hours. The magnitude and distribution of artery-related ST-segment patterns were comparable in patients with single (n = 149) and multivessel (n = 140) CAD. Occlusion of proximal (n = 55) or mid-distal (n = 85) LAD artery induced ST-segment elevation in leads V1 to V5, but only the proximal occlusion induced reciprocal ST-segment depression in leads II, III, and aVF (p <0.001). Proximal and mid-distal occlusion of right (n = 45 and 73, respectively) or LCx (n = 15 and 16) coronary artery always induced ST-segment elevation in leads II, III, and aVF and reciprocal ST-segment depression in leads V2 and V3. ST-segment elevation in lead V6 >0.1 mV predicted LCx artery occlusion. In conclusion, patients with STEMI with single or multivessel CAD have concordant artery-related ST-segment patterns on the admission ECG; in both groups, reciprocal ST-segment depression in LAD artery occlusion predicts a large infarct. Subendocardial ischemia at a distance is not a requisite for the genesis of reciprocal ST-segment changes.

01 marzo 2014

THE AMERICAN JOURNAL OF CARDIOLOGY. Coronary Computed Tomographic Angiographic Findings in Asymptomatic Patients With Type 2 Diabetes Mellitus

Gyung-Min Park, MD, Seung-Whan Lee, MD, Young-Rak Cho, MD, Chan Joon Kim, MD, Jung Sun Cho, MD, Mahn-Won Park, MD, Sung Ho Her, MD, Jung-Min Ahn, MD, Jong-Young Lee, MD, Duk-Woo Park, MD, Soo-Jin Kang, MD, Young-Hak Kim, MD, Cheol Whan Lee, MD, Eun Hee Koh, MD, Woo Je Lee, MD, Min-Seon Kim, MD, Ki-Up Lee, MD, Joon-Won Kang, MD, Tae-Hwan Lim, MD, Seong-Wook Park, MD, Seung-Jung Park, MD, Joong-Yeol Park, MD

There are limited data regarding the role of coronary computed tomographic angiography (CCTA) in asymptomatic patients with type 2 diabetes mellitus. We analyzed 557 asymptomatic type 2 diabetic patients who underwent CCTA. Cardiac event was defined as a composite of cardiac death, nonfatal myocardial infarction, acute coronary syndrome requiring hospitalization, or late revascularization. Atherosclerotic plaques were observed in 395 patients (70.9%), and 170 patients (30.5%) showed significant coronary artery disease (CAD) on CCTA. Ninety-two patients (16.5%) were associated with a significant stenosis in the left main or proximal left anterior descending artery. During the follow-up period (33.7 ± 7.8 months), although an excellent prognosis was observed in patients without significant CAD on CCTA, those with significant CAD showed more cardiac events (7.1% vs 0.5%) and lower 3-year event-free survival rates (99.2 ± 0.6% vs 90.9 ± 2.6%, p <0.001). Furthermore, in group with significant CAD, patients with significant CAD in the left main or proximal left anterior descending artery had more cardiac events (10.9% vs 2.6%) and lower 3-year event-free survival rates (97.4 ± 1.8% vs 86.1 ± 4.2%, p = 0.049). On multivariate analysis, family history of premature CAD, previous history of stroke, higher UK Prospective Diabetes Study 10-year risk scores, neuropathy, and retinopathy were independent clinical predictors of having significant CAD and left main or proximal left anterior descending artery significant CAD on CCTA. In conclusion, about 1/3 of asymptomatic type 2 diabetic patients had significant CAD on CCTA with a subsequent high risk for cardiac events. These findings suggest that CCTA may have a potential role in identifying patients with high cardiovascular risks in asymptomatic type 2 diabetes.