01 octubre 2012

AMERICAN HEART JOURNAL. Coronary angiographic scoring systems: An evaluation of their equivalence and validity

Ian J. Neeland, MD , Riyaz S. Patel, MD , Parham Eshtehardi, MD , Saurabh Dhawan, MD , Michael C. McDaniel, MD , S. Tanveer Rab, MD , Viola Vaccarino, MD, PhD , A. Maziar Zafari, MD, PhD , Habib Samady, MD , Arshed A. Quyyumi, MD

Background: Multiple scoring systems have been devised to quantify angiographic coronary artery disease (CAD) burden, but it is unclear how these scores relate to each other and which scores are most accurate. The aim of this study was to compare coronary angiographic scoring systems (1) with each other and (2) with intravascular ultrasound (IVUS)–derived plaque burden in a population undergoing angiographic evaluation for CAD.

01 marzo 2012

JACC. Consensus Standards for Acquisition, Measurement, and Reporting of Intravascular Optical Coherence Tomography Studies

A Report From the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation

Objectives The purpose of this document is to make the output of the International Working Group for Intravascular Optical Coherence Tomography (IWG-IVOCT) Standardization and Validation available to medical and scientific communities, through a peer-reviewed publication, in the interest of improving the diagnosis and treatment of patients with atherosclerosis, including coronary artery disease.

01 noviembre 2012

JACC: CARDIOVASCULAR INTERVENTIONS. Impact of Insulin Resistance on Post-Procedural Myocardial Injury and Clinical Outcomes in Patients Who Underwent Elective Coronary Interventions With Drug-Eluting Stents

Tadayuki Uetani, MD, PhD?; Tetsuya Amano, MD, PhD†; Kazuhiro Harada, MD?; Katsuhide Kitagawa, MD?; Ayako Kunimura, MD?; Yusaku Shimbo, MD?; Ken Harada, MD?; Tomohiro Yoshida, MD?; Bunichi Kato, MD, PhD?; Masataka Kato, MD?; Nobuyuki Marui, MD, PhD?; Michio Nanki, MD, PhD?; Nigishi Hotta, MD, PhD?; Hideki Ishii, MD, PhD‡; Tatsuaki Matsubara, MD, PhD§; Toyoaki Murohara, MD, PhD‡

Objectives: This study sought to evaluate the associations between homeostatic indexes of insulin resistance (HOMA-IR) and post-procedural myocardial injury and clinical outcome after a percutaneous coronary intervention (PCI) with a drug-eluting stent.

01 octubre 2013

THE AMERICAN JOURNAL OF CARDIOLOGY. Racial Differences in Rates of Aortic Valve Replacement in Patients With Severe Aortic Stenosis

Michael Yeung, MD , Jimmy Kerrigan, MD , Sandeep Sodhi, MD , Pei-Hsiu Huang, MD , Eric Novak, MS , Hersh Maniar, MD , Alan Zajarias, MD

Racial disparities exist in the treatment of many cardiovascular diseases. Aortic valve replacement (AVR) is the only treatment for aortic stenosis (AS) that improves patient symptoms and survival. To date, no studies have compared the rate of AVR among different races. The records of patients with an aortic valve area <1 cm2 by echocardiography diagnosed between January 2004 and May 2010 at Barnes-Jewish Hospital were reviewed retrospectively. Patients were stratified by race. Of the 880 patients analyzed, 10% were African American (AA), and 90% were European American (EA). AA more frequently had hypertension (82% vs 67%, p <0.01), diabetes mellitus (45% vs 32%, p = 0.02), chronic kidney disease (28% vs 17%, p = 0.01), and end stage renal disease (18% vs 2%, p <0.001). AA underwent AVR less frequently than EA (39% vs 53%, p = 0.02) and refused intervention more often (33% vs 20%, p = 0.04). When treated, AA and EA had similar 3-year survival (49% [38 to 60] vs 50% [45 to 54], p = 0.31). Identification of the factors associated with treatment refusal would further our ability to counsel patients on the decision to pursue AVR.

01 octubre 2012

EUROPEAN HEART JOURNAL. Expert review document part 2: methodology, terminology and clinical applications of optical coherence tomography for the assessment of interventional procedures

Francesco Prati, Giulio Guagliumi, Gary S. Mintz, Marco Costa, Evelyn Regar, Takashi Akasaka, Peter Barlis, Guillermo J. Tearney, Ik-Kyung Jang, Elosia Arbustini, Hiram G. Bezerra, Yukio Ozaki, Nico Bruining, Darius Dudek, Maria Radu, Andrejs Erglis, Pascale Motreff, Fernando Alfonso, Kostas Toutouzas, Nieves Gonzalo, Corrado Tamburino, Tom Adriaenssens, Fausto Pinto, Patrick W.J. Serruys, Carlo Di Mario and for the Expert s OCT Review Document

This document is complementary to an Expert Review Document on Optical Coherence Tomography (OCT) for the study of coronary arteries and atherosclerosis.1 The goal of this companion manuscript is to provide a practical guide framework for the appropriate use and reporting of the novel frequency domain (FD) OCT imaging to guide interventional procedures, with a particular interest on the comparison with intravascular ultrasound (IVUS).1–4

01 noviembre 2012

JACC. Prospective, Randomized, Multicenter Evaluation of a Polyethylene Terephthalate Micronet Mesh–Covered Stent (MGuard) in ST-Segment Elevation Myocardial Infarction. The MASTER Trial

Gregg W. Stone, MD?; Alexandre Abizaid, MD, PhD‡; Sigmund Silber, MD, PhD§; Jose M. Dizon, MD?; Béla Merkely, MD?; Ricardo A. Costa, MD‡; Ran Kornowski, MD¶; Andrea Abizaid, MD, PhD‡; Roman Wojdyła, MD#; Akiko Maehara, MD?; Ovidiu Dressler, MD†; Sorin J. Brener, MD†; Eli Bar, BSc††; Dariusz Dudek, MD, PhD‡‡

Objectives: This study sought to evaluate the potential utility of a novel polyethylene terephthalate micronet mesh–covered stent (MGuard) in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI).

01 octubre 2013

THE AMERICAN JOURNAL OF CARDIOLOGY. Long-Term Follow Up of Percutaneous Coronary Intervention of Coronary Artery Disease in Women ≤45 Years of Age

Wei Liu, MD , Venkata Kishore Mukku, MD , Yu-Yang Liu, MD , Dong-Mei Shi, MD , Ying-Xin Zhao, MD , Yu-Jie Zhou, MD, PhD

The aim of the present study was to report the short- and long-term clinical outcomes of percutaneous coronary intervention in young women with premature coronary artery disease. From February 2003 to December 2011, 168 consecutive women aged ≤45 years who underwent percutaneous coronary intervention with stent implantation were retrospectively analyzed. The primary end point was the incidence of major adverse cardiac events (MACEs) at short- and long-term follow-up. The mean age was 40.3 ± 2.0 years. Conventional coronary artery disease risk factors were common. Autoimmune or connective tissue diseases were present in 6.5% of the population, 4% had gynecologic diseases, 4 were postpartum, and 9 were taking contraceptives. The left anterior descending coronary artery was the most commonly affected vessel (83.3%) and the most common target vessel for stenting (76.8%). A total of 268 stents were implanted, 95.3% of which were drug-eluting stents. During the hospital stay, 1 patient died, and the incidence of MACEs was 1.2%. No additional events had occurred at 30-day follow-up. After a median follow-up duration of 36 months (interquartile range 12 to 60), cumulate MACE-free survival was 80.5%, the rate of target vessel revascularization was 16.5%, and the rate of stent thrombosis was 3.6%. Cox regression showed that hypertension, smoking, a left ventricular ejection fraction <50%, anterior myocardial infarction, and autoimmune disease were independent predictors of MACEs. In conclusion, percutaneous coronary intervention in young women tends to result in an increased rate of target vessel revascularization during long-term follow-up, which may be influenced by conventional and nonconventional risk factors.

01 noviembre 2012

JACC: CARDIOVASCULAR INTERVENTIONS. Comparison of Nonculprit Coronary Plaque Characteristics Between Patients With and Without Diabetes. A 3-Vessel Optical Coherence Tomography Study

Koji Kato, MD, PhD?; Taishi Yonetsu, MD?; Soo-Joong Kim, MD, PhD?; Lei Xing, MD?; Hang Lee, PhD‡; Iris McNulty, RN?; Robert W. Yeh, MD, MSc?; Rahul Sakhuja, MD, MPP, MSc§; Shaosong Zhang, MD, PhD?; Shiro Uemura, MD, PhD#; Bo Yu, MD, PhD††; Kyoichi Mizuno, MD, PhD?; Ik-Kyung Jang, MD, PhD?

Objectives: The aim of the present study was to compare the characteristics of nonculprit coronary plaques between diabetes mellitus (DM) and non-DM patients using 3-vessel optical coherence tomography (OCT) imaging.

01 noviembre 2012

JACC. Assessing the Association of Appropriateness of Coronary Revascularization and Clinical Outcomes for Patients With Stable Coronary Artery Disease

Dennis T. Ko, MD, MSc?; Helen Guo, MSc?; Harindra C. Wijeysundera, MD, PhD?; Madhu K. Natarajan, MD, MSc§; A. Dave Nagpal, MD?; Christopher M. Feindel, MD‡; Kori Kingsbury, MSN#; Eric A. Cohen, MD†; Jack V. Tu, MD, PhD?

Objectives: The study assessed the appropriateness of coronary revascularization in Ontario, Canada, and examined its association with longer-term outcomes.

01 septiembre 2012

EUROPEAN HEART JOURNAL. Effects of Celecoxib On Restenosis after Coronary Intervention and Evolution of Atherosclerosis (Mini-COREA) Trial: celecoxib, a double-edged sword for patients with angina

Hyun-Jae Kang1,†, Il-Young Oh2,†, Jin-Wook Chung3, Han-Mo Yang1, Jung-Won Suh2, Kyung Woo Park1, Taek Keun Kwon4, Hae-Young Lee1, Young-Seok Cho2, Tae-Jin Youn2, Bon-Kwon Koo1, Won-Yu Kang5, Weon Kim6, Seung-Woon Rha7, Jang Ho Bae4, In-Ho Chae2, Dong-Ju Choi2 and Hyo-Soo Kim1,*

Aims In the previous COREA-TAXUS trial, a 6-month adjunctive use of celecoxib reduced target-lesion revascularization (TLR) without increased thrombotic risk. We aimed to confirm the effects of 3-month celecoxib in patients receiving drug-eluting stent (DES) implantation in the larger prospective, randomized trial.

01 octubre 2012

THE AMERICAN JOURNAL OF CARDIOLOGY. Comparison of Results of Coronary Artery Bypass Grafting Versus Percutaneous Coronary Intervention in Octogenarians

Jarmo Gunn, MD , Kari Kuttila, MD, PhD , Francesco Vasques, MS , Raine Virtanen, MD, PhD , Anne Lahti, MD , Juhani Airaksinen, MD, PhD , Fausto Biancari, MD, PhD

The aim of the present study was to compare the outcomes after coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in patients aged ≥80 years. The present analysis included 274 patients who underwent isolated CABG and 393 patients who underwent PCI. The patients undergoing PCI had a greater prevalence of a history of cardiac surgery and recent myocardial infarction and had more frequently undergone emergency revascularization. Patients undergoing CABG had a significantly greater prevalence of 3-vessel coronary artery disease. The unadjusted 30-day mortality rate was 8.8% after CABG and 7.4% after PCI (p = 0.514). However, on multivariate analysis, CABG was associated with a significantly increased risk of 30-day mortality (odds ratio 2.246, 95% confidence interval 1.141 to 4.422). The unadjusted overall intermediate survival was significantly poorer after PCI (at 5 years, CABG 72.2% vs PCI 59.5%, p = 0.004), but this was not confirmed on multivariate analysis. PCI and CABG had similar intermediate survival rates when adjusted for propensity score (p = 0.698), a finding confirmed by the analysis of 130 propensity score-matched pairs (at 5 years, CABG 66.4% vs PCI 58.9%, p = 0.730). In conclusion, the survival of patients aged ≥80 years undergoing CABG is excellent, and the suboptimal survival after PCI seems to be related to the disproportionately greater risk of these patients compared to those undergoing CABG. When adjusted for important clinical variables, PCI and CABG achieved similar intermediate results.

01 noviembre 2012

JACC: CARDIOVASCULAR INTERVENTIONS. Clinical Impact of Second-Generation Everolimus-Eluting Stent Compared With First-Generation Drug-Eluting Stents in Diabetes Mellitus Patients. Insights From a Nationwide Coronary Intervention Register

Elvin Kedhi, MD, PhD?; Marc E. Gomes, MD, PhD?; Bo Lagerqvist, MD, PhD‡; J. Gustav Smith, MD, PhD§; Elmir Omerovic, MD, PhD?; Stefan James, MD, PhD‡; Jan Harnek, MD, PhD§; Göran K. Olivecrona, MD, PhD§

Objectives: This study sought to study the second-generation everolimus-eluting stent (EES) as compared with first-generation sirolimus-eluting (SES) and paclitaxel-eluting stents (PES) in diabetes mellitus (DM) patients.

01 noviembre 2012

JACC. Long-Term Outcomes After Transcatheter Aortic Valve Implantation. Insights on Prognostic Factors and Valve Durability From the Canadian Multicenter Experience

Josep Rodés-Cabau, MD?; John G. Webb, MD†; Anson Cheung, MD†; Jian Ye, MD†; Eric Dumont, MD?; Mark Osten, MD‡; Christopher M. Feindel, MD‡; Madhu K. Natarajan, MD§; James L. Velianou, MD§; Giussepe Martucci, MD?; Benoît DeVarennes, MD?; Robert Chisholm, MD¶; Mark Peterson, MD¶; Christopher R. Thompson, MD†; David Wood, MD†; Stefan Toggweiler, MD†; Ronen Gurvitch, MD†; Samuel V. Lichtenstein, MD†; Daniel Doyle, MD?; Robert DeLarochellière, MD?; Kevin Teoh, MD§; Victor Chu, MD§; Kevin Bainey, MD§; Kevin Lachapelle, MD?; Asim Cheema, MD¶; David Latter, MD¶; Jean G. Dumesnil, MD?; Philippe Pibarot, PhD†; Eric Horlick, MD‡

Objectives: This study sought to evaluate the long-term outcomes after transcatheter aortic valve implantation (TAVI) in the Multicenter Canadian Experience study, with special focus on the causes and predictors of late mortality and valve durability.

01 septiembre 2012

EUROPEAN HEART JOURNAL. Patent foramen ovale transcatheter closure vs. medical therapy on recurrent vascular events: a systematic review and meta-analysis of randomized controlled trials

Pablo Rengifo-Moreno1, Igor F. Palacios2, Parichart Junpaparp3, Christian F. Witzke1, D. Lynn Morris1,4 and Abel Romero-Corral1,5,*

Background In patients with cryptogenic stroke, transcatheter (TC) closure of a patent foramen ovale (PFO) has not been shown to better prevent recurrent vascular events than medical therapy. However, randomized controlled trials (RCT) to date have included few vascular events, and lack of power has been raised as an important concern.

01 septiembre 2013

CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS. Objectifying the impact of incomplete revascularization by repeat angiographic risk assessment with the residual SYNTAX score after left main coronary artery percutaneous coronary intervention

Davide Capodanno MD, PHD1,2,*, Alberto Chisari MD1, Daniele Giacoppo MD1, Salvatore Bonura MD1, Vincenzo Lavanco MD1, Piera Capranzano MD1, Anna Caggegi MD1, Margherita Ministeri MD1, Corrado Tamburino MD, PHD1,2

Objectives: We investigated the prognostic accuracy of a standardized quantification of incomplete revascularization after percutaneous coronary intervention (PCI) of the unprotected left main coronary artery (ULMCA) named residual SYNTAX score (rSS).