01 agosto 2013

STROKE. Effects on Ischemic and Hemorrhagic Strokes and Bleeding in Asians and Non-Asians With Atrial Fibrillation

Masatsugu Hori, MD, PhD; Stuart J. Connolly, MD; Jun Zhu, MD; Li Sheng Liu, MD; Chu-Pak Lau, MD; Prem Pais, MD; Denis Xavier, MD; Sung Soon Kim, MD; Razali Omar, MD; Antonio L. Dans, MD; Ru San Tan, MD; Jyh-Hong Chen, MD; Supachai Tanomsup, MD; Mitsunori Watanabe, MD, PhD; Masahide Koyanagi, BA; Michael D. Ezekowitz, MBChB, DPhil; Paul A. Reilly, PhD; Lars Wallentin, MD; Salim Yusuf, MD, DPhil the RE-LY Investigators

Background and Purpose—Intracranial hemorrhage rates are higher in Asians than non-Asians, especially in patients receiving warfarin. This randomized evaluation of long-term anticoagulation therapy subgroup analysis assessed dabigatran etexilate (DE) and warfarin effects on stroke and bleeding rates in patients from Asian and non-Asian countries.

01 septiembre 2012

CIRCULATION. Clinical Features, Management, and Prognosis of Spontaneous Coronary Artery Dissection

Marysia S. Tweet, MD; Sharonne N. Hayes, MD; Sridevi R. Pitta, MBBS; Robert D. Simari, MD; Amir Lerman, MD; Ryan J. Lennon, MS; Bernard J. Gersh, MB, ChB, DPhil; Sherezade Khambatta, DO; Patricia J.M. Best, MD; Charanjit S. Rihal, MD, MBA; Rajiv Gulati, MD, PhD

Background—Spontaneous coronary artery dissection (SCAD) is an acute coronary event of uncertain origin. Clinical features and prognosis remain insufficiently characterized.

01 agosto 2012

EUROPEAN HEART JOURNAL. A clinical decision aid for the selection of antithrombotic therapy for the prevention of stroke due to atrial fibrillation

Stephen Andrew LaHaye, Sabra Lynn Gibbens, David Gerald Andrew Ball, Andrew George Day, Jonas Bjerring Olesen and Allan Cameron Skanes

Aims The availability of new antithrombotic agents, each with a unique efficacy and bleeding profile, has introduced a considerable amount of clinical uncertainty with physicians. We have developed a clinical decision aid in order to assist clinicians in determining an optimal antithrombotic regime for the prevention of stroke in patients who are newly diagnosed with non-valvular atrial fibrillation.

CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS. Acute outcome of stent therapy for coarctation of the aorta: Results of the coarctation of the aorta stent trial

Richard E. Ringel MD, Julie Vincent MD, Kathy J. Jenkins MD, MPH, Kimberlee Gauvreau ScD, Heidi Moses MEd, CCRA, Kimberly Lofgren BA, Kudret Usmani BA, BSc

Objectives: The coarctation of the aorta stent trial (COAST) is a pivotal trial of the NuMED Cheatham Platinum Stent® for treatment of coarctation of the aorta (CoA).

01 agosto 2013

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Should We Recommend Oral Anticoagulation Therapy in Patients With Atrial Fibrillation Undergoing Coronary Artery Stenting With a High HAS-BLED Bleeding Risk Score?

Juan M. Ruiz-Nodar, MD, PhD, Francisco Marín, MD, PhD, Vanessa Roldán, MD, PhD, José Valencia, MD, PhD, Sergio Manzano-Fernández, MD, PhD, Luis Caballero, MD, José A. Hurtado, MD, Francisco Sogorb, MD, PhD, Mariano Valdés, MD, PhD and Gregory Y.H. Lip, MD, FACC, FESC

Background—Recent European guidelines for the management of atrial fibrillation recommend oral anticoagulation (OAC) in patients with CHA2DS2-VASc score (congestive heart failure, hypertension, age ≥75 years, diabetes, history of previous stroke, vascular disease, age 65–74 years, and sex category [female]) ≥1. The HAS-BLED score (Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile international normalized ratio, Elderly [>65 years], Drugs/alcohol concomitantly) has been suggested to assess bleeding risk in patients with atrial fibrillation (score ≥3 indicates high risk of bleeding). Despite the guidelines, this approach has never been tested in a cohort of patients with atrial fibrillation undergoing percutaneous coronary intervention with stent implantation.

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, PHD, Alberto Chisari MD, Daniele Giacoppo MD, Salvatore Bonura MD, Vincenzo Lavanco MD, Piera Capranzano MD, Anna Caggegi MD, Margherita Ministeri MD, Corrado Tamburino MD, PHD

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).

01 agosto 2012

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Long-Term Outcome of Stents Versus Bypass Surgery in Diabetic and Nondiabetic Patients With Multivessel or Left Main Coronary Artery Disease. A Pooled Analysis of 5775 Individual Patient Data

Duk-Woo Park, MD, Young-Hak Kim, MD, Hae Geun Song, MD, Jung-Min Ahn, MD, Won-Jang Kim, MD, Jong-Young Lee, MD, Soo-Jin Kang, MD, Seung-Whan Lee, MD, Cheol Whan Lee, MD, Seong-Wook Park, MD, Sung-Cheol Yun, PhD, Sung-Ho Chung, MD, Suk Jung Choo, MD, Cheol Hyun Chung, MD, Jae-Won Lee, MD and Seung-Jung Park, MD

Background—Coronary artery bypass grafting and percutaneous coronary intervention (PCI) are alternative treatments for complex multivessel or left main disease. However, the relative treatment effects in diabetic and nondiabetic patients remain uncertain.

01 julio 2013

JACC: CARDIVASCULAR INTERVENTIONS. Angiographic Outcomes in the PLATO Trial (Platelet Inhibition and Patient Outcomes)

Vijay Kunadian, MBBS, MD; Stefan K. James, MD, PhD; Daniel M. Wojdyla, MS; Cafer Zorkun, MD, PhD; Jinhui Wu, MD; Robert F. Storey, MD, DM; Ph. Gabriel Steg, MD; Hugo Katus, MD; Hakan Emanuelsson, MD, PhD; Jay Horrow, MD, MS; Juan Maya, MD; Lars Wallentin, MD, PhD; Robert A. Harrington, MD; C. Michael Gibson, MS, MD

Objectives: The PLATO (Platelet Inhibition and Patient Outcomes) angiographic substudy sought to compare the efficacy of ticagrelor versus clopidogrel with respect to angiographic outcomes before and after PCI in the setting of acute coronary syndrome.

01 julio 2012

EUROPEAN HEART JOURNAL. Catheterization laboratories open 24 hours a day, every day: does stable non-ST-elevation acute coronary syndrome need the offer?

Pedro L. Sanchez and Francisco Fernandez-Aviles

Non- ST-elevation acute coronary syndrome (NSTE-ACS) represents the majority of ACS. Despite the fact that we pay most attention to ST-elevation-ACS, NSTE-ACS is where logistically the action is, as these patients account for ∼3 out of 4 hospital ACS discharges.1 Recent studies have helped to clarify that a strategy of routine catheterization is superior to a conservative strategy of catheterization only if the patient develops spontaneous or stress-induced ischaemia. Routine angiography and revascularization after NSTE-ACS reduces mortality by 25%, myocardial infarction by 18%, and re-hospitalization for unstable angina by 31% at mid-term follow-up.2 However, it is still controversial, for initially stabilized patients, whether the catheterization and percutaneous coronary intervention (PCI) need to be done early (i.e. within 24 h) or whether they could be delayed ≥1 day while the patient receives medical therapy and logistic attention. Thus, should we open our laboratories 24 h a day, every day, to catheterize NSTE-ACS patients early, even within the first few hours of hospital admission, analogous to the standard of primary PCI?

01 agosto 2012

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Clinical and Procedural Predictors of Suboptimal Outcome After the Treatment of Drug-Eluting Stent Restenosis in the Unprotected Distal Left Main Stem. The Milan and New-Tokyo (MITO) Registry

Kensuke Takagi, MD, Alfonso Ielasi, MD, Joanne Shannon, MD, Azeem Latib, MD, Cosmo Godino, MD, Giedrius Davidavicius, MD, Marco Mussardo, MD, Santo Ferrarello, MD, Filippo Figini, MD, Mauro Carlino, MD, Matteo Montorfano, MD, Alaide Chieffo, MD, Sunao Nakamura, MD and Antonio Colombo, MD

Background—Few data are available regarding the optimal revascularization strategy for unprotected distal left main coronary artery (UDLM) in-stent restenosis (ISR).

01 agosto 2012

CIRCULATION. A Prospective, Randomized Clinical Trial of Hemodynamic Support With Impella 2.5 Versus Intra-Aortic Balloon Pump in Patients Undergoing High-Risk Percutaneous Coronary Intervention. The PROTECT II Study

William W. O Neill, MD; Neal S. Kleiman, MD; Jeffrey Moses, MD; Jose P.S. Henriques, MD, PhD; Simon Dixon, MBChB; Joseph Massaro, PhD; Igor Palacios, MD; Brijeshwar Maini, MD; Suresh Mulukutla, MD; Vladimír Džavík, MD; Jeffrey Popma, MD; Pamela S. Douglas, MD; Magnus Ohman, MD

Background—Although coronary artery bypass grafting is generally preferred in symptomatic patients with severe, complex multivessel, or left main disease, some patients present with clinical features that make coronary artery bypass grafting clinically unattractive. Percutaneous coronary intervention with hemodynamic support may be feasible for these patients. Currently, there is no systematic comparative evaluation of hemodynamic support devices for this indication.

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 FREE CME

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 julio 2012

EUROPEAN HEART JOURNAL. Optimal timing of invasive angiography in stable non-ST-elevation myocardial infarction: the Leipzig Immediate versus early and late PercutaneouS coronary Intervention triAl in NSTEMI (LIPSIA-NSTEMI Trial)

Holger Thiele, Justus Rach, Norbert Klein, Dietrich Pfeiffer, Andreas Hartmann, Rainer Hambrecht, Peter Sick, Ingo Eitel, Steffen Desch and Gerhard Schuler for the LIPSIA-NSTEMI Trial Group

Aims The optimal timing of intervention in non-ST-elevation myocardial infarction (NSTEMI) remains uncertain. The aim of this multicentre trial was to assess whether an immediate invasive approach is superior to an early invasive or a selective invasive approach with respect to reduction of large infarction.

CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS. Women treated with second-generation zotarolimus-eluting resolute stents and everolimus-eluting xience V stents: insights from the gender-stratified, randomized, controlled TWENTE trial

Kenneth Tandjung MD, Mounir W.Z. Basalus MD, Hanim Sen MD, Martin G. Stoel MD, K. Gert van Houwelingen MD, J. (Hans) W. Louwerenburg MD, Frits H.A.F. de Man MD, PhD, Gerard C.M. Linssen MD, PhD, Salah A.M. Saïd MD, PhD, Miep A.W.J. Kleijne MD, Job van der Palen PhD, Clemens von Birgelen MD, PhD

Background: Women are underrepresented in clinical research, and few data are available from randomized head-to-head comparisons of second-generation drug-eluting stents (DES) in female patients. Aim of this study was to assess safety and efficacy of two second-generation DES in women. In TWENTE—a prospective, randomized, comparative DES trial—“real-world” patients were stratified for gender before randomization for Resolute or Xience V stents.

01 agosto 2013

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Flow Patterns at Stented Coronary Bifurcations. Computational Fluid Dynamics Analysis

Demosthenes G. Katritsis, MD, PhD, FRCP, Andreas Theodorakakos, PhD, Ioannis Pantos, MSc, Manolis Gavaises, PhD, Nicos Karcanias, PhD, DSc and Efstathios P. Efstathopoulos, PhD

Background—The ideal bifurcation stenting technique is not established, and data on the hemodynamic characteristics at stented bifurcations are limited.