01 marzo 2012

CIRCULATION. Randomized Comparison of Everolimus-Eluting and Sirolimus-Eluting Stents in Patients Treated With Percutaneous Coronary Intervention. The Scandinavian Organization for Randomized Trials With Clinical Outcome IV (SORT OUT IV)

Lisette Okkels Jensen, MD, DMSci, PhD; Per Thayssen, MD, DMSci; Henrik Steen Hansen, MD, DMSci; Evald Høj Christiansen, MD, PhD; Hans Henrik Tilsted, MD; Lars Romer Krusell, MD; Anton Boel Villadsen, MD; Anders Junker, MD, PhD; Knud Nørregaard Hansen, MD; Anne Kaltoft, MD, PhD; Michael Maeng, MD, PhD; Knud Erik Pedersen, MD, DMSci; Steen Dalby Kristensen, MD, DMSci; Hans Erik Bøtker, MD, DMSci, PhD; Jan Ravkilde, MD, DMSci; Richardo Sanchez, MD; Jens Aarøe, MD; Morten Madsen, MSc; Henrik Toft Sørensen, MD, DMSci, PhD; Leif Thuesen, MD, DMSci; Jens Flensted Lassen, MD, PhD; for the Scandinavian Organization for Randomized Trials With Clinical Outcome IV (SORT OUT IV) Investigators

Background—Among drug-eluting stents released to date, the sirolimus-eluting stent has demonstrated the least amount of late lumen loss, but its efficacy and safety have not been compared head-to-head with the next-generation everolimus-eluting stent.

15 abril 2012

JACC. Primary Endpoint Results of the EVOLVE Trial. A Randomized Evaluation of a Novel Bioabsorbable Polymer-Coated, Everolimus-Eluting Coronary Stent

Ian T. Meredith, MBBS, PhD; Stefan Verheye, MD, PhD; Christophe L. Dubois, MD; Joseph Dens, MD; Jean Fajadet, MD; Didier Carrié, MD; Simon Walsh, MD; Keith G. Oldroyd, MD; Olivier Varenne, MD; Seif El-Jack, MD; Raul Moreno, MD; Anita A. Joshi, PhD; Dominic J. Allocco, MD; Keith D. Dawkins, MD

Objectives This study sought to compare the safety and efficacy of 2 dose formulations of SYNERGY, a novel bioabsorbable polymer everolimus-eluting stent (EES) (Boston Scientific Corp., Natick, Massachusetts) compared with the durable polymer PROMUS Element EES (Boston Scientific Corp.).

01 marzo 2013

JACC CARDIOVASCULAR INTERVENTIONS. Transcatheter Aortic Valve Replacement With the SAPIEN 3. A New Balloon-Expandable Transcatheter Heart Valve

Ronald K. Binder, MD; Josep Rodés-Cabau, MD; David A. Wood, MD; Michael Mok, MD; Jonathon Leipsic, MD; Robert De Larochellière, MD; Stefan Toggweiler, MD; Eric Dumont, MD; Melanie Freeman, MBBS; Alexander B. Willson, MBBS; John G. Webb, MD

Objectives: The aim of this study was to demonstrate the first-in-human feasibility and short-term clinical outcomes with a new balloon-expandable transcatheter heart valve (THV).

01 marzo 2013

JACC CARDIOVASCULAR INTERVENTIONS. Transcatheter Aortic Valve Replacement With a New Self-Expanding Transcatheter Heart Valve and Motorized Delivery System

Ronald K. Binder, MD; Ulrich Schäfer, MD; Karl-Heinz Kuck, MD; David A. Wood, MD; Robert Moss, MD; Jonathon Leipsic, MD; Stefan Toggweiler, MD; Melanie Freeman, MBBS; Avi J. Ostry, MD; Christian Frerker, MD; Alexander B. Willson, MBBS; John G. Webb, MD

Objectives The aim of this study was to demonstrate feasibility and short- and midterm clinical outcomes with a new self-expanding transcatheter heart valve and motorized delivery system.

01 marzo 2012

EUROPEAN HEART JOURNAL. Relations between professional medical associations and the health-care industry, concerning scientific communication and continuing medical education: a Policy Statement from the European Society of Cardiology

ESC Board

Physicians have an ethical duty to keep up-to-date with current knowledge. Professional medical associations such as the European Society of Cardiology (ESC) support these obligations. In Europe, the costs of continuing medical education (CME) are insufficiently supported from governments and employers; however, medical associations have been criticized for accepting alternative financial support from industry. Medical education and training in research include learning how to assess the quality and reliability of any information. There is some risk of bias in any form of scientific communication including intellectual, professional, and financial and it is essential that in particular, the latter must be acknowledged by full disclosure. It is essential that there is strong collaboration between basic and clinical researchers from academic institutions on the one hand, with engineers and scientists from the research divisions of device and pharmaceutical companies on the other. This is vital so that new diagnostic methods and treatments are developed. Promotion of advances by industry may accelerate their implementation into clinical practice. Universities now frequently exhort their academic staff to protect their intellectual property or commercialize their research. Thus, it is not commercial activity or links per se that have become the target for criticism but the perceived influence of commercial enterprises on clinical decision-making or on messages conveyed by professional medical organizations. This document offers the perspective of the ESC on the current debate, and it recommends how to minimize bias in scientific communications and CME and how to ensure proper ethical standards and transparency in relations between the medical profession and industry.

01 marzo 2012

STROKE. Insufficient Platelet Inhibition Is Related to Silent Embolic Cerebral Infarctions After Coronary Angiography

Bum Joon Kim, MD; Seung-Whan Lee, MD; Seong-Wook Park, MD; Dong-Wha Kang, MD; Jong S. Kim, MD; Sun U. Kwon, MD, PhD

Background and Purpose—Considering that insufficient platelet inhibition is related to thrombotic complications after coronary angiography, we hypothesized that the extent of platelet inhibition by antiplatelet agents is related to the occurrence of silent embolic cerebral infarction (SECI) after coronary angiography.

01 marzo 2012

STROKE. Cost-Effectiveness of Dabigatran Compared With Warfarin for Stroke Prevention in Patients With Atrial Fibrillation and Prior Stroke or Transient Ischemic Attack

Hooman Kamel, MD; S. Claiborne Johnston, MD, PhD; J. Donald Easton, MD; Anthony S. Kim, MD, MAS

Background and Purpose—The cost-effectiveness of dabigatran for stroke prevention in patients with atrial fibrillation and prior stroke or transient ischemic attack has not been directly assessed.

01 marzo 2012

JACC CARDIOVASCULAR INTERVENTIONS. Long-Term Follow-Up After Treatment of Coronary In-Stent Restenosis With a Paclitaxel-Coated Balloon Catheter

Bruno Scheller, MD; Yvonne P. Clever, MD; Bettina Kelsch, M.Chem; Christoph Hehrlein, MD; Wolfgang Bocksch, MD; Wolfgang Rutsch, MD; Dariush Haghi, MD; Ulrich Dietz, MD; Ulrich Speck, PhD; Michael Böhm, MD; Bodo Cremers, MD

Objectives: This study presents long-term clinical follow-up, including binary restenosis rate and major adverse cardiovascular events, of the PACCOCATH-ISR (Treatment of In-Stent Restenosis by Paclitaxel Coated PTCA Balloons) I and II trial.

01 marzo 2012

EUROPEAN HEART JOURNAL. Lower risk of stent thrombosis and restenosis with unrestricted use of ‘new-generation’ drug-eluting stents: a report from the nationwide Swedish Coronary Angiography and Angioplasty Registry (SCAAR)

Giovanna Sarno, Bo Lagerqvist, Ole FröberT, Johan Nilsson, Göran Olivecrona, Elmir Omerovic, Nawzad Saleh, Dimitris Venetzanos and Stefan James

Aims: To compare the long-term outcome after percutaneous coronary intervention with new-generation drug-eluting stents (n-DES) to ‘older generation’ DES (o-DES), and bare-metal stents (BMS) in a real-world population.

01 marzo 2012

JACC CARDIOVASCULAR INTERVENTIONS. Comparison of Drug-Eluting and Bare-Metal Stents for Primary Percutaneous Coronary Intervention With or Without Abciximab in ST-Segment Elevation Myocardial InfarctionDEBATER: The Eindhoven Reperfusion Study

Objectives: The goal of this study was to demonstrate superiority of sirolimus-eluting stents (SES) over bare-metal stents (BMS) and of abciximab over no abciximab in primary percutaneous coronary intervention (PCI).

22 febrero 2010

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Polymer-Free Biolimus A9-Coated Stent Demonstrates More Sustained Intimal Inhibition, Improved Healing, and Reduced Inflammation Compared With a Polymer-Coated Sirolimus-Eluting Cypher Stent in a Porcine Model

Norio Tada, MD, Renu Virmani, MD, Gordon Grant, Lauren Bartlett, BS, Alexander Black, MB, BS, Claudia Clavijo, MD, Uwe Christians, MD, PhD, Ron Betts, PhD, Doug Savage, PhD, Shih-Horng Su, PhD, John Shulze and Saibal Kar, MD

Background— Drug-eluting stents effectively reduce restenosis but may increase late thrombosis and delayed restenosis. Persistent polymer, the drug, or a combination of both could be responsible. Local delivery of Biolimus A9, a rapamycin derivative, from a polymer-free BioFreedom stent (Biosensors International) may prevent these complications.

01 marzo 2012

JACC CARDIOVASCULAR INTERVENTIONS. Impact of Sex on Clinical and Angiographic Outcomes Among Patients Undergoing Revascularization With Drug-Eluting Stents

Giulio G. Stefanini, MD; Bindu Kalesan, MSc; Thomas Pilgrim, MD; Lorenz Räber, MD; Yoshinobu Onuma, MD; Sigmund Silber, MD; Patrick W. Serruys, MD; Bernhard Meier, MD; Peter Jüni, MD; Stephan Windecker, MD

Objectives: The goal of this study was to investigate sex-based differences in long-term clinical and angiographic outcomes after coronary revascularization with drug-eluting stents (DES).

01 marzo 2012

JACC CARDIOVASCULAR INTERVENTIONS. The Illusion of “Optimal” Platelet Inhibition

Steven R. Steinhubl, MD

Having the ability to measure whether and how much a drug is able to influence platelet function ex vivo has led to some remarkable contributions to cardiovascular medicine over the last several decades. For example, the nearly 40-year journey for aspirin to go from a hypothesized to a proven therapy for ischemic heart disease may have never occurred if not for a series of mechanistic investigations of its effects on platelet function (2). The entire thienopyridine class of antiplatelet agents may have been forever relegated to the trash heap of failed pharmaceutical entities if not for the fortuitous finding that it prevented adenosine diphosphate (ADP)-induced platelet aggregation after it initially failed for its proposed use as an anti-inflammatory agent (3). And the parenteral platelet glycoprotein (GP) IIb/IIIa inhibitors are a drug class that was specifically designed around their ability to potently inhibit platelet aggregation. But even with these notable successes, historically, platelet function testing has proven to be a somewhat unreliable and confusing “crystal ball”—inconsistent in its ability to predict what, if any, antithrombotic efficacy an agent may have—and still of no proven clinical use in guiding individual therapy. Nonetheless, because our ability to adequately tame the platelet is so critical for the successful treatment and prevention of arterial thrombosis, and because, as of yet, we have no viable testing alternative, ex vivo platelet function assessments have and will continue to play a substantial role in clinical research and drug development.

01 marzo 2012

JACC CARDIOVASCULAR INTERVENTIONS. Prasugrel Versus Tirofiban Bolus With or Without Short Post-Bolus Infusion With or Without Concomitant Prasugrel Administration in Patients With Myocardial Infarction Undergoing Coronary Stenting. The FABOLUS PRO trial

Marco Valgimigli, MD, PhD; Matteo Tebaldi, MD; Gianluca Campo, MD; Stefania Gambetti, BSc; Laura Bristot, BSc; Monia Monti, BSc; Giovanni Parrinello, PhD; Roberto Ferrari, MD, PhD

Objectives: The authors sought to compare the effect on inhibition of platelet aggregation (IPA) of prasugrel therapy versus tirofiban bolus with or without a post-bolus short drug infusion in ST-segment elevation myocardial infarction (STEMI) patients.

01 febrero 2012

JACC. Coronary Artery Disease Progression Late After Successful Stent Implantation

Michael J. Zellweger, MD; Christoph Kaiser, MD; Raban Jeger, MD; Hans-Peter Brunner-La Rocca, MD; Peter Buser, MD; Franziska Bader, RN; Jan Mueller-Brand, MD; Matthias Pfisterer, MD

Objectives: This study sought to define the importance of 5-year coronary artery disease (CAD) progression after successful stenting.