01 enero 2012

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. No Association of ABCB1 C3435T Genotype With Clopidogrel Response or Risk of Stent Thrombosis in Patients Undergoing Coronary Stenting

Juliane Jaitner, MD, Tanja Morath, MD, Robert A. Byrne, MD, MB, BCh, Siegmund Braun, MD, Daniela Gebhard, MD, Isabell Bernlochner, MD, Stefanie Schulz, MD, Julinda Mehilli, MD, Albert Schömig, MD, Werner Koch, MD, Adnan Kastrati, MD and Dirk Sibbing, MD

Background—The prodrug clopidogrel requires intestinal absorption by the efflux pump P-glycoprotein MDR1 (multidrug resistant-1), encoded by the ABCB1 gene. Prior studies suggested that a common and functional genetic variant (C3435T, rs1045642) within ABCB1 influences clopidogrel treatment efficacy; however, existing data are highly inconsistent, because other studies failed to replicate this postulated association. Thus, the aim of this study was to assess the association of ABCB1 C3435T genotypes with the antiplatelet efficacy of clopidogrel and the risk of stent thrombosis (ST) in large cohorts of clopidogrel-treated patients undergoing percutaneous coronary intervention.

01 febrero 2012

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Outcomes After Stent Implantation for the Treatment of Congenital and Postoperative Pulmonary Vein Stenosis in Children

Sowmya Balasubramanian, MD, Audrey C. Marshall, MD, Kimberlee Gauvreau, ScD, Lynn F. Peng, MD, Alan W. Nugent, MBBS, James E. Lock, MD and Doff B. McElhinney, MD

Background—Pulmonary vein stenosis (PVS) is a rare condition that can lead to worsening pulmonary hypertension and cardiac failure in children, and it is frequently lethal. Surgical and transcatheter approaches are acutely successful but restenosis is common and rapid.

01 febrero 2012

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Is There a Clinically Significant Interaction Between Calcium Channel Antagonists and Clopidogrel? Results From the Clopidogrel for the Reduction of Events During Observation (CREDO) Trial

Christopher W. Good, DO, Steven R. Steinhubl, MD, Danielle M. Brennan, MS, A. Michael Lincoff, MD, Eric J. Topol, MD and Peter B. Berger, MD

Background—Clopidogrel is an inactive prodrug; it is converted to its active metabolite through the cytochrome P450 (CYP3A4) pathway, which also metabolizes calcium channel blockers (CCBs). Several studies have reported that CCBs reduce the ability of clopidogrel to inhibit platelet aggregability; one suggested that CCBs reduce the efficacy of clopidogrel.

01 febrero 2012

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Clinical Outcomes and Treatment After Drug-Eluting Stent Failure. The Absence of Traditional Risk Factors for In-Stent Restenosis

Gabriel Maluenda, MD, Itsik Ben-Dor, MD, Michael A. Gaglia Jr, MD, MSc, Kohei Wakabayashi, MD, Michael Mahmoudi, MD, PhD, Gabriel Sardi, MD, Ana Laynez-Carnicero, MD, Rebecca Torguson, MPH, Zhenyi Xue, MS, Adrian D. Margulies, William O. Suddath, MD, Kenneth M. Kent, MD, PhD, Nelson L. Bernardo, MD, Lowell F. Satler, MD, Augusto D. Pichard, MD and Ron Waksman, MD

Background—The optimal percutaneous treatment of drug-eluting stent (DES) in-stent restenosis (ISR) and the correlates for recurrent DES ISR remain unclear.

01 febrero 2012

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Long-Term Clinical Outcome After Fractional Flow Reserve–Guided Percutaneous Coronary Revascularization in Patients With Small-Vessel Disease

Etienne Puymirat, MD, Aaron Peace, MD, PhD, Fabio Mangiacapra, MD, Micaela Conte, MD, Yiannis Ntarladimas, MD, Jozef Bartunek, MD, PhD, Marc Vanderheyden, MD, PhD, William Wijns, MD, PhD, Bernard De Bruyne, MD, PhD and Emanuele Barbato, MD, PhD

Background—Small coronary vessels supply small myocardial territories. The clinical significance of small-vessel stenoses is therefore questionable. Moreover, percutaneous coronary intervention (PCI) of nonfunctionally significant lesions does not improve clinical outcome and might be associated with potential procedural or stent related risks. The aim of this study was to assess the clinical outcome of fractional flow reserve (FFR)-guided PCI in the treatment of small coronary vessel lesions as compared with an angio-guided PCI.

01 febrero 2012

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Composition of Target Lesions by Near-Infrared Spectroscopy in Patients With Acute Coronary Syndrome Versus Stable Angina

Ryan D. Madder, MD, James L. Smith, MD, Simon R. Dixon, MBChB and James A. Goldstein, MD

Background—Whereas acute coronary syndromes (ACS) typically develop from the rupture of lipid core plaque (LCP), lesions causing stable angina are believed to be composed of fibrocalcific plaque. In this study, intracoronary near-infrared spectroscopy (NIRS) was used to determine the frequency of LCP at target and remote sites in patients with ACS versus those with stable angina.

01 febrero 2012

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Vascular Tissue Reaction to Acute Malapposition in Human Coronary Arteries

Juan Luis Gutiérrez-Chico, MD, PhD, Joanna Wykrzykowska, MD, PhD, Eveline Nüesch, PhD, Robert Jan van Geuns, MD, PhD, Karel T. Koch, MD, PhD, Jacques J. Koolen, MD, PhD, Carlo di Mario, MD, PhD, Stephan Windecker, MD, PhD, Gerrit-Anne van Es, MSc, PhD, Pierre Gobbens, MSc, Peter Jüni, MD, Evelyn Regar, MD, PhD and Patrick W. Serruys, MD, PhD

Background—The vascular tissue reaction to acute incomplete stent apposition (ISA) is not well known. The aim of this study was to characterize the vascular response to acute ISA in vivo and to look for predictors of incomplete healing.

01 enero 2012

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Refined Balloon Pulmonary Angioplasty for Inoperable Patients with Chronic Thromboembolic Pulmonary Hypertension

Hiroki Mizoguchi, MD, Aiko Ogawa, MD, PhD, Mitsuru Munemasa, MD, PhD, Hiroshi Mikouchi, MD, PhD, Hiroshi Ito, MD, PhD and Hiromi Matsubara, MD, PhD

Background—Although balloon pulmonary angioplasty (BPA) for inoperable patients with chronic thromboembolic pulmonary hypertension was first reported over a decade ago, its clinical application has been restricted because of limited efficacy and complications. We have refined the procedure of BPA to maximize its clinical efficacy.

01 febrero 2012

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Bare Metal Stent Thrombosis and In-Stent Neoatherosclerosis

Kyohei Yamaji, MD, Katsumi Inoue, MD, Takuya Nakahashi, MD, Masahiko Noguchi, MD, Takenori Domei, MD, Makoto Hyodo, MD, Yoshimitsu Soga, MD, Shinichi Shirai, MD, Kenji Ando, MD, Katsuhiro Kondo, MD, Koyu Sakai, MD, Masashi Iwabuchi, MD, Hiroyoshi Yokoi, MD, Hideyuki Nosaka, MD, Masakiyo Nobuyoshi, MD and Takeshi Kimura, MD

Background—Very late stent thrombosis (VLST) was reported to occur even in patients with bare metal stent (BMS) implantation, although the annual incidence of VLST after BMS was much lower than that after drug-eluting stent implantation. Pathophysiologic mechanisms of VLST after BMS implantation remain largely unknown.

01 enero 2012

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Percutaneous Transluminal Pulmonary Angioplasty for the Treatment of Chronic Thromboembolic Pulmonary Hypertension

Masaharu Kataoka, MD,Takumi Inami, MD, Kentaro Hayashida, MD, Nobuhiko Shimura, MD, Haruhisa Ishiguro, MD, Takayuki Abe, PhD, Yuichi Tamura, MD, Motomi Ando, MD, Keiichi Fukuda, MD, Hideaki Yoshino, MD and Toru Satoh, MD

Background—Chronic thromboembolic pulmonary hypertension leads to pulmonary hypertension and right-sided heart failure. The purpose of this study was to investigate the efficacy of percutaneous transluminal pulmonary angioplasty (PTPA) for the treatment of chronic thromboembolic pulmonary hypertension.

01 enero 2012

JACC: CARDIOVASCULAR INTERVENTIONS. Overcoming Limited Depth Penetration of Optical Coherence Tomography With Wire Bias FREE

Warren Yan, MBBS; Michael R. Ward, MBBS, PhD; Gregory Nelson, MBBS; Gemma A. Figtree, MBBS, DPhil; Ravinay Bhindi, MBBS, PhD

A 32-year-old man presented with acute chest pain and anterior ST-segment elevation on electrocardiography after rowing a surfboat. He was a smoker, overweight with a body mass index of 28, denied any illicit drug use, and had no other significant cardiovascular risk factors. He proceeded to primary percutaneous coronary intervention. Angiography demonstrated large caliber left coronary vessels, with a prominent filling defect at the floor of the proximal left anterior descending coronary artery (LAD) and good flow distally (Figure 1A). The rest of the coronary arterial system was normal (Figure 1B). After passing a coronary wire into the distal LAD, multiple attempts at aspiration thrombectomy were unsuccessful, and aspiration of the thrombus was instead achieved by biasing the wire down the septal perforating branch (Figure 1C).

01 febrero 2012

CIRCULATION: Serial Assessment of Coronary Artery Response to Paclitaxel-Eluting Stents Using Optical Coherence Tomography

Giulio Guagliumi, MD, FESC, Hiram G. Bezerra, MD, PhD, Vasile Sirbu, MD, Hideyuki Ikejima, MD, PhD, Giuseppe Musumeci, MD, Giuseppe Biondi-Zoccai, MD, Nikoloz Lortkipanidze, MD, Luigi Fiocca, MD, Davide Capodanno, MD, PhD, Wei Wang, MS, Satoko Tahara, MD, PhD, Angelina Vassileva, MD, Aleksandre Matiashvili, MD, Orazio Valsecchi, MD and Marco A. Costa, MD, PhD

Background—The paucity of longitudinal, serial high-resolution imaging studies has limited our understanding of in vivo arterial response to drug-eluting stents. We sought to investigate the human coronary response to paclitaxel-eluting stent implantation, using serial optical coherence tomography assessments.

15 diciembre 2012

REVISTA ESPAÑOLA DE CARDIOLOGIA. Modelo de intervención coronaria percutánea primaria en la Comunidad de Navarra

Román Lezáun*, María Soledad Alcasena, María Teresa Basurte, Jesús Berjón, César Maraví, Miguel Aleu, José Ramón Carmona, Nuria Basterra, Miguel A. Imizcoz y Javier Abad. Complejo Hospitalario de Navarra, Área Clínica del Corazón, Pamplona, Navarra, España

El tratamiento del infarto agudo de miocardio ha evolucionado notablemente en las últimas tres décadas. Actualmente están establecidas con total nitidez las ventajas del tratamiento de reperfusión en cuanto a reducción de la morbimortalidad en una enfermedad tan prevalente en los países desarrollados. Si las diferentes opciones de reperfusión, farmacológica o mecánica, se aplican y especialmente si es precozmente desde el inicio de los síntomas, la mortalidad del infarto de miocardio puede ser inferior al 5%, cifra impensable hace tan sólo unos años. La intervención coronaria percutánea primaria es el método de reperfusión ideal. Sin embargo, desde una visión comunitaria y a la vista de la extensión del territorio y los tiempos de acceso desde el inicio de los síntomas al contacto con el sistema sanitario, así como al centro intervencionista, la reperfusión farmacológica y el traslado simultáneo para realizar intervención coronaria percutánea de rescate, si procediera, pueden ser una opción complementaria, con resultados no inferiores a los de la intervención coronaria percutánea primaria, en caso de que se la considerara como única opción. Rev Esp Cardiol Supl. 2011;11(C):21-27. Copyright © 2011 Sociedad Española de Cardiología. Publicado por Elsevier España, SL.

04 agosto 2011

STROKE. Patent Foramen Ovale May Be Causal for the First Stroke but Unrelated to Subsequent Ischemic Events

Marie-Luise Mono, MD; Laura Geister, BSc; Aekaterini Galimanis, MD; Simon Jung, MD; Fabien Praz, MD; Marcel Arnold, MD; Urs Fischer, MD; Stefan Wolff, MD; Oliver Findling, MD; Stephan Windecker, MD; Andreas Wahl, MD; Bernhard Meier, MD; Heinrich P. Mattle, MD; Krassen Nedeltchev, MD

Background and Purpose—Studies with very long follow-up are scarce in patients with cryptogenic stroke and patent foramen ovale (PFO). Little is known about the etiology of recurrent cerebrovascular events (CVE) in PFO patients. Stroke. 2011; 42: 2891-2895 Published online before print August 4, 2011, doi: 10.1161/​STROKEAHA.111.619577. Copyright © 2011 American Heart Association, Inc. All rights reserved.

01 noviembre 2011

JACC CARDIOVASCULAR INTERVENTIONS. Fractional Flow Reserve in Unstable Angina and Non–ST-Segment Elevation Myocardial Infarction

Jan-Willem E.M. Sels, MD; Pim A.L. Tonino, MD, PhD; Uwe Siebert, MD, MPH, MSc; William F. Fearon, MD; Marcel Van t Veer, MSc, PhD; Bernard De Bruyne, MD, PhD; Nico H.J. Pijls, MD, PhD

Experience From the FAME (Fractional flow reserve versus Angiography for Multivessel Evaluation) Study. J Am Coll Cardiol Intv. 2011;4(11):1183-1189. doi:10.1016/j.jcin.2011.08.008. Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.