01 octubre 2011

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Triple Antithrombotic Therapy After Coronary Stenting

Freek W.A. Verheugt, MD, FACC, FESC

Dual antiplatelet therapy has become the cornerstone of the treatment of patients undergoing coronary stenting and of those with acute coronary syndromes with or without stent implantation.1 Although there is consensus about the indication for dual antiplatelet therapy, there is little evidence about the optimal duration of therapy. In patients surviving non–ST-segment elevation–acute coronary syndromes, 1 year of treatment is advised.2 Intuitively, cardiologists prefer longer dual antiplatelet therapy rather than single antiplatelet medication (aspirin alone) in patients with drug-eluting stents when compared with carriers of bare metal stents. Consequently, many patients in the cardiology practice in 2011 are on dual antiplatelet therapy, mainly aspirin and clopidogrel. The only important side effect of dual antiplatelet therapy is increased bleeding in comparison to aspirin alone. Circulation: Cardiovascular Interventions. 2011; 4: 410-412 doi: 10.1161/​CIRCINTERVENTIONS.111.965210. Copyright © 2011 American Heart Association, Inc.

01 septiembre 2012

JACC: CARDIOVASCULAR INTERVENTIONS. Long-Term Vascular Healing in Response to Sirolimus- and Paclitaxel-Eluting Stents An Optical Coherence Tomography Study

Lorenz Räber, MD; Sandro Baumgartner, MS; Hector M. Garcia Garcia, MD, PhD; Bindu Kalesan, MSc; Jörn Justiz, MSc, PhD; Thomas Pilgrim, MD; Aris Moschovitis, MD; Ahmed A. Khattab, MD; Lutz Buellesfeld, MD; Peter Wenaweser, MD; Bernhard Meier, MD; Patrick W. Serruys, MD, PhD; Peter Jüni, MD; Stephan Windecker, MD

Objectives This study sought to assess stent strut coverage, malapposition, protrusion, and coronary evaginations as markers of healing 5 years after implantation of sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES), by optical coherence tomography (OCT). J Am Coll Cardiol Intv. 2012;5(9):946-957. doi:10.1016/j.jcin.2012.05.012. Copyright © 2012 by the American College of Cardiology Foundation

10 septiembre 2012

JACC. Sex Differences in Mortality After Transcatheter Aortic Valve Replacement for Severe Aortic Stenosis

Karin H. Humphries, DSc; Stefan Toggweiler, MD; Josep Rodés-Cabau, MD; Luis Nombela-Franco, MD; Eric Dumont, MD; David A. Wood, MD; Alexander B. Willson, MD; Ronald K. Binder, MD; Melanie Freeman, MD; May K. Lee, MSc; Min Gao, PhD; Mona Izadnegahdar, MSc; Jian Ye, MD; Anson Cheung, MD; John G. Webb, MD

Objectives The aim of this study was to examine sex differences in outcome after transcatheter aortic valve replacement (TAVR) with real-world data from 2 large centers in Canada. J Am Coll Cardiol. 2012;60(10):882-886. doi:10.1016/j.jacc.2012.05.009. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

01 septiembre 2012

JACC: CARDIOVASCULAR INTERVENTIONS. The Impact of Frailty Status on Survival After Transcatheter Aortic Valve Replacement in Older Adults With Severe Aortic Stenosis A Single-Center Experience

Philip Green, MD; Abigail E. Woglom, RN; Philippe Genereux, MD; Benoit Daneault, MD; Jean-Michel Paradis, MD; Susan Schnell, ACNP-C; Marian Hawkey, RN; Mathew S. Maurer, MD; Ajay J. Kirtane, MD; Susheel Kodali, MD; Jeffrey W. Moses, MD; Martin B. Leon, MD; Craig R. Smith, MD; Mathew Williams, MD

Objectives This study sought to evaluate the impact of frailty in older adults undergoing transcatheter aortic valve replacement (TAVR) for symptomatic aortic stenosis. J Am Coll Cardiol Intv. 2012;5(9):974-981. doi:10.1016/j.jcin.2012.06.011. Copyright © 2012 by the American College of Cardiology Foundation

01 septiembre 2012

JACC: CARDIOVASCULAR INTERVENTIONS. Unrestricted Use of 2 New-Generation Drug-Eluting Stents in Patients With Acute Myocardial Infarction A Propensity Score-Matched Analysis

Kang-Yin Chen, MD; Seung-Woon Rha, MD; Lin Wang, MD; Yong-Jian Li, MD; Guang-Ping Li, MD; Kanhaiya L. Poddar, MD; Ji-Young Park, MD; Cheol Ung Choi, MD; Chang-Gyu Park, MD; Hong Seog Seo, MD; Dong Joo Oh, MD; Myung Ho Jeong, MD; Young Keun Ahn, MD; Taek Jong Hong, MD; Young Jo Kim, MD; Seung Ho Hur, MD; In Whan Seong, MD; Jei Keon Chae, MD; Myeong Chan Cho, MD; Jang Ho Bae, MD; Dong Hoon Choi, MD; Yang Soo Jang, MD; In Ho Chae, MD; Chong Jin Kim, MD; Jung Han Yoon, MD; Wook Sung Chung, MD; Ki Bae Seung, MD; Seung Jung Park, MD

Objectives This study sought to compare everolimus-eluting stents (EES) with zotarolimus-eluting stents (ZES) in patients with acute myocardial infarction (AMI). J Am Coll Cardiol Intv. 2012;5(9):936-945. doi:10.1016/j.jcin.2012.05.009. Copyright © 2012 by the American College of Cardiology Foundation

01 septiembre 2012

JACC: CARDIOVASCULAR INTERVENTIONS. Use of Invasive Strategy in Non–ST-Segment Elevation Myocardial Infarction Is a Major Determinant of Improved Long-Term Survival FAST-MI (French Registry of Acute Coronary Syndrome)

Etienne Puymirat, MD; Guillaume Taldir, MD; Nadia Aissaoui, MD; Gilles Lemesle, MD; Luc Lorgis, MD; Thomas Cuisset, MD; Pierre Bourlard, MD; Bruno Maillier, MD; Gregory Ducrocq, MD; Jean Ferrieres, MD, PhD; Tabassome Simon, MD, PhD; Nicolas Danchin, MD, PhD

Objectives This study sought to assess the impact of invasive strategy (IS) versus a conservative strategy (CS) on in-hospital complications and 3-year outcomes in patients with non–ST-segment elevation myocardial infarction (NSTEMI) from the FAST-MI (French Registry of Acute Coronary Syndrome). J Am Coll Cardiol Intv. 2012;5(9):893-902. doi:10.1016/j.jcin.2012.05.008. Copyright © 2012 by the American College of Cardiology Foundation

01 septiembre 2012

JACC: CARDIOVASCULAR INTERVENTIONS. Outcomes of Patients With Prior Coronary Artery Bypass Grafting and Acute Coronary Syndromes Analysis From the ACUITY (Acute Catheterization and Urgent Intervention Triage Strategy) Trial

Eugenia Nikolsky, MD, PhD; Brent T. McLaurin, MD; David A. Cox, MD; Steven V. Manoukian, MD; Ke Xu, PhD; Roxana Mehran, MD; Gregg W. Stone, MD

Objectives This study sought to assess the contemporary outcomes of patients with prior coronary artery bypass graft (CABG) who present with moderate and high-risk acute coronary syndromes (ACS) and are treated with an early invasive strategy and contemporary antithrombin regimens. J Am Coll Cardiol Intv. 2012;5(9):919-926. doi:10.1016/j.jcin.2012.06.009. Copyright © 2012 by the American College of Cardiology Foundation

01 septiembre 2012

JACC: CARDIOVASCULAR INTERVENTIONS. Coronary Endothelial Dysfunction Distal to Stent of First-Generation Drug-Eluting Stents

Yoshiaki Mitsutake, MD; Takafumi Ueno, MD, PhD; Shinji Yokoyama, MD, PhD; Ken-ichiro Sasaki, MD, PhD; Yusuke Sugi, MD, PhD; Yasuyuki Toyama, MD; Hiroshi Koiwaya, MD; Masanori Ohtsuka, MD; Takaharu Nakayoshi, MD; Naoki Itaya, MD; Hidetoshi Chibana, MD; Tatsuyuki Kakuma, PhD; Tsutomu Imaizumi, MD, PhD

Objectives This study sought to evaluate the relationship between coronary endothelial function and neointimal coverage after drug-eluting stent (DES) implantation. J Am Coll Cardiol Intv. 2012;5(9):966-973. doi:10.1016/j.jcin.2012.06.010. Copyright © 2012 by the American College of Cardiology Foundation

01 septiembre 2012

JACC: CARDIOVASCULAR INTERVENTIONS. Early Aggressive Versus Initially Conservative Treatment in Elderly Patients With Non–ST-Segment Elevation Acute Coronary Syndrome A Randomized Controlled Trial

Stefano Savonitto, MD; Claudio Cavallini, MD; A. Sonia Petronio, MD; Ernesto Murena, MD; Roberto Antonicelli, MD; Alice Sacco, MD; Giuseppe Steffenino, MD; Francesco Bonechi, MD; Ernesto Mossuti, MD; Antonio Manari, MD; Salvatore Tolaro, MD; Anna Toso, MD; Alessandro Daniotti, MD; Federico Piscione, MD; Nuccia Morici, MD; Bruno M. Cesana, MD; M. Cristina Jori, MD; Stefano De Servi, MD

Objectives This study sought to determine the risk versus benefit ratio of an early aggressive (EA) approach in elderly patients with non–ST-segment elevation acute coronary syndromes (NSTEACS). J Am Coll Cardiol Intv. 2012;5(9):906-916. doi:10.1016/j.jcin.2012.06.008. Copyright © 2012 by the American College of Cardiology Foundation

01 septiembre 2012

JACC: CARDIOVASCULAR INTERVENTIONS. Conformational Pulsatile Changes of the Aortic Annulus Impact on Prosthesis Sizing by Computed Tomography for Transcatheter Aortic Valve Replacement

Philipp Blanke, MD; Maximillian Russe, MD; Jonathon Leipsic, MD; Jochen Reinöhl, MD; Ullrich Ebersberger, MD; Pal Suranyi, MD, PhD; Matthias Siepe, MD; Gregor Pache, MD; Mathias Langer, MD; U. Joseph Schoepf, MD

Objectives This study sought to investigate pulsatile changes of the aortic annulus and their impact on prosthesis selection by computed tomography (CT). J Am Coll Cardiol Intv. 2012;5(9):984-994. doi:10.1016/j.jcin.2012.05.014. Copyright © 2012 by the American College of Cardiology Foundation

29 mayo 2012

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. A Randomized, Double-Blind, Active-Controlled Phase 2 Trial to Evaluate a Novel Selective and Reversible Intravenous and Oral P2Y12 Inhibitor Elinogrel Versus Clopidogrel

Robert C. Welsh, MD, Sunil V. Rao, MD, Uwe Zeymer, MD, Vivian P. Thompson, MPH, Kurt Huber, MD, Janusz Kochman, MD, Matthew W. McClure, MD, Daniel D. Gretler, MD, Deepak L. Bhatt, MD, MPH, C. Michael Gibson, MD, Dominick J. Angiolillo, MD, PhD, Paul A. Gurbel, MD, Lisa G. Berdan, PA-C, MHS, Gayle Paynter, RN, Sergio Leonardi, MD, Mina Madan, MD, William J. French, MD and Robert A. Harrington, MD on behalf of the INNOVATE-PCI Investigators

Background—We evaluated the safety, efficacy, and tolerability of elinogrel, a competitive, reversible intravenous and oral P2Y12 inhibitor that does not require metabolic activation, in patients undergoing nonurgent percutaneous coronary intervention. Circulation: Cardiovascular Interventions. 2012; 5: 336-346 Published online before print May 29, 2012, doi: 10.1161/​CIRCINTERVENTIONS.111.964197. Copyright © 2012 American Heart Association, Inc. All rights reserved.

01 septiembre 2012

THE AMERICAN JOURNAL OF CARDIOLOGY. Dilation of the Ascending Aorta After Balloon Valvuloplasty for Aortic Stenosis During Infancy and Childhood

Dilation of the ascending aorta (AA) is common in patients with a bicuspid aortic valve. The natural history of the aortic root and AA and the risk factors for dilation have not been characterized in patients with congenital aortic stenosis (AS) treated with balloon valvuloplasty during childhood. The present study was performed to determine the prevalence of aortic dilation in patients with congenital AS before and up to 20 years after balloon valvuloplasty performed during childhood. In patients who underwent balloon valvuloplasty for AS at age ≤18 years from 1984 to 2005, the aortic diameter measurements before intervention and at 5-year intervals afterward were recorded and the Z scores calculated. Among 156 patients (median age 1.5 years at valvuloplasty), the AA Z scores were significantly larger than normal before intervention (median Z score 1.5) and at all follow-up points (all p <0.001). Using mixed modeling, with time as a categorical variable (before intervention, 5-year window, 10-year window, and so forth), the mean AA Z score was greater at all postvalvuloplasty points than before the intervention, with mean Z score increases of 1.20 at 5 years and 2.11 at 20 years (p <0.001). Moderate or greater aortic regurgitation early after valvuloplasty was associated with greater AA Z scores than mild or less aortic regurgitation, with a progressive difference over time. More significant residual AS after valvuloplasty was associated with lower AA Z scores over time. In conclusion, AA dilation is common in children with congenital AS and continues to progress over many years after balloon valvuloplasty. American Journal of Cardiology Volume 110, Issue 5 , Pages 702-708, 1 September 2012. Copyright © 2012 Elsevier Inc. All rights reserved.

05 junio 2012

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Stent Thrombosis With Everolimus-Eluting Stents Meta-Analysis of Comparative Randomized Controlled Trials

Tullio Palmerini, MD, Ajay J. Kirtane, MD, SM, Patrick W. Serruys, MD, Pieter C. Smits, MD, Elvin Kedhi, MD, Dean Kereiakes, MD, Diego Sangiorgi, MStat, Letizia Bacchi Reggiani, MSc, Christoph Kaiser, MD, Hyo-Soo Kim, MD, Antoinette De Waha, MD, Flavio Ribichini, MD and Gregg W. Stone, MD

Background—Some but not all studies have reported reduced rates of stent thrombosis (ST) with everolimus-eluting stents (EES) compared with other drug-eluting stents (DES). All of these studies were insufficiently powered to reliably detect differences in ST. We therefore performed a meta-analysis of randomized controlled trials comparing the risk of 2-year definite ST between EES and other DES. Circulation: Cardiovascular Interventions. 2012; 5: 357-364 Published online before print June 5, 2012, doi: 10.1161/​CIRCINTERVENTIONS.111.967083. Copyright © 2012 American Heart Association, Inc. All rights reserved.

10 abril 2012

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Transcatheter Aortic Valve Implantation in Patients With Severe Left Ventricular Dysfunction Immediate and Mid-Term Results, A Multicenter Study

Chiara Fraccaro, MD, Rasha Al-Lamee, MA, MRCP, Giuseppe Tarantini, MD, PhD, Francesco Maisano, MD, Massimo Napodano, MD, Matteo Montorfano, MD, Anna Chiara Frigo, MSc, Sabino Iliceto, MD, Gino Gerosa, MD, Giambattista Isabella, MD and Antonio Colombo, MD

Background—Few data exist about transcatheter aortic valve implantation (TAVI) in patients with low ejection fraction. The aim of the study was to analyze safety, feasibility, and efficacy of TAVI in patients with severe left ventricular dysfunction. Circulation: Cardiovascular Interventions. 2012; 5: 253-260 Published online before print April 10, 2012, doi: 10.1161/​CIRCINTERVENTIONS.111.964213. Copyright © 2012 American Heart Association, Inc. All rights reserved.

01 agosto 2012

JACC: CARDIOVASCULAR INTERVENTIONS. Vascular Closure Device Failure in Contemporary Practice

Venkatesan D. Vidi, MD, MPH; Michael E. Matheny, MD, MS, MPH; Usha S. Govindarajulu, PhD; Sharon-Lise T. Normand, PhD; Susan L. Robbins, BS; Vikram V. Agarwal, MD, MPH; Sripal Bangalore, MD, MHA; Frederic S. Resnic, MD, MSc

Objectives The goal of this study was to assess the frequency and predictors of vascular closure device (VCD) deployment failure, and its association with vascular complications of 3 commonly used VCDs. J Am Coll Cardiol Intv. 2012;5(8):837-844. doi:10.1016/j.jcin.2012.05.005. Copyright © 2012 by the American College of Cardiology Foundation