20 marzo 2012

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Periprocedural Myocardial Infarction in a Randomized Trial of Everolimus-Eluting and Paclitaxel-Eluting Coronary Stents

M. Hassan Pervaiz, MD, Poornima Sood, MD, MBA, Krishnankutty Sudhir, MD, PhD, James B. Hermiller, MD, Liming Hou, PhD, Kyoko Hattori, RN, BSN, Xiaolu Su, MS, Sherry Cao, MS, John Wang, MD, Robert J. Applegate, MD, Dean J. Kereiakes, MD, Manejeh Yaqub, MD, Gregg W. Stone, MD and Donald E. Cutlip, MD

Background—A consensus definition for periprocedural myocardial infarction (MI) in coronary stent trials has not been established. Differences between a historic definition, based on modified World Health Organization (WHO) criteria, and a proposed universal definition have not been compared in a prospective clinical trial. Circulation: Cardiovascular Interventions. 2012; 5: 150-156 Published online before print March 20, 2012, doi: 10.1161/​CIRCINTERVENTIONS.111.965566. Copyright © 2012 American Heart Association, Inc. All rights reserved.

01 enero 2012

THE AMERICAN JOURNAL OF CARDIOLOGY. Analysis of Target Lesion Length Before Coronary Artery Stenting Using Angiography and Near-Infrared Spectroscopy Versus Angiography Alone

Simon R. Dixon, MBChB, Cindy L. Grines, MD, Ahmad Munir, MD, Ryan D. Madder, MD, Robert D. Safian, MD, George S. Hanzel, MD, Mark C. Pica, BS, James A. Goldstein, MD

Lipid core plaque (LCP) can extend beyond the angiographic margins of a target lesion, potentially resulting in incomplete lesion coverage. We sought to compare the target lesion length using near-infrared spectroscopy (NIRS) combined with conventional coronary angiography versus angiography alone. NIRS was performed in 69 patients (75 lesions) undergoing native vessel percutaneous coronary intervention (LipiScan Coronary Imaging System). Chemograms were analyzed for the presence and location of LCP, either within or extending beyond, the angiographic margins of the target lesion. The target lesion length was measured by quantitative coronary angiography (QCA) and compared to the lesion length measured using QCA and NIRS. LCP was present in 50 target lesions (67%). In 42 lesions (84%), LCP was present only within the target lesion. In 8 lesions (16%) LCP extended beyond the angiographic margins of the lesion. Of these 8 lesions, 4 (8%) had LCP ≤5 mm from the margins, and 4 lesions (8%) had LCP >5 mm from the angiographic margins. The mean distance that the LCP extended beyond the angiographic lesion margin was 7 ± 4 mm (range 2 to 14). For these 8 lesions, the target lesion length with NIRS plus QCA was 28 ± 10 mm versus 21 ± 8 mm with QCA alone. In conclusion, patients undergoing coronary artery stenting could have LCP extending beyond the intended treatment margins as defined using QCA alone. This could have implications for stent length selection and optimal lesion coverage. American Journal of Cardiology Volume 109, Issue 1 , Pages 60-66, 1 January 2012. Copyright © 2012 Published by Elsevier Inc.

01 julio 2012

THE AMERICAN JOURNAL OF CARDIOLOGY. Comparison of Additional Versus No Additional Heparin During Therapeutic Oral Anticoagulation in Patients Undergoing Percutaneous Coronary Intervention

Tuomas Kiviniemi, MD, PhD AFFILIATIONS Department of Medicine, Turku University Hospital, Turku, Finland , Pasi Karjalainen, MD, PhD, Mikko Pietilä, MD, PhD, Antti Ylitalo, MD, PhD, Matti Niemelä, MD, PhD, Saila Vikman, MD, PhD, Marja Puurunen, MD, PhD, Fausto Biancari, MD, PhD, Kari Eino Juhani Airaksinen, MD, PhD

Uninterrupted oral anticoagulation (OAC) therapy can be the preferred strategy in patients with atrial fibrillation at moderate to high risk of thromboembolism undergoing percutaneous coronary intervention (PCI). To evaluate the need for additional heparins in addition to therapeutic peri-PCI OAC, we assessed bleeding complications and major adverse cardiac and cerebrovascular events in 414 consecutive patients undergoing PCI during therapeutic (international normalized ratio 2 to 3.5) periprocedural OAC. Patients were divided into those with no (n = 196) and with (n = 218) additional use of periprocedural heparins. No differences in major adverse cardiac and cerebrovascular events (4.1% vs 3.2%, p = 0.79) or major bleeding (1.0% vs 3.7%, p = 0.11) were detected, but access site complications (5.1% vs 11.0%, p = 0.032) were less frequent in those without additional heparins. When adjusted for propensity score, patients with additional heparins had a higher risk of access site complications (odds ratio 2.6, 95% confidence interval 1.1 to 6.1, p = 0.022) without any increased risk of any other adverse event. Analysis of 1-to-1 propensity-matched pairs showed a significantly higher risk of access site complication in patients receiving additional AC (13.1% vs 5.7%, p = 0.049). In conclusion, therapeutic warfarin treatment seems to provide sufficient AC for PCI. Additional heparins are not needed and may increase access site complications. American Journal of Cardiology Volume 110, Issue 1 , Pages 30-35, 1 July 2012. Copyright © 2012 Elsevier Inc. All rights reserved.

01 mayo 2012

AMERICAN HEART JOURNAL. Assessing the role of eptifibatide in patients with diffuse coronary disease undergoing drug-eluting stenting: The INtegrilin plus STenting to Avoid myocardial Necrosis Trial

Giuseppe Biondi-Zoccai, MD AFFILIATIONS Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Italy Reprint requests: Giuseppe Biondi Zoccai, MD, Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 79, 04100 Latina, Italy. , Marco Valgimigli, MD, PhD, Massimo Margheri, MD, Antonio Marzocchi, MD, Corrado Lettieri, MD, Amerigo Stabile, MD, A. Sonia Petronio, MD, Giorgio Binetti, MD, Leonardo Bolognese, MD, Pietro Bellone, MD, Gennaro Sardella, MD, Marco Contarini, MD, Imad Sheiban, MD, Sebastiano Marra, MD, Federico Piscione, MD, Francesco Romeo, MD, Antonio Colombo, MD, Giuseppe Sangiorgi, MD

Background: The optimal antiplatelet regimen in elective patients undergoing complex percutaneous coronary interventions (PCIs) is uncertain. We aimed to assess the impact of glycoprotein IIb/IIIa (GpIIb/IIIa) inhibition with eptifibatide in clinically stable subjects with diffuse coronary lesions. American Heart Journal Volume 163, Issue 5 , Pages 835.e1-835.e7, May 2012. Copyright © 2012 Mosby, Inc. All rights reserved.

01 julio 2012

JACC: CARDIOVASCULAR INTERVENTIONS. Meta-Analysis of Transcatheter Closure Versus Medical Therapy for Patent Foramen Ovale in Prevention of Recurrent Neurological Events After Presumed Paradoxical Embolism

Shikhar Agarwal, MD, MPH, CPH; Navkaranbir Singh Bajaj, MD; Dharam J. Kumbhani, MD, SM; E. Murat Tuzcu, MD; Samir R. Kapadia, MD

Objectives In this study, a meta-analysis of observational studies was performed to compare the rate of recurrent neurological events (RNE) between transcatheter closure and medical management of patients with cryptogenic stroke/transient ischemic attack (TIA) and concomitant patent foramen ovale (PFO). J Am Coll Cardiol Intv. 2012;5(7):777-789. doi:10.1016/j.jcin.2012.02.021. Copyright © 2012 by the American College of Cardiology Foundation

01 julio 2012

JACC: CARDIOVASCULAR INTERVENTIONS. Everolimus-Eluting Stent Implantation for Unprotected Left Main Coronary Artery Stenosis The PRECOMBAT-2 Study

Young-Hak Kim, MD, PhD; Duk-Woo Park, MD, PhD; Jung-Min Ahn, MD; Sung-Cheol Yun, PhD; Hae Geun Song, MD; Jong-Young Lee, MD; Won-Jang Kim, MD, PhD; Soo-Jin Kang, MD, PhD; Seung-Whan Lee, MD, PhD; Cheol Whan Lee, MD, PhD; Seong-Wook Park, MD, PhD; Yangsoo Jang, MD, PhD; Myung-Ho Jeong, MD, PhD; Hyo-Soo Kim, MD, PhD; Seung-Ho Hur, MD, PhD; Seung-Woon Rha, MD, PhD; Do-Sun Lim, MD, PhD; Sung-Ho Her, MD, PhD; Ki Bae Seung, MD, PhD; In-Whan Seong, MD, PhD; Seung-Jung Park, MD, PhD

Objectives This study sought to evaluate the safety and efficacy of second-generation drug-eluting stents (DES) for patients with unprotected left main coronary artery (ULMCA) stenosis. J Am Coll Cardiol Intv. 2012;5(7):708-717. doi:10.1016/j.jcin.2012.05.002. Copyright © 2012 by the American College of Cardiology Foundation

01 julio 2012

JACC: CARDIOVASCULAR INTERVENTIONS. Drug-Eluting Stent for Left Main Coronary Artery Disease The DELTA Registry: A Multicenter Registry Evaluating Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting for Left Main Treatment

Alaide Chieffo, MD; Emanuele Meliga, MD; Azeem Latib, MD; Seung-Jung Park, MD; Yoshinobu Onuma, MD; Piera Capranzano, MD; Marco Valgimigli, MD; Sanda Jegere, MD; Raj R. Makkar, MD; Igor F. Palacios, MD; Young-Hak Kim, MD; Pawel E. Buszman, MD; Tarun Chakravarty, MD; Imad Sheiban, MD; Roxana Mehran, MD; Christoph Naber, MD; Ronan Margey, MD; Arvind Agnihotri, MD; Sebastiano Marra, MD; Davide Capodanno, MD, PhD; Martin B. Leon, MD; Jeffrey W. Moses, MD; Jean Fajadet, MD; Thierry Lefevre, MD; Marie-Claude Morice, MD; Andrejs Erglis, MD; Corrado Tamburino, MD, PhD; Ottavio Alfieri, MD; Patrick W. Serruys, MD, PhD; Antonio Colombo, MD

Objectives The aim of this study was to compare, in a large all-comers registry, major adverse cardiac and cerebrovascular events (MACCE) after percutaneous coronary intervention (PCI) with first-generation drug-eluting stents (DES) versus coronary artery bypass grafting (CABG) in unprotected left main coronary artery (ULMCA) stenosis. J Am Coll Cardiol Intv. 2012;5(7):718-727. doi:10.1016/j.jcin.2012.03.022. Copyright © 2012 by the American College of Cardiology Foundation

05 julio 2012

JACC. Second-Generation Everolimus-Eluting Stents Versus First-Generation Sirolimus-Eluting Stents in Acute Myocardial Infarction

Sjoerd H. Hofma, MD, PhD; Jan Brouwer, MD, PhD; Matthijs A. Velders, MD; Arnoud W.J. vant Hof, MD, PhD; Pieter C. Smits, MD, PhD; Michel Queré, MD; Cornelis Jan de Vries, MD; Adrianus J. van Boven, MD, PhD

Objectives The goal of this study was to compare the efficacy and safety of second-generation everolimus-eluting stents (EES) with first-generation sirolimus-eluting stents (SES) in primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). J Am Coll Cardiol. 2012;60(5):381-387. doi:10.1016/j.jacc.2012.01.073. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

01 julio 2012

JACC: CARDIOVASCULAR INTERVENTIONS. Time Course of Endothelium-Dependent and -Independent Coronary Vasomotor Response to Coronary Balloons and Stents Comparison of Plain and Drug-Eluting Balloons and Stents

Christian A. Plass, MD; Inna Sabdyusheva-Litschauer, MSc; Andreas Bernhart, MD; Eslam Samaha, MD; Örs Petnehazy, PhD; Eszter Szentirmai, VMD; Zsolt Petrási, PhD; Victor Lamin, MSc; Noemi Pavo, MD, MSc; Noemi Nyolczas, MD; András Jakab, MD; Zsolt Murlasits, PhD; Jutta Bergler-Klein, MD; Gerald Maurer, MD; Mariann Gyöngyösi, MD, PhD

Objectives This study sought to determine the time dependency of the endothelium-dependent and -independent vascular responses after percutaneous coronary intervention (PCI) with drug-eluting (DEB) or plain balloons, bare-metal (BMS), and drug-eluting (DES) stents, or controls. J Am Coll Cardiol Intv. 2012;5(7):741-751. doi:10.1016/j.jcin.2012.03.021. Copyright © 2012 by the American College of Cardiology Foundation

01 julio 2012

JACC: CARDIOVASCULAR INTERVENTIONS. Optimizing Outcomes During Left Main Percutaneous Coronary Intervention With Intravascular Ultrasound and Fractional Flow Reserve. The Current State of Evidence

Rishi Puri, MBBS; Samir R. Kapadia, MD; Stephen J. Nicholls, MBBS, PhD; James E. Harvey, MD, MSc; Yu Kataoka, MD; E. Murat Tuzcu, MD

Percutaneous coronary intervention (PCI) is an evolving indication for the treatment of unprotected left main coronary arterial (UMLCA) stenoses in selected individuals. Intravascular ultrasound (IVUS)-guided PCI within the epicardial coronary tree has been shown to improve acute procedural results and subsequent clinical outcomes. Similarly, fractional flow reserve (FFR) is rapidly gaining popularity as a means to guide the coronary interventionalist to embark upon a “physiological-based” revascularization strategy. J Am Coll Cardiol Intv. 2012;5(7):697-707. doi:10.1016/j.jcin.2012.02.018. Copyright © 2012 by the American College of Cardiology Foundation

05 junio 2012

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Predictors and Prognostic Value of Myocardial Injury During Transcatheter Aortic Valve Implantation

Ze Yie Yong, MD, Esther M. A. Wiegerinck, MD, Kirsten Boerlage-van Dijk, MD, Karel T. Koch, MD, PhD, Marije M. Vis, MD, Berto J. Bouma, MD, PhD, José P. S. Henriques, MD, PhD, Riccardo Cocchieri, MD, Jan J. Piek, MD, PhD, Bas A. J. M. de Mol, MD, PhD and Jan Baan Jr, MD, PhD

Background—Myocardial injury is a common complication during cardiac surgery and percutaneous coronary intervention and is associated with postprocedural cardiovascular morbidity and mortality. Limited data have been reported about the occurrence of myocardial damage associated with transcatheter aortic valve implantation (TAVI). Therefore, our purpose was to investigate the incidence, predictors, and prognostic value of myocardial injury during TAVI. Circulation: Cardiovascular Interventions. 2012; 5: 415-423. Published online before print June 5, 2012. Copyright © American Heart Association. All rights reserved. Print ISSN: 1941-7640. Online ISSN: 1941-7632

01 junio 2011

JACC. Second-Generation Drug-Eluting Stents

Fernando Alfonso, MD, PhD and Cristina Fernandez, MD, PhD

Drug-eluting stents (DES) have revolutionized interventional cardiology and have fueled vascular research. However, not all DES are created equal, and recently, second-generation DES became available (1–4). Some esteemed basic and clinical cardiovascular investigators openly argue that simply comparing stent "A" with stent "B" should not be considered as proper research. Although the value of this criticism should not be completely dismissed, the other side of the same coin is that clinical research should actually focus on improving patient care. In this regard, the potentially superior results of novel devices in the clinical arena should not be taken for granted, based on promising bench findings or surrogate endpoints, but rather carefully scrutinized and confirmed in rigorous clinical studies with robust methodology and long-term follow-up (1–4). Journal of the American College of Cardiology Vol. 58, No. 1, 2011. Copyright © 2011 by the American College of Cardiology Foundation ISSN 0735-1097/$36.00. Published by Elsevier Inc. doi:10.1016/j.jacc.2011.03.013.

01 junio 2011

JACC: CARDIOVASCULAR INTERVENTIONS. Left-to-Right Interventricular Shunt as a Late Complication of Transapical Aortic Valve Implantation

Pierre Massabuau, MD, Nicolas Dumonteil, MD, Pierre Berthoumieu, MD, Bertrand Marcheix, MD, PhD, David Duterque, MD, Gérard Fournial, MD, Didier Carrié, MD, PhD

An 86-year-old man was referred to our institution for a symptomatic severe aortic stenosis (New York Heart Association [NYHA] functional dyspnea class III; indexed effective orifice area [EOA]: 0.3 cm2/m2; mean gradient [MG]: 54 mm Hg; left ventricular ejection fraction [LVEF]: 56%). He had a history of dyslipidemia, prostate cancer, and coronary artery bypass graft (saphenous vein graft on left anterior descending coronary artery [LAD] and right coronary artery) 26 years ago. JACC: CARDIOVASCULAR INTERVENTIONS VOL. 4, NO. 6, 2011. Copyright © 2011 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION ISSN 1936-8798/$36.00. PUBLISHED BY ELSEVIER INC. DOI: 10.1016/j.jcin.2010.11.018

01 junio 2011

JACC: CARDIOVASCULAR INTERVENTIONS. Percutaneous Intervention of an Acute Left Main Coronary Occlusion Due to Dissection of the Aortic Root

Amir Ravandi, MD, PhD, William F. Penny, MD

The patient is an 86-year-old man who presented to the hospital with 4 h of retrosternal chest pain and an anterior ST-segment elevation myocardial infarction on electrocardiogram. His past medical history included pulmonary sarcoidosis, a bioprosthetic aortic valve implanted in 1997, and long-standing aortic root dilation that had been followed clinically because of high reoperative risk. JACC: CARDIOVASCULAR INTERVENTIONS VOL. 4, NO. 6, 2011. Copyright © 2011 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION ISSN 1936-8798/$36.00. PUBLISHED BY ELSEVIER INC. DOI: 10.1016/j.jcin.2010.12.017

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/. Copyright © American Heart Association. All rights reserved. Print ISSN: 1941-7640. Online ISSN: 1941-7632.