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ESTUDIOS


24 enero 2020

Trends in Usage and Clinical Outcomes of Coronary Atherectomy

Nirat Beohar, Lisa A. Kaltenbach, Daniel Wojdyla, Andrés M. Pineda, Sunil V. Rao, Gregg W. Stone, Martin B. Leon, Kintur A. Sanghvi, Jeffrey W. Moses and Ajay J. Kirtane

Abstract Background: Adjunctive coronary atherectomy (CA) can be utilized in treating severely calcified coronary lesions; however, the temporal trends, patient selection, and variation in use of CA have not been well described. We sought to assess the trends in usage, interhospital variability, and outcomes with CA among patients undergoing percutaneous coronary intervention (PCI).

15 enero 2020

Incidence, Temporal Trends, and Associated Outcomes of Vascular and Bleeding Complications in Patients Undergoing Transfemoral Transcatheter Aortic Valve Replacement

Matthew W. Sherwood, Katelyn Xiang, Roland Matsouaka, Zhuokai Li, Sreekanth Vemulapalli, Amit N. Vora, Alexander Fanaroff, J. Kevin Harrison, Vinod H. Thourani, David Holmes, Ajay Kirtane, Andres M. Pineda, Eric D. Peterson and Sunil V. Rao

Abstract Background: Vascular and bleeding complications were commonly reported in transcatheter aortic valve replacement clinical trials. Little is known about complication rates in contemporary US clinical practice or clinical outcomes associated with these complications.

15 enero 2020

Impact of Valvulo-Arterial Impedance on Long-Term Quality of Life and Exercise Performance After Transcatheter Aortic Valve Replacement

Rutger-Jan Nuis, Jeannette A. Goudzwaard, Marjo J.A.G. de Ronde-Tillmans, Herbert Kroon, Joris F. Ooms, Maarten P. van Wiechen, Marcel L. Geleijnse, Felix Zijlstra, Joost Daemen, Nicolas M. Van Mieghem, Francesco U.S. Mattace-Raso, Mattie J. Lenzen and Peter P.T. de Jaegere

Abstract Background: In aortic stenosis, valvulo-arterial impedance (Zva) estimates the overall left ventricular afterload (valve and arterial component). We investigated the association of Zva (≥5 versus <5 mm Hg mL−1 m−2) on quality of life (QOL) and exercise performance (EP) ≥1 year after transcatheter aortic valve replacement (TAVR).

27 febrero 2020

Impact of Kissing Balloon in Patients Treated With Ultrathin Stents for Left Main Lesions and Bifurcations

Luca Gaido, Fabrizio D’Ascenzo, Yoichi Imori, Wojciech Wojakowski, Andrea Saglietto, Filippo Figini, Alessio Mattesini, Daniela Trabattoni, Andrea Rognoni, Francesco Tomassini, Alessandro Bernardi, Nicola Ryan, Saverio Muscoli, Gerard Helft, Ovidio De Filippo, Radoslaw Parma, Leonardo De Luca, Fabrizio Ugo, Enrico Cerrato, Antonio Montefusco, Mauro Pennacchi, Wojciech Wańha, Grzegorz Smolka, Giulia de Lio, Francesco Bruno, Zenon Huczek, Giacomo Boccuzzi, Bernardo Cortese, Davide Capodanno, Pierluigi Omedè, Massimo Mancone, Ivan Nuñez-Gil, Francesco Romeo, Ferdiando Varbella, Mauro Rinaldi, Javier Escaned, Federico Conrotto, Francesco Burzotta, Alaide Chieffo, Leor Perl, Maurizio D’Amico, Carlo di Mario, Imad Sheiban, Andrea Gagnor, Massimo Giammaria and Gaetano Maria De Ferrari

Abstract Background: There are limited data regarding the impact of final kissing balloon (FKI) in patients treated with percutaneous coronary intervention using ultrathin stents in left main or bifurcations.

10 marzo 2020

Contributors to the Growth of Same Day Discharge After Elective Percutaneous Coronary Intervention

Paraskevi Taxiarchi, Glen P. Martin, Tim Kinnaird, Nick Curzen, Javed Ahmed, Peter Ludman, Mark De Belder, Ahmad Shoaib, Muhammad Rashid, Evangelos Kontopantelis and Mamas A. Mamas

Abstract Background: Financial pressures for reducing hospitalization costs have driven to a move toward same day discharge (SDD) following uncomplicated percutaneous coronary intervention. The UK healthcare system has transitioned to predominantly SDD for elective percutaneous coronary intervention. This study aimed to examine patient’s clinical, procedural, and institutional characteristics that are associated with the increased adoption of SDD adoption over time in the United Kingdom and determine whether these vary by region.

06 marzo 2020

Thirty-Day Outcomes of Transcatheter Mitral Valve Replacement for Degenerated Mitral Bioprostheses (Valve-in-Valve), Failed Surgical Rings (Valve-in-Ring), and Native Valve With Severe Mitral Annular Calcification (Valve-in-Mitral Annular Calcification) in the United States

Mayra Guerrero, Sreekanth Vemulapalli, Qun Xiang, Dee Dee Wang, Mackram Eleid, Allison K. Cabalka, Gurpreet Sandhu, Michael Salinger, Hyde Russell, Adam Greenbaum, Susheel Kodali, Isaac George, Danny Dvir, Brian Whisenant, Mark J. Russo, Ashish Pershad, Kenith Fang, Megan Coylewright, Pinak Shah, Vasilis Babaliaros, Jaffar M. Khan, Carl Tommaso, Jorge Saucedo, Saibal Kar, Rajj Makkar, Michael Mack, David Holmes, Martin Leon, Vinayak Bapat, Vinod H. Thourani, Charanjit Rihal, William O’Neill and Ted Feldman

Abstract Background: Transcatheter mitral valve replacement using aortic transcatheter heart valves has recently become an alternative for patients with degenerated mitral bioprostheses, failed surgical repairs with annuloplasty rings or severe mitral annular calcification who are poor surgical candidates. Outcomes of these procedures are collected in the Society of Thoracic Surgeons/American College of Cardiology/Transcatheter Valve Therapy Registry. A comprehensive analysis of mitral valve-in-valve (MViV), mitral valve-in-ring (MViR), and valve-in-mitral annular calcification (ViMAC) outcomes has not been performed. We sought to evaluate short-term outcomes of early experience with MViV, MViR, and ViMAC in the United States.

24 febrero 2020

Comparison of Transfemoral Versus Transradial Secondary Access in Transcatheter Aortic Valve Replacement

Lucía Junquera, Marina Urena, Azeem Latib, Antonio Muñoz-Garcia, Luis Nombela-Franco, Benjamin Faurie, Gabriela Veiga-Fernandez, Alberto Alperi, Vicenç Serra, Ander Regueiro, Quentin Fischer, Dominique Himbert, Antonio Mangieri, Antonio Colombo, Erika Muñoz-García, Rafael Vera-Urquiza, Pilar Jiménez-Quevedo, Jose Maria de la Torre, Isaac Pascual, Bruno Garcia del Blanco, Manel Sabaté, Siamak Mohammadi, Afonso B. Freitas-Ferraz, Leonardo Guimarães, Thomas Couture, Melanie Côté and Josep Rodés-Cabau

Abstract Background: Transfemoral approach has been commonly used as secondary access in transcatheter aortic valve replacement (TAVR). Scarce data exist on the use and potential clinical benefits of the transradial approach as secondary access during TAVR procedures. The objective of the study is to determine the occurrence of vascular complications (VC) and clinical outcomes according to secondary access (transfemoral versus transradial) in patients undergoing TAVR.

10 marzo 2020

Sex-Specific Management in Patients With Acute Myocardial Infarction and Cardiogenic Shock

Maria Rubini Gimenez, Uwe Zeymer, Steffen Desch, Suzanne de Waha-Thiele, Taoufik Ouarrak, Janine Poess, Roza Meyer-Saraei, Steffen Schneider, Georg Fuernau, Janina Stepinska, Kurt Huber, Stephan Windecker, Gilles Montalescot, Stefano Savonitto, Raban V. Jeger and Holger Thiele

Abstract Background: Women are more likely to suffer and die from cardiogenic shock (CS) as the most severe complication of acute myocardial infarction. Data concerning optimal management for women with CS are scarce. Aim of this study was to better define characteristics of women experiencing CS and to the influence of sex on different treatment strategies.

27 febrero 2020

Myocardial Ischemia in Children With Anomalous Aortic Origin of a Coronary Artery With Intraseptal Course

Tam T. Doan, Rodrigo Zea-Vera, Hitesh Agrawal, Carlos M. Mery, Prakash Masand, Dana L. Reaves-O’Neal, Cory V. Noel, Athar M. Qureshi, S. Kristen Sexson-Tejtel, Charles D. Fraser Jr and Silvana Molossi

Abstract Background: Intraseptal anomalous aortic origin of a coronary artery is considered a benign condition. However, there have been case reports of patients with myocardial ischemia, arrhythmia, and sudden cardiac death. The purpose of this study was to determine the clinical presentation, myocardial perfusion on provocative stress testing, and management of children with anomalous aortic origin of a coronary artery with an intraseptal course in a prospective cohort.

25 febrero 2020

Mechanism of Drug-Eluting Absorbable Metal Scaffold Restenosis

Yasushi Ueki, Lorenz Räber, Tatsuhiko Otsuka, Himanshu Rai, Sylvain Losdat, Stephan Windecker, Hector M. Garcia-Garcia, Ulf Landmesser, Jacques Koolen, Robert Byrne, Michael Haude and Michael Joner

Abstract Background: The pathomechanisms underlying restenosis of the bioabsorbable sirolimus-eluting metallic scaffold (Magmaris) remain unknown. Using serial optical coherence tomography, we investigated causes of restenosis, including the contribution of late scaffold recoil versus neointimal hyperplasia.

25 febrero 2020

How Do Fractional Flow Reserve, Whole-Cycle PdPa, and Instantaneous Wave-Free Ratio Correlate With Exercise Coronary Flow Velocity During Exercise-Induced Angina?

Christopher M. Cook, James P. Howard, Yousif Ahmad, Matthew J. Shun-Shin, Amarjit Sethi, Gerald J. Clesham, Kare H. Tang, Sukhjinder S. Nijjer, Paul A. Kelly, John R. Davies, Iqbal S. Malik, Raffi Kaprielian, Ghada Mikhail, Ricardo Petraco, Takayuki Warisawa, Firas Al-Janabi, Grigoris V. Karamasis, Shah Mohdnazri, Reto Gamma, Guus A. de Waard, Rasha Al-Lamee, Thomas R. Keeble, Jamil Mayet, Sayan Sen, Darrel P. Francis and Justin E. Davies

The use of either fractional flow reserve (FFR) or instantaneous wave-free ratio (iFR) is currently recommended to guide ischemia-driven revascularization decision-making in patients with stable angina.1 However, the recently presented ISCHEMIA trial (International Study of Comparative Health Effectiveness With Medical and Invasive Approaches) challenges the prognostic potential of ischemia-driven revascularization in patients with (non left main) stable coronary artery disease.2 Instead, in such patients, the therapeutic role of myocardial revascularization is further focused on improving angina-limiting symptoms.

07 abril 2020

Effect of Lesion Complexity and Clinical Risk Factors on the Efficacy and Safety of Dabigatran Dual Therapy Versus Warfarin Triple Therapy in Atrial Fibrillation After Percutaneous Coronary Intervention

Natalia C. Berry, Laura Mauri, Philippe Gabriel Steg, Deepak L. Bhatt, Stefan H. Hohnloser, Matias Nordaby, Corinna Miede, Takeshi Kimura, Gregory Y.H. Lip, Jonas Oldgren, Jurriën M. ten Berg, Christopher P. Cannon and on behalf of the REDUAL PCI Steering Committee and Investigators

Abstract Background: The REDUAL PCI trial (Evaluation of Dual Therapy With Dabigatran vs Triple Therapy With Warfarin in Patients With AF That Undergo a PCI With Stenting) demonstrated that, in patients with atrial fibrillation following percutaneous coronary intervention, bleeding risk was lower with dabigatran plus clopidogrel or ticagrelor (dual therapy) than warfarin plus clopidogrel or ticagrelor and aspirin (triple therapy). Dual therapy was noninferior for risk of thromboembolic events. Whether these results apply equally to patients at higher risk of ischemic events due to lesion complexity or clinical risk factors is unclear.

13 abril 2020

Global Approach to High Bleeding Risk Patients With Polymer-Free Drug-Coated Coronary Stents

Mitchell W. Krucoff, Philip Urban, Jean-François Tanguay, Thomas McAndrew, Yiran Zhang, Sunil V. Rao, Marie-Claude Morice, Matthew J. Price, David J. Cohen, Mohamed Abdel-Wahab, Shamir R. Mehta, Benjamin Faurie, Brent McLaurin, Corie Diaz, Hans-Peter Stoll, Stuart Pocock and Martin B. Leon

Abstract Background: High bleeding risk (HBR) patients undergoing percutaneous coronary intervention have been widely excluded from randomized device registration trials. The LF study (LEADERS FREE) reported superior outcomes of HBR patients receiving 30-day dual antiplatelet therapy after percutaneous coronary intervention with a polymer-free drug-coated stent (DCS). LFII was designed to assess the reproducibility and generalizability of the benefits of DCS observed in LF to inform the US Food and Drug Administration in a device registration decision.

13 abril 2020

Long-Term Outcomes After Revascularization for Stable Ischemic Heart Disease

Mahesh V. Madhavan, Björn Redfors, Ziad A. Ali, Megha Prasad, Bahira Shahim, Pieter C. Smits, Clemens von Birgelen, Zixuan Zhang, Roxana Mehran, Patrick W. Serruys, Akiko Maehara, Martin B. Leon, Ajay J. Kirtane and Gregg W. Stone

Abstract Background: Whether revascularization improves prognosis in stable ischemic heart disease is controversial.

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