26 enero 2016

CIRCULATION. Arrhythmia/Electrophysiology. Programmed Ventricular Stimulation for Risk Stratification in the Brugada Syndrome. A Pooled Analysis

Jakub Sroubek, MD, PhD; Vincent Probst, MD, PhD; Andrea Mazzanti, MD; Pietro Delise, MD; Jesus Castro Hevia, MD; Kimie Ohkubo, MD; Alessandro Zorzi, MD; Jean Champagne, MD; Anna Kostopoulou, MD; Xiaoyan Yin, PhD; Carlo Napolitano, MD, PhD; David J. Milan, MD; Arthur Wilde, MD; Frederic Sacher, MD, PhD; Martin Borggrefe, MD, PhD; Patrick T. Ellinor, MD, PhD; George Theodorakis, MD; Isabelle Nault, MD; Domenico Corrado, MD, PhD; Ichiro Watanabe, MD; Charles Antzelevitch, PhD; Giuseppe Allocca, MD; Silvia G. Priori, MD, PhD; Steven A. Lubitz, MD, MPH

Background: The role of programmed ventricular stimulation in identifying patients with Brugada syndrome at the highest risk for sudden death is uncertain.

01 julio 2014

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Advances in Interventional Cardiology. Intra-Aortic Balloon Pump for High-Risk Percutaneous Coronary Intervention

Tiffany Patterson, MBBS, BSc, MRCP, Divaka Perera, MB BChir, MD, FRCP and Simon R. Redwood, MBBS, MD, FRCP

The intra-aortic balloon pump (IABP) was first introduced into clinical practice in 1968.1 Early experimental and clinical trials suggested that intra-aortic balloon counterpulsation could provide circulatory assistance to a failing left ventricle.2,3 Counterpulsation—balloon inflation during diastole and deflation in systole—augments the intrinsic Windkessel effect, whereby potential energy stored in the aortic root during systole is converted to kinetic energy with the elastic recoil of the aortic root.

01 julio 2014

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Images and Case Reports in Interventional Cardiology. Early Malfunction of Polyvinyl Alcohol Membrane–Covered Atrial Septal Defect Closure Devices

Pierre Aubry, MD, Eric Brochet, MD, Xavier Halna du Fretay, MD, Sophie Bouton-Brochet, MD, Hassan Ibrahim, MD, Xavier Arrault, PharmD, Ulrik Hvass, MD and Jean-Michel Juliard, MD

A 77-year-old man was referred for treatment of a secundum type atrial septal defect (ASD). Transthoracic echocardiography and transesophageal echocardiography showed a 20-mm atrial ASD (Figure [A]) with important enlargement of the right ventricle. A 24-mm ASD Ultrasept II (Cardia Inc, Eagan, MN) closure device was successfully implanted (Figure [B]) after the first attempt with no residual shunt. The Ultrasept II device was loaded and deployed in a similar manner to Amplatzer devices.

01 julio 2014

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Images and Case Reports in Interventional Cardiology. Transcaval Transcatheter Aortic Valve Implantation for Severe Aortic Insufficiency

Vikas Singh, MD, Pedro O. Martinez-Clark, MD, Jairo Cadena, MD, Cesia Gallegos, MD, Antonio Dager, MD, Mayra Guerrero, MD and William W. O’Neill, MD

A 72-year-old man with severely dilated ischemic cardiomyopathy (ejection fraction, 20%) was admitted because of decompensated heart failure. A cardiac catheterization revealed nonobstructive coronary artery disease and severe (>4) AI. His Society of Thoracic Surgeons score was 12.4% mainly because of age, low ejection fraction, New York Heart Association class IV, peripheral arterial disease, severe chronic obstructive pulmonary disease, diabetes mellitus on insulin, and chronic kidney disease stage 3.

01 julio 2014

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Images and Case Reports in Interventional Cardiology. Inappropriate Vascular Response in Patients With Behcet Syndrome

Ashish H. Shah, MD, MRCP, Rhian Goodfellow, MD, MRCP, Timothy Kinnaird, MD, MRCP and Rito Mitra, MD, MRCP

Behcet syndrome (BS) is an uncommon systemic vasculitis, with limited understanding of the pathophysiology and treatment options are nonspecific. Associated morbidity is higher in men, specifically those affected by vascular, neuronal, or ocular involvement. Systemic veins and pulmonary arteries are predominantly involved, both of which carrying deoxygenated blood at low pressure, presenting as occlusive (thrombotic/stenotic) or aneurysmal lesions. Arteries are also affected by similar lesions, because of inflammation of the vasa-vasorum resulting in medial defragmentation of the vessel wall. Stenotic lesions are considered benign, whereas aneurysmal change can be progressive and rupture can be fatal. Stenotic lesions are thought to be better treated with stenting, as surgical repair can result in aneurysmal change at the site of vascular injury.1

01 agosto 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Interventions. Proton Pump Inhibitors, Platelet Reactivity, and Cardiovascular Outcomes After Drug-Eluting Stents in Clopidogrel-Treated Patients. The ADAPT-DES Study

Giora Weisz, MD, Nathaniel R. Smilowitz, MD, Ajay J. Kirtane, MD, SM, Michael J. Rinaldi, MD, Rupa Parvataneni, MS, Ke Xu, PhD, Thomas D. Stuckey, MD, Akiko Maehara, MD, Bernhard Witzenbichler, MD, Franz-Josef Neumann, MD, D. Christopher Metzger, MD, Timothy D. Henry, MD, David A. Cox, MD, Peter L. Duffy, MD, MMM, Bruce R. Brodie, MD, Ernest L. Mazzaferri Jr, MD, Roxana Mehran, MD and Gregg W. Stone, MD

Background: Certain proton pump inhibitors (PPIs) interfere with clopidogrel metabolism, potentially attenuating P2Y12 receptor inhibition. Previous observational and randomized trials report conflicting results regarding the clinical significance of this pharmacological interaction. We examined the interaction between concomitant administration of PPI and clopidogrel on platelet reactivity and clinical outcomes in the large-scale, prospective Assessment of Dual AntiPlatelet Therapy With Drug-Eluting Stents study.

01 agosto 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Interventions. Efficacy of Various Percutaneous Interventions for In-Stent Restenosis. Comprehensive Network Meta-Analysis of Randomized Controlled Trials

Ankur Sethi, MBBS, Gurveen Malhotra, MD, Sukhchain Singh, MD, Param P. Singh, MD and Sandeep Khosla, MD

Background: In-stent restenosis (ISR) remains a difficult problem in interventional cardiology. The relative efficacy and safety of available interventions is not clear. We aimed to perform a network meta-analysis using both direct evidence and indirect evidence to compare all available interventions.

01 agosto 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Pulmonary Vascular Disease. Hemodynamic, Functional, and Clinical Responses to Pulmonary Artery Denervation in Patients With Pulmonary Arterial Hypertension of Different Causes. Phase II Results From the Pulmonary Artery Denervation-1 Study

Shao-Liang Chen, MD, Hang Zhang, MD, Du-Jiang Xie, MD, Juan Zhang, MD, Ling Zhou, MD, Alexander M.K. Rothman, MD and Gregg W. Stone, MD

Background: The mechanisms underlying pulmonary arterial hypertension (PAH) are multifactorial. The efficacy of pulmonary artery denervation (PADN) for idiopathic PAH treatment has been evaluated. This study aimed to analyze the hemodynamic, functional, and clinical responses to PADN in patients with PAH of different causes.

01 agosto 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Pulmonary Vascular Disease. Pulmonary Artery Denervation Reduces Pulmonary Artery Pressure and Induces Histological Changes in an Acute Porcine Model of Pulmonary Hypertension

Alexander M.K. Rothman, MD, Nadine D. Arnold, VN, William Chang, BA, Oliver Watson, MD, Andrew J. Swift, MD, Robin Condliffe, MD, Charlie A. Elliot, MD, David G. Kiely, MD, S. Kim Suvarna, MD, Julian Gunn, MD and Allan Lawrie, PhD

Background: Pulmonary arterial hypertension is a devastating disease with high morbidity and mortality and limited treatment options. Recent studies have shown that pulmonary artery denervation improves pulmonary hemodynamics in an experimental model and in an early clinical trial. We aimed to evaluate the nerve distribution around the pulmonary artery, to determine the effect of radiofrequency pulmonary artery denervation on acute pulmonary hypertension induced by vasoconstriction, and to demonstrate denervation of the pulmonary artery at a histological level.

01 octubre 2015

AMERICAN HEART JOURNAL. Rationale and design of the Fractional Flow Reserve versus Angiography for Multivessel Evaluation (FAME) 3 Trial: A comparison of fractional flow reserve–guided percutaneous coronary intervention and coronary artery bypass graft surgery in patients with multivessel coronary artery disease

Frederik M. Zimmermann, MD, Bernard De Bruyne, MD, PhD, Nico H.J. Pijls, MD, PhD, Manisha Desai, PhD, Keith G. Oldroyd, MD, Seung-Jung Park, MD, PhD, Michael J. Reardon, MD, Olaf Wendler, MD, PhD, Joseph Woo, MD, Alan C. Yeung, MD, William F. Fearon, MD

Background: Guidelines recommend coronary artery bypass graft (CABG) surgery over percutaneous coronary intervention (PCI) for the treatment of 3-vessel coronary artery disease (3-VD). The inferior results of PCI demonstrated by previous large randomized trials comparing PCI and CABG might be explained by the use of suboptimal stent technology and by the lack of fractional flow reserve (FFR) guidance of PCI.

01 octubre 2015

AMERICAN HEART JOURNAL. Evaluation of a fully bioresorbable vascular scaffold in patients with coronary artery disease: Design of and rationale for the ABSORB III randomized trial

Dean J. Kereiakes, MD, Stephen G. Ellis, MD, Jeffrey J. Popma, MD, Peter J. Fitzgerald, MD, Habib Samady, MD, Jennifer Jones-McMeans, PhD, Zhen Zhang, PhD, Wai-Fung Cheong, PhD, Xiaolu Su, MS, Ori Ben-Yehuda, MD, Gregg W. Stone, MD

Background: Randomized trials have demonstrated progressive improvements in clinical and angiographic measures of restenosis with technologic iterations from balloon angioplasty to bare-metal stents and subsequently to drug-eluting stents (DES). However, the permanent presence of a metal stent prevents coronary vasomotion, autoregulation, and adaptive coronary remodeling. The limitations imposed by a permanent metal implant may be overcome with a bioresorbable scaffold. ABSORB III is a large-scale, multicenter, randomized trial designed to support US premarket approval of the ABSORB BVS platform and is the first study with sufficient size to allow valid examination of the relative clinical outcomes between metallic DES and bioresorbable scaffold.

01 octubre 2015

AMERICAN HEART JOURNAL. Granulocyte-colony stimulating factor for large anterior ST-elevation myocardial infarction: Rationale and design of the prospective randomized phase III STEM-AMI OUTCOME trial

Felice Achilli, MD, Cristina Malafronte, MD, Francesca Cesana, MD, PhD, Stefano Maggiolini, MD, Ciro Mauro, MD, Gaetano M. De Ferrari, MD, Laura Lenatti, MD, Maurizio Tespili, MD, Paola Pasqualini, MD, Francesco Gentile, MD, Maurizio C. Capogrossi, MD, Aldo Maggioni, MD, Attilio Maseri, MD, Gianluca Pontone, MD, Gualtiero I. Colombo, MD, PhD1, Giulio Pompilio, MD, PhD1 for the STEM-AMI OUTCOME Trial Investigators

Background: Granulocyte-colony stimulating factor (G-CSF) has been clinically tested in ST-elevation myocardial infarction (STEMI) with mixed results. Our 3-year follow-up data from STEM-AMI trial documented a sustained benefit of G-CSF on adverse ventricular remodeling after large anterior STEMI, when administered early and at a high-dose in patients with left ventricular (LV) dysfunction. The Aim of the present trial is to establish whether G-CSF improves hard clinical long-term outcomes.

01 octubre 2015

AMERICAN HEART JOURNAL. Concomitant proton-pump inhibitor use, platelet activity, and clinical outcomes in patients with acute coronary syndromes treated with prasugrel versus clopidogrel and managed without revascularization: Insights from the Targeted Platelet Inhibition to Clarify the Optimal Strategy to Medically Manage Acute Coronary Syndromes trial

Jose Carlos Nicolau, MD, PhD, Deepak L. Bhatt, MD, MPH, Matthew T. Roe, MD, MHS, Yuliya Lokhnygina, PhD, Benjamin Neely, MS, Ramón Corbalán, MD, José L. Leiva-Pons, MD, Felipe Martinez, MD, Shaun G. Goodman, MD, MSc, Kenneth J. Winters, MD, Freek W.A. Verheugt, MD, Paul W. Armstrong, MD, Harvey D. White, MB, ChB, DSc, Keith A.A. Fox, MB, ChB, Dorairaj Prabhakaran, MD, DM, MSc, E. Magnus Ohman, MD for the TRILOGY ACS investigators

Background: Concomitant use of proton-pump inhibitors (PPIs) has been implicated in diminished antiplatelet response to clopidogrel and an increased risk of ischemic events, but primarily among patients undergoing percutaneous coronary intervention. We sought to examine the potential influence of interactions between PPIs and clopidogrel versus prasugrel on platelet reactivity and clinical outcomes after acute coronary syndromes (ACS) in patients managed medically without revascularization.

01 octubre 2015

AMERICAN HEART JOURNAL. Long-term outcomes for women versus men with unstable angina/non–ST-segment elevation myocardial infarction managed medically without revascularization: Insights from the TaRgeted platelet Inhibition to cLarify the Optimal strateGy to medicallY manage Acute Coronary Syndromes trial

Peter Clemmensen, MD, DMSc, Matthew T. Roe, MD, MHS, Judith S. Hochman, MD, Derek D. Cyr, PhD, Megan L. Neely, PhD, Darren K. McGuire, MD, Jan H. Cornel, MD, PhD, Kurt Huber, MD, Dmitry Zamoryakhin, MD, Harvey D. White, MB, ChB, DSc, Paul W. Armstrong, MD, Keith A.A. Fox, MB, ChB, Dorairaj Prabhakaran, MD, DM, MSc, Erik Magnus Ohman, MD for the TRILOGY ACS Investigators

Background: Women with acute coronary syndromes (ACS) are less likely to undergo invasive revascularization than men, but sex-specific differences in long-term outcomes and platelet reactivity among medically managed ACS patients remain uncertain. We examined sex-specific differences in long-term ischemic and bleeding outcomes and platelet reactivity for medically managed ACS patients randomized to prasugrel versus clopidogrel plus aspirin.

01 octubre 2015

AMERICAN HEART JOURNAL. Blood transfusion, bleeding, anemia, and survival in patients with acute myocardial infarction: FAST-MI registry

Gregory Ducrocq, Etienne Puymirat, Philippe Gabriel Steg, Patrick Henry, Michel Martelet, Carma Karam, François Schiele, Tabassome Simon, Nicolas Danchin

Background: An association between transfusion during index hospitalization and increased subsequent mortality has been reported in acute myocardial infarction (AMI). Whether this reflects the prognostic role of transfusion per se, or the impact of the index event leading to transfusion, remains unclear. We sought to evaluate the impact of transfusion on mortality in patients with AMI.