01 agosto 2014

JACC. Prevalence and Characteristics of TCFA and Degree of Coronary Artery Stenosis. An OCT, IVUS, and Angiographic Study

Jinwei Tian, MD, PhD∗; Harold Dauerman, MD‡; Catalin Toma, MD§; Habib Samady, MD‖; Tomonori Itoh, MD¶; Shoichi Kuramitsu, MD#; Takenori Domei, MD#; Haibo Jia, MD, PhD∗; Rocco Vergallo, MD†; Tsunenari Soeda, MD, PhD†; Sining Hu, MD∗; Yoshiyasu Minami, MD†; Hang Lee, PhD∗∗; Bo Yu, MD, PhD∗; Ik-Kyung Jang, MD, PhD†

Background: The relationship between features of vulnerable plaque and angiographic coronary stenosis is unknown.

01 agosto 2014

JACC. Accuracy of Coronary CT Angiography Using a Submillisievert Fraction of Radiation Exposure. Comparison With Invasive Coronary Angiography

Julia Stehli, MD∗; Tobias A. Fuchs, MD∗; Sacha Bull, MD∗; Olivier F. Clerc, MD∗; Mathias Possner, MD∗; Ronny R. Buechel, MD∗; Oliver Gaemperli, MD∗; Philipp A. Kaufmann, MD∗

Background: Coronary computed tomography angiography (CTA) is increasingly being used for evaluation of coronary artery disease (CAD). As a result of the widely reported potential of carcinogenic risk from x-ray based examinations, many strategies have been developed for dose reduction with CTA.

01 septiembre 2014

JACC. Aspirin Treatment and Outcomes After Percutaneous Coronary Intervention. Results of the ISAR-ASPI Registry

Katharina Mayer, MD∗; Isabell Bernlochner, MD†; Siegmund Braun, MD∗; Stefanie Schulz, MD∗; Martin Orban, MD‡; Tanja Morath, MD∗; Lisena Cala, MS∗; Petra Hoppmann, MD†; Heribert Schunkert, MD∗; Karl-Ludwig Laugwitz, MD†; Adnan Kastrati, MD∗; Dirk Sibbing, MD‡

Background: Aspirin administration, as part of a dual antiplatelet treatment regimen, is essential for patients undergoing percutaneous coronary intervention (PCI). Although the correlation between high on-clopidogrel treatment platelet reactivity (HCPR) and clinical outcome is well established, data for high on-aspirin treatment platelet reactivity (HAPR) are conflicting.

01 septiembre 2014

JACC. Percutaneous Mitral Valve Edge-to-Edge Repair. In-Hospital Results and 1-Year Follow-Up of 628 Patients of the 2011–2012 Pilot European Sentinel Registry

Georg Nickenig, MD, PhD∗; Rodrigo Estevez-Loureiro, MD, PhD†; Olaf Franzen, MD‡; Corrado Tamburino, MD, PhD§; Marc Vanderheyden, MD‖; Thomas F. Lüscher, MD¶; Neil Moat, MS#; Susanna Price, MD, PhD∗∗; Gianni Dall’Ara, MD†; Reidar Winter, MD, PhD††; Roberto Corti, MD¶; Carmelo Grasso, MD§; Thomas M. Snow, MD†; Raban Jeger, MD‡‡; Stefan Blankenberg, MD§§; Magnus Settergren, MD, PhD††; Klaus Tiroch, MD‖‖; Jan Balzer, MD¶¶; Anna Sonia Petronio, MD##; Heinz-Joachim Büttner, MD∗∗∗; Federica Ettori, MD†††; Horst Sievert, MD‡‡‡; Maria Giovanna Fiorino, MD§§§; Marc Claeys, MD, PhD‖‖‖; Gian Paolo Ussia, MD¶¶¶; Helmut Baumgartner, MD###; Salvatore Scandura, MD§; Farqad Alamgir, MD∗∗∗∗; Freidoon Keshavarzi, MD∗∗∗∗; Antonio Colombo, MD††††; Francesco Maisano, MD, PhD‡‡‡‡; Henning Ebelt, MD§§§§; Patrizia Aruta, MD§; Edith Lubos, MD§§; Björn Plicht, MD‖‖‖‖; Robert Schueler, MD∗; Michele Pighi, MD†; Carlo Di Mario, MD, PhD†

Background: The use of transcatheter mitral valve repair (TMVR) has gained widespread acceptance in Europe, but data on immediate success, safety, and long-term echocardiographic follow-up in real-world patients are still limited.

01 septiembre 2014

JACC. A Systematic Examination of the 2013 ACC/AHA Pooled Cohort Risk Assessment Tool for Atherosclerotic Cardiovascular Disease

Kunal N. Karmali, MD∗; David C. Goff, Jr., MD, PhD†; Hongyan Ning, MD∗; Donald M. Lloyd-Jones, MD, ScM∗

Background: The 2013 American College of Cardiology/American Heart Association updated cholesterol guidelines recommend the use of Pooled Cohort Equations to estimate 10-year absolute risk for atherosclerotic cardiovascular disease (ASCVD) in primary prevention.

01 julio 2014

JACC. Predictors of Permanent Pacemaker Implantation in Patients With Severe Aortic Stenosis Undergoing TAVR. A Meta-Analysis

George C.M. Siontis, MD∗; Peter Jüni, MD†; Thomas Pilgrim, MD∗; Stefan Stortecky, MD∗; Lutz Büllesfeld, MD∗; Bernhard Meier, MD∗; Peter Wenaweser, MD∗; Stephan Windecker, MD∗

Background: Atrioventricular (AV) conduction disturbances requiring permanent pacemaker (PPM) implantation may complicate transcatheter aortic valve replacement (TAVR). Available evidence on predictors of PPM is sparse and derived from small studies.

01 julio 2014

JACC. Comprehensive Analysis of Mortality Among Patients Undergoing TAVR. Results of the PARTNER Trial

Lars G. Svensson, MD, PhD∗; Eugene H. Blackstone, MD∗; Jeevanantham Rajeswaran, PhD∗; Nicholas Brozzi, MD‡; Martin B. Leon, MD†; Craig R. Smith, MD§; Michael Mack, MD‖; D. Craig Miller, MD¶; Jeffrey W. Moses, MD§; E. Murat Tuzcu, MD∗; John G. Webb, MD#; Samir Kapadia, MD∗; Gregory P. Fontana, MD∗∗; Raj R. Makkar, MD∗∗; David L. Brown, MD‖; Peter C. Block, MD††; Robert A. Guyton, MD††; Vinod H. Thourani, MD††; Augusto D. Pichard, MD‡‡; Joseph E. Bavaria, MD§§; Howard C. Herrmann, MD§§; Mathew R. Williams, MD§; Vasilis Babaliaros, MD††; Philippe Généreux, MD§; Jodi J. Akin, MSN‖‖

Background: Patients with severe aortic stenosis (AS) who were deemed too high risk or inoperable for conventional aortic valve replacement (AVR) in the PARTNER (Placement of Aortic Transcatheter Valves) trial were randomized to transcatheter aortic valve replacement (TAVR) versus AVR (PARTNER-A arm) or standard therapy (PARTNER-B arm).

01 julio 2014

JACC. Percutaneous Mitral Valve Repair for Mitral Regurgitation in High-Risk Patients. Results of the EVEREST II Study

Donald D. Glower, MD∗; Saibal Kar, MD†; Alfredo Trento, MD†; D. Scott Lim, MD‡; Tanvir Bajwa, MD§; Ramon Quesada, MD¶; Patrick L. Whitlow, MD#; Michael J. Rinaldi, MD∗∗; Paul Grayburn, MD††; Michael J. Mack, MD††; Laura Mauri, MD‡‡; Patrick M. McCarthy, MD‖‖; Ted Feldman, MD¶¶

Background: The EVEREST II (Endovascular Valve Edge-to-Edge REpair STudy) High-Risk registry and REALISM Continued Access Study High-Risk Arm are prospective registries of patients who received the MitraClip device (Abbott Vascular, Santa Clara, California) for mitral regurgitation (MR) in the United States.

01 julio 2014

JACC. Improved Functional Status and Quality of Life in Prohibitive Surgical Risk Patients With Degenerative Mitral Regurgitation After Transcatheter Mitral Valve Repair

D. Scott Lim, MD∗; Matthew R. Reynolds, MD, MSc†; Ted Feldman, MD§; Saibal Kar, MD‖; Howard C. Herrmann, MD¶; Andrew Wang, MD#; Patrick L. Whitlow, MD∗∗; William A. Gray, MD††; Paul Grayburn, MD‡‡; Michael J. Mack, MD‡‡; Donald D. Glower, MD#

Background: Surgical mitral valve repair (SMVR) remains the gold standard for severe degenerative mitral regurgitation (DMR). However, the results with transcatheter mitral valve repair (TMVR) in prohibitive-risk DMR patients have not been previously reported.

01 julio 2014

JACC. Long-Term Follow-Up of Elective Chronic Total Coronary Occlusion Angioplasty. Analysis From the U.K. Central Cardiac Audit Database

Sudhakar George, MD∗; James Cockburn, MD∗; Tim C. Clayton, MSc†; Peter Ludman, MD‡; James Cotton, MD§; James Spratt, MA‖; Simon Redwood, MD#; Mark de Belder, MD¶; Adam de Belder, MD∗; Jonathan Hill, MA∗∗; Angela Hoye, MBChB, PhD††; Nick Palmer, MD‡‡; Sudhir Rathore, MD§§; Anthony Gershlick, MB BS‖‖; Carlo Di Mario, MD, PhD##; David Hildick-Smith, MD∗

Background: Chronic total occlusion (CTO) is common, being reported in 18% to 30% of patients undergoing coronary angiography. Percutaneous coronary intervention (PCI) is usually performed to relieve anginal symptoms, but data are emerging to suggest that there may also be a mortality benefit.

01 julio 2014

JACC. Aspirin Therapy in Primary Cardiovascular Disease Prevention. A Position Paper of the European Society of Cardiology Working Group on Thrombosis

Sigrun Halvorsen, MD∗; Felicita Andreotti, MD, PhD†; Jurriën M. ten Berg, MD‡; Marco Cattaneo, MD§; Sergio Coccheri, MD‖; Roberto Marchioli, MD¶; João Morais, MD#; Freek W.A. Verheugt, MD∗∗; Raffaele De Caterina, MD, PhD††

Although the use of oral anticoagulants (vitamin K antagonists) has been abandoned in primary cardiovascular prevention due to lack of a favorable benefit-to-risk ratio, the indications for aspirin use in this setting continue to be a source of major debate, with major international guidelines providing conflicting recommendations. Here, we review the evidence in favor and against aspirin therapy in primary prevention based on the evidence accumulated so far, including recent data linking aspirin with cancer protection. While awaiting the results of several ongoing studies, we argue for a pragmatic approach to using low-dose aspirin in primary cardiovascular prevention and suggest its use in patients at high cardiovascular risk, defined as ≥2 major cardiovascular events (death, myocardial infarction, or stroke) projected per 100 person-years, who are not at increased risk of bleeding.

01 julio 2014

JACC. Stent Thrombosis in New-Generation Drug-Eluting Stents in Patients With STEMI Undergoing Primary PCI. A Report From SCAAR

Giovanna Sarno, MD, PhD∗; Bo Lagerqvist, MD, PhD∗; Johan Nilsson, MD†; Ole Frobert, MD, PhD‡; Kristina Hambraeus, MD, PhD§; Christoph Varenhorst, MD, PhD∗; Ulf J. Jensen, MD‖; Tim Tödt, MD¶; Matthias Götberg, MD, PhD#; Stefan K. James, MD∗

Background: Some concerns still have not been resolved about the long-term safety of drug-eluting stents (DES) in patients with acute STEMI.

01 julio 2014

JACC. Prospective Randomized Evaluation of the Watchman Left Atrial Appendage Closure Device in Patients With Atrial Fibrillation Versus Long-Term Warfarin Therapy. The PREVAIL Trial

David R. Holmes, Jr., MD∗; Saibal Kar, MD†; Matthew J. Price, MD‡; Brian Whisenant, MD§; Horst Sievert, MD‖; Shephal K. Doshi, MD¶; Kenneth Huber, MD#; Vivek Y. Reddy, MD∗∗

Background: In the PROTECT AF (Watchman Left Atrial Appendage Closure Technology for Embolic Protection in Patients With Atrial Fibrillation) trial that evaluated patients with nonvalvular atrial fibrillation (NVAF), left atrial appendage (LAA) occlusion was noninferior to warfarin for stroke prevention, but a periprocedural safety hazard was identified.

01 julio 2014

JACC. A Randomized Comparison of Platinum Chromium-Based Everolimus-Eluting Stents Versus Cobalt Chromium-Based Zotarolimus-Eluting Stents in All-Comers Receiving Percutaneous Coronary Intervention

Kyung Woo Park, MD, PhD∗; Si-Hyuck Kang, MD, MSc∗; Hyun-Jae Kang, MD, PhD∗; Bon-Kwon Koo, MD, PhD∗; Byoung-Eun Park, MD, PhD†; Kwang Soo Cha, MD, PhD‡; Jay Young Rhew, MD, PhD§; Hui-Kyoung Jeon, MD, PhD‖; Eun-Seok Shin, MD, PhD¶; Ju Hyeon Oh, MD, PhD#; Myung-Ho Jeong, MD, PhD∗∗; Sanghyun Kim, MD, PhD††; Kyung-Kuk Hwang, MD, PhD‡‡; Jung-Han Yoon, MD, PhD§§; Sung Yun Lee, MD, PhD‖‖; Tae-Ho Park, MD, PhD¶¶; Keon Woong Moon, MD, PhD##; Hyuck-Moon Kwon, MD, PhD∗∗∗; Seung-Ho Hur, MD, PhD†††; Jae-Kean Ryu, MD, PhD‡‡‡; Bong-Ryul Lee, MD, PhD§§§; Yong Whi Park, MD, PhD‖‖‖; In-Ho Chae, MD, PhD¶¶¶; Hyo-Soo Kim, MD, PhD∗

Objectives: This study sought to test whether the newly developed platinum chromium (PtCr)-based everolimus-eluting stent (EES) is noninferior to the cobalt chromium (CoCr)-based zotarolimus-eluting stent (ZES) in all-comers receiving percutaneous coronary intervention (PCI).

01 julio 2014

JACC. Caval-Aortic Access to Allow Transcatheter Aortic Valve Replacement in Otherwise Ineligible Patients. Initial Human Experience

Objectives: This study describes the first use of caval-aortic access and closure to enable transcatheter aortic valve replacement (TAVR) in patients who lacked other access options. Caval-aortic access refers to percutaneous entry into the abdominal aorta from the femoral vein through the adjoining inferior vena cava.