01 agosto 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Structural Heart Disease. Routine Screening of Coronary Artery Disease With Computed Tomographic Coronary Angiography in Place of Invasive Coronary Angiography in Patients Undergoing Transcatheter Aortic Valve Replacement

Maria Del Trigo, MD and Josep Rodés-Cabau, MD

Introduction: Heart failure (HF) is a major cause of mortality and morbidity in developed countries.1 In the past 2 decades, improvements in drug therapy and the widespread use of implantable cardioverter-defibrillators and cardiac resynchronization therapy devices has improved the prognosis of HF patients.2 However, morbidity and mortality rates remain high, with an estimated 5-year mortality rate exceeding 50% coupled with significant rehospitalization rates. Several transcatheter implantable devices have recently emerged in an attempt to improve the prognosis and quality of life of such patients.

01 agosto 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Interventions. Prevalence and Impact of High Platelet Reactivity in Chronic Kidney Disease. Results From the Assessment of Dual Antiplatelet Therapy With Drug-Eluting Stents Registry

Usman Baber, MD, MS, Roxana Mehran, MD, Ajay J. Kirtane, MD, SM, Paul A. Gurbel, MD, Georgios Christodoulidis, MD, Akiko Maehara, MD, Bernhard Witzenbichler, MD, Giora Weisz, MD, Michael J. Rinaldi, MD, D. Christopher Metzger, MD, Timothy D. Henry, MD, David A. Cox, MD, Peter L. Duffy, MD, MMM, Ernest L. Mazzaferri Jr, MD, Ke Xu, PhD, Helen Parise, ScD, Bruce R. Brodie, MD, Thomas D. Stuckey, MD and Gregg W. Stone, MD

Background: Chronic kidney disease (CKD) is associated with increased rates of adverse events after percutaneous coronary intervention. We sought to determine the impact of CKD on platelet reactivity in clopidogrel-treated patients and whether high platelet reactivity (HPR) confers a similar or differential risk for adverse events among patients with CKD and non-CKD.

01 agosto 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Interventions. Impact of Arterial Access Site on Outcomes After Primary Percutaneous Coronary Intervention. Prespecified Subgroup Analysis From the EUROMAX Trial

Martial Hamon, MD, Pierre Coste, MD, Arnoud van’t Hof, MD, PhD, Jurrien Ten Berg, MD, PhD, Peter Clemmensen, MD, PhD, Xavier Tabone, MD, Hakim Benamer, MD, Steen D. Kristensen, MD, Claudio Cavallini, MD, Antonio Marzocchi, MD, Christian Hamm, MD, Vojko Kanic, MD, Debra Bernstein, PhD, Prodromos Anthopoulos, MD, Efthymios N. Deliargyris, MD and Philippe Gabriel Steg, MD

Background: In European Ambulance Acute Coronary Syndrome Angiography (EUROMAX), bivalirudin improved 30-day clinical outcomes with reduced major bleeding compared with heparins plus optional glycoprotein IIb/IIIa inhibitors. We assessed whether choice of access site (radial or femoral) had an impact on 30-day outcomes and whether it interacted with the benefit of bivalirudin.

01 agosto 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS.Coronary Interventions. Comparison of Zotarolimus- and Everolimus-Eluting Coronary Stents

Javaid Iqbal, MRCP, PhD, Patrick W. Serruys, MD, PhD, Sigmund Silber, MD, PhD, Henning Kelbaek, MD, Gert Richardt, MD, Marie-Angele Morel, BSc, Manuela Negoita, MD, Pawel E. Buszman, MD and Stephan Windecker, MD

Background: Newer-generation drug-eluting stents that release zotarolimus or everolimus have been shown to be superior to the first-generation drug-eluting stents. However, data comparing long-term safety and efficacy of zotarolimus- (ZES) and everolimus-eluting stents (EES) are limited. RESOLUTE all-comers (Randomized Comparison of a Zotarolimus-Eluting Stent With an Everolimus-Eluting Stent for Percutaneous Coronary Intervention) trial compared these 2 stents and has shown that ZES was noninferior to EES at 12-month for the primary end point of target lesion failure. We report the secondary clinical outcomes at the final 5-year follow-up of this trial.

01 agosto 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Interventions. Angiographic and Optical Coherence Tomography Insights Into Bioresorbable Scaffold Thrombosis

Antonios Karanasos, MD, PhD, Nicolas Van Mieghem, MD, PhD, Nienke van Ditzhuijzen, MSc, Cordula Felix, MD, Joost Daemen, MD, PhD, Anouchska Autar, MD, Yoshinobu Onuma, MD, PhD, Mie Kurata, MD, PhD, Roberto Diletti, MD, Marco Valgimigli, MD, PhD, Floris Kauer, MD, Heleen van Beusekom, MD, PhD, Peter de Jaegere, MD, PhD, Felix Zijlstra, MD, PhD, Robert-Jan van Geuns, MD, PhD and Evelyn Regar, MD, PhD

Background: As bioresorbable vascular scaffolds (BVSs) are being increasingly used in complex real-world lesions and populations, BVS thrombosis cases have been reported. We present angiographic and optical coherence tomography (OCT) findings in a series of patients treated in our center for definite bioresorbable scaffold thrombosis.

01 agosto 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Interventions. Association of Smoking Status With Health-Related Outcomes After Percutaneous Coronary Intervention

Jae-Sik Jang, MD, PhD, Donna M. Buchanan, PhD, Kensey L. Gosch, MS, Philip G. Jones, MS, Praneet K. Sharma, MD, Ali Shafiq, MD, Anna Grodzinsky, MD, Timothy J. Fendler, MD, Garth Graham, MD, MPH and John A. Spertus, MD, MPH

Background: Patients who smoke at the time of percutaneous coronary intervention (PCI) would ideally have a strong incentive to quit, but most do not. We sought to compare the health status outcomes of those who did and did not quit smoking after PCI with those who were not smoking before PCI.

01 agosto 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Interventions. Incremental Value of Platelet Reactivity Over a Risk Score of Clinical and Procedural Variables in Predicting Bleeding After Percutaneous Coronary Intervention via the Femoral Approach

Fabio Mangiacapra, MD, PhD, Elisabetta Ricottini, MD, Emanuele Barbato, MD, PhD, Chiara Demartini, MD, Aaron Peace, MD, PhD, Giuseppe Patti, MD, Vincenzo Vizzi, MD, Bernard De Bruyne, MD, PhD, William Wijns, MD, PhD and Germano Di Sciascio, MD

Background: Growing evidence suggests that platelet reactivity (PR) may predict bleeding. We investigate the incremental value of PR in predicting bleeding after percutaneous coronary intervention (PCI) via the femoral approach over a validated bleeding risk score (BRS) of clinical and procedural variables.

01 agosto 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Controlling Radiation Exposure in Interventional Cardiology

J. Dawn Abbott, MD

Introduction: The idiom “double-edged sword” describes the use of ionizing radiation in the field of medicine. Medical radiation from x-rays and nuclear medicine is the largest man-made source of radiation in Western countries and although it has benefited patients there is an associated liability or health risk that is unavoidable. A 2009 report by the National Council on Radiation Protection and Measurements found the total exposure to ionizing radiation in the United States has almost doubled during the past 2 decades.1,2 This finding is to a large part attributable to the rise in cardiovascular diagnostic and therapeutic interventions, which are responsible for ≈40% of the cumulative effective dose of radiation to the population exclusive of radiation oncology.3,4 As a field, interventional cardiology has flourished with the advent of technology to allow the treatment of more complex coronary artery disease and expansion in the arenas of endovascular and structural heart disease. With our success comes a heavy burden, that of awareness of the hazards of radiation, appropriate use and documentation of exposure, and constant effort to achieve the lowest achievable exposure necessary to care for an individual patient.

08 julio 2014

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Cardiac Catheterization. Effect of Reduction of the Pulse Rates of Fluoroscopy and CINE-Acquisition on X-Ray Dose and Angiographic Image Quality During Invasive Cardiovascular Procedures

Christopher T. Pyne, MD, Gautam Gadey, MD, Cathy Jeon, MD, Thomas Piemonte, MD, Sergio Waxman, MD and Frederic Resnic, MD, MSc

Background: Reducing digital pulse rates (PR) are known to reduce total energy during invasive cardiovascular procedures, which likely has benefits for patients and staff. Physicians may be reluctant to reduce these parameters because they fear a decline in image quality that could affect procedural outcomes. We sought to assess the effect of default rates of fluoroscopy (Fluoro) and CINE-acquisition (CINE) on total x-ray dose and image quality during invasive cardiovascular procedures.

05 agosto 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Cardiac Catheterization. Measures to Reduce Radiation in a Modern Cardiac Catheterization Laboratory

Shikhar Agarwal, MD, MPH, Akhil Parashar, MD, Stephen G. Ellis, MD, Frederick A. Heupler Jr, MD, Evan Lau, MD, E. Murat Tuzcu, MD and Samir R. Kapadia, MD

Background: X-ray use in the catheterization laboratory is guided by the principle of as low as reasonably achievable. In accordance with this principle, we reduced the default fluoroscopic frame rate from 10 to 7.5 frames/s and increased the emphasis on the use of low-dose acquisition starting January 1, 2013. We aimed to study the impact of these measures on the total air kerma during diagnostic catheterization (DC) and percutaneous interventions (PCI).

05 agosto 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Structural Heart Disease. Open Transapical Approach to Transcatheter Paravalvular Leakage Closure

Vincent J. Nijenhuis, MD, Martin J. Swaans, MD, Martijn C. Post, MD, PhD, Robin H. Heijmen, MD, PhD, Thomas L. de Kroon, MD and Jurrien M. ten Berg, MD, PhD

Background: Significant prosthetic paravalvular leakage (PVL) could have serious clinical consequences and impairs survival. Reoperation is associated with a high mortality rate, and transcatheter closure is a new treatment modality for high-risk patients. The goal of this study was to determine safety and midterm clinical efficacy of transcatheter PVL closure using an open transapical approach.

08 julio 2014

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Structural Heart Disease. Clinical Outcomes and Safety of Transfemoral Aortic Valve Implantation Under General Versus Local Anesthesia

Atsushi Oguri, MD, Masanori Yamamoto, MD, Gauthier Mouillet, MD, Martine Gilard, MD, Marc Laskar, MD, Helene Eltchaninoff, MD, Jean Fajadet, MD, Bernard Iung, MD, Patrick Donzeau-Gouge, MD, Pascal Leprince, MD, Alain Leguerrier, MD, Alain Prat, MD, Michel Lievre, PhD, Karine Chevreul, MD, Jean-Luc Dubois-Rande, MD, Romain Chopard, MD, Eric Van Belle, MD, Toshiaki Otsuka, MD and Emmanuel Teiger, MD; on behalf of FRANCE 2 Registry Investigators

Background: Transcatheter aortic valve implantation (TAVI) performed under local anesthesia (LA) is becoming increasingly common. We aimed to compare the clinical outcomes in patients who underwent transfemoral-TAVI under general anesthesia (GA) and LA.

05 agosto 2014

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Pharmacology. In-Hospital Switching Between Clopidogrel and Prasugrel Among Patients With Acute Myocardial Infarction Treated With Percutaneous Coronary Intervention

Akshay Bagai, MD, MHS, Yongfei Wang, MS, Tracy Y. Wang, MD, MHS, MSc, Jeptha P. Curtis, MD, Hitinder S. Gurm, MD, Binita Shah, MD, MS, Asim N. Cheema, MD, PhD, Eric D. Peterson, MD, MPH, Jorge F. Saucedo, MD, Christopher B. Granger, MD, Matthew T. Roe, MD, MHS, Deepak L. Bhatt, MD, MPH, Robert L. McNamara, MD, MHS and Karen P. Alexander, MD

Background: Although randomized clinical trials have compared clopidogrel with higher potency ADP receptor inhibitors (ADPris) among patients with myocardial infarction, little is known about the frequency and factors associated with switching between ADPris in clinical practice.

15 julio 2014

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Peripheral Vascular Disease. Factors Associated With Vascular Complications in Patients Undergoing Balloon-Expandable Transfemoral Transcatheter Aortic Valve Replacement via Open Versus Percutaneous Approaches

Mitul B. Kadakia, MD, Howard C. Herrmann, MD, Nimesh D. Desai, MD, Zachary Fox, BS, Jeffrey Ogbara, MD, Saif Anwaruddin, MD, Dinesh Jagasia, MD, Joseph E. Bavaria, MD, Wilson Y. Szeto, MD, Prashanth Vallabhajosyula, MD, Robert Li, MD, Rohan Menon, BS, Dale M. Kobrin, BA and Jay Giri, MD, MPH

Background: Vascular complications after transfemoral transcatheter aortic valve replacement are common and associated with significant morbidity and mortality. Little is known about the effect of access approach on vascular complications.

29 julio 2014

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. New Techniques. Fully Integrated High-Speed Intravascular Optical Coherence Tomography/Near-Infrared Fluorescence Structural/Molecular Imaging In Vivo Using a Clinically Available Near-Infrared Fluorescence–Emitting Indocyanine Green to Detect Inflamed Lipid-Rich Atheromata in Coronary-Sized Vessels

Sunki Lee, MD*, Min Woo Lee, BS*, Han Saem Cho, MS*, Joon Woo Song, BS, Hyeong Soo Nam, BS, Dong Joo Oh, MD, PhD, Kyeongsoon Park, PhD, Wang-Yuhl Oh, PhD†, Hongki Yoo, PhD† and Jin Won Kim, MD, PhD†

Background: Lipid-rich inflamed coronary plaques are prone to rupture. The purpose of this study was to assess lipid-rich inflamed plaques in vivo using fully integrated high-speed optical coherence tomography (OCT)/near-infrared fluorescence (NIRF) molecular imaging with a Food and Drug Administration–approved indocyanine green (ICG).