18 marzo 2014

CIRCULATION. Interventional Cardiology. ST-Elevation Myocardial Infarction Diagnosed After Hospital Admission

Ross F. Garberich, MS; Jay H. Traverse, MD; Michael T. Claussen, BS; Gabriel Rodriguez, BS; Anil K. Poulose, MD; Ivan J. Chavez, MD; Stephanie Rutten-Ramos, DVM, PhD; David A. Hildebrandt, RN; Timothy D. Henry, MD

Background: Treatment times for ST-elevation myocardial infarction (STEMI) patients presenting to percutaneous coronary intervention hospitals have improved dramatically over the past 10 years, particularly for patients using emergency medical services. Limited data exist regarding treatment times and outcomes for patients who develop STEMI after hospital admission.

18 marzo 2014

CIRCULATION. Interventional Cardiology. Permanent Pacemaker Implantation After Transcatheter Aortic Valve Implantation. Impact on Late Clinical Outcomes and Left Ventricular Function

Marina Urena, MD; John G. Webb, MD; Corrado Tamburino, MD; Antonio J. Muñoz-García, MD, PhD; Asim Cheema, MD; Antonio E. Dager, MD; Vicenç Serra, MD; Ignacio J. Amat-Santos, MD; Marco Barbanti, MD; Sebastiano Immè, MD; Juan H. Alonso Briales, MD; Luis Miguel Benitez, MD; Hatim Al Lawati, MD; Angela Maria Cucalon, MD; Bruno García del Blanco, MD; Javier López, MD, PhD; Eric Dumont, MD; Robert DeLarochellière, MD; Henrique B. Ribeiro, MD; Luis Nombela-Franco, MD; François Philippon, MD, FRCPC, FHRS; Josep Rodés-Cabau, MD

Background: Very few data exist on the clinical impact of permanent pacemaker implantation (PPI) after transcatheter aortic valve implantation. The objective of this study was to assess the impact of PPI after transcatheter aortic valve implantation on late outcomes in a large cohort of patients.

18 marzo 2014

CIRCULATION. Coronary Heart Disease. Randomized Comparison of Xience V and Multi-Link Vision Coronary Stents in the Same Multivessel Patient With Chronic Kidney Disease (RENAL-DES) Study

Fabrizio Tomai, MD, FACC, FESC; Flavio Ribichini, MD; Leonardo De Luca, MD, FACC, PhD; Alessandro Petrolini, MD; Anna S. Ghini, MD, PhD; Luca Weltert, MD; Carmen Spaccarotella, MD; Igino Proietti, MD; Carlo Trani, MD; Francesco Nudi, MD; Michele Pighi, MD; Corrado Vassanelli, MD, FESC

Background: Percutaneous coronary interventions in patients with chronic kidney disease have shown suboptimal results. Drug-eluting stents (DES) might reduce the rate of target vessel revascularization in comparison with bare-metal stents (BMS) in patients with chronic kidney disease. However, given the multiple concomitant individual variables present in such patients, the comparison of neointimal growth after percutaneous coronary intervention is complex and difficult to assess.

18 marzo 2014

CIRCULATION. Arrhythmia/Electrophysiology. Efficacy and Safety of Dabigatran Compared With Warfarin in Relation to Baseline Renal Function in Patients With Atrial Fibrillation. A RE-LY (Randomized Evaluation of Long-term Anticoagulation Therapy) Trial Analysis

Ziad Hijazi, MD, PhD; Stefan H. Hohnloser, MD; Jonas Oldgren, MD, PhD; Ulrika Andersson, MSc; Stuart J. Connolly, MD; John W. Eikelboom, MD; Michael D. Ezekowitz, MB, ChB, PhD; Paul A. Reilly, PhD; Agneta Siegbahn, MD, PhD; Salim Yusuf, MD, PhD; Lars Wallentin, MD, PhD

Background: Renal impairment increases the risk of stroke and bleeding in patients with atrial fibrillation. In the Randomized Evaluation of Long-Term Anticoagulant Therapy (RELY) trial, dabigatran, with ≈80% renal elimination, displayed superiority over warfarin for prevention of stroke and systemic embolism in the 150-mg dose and significantly less major bleeding in the 110-mg dose in 18 113 patients with nonvalvular atrial fibrillation. This prespecified study investigated these outcomes in relation to renal function.

18 marzo 2014

CIRCULATION. Valvular Heart Disease. The Echo Score Revisited. Impact of Incorporating Commissural Morphology and Leaflet Displacement to the Prediction of Outcome for Patients Undergoing Percutaneous Mitral Valvuloplasty

Maria Carmo P. Nunes, MD, PhD; Timothy C. Tan, MD, PhD; Sammy Elmariah, MD, MPH; Rodrigo do Lago, MD; Ronan Margey, MD; Ignacio Cruz-Gonzalez, MD; Hui Zheng, PhD; Mark D. Handschumacher, BS; Ignacio Inglessis, MD; Igor F. Palacios, MD; Arthur E. Weyman, MD; Judy Hung, MD

Background: Current echocardiographic scoring systems for percutaneous mitral valvuloplasty (PMV) have limitations. This study examined new, more quantitative methods for assessing valvular involvement and the combination of parameters that best predicts immediate and long-term outcome after PMV.

18 marzo 2014

CIRCULATION. Epidemiology and Prevention. Aneurysm Global Epidemiology Study. Public Health Measures Can Further Reduce Abdominal Aortic Aneurysm Mortality

David Sidloff, BSc (Hon), MBBS, MRCS; Philip Stather, MBChB, MRCS; Nikesh Dattani, BSc (Hon), MBBS, MRCS; Matthew Bown, MBBCh, MD, FRCS, PGCert (Bioinformatics); John Thompson, PhD; Robert Sayers, MBChB (Hons), FRCS (Ed), FRCS (Eng), MD; Edward Choke, MBBS, FRCS, PhD

Background: Contemporary data from Western populations suggest steep declines in abdominal aortic aneurysm (AAA) mortality; however, international trends are unclear. This study aimed to investigate global AAA mortality trends and to analyze any association with common cardiovascular risk factors.

01 febrero 2014

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Stents. Stent Thrombosis With Second-Generation Drug-Eluting Stents Compared With Bare-Metal Stents. Network Meta-Analysis of Primary Percutaneous Coronary Intervention Trials in ST-Segment–Elevation Myocardial Infarction

Femi Philip, MD, Shikhar Agarwal, MD, Matthew C. Bunte, MD, Sachin S. Goel, MD, E. Murat Tuzcu, MD, Stephen Ellis, MD and Samir R. Kapadia, MD

Background: The relative safety of drug-eluting stents (DESs) and bare-metal stents (BMSs) with respect to stent thrombosis (ST) continues to be debated. There are limited data comparing safety and efficacy of second-generation DES to BMS. We compared the clinical outcomes between second-generation DES and BMS for primary percutaneous coronary intervention using network meta-analysis.

01 febrero 2014

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Stents. Stent Longitudinal Strength Assessed Using Point Compression. Insights From a Second-Generation, Clinically Related Bench Test

John A. Ormiston, MBChB, Bruce Webber, MHSc, Ben Ubod, BSN, Jonathon White, MBChB and Mark W.I. Webster, MBChB

Background: Stent longitudinal distortion, while infrequent, can lead to adverse clinical events. Our first bench comparison of susceptibility of different stent designs to distortion applied force to the entire circumference of the proximal stent hoop. The test increased understanding of stent design and led to recommendations for design change in some. Our second-generation test more closely mimics clinical scenarios by applying force to a point on the proximal hoop of a malapposed stent.

01 febrero 2014

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Outcomes. Risk Stratification for Long-Term Mortality After Percutaneous Coronary Intervention

Chuntao Wu, MD, PhD, Fabian T. Camacho, MS, Spencer B. King III, MD, Gary Walford, MD, David R. Holmes Jr, MD, Nicholas J. Stamato, MD, Peter B. Berger, MD, Samin Sharma, MD, Jeptha P. Curtis, MD, Ferdinand J. Venditti, MD, Alice K. Jacobs, MD and Edward L. Hannan, PhD

Background: A simple risk score to predict long-term mortality after percutaneous coronary intervention (PCI) using preprocedural risk factors is currently not available. In this study, we created one by simplifying the results of a Cox proportional hazards model.

01 febrero 2014

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Outcomes. Incidences, Predictors, and Clinical Outcomes of Acute and Late Stent Malapposition Detected by Optical Coherence Tomography After Drug-Eluting Stent Implantation

Eui Im, MD*, Byeong-Keuk Kim, MD*, Young-Guk Ko, MD, Dong-Ho Shin, MD, Jung-Sun Kim, MD, Donghoon Choi, MD, Yangsoo Jang, MD and Myeong-Ki Hong, MD, PhD

Background: We investigated the incidences, predictors, and clinical outcomes of acute and late stent malapposition detected by optical coherence tomography (OCT) after drug-eluting stent implantation.

02 febrero 2014

THE NEW ENGLAND JOURNAL OF MEDICINE. Mitral-Valve Repair versus Replacement for Severe Ischemic Mitral Regurgitation

Background: Ischemic mitral regurgitation is associated with a substantial risk of death. Practice guidelines recommend surgery for patients with a severe form of this condition but acknowledge that the supporting evidence for repair or replacement is limited.

25 febrero 2014

CIRCULATION. Contemporary Reviews in Cardiovascular Medicine. Characterization of Neurological Injury in Transcatheter Aortic Valve Implantation

Jonathon P. Fanning, BSc, MBBS; Darren L. Walters, MBBS, MPhil, GradCertMang (Health), FRACP, FCSANZ, FSCAI; David G. Platts, BMedSci, MBBS, MD, FRACP, FCSANZ, FESC, FASE; Eamonn Eeles, MBBS, MRCP, MSc; Judith Bellapart, MD, ESICM, FCICM; John F. Fraser, MB ChB, PhD, DA, MRCP (UK), FFARCSI, FRCA, FCICM

The application of transcatheter aortic valve implantation (TAVI) to high-surgical-risk and inoperable patients with severe aortic stenosis (AS) is gaining widespread acceptance with a burgeoning supportive evidence base.1 The benefits associated with the application of this technique, however, are mitigated by the occurrence of major, disabling stroke with associated increased mortality and early-reduced quality of life.2 Despite this, the risk/benefit ratio has been considered acceptable in appropriately selected patients given the outcomes of alternate management options in these high-risk and inoperable populations.

21 octubre 2013

CIRCULATION. Vascular Medicine. Mild Antithrombin Deficiency and Risk of Recurrent Venous Thromboembolism. A Prospective Cohort Study

Matteo Nicola Dario Di Minno, MD; Francesco Dentali, MD; Roberta Lupoli, MD; Walter Ageno, MD

Background: Antithrombin deficiency, defined by antithrombin levels of <70%, is a major thrombophilic condition associated with an increased risk of venous thromboembolism (VTE). No prospective data are available about the risk of recurrent VTE associated with mildly decreased antithrombin levels (70–80%).

13 noviembre 2013

CIRCULATION. Interventional Cardiology. Randomized, Controlled Trial of Ultrasound-Assisted Catheter-Directed Thrombolysis for Acute Intermediate-Risk Pulmonary Embolism

Nils Kucher, MD; Peter Boekstegers, MD; Oliver J. Müller, MD; Christian Kupatt, MD; Jan Beyer-Westendorf, MD; Thomas Heitzer, MD; Ulrich Tebbe, MD; Jan Horstkotte, MD; Ralf Müller, MD; Erwin Blessing, MD; Martin Greif, MD; Philipp Lange, MD; Ralf-Thorsten Hoffmann, MD; Sebastian Werth, MD; Achim Barmeyer, MD; Dirk Härtel, MD; Henriette Grünwald, MD; Klaus Empen, MD; Iris Baumgartner, MD

Background: In patients with acute pulmonary embolism, systemic thrombolysis improves right ventricular (RV) dilatation, is associated with major bleeding, and is withheld in many patients at risk. This multicenter randomized, controlled trial investigated whether ultrasound-assisted catheter-directed thrombolysis (USAT) is superior to anticoagulation alone in the reversal of RV dilatation in intermediate-risk patients.

26 noviembre 2013

CIRCULATION. Imaging. Relationship Between Intravascular Ultrasound Guidance and Clinical Outcomes After Drug-Eluting Stents. The Assessment of Dual Antiplatelet Therapy With Drug-Eluting Stents (ADAPT-DES) Study

Bernhard Witzenbichler, MD*; Akiko Maehara, MD*; Giora Weisz, MD; Franz-Josef Neumann, MD; Michael J. Rinaldi, MD; D. Christopher Metzger, MD; Timothy D. Henry, MD; David A. Cox, MD; Peter L. Duffy, MD, MMM; Bruce R. Brodie, MD; Thomas D. Stuckey, MD; Ernest L. Mazzaferri Jr, MD; Ke Xu, PhD; Helen Parise, ScD; Roxana Mehran, MD; Gary S. Mintz, MD; Gregg W. Stone, MD

Background: Prior small to modest-sized studies suggest a benefit of intravascular ultrasound (IVUS) guidance in noncomplex lesions. Whether IVUS guidance is associated with improved clinical outcomes after drug-eluting stent (DES) implantation in an unrestricted patient population is unknown.