01 agosto 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Physiologic Assessment and Imaging. Assessment of Fractional Flow Reserve in Patients With Recent Non–ST-Segment–Elevation Myocardial Infarction

Jamie Layland, PhD, Samuli Rauhalammi, MSci, Stuart Watkins, MD, Nadeem Ahmed, MBChB, John McClure, PhD, Matthew M.Y. Lee, MRCP, David Carrick, MBChB, Anna O’Donnell, BN, Arvind Sood, MRCP, MD, Mark C. Petrie, MD, Vannesa Teng Yue May, BMedSci, Hany Eteiba, MD, Mitchell Lindsay, MD, Margaret McEntegart, PhD, Keith G. Oldroyd, MD (Hons), Aleksandra Radjenovic, PhD and Colin Berry, PhD

Background: The use of fractional flow reserve (FFR) in acute coronary syndromes is controversial. The British Heart Foundation Fractional Flow Reserve Versus Angiography in Guiding Management to Optimize Outcomes in Non-ST-Elevation Myocardial Infarction (FAMOUS-NSTEMI) study (NCT01764334) has recently demonstrated the safety and feasibility of FFR measurement in patients with non–ST-segment–elevation myocardial infarction. We report the findings of the cardiac magnetic resonance (CMR) substudy to assess the diagnostic accuracy of FFR compared with 3.0-T stress CMR perfusion.

01 agosto 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Structural Heart Disease. Thirty-Day Readmissions After Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement in Patients With Severe Aortic Stenosis in New York State

Edward L. Hannan, PhD, Zaza Samadashvili, MD, Desmond Jordan, MD, Thoralf M. Sundt III, MD, Nicholas J. Stamato, MD, Stephen J. Lahey, MD, Jeffrey P. Gold, MD, Andrew Wechsler, MD, Mohammed H. Ashraf, MD, Carlos Ruiz, MD, Sean Wilson, MD and Craig R. Smith, MD

Background: Several studies have compared short-term and medium-term mortality rates for patients with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR), but no studies have compared short-term readmission rates for the 2 procedures.

01 agosto 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Interventions. Clinical Utility of the Japan–Chronic Total Occlusion Score in Coronary Chronic Total Occlusion Interventions

Georgios Christopoulos, MD, R. Michael Wyman, MD, Khaldoon Alaswad, MD, Dimitri Karmpaliotis, MD, William Lombardi, MD, J. Aaron Grantham, MD, Robert W. Yeh, MD, MBA, Farouc A. Jaffer, MD, PhD, Daisha J. Cipher, PhD, Bavana V. Rangan, BDS, MPH, Georgios E. Christakopoulos, MD, Megan A. Kypreos, BS, Nicholas Lembo, MD, David Kandzari, MD, Santiago Garcia, MD, Craig A. Thompson, MD, MMSc, Subhash Banerjee, MD and Emmanouil S. Brilakis, MD, PhD

Background: The performance of the Japan–chronic total occlusion (J-CTO) score in predicting success and efficiency of CTO percutaneous coronary intervention has received limited study.

01 agosto 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Myocardial Infarction. Is Aspiration Thrombectomy Beneficial in Patients Undergoing Primary Percutaneous Coronary Intervention?

Islam Y. Elgendy, MD, Tianyao Huo, MS, Deepak L. Bhatt, MD, MPH and Anthony A. Bavry, MD, MPH

Background: It is unclear whether intravenous glycoprotein IIb/IIIa inhibitors or ischemic time might modify any clinical benefits observed with aspiration thrombectomy before primary percutaneous coronary intervention (PCI) in patients with ST-segment–elevation myocardial infarction.

01 agosto 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Structural Heart Disease. Effect of Pulmonary Hypertension Hemodynamic Presentation on Clinical Outcomes in Patients With Severe Symptomatic Aortic Valve Stenosis Undergoing Transcatheter Aortic Valve Implantation

Crochan J. O’Sullivan, MD*, Peter Wenaweser, MD*, Osman Ceylan, MS, Julie Rat-Wirtzler, MSc, Stefan Stortecky, MD, Dik Heg, PhD, Ernest Spitzer, MD, Thomas Zanchin, MD, Fabien Praz, MD, David Tüller, MD, Christoph Huber, MD, Thomas Pilgrim, MD, Fabian Nietlispach, MD, Ahmed A. Khattab, MD, Thierry Carrel, MD, Bernhard Meier, MD, Stephan Windecker, MD and Lutz Buellesfeld, MD

Background: Pulmonary hypertension (PH) frequently coexists with severe aortic stenosis, and PH severity has been shown to predict outcomes after transcatheter aortic valve implantation (TAVI). The effect of PH hemodynamic presentation on clinical outcomes after TAVI is unknown.

01 agosto 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Artery Disease. Surgical Versus Percutaneous Coronary Revascularization for Multivessel Disease in Diabetic Patients With Non–ST-Segment–Elevation Acute Coronary Syndrome

Yanai Ben-Gal, MD, Rephael Mohr, MD, Frederick Feit, MD, E. Magnus Ohman, MD, Ajay Kirtane, MD, Ke Xu, PhD, Roxana Mehran, MD and Gregg W. Stone, MD

Background: The preferred revascularization strategy for diabetic patients with acute coronary syndromes and multivessel coronary artery disease is uncertain. We evaluated the outcomes of diabetic patients with moderate and high-risk acute coronary syndrome and multivessel disease managed with percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG).

01 agosto 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Interventions. Association Between Acute Kidney Injury and In-Hospital Mortality in Patients Undergoing Percutaneous Coronary Interventions

Judith Kooiman, MSc, Milan Seth, MS, Brahmajee K. Nallamothu, MD, Michael Heung, MD, David Humes, MD and Hitinder S. Gurm, MD

Background: Acute kidney injury (AKI) post percutaneous coronary intervention (PCI) is associated with increased mortality but both death and AKI share common risk factors. Moreover, the effect of a high contrast dose, a known modifiable risk factor for AKI, on mortality is unknown. The aim of our study was to analyze the association between AKI and in-hospital mortality post PCI after adjustment for confounding by common risk factors.

01 agosto 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Interventions. High Event Rate After a First Percutaneous Coronary Intervention in Patients With Diabetes Mellitus

Viveca Ritsinger, MD, Nawsad Saleh, MD, PhD, Bo Lagerqvist, MD, PhD and Anna Norhammar, MD, PhD

Background: Patients with diabetes mellitus have reduced longevity after acute coronary syndromes and revascularization. However, knowledge of the long-term complication rates and patterns from an everyday life setting is lacking.

01 agosto 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Interventions. Thrombogenicity and Early Vascular Healing Response in Metallic Biodegradable Polymer-Based and Fully Bioabsorbable Drug-Eluting Stents

Tobias Koppara, MD, Qi Cheng, MD, Kazuyuki Yahagi, MD, Hiroyoshi Mori, MD, Oscar David Sanchez, MD, Julia Feygin, PhD, Eric Wittchow, PhD, Frank D. Kolodgie, PhD, Renu Virmani, MD and Michael Joner, MD

Background—: thrombogenicity and re-endothelialization represent clinically relevant end points pertaining to the safety of coronary stents, which have not been compared among biodegradable polymer-based drug-eluting metallic stents and fully bioabsorbable scaffolds to date.

01 agosto 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Myocardial Infarction. Magnitude of Troponin Elevation and Long-Term Clinical Outcomes in Acute Coronary Syndrome Patients Treated With and Without Revascularization

Akshay Bagai, MD, MHS, Zhen Huang, MS, Yuliya Lokhnygina, PhD, Robert A. Harrington, MD, Paul W. Armstrong, MD, John Strony, MD, Harvey D. White, DSc, Sergio Leonardi, MD, Claes Held, MD, PhD, Frans Van de Werf, MD, Lars Wallentin, MD, PhD, Pierluigi Tricoci, MD, PhD, MHS and Kenneth W. Mahaffey, MD

Background: In patients with non–ST-segment–elevation acute coronary syndrome (NSTE ACS), elevated troponin levels identify patients at high risk for adverse outcomes; however, it is unknown whether the magnitude of troponin elevation during hospitalization remains predictive of subsequent events in patients undergoing coronary revascularization.

01 agosto 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Structural Heart Disease. Fully Percutaneous Transthoracic Left Atrial Entry and Closure as a Potential Access Route for Transcatheter Mitral Valve Interventions

Toby Rogers, BM BCh, MRCP, Kanishka Ratnayaka, MD, William H. Schenke, BA, Merdim Sonmez, PhD, Ozgur Kocaturk, PhD, Jonathan R. Mazal, MS, Marcus Y. Chen, MD, Moshe Y. Flugelman, MD, James F. Troendle, PhD, Anthony Z. Faranesh, PhD and Robert J. Lederman, MD

Background: Percutaneous access for mitral interventions is currently limited to transapical and transseptal routes, both of which have shortcomings. We hypothesized that the left atrium could be accessed directly through the posterior chest wall under imaging guidance.

01 agosto 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Interventions. Time-Trend Analyses of Bleeding and Mortality After Primary Percutaneous Coronary Intervention During Out of Working Hours Versus In-Working Hours

M. Bilal Iqbal, MD, PhD, Ramzi Khamis, MD, Charles Ilsley, MD, Ghada Mikhail, MD, Tom Crake, MD, Sam Firoozi, MD, Sundeep Kalra, MD, Charles Knight, MD, Andrew Archbold, MD, Pitt Lim, MD, Anthony Mathur, MD, Pascal Meier, MD, Roby D. Rakhit, MD, Simon Redwood, MD, Mark Whitbread, MSc, Dan Bromage, MD, Krishna Rathod, MD, Daniel A. Jones, MD, Andrew Wragg, MD, Miles Dalby, MD, Phil MacCarthy, MD and Iqbal S. Malik, MD; from the London Heart Attack Centre Group Investigators

Background: Primary percutaneous coronary intervention (PPCI) is the treatment of choice for ST-segment–elevation myocardial infarction. Resources are limited during out of working hours (OWH). Whether PPCI outside working hours is associated with worse outcomes and whether outcomes have improved over time are unknown.

01 agosto 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Physiologic Assessment and Imaging. Change in Coronary Blood Flow After Percutaneous Coronary Intervention in Relation to Baseline Lesion Physiology

Sukhjinder S. Nijjer, MBChB, Ricardo Petraco, MD, Tim P. van de Hoef, MD, Sayan Sen, MBBS, PhD, Martijn A. van Lavieren, MSc, Rodney A. Foale, MD, Martijn Meuwissen, MD, PhD, Christopher Broyd, MBBS, Mauro Echavarria-Pinto, MD, Rasha Al-Lamee, MBBS, Nicolas Foin, PhD, Amarjit Sethi, MBBS, PhD, Iqbal S. Malik, MBBS, PhD, Ghada W. Mikhail, BSc, MD, Alun D. Hughes, MBBS, PhD, Jamil Mayet, MBChB, MD, MBA, Darrel P. Francis, MB BChir, MA, MD, Carlo Di Mario, MD, PhD, Javier Escaned, MD, PhD, Jan J. Piek, MD, PhD and Justin E. Davies, MBBS, PhD

Background: Percutaneous coronary intervention (PCI) aims to increase coronary blood flow by relieving epicardial obstruction. However, no study has objectively confirmed this and assessed changes in flow over different phases of the cardiac cycle. We quantified the change in resting and hyperemic flow velocity after PCI in stenoses defined physiologically by fractional flow reserve and other parameters.

01 agosto 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Interventions. Clinical Outcomes According to Diabetic Status in Patients Treated With Biodegradable Polymer Sirolimus-Eluting Stents Versus Durable Polymer Everolimus-Eluting Stents

Anna Franzone, MD, Thomas Pilgrim, MD, Dik Heg, PhD, Marco Roffi, MD, David Tüller, MD, André Vuilliomenet, MD, Olivier Muller, MD, Stéphane Cook, MD, Daniel Weilenmann, MD, Christoph Kaiser, MD, Peiman Jamshidi, MD, Lorenz Räber, MD, Stefan Stortecky, MD, Peter Wenaweser, MD, Peter Jüni, MD and Stephan Windecker, MD

Background: Ultrathin strut biodegradable polymer sirolimus-eluting stents (BP-SES) proved noninferior to durable polymer everolimus-eluting stents (DP-EES) for a composite clinical end point in a population with minimal exclusion criteria. We performed a prespecified subgroup analysis of the Ultrathin Strut Biodegradable Polymer Sirolimus-Eluting Stent Versus Durable Polymer Everolimus-Eluting Stent for Percutaneous Coronary Revascularisation (BIOSCIENCE) trial to compare the performance of BP-SES and DP-EES in patients with diabetes mellitus.

01 agosto 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Interventions. Safe Limits of Contrast Vary With Hydration Volume for Prevention of Contrast-Induced Nephropathy After Coronary Angiography Among Patients With a Relatively Low Risk of Contrast-Induced Nephropathy

Yong Liu, MD, Ji-Yan Chen, MD, Ning Tan, MD, Ying-Ling Zhou, MD, Dan-Qing Yu, MD, Zhu-Jun Chen, MD, Yi-Ting He, MD, Yuan-Hui Liu, MD, Jian-Fang Luo, MD, Wen-Hui Huang, MD, Guang Li, MD, Peng-Cheng He, MD, Jun-Qing Yang, MD, Nian-Jin Xie, MD, Xiao-Qi Liu, MD, Da-Hao Yang, MD, Shui-Jin Huang, MD, Piao- Ye, MD, Hua-Long Li, MD, Peng Ran, MD, Chong-Yang Duan, MD and Ping-Yan Chen, MS

Background: Few studies have investigated the safe limits of contrast to prevent contrast-induced nephropathy (CIN) based on hydration data. We aimed to investigate the relative safe maximum contrast volume adjusted for hydration volume in a population with a relatively low risk of CIN.