01 agosto 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Interventions. Stent Thrombosis and Dual Antiplatelet Therapy Interruption With Everolimus-Eluting Stents

Philippe Généreux, MD, David R. Rutledge, PharmD, Tullio Palmerini, MD, Adriano Caixeta, MD, PhD, Elvin Kedhi, MD, PhD, James B. Hermiller, MD, Jin Wang, PhD, Mitchell W. Krucoff, MD, Jennifer Jones-McMeans, PhD, Krishnankutty Sudhir, MD, PhD, Charles A. Simonton, MD, Patrick W. Serruys, MD, PhD and Gregg W. Stone, MD

Background: Whether premature dual antiplatelet therapy (DAPT) interruption is safe in patients receiving cobalt chromium everolimus–eluting stents remains controversial. We sought to examine the relationship between DAPT discontinuation and stent thrombosis (ST) after cobalt chromium everolimus-eluting stents.

01 agosto 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Congenital Heart Disease. Pharmacokinetics of Sirolimus-Eluting Stents Implanted in the Neonatal Arterial Duct

Kyong-Jin Lee, MD, Winnie Seto, PharmD, MSc, Lee Benson, MD and Rajiv R. Chaturvedi, MRCP(UK), MD, PhD

Background: Sirolimus-eluting stents may have clinical advantages over bare-metal stents in the extremely proliferative environment of the neonatal arterial duct. However, sirolimus has immunosuppressive actions and little is known regarding sirolimus pharmacokinetics in the newborn.

01 agosto 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Cardiac Catheterization. Underutilization of Radial Access in Patients Undergoing Percutaneous Coronary Intervention for ST-Segment–Elevation Myocardial Infarction

Michael J. Howe, MD, Milan Seth, MS, Arthur Riba, MD, George Hanzel, MD, Mark Zainea, MD and Hitinder S. Gurm, MD

Background: The purpose of this study was to evaluate the frequency and temporal trends in use of transradial access (TRA) for percutaneous coronary intervention (PCI) in ST-segment–elevation myocardial infarction (STEMI). The use of TRA has been associated with less bleeding and improved clinical outcomes in patients undergoing PCI for STEMI.

01 agosto 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Interventions. Clinical Impact of Gastrointestinal Bleeding in Patients Undergoing Percutaneous Coronary Interventions

Konstantinos C. Koskinas, MD, MSc*, Lorenz Räber, MD, PhD*, Thomas Zanchin, MD, Peter Wenaweser, MD, Stefan Stortecky, MD, Aris Moschovitis, MD, Ahmed A. Khattab, MD, Thomas Pilgrim, MD, Stefan Blöchlinger, MD, Christina Moro, MSc, Peter Jüni, MD, Bernhard Meier, MD, Dik Heg, PhD and Stephan Windecker, MD

Background: The risk factors and clinical sequelae of gastrointestinal bleeding (GIB) in the current era of drug-eluting stents, prolonged dual antiplatelet therapy, and potent P2Y12 inhibitors are not well established. We determined the frequency, predictors, and clinical impact of GIB after percutaneous coronary interventions (PCIs) in a contemporary cohort of consecutive patients treated with unrestricted use of drug-eluting stents.

01 abril 2015

JACC: CARDIOVASCULAR INTERVENTIONS. European Experience With the Second-Generation Edwards SAPIEN XT Transcatheter Heart Valve in Patients With Severe Aortic Stenosis

Gerhard Schymik, MD∗; Thierry Lefèvre, MD†; Antonio L. Bartorelli, MD‡; Paolo Rubino, MD§; Hendrik Treede, MD‖; Thomas Walther, MD¶; Helmut Baumgartner, MD#; Stephan Windecker, MD∗∗; Olaf Wendler, MD††; Philip Urban, MD‡‡; Lazar Mandinov, MD§§; Martyn Thomas, MD‖‖; Alec Vahanian, MD¶¶

Objectives: The SOURCE XT Registry (Edwards SAPIEN XT Aortic Bioprosthesis Multi-Region Outcome Registry) assessed the use and clinical outcomes with the SAPIEN XT (Edwards Lifesciences, Irvine, California) valve in the real-world setting.

01 abril 2015

JACC: CARDIOVASCULAR INTERVENTIONS. Long-Term Outcomes After Transcatheter Aortic Valve Replacement in High-Risk Patients With Severe Aortic Stenosis. The U.K. Transcatheter Aortic Valve Implantation Registry

Alison Duncan, MB BS, BSc, PhD∗; Peter Ludman, MA, MD†; Winston Banya, MSc∗; David Cunningham, MA‡; Damian Marlee, MA‡; Simon Davies, MA, MB BS∗; Michael Mullen, MD§; Jan Kovac, MD‖; Thomas Spyt, MD‖; Neil Moat, MB, BS, MS∗

Objectives: The U.K. Transcatheter Aortic Valve Implantation Registry reported 30-day and 1-year mortality rates of 7.1% and 21.4%, respectively, for patients who underwent transcatheter aortic valve replacement (TAVR) in the United Kingdom between 2007 and 2009. The study aim was to report long-term outcomes in this same cohort of patients.

01 marzo 2015

JACC. Randomized Trial of Complete Versus Lesion-Only Revascularization in Patients Undergoing Primary Percutaneous Coronary Intervention for STEMI and Multivessel Disease. The CvLPRIT Trial

Anthony H. Gershlick, MBBS∗; Jamal Nasir Khan, MB ChB∗; Damian J. Kelly, MB ChB, MD†; John P. Greenwood, MB ChB, PhD‡; Thiagarajah Sasikaran, BSc, PhD‖; Nick Curzen, BM, PhD¶; Daniel J. Blackman, MD§; Miles Dalby, MBBS, MD#; Kathryn L. Fairbrother, BA∗∗; Winston Banya, MSc††; Duolao Wang, PhD‡‡; Marcus Flather, MB BS§§; Simon L. Hetherington, MB ChB, MD‖‖; Andrew D. Kelion, BM BCh, DM¶¶; Suneel Talwar, MB BS, MD##; Mark Gunning, MD∗∗∗; Roger Hall, MD§§; Howard Swanton, MB BChir, MD†††; Gerry P. McCann, MB ChB, MD∗

Background: The optimal management of patients found to have multivessel disease while undergoing primary percutaneous coronary intervention (P-PCI) for ST-segment elevation myocardial infarction is uncertain.

01 marzo 2015

JACC. Prevalence, Impact, and Predictive Value of Detecting Subclinical Coronary and Carotid Atherosclerosis in Asymptomatic Adults. The BioImage Study

Usman Baber, MD, MS∗; Roxana Mehran, MD∗; Samantha Sartori, PhD∗; Mikkel Malby Schoos, MD, PhD†; Henrik Sillesen, MD, DMSc†; Pieter Muntendam, MD‡; Mario J. Garcia, MD§; John Gregson, PhD‖; Stuart Pocock, PhD‖; Erling Falk, MD, DMSc¶; Valentin Fuster, MD, PhD∗

Background: Although recent studies suggest that measuring coronary artery calcification (CAC) may be superior to indirect atherosclerotic markers in predicting cardiac risk, there are limited data evaluating imaging-based biomarkers that directly quantify atherosclerosis in different vascular beds performed in a single cohort.

01 marzo 2015

JACC. Discordance Between Echocardiography and MRI in the Assessment of Mitral Regurgitation Severity. A Prospective Multicenter Trial

Seth Uretsky, MD∗; Linda Gillam, MD, MPH∗; Roberto Lang, MD†; Farooq A. Chaudhry, MD‡; Edgar Argulian, MD, MPH§; Azhar Supariwala, MD§; Srinivasa Gurram, MD§; Kavya Jain, MD§; Marjorie Subero, MD§; James J. Jang, MD‖; Randy Cohen, MD§; Steven D. Wolff, MD, PhD¶

Background: The decision to undergo mitral valve surgery is often made on the basis of echocardiographic criteria and clinical assessment. Recent changes in treatment guidelines recommending surgery in asymptomatic patients make the accurate assessment of mitral regurgitation (MR) severity even more important.

01 marzo 2015

JACC. Short- Versus Long-Term Dual Antiplatelet Therapy After Drug-Eluting Stent Implantation. An Individual Patient Data Pairwise and Network Meta-Analysis

Tullio Palmerini, MD∗; Diego Sangiorgi, MStat∗; Marco Valgimigli, MD, PhD†; Giuseppe Biondi-Zoccai, MD‡; Fausto Feres, MD‖; Alexandre Abizaid, MD‖; Ricardo A. Costa, MD‖; Myeong-Ki Hong, MD, PhD¶; Byeong-Keuk Kim, MD, PhD¶; Yangsoo Jang, MD, PhD¶; Hyo-Soo Kim, MD, PhD#; Kyung Woo Park, MD#; Andrea Mariani, MD∗; Diego Della Riva, MD∗; Philippe Genereux, MD∗∗; Martin B. Leon, MD∗∗; Deepak L. Bhatt, MD††; Umberto Bendetto, MD, PhD‡‡; Claudio Rapezzi, MD∗; Gregg W. Stone, MD∗∗

Background: Randomized controlled trials comparing short- (≤6 months) with long-term (≥1 year) dual antiplatelet therapy (DAPT) after drug-eluting stent(s) (DES) placement have been insufficiently powered to detect significant differences in the risk of major adverse cardiac events (MACE).

01 marzo 2015

JACC. Smoking Is Associated With Adverse Clinical Outcomes in Patients Undergoing Revascularization With PCI or CABG. The SYNTAX Trial at 5-Year Follow-Up

Yao-Jun Zhang, PhD∗; Javaid Iqbal, PhD‡; David van Klaveren, MSc§; Carlos M. Campos, MD∗; David R. Holmes, MD‖; Arie Pieter Kappetein, MD∗; Marie-Claude Morice, MD¶; Adrian P. Banning, MD#; Ever D. Grech, MD‡; Christos V. Bourantas, PhD∗; Yoshinobu Onuma, PhD∗; Hector M. Garcia-Garcia, PhD∗; Michael J. Mack, MD∗∗; Antonio Colombo, MD††; Friedrich W. Mohr, MD‡‡; Ewout W. Steyerberg, PhD§; Patrick W. Serruys, MD, PhD∗

Background: smoking is a well-known risk factor for development of coronary artery disease (CAD). However, some studies have suggested a “smoker’s paradox,” meaning neutral or favorable outcomes in smokers who have developed CAD, especially myocardial infarction (MI).

01 marzo 2015

JACC. Hospital Length of Stay and Clinical Outcomes in Older STEMI Patients After Primary PCI. A Report From the National Cardiovascular Data Registry

Rajesh V. Swaminathan, MD∗; Sunil V. Rao, MD†; Lisa A. McCoy, MS†; Luke K. Kim, MD∗; Robert M. Minutello, MD∗; S. Chiu Wong, MD∗; David C. Yang, MD∗; Paramita Saha-Chaudhuri, PhD‡; Harsimran S. Singh, MD, MSc∗; Geoffrey Bergman, MD∗; Dmitriy N. Feldman, MD∗

Background: There has been a decline in hospital length of stay (LOS) after primary percutaneous coronary intervention (PPCI) for ST-segment elevation myocardial infarction (STEMI).

01 marzo 2015

JACC. First-in-Human Transcatheter Tricuspid Valve Repair in a Patient With Severely Regurgitant Tricuspid Valve

Joachim Schofer, MD∗; Klaudija Bijuklic, MD∗; Claudia Tiburtius, MD∗; Lorenz Hansen, MD∗; Adam Groothuis, PhD†; Rebecca T. Hahn, MD‡

Background: Severe tricuspid regurgitation is associated with poor prognosis; however, there are limited Class I indications for intervention, and high–surgical risk patients may go untreated. We report the first-in-human successful transcatheter tricuspid valve repair for severe tricuspid regurgitation.

01 marzo 2015

JACC. Duration of Dual Antiplatelet Therapy After Drug-Eluting Stent Implantation. A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Gennaro Giustino, MD∗; Usman Baber, MD∗; Samantha Sartori, PhD∗; Roxana Mehran, MD∗; Ioannis Mastoris, MD∗; Annapoorna S. Kini, MD∗; Samin K. Sharma, MD∗; Stuart J. Pocock, PhD†; George D. Dangas, MD, PhD∗

Background: The optimal duration of dual antiplatelet therapy (DAPT) after drug-eluting stent (DES) implantation is unclear, and its risks and benefits may vary according to DES generation.

01 abril 2015

JACC. 12-Month Blood Pressure Results of Catheter-Based Renal Artery Denervation for Resistant Hypertension. The SYMPLICITY HTN-3 Trial

George L. Bakris, MD∗; Raymond R. Townsend, MD†; John M. Flack, MD, MPH‡; Sandeep Brar, MD§; Sidney A. Cohen, MD, PhD†; Ralph D’Agostino, PhD‖; David E. Kandzari, MD¶; Barry T. Katzen, MD#; Martin B. Leon, MD∗∗; Laura Mauri, MD, MSc††; Manuela Negoita, MD§; William W. O’Neill‡‡; Suzanne Oparil, MD§§; Krishna Rocha-Singh, MD‖‖; Deepak L. Bhatt, MD, MPH¶¶

Background: Results of the SYMPLICITY HTN-3 (Renal Denervation in Patients With Uncontrolled Hypertension) trial confirmed the safety but not the efficacy of renal denervation for treatment-resistant hypertension at 6 months post procedure.