14 marzo 2013

EUROPEAN HEART JOURNAL. Long-term clinical follow-up of the multicentre, randomized study to test immunosuppressive therapy with oral prednisone for the prevention of restenosis after percutaneous coronary interventions: Cortisone plus BMS or DES veRsus BMS alone to EliminAte Restenosis (CEREA-DES)

Flavio Ribichini1,2,*, Fabrizio Tomai3, Gabriele Pesarini1, Carlo Zivelonghi1, Andrea Rognoni4, Giuseppe De Luca4, Giacomo Boccuzzi5, Patrizia Presbitero6, Valeria Ferrero1, Anna S. Ghini3, Paolo Marino4, Corrado Vassanelli1,†

Aims: To analyse the clinical outcome at 4 years in patients with coronary artery disease treated with bare metal stents (BMS) vs. BMS and oral prednisone, or drug-eluting stents (DES), all assuming similar adjunctive medical treatment.

13 febrero 2013

EUROPEAN HEART JOURNAL. Frequency, causes, predictors, and clinical significance of peri-procedural myocardial infarction following percutaneous coronary intervention

Duk-Woo Park1, Young-Hak Kim1, Sung-Cheol Yun2, Jung-Min Ahn1, Jong-Young Lee1, Won-Jang Kim1, Soo-Jin Kang1, Seung-Whan Lee1, Cheol Whan Lee1, Seong-Wook Park1 and Seung-Jung Park1,*

Aims: Peri-procedural myocardial infarction (MI) is a not infrequent complication of percutaneous coronary intervention (PCI), but conflicting information exists regarding incidence and prognostic impact of this event. We investigated frequency, causes, predictors, and clinical relevance of peri-procedural MI, using a large database.

13 marzo 2013

EUROPEAN HEART JOURNAL. Betrixaban compared with warfarin in patients with atrial fibrillation: results of a phase 2, randomized, dose-ranging study (Explore-Xa)

Stuart J. Connolly1,*, John Eikelboom1, Paul Dorian2, Stefan H. Hohnloser3, Daniel D. Gretler4, Uma Sinha4 and Michael D. Ezekowitz5

Aims: Patients with atrial fibrillation (AF) are at increased risk of stroke. Betrixaban is a novel oral factor Xa inhibitor administered once daily, mostly excreted unchanged in the bile and with low (17%) renal excretion.

23 enero 2013

EUROPEAN HEART JOURNAL. Long-term outcomes of fractional flow reserve-guided vs. angiography-guided percutaneous coronary intervention in contemporary practice

Jing Li1, Muhamad Y. Elrashidi2, Andreas J. Flammer3,4, Ryan J. Lennon5, Malcolm R. Bell3, David R. Holmes3, John F. Bresnahan3, Charanjit S. Rihal3, Lilach O. Lerman6 and Amir Lerman3,*

Aims: Fractional flow reserve (FFR) is the reference standard for the assessment of the functional significance of coronary artery stenoses, but is underutilized in daily clinical practice. We aimed to study long-term outcomes of FFR-guided percutaneous coronary intervention (PCI) in the general clinical practice.

01 junio 2014

AMERICAN HEART JOURNAL. Spatial heterogeneity of neoatherosclerosis and its relationship with neovascularization and adjacent plaque characteristics: Optical coherence tomography study

Jinwei Tian, MD, PhD, Xuefeng Ren, MD, Shiro Uemura, MD, PhD, Harold Dauerman, MD, Abhiram Prasad, MD, Catalin Toma, MD, Haibo Jia, MD, PhD, Farhad Abtahian, MD, PhD, Rocco Vergallo, MD, Sining Hu, MD, Iris McNulty, RN, Hang Lee, PhD, Stephen Lee, MD, Bo Yu, MD, PhD, Ik-Kyung Jang, MD, PhD

Background: Development of neoatherosclerosis (NA) has been reported to be a potential cause of late stent failure. However, the distribution of NA and its relationship with neovascularization (NV) and adjacent plaque characteristics remain unclear.

01 julio 2014

AMERICAN HEART JOURNAL. CYP2C19 genotype–guided antiplatelet therapy in ST-segment elevation myocardial infarction patients—Rationale and design of the Patient Outcome after primary PCI (POPular) Genetics study

Thomas O. Bergmeijer, MD, Paul W.A. Janssen, MD, Jurjan C. Schipper, MD, Khalid Qaderdan, MD, Maycel Ishak, MD, Rianne S. Ruitenbeek, BSc, Folkert W. Asselbergs, MD, PhD, FESC, Arnoud W.J. van ‘t Hof, MD, PhD, Willem J.M. Dewilde, MD, Fabrizio Spanó, MD, Jean-Paul R. Herrman, MD, PhD, Johannes C. Kelder, MD, PhD, Maarten J. Postma, PharmD, PhD, Anthonius de Boer, MD, PhD, Vera H.M. Deneer, PharmD, PhD, Jurriën M. ten Berg, MD, PhD, FESC, FACC

Rationale: In patients with ST-segment elevation myocardial infarction (STEMI) who undergo primary percutaneous coronary intervention (pPCI), the use of dual antiplatelet therapy is essential to prevent atherothrombotic complications. Therefore, patients are treated with acetylsalicylic acid and clopidogrel, prasugrel, or ticagrelor. Clopidogrel, however, shows a major interindividual variation in antiplatelet effect, which is correlated to an increase in atherothrombotic events in patients with high platelet reactivity. This interindividual variation is partly a result of CYP2C19 genetic variants. Ticagrelor and prasugrel reduce atherothrombotic events but increase bleeding rate and drug costs, as compared with clopidogrel. CYP2C19-based tailoring of antiplatelet therapy might be beneficial to STEMI patients.

26 febrero 2013

STROKE. Interventional and New Approaches to Stroke Prevention. Dabigatran, ROCKET Atrial Fibrillation, and Beyond. Basic Science, Mechanisms of Agents, Monitoring, and Reversal

Kenneth A. Bauer, MD

For >50 years, vitamin K antagonists (eg, warfarin) were the only available oral anticoagulants. Warfarin, however, is associated with >10-fold interindividual variation in dose to achieve therapeutic anticoagulation. The pharmacokinetics and pharmacodynamics of warfarin are influenced by genetic polymorphisms (CYP 2C9 and VKORC1), dietary vitamin K intake, concomitant medications, alcohol use, patient age, body weight, and various disease states, necessitating regular coagulation monitoring to ensure that each patient’s international normalized ratio (INR) remains within the target range.

11 marzo 2013

STROKE. Interventional and New Approaches to Stroke Prevention. PFO Closure: CLOSURE

Anthony J. Furlan, MD, for the CLOSURE I Investigators

Introduction: The optimal secondary prevention strategy in patients presenting with a cryptogenic stroke or transient ischemic attack (TIA) and a patent foramen ovale (PFO) is uncertain. In the United States, closure of a PFO using a percutaneous transcatheter device is currently considered investigational by the Food and Drug Administration. Nonetheless, many patients in this setting are treated off-label with devices that are approved for the closure of secundum atrial septal defects. There are also no definitive data about the use of medical therapy for secondary stroke prevention in this patient population. We evaluated the potential benefit of device closure of a PFO in this setting in CLOSURE I (evaluation of the STARFlex Septal Closure System in patients with a stroke and/or TIA because of presumed paradoxical embolism through a PFO).1

01 mayo 2014

JOURNAL OF THE AMERICAN HEART ASSOCIATION. Interventional Cardiology. The Epidemiology and Outcomes of Percutaneous Coronary Intervention Before High‐Risk Noncardiac Surgery in Contemporary Practice: Insights From the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2) Registry

Palaniappan Muthappan, MD; Dean Smith, PhD, MPH; Herbert D. Aronow, MD; Kim Eagle, MD; David Wohns, MD; James Fox, MD; David Share, MD, MPH; Hitinder S. Gurm, MD

Background: Percutaneous coronary intervention (PCI) is sometimes performed with the intent to lower cardiovascular risk before high‐risk noncardiac surgery (HRNCS). There are limited data on the frequency and outcome of PCIs performed in this setting.

01 mayo 2014

JOURNAL OF THE AMERICAN HEART ASSOCIATION. Interventional Cardiology. Delay in Filling First Clopidogrel Prescription After Coronary Stenting Is Associated With an Increased Risk of Death and Myocardial Infarction

Nicholas L. Cruden, MBChB, PhD; Jehangir N. Din, MBChB, MD; Christian Janssen, PhD; Reginald Smith, PhD; J. David Hilton, MD; W. Peter Klinke, MD; Ron G. Carere, MD; Simon D. Robinson, MBChB, MD; Anthony Della Siega, MD

Background: Patients frequently experience difficulties with medication compliance after hospital discharge. We investigated the effect of a delay in filling a first clopidogrel prescription after hospital discharge on clinical outcomes subsequent to coronary stenting.

01 julio 2013

JACC. Cause of Death Within 30 Days of Percutaneous Coronary Intervention in an Era of Mandatory Outcome Reporting

Bhuvnesh Aggarwal, MD∗; Stephen G. Ellis, MD†; A. Michael Lincoff, MD†; Samir R. Kapadia, MD†; Joseph Cacchione, MD†; Russell E. Raymond, DO†; Leslie Cho, MD†; Christopher Bajzer, MD†; Ravi Nair, MD†; Irving Franco, MD†; Conrad Simpfendorfer, MD†; E. Murat Tuzcu, MD†; Patrick L. Whitlow, MD†; Mehdi H. Shishehbor, DO, MPH†

Objectives: This study sought to ascertain causes of death and the incidence of percutaneous coronary intervention (PCI)-related mortality within 30 days.

01 julio 2013

JACC. Determinants and Outcomes of Acute Transcatheter Valve-in-Valve Therapy or Embolization. A Study of Multiple Valve Implants in the U.S. PARTNER Trial (Placement of AoRTic TraNscathetER Valve Trial Edwards SAPIEN Transcatheter Heart Valve)

Raj R. Makkar, MD∗; Hasan Jilaihawi, MD∗; Tarun Chakravarty, MD∗; Gregory P. Fontana, MD†; Samir Kapadia, MD‡; Vasilis Babaliaros, MD§; Wen Cheng, MD∗; Vinod H. Thourani, MD§; Joseph Bavaria, MD⋮; Lars Svensson, MD‡; Susheel Kodali, MD¶; Takahiro Shiota, MD∗; Robert Siegel, MD∗; E. Murat Tuzcu, MD‡; Ke Xu, PhD¶; Rebecca T. Hahn, MD¶; Howard C. Herrmann, MD⋮; Mark Reisman, MD#; Brian Whisenant, MD∗∗; Scott Lim, MD††; Nirat Beohar, MD‡‡; Michael Mack, MD§§; Paul Teirstein, MD⋮⋮; Charanjit Rihal, MD, MBA¶¶; Pamela S. Douglas, MD##; Eugene Blackstone, MD‡; Augusto Pichard, MD∗∗∗; John G. Webb, MD†††; Martin B. Leon, MD¶

Objectives: This study investigated the determinants and outcomes of acute insertion of a second transcatheter prosthetic valve (TV) within the first (TV-in-TV) or transcatheter valve embolization (TVE) after transcatheter aortic valve replacement (TAVR).

01 julio 2013

JACC. The Impact of Integration of a Multidetector Computed Tomography Annulus Area Sizing Algorithm on Outcomes of Transcatheter Aortic Valve Replacement. A Prospective, Multicenter, Controlled Trial

Ronald K. Binder, MD∗; John G. Webb, MD∗; Alexander B. Willson, MBBS∗; Marina Urena, MD†; Nicolaj C. Hansson, MD‡; Bjarne L. Norgaard, MD, PhD‡; Philippe Pibarot, MD†; Marco Barbanti, MD∗; Eric Larose, MD†; Melanie Freeman, MBBS∗; Eric Dumont, MD†; Chris Thompson, MD∗; Miriam Wheeler, MBChB∗; Robert R. Moss, MD∗; Tae-hyun Yang, MD∗; Sergio Pasian, MD†; Cameron J. Hague, MD∗; Giang Nguyen, MD∗; Rekha Raju, MD∗; Stefan Toggweiler, MD∗; James K. Min, MD§; David A. Wood, MD⋮; Josep Rodés-Cabau, MD†; Jonathon Leipsic, MD∗

Objectives: This study prospectively investigated the impact of integration of a multidetector computed tomography (MDCT) annular area sizing algorithm on transcatheter aortic valve replacement (TAVR) outcomes.

01 julio 2013

JACC. Use of Stress Testing and Diagnostic Catheterization After Coronary Stenting. Association of Site-Level Patterns With Patient Characteristics and Outcomes in 247,052 Medicare Beneficiaries

Bimal R. Shah, MD, MBA∗; Lisa A. McCoy, MS†; Jerome J. Federspiel, AB†; Daniel Mudrick, MD, MPH∗; Patricia A. Cowper, PhD†; Frederick A. Masoudi, MD, MSPH¶; Barbara L. Lytle, MS†; Cynthia L. Green, PhD†; Pamela S. Douglas, MD∗

Objectives: The aim of this study was to determine diagnostic testing patterns after percutaneous coronary intervention (PCI).

01 julio 2013

JACC. Aggregate Plaque Volume by Coronary Computed Tomography Angiography Is Superior and Incremental to Luminal Narrowing for Diagnosis of Ischemic Lesions of Intermediate Stenosis Severity

Ryo Nakazato, MD, PhD∗; Aryeh Shalev, MD∗; Joon-Hyung Doh, MD, PhD†; Bon-Kwon Koo, MD, PhD‡; Heidi Gransar, MS∗; Millie J. Gomez, MD§; Jonathon Leipsic, MD⋮; Hyung-Bok Park, MD∗; Daniel S. Berman, MD∗; James K. Min, MD§

Objectives: This study examined the performance of percent aggregate plaque volume (%APV), which represents cumulative plaque volume as a function of total vessel volume, by coronary computed tomography angiography (CTA) for identification of ischemic lesions of intermediate stenosis severity.