المؤلفون: Jennifer A. Tremmel, Robert W. Yeh, Cinthia Bateman, Dominic J. Allocco, William Bachinsky, Wayne Batchelor, Paul Underwood, J. Dawn Abbott, Robert C. Stoler, Ajay J. Kirtane, Suhail Dohad

المصدر: American Heart Journal. 241:101-107

مصطلحات موضوعية: Male, Reoperation, Target lesion, medicine.medical_specialty, Paclitaxel, medicine.medical_treatment, Coronary Artery Disease, Balloon, Revascularization, Cardiac Catheters, Coronary Restenosis, Coronary artery disease, Coated Materials, Biocompatible, Restenosis, Angioplasty, Clinical endpoint, medicine, Humans, Multicenter Studies as Topic, Angioplasty, Balloon, Coronary, Randomized Controlled Trials as Topic, business.industry, Drug-Eluting Stents, Middle Aged, Interim analysis, medicine.disease, Antineoplastic Agents, Phytogenic, Female, Radiology, Cardiology and Cardiovascular Medicine, business

الوصف: Background Drug-coated balloon (DCB) technology was developed as an alternative treatment for obstructive coronary artery disease (CAD) and in-stent restenosis (ISR). Management of coronary ISR is clinically challenging and frequently encountered in practice. The Agent DCB uses an inactive excipient to effectively deliver a targeted, therapeutic dose of paclitaxel to the vessel wall. Study Design AGENT IDE is a prospective, multicenter, randomized controlled trial to evaluate superiority of the Agent DCB to balloon angioplasty in treating patients with ISR. A total of 480 patients with ISR of a previously treated lesion length 2.0 mm to ≤4.0 mm will be initially randomized. Subjects presenting with recent myocardial infarction (MI), complex lesions, or thrombus in the target vessel will be excluded. An adaptive group sequential design with one formal interim analysis for sample size re-estimation will be conducted, and the sample size may be increased to a maximum of 600 subjects. The primary endpoint is the rate of 12-month target lesion failure (TLF; composite of any ischemia-driven revascularization of the target lesion (TLR), target vessel related MI, or cardiac death) and will be tested for superiority in the test arm against the control. Functional status and general health-related quality of life will be measured by changes in the EQ-5D scores. Subjects will be followed for 5 years following the index procedure. Conclusion This study will prospectively evaluate the safety and efficacy of Agent DCB in patients treated for coronary ISR.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::79ecd863b4254210d23b67021ae1603fTest
https://doi.org/10.1016/j.ahj.2021.07.008Test

المؤلفون: A T Marcel Gosselink, Christian W. Hamm, Arnoud W J van 't Hof, Jurriën M. ten Berg, Jan Paul Ottervanger, Petra C. Koopmans, Gianfranco Sinagra, Renicus S Hermanides, Enrico Fabris, Evangelos Giannitsis, Jan Henk Dambrink

المساهمون: RS: Carim - H01 Clinical atrial fibrillation, Cardiologie, MUMC+: MA Med Staf Spec Cardiologie (9)

المصدر: American Heart Journal, 233, 78-85. MOSBY-ELSEVIER

مصطلحات موضوعية: Male, medicine.medical_treatment, PRIMARY ANGIOPLASTY, 030204 cardiovascular system & hematology, DISEASE, law.invention, 0302 clinical medicine, Randomized controlled trial, law, Natriuretic Peptide, Brain, PERFUSION, Natriuretic peptide, Prospective Studies, 030212 general & internal medicine, Myocardial infarction, Prospective cohort study, Aged, 80 and over, Tirofiban, Middle Aged, Brain natriuretic peptide, ADMISSION, ST-SEGMENT RESOLUTION, PROGNOSTIC VALUE, BRAIN NATRIURETIC PEPTIDE, Cardiology, Regression Analysis, Female, INFARCTION, Cardiology and Cardiovascular Medicine, medicine.drug, Adult, medicine.medical_specialty, medicine.drug_class, PERCUTANEOUS CORONARY INTERVENTION, Myocardial Reperfusion, Time-to-Treatment, Young Adult, 03 medical and health sciences, Double-Blind Method, Fibrinolytic Agents, Internal medicine, Diabetes Mellitus, medicine, Humans, cardiovascular diseases, Anterior Wall Myocardial Infarction, Aged, business.industry, MORTALITY, Percutaneous coronary intervention, medicine.disease, Peptide Fragments, Conventional PCI, ST Elevation Myocardial Infarction, business, Biomarkers

الوصف: Background N-terminal fragment of the brain natriuretic peptide prohormone (NT-proBNP), a marker for neurohumoral activation, has been associated with adverse outcome in patients with myocardial infarction. NT-proBNP levels may reflect extensive ischemia and microvascular damage, therefore we investigated the potential association between baseline NTproBNP level and ST-resolution (STR), a marker of myocardial reperfusion, after primary percutaneous coronary intervention (pPCI).Methods we performed a post-hoc analysis of the On-TIME II trial (which randomized ST-elevation myocardial infarction (STEMI) patients to pre-hospital tirofiban administration vs placebo). Patients with measured NT-proBNP before angiography were included. Multivariate logistic-regression analyses was performed to investigate the association between baseline NTproBNP level and STR one hour after pPCI.Results Out of 984 STEMI patients, 918 (93.3%) had NT-proBNP values at baseline. Patients with STR 70% had higher NT-proBNP values compared to patients with complete STR (70%) [Mean +/- SD 375.2 +/- 1021.7 vs 1007.4 +/- 2842.3, Median (IQR) 111.7 (58.4-280.0) vs 168.0 (62.3-601.3), P < .001]. At multivariate logistic regression analysis, independent predictors associated with higher risk of poor myocardial reperfusion (STR < 70%) were: NT-proBNP (OR 1.17, 95%CI 1.041.31, P = .009), diabetes mellitus (OR 1.87, 95%CI 1.14-3.07, P = .013), anterior infarct location (OR 2.74, 95% CI 2.00-3.77, P < .001), time to intervention (OR 1.06, 95%CI 1.01-1.11, P = .021), randomisation to placebo (OR 1.45, 95%CI 1.05-1.99, P = .022).Conclusions In STEMI patients, higher baseline NT-proBNP level was independently associate with higher risk of poor myocardial reper fusion, suppor ting the potential use of NT-proBNP as an early marker for risk stratification of myocardial reperfusion after pPCI in STEMI patients.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::fcc85d6faa9bbff5080fd5a22938168fTest
https://doi.org/10.1016/j.ahj.2020.12.017Test

المؤلفون: Bruno Leonardo de Freitas Soares, Roberto Sacilotto, Nelson Wolosker, Anthony J. Comerota, Leandro Barile Agati, Marcone Lima Sobreira, Edwaldo Edner Joviliano, Renato D. Lopes, Ronald Luiz Gomes Flumignan, Rodrigo Bruno Biagioni, Bonno Van Bellen, Roberto Augusto Caffaro, Ivan Benaduce Casella, Alexandre Fioranelli, Walkiria Hueb Bernardi, Ronald José Ribeiro Fidelis, Eduardo Ramacciotti, Valter Castelli Júnior

المساهمون: São Paulo State Public Servant Hospital, Duke University School of Medicine, Science Valley Research Institute, Albert Einstein Hospital, Universidade Estadual Paulista (Unesp), Maceio, Universidade de São Paulo (USP), Santa Casa de São Paulo School of Medical Sciences, Beneficência Portuguesa de São Paulo, Universidade Federal da Bahia (UFBA), Inova Heart and Vascular Institute, Hemostasis & Thrombosis Research Laboratories at Loyola University Medical Center

المصدر: Repositório Institucional da USP (Biblioteca Digital da Produção Intelectual)
Universidade de São Paulo (USP)
instacron:USP
Scopus
Repositório Institucional da UNESP
Universidade Estadual Paulista (UNESP)
instacron:UNESP

مصطلحات موضوعية: medicine.medical_specialty, Pyridones, Critical Illness, medicine.medical_treatment, 030204 cardiovascular system & hematology, Revascularization, Proof of Concept Study, Peripheral Arterial Disease, COMPLICAÇÕES PÓS-OPERATÓRIAS, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Restenosis, Ischemia, Internal medicine, Angioplasty, medicine, Clinical endpoint, Humans, Multicenter Studies as Topic, Popliteal Artery, Prospective Studies, 030212 general & internal medicine, Randomized Controlled Trials as Topic, Leg, Aspirin, business.industry, Thrombosis, Critical limb ischemia, Clopidogrel, medicine.disease, Cardiology, Pyrazoles, Apixaban, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Platelet Aggregation Inhibitors, Factor Xa Inhibitors, medicine.drug

الوصف: Made available in DSpace on 2020-12-12T02:25:22Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-09-01 Background: New antithrombotic strategies that reduce primary thrombosis and restenosis might improve vascular outcomes in patients with peripheral artery disease (PAD) undergoing arterial angioplasty. The study objective is to evaluate the potential benefit of apixaban plus aspirin compared with standard of care dual antiplatelet therapy (DAPT) in reducing thrombotic restenosis and artery re-occlusion in patients undergoing endovascular infrapopliteal revascularization. Study design: This multicenter, parallel-group, prospective, randomized, open-label, blinded-endpoint adjudication, proof-of-concept, exploratory trial aims to randomize 200 patients 72 hours after successful infrapopliteal angioplasty for critical limb ischemia (CLI). Patients will be randomly assigned in a 1:1 ratio to receive oral apixaban (2.5 mg twice daily) plus aspirin (100 mg once daily) for 12 months or clopidogrel (75 mg daily) for at least 3 months on a background of aspirin (100 mg once daily) for 12 months. The primary endpoint is the composite of target lesion revascularization (TLR), major amputation, or restenosis/occlusion (RAS) in addition to major adverse cardiovascular events – MACE (myocardial infarction, stroke or cardiovascular death) at 12 months. The primary safety endpoint is the composite of major bleeding or clinically relevant non-major bleeding at 12 months. This study will evaluate the efficacy and safety of apixaban 2.5 mg twice daily plus aspirin compared with DAPT (clopidogrel plus aspirin) in patients with CLI undergoing endovascular infrapopliteal revascularization and might prove the concept of an alternative antithrombotic regimen for these patients to be tested in a future large randomized clinical trial. São Paulo State Public Servant Hospital Duke Clinical Research Institute Duke University School of Medicine Science Valley Research Institute Albert Einstein Hospital Universidade Estadual Paulista (UNESP) Santa Casa de Maceio Maceio Hospital das Clínicas de Ribeirão Preto São Paulo University Medical School (USP) Santa Casa de São Paulo School of Medical Sciences Beneficência Portuguesa de São Paulo Hospital das Clínicas de São Paulo São Paulo University Vascular and Endovascular Surgery–Federal University of Bahia Federal University of São Paulo Inova Heart and Vascular Institute Hemostasis & Thrombosis Research Laboratories at Loyola University Medical Center Universidade Estadual Paulista (UNESP)

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::39421b577730d272ab1f2184f333b390Test
https://doi.org/10.1016/j.ahj.2020.06.010Test

المؤلفون: S. Chiu Wong, James P. Zidar, Gheorghe Doros, Steven J. Yakubov, Sunil V. Rao, David Cohen, Laura Mauri, Dean J. Kereiakes, John M. Lasala

المصدر: American Heart Journal. 216:82-90

مصطلحات موضوعية: Target lesion, medicine.medical_specialty, Randomization, medicine.medical_treatment, Coronary Artery Disease, Equivalence Trials as Topic, 030204 cardiovascular system & hematology, Prosthesis Design, law.invention, 03 medical and health sciences, Percutaneous Coronary Intervention, 0302 clinical medicine, Randomized controlled trial, law, Angioplasty, Coronary stent, Clinical endpoint, Humans, Multicenter Studies as Topic, Medicine, Single-Blind Method, Everolimus, Prospective Studies, cardiovascular diseases, 030212 general & internal medicine, Myocardial infarction, Randomized Controlled Trials as Topic, Sirolimus, business.industry, Stent, Drug-Eluting Stents, equipment and supplies, medicine.disease, Dilatation, Treatment Outcome, Radiology, Cardiology and Cardiovascular Medicine, business, Immunosuppressive Agents, Platelet Aggregation Inhibitors

الوصف: Background Coronary stenting without angioplasty pretreatment (direct stenting) may simplify procedures in appropriate lesions. Direct stenting is facilitated by smaller profile coronary stent platforms. The present study was designed for regulatory approval of a novel drug-eluting coronary stent and incorporates both randomized comparison for non-inferiority to an approved predicate device as well as a nested evaluation of subjects eligible for direct stenting. Study Design and Objectives. Prospective, single-blind, randomized, active-control, multi-center study designed to assess the safety and efficacy of the novel Svelte sirolimus-eluting stent (SES) systems. A total of 1630 subjects with up to 3 target lesions will be randomized 1:1 to the Svelte SES versus either the Xience or Promus everolimus-eluting stents (control). Randomization will be stratified by whether or not a direct stenting strategy is planned by the investigator. The primary endpoint is target lesion failure (TLF) at 12 months post index procedure, defined as cardiac death, target vessel myocardial infarction, or clinically driven target lesion revascularization, and the primary analysis is a non-inferiority test with a non-inferiority margin of 3.58%. Secondary clinical endpoints include individual components of TLF, stent thrombosis and measures of procedural resource utilization including contrast administration, fluoroscopy exposure and procedural resource utilization as well as costs. Conclusion The OPTMIZE Trial will evaluate the safety, efficacy and clinical value of the novel Svelte SES in subjects with up to 3 lesions, and will provide a comparison of direct stenting between randomized devices.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d98b61e51401e1c92efee165857a446aTest
https://doi.org/10.1016/j.ahj.2019.07.003Test

المؤلفون: Aurel Toma, Frank Ruschitzka, Peter Nordbeck, P. Christian Schulze, Christian M. Valina, Angelos G. Rigopoulos, Stephan B. Felix, Karl-Ludwig Laugwitz, Franz Weidinger, Willibald Maier, Stephan Achenbach, Manfred Wischnewsky, Franz-Josef Neumann, Axel Linke, Bettina Schwarz, Matthias Schindler, Matteo Vercellino, Irene M. Lang, Gert Richardt, Kurt Huber, Adnan Kastrati, Marco Moccetti, Barbara E. Stähli, Miklos Rohla, Ian Ford, Ferdinando Varbella, Wolfgang Rottbauer, Multistars Ami Investigators

المساهمون: University of Zurich, Maier, Willibald

المصدر: American heart journal. 228

مصطلحات موضوعية: Male, medicine.medical_specialty, medicine.medical_treatment, 610 Medicine & health, 030204 cardiovascular system & hematology, Revascularization, Coronary Angiography, Severity of Illness Index, 11171 Cardiocentro Ticino, 2705 Cardiology and Cardiovascular Medicine, law.invention, Time-to-Treatment, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Percutaneous Coronary Intervention, Postoperative Complications, Randomized controlled trial, law, Risk Factors, Angioplasty, Internal medicine, medicine, Clinical endpoint, Humans, 030212 general & internal medicine, Myocardial infarction, cardiovascular diseases, Randomized Controlled Trials as Topic, business.industry, Percutaneous coronary intervention, Middle Aged, medicine.disease, R1, Coronary Vessels, ddc, Outcome and Process Assessment, Health Care, Conventional PCI, Cardiology, 10209 Clinic for Cardiology, ST Elevation Myocardial Infarction, Female, Cardiology and Cardiovascular Medicine, business

الوصف: Background: \ud About half of patients with acute ST-segment elevation myocardial infarction (STEMI) present with multivessel coronary artery disease (MVD). Recent evidence supports complete revascularization in these patients. However, optimal timing of non-culprit lesion revascularization in STEMI patients is unknown because dedicated randomized trials on this topic are lacking.\ud \ud Study design: \ud The MULTISTARS AMI trial is a prospective, international, multicenter, randomized, two-arm, open-label study planning to enroll at least 840 patients. It is designed to investigate whether immediate complete revascularization is non-inferior to staged (within 19-45 days) complete revascularization in patients in stable hemodynamic conditions presenting with STEMI and MVD and undergoing primary percutaneous coronary intervention (PCI). After successful primary PCI of the culprit artery, patients are randomized in a 1:1 ratio to immediate or staged complete revascularization. The primary endpoint is a composite of all-cause death, non-fatal myocardial infarction, ischemia-driven revascularization, hospitalization for heart failure, and stroke at 1 year.\ud \ud Conclusions: \ud The MULTISTARS AMI trial tests the hypothesis that immediate complete revascularization is non-inferior to staged complete revascularization in stable patients with STEMI and MVD.

وصف الملف: 7_Rationale_and_design_of_the_Multistars_AMI_Trial.pdf - application/pdf; application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3122211fcb8b884904857238b2e024a1Test
https://pubmed.ncbi.nlm.nih.gov/32871329Test

المؤلفون: Duk-Woo Park, Woo-Young Chung, Soo Jin Kang, Pil Hyung Lee, Seung-Woon Rha, Seong Wook Park, Seung-Jung Park, Yiu Tung Anthony Wong, Moo Hyun Kim, Do Yoon Kang, Young Joon Hong, Seung-Whan Lee, Jung-Min Ahn, Eun-Seok Shin, Sung Ho Her, Chang-Wook Nam, Cheol Hyun Lee, Young-Hak Kim, Jin Bae Lee, Cheol Whan Lee

المصدر: American Heart Journal. 197:35-42

مصطلحات موضوعية: medicine.medical_specialty, Everolimus, business.industry, medicine.medical_treatment, Stent, 030204 cardiovascular system & hematology, medicine.disease, Balloon, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Restenosis, law, Angioplasty, Internal medicine, Coronary stent, medicine, Cardiology, 030212 general & internal medicine, Myocardial infarction, Cardiology and Cardiovascular Medicine, business, Nuclear medicine, medicine.drug

الوصف: Background This study sought to evaluate the optimal treatment for in-stent restenosis (ISR) of drug-eluting stents (DESs). Methods This is a prospective, multicenter, open-label, randomized study comparing the use of drug-eluting balloon (DEB) versus second-generation everolimus-eluting stent for the treatment of DES ISR. The primary end point was in-segment late loss at 9-month routine angiographic follow-up. Results A total of 172 patients were enrolled, and 74 (43.0%) patients underwent the angiographic follow-up. The primary end point was not different between the 2 treatment groups (DEB group 0.15 ± 0.49 mm vs DES group 0.19 ± 0.41 mm, P = .54). The secondary end points of in-segment minimal luminal diameter (MLD) (1.80 ± 0.69 mm vs 2.09 ± 0.46 mm, P = .03), in-stent MLD (1.90 ± 0.71 mm vs 2.29 ± 0.48 mm, P = .005), in-segment percent diameter stenosis (34% ± 21% vs 26% ± 15%, P = .05), and in-stent percent diameter stenosis (33% ± 21% vs 21% ± 15%, P = .002) were more favorable in the DES group. The composite of death, myocardial infarction, or target lesion revascularization at 1 year was comparable between the 2 groups (DEB group 7.0% vs DES group 4.7%, P = .51). Conclusions Treatment of DES ISR using DEB or second-generation DES did not differ in terms of late loss at 9-month angiographic follow-up, whereas DES showed better angiographic results regarding minimal MLD and percent diameter stenosis. Both treatment strategies were safe and effective up to 1 year after the procedure.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::7b6468f91963952069e6dfd06cc4ced9Test
https://doi.org/10.1016/j.ahj.2017.11.008Test

المؤلفون: Anne Tsatsaris, Christopher J. Hammett, Akshay Bagai, Angel Cequier, Jad El Khoury, Warren J. Cantor, Béla Merkely, Arnoud W. van't Hof, Leonardo Bolognese, Frédéric Lapostolle, Shaun G. Goodman, Uwe Zeymer, Jurriën M. ten Berg, Jens Flensted Lassen, Kurt Huber, Christian W. Hamm, Robert F. Storey, Gilles Montalescot, Mohamed Chettibi, Magnus Janzon, Eric Vicaut, Abdourahmane Diallo

المساهمون: Cardiologie, MUMC+: MA Med Staf Spec Cardiologie (9), RS: CARIM - R2.01 - Clinical atrial fibrillation

المصدر: American Heart Journal, 196, 56-64. MOSBY-ELSEVIER

مصطلحات موضوعية: Male, Emergency Medical Services, Ticagrelor, Internationality, medicine.medical_treatment, PREHOSPITAL TICAGRELOR, Myocardial Ischemia, PRIMARY ANGIOPLASTY, 030204 cardiovascular system & hematology, Coronary Angiography, ST Elevation Myocardial Infarction/diagnostic imaging, law.invention, Electrocardiography, DOUBLE-BLIND, 0302 clinical medicine, Randomized controlled trial, law, ST segment, REPERFUSION, 030212 general & internal medicine, Myocardial infarction, PREDICTORS, Percutaneous Coronary Intervention/methods, Absolute risk reduction, Ticagrelor/administration & dosage, Middle Aged, Prognosis, TIME, Treatment Outcome, Cardiology, Disease Progression, Female, Stents, Cardiology and Cardiovascular Medicine, medicine.drug, Myocardial Ischemia/diagnostic imaging, medicine.medical_specialty, Electrocardiography/methods, PERCUTANEOUS CORONARY INTERVENTION, Risk Assessment, Time-to-Treatment, 03 medical and health sciences, Double-Blind Method, Internal medicine, Post-hoc analysis, STENT THROMBOSIS, medicine, Humans, Aged, Coronary Angiography/methods, business.industry, MORTALITY, Percutaneous coronary intervention, Emergency Medical Services/methods, medicine.disease, Survival Analysis, Surgery, SIZE, Conventional PCI, ST Elevation Myocardial Infarction, business

الوصف: BACKGROUND: Among patients with STEMI in the ATLANTIC study, pre-hospital administration of ticagrelor improved post-PCI ST-segment resolution and 30-day stent thrombosis. We investigated whether this clinical benefit with pre-hospital ticagrelor differs by ischemic duration.METHODS: In a post hoc analysis we compared absence of ST-segment resolution post-PCI and stent thrombosis at 30 days between randomized treatment groups (pre- versus in-hospital ticagrelor) stratified by symptom onset to first medical contact (FMC) duration [≤1 hour (n = 773), >1 to ≤3 hours (n = 772), and >3 hours (n = 311)], examining the interaction between randomized treatment strategy and duration of symptom onset to FMC for each outcome.RESULTS: Patients presenting later after symptom onset were older, more likely to be female, and have higher baseline risk. Patients with symptom onset to FMC >3 hours had the greatest improvement in post-PCI ST-segment elevation resolution with pre- versus in-hospital ticagrelor (absolute risk difference: ≤1 hour, 2.9% vs. >1 to ≤3 hours, 3.6% vs. >3 hours, 12.2%; adjusted p for interaction = 0.13), while patients with shorter duration of ischemia had greater improvement in stent thrombosis at 30 days with pre- versus in-hospital ticagrelor (absolute risk difference: ≤1 hour, 1.3% vs. >1 hour to ≤3 hours, 0.7% vs. >3 hours, 0.4%; adjusted p for interaction = 0.55). Symptom onset to active ticagrelor administration was independently associated with stent thrombosis at 30 days (adjusted OR 1.89 per 100 minute delay, 95%CI 1.20-2.97, P < .01), but not post-PCI ST-segment resolution (P = .41).CONCLUSIONS: The effect of pre-hospital ticagrelor to reduce stent thrombosis was most evident when given early within 3 hours after symptom onset, with delay in ticagrelor administration after symptom onset associated with higher rate of stent thrombosis. These findings re-emphasize the need for early ticagrelor administration in primary PCI treated STEMI patients.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::4765c4bf416bd3e6559490b7922c1882Test
https://doi.org/10.1016/j.ahj.2017.10.021Test

المؤلفون: Karl Andersen, Bo Lagerqvist, Gudny Stella Gudnadottir, Thorarinn Gudnason, Stefan James, Inga Sigurros Thrainsdottir

المصدر: American Heart Journal. 191:65-74

مصطلحات موضوعية: Male, medicine.medical_specialty, medicine.medical_treatment, Iceland, 030204 cardiovascular system & hematology, Coronary Angiography, Revascularization, Risk Assessment, Coronary artery disease, 03 medical and health sciences, Percutaneous Coronary Intervention, Postoperative Complications, Sex Factors, 0302 clinical medicine, Risk Factors, Internal medicine, Angioplasty, Odds Ratio, Humans, Medicine, Prospective Studies, Registries, 030212 general & internal medicine, Acute Coronary Syndrome, Coronary Artery Bypass, Sex Distribution, Propensity Score, Prospective cohort study, Aged, Sweden, business.industry, Incidence, Odds ratio, medicine.disease, Survival Rate, Stenosis, surgical procedures, operative, Conventional PCI, Propensity score matching, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies

الوصف: Background The objective was to investigate whether gender disparities are found in referrals of patients with acute coronary syndromes to percutaneous coronary interventions (PCIs) or coronary artery bypass grafting (CABG) and, furthermore, to study gender differences in complications and mortality. Methods All consecutive coronary angiographies (CAs) and PCIs performed in Sweden and Iceland are prospectively registered in the Swedish Coronary Angiography and Angioplasty Registry. For the present analysis, data of patients with acute coronary syndromes, enrolled in 2007-2011, were used to analyze gender differences in revascularization, in-hospital complications, and 30-day mortality. Results A total of 106,881 CAs were performed during the study period. In patients with significant coronary artery disease, the adjusted odds ratio (OR) for women to undergo PCI compared with men was 0.95 (95% CI 0.92-0.99) and 0.81 (0.76-0.87) for referrals to CABG. In patients with 1-vessel disease, women were less likely to undergo PCI than men, but women with 2- or 3-vessel or left main stem disease were more likely to undergo PCI. All in-hospital complications after CA followed by PCI were more frequent among women (adjusted OR 1.58 [1.47-1.70]). There was no gender difference in adjusted 30-day mortality after PCI (1.02 [0.92-1.12]) and after CABG (0.97 [0.72-1.31]). Conclusions After CA showing 1-vessel disease, women as compared with men were less likely to undergo PCI. In the group with 2- or 3-vessel disease or left main stem stenosis, women were more likely to undergo PCI but less likely to undergo CABG. However, there was no gender difference in 30-day mortality.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8fc7690cc1961cf13ee83307c4d0aa1cTest
https://doi.org/10.1016/j.ahj.2017.06.014Test

المؤلفون: Piero O. Bonetti, Osmund Bertel, Matthias Pfisterer, Paul Erne, Soeren Galatius, T. Moccetti, Christoph Kaiser, Giuseppe Vassalli, Burkhard Hornig, Franz R. Eberli, Stefano De Servi, Giovanni Pedrazzini, Hans Rickli, Catherine Klersy

المصدر: American Heart Journal. 173:1-7

مصطلحات موضوعية: Male, medicine.medical_specialty, Time Factors, Denmark, medicine.medical_treatment, Coronary Artery Disease, 030204 cardiovascular system & hematology, Prosthesis Design, Risk Assessment, Coronary artery disease, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Restenosis, Risk Factors, Cause of Death, Internal medicine, Angioplasty, medicine, Humans, 030212 general & internal medicine, Myocardial infarction, Angioplasty, Balloon, Coronary, Aged, Retrospective Studies, Cause of death, Unstable angina, business.industry, Incidence, Hazard ratio, Age Factors, Stent, Prognosis, medicine.disease, Survival Rate, Austria, Cardiology, Female, Stents, Cardiology and Cardiovascular Medicine, business, Switzerland, Follow-Up Studies

الوصف: Background The randomized BASKET-PROVE study showed no significant differences between sirolimus-eluting stents (SES), everolimus-eluting stents (EES), and bare-metal stents (BMS) with respect to the primary end point, rates of death from cardiac causes, or myocardial infarction (MI) at 2 years of follow-up, in patients requiring stenting of a large coronary artery. Clinical risk factors may affect clinical outcomes after percutaneous coronary interventions. We present a retrospective analysis of the BASKET-PROVE data addressing the question as to whether the optimal type of stent can be predicted based on a cumulative clinical risk score. Methods A total of 2,314 patients (mean age 66 years) who underwent coronary angioplasty and implantation of ≥1 stents that were ≥3.0 mm in diameter were randomly assigned to receive SES, EES, or BMS. A cumulative clinical risk score was derived using a Cox model that included age, gender, cardiovascular risk factors (hypercholesterolemia, hypertension, family history of cardiovascular disease, diabetes, smoking), presence of ≥2 comorbidities (stroke, peripheral artery disease, chronic kidney disease, chronic rheumatic disease), a history of MI or coronary revascularization, and clinical presentation (stable angina, unstable angina, ST-segment elevation MI). Results An aggregate drug-eluting stent (DES) group (n = 1,549) comprising 775 patients receiving SES and 774 patients receiving EES was compared to 765 patients receiving BMS. Rates of death from cardiac causes or nonfatal MI at 2 years of follow-up were significantly increased in patients who were in the high tertile of risk stratification for the clinical risk score compared to those who were in the aggregate low-mid tertiles. In patients with a high clinical risk score, rates of death from cardiac causes or nonfatal MI were lower in patients receiving DES (2.4 per 100 person-years, 95% CI 1.6-3.6) compared with BMS (5.5 per 100 person-years, 95% CI 3.7-8.2, hazard ratio 0.45, 95% CI 0.26-0.80, P = .007). However, they were not significantly different between receivers of DES and BMS in patients in the low-mid risk tertiles. Conclusions This exploratory analysis suggests that, in patients who require stenting of a large coronary artery, use of a clinical risk score may identify those patients for whom DES use may confer a clinical advantage over BMS, beyond lower restenosis rates.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::362d634cedb449d0753be13a5fda341dTest
https://doi.org/10.1016/j.ahj.2015.11.007Test

المؤلفون: Sammy Elmariah, Shawn Fuller, Gheorghe Doros, Marianne Brodmann, Gary M. Ansel, Laura Mauri, Duane S. Pinto, William A. Gray, Kenneth Rosenfield

المصدر: American heart journal. 209

مصطلحات موضوعية: Male, medicine.medical_specialty, Percutaneous, Time Factors, Paclitaxel, medicine.medical_treatment, Arterial Occlusive Diseases, Femoral artery, 030204 cardiovascular system & hematology, Revascularization, law.invention, 03 medical and health sciences, 0302 clinical medicine, Restenosis, Randomized controlled trial, Coated Materials, Biocompatible, law, Angioplasty, medicine.artery, medicine, Humans, Popliteal Artery, Single-Blind Method, 030212 general & internal medicine, Prospective Studies, Vascular Patency, Aged, business.industry, Angiography, Equipment Design, Middle Aged, medicine.disease, Popliteal artery, Surgery, Femoral Artery, Stenosis, Treatment Outcome, Female, Cardiology and Cardiovascular Medicine, business, Angioplasty, Balloon, Follow-Up Studies

الوصف: Background Drug-coated balloons (DCBs), developed to reduce restenosis after percutaneous intervention in peripheral arterial disease (PAD), have been shown to be safe and efficacious, particularly in treating PAD affecting the femoropopliteal segment. The SurVeil DCB uses an excipient intended to optimize both the uniformity and transfer of paclitaxel to the vessel wall, allowing for efficient drug loading and lower systemic exposure than currently available DCBs, Heretofore, clinical outcomes have not previously been compared to other DCBs. Study Design and Objectives This prospective, multicenter, international, randomized, single-blind, trial will compare 1:1 the SurVeil DCB with the IN.PACT Admiral DCB for treatment of patients with Rutherford classification 2 to 4 due to femoral and/or popliteal arterial disease. The trial will randomize 446 subjects (with reference vessel diameter 4–7 mm and total lesion length ≤180 mm). Subjects will be followed for 60 months. The primary efficacy endpoint is 1 year primary patency, defined as composite freedom from clinically-driven target-lesion revascularization (TLR) and binary restenosis (core lab-adjudicated duplex ultrasound peak systolic velocity ratio ≥2.4, or ≥50% stenosis via angiography). The primary safety endpoint is composite freedom from device- and procedure-related death through 30 days and freedom from target limb major amputation and clinically-driven target vessel revascularization through 12 months. The primary analysis is a test of noninferiority of the SurVeil vs. IN.PACT Admiral on the primary efficacy and safety endpoints according to absolute deltas of 15.0% and 10.0%, respectively. Conclusion The Randomized And Controlled Noninferiority Trial to Evaluate Safety and Clinical Efficacy of the SurVeil DCB in the Treatment of Subjects with Stenotic Lesions of the Femoropopliteal Artery Compared to the Medtronic IN.PACT Admiral (TRANSCEND) study will assess safety and efficacy of the SurVeil DCB relative to a commonly used DCB.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d95785f681841638513909a9512d891cTest
https://pubmed.ncbi.nlm.nih.gov/30685679Test