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From Detecting the Vulnerable Plaque to Managing the Vulnerable Patient

Review Article | By A Arbab-Zadeh, V Fuster.

The past decades have seen tremendous progress on elucidating mechanisms leading to acute coronary syndrome and sudden cardiac death. Pathology and imaging studies have identified features of coronary atherosclerosis that precede acute coronary events. However, many factors influence the risk of adverse events from coronary atherosclerotic disease and available data support our transition from focusing on individual “vulnerable plaque,” coronary arte...

From Focal Lipid Storage to Systemic Inflammation

Review Article | By P Libby, GK Hansson.

Concepts of atherogenesis have evolved considerably with time. Early animal experiments showed that a cholesterol-rich diet could induce fatty lesion formation in arteries. The elucidation of lipoprotein metabolism ultimately led to demonstrating the clinical benefits of lipid lowering. The view of atheromata as bland accumulations of smooth muscle cells that elaborated an extracellular matrix that could entrap lipids then expanded to embrace...

From Subclinical Atherosclerosis to Plaque Progression and Acute Coronary Events

Review Article | By A Ahmadi, E Argulian, J Leipsic et al.

It has been believed that most acute coronary events result from the rupture of mildly stenotic plaques, based on studies in which angiographic information was available from many months to years before the event. However, serial studies in which angiographic data were available from the past as also within 1 to 3 months of myocardial infarction have clarified that nonobstructive lesions progressively enlarged relatively rapidly before the acute e...

High-Sensitivity Troponin and The Application of Risk Stratification Thresholds in Patients with Suspected Acute Coronary Syndrome

Original Research | By A Bularga, KK Lee, the High-STEACS Investigators et al.

A Randomized Trial of a 1-Hour Troponin T Protocol in Suspected Acute Coronary Syndromes: The Rapid Assessment of Possible ACS In the Emergency Department with High Sensitivity Troponin T (RAPID-TnT) Study

Clinical Trial | By DP Chew, K Lambrakis, A Blyth et al.

Long-Term Durability of Transcatheter Heart Valves: Insights From Bench Testing to 25 Years

Original Research | By J Sathananthan, M Hensey, U Landes et al.

OBJECTIVES - This study assessed the long-term durability of nominally deployed transcatheter heart valves (THV) to 1 billion cycles (equivalent to 25 years) and non-nominal (overexpansion, underexpansion, and elliptical) THV deployments to 200 million cycles (equivalent to 5 years) with accelerated wear testing. METHODS - SAPIEN 3 THVs, sized 20, 23, 26, and 29 mm were assessed. Nominally deplo...

Left Ventricular Rapid Pacing Via the Valve Delivery Guidewire in Transcatheter Aortic Valve Implantation

Clinical Trial | By B Faurie, G Souteyrand, the EASY TAVI investigators.

BACKGROUND - Rapid ventricular pacing is necessary to ensure cardiac standstill during transcatheter aortic valve implantation (TAVI).   OBJECTIVES - We investigated whether left ventricular (LV)-stimulation via a guidewire reduced procedure duration while maintaining efficacy and safety compared with standard right ventricular (RV)-stimulation.     METHODS - T...

Physiologic Characteristics and Clinical Outcomes of Patients With Discordance Between FFR and iFR

Original Research | By SH Lee, KH Choi, JM Lee et al.

OBJECTIVES - The study evaluated the physiologic characteristics of discordant lesions between instantaneous wave-free ratio (iFR) and fractional flow reserve (FFR) and the prognosis at 5 years.   BACKGROUND - FFR or iFR have been standard methods for assessing the functional significance of coronary artery stenosis. However, limited data exist about the physiologic characteristics of discordant lesions and ...

Ticagrelor with or without Aspirin in High-Risk Patients after PCI

Clinical Trial | By R Mehran, U Baber, SK Sharma et al.

BACKGROUND - Monotherapy with a P2Y12 inhibitor after a minimum period of dual antiplatelet therapy is an emerging approach to reduce the risk of bleeding after percutaneous coronary intervention (PCI).   METHODS - In a double-blind trial, we examined the effect of ticagrelor alone as compared with ticagrelor plus aspirin with regard to clinically relevant bleeding among patients who were at high ris...

Antithrombotic Therapy in Patients with Atrial Fibrillation and Acute Coronary Syndrome Treated Medically or with Percutaneous Coronary Intervention or Undergoing Elective Percutaneous Coronary Intervention: Insights from the AUGUSTUS Trial

Clinical Trial | By S Windecker , RD Lopes, AUGUSTUS Investigators et al.

By Article Type

Original Research 785
Review Article 294
Clinical Case Study 28
Clinical Trial 415
Perspective 9
Guideline 50

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2019 10

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N Engl J Med. 1
JACC Cardiovasc Interv. 3
J Am Coll Cardiol. 3
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