Complete Revascularization with Multivessel PCI for Myocardial Infarction
Clinical Trial | By Mehta SR, Wood DA, COMPLETE Trial Steering Committee and Investigators.
BACKGROUND - In patients with ST-segment elevation myocardial infarction (STEMI), percutaneous coronary intervention (PCI) of the culprit lesion reduces the risk of cardiovascular death or myocardial infarction. Whether PCI of nonculprit lesions further reduces the risk of such events is unclear. METHODS - We randomly assigned patients with STEMI and multivessel coronary artery disease who ha...
Clinical Trial | By GN Janssens, NW van der Hoeven, JS Lemkes et al.
OBJECTIVES- The aim of the present study was to determine the effect of a delayed versus an immediate invasive approach on final infarct size and clinical outcome up to 1 year. BACKGROUND- Up to 24% of patients with acute coronary syndromes present with ST-segment elevation myocardial infarction (STEMI) but show complete resolution of ST-segment elevation and symptoms before revascularization. Cu...
A Genotype-Guided Strategy for Oral P2Y12 Inhibitors in Primary PCI
Clinical Trial | By DMF Claassens, GJA Vos, TO Bergmeijer et al.
BACKGROUND - It is unknown whether patients undergoing primary percutaneous coronary intervention (PCI) benefit from genotype-guided selection of oral P2Y12 inhibitors. METHODS - We conducted a randomized, open-label, assessor-blinded trial in which patients undergoing primary PCI with stent implantation were assigned in a 1:1 ratio to receive either a P2Y12 inhibitor on the basis of early CYP2...
Ticagrelor or Prasugrel in Patients with Acute Coronary Syndromes
Clinical Trial | By Schüpke S, Neumann FJ, ISAR-REACT 5 Trial Investigators.
BACKGROUND - The relative merits of ticagrelor as compared with prasugrel in patients with acute coronary syndromes for whom invasive evaluation is planned are uncertain. METHODS - In this multicenter, randomized, open-label trial, we randomly assigned patients who presented with acute coronary syndromes and for whom invasive evaluation was planned to receive either ticagrelor or prasugrel. The primary end point...
Angiotensin–Neprilysin Inhibition in Heart Failure with Preserved Ejection Fraction
Clinical Trial | By SD Solomon, the PARAGON-HF Investigators and Committees. JohnJV McMurray,
BACKGROUND - The angiotensin receptor–neprilysin inhibitor sacubitril–valsartan led to a reduced risk of hospitalization for heart failure or death from cardiovascular causes among patients with heart failure and reduced ejection fraction. The effect of angiotensin receptor–neprilysin inhibition in patients with heart failure with preserved ejection fraction is unclear. METHODS - We randomly assigned 482...
Empagliflozin and Progression of Kidney Disease in Type 2 Diabetes
Clinical Trial | By Wanner C, Inzucchi SE, EMPA-REG OUTCOME Investigators.
BACKGROUND - Diabetes confers an increased risk of adverse cardiovascular and renal events. In the EMPA-REG OUTCOME trial, empagliflozin, a sodium-glucose cotransporter 2 inhibitor, reduced the risk of major adverse cardiovascular events in patients with type 2 diabetes at high risk for cardiovascular events. We wanted to determine the long-term renal effects of empagliflozin, an analysis that was a prespecified component of the...
Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes
Clinical Trial | By Neal B, Perkovic V, CANVAS Program Collaborative Group.
BACKGROUND - Canagliflozin is a sodium-glucose cotransporter 2 inhibitor that reduces glycemia as well as blood pressure, body weight, and albuminuria in people with diabetes. We report the effects of treatment with canagliflozin on cardiovascular, renal, and safety outcomes. METHODS - The CANVAS Program integrated data from two trials involving a total of 10,142 participants with type 2 di...
Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy
Clinical Trial | By Perkovic V, Jardine MJ, CREDENCE Trial Investigators.
BACKGROUND - Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium-glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS - In this double-blind, randomized trial, we assigned pat...
Original Research | By H Bueno, X Rossello, SJ Pocock et al.
BACKGROUND - The relationship between in-hospital coronary revascularization rate (CRR) and post-discharge mortality rates in survivors of non–ST-segment elevation acute coronary syndrome (NSTE-ACS) at a system level is unclear. OBJECTIVES- The purpose of this study was to evaluate CRR and 2-year post-discharge mortality rate (2YMR) in NSTE-ACS. METHOD...
Transcatheter Versus Surgical Aortic Valve Replacement in Low-Risk Patients
Review Article | By DKolte, GJ Vlahakes, IF Palacios et al.
BACKGROUND- Transcatheter aortic valve replacement (TAVR) has emerged as a safe and effective therapeutic option for patients with severe aortic stenosis (AS) who are at prohibitive, high, or intermediate risk for surgical aortic valve replacement (SAVR). However, in low-risk patients, SAVR remains the standard therapy in current clinical practice. OBJECTIVES - This study sought to perfo...