Efficacy and Safety of Stents in ST-Segment Elevation Myocardial Infarction
Review Article | By P Chichareon, R Modolo, PW Serruys et al.
BACKGROUND - To date, no specific drug-eluting stent (DES) has fully proven its superiority over others in patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention. OBJECTIVES - The purpose of this study was to compare the safety and efficacy of coronary artery stents in STEMI patients in a patient-level network meta-analysis. METHOD...
Early Surgery or Conservative Care for Asymptomatic Aortic Stenosis
Clinical Trial | By DH Kang, SJ Park , SA Lee et al.
BACKGROUND - The timing and indications for surgical intervention in asymptomatic patients with severe aortic stenosis remain controversial. METHODS - In a multicenter trial, we randomly assigned 145 asymptomatic patients with very severe aortic stenosis (defined as an aortic-valve area of ≤0.75 cm2 with either an aortic jet velocity of ≥4.5 m per second or a mean transaortic gradient of ≥50 mm ...
Timing of Intervention in Aortic Stenosis
Editorial | By P Lancellotti, MA Vannan.
Current guidelines require that in patients with severe aortic stenosis, symptoms related to the valvular disease be present for consideration of transcatheter aortic-valve replacement (TAVR) or surgical aortic-valve replacement. In the absence of symptoms, only very severe aortic stenosis is an indication (class IIa) for intervention. Kang et al. now report in the Journal the results of a trial involving patients with asymptom...
Rare Genetic Variants Associated With Sudden Cardiac Death in Adults
Original Research | By AV Khera, H Mason-Suares, D Brockman et al.
BACKGROUND- Sudden cardiac death occurs in ∼220,000 U.S. adults annually, the majority of whom have no prior symptoms or cardiovascular diagnosis. Rare pathogenic DNA variants in any of 49 genes can pre-dispose to 4 important causes of sudden cardiac death: cardiomyopathy, coronary artery disease, inherited arrhythmia syndrome, and aortopathy or aortic dissection. OBJECTIVES- This study assessed the preval...
Clinical Trial | By AH Gershlick, AS Banning, E Parker
BACKGROUND - Randomized trials have shown that complete revascularization in patients with ST-segment elevation myocardial infarction (MI) with multivessel disease results in lower major adverse cardiovascular events (MACE) (all-cause death, MI, ischemia-driven revascularization, heart failure). OBJECTIVES- The goal of this study was to determine whether the benefits of complete revascularization are su...
Limitations of Repeat Revascularization as an Outcome Measure
Review Article | By P Lamelas, J Belardi, R Whitlock et al.
Repeat revascularization is a commonly used outcome measure in trials comparing percutaneous coronary intervention and coronary artery bypass graft surgery, and differences in this outcome often drive the relative risk for the primary endpoint. However, repeat revascularization as an outcome measure has important limitations that complicates its meaningful interpretation, including confounding by indication (driven by varying use of stress testi...
Recommandation Statement | By SE Wiegers, T Ryan, JA Arrighi et al.
Recommandation Statement | By DE Casey Jr., RJ Thomas, V Bhalla
Clinical Trial | By Benjamin Faurie, Géraud Souteyrand, the EASY TAVI Investigators.
OBJECTIVES - This study investigated whether left ventricular (LV) stimulation via a guidewire-reduced procedure duration while maintaining efficacy and safety compared with standard right ventricular (RV) stimulation. BACKGROUND - Rapid ventricular pacing is necessary to ensure cardiac standstill during transcatheter aortic valve replacement (TAVR). METH...
Original Research | By AO Malik, M Omer, MC Pflederer et al.
OBJECTIVES - The aim of this study was to assess the association of baseline left ventricular diastolic dysfunction (LVDD) with health status outcomes of patients undergoing transcatheter aortic valve replacement (TAVR). BACKGROUND - Although LVDD in patients with aortic stenosis is associated with higher mortality after TAVR, it is unknown if it is also associated with health status recovery. &...