Original Research | By RV Parikh, SW Waldo, WF Fearon et al.
BACKGROUND - The use and clinical outcomes of fractional flow reserve (FFR) measurement in patients with stable ischemic heart disease (SIHD) are uncertain, as prior studies have been based on selected populations. OBJECTIVES - This study sought to evaluate contemporary, real-world patterns of FFR use and its effect on outcomes among unselected patients with SIHD and angiographically intermediate stenose...
Original Research | By O Marsit, MA Clavel, J Beaudoin et al.
BACKGROUND - Mitral leaflet enlargement has been identified as an adaptive mechanism to prevent mitral regurgitation in dilated left ventricles (LVs) caused by chronic aortic regurgitation (AR). This enlargement is deficient in patients with functional mitral regurgitation, which remains frequent in the population with ischemic cardiomyopathy. Maladaptive fibrotic changes have been identified in post-myocardial infarction (MI) mitr...
Original Research | By SA Hirji, E McCarthy, D Kim et al.
OBJECTIVES - The aim of this study was to examine whether hospital surgical aortic valve replacement (SAVR) volume was associated with corresponding transcatheter aortic valve replacement (TAVR) outcomes. BACKGROUND - Recent studies have demonstrated a volume-outcome relationship for TAVR. METHODS - In total, 208,400 fee-for-service Medicare beneficiaries w...
Original Research | By T Kinnaird, T Johnson, R Anderson et al.
OBJECTIVES - The authors used the British Cardiovascular Intervention Society (BCIS) national percutaneous coronary intervention (PCI) database to explore temporal changes in the use of intravascular imaging for unprotected left main stem PCI (uLMS PCI), defined the associates of imaging use, and correlate clinical outcomes including survival with imaging use. BACKGROUND - Limited registr...
Coronary CT Angiography in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome
Clinical Trial | By JJ Linde, H Kelbæk, KF Kofoed et al.
BACKGROUND- In patients with non–ST-segment elevation acute coronary syndrome (NSTEACS), coronary pathology may range from structurally normal vessels to severe coronary artery disease. OBJECTIVES- The purpose of this study was to test if coronary computed tomography angiography (CTA) may be used to exclude coronary artery stenosis ≥50% in patients with NSTEACS. MET...
Original Research | By YH Yoon, JM Ahn, SJ Park et al.
OBJECTIVES - The aim of this study was to investigate the long-term impact of SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) score (SS) on differential outcomes after percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) for left main coronary artery (LMCA) disease. BACKGROUND - The very long term prognostic effe...
Clinical Trial | By G Giustino, PW Serruys, GW Stone et al.
OBJECTIVES - The aim of this study was to investigate the incidence and impact on mortality of repeat revascularization after index percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) for left main coronary artery disease (LMCAD). BACKGROUND - The impact on mortality of the need of repeat revascularization following PCI or CABG in patients with unprotected LMCAD is ...
Management of Asymptomatic Severe Aortic Stenosis: Evolving Concepts in Timing of Valve Replacement
Review Article | By BR Lindman, MR Dweck, P Lancellotti et al.
New insights into the pathophysiology and natural history of patients with aortic stenosis, coupled with advances in diagnostic imaging and the dramatic evolution of transcatheter aortic valve replacement, are fueling intense interest in the management of asymptomatic patients with severe aortic stenosis. An intervention that is less invasive than surgery could conceivably justify pre-emptive transcatheter aortic valve replacement in subsets of patients, rat...
Five-Year Outcomes of Transcatheter or Surgical Aortic-Valve Replacement
Clinical Trial | By RR Makkar, VH Thourani, the PARTNER 2 Investigators.
BACKGROUND - There are scant data on long-term clinical outcomes and bioprosthetic-valve function after transcatheter aortic-valve replacement (TAVR) as compared with surgical aortic-valve replacement in patients with severe aortic stenosis and intermediate surgical risk. METHODS - We enrolled 2032 intermediate-risk patients with severe, symptomatic aortic stenosis at 57 centers. Patients were st...
Original Research | By Beohar N, Kaltenbach LA, Wojdyla D et al.
BACKGROUND - Adjunctive coronary atherectomy (CA) can be utilized in treating severely calcified coronary lesions; however, the temporal trends, patient selection, and variation in use of CA have not been well described. We sought to assess the trends in usage, interhospital variability, and outcomes with CA among patients undergoing percutaneous coronary intervention (PCI). METHODS - All patients undergoing PC...