Last nail in the coffin for PCI in stable angina?
Editorial | By Brown DL, Redberg RF.
Interventional cardiology began in Switzerland in 1977, when Andreas Gruentzig performed the first successful percutaneous transluminal coronary angioplasty (PTCA) on a 38-year-old man with angina and a focal proximal stenosis of the left anterior descending coronary artery. Despite numerous subsequent randomised trials and meta-analyses of these trials, which have shown no reduction in death or myocardial infarction,1 the use of percutaneous ...
The changing landscape of chronic thromboembolic pulmonary hypertension management
Review Article | By Madani M, Ogo T, Simonneau G.
For patients with chronic thromboembolic pulmonary hypertension (CTEPH), the current standard of care involves surgical removal of fibro-thrombotic obstructions by pulmonary endarterectomy. While this approach has excellent outcomes, significant proportions of patients are not eligible for surgery or suffer from persistent/recurrent pulmonary hypertension after the procedure. The availability of&n...
Balloon pulmonary angioplasty for treatment of chronic thromboembolic pulmonary hypertension
Clinical Trial | By Feinstein JA, Goldhaber SZ, Lock JE et al.
BACKGROUND - Although pulmonary thromboendarterectomy is increasingly successful for the definitive treatment of chronicthromboembolic pulmonary hypertension (CTEPH), not all patients have surgically accessible disease. Others are poor surgical candidates because of comorbid illness. Therefore, for selected patients, we defined and implemented an alternative interventional strategy of&nb...
Original Research | By Peacock WF, Baumann BM, Bruton D et al.
IMPORTANCE - Physicians need information on how to use the first available high-sensitivity troponin (hsTnT) assay in the United States to identify patients at very low risk for 30-day adverse cardiac events (ACE). OBJECTIVE- To determine whether a negative hsTnT assay at 0 and 3 hours following emergency department presentation could identify patients at less than 1% risk of a 30-day ACE. ...
Clinical Trial | By Zhang H, Mu L, China PEACE Collaborative Group et al.
IMPORTANCE - Although physician visual assessment (PVA) of stenosis severity is a standard clinical practice to support decisions for coronary revascularization, there are concerns about its accuracy. OBJECTIVE - To compare PVA with quantitative coronary angiography (QCA) as a means of assessing stenosis severity among patients undergoing percutaneous coronary intervention (PCI) in China. ...
Original Research | By Batchelor W, Kandzari DE, Davis S et al.
IMPORTANCE - There exist limited outcomes data for women and minorities after contemporary percutaneous coronary intervention (PCI). OBJECTIVE - To examine 1-year outcomes in women and minorities vs white men after PCI with everolimus-eluting stents. DESIGN, SETTINGS, AND PARTICIPANTS - The PLATINUM Diversity study was a single-arm study enrolling women and ...
Clinical Trial | By Mäkikallio T, Holm NR, NOBLE study investigators et al.
BACKGROUND - Coronary artery bypass grafting (CABG) is the standard treatment for revascularisation in patients with left main coronary artery disease, but use of percutaneous coronary intervention (PCI) for this indication is increasing. We aimed to compare PCI and CABG for treatment of left main coronary artery disease. METHODS - In this prospective, randomised, open-label, non-inferiority trial, ...
What Is the Optimal Revascularization Strategy for Left Main Coronary Stenosis?
Editorial | By Ruel M, Verma S, Bhatt DL.
Over the last months, 2 major trials and several meta-analyses have been published on the treatment of stable, unprotected left main coronary artery stenosis. Currently, North American and European guidelines for the treatment of left main stenosis indicate a class I recommendation for the performance of coronary artery bypass grafting (CABG). They also indicate a class IIa to III (North American) or a class I to III (European) recommendation for...
Everolimus-Eluting Stents or Bypass Surgery for Left Main Coronary Artery Disease
Clinical Trial | By Stone GW, Sabik JF, EXCEL Trial Investigators et al.
BACKGROUND - Patients with obstructive left main coronary artery disease are usually treated with coronary-artery bypass grafting (CABG). Randomized trials have suggested that drug-eluting stents may be an acceptable alternative to CABG in selected patients with left main coronary disease. METHODS - We randomly assigned 1905 eligible patients with left main coronary artery disease of low or interme...