Review Article | By DK Chu, LH-Y Kim, PJ Young et al.
Background - Supplemental oxygen is often administered liberally to acutely ill adults, but the credibility of the evidence for this practice is unclear. We systematically reviewed the efficacy and safety of liberal versus conservative oxygen therapy in acutely ill adults. Methods - In the Improving Oxygen Therapy in Acute-illness (IOTA) systematic review and meta-analysis, we searched the Cochrane Central Register of Contr...
Clinical Trial | By Khan SS, Ning H, Wilkins JT et al.
IMPORTANCE - Prior studies have demonstrated lower all-cause mortality in individuals who are overweight compared with those with normal body mass index (BMI), but whether this may come at the cost of greater burden of cardiovascular disease (CVD) is unknown. OBJECTIVE - To calculate lifetime risk estimates of incident CVD and subtypes of CVD and to estimate years lived with and without CV...
Prognostic Effect and Longitudinal Hemodynamic Assessment of Borderline Pulmonary Hypertension
Original Research | By Assad TR, Maron BA, Robbins IM et al.
IMPORTANCE - Pulmonary hypertension (PH) is diagnosed by a mean pulmonary arterial pressure (mPAP) value of at least 25 mm Hg during right heart catheterization (RHC). While several studies have demonstrated increased mortality in patients with mPAP less than that threshold, little is known about the natural history of borderline PH. OBJECTIVE - To test the hypothesis that patients with borderl...
Original Research | By Shlofmitz E, Martinsen B, Lee M et al.
OBJECTIVES - We sought to assess the clinical outcomes when intravascular ultrasound (IVUS) was used prior to orbital atherectomy treatment (OA) versus angiography alone for lesion assessment. BACKGROUND - Percutaneous coronary intervention (PCI) of severely calcified lesions is associated with high rates of major adverse cardiac events (MACE). IVUS provides additional diagnostic information to optimize PC...
Original Research | By Kinnaird T, Cockburn J, Gallagher S et al.
AIMS - Access site choice for cases requiring rotational atherectomy (PCI-ROTA) is poorly defined. Using the British Cardiovascular Intervention Society PCI database, temporal changes and contemporary associates/outcomes of access site choice for PCI-ROTA were studied. METHODS AND RESULTS - Data were analysed from 11,444 PCI-ROTA procedures performed in England and Wales between 2007 and 2014....
Original Research | By Lee MS, Shlofmitz E, Goldberg A et al.
OBJECTIVES - We report the 1-year outcomes of real-world patients with severely calcified coronary arteries who underwent orbital atherectomy. BACKGROUND - Percutaneous coronary intervention of heavily calcified lesions is technically challenging and associated with worse clinical outcomes. Modification of severely calcified coronary lesions with orbital atherectomy facilitates stent delivery and expansion. Altho...
Clinical Trial | By Lee M, Généreux P, Shlofmitz R et al.
BACKGROUND/PURPOSE - The presence of heavy coronary artery calcification increases the complexity of percutaneous coronary intervention (PCI) and increases the incidence of major adverse cardiac events (MACE): death, myocardial infarction (MI), target vessel revascularization (TVR), and stent thrombosis. The ORBIT II (Evaluate the Safety and Efficacy of OAS in Treating Severely Calcified Coronary Lesions) trial repo...
Clinical Trial | By Chambers JW, Feldman RL, Himmelstein S et al.
OBJECTIVES - The ORBIT II (Evaluate the Safety and Efficacy of OAS in Treating Severely Calcified Coronary Lesions) trial evaluated the safety and efficacy of the coronary Orbital Atherectomy System (OAS) to prepare de novo, severely calcified coronary lesions for stent placement. BACKGROUND - Despite advances in interventional techniques, treatment of calcified coronary lesions remains a challenge. ...
Clinical Case Study | By Généreux P, Bettinger N, Redfors B et al.
OBJECTIVES - We report 2-year outcomes of the Evaluate the Safety and Efficacy of OAS in Treating Severely Calcified Coronary Lesions (ORBIT II) trial, with emphasis on the impact of stent type. BACKGROUND - The ORBIT II trial demonstrated the safety and efficacy of the Diamondback 360° Coronary Orbital Atherectomy System (OAS; Cardiovascular Systems, Inc., St. Paul, MN) in the treatme...
Clinical Trial | By Lee MS, Shlofmitz E, Shlofmitz R et al.
OBJECTIVES - The ORBIT II trial reported excellent outcomes in patients with severely calcified coronary lesions treated with orbital atherectomy. Severe calcification of the left main (LM) artery represents a complex coronary lesion subset. This study evaluated the safety and efficacy of coronary orbital atherectomy to prepare severely calcified protected LM artery lesions for stent placement. METHODS - The ORB...