Clinical Trial | By Lee MS, Shlofmitz RA, Shlofmitz E et al.
OBJECTIVES - We assessed the safety and efficacy of orbital atherectomy to modify severely calcified coronary plaque prior to stent implantation in patients with small vessel (2.5mm) disease. BACKGROUND - Severe coronary artery calcification increases the risk of adverse clinical events during percutaneous coronary intervention (PCI). Patients who undergo PCI of small vessels have worse clinical outcomes inclu...
Impact of the Use of Intravascular Imaging on Patients Who Underwent Orbital Atherectomy
Original Research | By Lee MS, Shlofmitz E, Kong J et al.
OBJECTIVES - We assessed the impact of intravascular ultrasound (IVUS)/optical coherence tomography (OCT) on outcomes of patients who underwent orbital atherectomy. BACKGROUND - Intravascular imaging provides enhanced lesion morphology assessment and optimization of percutaneous coronary intervention (PCI) outcomes. Severe coronary artery calcification increases the complexity of PCI and is associated w...
Clinical Trial | By G Siasos, JD Sara, PH Stone et al.
BACKGROUND - Local hemodynamic factors are important determinants of atherosclerotic plaque development and progression. OBJECTIVES - The goal of this study was to determine the association between low endothelial shear stress (ESS) and microvascular and epicardial endothelial dysfunction in patients with early atherosclerosis. METHODS - Sixty-five patients (mean age 52 ± 11 years) ...
Review Article | By Antoniadis AP, Stone PH.
PURPOSE OF REVIEW - Anatomic and morphologic features of high-risk coronary plaque have been identified by novel imaging modalities, but it has been less clear which ostensibly high-risk plaques will actually destabilize and cause a new cardiac event. Different plaques with different morphologies coexist within the same artery, but the impact of this heterogeneity on the natural history of coronary artery disease has not been exte...
Clinical Trial | By Yamamoto E, Siasos G, Jang IK et al.
BACKGROUND - Low endothelial shear stress (ESS) is associated with plaque progression and vulnerability. To date, changes in plaque phenotype over time in relation to ESS have not been studied in humans. The aim of this study was to investigate whether local ESS can predict subsequent changes to plaque phenotype using optical coherence tomography. METHODS AND RESULTS - A total of 25 coronary arterie...
4-Step Protocol for Disparities in STEMI Care and Outcomes in Women
Clinical Trial | By CP Huded, M Johnson, UN Khot et al.
BACKGROUND - Women with ST-segment elevation myocardial infarction (STEMI) receive suboptimal care and have worse outcomes than men. Whether strategies to reduce STEMI care variability impact disparities in the care and outcomes of women with STEMI is unknown. OBJECTIVES - The study assessed the care and outcomes of men versus women with STEMI before and after implementation of a compr...
Defining Staged Procedures for Percutaneous Coronary Intervention Trials A Guidance Document
Guideline | By E Spitzer, E Mc Fadden, P Vranckx et al.
Patients in coronary intervention trials may require more than 1 procedure to complete the intended revascularization strategy. However, these staged interventions are not consistently defined. Standardized definitions are needed to allow meaningful comparisons of this outcome among trials. This document provides guidance on relevant parameters involving staged procedures, including minimum data collection and consistent classification of corona...
Clinical Trial | By P Tricoci, LK Newby et al.
OBJECTIVES - In 13,038 patients with non–ST-segment elevation acute coronary syndrome undergoing index percutaneous coronary intervention (PCI) in the EARLY ACS (Early Glycoprotein IIb/IIIa Inhibition in Non–ST-Segment Elevation Acute Coronary Syndrome) and TRACER (Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome) trials, the relationship between PCI-related myocardial i...
Research Correspondence | By Reinstadler SJ, Stiermaier T, Eitel C et al.
There is an ongoing debate on potential differences in outcome between ST-segment elevation myocardial infarction (STEMI) patients presenting outside of usual hospital working hours (“off-hours”) compared with patients presenting during classical working hours (“on-hours”) (1,2). The aim of this study was to evaluate potential differences in the amount of salvaged myocardium and the extent of myocardial damage by applying cardiac magne...
Research Correspondence | By Elgendy IY, Ha LD, Elbadawi A et al.
Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) have emerged as helpful intravascular imaging tools to guide revascularization decisions during percutaneous coronary intervention (PCI). Studies have demonstrated that intravascular imaging is associated with improved clinical outcomes. However, little is known about the temporal trends of intravascular imaging use. Thus, we conducted this study to examine the trends ...