DAPT, Our Genome and Clopidogrel
Expert Opinion | By Peter C. Block, M.D., FACC
I bet few, if any, interventional cardiologists fail to prescribe dual antiplatelet therapy (DAPT) using a P2Y12 inhibitor plus aspirin after performing a PCI. After all, the ravages that balloons, stents and other devices incur on the fragile endothelial lining of arteries that result in immediate platelet deposition have been known since the early days of PCI.1 We’ve come a long way from using low molecular weight dextra...
Clinical Trial | By Tajti P, Karmpaliotis D, Alaswad K et al.
OBJECTIVES - The aim of this study was to determine the techniques and outcomes of hybrid chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in a diverse group of patients and operators on 2 continents. BACKGROUND - CTO PCI has been evolving with constant improvement of equipment and techniques. METHODS - Contemporary outcomes of CTO PCI were examined by anal...
Original Research | By Otaki Y, Ashikaga T, Tokyo-MD PCI Study Investigators.
BACKGROUND - Long-term clinical outcomes of permanent polymer everolimus-eluting stent (PP-EES) implantation after rotational atherectomy (RA) have not been fully evaluated. We sought to investigate the long-term clinical outcomes of PP-EES implantation after RA and assess the impact of hemodialysis on this treatment strategy. METHODS - Patients who underwent percutaneous coronary intervention (...
One-Year Outcomes of Orbital Atherectomy of Long, Diffusely Calcified Coronary Artery Lesions
Clinical Trial | By Lee MS, Shlofmitz E, Lluri G et al.
OBJECTIVES - The aim of this study was to determine the clinical outcomes of patients with long, diffusely calcified coronary artery lesions who underwent orbital atherectomy. BACKGROUND - The presence of severe coronary artery calcification increases the complexity of percutaneous coronary intervention. Orbital atherectomy of long, diffusely calcified lesions may increase the risk of periprocedural angio...
Clinical Case Study | By Shahin M.
Calcified coronary lesions represents technical challenges and are associated with a high frequency of restenosis and target lesion revascularization. Rotational atherectomy has been shown to increase procedural success in severely calcified lesions, facilitate stent delivery in undilatable lesions and ensure complete stent expansion. However rotational atherectomy in ST-elevation myocardial infarction (STEMI) is traditionally avoided given the concern for ...
Risk of Myocardial Infarction in Anticoagulated Patients With Atrial Fibrillation
Clinical Trial | By C J-Y Lee, TA Gerds, N Carlson et al.
BACKGROUND - Evidence is conflicting as to the efficacy of direct oral anticoagulation (DOAC) and vitamin K antagonist (VKA) for prevention of myocardial infarction (MI). OBJECTIVES - This study aimed to investigate the risk of MI associated with the use of apixaban, dabigatran, rivaroxaban, and VKA in patients with atrial fibrillation. METHODS...
Clinical Trial | By Orme RC, Parker WAE, Storey RF et al.
BACKGROUND - Ticagrelor has superior efficacy to clopidogrel in the management of acute coronary syndromes but has not been assessed in patients undergoing percutaneous coronary intervention (PCI) for stable coronary artery disease (CAD). We compared the pharmacodynamic effects of ticagrelor and clopidogrel in this stable population. METHODS - 180 aspirin-treated stable CAD patients, who were planned to...
Clinical Trial | By Hougaard M, Hansen HS, Thayssen P et al.
OBJECTIVES - This study assessed the incidence and course of healing of uncovered plaque ruptures (PR) following primary percutaneous coronary intervention. BACKGROUND - The infarct-related occlusion is frequently located at the lesion site with maximum thrombus burden, whereas the culprit PR may be situated more proximally or distally. METHODS - Uncovered PR in segments adjacent to the...
Coronary Microcirculation in Ischemic Heart Disease
Review Article | By Pries AR, Kuebler WM, Habazettl H.
BACKGROUND - Ischemic heart disease has long been considered to be exlusively caused by stenosis or occlusion. However, the coronary microcirculation too may play an important role in ischemic conditions. Also, the crucial role of microvessels in not only regulating blood flow on a local level but also mediating vascular permeability or inflammatory responses has been recognized. OBJECTIVE - To review important ...
Clinical Trial | By WC Levy, AS Hellkamp, DB Mark et al.
OBJECTIVES - The authors previously developed the Seattle Proportional Risk Model (SPRM) in systolic heart failure patients without implantable cardioverter-defibrillators (ICDs)to predict the proportion of deaths that were sudden. They subsequently validated the SPRM in 2 observational ICD data sets. The objectives in the present study were to determine whether this validated model could improve identification of clinically im...