Original Research | By Mohr FW, Morice MC, Kappetein AP et al.
BACKGROUND - We report the 5-year results of the SYNTAX trial, which compared coronary artery bypass graft surgery (CABG) with percutaneous coronary intervention (PCI) for the treatment of patients with left main coronary disease or three-vessel disease, to confirm findings at 1 and 3 years. METHODS - The randomised, clinical SYNTAX trial with nested registries took place in 85 centres in the USA an...
Clinical Trial | By Tonino PA, Fearon WF, De Bruyne B et al.
OBJECTIVES - The purpose of this study was to investigate the relationship between angiographic and functional severity of coronary artery stenoses in the FAME (Fractional Flow Reserve Versus Angiography in Multivessel Evaluation) study. BACKGROUND - It can be difficult to determine on the coronary angiogram which lesions cause ischemia. Revascularization of coronary stenoses that induce ischemia improv...
Original Research | By Behan MW, Holm NR, de Belder AJ et al.
AIMS - Randomized trials of coronary bifurcation stenting have shown better outcomes from a simple (provisional) strategy rather than a complex (planned two-stent) strategy in terms of short-term efficacy and safety. Here, we report the 5-year all-cause mortality based on pooled patient-level data from two large bifurcation coronary stenting trials with similar methodology: the Nordic Bifurcation Study (NORDIC I) and the British...
Blood CSF1 and CXCL12 as Causal Mediators of Coronary Artery Disease
Original Research | By J Sjaarda, H Gerstein, M Chong et al.
BACKGROUND - Identification of biomarkers that cause coronary artery disease (CAD) has led to important advances in prevention and treatment. Epidemiological analyses have identified many biomarker-CAD relationships; however, these associations may arise from reverse causation and/or confounding and therefore may not represent true causal associations. Mendelian randomization (MR) analyses overcome these limitations. ...
How Will the Transition to hs-cTn Affect the Diagnosis of Type 1 and 2 MI?
Expert Opinion | By Y Sandoval; FS Apple; AS Jaffe
Cardiac troponin (cTn) is the preferred cardiac biomarker used for the detection of myocardial injury.1 It can be used to facilitate the exclusion of acute myocardial infarction (MI) or its inclusion when there is a rising and/or falling pattern of cTn with at least one value >99th percentile.1 High-sensitivity cTn assays have been used clinically outside the United States for years. In January 2017, the US Food and Drug Administration (F...
Original Research | By S. Mohsen Hosseini, Raymond Kim, Sharmila Udupa
BACKGROUND - Implicit in the genetic evaluation of patients with suspected genetic diseases is the assumption that the genes evaluated are causative for the disease based on robust scientific and statistical evidence. However, in the past 20 years considerable variability has existed in the study design and quality of evidence supporting reported gene-disease associations raising concerns of the validity of many published disease-causing gene...
Clinical Trial | By Werner GS, Martin-Yuste V, EUROCTO trial investigators.
AIMS - The clinical value of percutaneous coronary intervention (PCI) for chronic coronary total occlusions (CTOs) is not established by randomized trials. This study should compare the benefit of PCI vs. optimal medical therapy (OMT) on the health status in patients with at least one CTO. METHOD AND RESULTS - Three hundred and ninety-six patients were enrolled in a prospective randomized, multi...
Clinical Trial | By SR Steinhubl, J Waalen, AM Edwards et al.
IMPORTANCE - Opportunistic screening for atrial fibrillation (AF) is recommended, and improved methods of early identification could allow for the initiation of appropriate therapies to prevent the adverse health outcomes associated with AF. OBJECTIVE - To determine the effect of a self-applied wearable electrocardiogram (ECG) patch in detecting AF and the clinical consequences associated with such a det...
Clinical Trial | By Chen L, Xu T, Chen SL et al.
Stenting coronary artery bifurcation lesion is associated with suboptimal clinical results. Clinical improvement by intravascular ultrasound (IVUS) guided bifurcation stenting is controversial because small-side-branch (SB), low-risk patients and false bifurcations were included in previous studies that had no exact IVUS criteria for optimal stent expansion. We sought determine whether IVUS guidance is superior to angiography guidance for ...
Chronic Total Occlusion Percutaneous Coronary Intervention: Evidence and Controversies
Review Article | By Tajti P, Brilakis ES.
Coronary chronic total occlusions (CTOs) are defined as 100% occlusions with TIMI (Thrombolysis in Myocardial Infarction) 0 flow with at least a 3‐month duration. Treatment options for patients with coronary CTOs include lifestyle changes and medications (as is appropriate for all patients with coronary artery disease) and coronary revascularization with either percutaneous coronary intervention (PCI) or coronary artery bypass grafting (C...