One or two stents for the distal Left Main bifurcation The DK crush V study - The DK crush V study
Expert Opinion | By Tanveer Rab, MD, FACC ; Shao-Liang Chen, MD, FACC
The DK (double kiss) CRUSH V trial reported at TCT2017 and published in the Journal of the American College of Cardiology(1) compared outcomes of a one stent provisional side branch(SB) stenting (PS) approach to the two stent (double kissing[DK]) crush technique for the distal Left Main true bifurcation (LMB).The primary endpoint was 1-year target lesion failure (TLF). Two hundred and forty patients were ra...
How Low to Go With Glucose, Cholesterol, and Blood Pressure in Primary Prevention of CVD
Review Article | By Hong KN, Fuster V, Bhatt DL et al.
Diabetes, hyperlipidemia, and hypertension are modifiable risk factors that predict cardiovascular disease events. The effect of these risk factors on incident cardiovascular disease increases with progressively higher levels of glucose, low-density lipoprotein cholesterol, and blood pressure. The thresholds for initiating treatment of these modifiable risk factors and the optimal goals of risk factor modification are a focus of primary prevention r...
Quality of Life after Everolimus-Eluting Stents or Bypass Surgery for Treatment of Left Main Disease
Clinical Trial | By SJ Baron, K Chinnakondepalli, EA. Magnuson et al.
Background - The EXCEL trial compared outcomes in patients with unprotected left main coronary artery disease (LMCAD) treated with coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) using everolimus-eluting stents. While rates of death, stroke, and myocardial infarction were similar at 36 months, event timing and repeat revascularization rates differed by treatment group. Objectives - T...
PCI Strategies in Patients with Acute Myocardial Infarction and Cardiogenic Shock
Clinical Trial | By Thiele H, Akin I, Sandri M et al.
BACKGROUND - In patients who have acute myocardial infarction with cardiogenic shock, early revascularization of the culprit artery by means of percutaneous coronary intervention (PCI) improves outcomes. However, the majority of patients with cardiogenic shock have multivessel disease, and whether PCI should be performed immediately for stenoses in nonculprit arteries is controversial. METHODS - In this multicenter ...
Review Article | By de la Torre Hernández JM, Edelman ER
The most important challenge faced by human beings is health. The only way to provide better solutions for health care is innovation, true innovation. The only source of true innovation is research, good research indeed. The pathway from a basic science study to a randomized clinical trial is long and not free of bumps and even landmines. These are all the obstacles and barriers that limit the availability of resources, entangle administrative-regulatory pr...
Clinical Trial | By Kedhi E, Fabris E, van der Ent M et al.
BACKGROUND - The optimal duration of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention with second-generation drug eluting stents (DESs) is unclear. Because prolonged DAPT is associated with higher bleeding risk and health care costs, establishing optimal DAPT duration is of paramount importance. No other randomized controlled trials have evaluated the safety of shorter DAPT duration in S...
Clinical Trial | By Paolo Z; Liefke C; van der Heijden et al.
Aims - Acute coronary syndrome (ACS) guidelines have been changed, favouring more potent antiplatelet drugs. We aimed to evaluate the safety and efficacy of a ticagrelor- instead of a clopidogrel-based primary dual antiplatelet (DAPT) regimen in ACS patients treated with newer-generation drug-eluting stents (DES). Methods and results - CHANGE DAPT (clinicaltrials.gov: NCT03197298) assessed 2,062 consecutive r...
Clinical Trial | By Piroth Z, Toth GG, De Bruyne B et al.
Methods and Results — All patients of FAME 1 and FAME 2 who had post-PCI FFR measurement were included. The primary outcome was vessel-oriented composite end point at 2 years, defined as vessel-related cardiovascular death, vessel-related spontaneous myocardial infarction, and ischemia-driven target vessel revascularization. Eight hundred thirty-eight vessels in 639 patients were analyzed. Baseline FFR values did not differ between ve...
Review Article | By Rimac G, Fearon WF, Bertrand OF et al.
BACKGROUND - Fractional flow reserve (FFR) prior to percutaneous coronary intervention (PCI) is useful to guide treatment. Whether post-PCI FFR assessment might have clinical impact is controversial. The aim of this study is to evaluate the range of post-PCI FFR values and analyze the relationship between post-PCI FFR and clinical outcomes. METHODS - We systematically searched the PubMed, EMBASE...
Review Article | By Jeffrey L. Anderson, David A. Morrow
Acute myocardial infarction with or without ST-segment elevation (STEMI or non-STEMI) is a common cardiac emergency, with the potential for substantial morbidity and mortality. The management of acute myocardial infarction has improved dramatically over the past three decades and continues to evolve. This review focuses on the initial presentation and in-hospital management of type 1 acute myocardial infarction.