Original Research | By N Pinilla-Echeverri , SR Mehta, T Sheth et al.
BACKGROUND- Complete revascularization with routine percutaneous coronary intervention of nonculprit lesions after primary percutaneous coronary intervention improves outcomes in ST-segment–elevation myocardial infarction. Whether this benefit is associated with nonculprit lesion vulnerability is unknown. METHODS - In a prospective substudy of the COMPLETEs trial (Complete vs Culprit-Only Revasc...
Review Article | By TJ Ford, P Ong, and on behalf of the COVADIS Study Group
Considerations for Optimal Device Selection in Transcatheter Aortic Valve Replacement: A Review
Review Article | By BE Claessen, GHL Tang, AS Kini et al.
IMPORTANCE - Aortic valve stenosis (AS) is the most common manifestation of acquired valvular heart disease in developed countries. Several large-scale randomized clinical trials investigating the entire spectrum of patients with severe symptomatic AS from low to prohibitive risk have established transcatheter aortic valve replacement (TAVR) as a safe and effective alternative to surgical aortic valve replacement. ...
Timing of intervention in asymptomatic patients with valvular heart disease
Review Article | By H Baumgartner, B Iung, CM Otto.
Current management of valvular heart disease (VHD) seeks to optimize long-term outcome by timely intervention. Recommendations for treatment of patients with symptoms due to severe valvular disease are based on a foundation of solid evidence. However, when to intervene in asymptomatic patients remains controversial and decision requires careful individual weighing of the potential benefits against the risk of intervention and its long-te...
Expert Opinion | By D Capodanno, MC Morice, DJ Angiolillo et al.
Investigating the balance of risk for thrombotic and bleeding events after percutaneous coronary intervention (PCI) is especially relevant for patients at high bleeding risk (HBR). The Academic Research Consortium for HBR recently proposed a consensus definition in an effort to standardize the patient population included in HBR trials. The aim of this consensus-based document, the second initiative from the Academic Research Consortium...
Leaflet immobility and thrombosis in transcatheter aortic valve replacement
Original Research | By ACT Ng, DR Holmes, MJ Mack et al.
Transcatheter aortic valve replacement (TAVR) has grown exponentially worldwide in the last decade. Due to the higher bleeding risks associated with oral anticoagulation and in patients undergoing TAVR, antiplatelet therapy is currently considered first-line antithrombotic treatment after TAVR. Recent studies suggest that some patients can develop subclinical transcatheter heart valve (THV) thrombosis after the procedure, whereby thr...
Original Research | By A Brann, S Janvanishstaporn, B Greenberg et al.
IMPORTANCE - Patients categorized as having heart failure (HF) with left ventricular ejection fraction (LVEF) in the midrange between 40% and 50% (HFmrEF) are known to be at increased risk of future events. Although patients can transition into the midrange through either improvement or deterioration in their LVEF, there is limited information available assessing the association of directional change in LVEF with future...
Original Research | By H Park, J-M Ahn, the IRIS-MAIN Registry Investigators et al.
BACKGROUND - Left main coronary artery (LMCA) disease is associated with high mortality and morbidity due to a large area of jeopardized myocardium. However, the optimal revascularization strategy for patients with LMCA disease and left ventricular dysfunction is still unclear. OBJECTIVES - This study sought to examine long-term comparative outcomes after percutaneous coronary intervention (PCI) o...
Cardiovascular Biomarkers and Imaging in Older Adults: JACC Council Perspectives
Whereas the burgeoning population of older adults is intrinsically vulnerable to cardiovascular disease, the utility of many management precepts that were validated in younger adults is often unclear. Whereas biomarker- and imaging-based tests are a major part of cardiovascular disease care, basic assumptions about their use and efficacy cannot be simply extrapolated to many older adults. Biology, physiology, and body composition change with agin...
Original Research | By N Kogame, PO Guimarães, PA Lemos et al.
OBJECTIVES - The aim of this study was to evaluate the hypothesis that prasugrel monotherapy following successful everolimus-eluting stent implantation is feasible and safe in patients with stable coronary artery disease (CAD). BACKGROUND - Recent studies have suggested that short dual-antiplatelet therapy strategies may provide an adequate balance between ischemic and blee...