Instantaneous Wave-free Ratio versus Fractional Flow Reserve to Guide PCI
Clinical Trial | By Götberg M, Christiansen EH, iFR-SWEDEHEART Investigators et al.
BACKGROUND - The instantaneous wave-free ratio (iFR) is an index used to assess the severity of coronary-artery stenosis. The index has been tested against fractional flow reserve (FFR) in small trials, and the two measures have been found to have similar diagnostic accuracy. However, studies of clinical outcomes associated with the use of iFR are lacking. We aimed to evaluate whether iFR is noninferior to FFR wi...
Meta-Analysis of Death and Myocardial Infarction in the DEFINE-FLAIR and iFR-SWEDEHEART Trials
Why NOBLE and EXCEL Are Consistent With Each Other and With Previous Trials
Expert Opinion | By Gersh BJ, Stone GW, Bhatt DL et al.
Approximately 60 randomized controlled trials performed over the last 3 decades have failed to demonstrate statistically significant differences in death or myocardial infarction (MI) between coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI), apart from a few notable exceptions in which CABG was superior to PCI. The benefits for CABG have been reported in patients with diabetes mellitus with multivessel dis...
Original Research | By Head SJ, Milojevic M, Daemen J et al.
BACKGROUND - Numerous randomised trials have compared coronary artery bypass grafting (CABG) with percutaneous coronary intervention (PCI) for patients with coronary artery disease. However, no studies have been powered to detect a difference in mortality between the revascularisation strategies. METHODS - We did a systematic review up to July 19, 2017, to identify randomised clinical trials comparing CAB...
Original Research | By Bermejo J, Yotti R, SIOVAC investigators et al.
AIMS - We aimed to determine whether treatment with sildenafil improves outcomes of patients with persistent pulmonary hypertension (PH) after correction of valvular heart disease (VHD). METHODS AND RESULTS - The sildenafil for improving outcomes after valvular correction (SIOVAC) study was a multricentric, randomized, parallel, and placebo-controlled trial that enrolled stable adults with mean pulmon...
Original Research | By Scholz KH, Maier SKG, Maier LS et al.
AIMS - The aim of this study was to investigate the effect of contact-to-balloon time on mortality in ST-segment elevation myocardial infarction (STEMI) patients with and without haemodynamic instability. METHODS AND RESULTS - Using data from the prospective, multicentre Feedback Intervention and Treatment Times in ST-Elevation Myocardial Infarction (FITT-STEMI) trial, we assessed the progn...
Therapeutic Options for In-Stent Restenosis
Review Article | By Nicolais C, Lakhter V, Chatterjee S et al.
PURPOSE OF REVIEW - In-stent restenosis (ISR) is a complex disease process that became apparent shortly after the introduction of stents into clinical practice. This review seeks to define in-stent restenosis (ISR) as well as to summarize the major treatment options that have been developed and studied over the past two decades. RECENT FINDINGS - Recent developments in drug-coated balloons and bioresorbab...
Review Article | By Siontis GC, Stefanini GG, Windecker S et al.
BACKGROUND - Percutaneous coronary intervention (PCI) with drug-eluting stents is the standard of care for treatment of native coronary artery stenoses, but optimum treatment strategies for bare metal stent and drug-eluting stent in-stent restenosis (ISR) have not been established. We aimed to compare and rank percutaneous treatment strategies for ISR. METHODS - We did a network meta-analysis to synthesise bot...
Original Research | By Giacoppo D, Gargiulo G, Capodanno D et al.
STUDY QUESTION - What is the most safe and effective interventional treatment for coronary in-stent restenosis? METHODS - In a hierarchical Bayesian network meta-analysis, PubMed, Embase, Scopus, Cochrane Library, Web of Science, ScienceDirect, and major scientific websites were screened up to 10 August 2015. Randomised controlled trials of patients with any type of coronary in-stent restenosis (either o...