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&...
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 non culprit arteries is controversial. METHODS -&...
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...
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 randomiz...
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 ST-...
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 cons...
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, EMBAS...
Clinical Trial | By Piroth Z, Toth GG, De Bruyne B et al.
Background — The predictive value of fractional flow reserve (FFR) measured immediately after percutaneous coronary intervention (PCI) with drug-eluting stent placement has not been prospectively investigated. We investigated the potential of post-PCI FFR measurements to predict clinical outcome in patients from FAME 1 and 2 trials (Fractional Flow Reserve or Angiography for Multivessel Evaluation). Conclusions —...