The “fender” technique for redo-TAVR in a degenerated supra-annular valve with high-risk of coronary obstruction
A 77-year-old woman affected by diabetes mellitus and end-stage kidney disease on dialysis was admitted to our department for congestive heart failure and evidence of structural deterioration (1) of an Acurate Neo S (Boston Scientifics) aortic transcatheter heart valve (THV) implanted 4 years prior. At transthoracic echocardiography, sclerotic degeneration of THV's leaflets with significant increase in valve gradients (mean gradient 45 mmHg, valve area 0.97 cm2) and mild central aortic regurgitation was observed (Figure 1, Panel A-B). (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - January 24, 2024 Category: Cardiology Authors: Giuseppe Tarantini, Tommaso Fabris, Subhash Banerjee, Luca Nai Fovino Tags: Brief report Source Type: research
A New Lipid-Lowering Drug Looking For An Indication?
Cordero et al published their report entitled "Clinical Benefit of Bempedoic acid in Randomized Clinical Trials" in this month's issue of the American Journal of Cardiology.1 They published the results of their intention-to-treat meta-analysis of the 4 clinical trials with bempedoic acid (BPA). The authors have been trying to consolidate the results of the primary and secondary prevention trials that showed the following results. In the Cholesterol Lowering via Bempedoic Acid, an ACL-Inhibiting Regimen-Outcomes2 trial, BPA showed less benefit in the primary outcome of reducing the composite of major adverse cardiovascular ...
Source: The American Journal of Cardiology - January 23, 2024 Category: Cardiology Authors: Jacques D. Barth Tags: Editorial Source Type: research
Clinical and Structural Changes After TAVI in Low-Flow Aortic Stenosis: The Quest for Better Risk Assessment Parameters
The diagnosis of classic normal flow high gradient (NFHG) severe aortic stenosis (AS) is primarily based on specific echocardiographic criteria: aortic valve area (AVA) (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - January 23, 2024 Category: Cardiology Authors: Lina Ya'Qoub, Islam Y. Elgendy, Ayman Elbadawi Tags: Editorial Source Type: research
Is It Safe to Perform Noncardiac Surgery After Transcatheter Aortic Valve Replacement?
Aortic stenosis (AS) is one of the most common cardiac valve pathologies in the world, and its prevalence is approximately 3% in patients over the age of 75. The need for noncardiac surgery (NCS) increases with age and is approximately 15% every year in patients over the age of 70.1 If there are 100,000 75-year-old patients, 3,000 have severe AS and 450 would need NCS every year. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - January 23, 2024 Category: Cardiology Authors: Srinivasa Potluri Tags: Editorial Source Type: research
SGLT2 inhibitors in Patients Admitted for Acute Heart Failure: The Earlier the Better
The 4 pillars for the first-line treatment of heart failure (HF) therapy (i.e., guideline-directed medical therapy [GDMT]) include angiotensin receptor-neprilysin inhibitors, β adrenergic blockers, mineralocorticoid receptor antagonists, and, more recently, sodium-glucose co-transporters 2 inhibitors (SGLT2is), independent on whether the patients have diabetes mellitus or not. In patients with HF with reduced ejection fraction, this approach provides cumulative benefits on clinical outcomes such as hospitalizations and all-cause mortality with a number of years gained of ∼5 years when these therapies are implemented. (...
Source: The American Journal of Cardiology - January 23, 2024 Category: Cardiology Authors: Salvatore Carbone, Antonio Abbate Tags: Editorial Source Type: research
Reverse Septal Curvature: A Novel Comprehensive Risk Marker of Nonsustained Ventricular Tachycardia in Hypertrophic Cardiomyopathy
The field of sudden cardiac death risk stratification in hypertrophic cardiomyopathy continues to search for new markers. Despite decades of clinical investigation, few new clinical or imaging characteristics have been introduced into current Hypertrophic Cardiomyopathy (HCM) guidelines (1). Current risk factors that predict sudden cardiac death (SCD) include: massive segmental left ventricular thickening ≥ 30 mm; SCD in a first-degree relative or other close relative 50 years or younger, deemed to be due to HCM; unexplained syncope (deemed clinically not be neurocardiogenic, or due to left ventricular outflow tract (LVO...
Source: The American Journal of Cardiology - January 23, 2024 Category: Cardiology Authors: Leonard Ilkhanoff, Christopher R. Defilippi Tags: Editorial Source Type: research
Life After Chronic Total Occlusion Percutaneous Coronary Intervention
Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) should be performed when the anticipated benefits outweigh the risks. The main benefit is symptom improvement: randomized controlled trials (RCTs) comparing CTO PCI with medical therapy showed that patients who undergo CTO PCI experience improvement of angina and dyspnea without reduction of the risk of follow-up clinical events, such as death and myocardial infarction (MI).1 –4 However, patients enrolled in CTO PCI RCTs have lower risk profiles and less complex CTOs than those in real-world registries, highlighting a potential limitation of those stu...
Source: The American Journal of Cardiology - January 22, 2024 Category: Cardiology Authors: Athanasios Rempakos, Emmanouil S. Brilakis Tags: Editorial Source Type: research
Complete Coronary Revascularization and Outcomes in Patients Who Underwent Coronary Artery Bypass Grafting: Insights from The REGROUP Trial
There is growing evidence in support of coronary complete revascularization (CR). Nonetheless, there is no universally accepted definition of CR in patients who undergo coronary bypass grafting surgery (CABG). We sought to investigate the outcomes of CR, defined as surgical revascularization of any territory supplied by a suitable coronary artery with ≥50% stenosis. We performed a preplanned subanalysis in the REGROUP clinical trial cohort. Of 1,147 patients who underwent CABG, 810 (70.6%) received CR. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - January 22, 2024 Category: Cardiology Authors: Leonid Belyayev, Eileen M. Stock, Brack Hattler, Faisal G. Bakaeen, Scott Kinlay, Jacqueline A. Quin, Miguel Haime, Kousick Biswas, Marco A. Zenati Source Type: research
Patients Aged 90 Years and Above With Acute Coronary Syndrome in the Cardiac Intensive Care Unit: Management and Outcomes
The proportion of older patients in cardiac intensive care units (CICUs) is increasing, with acute coronary syndrome (ACS) accounting for a significant proportion of these admissions.1,2 Older age has been consistently associated with higher short-term and long-term mortality in CICU patients, especially in those with ACS or cardiogenic shock.3 –6 The small group of CICU patients aged ≥90 years are at particularly high risk of adverse outcomes, both during and after hospitalization.5 Patients, caregivers, and medical professionals often face uncertainty when deciding on the appropriateness of invasive treatments for p...
Source: The American Journal of Cardiology - January 22, 2024 Category: Cardiology Authors: Dhruv Sarma, Mitchell Padkins, Ryan Smith, Courtney E. Bennett, Joseph G. Murphy, Malcolm R. Bell, Abdulla A. Damluji, Nandan S. Anavekar, Gregory W. Barsness, Jacob C. Jentzer Source Type: research
Impact of Platelet Reactivity on 1-Year Clinical Outcomes After Endovascular Therapy for Femoropopliteal Lesions
Dual antiplatelet therapy with aspirin plus P2Y12 inhibitor for at least 1 month after endovascular therapy (EVT) is recommended in symptomatic lower extremity arterial disease (LEAD) with femoropopliteal (FP) lesions.1 However, the pharmacodynamic response to antiplatelet medication differs between individuals. In particular, greater individual differences in platelet r eactivity to clopidogrel, one of the P2Y12 inhibitors, have been reported compared with aspirin.2 Several previous studies evaluated the association of platelet reactivity with clinical outcomes in the area of LEAD management, but their conclusions were ...
Source: The American Journal of Cardiology - January 22, 2024 Category: Cardiology Authors: Takuya Tsujimura, Osamu Iida, Mitsuyoshi Takahara, Kazuki Tobita, Daizo Kawasaki, Masahiko Fujihara, Sinya Sasaki, Hiroyoshi Yokoi, Kenji Suzuki, Toshiaki Mano Tags: Brief Report Source Type: research
Midterm Clinical Outcomes of Robotic-Assisted Reverse Hybrid Coronary Revascularization: A Single-Center Experience
Outcomes of robotic-assisted reverse hybrid coronary revascularization (HCR) remain hindered. We aimed to analyze midterm clinical outcomes of robotic-assisted reverse HCR. All consecutive 285 patients who underwent reverse robotic-assisted HCR between September 2005 and July 2021 were included. Reverse HCR comprises percutaneous coronary intervention with stent implantation in non –left anterior descending (LAD) coronary arteries was performed within 30 days before robotic-assisted left internal thoracic artery (LITA) harvesting and LITA-to-LAD manual anastomosis through a 4-cm left minithoracotomy. Dual antiplatelet...
Source: The American Journal of Cardiology - January 22, 2024 Category: Cardiology Authors: Aleksander Dokollari, Marco Gemelli, Serge Sicouri, William A. Gray, Timothy A. Shapiro, Frank McGeehin, Marwan Badri, Paul Coady, Eric Gnall, Mara Caroline, Amid A. Khan, Massimo Bonacchi, Francesco Cabrucci, Beatrice Bacchi, Bruno Chiarello, Ashish Shah Source Type: research
Follow-up outcomes of the minimalistic hybrid approach for chronic total occlusion percutaneous coronary intervention
Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) should be performed when the anticipated benefits outweigh the risks. The main benefit is symptom improvement: randomized controlled trials (RCTs) comparing CTO PCI with medical therapy showed that patients who undergo CTO PCI experience improvement of angina and dyspnea without reduction of the risk of follow-up clinical events, such as death and myocardial infarction.1-4 However, patients enrolled in CTO PCI RCTs have lower risk profiles and less complex CTOs than those in real-world registries, highlighting a potential limitation of those studies. (S...
Source: The American Journal of Cardiology - January 22, 2024 Category: Cardiology Authors: Athanasios Rempakos, Emmanouil S. Brilakis Tags: Editorial Source Type: research
Low-density lipoprotein cholesterol-lowering therapy for atherosclerotic cardiovascular disease in the future.
Accumulated evidence from studies has estimated the target for controlling serum low-density lipoprotein (LDL) cholesterol levels in patients at high risk of developing atherosclerotic cardiovascular disease (ASCVD). Although guidelines recommend achieving this target, even with the use of high-intensity statin therapy not all patients reach their target level. Therefore, in the real world, ‘fire-and-forget’ with statins may actually mean forgetting about patients who do not meet their target goals. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - January 22, 2024 Category: Cardiology Authors: Shichiro Abe, Setus Nishino, Tomoaki Kanaya, Masashi Sakuma, Shigeru Toyoda Tags: Editorial Source Type: research
Complete Coronary Revascularization and Outcomes in Patients Undergoing CABG: Insights from the REGROUP Trial
There is growing evidence in support of complete coronary revascularization (CR). Nonetheless there is no universally accepted definition of CR in patients undergoing CABG. We sought to investigate the outcomes of CR defined as surgical revascularization of any territory supplied by a suitable coronary artery with at least 50% stenosis. We performed a pre-planned subanalysis of the REGROUP clinical trial cohort. Of 1,147 patients who underwent CABG, 810 (70.6%) received CR. The primary outcome was a composite of major adverse cardiac events (MACE), including death from any cause, nonfatal myocardial infarction (MI), or rep...
Source: The American Journal of Cardiology - January 22, 2024 Category: Cardiology Authors: Leonid Belyayev, Eileen M. Stock, Brack Hattler, Faisal G. Bakaeen, Scott Kinlay, Jacqueline A. Quin, Miguel Haime, Kousick Biswas, Marco A. Zenati Source Type: research
Impact of Platelet Reactivity on One-year Clinical Outcomes after Endovascular Therapy for Femoropopliteal Lesions
Dual antiplatelet therapy with aspirin plus P2Y12 inhibitor for at least 1 month after endovascular therapy (EVT) is recommended in symptomatic lower extremity arterial disease (LEAD) with femoropopliteal (FP) lesions [1]. However, the pharmacodynamic response to antiplatelet medication differs between individuals. In particular, greater individual differences in platelet reactivity to clopidogrel, one of the P2Y12 inhibitors, have been reported compared to aspirin [2]. Several previous studies evaluated the association of platelet reactivity with clinical outcomes in the area of LEAD management, but their conclusions were...
Source: The American Journal of Cardiology - January 22, 2024 Category: Cardiology Authors: Takuya Tsujimura, Osamu Iida, Mitsuyoshi Takahara, Kazuki Tobita, Daizo Kawasaki, Masahiko Fujihara, Sinya Sasaki, Hiroyoshi Yokoi, Kenji Suzuki, Toshiaki Mano Tags: Brief report Source Type: research
