Percutaneous Coronary Revascularization Strategies for Small Vessel Disease: Is an Old Solution Still in Its Prime?
The recent publication by Kiyohara et al1 entitled “Comparison of Clinical Outcomes Among Various Percutaneous Coronary Intervention Strategies for Small Coronary Artery Disease: A Network Meta-Analysis” brings forth an interesting analysis in terms of treatment of coronary artery disease (CAD) in small vessels. This network meta-analysis of pre sent randomized control trials scrutinizes the efficacy of different percutaneous coronary intervention (PCI) in this subtype of vessels and their consequential clinical outcomes. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - January 17, 2024 Category: Cardiology Authors: Sebastian Mrad, Jean-Francois Tanguay Tags: Editorial Source Type: research
Shedding Light on the Puzzle in the Paradox
A man is as old as his arteries (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - January 17, 2024 Category: Cardiology Authors: Christopher L. Hansen Tags: Editorial Source Type: research
Frailty and P2Y12 Inhibitors: Does The Best Approach Need to Be Black or White?
We have read with interest the manuscript by Ko et al1 about frailty and P2Y12 inhibitors. As the authors state, the choice of the most adequate antiplatelet therapy is key, and it is 1 of the most challenging issues in the care of this subgroup of patients. In their series, the 2 major players limiting the use of prasugrel and ticagrelor were anemia and frailty, but despite these factors, the use of clopidogrel was reduced from 78.3% in the period 2010 to 2013 to 42.1% in the interval 2018 to 2020. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - January 17, 2024 Category: Cardiology Authors: I ñigo Lozano, Jose M. Vegas, Juan Rondan Tags: Readers ’ Comments Source Type: research
Myocardial Injury After Transcatheter Mitral Valve Replacement Versus Surgical Reoperation
This study aimed to evaluate the incidence and clinical implications of myocardial injury, as determined by cardiac biomarker increase, in patients who underwent mitral bioprosthesis dysfunction treatment with transcatheter mitral valve replacement (TMVR) versus surgical mitral valve replacement reoperation (SMVR-REDO). Between 2014 and 2023, 310 patients with mitral bioprosthesis failure were included (90 and 220 patients for TMVR and SMVR-REDO, respectively). Multivariable analysis and propensity score matching were performed to adjust for the intergroup differences in baseline characteristics. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - January 16, 2024 Category: Cardiology Authors: Mauricio Felippi de S á Marchi, Vitor Emer Egypto Rosa, Pedro Felipe Gomes Nicz, José Honório de Almeida Palma da Fonseca, Pedro Calomeni, Fernando Chiodini, Roney Orismar Sampaio, Pablo Maria Alberto Pomerantzeff, Marcelo de Campos Vieira, Flávio Tar Source Type: research
Five-Year Follow-Up from the CoreValve Expanded Use Transcatheter Aortic Valve-in-Surgical Aortic Valve Study
Transcatheter aortic valve replacement (TAVR) provides an option for extreme-risk patients who underwent reoperation for a failed surgical aortic bioprosthesis. Long-term data on patients who underwent TAVR within a failed surgical aortic valve (TAV-in-SAV) are limited. The CoreValve Expanded Use Study evaluated patients at extreme surgical risk who underwent TAV-in-SAV. Outcomes at 5 years were analyzed by SAV failure mode (stenosis, regurgitation, or combined). Echocardiographic outcomes are site-reported. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - January 16, 2024 Category: Cardiology Authors: Tanvir K. Bajwa, Roger J. Laham, Kamal Khabbaz, Harold L. Dauerman, Ron Waksman, Eric Weiss, Suhail Allaqaband, Salem Badr, Michael Caskey, Timothy Byrne, Robert J. Applegate, Neal D. Kon, Shuzhen Li, Neal S. Kleiman, Michael J. Reardon, Stanley J. Chetcu Source Type: research
COMPArison of Multi-Point Pacing and ConvenTional Cardiac Resynchronization Therapy Through Noninvasive Hemodynamics Measurement: Short- and Long-Term Results of the COMPACT-MPP Study
Invasive hemodynamic studies have shown improved left ventricular (LV) performances when cardiac resynchronization therapy/defibrillator is delivered through multipoint pacing (MPP). Nowadays, strategies have become available that allow studying the same hemodynamic parameters at a noninvasive level. The aim of the present study was to evaluate the clinical implication of using a patient-tailored approach for cardiac resynchronization therapy programming based on noninvasively assessed LV hemodynamics to identify the best biventricular pacing modality between standard single-site pacing (STD) and MPP for each patient. (Sou...
Source: The American Journal of Cardiology - January 16, 2024 Category: Cardiology Authors: Francesco Passafaro, Antonio Rapacciuolo, Antonio Ruocco, Giuseppe Ammirati, Salvatore Crispo, Eugenia Pasceri, Giuseppe Santarpia, Ciro Mauro, Giovanni Esposito, Ciro Indolfi, Antonio Curcio Source Type: research
Do Not Count on It: Thrombolysis in Myocardial Infarction Frame Count Gets Left Behind in the Contemporary Era of Coronary Microvascular Dysfunction Assessment
During the early interventional cardiology era, more than a generation ago, a cohort of pioneering invasive cardiologists created a vast body of knowledge establishing the underpinnings of our understanding of coronary microvascular disease (CMD).1 –3 Notably, there has been a recent resurgence of interest in invasive indexes for the evaluation of CMD. This has occurred, in part, because of a growing need for the evaluation and treatment of patients with chest pain without large vessel coronary artery disease (CAD), and the development of ne w tools, including systems for dual analysis of CMD measures, index of microcirc...
Source: The American Journal of Cardiology - January 16, 2024 Category: Cardiology Authors: Waddah Malas, John J. Lopez Tags: Editorial Source Type: research
Effectiveness of Primary Coronary Intervention for Patients With Delayed ST-Segment Elevation Myocardial Infarction: Insights from Moroccan Cardiology Intensive Care Units
The benefits of myocardial revascularization in ST-segment elevation acute coronary syndrome after 12 to 24 hours from symptom onset remain a topic of debate, especially in patients who are stable and asymptomatic. We analyzed the benefit of late revascularization by primary coronary intervention in patients admitted to Moroccan cardiac intensive care units (CICUs) with ST-segment elevation myocardial i nfarction after 12 hours of symptom onset. We included a total of 406 patients who met the inclusion criteria: 262 patients in the invasive strategy group and 144 patients in the conservative strategy group. (Source: The...
Source: The American Journal of Cardiology - January 16, 2024 Category: Cardiology Authors: Amine Bouchlarhem, Salma Bouyadid, Zakaria Bazid, Nabila Ismaili, Noha El Ouafi Source Type: research
Diagnostic Performance of Diastolic Hyperemia-Free Ratio Compared With Invasive Fractional Flow Reserve for Evaluation of Coronary Artery Disease
Percutaneous coronary intervention guided by invasive fractional flow reserve (FFR) improves cardiovascular outcomes compared with coronary angiography alone and compared with medical therapy in patients with stable ischemic heart disease.1,2 FFR-guided revascularization has been incorporated into American and European practice guidelines.3,4 However, the need for adenosine to achieve maximum hyperemia limits FFR because of patient discomfort, increased cost, increased procedural time, and variability in the time to achieve maximal hyperemia. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - January 16, 2024 Category: Cardiology Authors: Amit Vira, Dinu-Valentin Balanescu, Julie A. George, Simon R. Dixon, Ivan D. Hanson, Robert D. Safian Source Type: research
Don't Count On It: TIMI Frame Count Gets Left Behind in the Contemporary Era of Coronary Microvascular Dysfunction Assessment
During the early interventional cardiology era, more than a generation ago, a cohort of pioneering invasive cardiologists created a vast body of knowledge establishing the underpinnings of our understanding of Coronary Microvascular Disease (CMD) (1-3). Notably, there has been a recent resurgence of interest in invasive indices for the evaluation of coronary microvascular disease. This has occurred, in part, as a result of a growing need for the evaluation and treatment of patients with chest pain without large vessel CAD, and the development of new tools, including systems for dual analysis of CMD measures, Index of Micro...
Source: The American Journal of Cardiology - January 16, 2024 Category: Cardiology Authors: Waddah Malas, John J Lopez Tags: Editorial Source Type: research
COMPArison of Multi-Point Pacing and ConvenTional CRT Through Non-invasive Hemodynamics Measurement: Short and Long Term Results of the COMPACT-MPP Study
Invasive hemodynamic studies have demonstrated improved left ventricular (LV) performances when cardiac resynchronization therapy/defibrillator (CRT-D) is delivered through multi-point pacing (MPP). Nowadays, strategies that allow to study the same hemodynamic parameters at a non-invasive level have become available. The aim of the present study was to evaluate the clinical implication of using a patient-tailored approach for CRT programming based on non-invasively assessed LV hemodynamics to identify the best biventricular pacing modality between standard single-site pacing (STD) and MPP for each patient. (Source: The Ame...
Source: The American Journal of Cardiology - January 16, 2024 Category: Cardiology Authors: Francesco Passafaro, Antonio Rapacciuolo, Antonio Ruocco, Giuseppe Ammirati, Salvatore Crispo, Eugenia Pasceri, Giuseppe Santarpia, Ciro Mauro, Giovanni Esposito, Ciro Indolfi, Antonio Curcio Source Type: research
An Endovascular- Versus a Surgery-First Revascularization Strategy for Chronic Limb-Threatening Ischemia: A Meta-Analysis of Randomized Controlled Trials
Timely revascularization is essential for limb salvage and to reduce mortality in patients with chronic limb-threatening ischemia (CLTI). In patients who are candidates for endovascular therapy and surgical bypass, the optimal revascularization strategy remains uncertain. Recently published randomized controlled trials (RCTs) have presented conflicting results. We conducted a trial-level meta-analysis to compare the outcomes between endovascular-first and surgery-first strategies for revascularization. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - January 15, 2024 Category: Cardiology Authors: Syed H. Mufarrih, Mohammad Saud Khan, Nada Qaisar Qureshi, Muhammad Shoaib Akbar, Mohammed Kazimuddin, Andrew M. Goldsweig, Philip P. Goodney, Herbert D. Aronow Source Type: research
Ohm My Goodness! Thoracic Impedance, Its Predictors, and How It Relates to Cardioversion
External electrical cardioversion is a mainstay treatment for acute rhythm control in patients with persistent atrial fibrillation (AF). While simple cardioversion without any specific preparation is commonly successful, in a significant minority of cases the initial attempt at cardioversion fails. In practice, usually, an initial failed shock is followed by further shocks, with or without modification to the method of shock delivery. The need to deliver additional shocks prolongs the procedure, requires a longer period of sedation, and involves some risk of proarrhythmia or other adverse effects including skin burns. (Sou...
Source: The American Journal of Cardiology - January 15, 2024 Category: Cardiology Authors: Daniel P. Morin, Joshua D. Aymond Tags: Editorial Source Type: research
Complete Revascularization Strategies in Women and Men With Acute Coronary Syndrome and Multivessel Disease
This prespecified substudy of the randomized BIOVASC trial aimed to compare immediate complete revascularization (ICR) and staged complete revascularization (SCR) in patients with acute coronary syndrome and multivessel disease, stratified by gender. The primary end point consisted of a composite of all-cause mortality, myocardial infarction, unplanned ischemia-driven revascularization, and cerebrovascular events at 1-year follow-up. The secondary end points included the individual components of the primary composite and major bleedings. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - January 15, 2024 Category: Cardiology Authors: Jacob J. Elscot, Hala Kakar, Wijnand K. den Dekker, Johan Bennett, Manel Sabat é, Giovanni Esposito, Joost Daemen, Eric Boersma, Nicolas M. Van Mieghem, Roberto Diletti, BIOVASC investigators Source Type: research
Effects of Mask Wearing on Treadmill Exercise Test
A treadmill exercise stress test for cardiac physiologic responsiveness to stress at different levels of exercise is useful in identifying the presence of ischemic heart disease in patients with suspected coronary artery disease and determining the cardiopulmonary functional capacity. With the spread of COVID-19, the World Health Organization recommends wearing face masks to SARS-CoV-2 transmission. However, this measure could inevitably impact some medical diagnostic procedures, although evidence on the effects of face masks wearing during treadmill exercise tests remains limited. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - January 15, 2024 Category: Cardiology Authors: Shao-Lun Ko, Chung-Lieh Hung, Chiao-Nan Chen, Tien-Ping Tsao, Man-Cai Fong, Wei-Hsian Yin, Hung-Yu Chang Tags: Brief Report Source Type: research
