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Extracorporeal Membrane Oxygenation in the Therapy of Cardiogenic Shock: Results of the ECMO-CS Randomized Clinical Trial
Conclusions: Immediate implementation of VA-ECMO in patients with rapidly deteriorating or severe cardiogenic shock did not improve clinical outcomes compared with an early conservative strategy that permitted downstream use of VA-ECMO in case of worsening hemodynamic status. Clinical Trial Registration: URL: https://www.clinicaltrials.gov; Unique identifier NCT02301819.PMID:36335478 | DOI:10.1161/CIRCULATIONAHA.122.062949
Source: Circulation - November 6, 2022 Category: Cardiology Authors: Petr Ostadal Richard Rokyta Jiri Karasek Andreas Kruger Dagmar Vondrakova Marek Janotka Jan Naar Jana Smalcova Marketa Hubatova Milan Hromadka Stefan Volovar Miroslava Seyfrydova Jiri Jarkovsky Michal Svoboda Ales Linhart Jan Belohlavek ECMO-CS Investigat Source Type: research

Percutaneous Transvalvular Microaxial Flow Pump Support in Cardiology
Circulation. 2022 Apr 19;145(16):1254-1284. doi: 10.1161/CIRCULATIONAHA.121.058229. Epub 2022 Apr 18.ABSTRACTThe Impella device (Impella, Abiomed, Danvers, MA) is a percutaneous transvalvular microaxial flow pump that is currently used for (1) cardiogenic shock, (2) left ventricular unloading (combination of venoarterial extracorporeal membrane oxygenation and Impella concept), (3) high-risk percutaneous coronary interventions, (4) ablation of ventricular tachycardia, and (5) treatment of right ventricular failure. Impella-assisted forward blood flow increased mean arterial pressure and cardiac output, peripheral tissue pe...
Source: Circulation - April 18, 2022 Category: Cardiology Authors: Enzo L üsebrink Antonia Kellnar Kathrin Krieg Leonhard Binzenh öfer Clemens Scherer Sebastian Zimmer Benedikt Schrage Stephanie Fichtner Tobias Petzold Daniel Braun Sven Peterss Stefan Brunner Christian Hagl Dirk Westermann J örg Hausleiter Steffen Mas Source Type: research

Use of Administrative Claims to Assess Outcomes and Treatment Effect in Randomized Clinical Trials for Transcatheter Aortic Valve Replacement: Findings from the Extending Trial-Based Evaluations of Medical Therapies Using Novel Sources of Data (EXTEND) Study.
Conclusions: In the CoreValve HiR and SURTAVI trials, ascertainment of trial primary endpoints using claims reproduced both the magnitude and direction of treatment effect compared with adjudicated event data, but non-fatal and non-procedural secondary outcomes were not as well reproduced. Use of claims to substitute for adjudicated outcomes in traditional trial treatment comparisons may be valid and feasible for all-cause mortality and certain procedural outcomes, but may be less suitable for other endpoints. PMID: 32436390 [PubMed - as supplied by publisher]
Source: Circulation - May 20, 2020 Category: Cardiology Authors: Strom JB, Faridi KF, Butala NM, Zhao Y, Tamez H, Valsdottir LR, Brennan JM, Shen C, Popma JJ, Kazi DS, Yeh RW Tags: Circulation Source Type: research

Contemporary Management of Cardiogenic Shock: A Scientific Statement From the American Heart Association.
lity of Care and Outcomes Research; and Mission: Lifeline Abstract Cardiogenic shock is a high-acuity, potentially complex, and hemodynamically diverse state of end-organ hypoperfusion that is frequently associated with multisystem organ failure. Despite improving survival in recent years, patient morbidity and mortality remain high, and there are few evidence-based therapeutic interventions known to clearly improve patient outcomes. This scientific statement on cardiogenic shock summarizes the epidemiology, pathophysiology, causes, and outcomes of cardiogenic shock; reviews contemporary best medical, surgical, me...
Source: Circulation - September 18, 2017 Category: Cardiology Authors: van Diepen S, Katz JN, Albert NM, Henry TD, Jacobs AK, Kapur NK, Kilic A, Menon V, Ohman EM, Sweitzer NK, Thiele H, Washam JB, Cohen MG, American Heart Association Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; Council on Qu Tags: Circulation Source Type: research

Prasugrel versus Ticagrelor in Patients with Acute Myocardial Infarction Treated with Primary Percutaneous Coronary Intervention: Multicenter Randomized PRAGUE-18 Study.
CONCLUSION: This head-to-head comparison of prasugrel and ticagrelor does not support the hypothesis that one is more effective or safer than the other in preventing ischemic and bleeding events in the acute phase of myocardial infarction treated with primary PCI strategy. The observed rates of major outcomes were similar, although with broad confidence intervals around the estimates. These interesting observations need to be confirmed in a larger trial. CLINICAL TRIAL REGISTRATION: URL: http://www.ClinicalTrials.gov. Unique identifier: NCT02808767. PMID: 27576777 [PubMed - as supplied by publisher]
Source: Circulation - August 29, 2016 Category: Cardiology Authors: Motovska Z, Hlinomaz O, Miklik R, Hromadka M, Varvarovsky I, Dusek J, Knot J, Jarkovsky J, Kala P, Rokyta R, Tousek F, Kramarikova P, Majtan B, Simek S, Branny M, Mrozek J, Cervinka P, Ostransky J, Widimsky P Tags: Circulation Source Type: research

Percutaneous Coronary Intervention at Centers With and Without On-Site Surgical Backup: An Updated Meta-Analysis of 23 Studies.
CONCLUSIONS: -Clinical outcomes and complication rates of PCI at centers without on-site surgery did not differ from those with on-site surgery, for both primary and non-primary PCI. Temporal trends indicated improving clinical outcomes in non-primary PCI at centers without on-site surgery. PMID: 26152708 [PubMed - as supplied by publisher]
Source: Circulation - July 7, 2015 Category: Cardiology Authors: Lee JM, Hwang D, Park J, Kim KJ, Ahn C, Koo BK Tags: Circulation Source Type: research

Yes, We Can! (Should We?).
Abstract Historically, percutaneous coronary intervention (PCI) was relegated to hospitals with co-located cardiac surgery because of the potential need for emergent surgical treatment of PCI-related complications. In the current issue of Circulation, Lee and colleagues(1) compare outcomes of PCI at hospitals with and without on-site cardiac surgery and show that emergency cardiac surgery is, in fact, rarely needed (<1%). This meta-analysis summarizes 23 studies that include over one million patients and demonstrates the incidence of other PCI-related complications including myocardial infarction, stroke, cardi...
Source: Circulation - July 7, 2015 Category: Cardiology Authors: Aversano TR Tags: Circulation Source Type: research