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Pharmacoinvasive Strategy Versus Primary Percutaneous Coronary Intervention For ST-Segment Elevation Myocardial Infarction In Patients ≥ 70 Years of Age
This study compared efficacy and safety of PI with primary percutaneous coronary intervention (pPCI). Data from 2841 patients (mean age: 78.1±5.6 years, fema le: 36.1%) included in a prospective multicenter registry, and who underwent either PI (n=269) or pPCI (n=2572), were analyzed. The primary endpoint was in-hospital major adverse cardiovascular events (MACE) defined as the composite of all-cause mortality, non-fatal MI, stroke and definite stent thr ombosis.
Source: The American Journal of Cardiology - October 10, 2019 Category: Cardiology Authors: Vincent Auffret, Cl ément Laurin, Guillaume Leurent, Romain Didier, Emmanuelle Filippi, Jean-Philippe Hacot, Amer Zabalawi, Gilles Rouault, Djamel Saouli, Philippe Druelles, Isabelle Coudert, Bertrand Boulanger, Emilie Bot, Josiane Treuil, Marc Bedossa, Source Type: research

Long-term outcomes with drug-eluting stents or coronary artery bypass surgery for unprotected left main coronary disease: A meta-analysis and trial sequential of randomized trials
Percutaneous coronary intervention (PCI) with drug-eluting stents (DES) has emerged as an acceptable revascularization strategy for select patients with unprotected left main coronary disease (LMCA).1 The EXCEL trial showed no difference between DES and coronary artery bypass surgery (CABG) at 5 years for the composite of death, procedure and non-procedure related myocardial infarction (MI), or stroke,2 however; all-cause mortality was higher with DES at 5 years, which was a secondary end-point.
Source: The American Journal of Cardiology - April 13, 2020 Category: Cardiology Authors: Islam Y. Elgendy, Ahmed N. Mahmoud, Mohamed Gad, Akram Y. Elgendy, Deepak L. Bhatt Source Type: research

Drug-eluting Stents Versus Bypass Surgery for Left Main Disease: An updated meta-analysis of randomized controlled trials with long-term follow-up
Debate is ongoing regarding the optimal mode of revascularization for patients with left main coronary artery disease (LMCAD). Longer-term follow-up from randomized trials has recently become available. We recently published a study-level meta-analysis that demonstrated similar mortality after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) when compared with coronary artery bypass grafting (CABG) 1. There were also no differences in cardiac death, stroke or myocardial infarction (MI), although there was a greater risk of unplanned revascularization after PCI.
Source: The American Journal of Cardiology - June 29, 2020 Category: Cardiology Authors: Yousif Ahmad, James P. Howard, Ahran D. Arnold, Ziad A. Ali, Darrel Francis, Jeffrey W. Moses, Martin B. Leon, Ajay J. Kirtane, Dimitri Karmpaliotis, Gregg W. Stone Source Type: research

Outcomes of Transcatheter Aortic Valve Replacement with Percutaneous Coronary Intervention versus Surgical Aortic Valve Replacement with Coronary Artery Bypass Grafting
We aimed to compare the outcomes of combined surgical aortic valve replacement (SAVR) with coronary artery bypass grafting (CABG) to concurrent transcatheter aortic valve replacement (TAVR) with percutaneous coronary intervention (PCI) in a large U.S. population sample. The National Inpatient Sample (NIS) was queried for all patients diagnosed with aortic valve stenosis who underwent SAVR with CABG or TAVR with PCI during the years 2016-2017. Study outcomes included all-cause in-hospital mortality, acute stroke, pacemaker insertion, vascular complications, major bleeding, acute kidney injury, sepsis, non-home discharge, le...
Source: The American Journal of Cardiology - September 25, 2020 Category: Cardiology Authors: Ashraf Abugroun, Mohammed Osman, Saria Awadalla, Lloyd Klein Source Type: research

Benefits and Risks of Prolonged Duration Dual Antiplatelet Therapy (Clopidogrel and Aspirin) after Percutaneous Coronary Intervention in High-Risk Patients with Diabetes Mellitus
The efficacy and safety of prolonged (>1-year) dual antiplatelet therapy (DAPT) duration in high-risk patients with diabetes mellitus (DM) undergoing PCI remain unknown. All patients undergoing PCI at Fuwai hospital between January 2013 and December 2013 were prospectively enrolled into the Fuwai PCI registry. 3696 high-risk diabetics patients with at least one additional atherothrombotic risk factor were screened for inclusion. The primary efficacy outcome was the composite of all-cause mortality, myocardial infarction, or stroke.
Source: The American Journal of Cardiology - December 4, 2020 Category: Cardiology Authors: Hao-Yu Wang, Zhong-Xing Cai, Dong Yin, Yue-Jin Yang, Wei-Hua Song, Ke-Fei Dou Source Type: research

Outpatient Versus Inpatient Percutaneous Coronary Intervention in Patients with Left Main Disease (From the EXCEL Trial)
Prior studies in patients with non-complex coronary artery disease (CAD) have demonstrated the safety of percutaneous coronary intervention (PCI) in the outpatient setting. We sought to examine the outcomes of outpatient PCI in patients with unprotected left main CAD (LMCAD). In the EXCEL trial, 1905 patients with LMCAD and site-assessed low or intermediate SYNTAX scores were randomized to PCI with everolimus-eluting stents versus coronary artery bypass grafting. The primary endpoint was major adverse cardiovascular events (MACE; the composite of death, stroke, or MI).
Source: The American Journal of Cardiology - December 22, 2020 Category: Cardiology Authors: Prakriti Gaba, Patrick W. Serruys, Dimitri Karmpaliotis, Nicholas J. Lembo, Adrian P. Banning, Zixuan Zhang, Marie-Claude Morice, David E. Kandzari, Anthony H. Gershlick, Ori Ben-Yehuda, Joseph F. Sabik, Arie Pieter Kappetein, Gregg W. Stone Tags: Outpatient Versus Inpatient PCI in EXCEL Source Type: research

Ischemic and Bleeding Events After First Major Bleeding Event in Patients Undergoing Coronary Stent Implantation
There is a scarcity of data on ischemic and bleeding events in patients who experienced major bleeding after percutaneous coronary intervention (PCI). Moreover, there also is a shortage of data on comparative outcomes between patients with and without interruption of an antithrombotic drug after major bleeding. We evaluated the incidence and prognostic impacts of ischemic (myocardial infarction or ischemic stroke) and bleeding (Bleeding Academic Research Consortium type 3 or 5) events after major bleeding in 12,691 consecutive patients who underwent first PCI in the Coronary Revascularization Demonstrating Outcome Study in...
Source: The American Journal of Cardiology - October 24, 2021 Category: Cardiology Authors: Ko Yamamoto, Masahiro Natsuaki, Takeshi Morimoto, Hiroki Shiomi, Yusuke Yoshikawa, Junichi Tazaki, Takeshi Tada, Hirotoshi Watanabe, Eri Kato, Mamoru Toyofuku, Tsukasa Inada, Kazuhisa Kaneda, Teruki Takeda, Hiroshi Sakai, Takashi Yamamoto, Hiroshi Eizawa, Source Type: research

Meta-Analysis of Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting for Left Main Narrowing
Randomized controlled trials (RCTs) comparing percutaneous coronary intervention (PCI) with drug-eluting stents and coronary artery bypass grafting (CABG) for patients with left main coronary artery disease (LMCAD) have reported conflicting results. We performed a systematic review up to May 23, 2021, and 1-stage reconstructed individual patient data meta-analysis (IPDMA) to compare outcomes between both groups. The primary outcome was 10-year all-cause mortality. Secondary outcomes included myocardial infarction (MI), stroke, and unplanned revascularization at 5  years.
Source: The American Journal of Cardiology - April 4, 2022 Category: Cardiology Authors: Nicholas W.S. Chew, Chen-Han Ng, Gwyneth Kong, Keng-Siang Lee, Darren J.H. Tan, Oliver Zi-Hern Lim, Yip Han Chin, Bee Choo Tai, Tianyuan Gu, Seung-Jung Park, Duk-Woo Park, Marie-Claude Morice, Theodoros Kofidis, James W.L. Yip, Poay-Huan Loh, Koo-Hui Chan Source Type: research

Impact of Timing and Treatment Strategy on Coronary Perforation During Percutaneous Coronary Intervention for Chronic Total Occlusion
This study aimed to describe the clinical characteristics and timing of perforations during CTO-PCI. Data from the Japanese CTO-PCI expert registry included 8,760 patients who underwent CTO-PCI between January 2014 and January 2019. The major adverse cardiac and cerebrovascular events were defined as death, tamponade, myocardial infarction, stent thrombosis, stroke, and revascularization.
Source: The American Journal of Cardiology - April 14, 2022 Category: Cardiology Authors: Katsuya Miura, Hiroyuki Tanaka, Koichi Kishi, Toshiya Muramatsu, Hisayuki Okada, Yuji Oikawa, Tomohiro Kawasaki, Ryohei Yoshikawa, Atsunori Okamura, Etsuo Tsuchikane Source Type: research

Influence of the Danish Co-morbidity Index Score on the Treatment and Outcomes of 2.5 Million Patients Admitted With Acute Myocardial Infarction in the United States
This study aimed to determine the association between the Danish Co-morbidity Index for Acute Myocardial Infarction (DANCAMI) and restricted DANCAMI (rDANCAMI) scores and clinical outcomes in patients hospitalized with AMI. Using the National Inpatient Sample, all AMI hospitalizations were stratified into four groups based on their DANCAMI and rDANCAMI score (0; 1 to 3; 4 to 5; ≥6). The primary outcome was all-cause mortality, whereas secondary outcomes were major adverse cardiovascular/cerebrovascular events, major bleeding, ischemic stroke, and receipt of coronary angiography or percutaneous coronary intervention.
Source: The American Journal of Cardiology - July 14, 2022 Category: Cardiology Authors: Balamrit Singh Sokhal, Andrija Mateti ć, Abhishek, Philip Freeman, Jan Walter Dhillon Shanmuganathan, Mohamed O. Mohamed, Christian Mallen, Mamas A. Mamas Source Type: research

Direct Oral Anticoagulants in the Setting of Percutaneous Coronary Intervention: “There Will Be Blood”
Direct oral anticoagulants (DOACs) are being increasingly used in clinical practice for various indications ranging from treatment of venous thromboembolism1 to stroke thromboprophylaxis in atrial fibrillation.2 Clinical practice guidelines now endorse DOACs in preference to vitamin K antagonists (VKAs) for thromboprophylaxis in patients with atrial fibrillation and after venous thromboembolism, reflecting the favorable efficacy and safety profile of this anticoagulant class compared with VKA.3 Despite increasing DOAC utilization, the optimal periprocedural antithrombotic management for patients treated with DOAC who under...
Source: The American Journal of Cardiology - August 12, 2023 Category: Cardiology Authors: Maximillian T. Bourdillon, Konstantinos Charitakis Tags: Editorial Source Type: research

Effect of Concomitant Cardiac Arrest on Outcomes in Patients With Acute Coronary Syndrome-Related Cardiogenic Shock
Patients with acute coronary syndrome (ACS)-related cardiogenic shock (CS) with or without concomitant CA may have disparate prognoses. We compared clinical characteristics and outcomes of patients with CS secondary to ACS with and without cardiac arrest (CA). Between 2014 and 2020, 1,573 patients with ACS-related CS with or without CA who underwent percutaneous coronary intervention enrolled in a multicenter Australian registry were analyzed. Primary outcome was 30-day major adverse cardiovascular and cerebrovascular events (MACCE) (composite of mortality, myocardial infarction, stent thrombosis, target vessel revascularization and stroke).
Source: The American Journal of Cardiology - August 2, 2023 Category: Cardiology Authors: Wayne C. Zheng, Diem Dinh, Samer Noaman, Jason E. Bloom, Riley J. Batchelor, Jeffrey Lefkovits, Angela L. Brennan, Christopher M. Reid, Omar Al-Mukhtar, James A. Shaw, Dion Stub, Yang Yang, Craig French, David M. Kaye, Nicholas Cox, William Chan Source Type: research

Efficacy of Percutaneous Coronary Intervention With Synergy Stents in Patients Aged ≥75 Years: 1-Year Clinical Outcomes from the Synergy Elderly Registry
This study investigated the 12-month clinical outcomes of older patients who underwent percutaneous coronary intervention with new-generation drug-eluting stents according to ischemic risks. This prospective multicenter study targeted patients aged ≥75 years who underwent S-EES implantation. The primary and secondary end points included 12-month device-oriented composite end point (DOCE) (cardiovascular death, target vessel myocardial infarction, or target lesion revascularization) and major adverse cardiac and cerebrovascular events (MACCE s; all-cause death, myocardial infarction, target vessel revascularization, sten...
Source: The American Journal of Cardiology - August 1, 2023 Category: Cardiology Authors: Jong-Il Park, Seung-Jun Lee, Young-Joon Hong, Sang-Yong Yoo, Yong-Sung Seo, Eui Im, Jong-Kwan Park, Jin-Bae Lee, Yong-Joon Lee, Sung-Jin Hong, Chul-Min Ahn, Jung-Sun Kim, Young-Guk Ko, Donghoon Choi, Myeong-Ki Hong, Byeong-Keuk Kim Source Type: research

Another Step Forward in Our Ability to Predict Percutaneous Coronary Intervention Outcomes
Despite advancements in devices, technique, and patient selection, adverse events including bleeding, vascular complications, myocardial infarction, stroke, and death still occur during percutaneous coronary intervention (PCI). Accurate and up-to-date risk-adjusted models that predict mortality after PCI are important to inform clinical decision making, identify patient factors that increase risk, provide a standardized format to measure programmatic quality, and drive continuous quality improvement efforts to improve operator outcomes.
Source: The American Journal of Cardiology - September 18, 2023 Category: Cardiology Authors: Araba Ofosu-Somuah, Matthew A. Cavender, George A. Stouffer Tags: Editorial Source Type: research

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