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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

Obstructive Sleep Apnea and Cardiovascular Events After Percutaneous Coronary Intervention.
CONCLUSIONS: -OSA is independently associated with subsequent MACCE in patients undergoing PCI. Evaluation of therapeutic approaches to mitigate OSA-associated risk is warranted. Clinical Trial Registration Information-ClinicalTrials.gov. Identifier: NCT01306526. PMID: 27178625 [PubMed - as supplied by publisher]
Source: Circulation - May 12, 2016 Category: Cardiology Authors: Lee CH, Sethi R, Li R, Ho HH, Hein T, Jim MH, Loo G, Koo CY, Gao XF, Chandra S, Yang XX, Furlan SF, Ge Z, Mundhekar A, Zhang WW, Uchôa CH, Kharwar RB, Chan PF, Chen SL, Chan MY, Richards A, Tan HC, Ong TH, Roldan G, Tai BC, Drager LF, Zhang JJ Tags: Circulation Source Type: research

Revascularization in Patients with Multivessel Coronary Artery Disease and Severe Left Ventricular Systolic Dysfunction: Everolimus Eluting Stents vs. Coronary Artery Bypass Graft Surgery.
CONCLUSIONS: -Among patients with multivessel disease and severe LV systolic dysfunction, PCI with EES had comparable long-term survival when compared with CABG. PCI was associated with higher risk of MI (in those with incomplete revascularization) and repeat revascularization, and CABG was associated with higher risk of stroke. PMID: 27151532 [PubMed - as supplied by publisher]
Source: Circulation - May 4, 2016 Category: Cardiology Authors: Bangalore S, Guo Y, Samadashvili Z, Blecker S, Hannan EL 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

Optimal Medical Therapy Improves Clinical Outcomes in Patients Undergoing Revascularization With Percutaneous Coronary Intervention or Coronary Artery Bypass Grafting: Insights From the Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery (SYNTAX) Trial at the 5-Year Follow-Up.
CONCLUSIONS: The use of OMT remains low in patients with complex coronary disease requiring coronary intervention with percutaneous coronary intervention and even lower in patients treated with CABG. Lack of OMT is associated with adverse clinical outcomes. Targeted strategies to improve OMT use in postrevascularization patients are warranted. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00114972. PMID: 25847979 [PubMed - in process]
Source: Circulation - April 7, 2015 Category: Cardiology Authors: Iqbal J, Zhang YJ, Holmes DR, Morice MC, Mack MJ, Kappetein AP, Feldman T, Stahle E, Escaned J, Banning AP, Gunn JP, Colombo A, Steyerberg EW, Mohr FW, Serruys PW Tags: Circulation Source Type: research

Cost-Effectiveness of Percutaneous Coronary Intervention with Drug-Eluting Stents vs. Bypass Surgery for Patients with 3-Vessel or Left Main Coronary Artery Disease: Final Results from the SYNTAX Trial.
CONCLUSIONS: -For most patients with 3-vessel or left-main CAD, CABG is a clinically and economically attractive revascularization strategy compared with DES-PCI. However, among patients with less complex disease, DES-PCI may be preferred on both clinical and economic grounds. Clinical Trial Registration Information-www.clinicaltrials.gov. Identifier: NCT00114972. PMID: 25085960 [PubMed - as supplied by publisher]
Source: Circulation - August 1, 2014 Category: Cardiology Authors: Cohen DJ, Osnabrugge RL, Magnuson EA, Wang K, Li H, Chinnakondepalli K, Pinto D, Abdallah MS, Vilain KA, Morice MC, Dawkins KD, Kappetein AP, Mohr FW, Serruys PW Tags: Circulation Source Type: research

Five-Year Outcomes in Patients with Left Main Disease Treated with Either Percutaneous Coronary Intervention or Coronary Artery Bypass Grafting in the SYNTAX Trial.
CONCLUSIONS: At 5 years, no difference in overall MACCE was found between treatment groups. PCI-treated patients had a lower stroke but higher revascularization rate versus CABG. These results suggest that both treatments are valid options for LM patients. The extent of disease should accounted for when choosing between surgery and PCI as patients with high SYNTAX scores seem to benefit more from surgery compared to the lower terciles. CLINICAL TRIAL REGISTRATION INFORMATION: clinicaltrials.gov. Identifier: NCT00114972. PMID: 24700706 [PubMed - as supplied by publisher]
Source: Circulation - April 3, 2014 Category: Cardiology Authors: Morice MC, Serruys PW, Kappetein AP, Feldman TE, Ståhle E, Colombo A, Mack MJ, Holmes DR, Choi JW, Ruzyllo W, Religa G, Huang J, Roy K, Dawkins KD, Mohr F Tags: Circulation Source Type: research

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