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Aspirin Instead of Oral Anticoagulant Prescription in Atrial Fibrillation Patients at Risk for Stroke
ConclusionsIn a large, real-world cardiac outpatient population of AF patients with a moderate to high risk of stroke, more than 1 in 3 were treated with aspirin alone without OAC. Specific patient characteristics predicted prescription of aspirin therapy over OAC.
Source: Journal of the American College of Cardiology - June 21, 2016 Category: Cardiology Source Type: research

The Incidence and Predictors of Early- and Mid-Term Clinically Relevant Neurological Events After Transcatheter Aortic Valve Replacement in Real-World Patients
ConclusionsTreatment of high-risk patients with aortic stenosis using a self-expandable system was associated with a low stroke rate at short- and long-term follow-up. Multivariable predictors of clinically relevant neurological events differed on the basis of the timing after TAVR. (CoreValve Advance International Post Market Study; NCT01074658)
Source: Journal of the American College of Cardiology - July 13, 2015 Category: Cardiology Source Type: research

The Heart and the Head Neurological Implications of Transcatheter Aortic Valve Replacement ∗
In this issue of the Journal, Bosmans et al. (1) report much-awaited stroke outcomes from the ADVANCE study, a multicenter, prospective, nonrandomized cohort of patients undergoing transcatheter aortic valve replacement (TAVR) with the CoreValve prosthesis (Medtronic Inc., Minneapolis, Minnesota) at 44 mostly European sites between March 2010 and July 2011. In this real-world cohort of patients with severe aortic stenosis, the investigators observed stroke rates of 3.0% at 30 days post-TAVR and 5.6% at 2 years. They reported no significant predictors of periprocedural stroke or transient ischemic attack (TIA) occurring ...
Source: Journal of the American College of Cardiology - July 13, 2015 Category: Cardiology Source Type: research

Coronary Artery Bypass Graft Surgery Versus Drug-Eluting Stents for Patients With Isolated Proximal Left Anterior Descending Disease
ConclusionsDespite the higher rating in current guidelines of CABG (Class IIa vs. Class IIb) for patients with isolated PLAD disease, there were no differences in mortality or mortality, MI, and/or stroke, although CABG patients had significantly lower repeat revascularization rates.
Source: Journal of the American College of Cardiology - December 22, 2014 Category: Cardiology Source Type: research

Revascularization in Patients With Multivessel Coronary Artery Disease and Chronic Kidney Disease Everolimus-Eluting Stents Versus Coronary Artery Bypass Graft Surgery
ConclusionsIn patients with CKD, CABG is associated with higher short-term risk of death, stroke, and repeat revascularization, whereas PCI with everolimus-eluting stents is associated with a higher long-term risk of repeat revascularization and perhaps MI, with no long-term mortality difference. In the subgroup on dialysis, the results favored CABG over PCI.
Source: Journal of the American College of Cardiology - September 7, 2015 Category: Cardiology Source Type: research

Smoking Is Associated With Adverse Clinical Outcomes in Patients Undergoing Revascularization With PCI or CABG The SYNTAX Trial at 5-Year Follow-Up
ConclusionsSmoking is associated with poor clinical outcomes after revascularization in patients with complex CAD. This places further emphasis on efforts at smoking cessation to improve revascularization benefits. (SYNTAX Study: TAXUS Drug-Eluting Stent Versus Coronary Artery Bypass Surgery for the Treatment of Narrowed Arteries; NCT00114972)
Source: Journal of the American College of Cardiology - March 16, 2015 Category: Cardiology Source Type: research

Randomized Trial of Stents Versus Bypass Surgery for Left Main Coronary Artery Disease 5-Year Outcomes of the PRECOMBAT Study
ConclusionsDuring 5 years of follow-up, our study did not show significant difference regarding the rate of MACCE between patients who underwent PCI with a sirolimus-eluting stent and those who underwent CABG. However, considering the limited power of our study, our results should be interpreted with caution. (Bypass Surgery Versus Angioplasty Using Sirolimus-Eluting Stent in Patients With Left Main Coronary Artery Disease [PRECOMBAT]; NCT00422968)
Source: Journal of the American College of Cardiology - May 18, 2015 Category: Cardiology Source Type: research

Hybrid Coronary Revascularization for the Treatment of Multivessel Coronary Artery Disease A Multicenter Observational Study
ConclusionsThese observational data from this first multicenter study of HCR suggest that there is no significant difference in MACCE rates over 12 months between patients treated with multivessel PCI or HCR, an emerging modality. A randomized trial with long-term outcomes is needed to definitively compare the effectiveness of these 2 revascularization strategies. (Hybrid Revascularization Observational Study; NCT01121263)
Source: Journal of the American College of Cardiology - July 18, 2016 Category: Cardiology Source Type: research

Hybrid Coronary Revascularization for  the Treatment of Multivessel Coronary Artery Disease A Multicenter Observational Study
Conclusions These observational data from this first multicenter study of HCR suggest that there is no significant difference in MACCE rates over 12 months between patients treated with multivessel PCI or HCR, an emerging modality. A randomized trial with long-term outcomes is needed to definitively compare the effectiveness of these 2 revascularization strategies. (Hybrid Revascularization Observational Study; NCT01121263)
Source: Journal of the American College of Cardiology - July 21, 2016 Category: Cardiology Source Type: research

Percutaneous Coronary Intervention Versus Coronary Bypass Surgery in United States Veterans With Diabetes
Conclusions: This study was severely underpowered for its primary endpoint, and therefore no firm conclusions about the comparative effectiveness of CABG and PCI are possible. There were interesting differences in the components of the primary endpoint. However, the confidence intervals are very large, and the findings must be viewed as hypothesis generating only. (Coronary Artery Revascularization in Diabetes; NCT00326196)
Source: Journal of the American College of Cardiology - February 20, 2013 Category: Cardiology Authors: Masoor Kamalesh, Thomas G. Sharp, X. Charlene Tang, Kendrick Shunk, Herbert B. Ward, James Walsh, Spencer King, Cindy Colling, Thomas Moritz, Kevin Stroupe, Domenic Reda, VA CARDS Investigators Tags: Interventional Cardiology Source Type: research

Rivaroxaban in Patients Stabilized After a ST-Segment Elevation Myocardial Infarction: Results From the ATLAS ACS-2–TIMI-51 Trial (Anti-Xa Therapy to Lower Cardiovascular Events in Addition to Standard Therapy in Subjects with Acute Coronary Syndrome–Thrombolysis In Myocardial Infarction-51)
Objectives: The present analysis reports on the pre-specified subgroup of ST-elevation myocardial infarction (STEMI) patients, in whom anticoagulant therapy has been of particular interest. Background: In ATLAS ACS-2–TIMI-51 (Anti-Xa Therapy to Lower Cardiovascular Events in Addition to Standard Therapy in Subjects with Acute Coronary Syndrome–Thrombolysis In Myocardial Infarction-51), rivaroxaban reduced cardiovascular events across the spectrum of acute coronary syndrome (ACS). Methods: Seven thousand eight hundred seventeen patients in ATLAS ACS-2-TIMI 51 presented with a STEMI. After being stabilized (1 to 7 d...
Source: Journal of the American College of Cardiology - May 1, 2013 Category: Cardiology Authors: Jessica L. Mega, Eugene Braunwald, Sabina A. Murphy, Alexei N. Plotnikov, Paul Burton, Robert Gabor Kiss, Alexander Parkhomenko, Michal Tendera, Petr Widimsky, C. Michael Gibson Tags: Coronary Artery Disease Source Type: research

Effect of Prasugrel Pre-Treatment Strategy in Patients Undergoing Percutaneous Coronary Intervention for NSTEMI The ACCOAST-PCI Study
ConclusionsThese findings support deferring treatment with prasugrel until a decision is made about revascularization in patients with NSTEMI undergoing angiography within 48 h of admission. (A Comparison of prasugrel at the time of percutaneous Coronary intervention Or as pre-treatment At the time of diagnosis in patients with non—ST-segment elevation myocardial infarction [ACCOAST]; NCT01015287)
Source: Journal of the American College of Cardiology - December 15, 2014 Category: Cardiology Source Type: research

Is the Long-Term Outcome of PCI or CABG in Insulin-Treated Diabetic Patients Really Worse Than Non-Insulin-Treated Ones?
In a recent issue of the Journal, Dangas et al. (1), after analyzing 1,850 subjects from the FREEDOM (Comparison of Two Treatments for Multivessel Coronary Artery Disease in Individuals With Diabetes) trial, found that in patients with diabetes and multivessel coronary artery disease, the rate of major adverse cardiovascular events (death, myocardial infarction, or stroke) is higher in patients treated with insulin than it is in those not treated with insulin. Their work is excellent, and the results deserved to be considered given the large number of patients with diabetes and multivessel coronary artery disease who are...
Source: Journal of the American College of Cardiology - March 16, 2015 Category: Cardiology Source Type: research

Impact of Type 1 and 2 Diabetes Mellitus on Long-Term Outcomes After CABG ∗
It is well-established both that the prevalence of diabetes mellitus (DM) is rising rapidly in the developed world and that its presence is a significant risk factor for cardiovascular disease and death (1). Over the last decade, it also has become increasingly clear that for patients with diabetes who require coronary artery revascularization, in addition to optimal medical therapy, that the results of coronary artery bypass grafting (CABG) are superior to percutaneous coronary intervention in terms of significant reductions in mortality, myocardial infarction, and the need for repeat interventions but at the cost of a sl...
Source: Journal of the American College of Cardiology - April 20, 2015 Category: Cardiology Source Type: research

Is CABG Superior to DES for Repeat Revascularization in Patients With Isolated Proximal LAD Disease?
We read with great interest the paper by Hannan et al. (1) comparing the clinical outcomes in a large number of patients with isolated proximal left anterior descending (PLAD) coronary artery disease who underwent coronary artery bypass graft (CABG) surgery and percutaneous coronary interventions (PCIs) with drug-eluting stents (DES). They showed that there were no statistically significant differences in mortality or mortality, myocardial infarction (MI), and/or stroke between the CABG and PCI-DES groups, whereas CABG patients had significantly lower repeat revascularization rates.
Source: Journal of the American College of Cardiology - April 20, 2015 Category: Cardiology Source Type: research

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