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Cangrelor reduces the risk of ischemic complications in patients with single-vessel and multi-vessel disease undergoing percutaneous coronary intervention: Insights from the CHAMPION PHOENIX trial
Conclusion In the CHAMPION PHOENIX trial, MVD and SVD patients had similar ischemic outcomes at 48hours and 30days. Cangrelor consistently reduced ischemic complications in both SVD and MVD patients without a significant increase in GUSTO severe bleeding. Clinical perspectives What's known? Cangrelor is a novel, intravenous, potent, and rapidly acting P2Y12 inhibitor that has been demonstrated to reduce the rate of ischemic events at 48hours in patients who received PCI compared with clopidogrel. What's new? In contrast to prior studies, we found that in this modern cohort, patients with SVD and MVD had a similar risk of i...
Source: American Heart Journal - April 18, 2017 Category: Cardiology Source Type: research

Dual Antiplatelet Therapy in Patients with Diabetes and Acute Coronary Syndromes Managed without Revascularization
Conclusions Among NSTE ACS patients managed medically without revascularization, patients with DM had a higher risk of ischemic events that was amplified among those treated with insulin. There was no differential treatment effect with a more potent DAPT regimen of aspirin + prasugrel vs. aspirin + clopidogrel.
Source: American Heart Journal - March 28, 2017 Category: Cardiology Source Type: research

A comparison of reduced-dose prasugrel and standard-dose clopidogrel in elderly patients with acute coronary syndromes undergoing early percutaneous revascularization: design and rationale of the randomized Elderly-ACS 2 Study
Conclusion The Elderly-ACS 2 study is a multicenter, randomized trial comparing a strategy of dual antiplatelet therapy with a reduced dose of prasugrel with a standard dose of clopidogrel in elderly patients with ACS undergoing percutaneous revascularization. (The Elderly ACS 2 trial: NCT01777503)
Source: American Heart Journal - August 26, 2016 Category: Cardiology Source Type: research

Non-eligibility for reperfusion therapy in patients presenting with ST-segment elevation myocardial infarction: Contemporary insights from the National Cardiovascular Data Registry (NCDR)
Conclusion Most patients with STEMI not receiving reperfusion therapy had a documented reason. Coronary anatomy not suitable for PCI was the major contributor to ineligibility. In-hospital mortality was higher in patients not receiving reperfusion therapy.
Source: American Heart Journal - January 12, 2016 Category: Cardiology Source Type: research

None-ligibility for reperfusion therapy in patients presenting with ST-segment elevation myocardial infarction: Contemporary insights from the National Cardiovascular Data Registry (NCDR)
Conclusion Most patients with STEMI not receiving reperfusion therapy had a documented reason. Coronary anatomy not suitable for PCI was the major contributor to ineligibility. In-hospital mortality was higher in patients not receiving reperfusion therapy.
Source: American Heart Journal - November 25, 2015 Category: Cardiology Source Type: research

Percutaneous left ventricular assist device for high-risk percutaneous coronary interventions: Real-world versus clinical trial experience
Conclusions USpella provides a real-world and contemporary estimation of the type of procedures and outcomes of high-risk patients undergoing PCI supported by Impella 2.5. Despite the higher risk of registry patients, clinical outcomes appeared to be favorable and consistent compared with the randomized trial.
Source: American Heart Journal - September 19, 2015 Category: Cardiology Source Type: research

Percutaneous Left Ventricular Assist Device for High Risk Percutaneous Coronary Interventions. Real World versus Clinical Trial Experience
Conclusions USpella provides a real world and contemporary estimation of the type of procedures and outcomes of high-risk patients undergoing PCI supported by Impella 2.5. Despite the higher risk of registry patients, clinical outcomes appeared to be favorable and consistent compared with the randomized trial.
Source: American Heart Journal - August 16, 2015 Category: Cardiology Source Type: research

Clinical outcomes of hybrid coronary revascularization versus coronary artery bypass surgery in patients with diabetes mellitus
Background: Hybrid coronary revascularization (HCR) involves minimally invasive left internal mammary artery to left anterior descending coronary artery grafting combined with percutaneous coronary intervention (PCI) of non–left anterior descending vessels. The safety and efficacy of HCR among diabetic patients are unknown.Methods: Patients with diabetes were included who underwent HCR at a US academic center between October 2003 and September 2013. These patients were matched 1:5 to similar patients treated with coronary artery bypass grafting (CABG) using a propensity score (PS)-matching algorithm. Conditional logistic...
Source: American Heart Journal - July 14, 2014 Category: Cardiology Authors: Ralf E. Harskamp, Patrick F. Walker, John H. Alexander, Ying Xian, Henry A. Liberman, Robbert J. de Winter, Thomas A. Vassiliades, Eric D. Peterson, John D. Puskas, Michael E. Halkos Tags: Diabetes and Metabolism Source Type: research

Change in enrollment patterns, patient selection, and clinical outcomes with the availability of drug-eluting stents in the Bypass Angioplasty Revascularization Investigation 2 Diabetes trial
Background: In the BARI 2D trial, patients with type 2 diabetes and stable coronary artery disease were randomized to prompt revascularization versus intensive medical therapy (IMT). This analysis sought to evaluate how the availability of drug-eluting stents (DESs) has changed practice and outcomes.Methods: In BARI 2D, 1,605 patients were in the percutaneous coronary intervention (PCI)–intended stratum. As DES became available midway through recruitment, we report clinical outcomes among patients who underwent IMT versus prompt PCI with bare-metal stents (BMSs) or DES up to 4 years.Results: In North America, after DES b...
Source: American Heart Journal - August 7, 2013 Category: Cardiology Authors: Binita Shah, Vankeepuram S. Srinivas, Jiang Lu, Maria M. Brooks, Eric R. Bates, Zoran S. Nedeljkovic, Jorge Escobedo, Gladwin S. Das, John J. Lopez, Frederick Feit Tags: Interventional Cardiology Source Type: research