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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

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

Temporal Trends in Risk Factors of Periprocedural Stroke in Patients Undergoing Percutaneous Coronary Intervention: Insights from the ACC NCDR CathPCI Registry
Periprocedural stroke complicates up to 1% of patients undergoing percutaneous coronary intervention (PCI) and is associated with increased morbidity, mortality, and subsequent health care resource utilization.1 –5 Contemporary reports suggest that despite iterative procedural evolution in PCI (e.g., smaller catheters, radial access, and potent pharmacotherapy), periprocedural stroke rates have not improved over the last few years, with our recent analysis suggesting these rates may be in fact be rising, likely as a result of an increasingly co-morbid population3 and higher procedural complexity.
Source: The American Journal of Cardiology - August 8, 2023 Category: Cardiology Authors: Adam J. Nelson, Rebecca Young, Imran H. Tarrar, Daniel Wojdyla, Tracy Y. Wang, Rajendra H. Mehta Tags: Brief Report 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

Adverse Impact of Peri-Procedural Stroke in Patients Who Underwent Percutaneous Coronary Intervention
Peri-procedural stroke (PPS) is an important complication in patients who underwent percutaneous coronary intervention (PCI). The extent to which PPS impacts mortality and outcomes remains to be defined. Consecutive patients who underwent PCI enrolled in the Victorian Cardiac Outcomes Registry (2014 to 2018) were categorized into PPS and no PPS groups. The primary outcome was 30-day major adverse cardiovascular events (MACEs) (composite of mortality, myocardial infarction, stent thrombosis, and unplanned revascularization).
Source: The American Journal of Cardiology - August 20, 2022 Category: Cardiology Authors: Noah Z. Wexler, Sara Vogrin, Angela L. Brennan, Samer Noaman, Omar Al-Mukhtar, Kawa Haji, Jason E. Bloom, Diem T. Dinh, Wayne C. Zheng, James A. Shaw, Stephen J. Duffy, Jeffrey Lefkovits, Christopher M. Reid, Dion Stub, David M. Kaye, Nicholas Cox, Willia Source Type: research

Stroke Risk Stratification With the CHADS2 Score in Patients Without Atrial Fibrillation Who Underwent Percutaneous Coronary Intervention
The clinical significance of the CHADS2 score remains unclear in patients with coronary artery disease (CAD) without atrial fibrillation (AF). Therefore, the purpose of this study was to evaluate the association between the CHADS2 score and the long-term risk of ischemic stroke and its severity in patients with CAD with and without AF. Using the CREDO (Coronary Revascularization Demonstrating Outcome study)-Kyoto Registry Cohort-3, the present study population consisted of 11,516 patients with CAD who underwent percutaneous coronary intervention without oral anticoagulants at discharge.
Source: The American Journal of Cardiology - August 13, 2022 Category: Cardiology Authors: Yuki Obayashi, Hiroki Shiomi, Takeshi Morimoto, Yodo Tamaki, Moriaki Inoko, Ryusuke Nishikawa, Kazuhisa Kaneda, Ko Yamamoto, Yasuaki Takeji, Akihiro Komasa, Kyohei Yamaji, Satoshi Shizuta, Tomohisa Tada, Kazuya Nagao, Satoru Suwa, Toshihiro Tamura, Hiroki 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

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

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

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

Prevalence and Determinants of Atrial Fibrillation-associated In-hospital Ischemic Stroke in patients with Acute Myocardial Infarction undergoing Percutaneous Coronary Intervention
Atrial Fibrillation (AF) is an established risk factor ischemic stroke (IS) and is commonly encountered in patient hospitalized with acute myocardial infarction (AMI). Uncommonly, IS can occur as a complication resulting from percutaneous coronary intervention (PCI). There is limited real world data regarding AF-associated in-hospital IS (IH-IS) in patients admitted with AMI undergoing PCI. We queried the National Inpatient Sample database from January 2010 to December 2014 to identify patients admitted with AMI who underwent PCI.
Source: The American Journal of Cardiology - December 29, 2020 Category: Cardiology Authors: Shivaraj Patil, Karthik Gonuguntla, Chaitanya Rojulpote, Manish Kumar, Srinivas Nadadur, Robert J. Nardino, Christopher Pickett 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

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

Periprocedural Stroke After Coronary Revascularization (From the CREDO-Kyoto PCI/CABG Registry Cohort-3)
There is a scarcity of data on incidence, risk factors, especially clinical severity, and long-term prognostic impact of periprocedural stroke after coronary revascularization in contemporary real-world practice. Among 14867 consecutive patients undergoing first coronary revascularization between January 2011 and December 2013 (percutaneous coronary intervention [PCI]: N=13258, and coronary artery bypass grafting [CABG]: N=1609) in the CREDO-Kyoto PCI/CABG registry Cohort-3, we evaluated the details on periprocedural stroke.
Source: The American Journal of Cardiology - December 3, 2020 Category: Cardiology Authors: Ko Yamamoto, Masahiro Natsuaki, Takeshi Morimoto, Hiroki Shiomi, Yukiko Matsumura-Nakano, Kenji Nakatsuma, Hiroki Watanabe, Erika Yamamoto, Eri Kato, Masayuki Fuki, Kyohei Yamaji, Ryusuke Nishikawa, Kazuya Nagao, Yasuaki Takeji, Hirotoshi Watanabe, Junich Source Type: research

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