The safety and efficacy of percutaneous alcohol septal ablation in young patients with obstructive hypertrophic cardiomyopathy has not been adequately studied. Data from 1,197 patients who were divided into young (≤50 years), middle-aged (51-64 years), and older (≥65 years) has indicated that 30-day mortality and pacemaker implantation rates are lower in the young. Annual adverse arrhythmic event rates were similar in the three age groups. Independent predictors of mortality in the young were age, female sex, and residual left ventricular outflow tract gradient.
The efficacy of bivalirudin, as compared to heparin, in STEMI patients has been doubtful. Data from the National Cardivascular Data Registry CathPCI database , examining the outcome of STEMI patients undergoing radial intervention, has indicated that bivalirudin is not associated with improvements in the composite endpoint of death, MI, or stroke when compared to heparin. Major bleeding rates were not significantly different.
The prognostic benefit of heart rate control in patients with heart failure with reduced ejection fraction in uncertain. A meta-analysis of 11 randomized studies has indicated that a higher heart rate at baseline in such patients was associated with greater mortality for patients in sinus rhythm but not in AF. Mortality was reduced in sinus rhythm patients randomised to beta blockers but not in AF patients. A lower resting heart rate, regardless of therapy, was associated with better prognosis for sinus rhythm patients.
Pearls From: William O'Neill, MD
Teva Announces Launch of Generic Zetia® in the United States
Saranas Closed $4 million to Advance New Device for Real-Time Detection of Active Bleeding During PCI
First Transcatheter Tricuspid Repair Subject with Trialign™ System Enrolled in Europe (SCOUT II Study)
A number of landmark studies have confirmed the safety and efficacy of FFR-guided coronary revascularization. The IRIS-FFR registry of 5846 patients with at least 1 coronary lesion that was evaluated by FFR in which 6468 lesions were deferred and 2165 lesions were revascularised has indicated that for deferred lesions the risk of MACE had an inverse relationship with the FFR value. In lesions with FFR ≥0.76, the risk of MACE was similar between deferred and revascularised lesions whilst in lesions with FFR≤0.75 the risk was lower in revascularised lesions.
The DANAMI-3-DEFER study illustrated that in patients with STEMI, a strategy of delayed stenting was not associated with any clinical benefit. A cardiac magnetic resonance sub-study of this cohort has indicated that delayed stenting was not associated with reductions in myocardial infarct size, improvements in myocardial salvage or microvascular obstruction.
The optimal percutaneous revascularization strategy for peripheral arterial disease (PAD) remains debatable. The ISAR-STATH study compared a strategy of paclitaxel-eluting balloon (PEB) angioplasty and stenting, POBA and stenting, or POBA and directional atherectomy in 155 patients with PAD. PEB angioplasty and stenting was associated with lower percent diameter stenosis at 6-month angiography and lower risk of TLR at 24-month follow-up.
Nicole Lou,Reporter, MedPage Today/CRTonline.org
June 23, 2017
June 16, 2017
Salynn Boyles, Contributing WriterJune 15, 2017
June 14, 2017
Crystal Phend, Senior Associate Editor, MedPage TodayJune 14, 2017
Crystal Phend, Senior Associate Editor, MedPage TodayJune 13, 2017
C Lee, et al.; JACC 2017; 69:2901-9
U Hoffmann, et al.; Circ 2017; 135:2320-32
R Ravindrarajah, et al.; Circ 2017; 135:2357-68
D Saleheen, et al.; Circ 2017; 135:2336-53
A Fanaroff, et al.; JACC 2017; 69:2913-24
What is your discharge anticoagulation protocol in patients presenting with ACS?
Aspirin with Berlinta or Prasugrel for 12 months
Aspirin with Clopidogrel for 12 months
Switch to Clopidogrel from Berlinta or Prasugrel after 30 days
If Only the Doctor Will Let Me Go Home: Same Day Discharge after PCI Ian C. Gilchrist
Evaluation of coronary flow conditions in complex coronary artery bifurcations stenting using computational fluid dynamics: Impact of final proximal optimization technique on different double-stent techniques Author(s): Gianluca Rigatelli, Marco Zuin, Fabio Dell'Avvocata, Dobrin Vassilev, Ramesh Daggubati, Thach Nguyen, Nguyen Van Viet Thang, Nicolas Foin
Predictors of same day discharge after percutaneous coronary interventions Author(s): Michail Koutouzis, Maria Agelaki, Christos Maniotis, Panagiotis Dimitriou, Andreas Tsoulmeleas, Ioannis Matsoukis, Constantinos Andreou, Efstathios Lazaris
Feasibility and safety of same-day discharge after complex percutaneous coronary intervention using forearm approach Author(s): Michael Koutouzis, Aris Karatasakis, Emmanouil S. Brilakis, Maria Agelaki, Christos Maniotis, Panagiotis Dimitriou, Efstathios Lazaris
Variation in emergency percutaneous coronary intervention in ventilated patients in the UK: Insights from a national database Author(s): John Rawlins, Peter F Ludman, Darragh O'Neil, Mamas A. Mamas, Mark de Belder, Simon Redwood, Adrian Banning, Andrew Whittaker, Nick Curzen
Troponin I elevation and all-cause mortality after elective percutaneous coronary interventions Author(s): Roberto Muniz Ferreira, Nelson Albuquerque de Souza e Silva, Lúcia Helena Alvares Salis, Rafael Ramos Mendes da Silva, Paula Dias Maia, Lucas Felipe Bastos Horta, Eliene Ferreira Salles, Henrique Moraes Pinto Nunes, Joana Beatriz Moutinho de Oliveira, Yasminne Pascoal de Sousa Domingues, Clarissa Castrighini Macedo de Sousa
Orbital atherectomy for treating de novo, severely calcified coronary lesions: 3-year results of the pivotal ORBIT II trial Author(s): Michael Lee, Philippe Généreux, Richard Shlofmitz, Daniel Phillipson, Bynthia M. Anose, Brad J. Martinsen, Stevan I. Himmelstein, Jeff W. Chambers
First and second generation DESs reduce diabetes adverse effect on mortality and re-intervention in multivessel coronary disease: 9-Year analysis Author(s): Sanaa A. Badour, Kamellia R. Dimitrova, Yumiko Kanei, Robert F. Tranbaugh, Mark M. Hajjar, Ameer Kabour, Thomas A. Schwann, Samir Alam, Kamal Badr, Robert H. Habib
Acute pulmonary embolism after post-traumatic spinal epidural hematoma: Use of catheter-direct treatment Author(s): Marco Zuin, Gianluca Rigatelli, Stefano Ferraresi, Pietro Zonzin, Loris Roncon
Successful treatment of a nonagenarian patient with acute coronary syndrome complicated with chronic total occlusion of the left main coronary artery Author(s): Yukio Mizuguchi, Sho Hashimoto, Hiroki Shibutani, Takeshi Yamada, Norimasa Taniguchi, Shunsuke Nakajima, Tetsuya Hata, Akihiko Takahashi
Skirt followed by trouser stenting technique: True anatomical preservation of coronary Y-shaped bifurcation lesions while using “vanishing” bioresorbable scaffolds: A report of two cases Author(s): Wael Elabbassi, Arif Al Nooryani
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