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Hirai T, Grantham JA, Sapontis J, Cohen DJ, Marso SP, Lombardi W, Karmpaliotis D, Moses J, Nicholson WJ, Pershad A, Wyman RM, Spaedy A, Cook S, Doshi P, Federici R, Nugent K, Gosch KL, Spertus JA, Salisbury AC. Impact of subintimal plaque modification procedures on health status after unsuccessful chronic total occlusion angioplasty. Catheter Cardiovasc Interv 2017; 91:1035-1042. [DOI: 10.1002/ccd.27380] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 09/19/2017] [Accepted: 09/28/2017] [Indexed: 11/11/2022]
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Vo MN, Brilakis ES, Grantham JA. Novel use of cutting balloon to treat subintimal hematomas during chronic total occlusion interventions. Catheter Cardiovasc Interv 2017; 91:53-56. [DOI: 10.1002/ccd.27184] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 04/26/2017] [Accepted: 06/08/2017] [Indexed: 01/20/2023]
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Qintar M, Towheed A, Tang F, Salisbury AC, Ho PM, Grantham JA, Spertus JA, Arnold SV. The Impact of De-escalation of Antianginal Medications on Health Status After Percutaneous Coronary Intervention. J Am Heart Assoc 2017; 6:e006405. [PMID: 29054844 PMCID: PMC5721850 DOI: 10.1161/jaha.117.006405] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 08/03/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Antianginal medications (AAMs) can be perceived to be less important after percutaneous coronary intervention (PCI) and may be de-escalated after revascularization. We examined the frequency of AAM de-escalation at discharge post-PCI and its association with follow-up health status. METHODS AND RESULTS In a 10-center PCI registry, the Seattle Angina Questionnaire was assessed before and 6 months post-PCI. AAM de-escalation was defined as fewer AAMs at discharge versus admission or >25% absolute dose decrease. Of 2743 PCI patients (70% male), AAM were de-escalated, escalated, and unchanged in 299 (11%), 714 (26%), and 1730 (63%) patients, respectively. Patients whose AAM were de-escalated were more likely to report angina at 6 months, compared with unchanged or escalated AAM (34% versus 24% versus 21%; P<0.001). The association of AAM de-escalation with health status was examined using multivariable models adjusting for the predicted risk of post-PCI angina, completeness of revascularization, and the interaction of AAM de-escalation×completeness of revascularization. There was a significant interaction between AAM de-escalation and completeness of revascularization (P<0.001), suggesting that AAM de-escalation was associated with greater impairment of health status among patients with incomplete revascularization. In patients with incomplete revascularization, de-escalation of AAM at discharge was associated with 43% increased angina risk (relative risk, 1.43; 95% confidence interval, 1.26-1.63) and worse angina-related health status at 6 months post-PCI. CONCLUSIONS De-escalation of AAM occurs in 1 in 10 patients post-PCI, and it is associated with an increased risk of angina and worse health status, particularly among those with incomplete revascularization.
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McCabe J, Khaki A, Nicholson W, Blank N, Grantham JA, Lombardi W, Tayal R. TCT-99 Safety and Efficacy of Percutaneous Axillary Artery Access for Mechanical Circulatory Support with the Impella© Devices: An Initial Evaluation from the Axillary Access Registry to Monitor Safety (ARMS) MultiCenter Registry. J Am Coll Cardiol 2017. [DOI: 10.1016/j.jacc.2017.09.1123] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Finn M, Kalra S, Kirtane AJ, Ali Z, Tang Y, Sapontis J, Spertus J, Qintar M, Moses J, Parikh M, Grantham JA, Karmpaliotis D. TCT-500 JCTO and PROGRESS CTO Scores Performance in Predicting Technical and Procedural Success after CTO PCI: An analysis of the OPEN CTO Multicenter Registry. J Am Coll Cardiol 2017. [DOI: 10.1016/j.jacc.2017.09.613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Secemsky E, Grantham JA, Spertus J, Cohen D, Jones P, Salisbury A, Arnold S, Harrell F, Lombardi W, Karmpaliotis D, Moses J, Sapontis J, Yeh R. TCT-497 Novel Risk Tool to Predict Angina-Related Health Status following Percutaneous Coronary Intervention of a Chronic Total Occlusion: A Sub-analysis of the OPEN CTO Registry. J Am Coll Cardiol 2017. [DOI: 10.1016/j.jacc.2017.09.610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Omer M, Safley D, Kennedy K, Mahmoud A, Elgendy I, Qintar M, Enriquez J, Grantham JA. TCT-467 Association of Chronic Total Occlusion with In-Hospital Outcomes after Percutaneous Coronary Intervention for Acute Myocardial Infarction: Insights from the National Inpatient Sample Database. J Am Coll Cardiol 2017. [DOI: 10.1016/j.jacc.2017.09.579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Qintar M, Hirai T, Patterson C, Sapontis J, Grantham JA, Gosch K, Jones P, Tang Y, Spertus J, Arnold S, Salisbury A. TCT-496 Predictors of Residual Angina after Chronic Total Occlusion Percutaneous Coronary Intervention: External Validation of an Existing Model. J Am Coll Cardiol 2017. [DOI: 10.1016/j.jacc.2017.09.609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kandzari D, Kini A, Karmpaliotis D, Moses J, Tummala P, Grantham JA, Lombardi W, Nicholson W, Lembo N. TCT-260 Safety and Effectiveness of XIENCE Stents in Chronic Total Occlusion Revascularization: Long-Term Results from the EXPERT CTO Multicenter Clinical Trial. J Am Coll Cardiol 2017. [DOI: 10.1016/j.jacc.2017.09.335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Rathore S, Seshasai S, Galassi A, Boukhris M, Tsuchikane E, Dens J, Mashayekhi K, Grantham JA, Brilakis E, Werner G. TCT-17 Procedural characteristics, Outcomes and Complications in patients undergoing percutaneous coronary chronic total occlusion angioplasty: Pooled analysis from RECHARGE, Expert JCTO, EURO CTO, PROGRESS and OPEN CTO Registries. J Am Coll Cardiol 2017. [DOI: 10.1016/j.jacc.2017.09.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sapontis J, Salisbury AC, Yeh RW, Cohen DJ, Hirai T, Lombardi W, McCabe JM, Karmpaliotis D, Moses J, Nicholson WJ, Pershad A, Wyman RM, Spaedy A, Cook S, Doshi P, Federici R, Thompson CR, Marso SP, Nugent K, Gosch K, Spertus JA, Grantham JA. Early Procedural and Health Status Outcomes After Chronic Total Occlusion Angioplasty. JACC Cardiovasc Interv 2017; 10:1523-1534. [DOI: 10.1016/j.jcin.2017.05.065] [Citation(s) in RCA: 181] [Impact Index Per Article: 25.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 04/17/2017] [Accepted: 05/31/2017] [Indexed: 01/14/2023]
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Karatasakis A, Iwnetu R, Danek BA, Karmpaliotis D, Alaswad K, Jaffer FA, Yeh RW, Kandzari DE, Lembo NJ, Patel M, Mahmud E, Lombardi WL, Wyman RM, Grantham JA, Doing AH, Toma C, Choi JW, Uretsky BF, Moses JW, Kirtane AJ, Ali ZA, Parikh M, Karacsonyi J, Rangan BV, Thompson CA, Banerjee S, Brilakis ES. The Impact of Age and Sex on In-Hospital Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention. THE JOURNAL OF INVASIVE CARDIOLOGY 2017; 29:116-122. [PMID: 28089997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVES We sought to determine the effect of age and sex on procedural outcomes and efficiency of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). METHODS We examined the clinical and angiographic characteristics and outcomes of 1675 CTO-PCIs performed in 1644 patients between 2012 and 2016 at 15 United States centers. RESULTS Mean age was 65.3 ± 10 years and 1408 (86%) were men. Overall technical and procedural success rates were 88% and 87%, respectively. Increasing age was associated with more comorbidities (dyslipidemia, hypertension, prior coronary artery bypass graft surgery, prior stroke, peripheral arterial disease, and chronic lung disease) and more lesion calcification. As compared with the reference age of <65 years, age >75 years was independently associated with technical failure (odds ratio [OR], 2.28; 95% confidence interval [CI], 1.20-4.28). Increasing age was also independently associated with the incidence of major adverse cardiovascular events (MACEs; OR, 2.93; 95% CI, 1.10-9.23 for 65-75 years and OR, 5.71; 95% CI, 1.89-19.60 for >75 years). Compared with men, women (n = 236; 14%) were older (66.8 ± 11.1 years vs 65.0 ± 9.8 years; P=.02), but had similar clinical characteristics and lower J-CTO scores (2.3 ± 1.3 vs 2.5 ± 1.2; P=.02). Although crude technical success rate was higher in women compared with men (92% vs 87%; P=.04), multivariable analysis did not show independent association between sex and technical failure (OR, men/women, 1.66; 95% CI, 0.86-3.50) or MACE (OR, 0.61; 95% CI, 0.25-1.73). CONCLUSIONS Older age, but not sex, is associated with lower technical success and higher in-hospital complication rate for CTO-PCI. CTO-PCI is relatively infrequently attempted in women, despite high technical success and acceptable complication rates.
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Karatasakis A, Danek BA, Karmpaliotis D, Alaswad K, Jaffer FA, Yeh RW, Patel M, Bahadorani JN, Lombardi WL, Wyman RM, Grantham JA, Kandzari DE, Lembo NJ, Doing AH, Toma C, Moses JW, Kirtane AJ, Parikh MA, Ali ZA, Garcia S, Kalsaria P, Karacsonyi J, Alame AJ, Thompson CA, Banerjee S, Brilakis ES. Comparison of various scores for predicting success of chronic total occlusion percutaneous coronary intervention. Int J Cardiol 2016; 224:50-56. [DOI: 10.1016/j.ijcard.2016.08.317] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 08/18/2016] [Accepted: 08/19/2016] [Indexed: 10/21/2022]
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Karatasakis A, Karmpaliotis D, Alaswad K, Jaffer F, Yeh R, Patel M, Bahadorani J, Lombardi W, Wyman RM, Grantham JA, Kandzari D, Lembo N, Doing A, Toma C, Moses J, Kirtane A, Ali Z, Parikh M, Garcia S, Danek B, Karacsonyi J, Alame A, Kalsaria P, Thompson C, Banerjee S, Brilakis E. Approaches to percutaneous coronary intervention of right coronary artery chronic total occlusions: insights from a multicentre US registry. EUROINTERVENTION 2016; 12:e1326-e1335. [DOI: 10.4244/eij-d-16-00265] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Christakopoulos GE, Christopoulos G, Karmpaliotis D, Alaswad K, Yeh RW, Jaffer FA, Wyman MR, Lombardi WL, Tarar MNJ, Grantham JA, Kandzari DE, Lembo N, Moses JW, Kirtane AJ, Parikh M, Green P, Finn M, Garcia S, Doing AH, Hatem R, Thompson CA, Banerjee S, Brilakis ES. Predictors of Excess Patient Radiation Exposure During Chronic Total Occlusion Coronary Intervention: Insights From a Contemporary Multicentre Registry. Can J Cardiol 2016; 33:478-484. [PMID: 28169091 DOI: 10.1016/j.cjca.2016.11.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 11/06/2016] [Accepted: 11/06/2016] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND High patient radiation dose during chronic total occlusion (CTO) percutaneous coronary intervention (PCI) might lead to procedural failure and radiation skin injury. METHODS We examined the association between several clinical and angiographic variables on patient air kerma (AK) radiation dose among 748 consecutive CTO PCIs performed at 9 experienced US centres between May 2012 and May 2015. RESULTS The mean age was 65 ± 10 years, 87% of patients were men, and 35% had previous coronary artery bypass graft surgery (CABG). Technical and procedural success was 92% and 90%, respectively. The median patient AK dose was 3.40 (interquartile range, 2.00-5.40) Gy and 34% of the patients received > 4.8 Gy (high radiation exposure). In univariable analysis male sex (P = 0.016), high body mass index (P < 0.001), history of hyperlipidemia (P = 0.023), previous CABG (P < 0.001), moderate or severe calcification (P < 0.001), tortuosity (P < 0.001), proximal cap ambiguity (P = 0.001), distal cap at a bifurcation (P = 0.006), longer CTO occlusion length (P < 0.001), blunt/no blunt stump (P < 0.001), and centre (P < 0.001) were associated with higher patient AK dose. In multivariable analysis high body mass index (P < 0.001), previous CABG (P = 0.005), moderate or severe calcification (P = 0.005), longer CTO occlusion length (P < 0.001), and centre (P < 0.001) were independently associated with higher patient AK dose. CONCLUSIONS Approximately 1 in 3 patients who undergo CTO PCI receive high AK radiation dose (> 4.8 Gy). Several baseline clinical and angiographic characteristics can help predict the likelihood of high radiation dose and assist with intensifying efforts to reduce radiation exposure for the patient and the operator.
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Danek BA, Karatasakis A, Karmpaliotis D, Alaswad K, Yeh R, Jaffer F, Patel M, Bahadorani J, Lombardi W, Wyman RM, Grantham JA, Doing A, Kandzari D, Lembo N, Garcia S, Toma C, Moses J, Kirtane A, Parikh M, Ali Z, Karacsonyi J, Alame A, Nguyen-Trong PK, Martinez-Parachini JR, Kalsaria P, Rangan B, Thompson C, Banerjee S, Brilakis E. TCT-281 Development and Validation of a Scoring System for Predicting Major Adverse Cardiovascular Events during Percutaneous Coronary Interventions of Chronic Total Occlusions: The PROGRESS CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention) MACE Score. J Am Coll Cardiol 2016. [DOI: 10.1016/j.jacc.2016.09.411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Alame A, Karmpaliotis D, Alaswad K, Jaffer F, Yeh R, Wyman RM, Patel M, Bahadorani J, Lombardi W, Grantham JA, Kandzari D, Lembo N, Moses J, Kirtane A, Toma C, Doing A, Choi J, Uretsky B, Karacsonyi J, Resendes E, Nguyen-Trong PK, Martinez-Parachini JR, Karatasakis A, Danek BA, Rangan B, Thompson C, Banerjee S, Brilakis E. TCT-301 Outcomes of Percutaneous Coronary Intervention in Chronic Total Occlusions Caused by In-Stent Restenosis: Insights from a U.S. Multicenter Registry. J Am Coll Cardiol 2016. [DOI: 10.1016/j.jacc.2016.09.431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Jaffer F, Grantham JA, Sapontis J, Spertus J, Gosch K, Jones P, Bruckel J, Lombardi W, Yeh R. TCT-284 Interrelationship between depression, angina, and dyspnea before and after CTO PCI in the OPEN CTO Registry. J Am Coll Cardiol 2016. [DOI: 10.1016/j.jacc.2016.09.414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Toma C, Karatasakis A, Karmpaliotis D, Alaswad K, Yeh R, Jaffer F, Kandzari D, Lembo N, Lombardi W, Grantham JA, Wyman RM, Doing A, Patel M, Bahadorani J, Moses J, Kirtane A, Ali Z, Danek BA, Karacsonyi J, Rangan B, Banerjee S, Brilakis E. TCT-273 Predictors of successful Stingray-assisted antegrade dissection reentry: data from the Progress CTO registry. J Am Coll Cardiol 2016. [DOI: 10.1016/j.jacc.2016.09.403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Karatasakis A, Danek BA, Karmpaliotis D, Alaswad K, Jaffer FA, Yeh R, Kandzari D, Lembo N, Patel M, Bahadorani J, Lombardi W, Wyman RM, Grantham JA, Doing A, Toma C, Choi J, Uretsky B, Garcia S, Moses J, Kirtane A, Ali Z, Parikh M, Karacsonyi J, Rangan B, Thompson C, Banerjee S, Brilakis E. TCT-278 Application and Outcomes of the Hybrid Approach to Chronic Total Occlusion Percutaneous Coronary Intervention: an Update from a Contemporary Multicenter US Registry. J Am Coll Cardiol 2016. [DOI: 10.1016/j.jacc.2016.09.408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Riley R, Sapontis J, Jones P, Kirtane A, Yeh R, Karmpaliotis D, Grantham JA, Lombardi W, Brilakis E, McCabe J. TCT-282 Risk Factors Associated with Adverse Events during Chronic Total Occlusion Percutaneous Coronary Interventions: A sub-Analysis of the OPEN-CTO Study. J Am Coll Cardiol 2016. [DOI: 10.1016/j.jacc.2016.09.412] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Danek BA, Karatasakis A, Karmpaliotis D, Alaswad K, Yeh R, Jaffer F, Patel M, Bahadorani J, Lombardi W, Wyman RM, Grantham JA, Doing A, Kandzari D, Lembo N, Garcia S, Toma C, Moses J, Kirtane A, Parikh M, Ali Z, Karacsonyi J, Alame A, Nguyen-Trong PK, Martinez-Parachini JR, Kalsaria P, Rangan B, Thompson C, Banerjee S, Brilakis E. TCT-15 Use of Antegrade Dissection Re-entry in Coronary Chronic Total Occlusion Percutaneous Coronary Intervention in a Contemporary Multicenter Registry. J Am Coll Cardiol 2016. [DOI: 10.1016/j.jacc.2016.09.892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Resendes E, Karmpaliotis D, Alaswad K, Jaffer F, Yeh R, Wyman RM, Patel M, Bahadorani J, Lombardi W, Grantham JA, Kandzari D, Lembo N, Moses J, Kirtane A, Toma C, Doing A, Choi J, Uretsky B, Alame A, Karacsonyi J, Danek BA, Smith M, Karatasakis A, Rangan B, Banerjee S, Brilakis E. TCT-308 Impact of Race and Ethnicity on Technical and In-Hospital Outcomes Following Chronic Total Occlusions Percutaneous Coronary Intervention. J Am Coll Cardiol 2016. [DOI: 10.1016/j.jacc.2016.09.438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Qintar M, Sapontis J, Grantham JA, Lombardi W, Karmpaliotis D, Moses J, Gosch K, Spertus J, Salisbury A, Arnold S. TCT-300 Dyspnea Among Patients with Chronic Total Occlusions Selected for Percutaneous Coronary Intervention: Prevalence and Predictors of Improvement. J Am Coll Cardiol 2016. [DOI: 10.1016/j.jacc.2016.09.430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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