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Wu X, Renkens MPL, Kerkmeijer L, Lunardi M, Huang J, Ding D, O'Leary N, de Winter RJ, Onuma Y, Serruys PW, Wykrzykowska J, Tu S, Wijns W. Angiography-Based Superficial Wall Strain of De Novo Stenotic Coronary Arteries: Serial Assessment of Vessels Treated with Bioresorbable Scaffold or Drug-Eluting Stent. Cardiovasc Revasc Med 2023; 53:51-60. [PMID: 37005105 DOI: 10.1016/j.carrev.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 03/14/2023] [Indexed: 03/29/2023]
Abstract
OBJECTIVES This study sought to present an angiography-based computational model for serial assessment of superficial wall strain (SWS, dimensionless) of de-novo coronary stenoses treated with either bioresorbable scaffold (BRS) or drug-eluting stent (DES). BACKGROUND A novel method for SWS allows the assessment of the mechanical status of arteries in-vivo, which may help for predicting cardiovascular outcomes. METHODS Patients with arterial stenosis treated with BRS (n = 21) or DES (n = 21) were included from ABSORB Cohort B1 and AIDA trials. The SWS analyses were performed along with quantitative coronary angiography (QCA) at pre-PCI, post-PCI, and 5-year follow-up. Measurements of QCA and SWS parameters were quantified at the treated segment and adjacent 5-mm proximal and distal edges. RESULTS Before PCI, the peak SWS on the 'to be treated' segment (0.79 ± 0.36) was significantly higher than at both virtual edges (0.44 ± 0.14 and 0.45 ± 0.21; both p < 0.001). The peak SWS in the treated segment significantly decreased by 0.44 ± 0.13 (p < 0.001). The surface area of high SWS decreased from 69.97mm2 to 40.08mm2 (p = 0.002). The peak SWS in BRS group decreased to a similar extent (p = 0.775) from 0.81 ± 0.36 to 0.41 ± 0.14 (p < 0.001), compared with DES group from 0.77 ± 0.39 to 0.47 ± 0.13 (p = 0.001). Relocation of high SWS to device edges was often observed in both groups after PCI (35 of 82 cases, 41.7 %). At follow-up of BRS, the peak SWS remained unchanged compared to post-PCI (0.40 ± 0.12 versus 0.36 ± 0.09, p = 0.319). CONCLUSION Angiography-based SWS provided valuable information about the mechanical status of coronary arteries. Device implantation led to a significant decrease of SWS to a similar extent with either polymer-based scaffolds or permanent metallic stents.
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Affiliation(s)
- Xinlei Wu
- The Lambe Institute for Translational Medicine, Smart Sensors Laboratory, Corrib Core Laboratory and Curam, University of Galway, Ireland
| | - Mick P L Renkens
- Amsterdam UMC, Heart Center, University of Amsterdam, Amsterdam, the Netherlands
| | | | - Mattia Lunardi
- The Lambe Institute for Translational Medicine, Smart Sensors Laboratory, Corrib Core Laboratory and Curam, University of Galway, Ireland
| | - Jiayue Huang
- The Lambe Institute for Translational Medicine, Smart Sensors Laboratory, Corrib Core Laboratory and Curam, University of Galway, Ireland
| | - Daixin Ding
- The Lambe Institute for Translational Medicine, Smart Sensors Laboratory, Corrib Core Laboratory and Curam, University of Galway, Ireland
| | - Neil O'Leary
- The Lambe Institute for Translational Medicine, Smart Sensors Laboratory, Corrib Core Laboratory and Curam, University of Galway, Ireland
| | - Robbert J de Winter
- Amsterdam UMC, Heart Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Yoshinobu Onuma
- The Lambe Institute for Translational Medicine, Smart Sensors Laboratory, Corrib Core Laboratory and Curam, University of Galway, Ireland
| | - Patrick W Serruys
- The Lambe Institute for Translational Medicine, Smart Sensors Laboratory, Corrib Core Laboratory and Curam, University of Galway, Ireland
| | - Joanna Wykrzykowska
- Amsterdam UMC, Heart Center, University of Amsterdam, Amsterdam, the Netherlands; UMC Groningen, Thorax Center, University of Groningen, Groningen, the Netherlands
| | - Shengxian Tu
- Med-X Research Institute, Shanghai Jiao Tong University, China
| | - William Wijns
- The Lambe Institute for Translational Medicine, Smart Sensors Laboratory, Corrib Core Laboratory and Curam, University of Galway, Ireland.
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Abdelshafy M, Serruys PW, Tsai TY, Revaiah PC, Garg S, Aben JP, Schultz CJ, Abdelghani M, Tonino PAL, Miyazaki Y, Rutten MCM, Cox M, Sahyoun C, Teng J, Tateishi H, Abdel-Wahab M, Piazza N, Pighi M, Modolo R, van Mourik M, Wykrzykowska J, de Winter RJ, Lemos PA, de Brito FS, Kawashima H, Søndergaard L, Rosseel L, Wang R, Gao C, Tao L, Rück A, Kim WK, van Royen N, Terkelsen CJ, Nissen H, Adam M, Rudolph TK, Wienemann H, Torii R, Josef Neuman F, Schoechlin S, Chen M, Elkoumy A, Elzomor H, Amat-Santos IJ, Mylotte D, Soliman O, Onuma Y. Quantitative aortography for assessment of aortic regurgitation in the era of percutaneous aortic valve replacement. Front Cardiovasc Med 2023; 10:1161779. [PMID: 37529710 PMCID: PMC10389707 DOI: 10.3389/fcvm.2023.1161779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/24/2023] [Indexed: 08/03/2023] Open
Abstract
Paravalvular leak (PVL) is a shortcoming that can erode the clinical benefits of transcatheter valve replacement (TAVR) and therefore a readily applicable method (aortography) to quantitate PVL objectively and accurately in the interventional suite is appealing to all operators. The ratio between the areas of the time-density curves in the aorta and left ventricular outflow tract (LVOT-AR) defines the regurgitation fraction (RF). This technique has been validated in a mock circulation; a single injection in diastole was further tested in porcine and ovine models. In the clinical setting, LVOT-AR was compared with trans-thoracic and trans-oesophageal echocardiography and cardiac magnetic resonance imaging. LVOT-AR > 17% discriminates mild from moderate aortic regurgitation on echocardiography and confers a poor prognosis in multiple registries, and justifies balloon post-dilatation. The LVOT-AR differentiates the individual performances of many old and novel devices and is being used in ongoing randomized trials and registries.
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Affiliation(s)
- Mahmoud Abdelshafy
- Department of Cardiology, CORRIB Research Centre for Advanced Imaging and Core Laboratory, National University of Ireland, Galway (NUIG), Galway, Ireland
- Department of Cardiology, Al-Azhar University, Cairo, Egypt
| | - Patrick W. Serruys
- Department of Cardiology, CORRIB Research Centre for Advanced Imaging and Core Laboratory, National University of Ireland, Galway (NUIG), Galway, Ireland
- NHLI, Imperial College London, London, United Kingdom
| | - Tsung-Ying Tsai
- Department of Cardiology, CORRIB Research Centre for Advanced Imaging and Core Laboratory, National University of Ireland, Galway (NUIG), Galway, Ireland
| | - Pruthvi Chenniganahosahalli Revaiah
- Department of Cardiology, CORRIB Research Centre for Advanced Imaging and Core Laboratory, National University of Ireland, Galway (NUIG), Galway, Ireland
| | - Scot Garg
- Department of Cardiology, Royal Blackburn Hospital, Blackburn, United Kingdom
| | | | - Carl J. Schultz
- Department of Cardiology, Royal Perth Hospital, Perth, WA, Australia
- Medical School, University of Western Australia, Perth, WA, Australia
| | - Mohammad Abdelghani
- Department of Cardiology, Al-Azhar University, Cairo, Egypt
- Department of Cardiology, Amsterdam UMC, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, Netherlands
| | - Pim A. L. Tonino
- Department of Cardiology, Catharina Hospital, Eindhoven, Netherlands
| | - Yosuke Miyazaki
- Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - Marcel C. M. Rutten
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | | | | | - Justin Teng
- Department of Cardiology, Royal Perth Hospital, Perth, WA, Australia
| | - Hiroki Tateishi
- Department of Cardiology, Shibata Hospital, Yamaguchi, Japan
- Division of Cardiology, Department of Clinical Science and Medicine, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Mohamed Abdel-Wahab
- Department of Internal Medicine/Cardiology, Heart Center Leipzig at the University of Leipzig, Leipzig, Germany
| | - Nicolo Piazza
- Department of Medicine, Division of Cardiology, McGill University, Montreal, QC, Canada
| | - Michele Pighi
- Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy
| | | | - Martijn van Mourik
- Department of Cardiology, Amsterdam UMC, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, Netherlands
| | | | - Robbert J. de Winter
- Department of Cardiology, Amsterdam UMC, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, Netherlands
| | - Pedro A. Lemos
- Heart Institute (InCor), University of São Paulo Medical School (USP), São Paulo, Brazil
| | - Fábio S. de Brito
- Heart Institute (InCor), University of São Paulo Medical School (USP), São Paulo, Brazil
| | - Hideyuki Kawashima
- Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan
| | - Lars Søndergaard
- The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Liesbeth Rosseel
- Department of Cardiology, Algemeen Stedelijk Ziekenhuis, Aalst, Belgium
| | - Rutao Wang
- Department of Cardiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Chao Gao
- Department of Cardiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Ling Tao
- Department of Cardiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Andreas Rück
- Department of Cardiology, Karolinska Institute, Stockholm, Sweden
| | - Won-Keun Kim
- Department of Cardiology, Kerckhoff Heart Centre, Bad Nauheim, Germany
| | - Niels van Royen
- Department of Cardiology, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Henrik Nissen
- Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - Matti Adam
- Department of Cardiology, Faculty of Medicine, Heart Center, University of Cologne, Cologne, Germany
| | - Tanja K. Rudolph
- Department for General and Interventional Cardiology/Angiology, Heart- und Diabetes Center NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany
| | - Hendrik Wienemann
- Department of Cardiology, Faculty of Medicine, Heart Center, University of Cologne, Cologne, Germany
| | - Ryo Torii
- Department of Mechanical Engineering, University College London, London, United Kingdom
| | - Franz Josef Neuman
- Division of Cardiology and Angiology II, University Heart Centre Freiburg—Bad Krozingen, Bad Krozingen, Germany
| | - Simon Schoechlin
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Mao Chen
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Ahmed Elkoumy
- Department of Cardiology, CORRIB Research Centre for Advanced Imaging and Core Laboratory, National University of Ireland, Galway (NUIG), Galway, Ireland
- Islamic Center of Cardiology and Cardiac Surgery, Al-Azhar University, Cairo, Egypt
| | - Hesham Elzomor
- Department of Cardiology, CORRIB Research Centre for Advanced Imaging and Core Laboratory, National University of Ireland, Galway (NUIG), Galway, Ireland
- Islamic Center of Cardiology and Cardiac Surgery, Al-Azhar University, Cairo, Egypt
| | | | - Darren Mylotte
- Department of Cardiology, CORRIB Research Centre for Advanced Imaging and Core Laboratory, National University of Ireland, Galway (NUIG), Galway, Ireland
| | - Osama Soliman
- Department of Cardiology, CORRIB Research Centre for Advanced Imaging and Core Laboratory, National University of Ireland, Galway (NUIG), Galway, Ireland
| | - Yoshinobu Onuma
- Department of Cardiology, CORRIB Research Centre for Advanced Imaging and Core Laboratory, National University of Ireland, Galway (NUIG), Galway, Ireland
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van Bergeijk K, Ginkel DJV, Voors A, Wykrzykowska J, Berg JT. TCT-561 Sex Differences in Bleeding and Ischemic Risks After Transcatheter Aortic Valve Implantation: A POPular TAVI Subanalysis. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.08.662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Armario X, Carron J, Abdel-Wahab M, Tchetche D, Bleiziffer S, Lefevre T, Modine T, Wolf A, Pilgrim T, Villablanca P, Cunnington M, Van Mieghem N, Hengstenberg C, Sondergaard L, Swaans M, Prendergast B, Barbanti M, Webb J, Uren N, Resar J, Chen M, Hildick-Smith D, Spence M, Zweiker D, Bagur R, de Cruz H, Ribichini F, Park DW, Codner P, Wykrzykowska J, Bunc M, Estevez-Loureiro R, Poon K, Götberg M, Ince H, Latib A, Packer E, Angelillis M, Kobari Y, Nombela-Franco L, Guo Y, Savontaus M, Arafat AA, Kliger C, Roy D, Merkely B, Silva M, White J, Yamamoto M, Ferreira PC, Toggweiler S, Ohno Y, Rodrigues I, Ojeda S, Voudris V, Grygier M, Almerri K, Cruz-Gonzalez I, Fridrich V, De la Torre Hernandez J, Piazza N, Noble S, Arzamendi D, İbrahim halil Kurt, Bosmans J, Erglis M, Casserly I, Sawaya F, Bhindi R, Kefer J, Yin WH, Rosseel L, Kim HS, O'Connor S, Hellig F, Sztejfman M, Mendiz O, Xuereb R, Brito Jr F, Bajoras V, Balghith M, Kang-Yin Lee M, Eid-Lidt G, Vandeloo B, Vaz V, Alasnag M, Ussia GP, Mayol J, Sardella G, Buddhari W, Kao HL, Dager A, Tzikas A, Edris A, Gutierrez L, Arias E, Erturk M, Conde Vela CN, Boljevic D, Guadagnoli AF, ElGuindy A, Santos L, Perez L, Maluenda G, Akyüz AR, Alhaddad I, Amin H, Yu SC, Alnooryani A, Albistur J, Nguyen Q, Mylotte D. TCT-549 Impact of COVID-19 Pandemic on TAVR Activity: A Worldwide Registry. J Am Coll Cardiol 2022. [PMCID: PMC9467506 DOI: 10.1016/j.jacc.2022.08.648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Renkens M, Kerkmeijer L, Kraak R, Grundeken M, Nassif M, Kalkman D, van der Schaaf R, Hofma S, Arkenbout K, Weevers A, Tijssen J, Koch K, Onuma Y, Serruys P, de Winter R, Wykrzykowska J, Tijssen R. TCT-60 The Impact of Implantation Techniques in Absorb BVS and Xience EES on Lesion-Oriented Outcomes at Complete 5-Year Follow-Up—An AIDA Trial QCA Substudy. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.08.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ninomiya K, Serruys PW, Garg S, Hara H, Masuda S, Kageyama S, Kotoku N, Sevestre E, Kumar A, O’Kane P, Zaman A, Farah B, Magro M, Oemrawsingh RM, Möllmann H, Meneveau N, Achenbach S, Lemoine J, Allali A, Gallagher S, Wykrzykowska J, Lesiak M, Silvestri M, Wijns W, Sharif F, Onuma Y. The Utility of the SYNTAX Score II and SYNTAX Score 2020 for Identifying Patients with Three-Vessel Disease Eligible for Percutaneous Coronary Intervention in the Multivessel TALENT Trial: A Prospective Pilot Experience. Rev Cardiovasc Med 2022. [DOI: 10.31083/j.rcm2304133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Hara H, Serruys PW, O'Leary N, Gao C, Murray A, Breslin E, Garg S, Bureau C, Reiber JH, Barbato E, Aminian A, Janssens L, Rosseel L, Benit E, Campo G, Guiducci V, Casella G, Santarelli A, Franzè A, Diaz VAJ, Iñiguez A, Brugaletta S, Sabate M, Amat-Santos IJ, Amoroso G, Wykrzykowska J, von Birgelen C, Somi S, Liu T, Hofma SH, Curzen N, Trillo R, Ocaranza R, Mathur A, Smits PC, Escaned J, Baumbach A, Wijns W, Sharif F, Onuma Y. Angiography-derived physiology guidance vs usual care in an All-comers PCI population treated with the healing-targeted supreme stent and Ticagrelor monotherapy: PIONEER IV trial design. Am Heart J 2022; 246:32-43. [PMID: 34990582 DOI: 10.1016/j.ahj.2021.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 12/29/2021] [Accepted: 12/30/2021] [Indexed: 11/13/2022]
Abstract
BACKGROUND Current ESC guidelines recommend the use of intra-coronary pressure guidewires for functional assessment of intermediate-grade coronary stenoses. Angiography-derived quantitative flow ratio (QFR) is a novel method of assessing these stenoses, and guiding percutaneous coronary intervention (PCI). METHODS/DESIGN The PIONEER IV trial is a prospective, all-comers, multi-center trial, which will randomize 2,540 patients in a 1:1 ratio to PCI guided by angiography-derived physiology or usual care, with unrestricted use in both arms of the Healing-Targeted Supreme sirolimus-eluting stent (HT Supreme). The stent's fast, biologically healthy, and robust endothelial coverage allows for short dual-antiplatelet therapy (DAPT); hence the antiplatelet regimen of choice is 1-month DAPT, followed by ticagrelor monotherapy. In the angiography-derived physiology guided arm, lesions will be functionally assessed using on-line QFR, with stenting indicated in lesions with a QFR ≤0.80. Post-stenting, QFR will be repeated in the stented vessel(s), with post-dilatation or additional stenting recommended if the QFR<0.91 distal to the stent, or if the delta QFR (across the stent) is >0.05. Usual care PCI is performed according to standard clinical practice. The primary endpoint is a non-inferiority comparison of the patient-oriented composite endpoint (POCE) of all-cause death, any stroke, any myocardial infarction, or any clinically, and physiologically driven revascularization with a non-inferiority risk-difference margin of 3.2%, at 1-year post-procedure. Clinical follow-up will be up to 3 years. SUMMARY The PIONEER IV trial aims to demonstrate non-inferiority of QFR-guided PCI to usual care PCI with respect to POCE at 1-year in patients treated with HT Supreme stents and ticagrelor monotherapy. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov UNIQUE IDENTIFIER: NCT04923191 CLASSIFICATIONS: Interventional Cardiology.
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Affiliation(s)
- Hironori Hara
- Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Department of Cardiology, National University of Ireland, Galway (NUIG), Galway, Ireland
| | - Patrick W Serruys
- Department of Cardiology, National University of Ireland, Galway (NUIG), Galway, Ireland; NHLI, Imperial College London, London, United Kingdom.
| | - Neil O'Leary
- CORRIB Research Centre, College of Medicine, Nursing and Health Sciences, National University of Ireland, Galway
| | - Chao Gao
- Department of Cardiology, National University of Ireland, Galway (NUIG), Galway, Ireland; Deparment of Cardiology. Radboudumc, Nijmegen, The Netherlands; Department of Cardiology, Xijing Hospital, Xi'an, China
| | - Alicia Murray
- CORRIB Research Centre, College of Medicine, Nursing and Health Sciences, National University of Ireland, Galway
| | - Elaine Breslin
- CORRIB Research Centre, College of Medicine, Nursing and Health Sciences, National University of Ireland, Galway
| | - Scot Garg
- Department of Cardiology, Royal Blackburn Hospital, Blackburn, United Kingdom
| | | | - Johan Hc Reiber
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Emanuele Barbato
- Cardiovascular Research Center Aalst, OLV-Clinic, Aalst, Belgium and Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Adel Aminian
- Department of Cardiology, Centre Hospitalier Universitaire de Charleroi, Charleroi, Belgium
| | - Luc Janssens
- Department of Cardiology, Imeldaziekenhuis, Bonheiden, Belgium
| | - Liesbeth Rosseel
- Department of Cardiology, Algemeen stedelijk ziekenhuis, Aalst, Belgium
| | - Edouard Benit
- Hartcentrum Jessa Ziekenhuis, Campus Virga Jesse, Hasselt, Belgium
| | - Gianluca Campo
- Cardiology Unit, Azienda Ospedaliera Universitaria di Ferrara, Cona, Italy
| | | | | | | | - Alfonso Franzè
- Interventional Cardiology Unit, San Luigi Gonzaga University Hospital (Orbassano) and Rivoli Infermi Hospital (Rivoli), Turin, Italy
| | | | - Andrés Iñiguez
- Department of Cardiology, Hospital Universitario de Vigo, Vigo, Spain; Department of Cardiology, Hospital Universitario Álvaro Cunqueiro, Vigo, Spain
| | - Salvatore Brugaletta
- Cardiology Department, Clinic Cardiovascular Institute, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, IDIBAPS, Barcelona, Spain
| | - Manel Sabate
- Cardiology Department, Clinic Cardiovascular Institute, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, IDIBAPS, Barcelona, Spain
| | | | | | - Joanna Wykrzykowska
- Department of Cardiology, University Medical Center Groningen, Groningen, the Netherlands
| | - Clemens von Birgelen
- Department of Cardiology, Medisch Spectrum Twente, Thoraxcentrum Twente, Enschede, the Netherlands; Department of Health Technology and Services Research, Faculty BMS, Technical Medical Centre, University of Twente
| | - Samer Somi
- Department of Cardiology, Haga Hospital, The Hague, the Netherlands
| | - Tommy Liu
- Department of Cardiology, Haga Hospital, The Hague, the Netherlands
| | - Sjoerd H Hofma
- Department of Cardiology, Medical Centre Leeuwarden, Leeuwarden, the Netherlands
| | - Nick Curzen
- Faculty of Medicine, University of Southampton, and University Hospital Southampton NHS Trust, Southampton, United Kingdom
| | - Ramiro Trillo
- Department of Cardiology, University Clinic Hospital, CIBERCV, Santiago de Compostela, Spain
| | - Raymundo Ocaranza
- Interventional Cardiology Section, Lucus Augusti University Hospital, Lugo, Spain
| | - Anthony Mathur
- Barts Interventional Group, Barts Heart Centre, Barts Health NHS Trust, London, UK; Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London
| | | | - Javier Escaned
- Hospital Clinico San Carlos IDISCC, Complutense University of Madrid, Madrid, Spain
| | - Andreas Baumbach
- Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London; Barts Heart Centre, London, United Kingdom; Yale University School of Medicine, New Haven, USA
| | - William Wijns
- The Lambe Institute for Translational Medicine and Curam, NUIG, Galway, Ireland
| | - Faisal Sharif
- Department of Cardiology, National University of Ireland, Galway (NUIG), Galway, Ireland; SFI infrastructure funding, NUIG, Galway, Ireland
| | - Yoshinobu Onuma
- Department of Cardiology, National University of Ireland, Galway (NUIG), Galway, Ireland
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8
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Kuku KO, Garcia-Garcia HM, Doros G, Mintz GS, Ali ZA, Singh S, Cate TT, Powers ER, Wong SC, Wykrzykowska J, Shah PR, Sum ST, Torguson R, Di Mario C, Waksman R. Two-year plaque level outcomes involving the left anterior descending artery: insights from the Lipid-Rich Plaque study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Coronary artery disease (CAD) is more frequently seen in the left anterior descending artery (LAD). LAD disease resulting in an acute anterior wall myocardial infarction (MI) is associated with a low left ventricular ejection fraction and invariably a worsened prognosis. The Lipid Rich Plaque (LRP) Study reported the strong association between NIRS-IVUS derived max4mmLCBI and future plaque events in non-culprit vessels.
Objective
To report the events involving the LAD versus the other major coronary vessels in the Lipid-Rich Plaque study.
Methods
The LRP Study was an international, multicenter, prospective cohort study conducted in patients with suspected CAD who underwent cardiac catheterization with possible ad hoc percutaneous coronary intervention (PCI) for an index event. Plaque level events within the subsequent 2 years were adjudicated. Plaque level events were defined as the composite of cardiac death, cardiac arrest, non-fatal MI, acute coronary syndrome (ACS), revascularization by coronary artery bypass grafting (CABG) or PCI, and rehospitalization for angina with >20% stenosis progression related and unrelated to the treatment at index procedure. All together these events were reported as Non-Culprit Lesion-related Major Adverse Cardiac Events (NC-MACE). Prespecified subgroups of segments were defined according to LAD (vs. non-LAD) with maxLCBI4mm ≤400 or >400.
Results
A total of 57 plaque events occurred through 2 years of follow-up. More than half occurred in the LAD, followed by the LCX and the RCA. There were more, albeit non-statistically significant, lipid-rich plaques in the LAD, compared to the LCX and RCA: 12.5% vs 10.4% and 11.3%, respectively, p=0.097. A minimum lumen area (MLA) ≤4mm2 within the maxLCBI4mm was observed more in the LAD and the LCX, compared to the RCA: 34.1% vs 25.9% vs 13.7%, respectively, p<0.001. Lipid rich plaque (maxLCBI4mm>400) was present in 20/57 (35.1%) of the plaque level events, a large PB (≥70%) was present in 6/57 (10.5%), and a small MLA (≤4mm2) was present in 26/57 (45.6%). Out of the 57 plaque level events, 4 (7%) had all three high risk plaque characteristics.
Presence of an elevated maxLCBI4mm (>400) was predictive of NC-MACE in all subgroups (for LAD >400 HR 4.32; 95% CI (1.93, 9.69; p 0.0004) and for the non-LAD >400 HR 2.56; 95% CI (1.06, 6.17; p 0.0354).
Conclusion
Non-culprit segments in the LAD with maxLCBI4mm values >400 were more frequently associated with plaque level events than in the lipid -rich segments in the other epicardial vessels. This sub-study results point to the unequivocal value of maxLCBI4mm>400 in predicting future plaque level events especially in the LAD.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Infraredx Plaque Events-Ware Segment Locations
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Affiliation(s)
- K O Kuku
- MedStar Health Research Institute, Cardiovascular Imaging, Washington DC, United States of America
| | - H M Garcia-Garcia
- Medstar Washington Hospital Centre, Interventional Cardiology, Washington, DC, United States of America
| | - G Doros
- Medstar Washington Hospital Centre, Interventional Cardiology, Washington, DC, United States of America
| | - G S Mintz
- Medstar Washington Hospital Centre, Interventional Cardiology, Washington, DC, United States of America
| | - Z A Ali
- Columbia University, Interventional Cardiology, New York, United States of America
| | - S Singh
- Long Island Jewish, Interventional Cardiology, New York, United States of America
| | - T T Cate
- University of Amsterdam, Cardiology, Amsterdam, Netherlands (The)
| | - E R Powers
- Medical University of South Carolina, Cardiology, Charleston, United States of America
| | - S C Wong
- Weill Cornell Medicine, Cardiology, New York, United States of America
| | - J Wykrzykowska
- University Medical Center Groningen, Cardiology, Groningen, Netherlands (The)
| | - P R Shah
- Infraredx, Boston, United States of America
| | - S T Sum
- Infraredx, Boston, United States of America
| | - R Torguson
- Icahn School of Medicine at Mount Sinai, Cardiology, New York, United States of America
| | - C Di Mario
- Royal Brompton Hospital, Cardiology, London, United Kingdom
| | - R Waksman
- Medstar Washington Hospital Centre, Interventional Cardiology, Washington, DC, United States of America
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9
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Kuku KO, Garcia-Garcia HM, Doros G, Mintz GS, Ali ZA, Skinner WH, Artis AK, Ten Cate T, Powers E, Wong SC, Wykrzykowska J, Dube S, Kazziha S, van der Ent M, Shah P, Sum S, Torguson R, Di Mario C, Waksman R. Predicting future left anterior descending artery events from non-culprit lesions: insights from the Lipid-Rich Plaque study. Eur Heart J Cardiovasc Imaging 2021; 23:1365-1372. [PMID: 34410335 DOI: 10.1093/ehjci/jeab160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 07/30/2021] [Indexed: 01/17/2023] Open
Abstract
AIMS The left anterior descending (LAD) artery is the most frequently affected site by coronary artery disease. The prospective Lipid Rich Plaque (LRP) study, which enrolled patients undergoing imaging of non-culprits followed over 2 years, reported the successful identification of coronary segments at risk of future events based on near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS) lipid signals. We aimed to characterize the plaque events involving the LAD vs. non-LAD segments. METHODS AND RESULTS LRP enrolled 1563 patients from 2014 to 2016. All adjudicated plaque events defined by the composite of cardiac death, cardiac arrest, non-fatal myocardial infarction, acute coronary syndrome, revascularization by coronary bypass or percutaneous coronary intervention, and rehospitalization for angina with >20% stenosis progression and reported as non-culprit lesion-related major adverse cardiac events (NC-MACE) were classified by NIRS-IVUS maxLCBI4 mm (maximum 4-mm Lipid Core Burden Index) ≤400 or >400 and association with high-risk-plaque characteristics, plaque burden ≥70%, and minimum lumen area (MLA) ≤4 mm2. Fifty-seven events were recorded with more lipid-rich plaques in the LAD vs. left circumflex and right coronary artery; 12.5% vs. 10.4% vs. 11.3%, P = 0.097. Unequivocally, a maxLCBI4 mm >400 in the LAD was more predictive of NC-MACE [hazard ratio (HR) 4.32, 95% confidence interval (CI) (1.93-9.69); P = 0.0004] vs. [HR 2.56, 95% CI (1.06-6.17); P = 0.0354] in non-LAD segments. MLA ≤4 mm2 within the maxLCBI4 mm was significantly higher in the LAD (34.1% vs. 25.9% vs. 13.7%, P < 0.001). CONCLUSION Non-culprit lipid-rich segments in the LAD were more frequently associated with plaque-level events. LAD NIRS-IVUS screening may help identify patients requiring intensive surveillance and medical treatment.
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Affiliation(s)
- Kayode O Kuku
- Section of Interventional Cardiology, Department of Cardiology, MedStar Washington Hospital Center, 110 Irving St NW, Suite 4B1, Washington, DC 20010, USA
| | - Hector M Garcia-Garcia
- Section of Interventional Cardiology, Department of Cardiology, MedStar Washington Hospital Center, 110 Irving St NW, Suite 4B1, Washington, DC 20010, USA
| | - Gheorghe Doros
- Section of Interventional Cardiology, Department of Cardiology, MedStar Washington Hospital Center, 110 Irving St NW, Suite 4B1, Washington, DC 20010, USA
| | - Gary S Mintz
- Section of Interventional Cardiology, Department of Cardiology, MedStar Washington Hospital Center, 110 Irving St NW, Suite 4B1, Washington, DC 20010, USA
| | - Ziad A Ali
- DeMatteis Cardiovascular Institute, Department of Cardiology, St. Francis Hospital & Heart Center, 100 Port Washington Blvd, Roslyn, NY 11576, USA
| | - William H Skinner
- Department of Cardiology, Baptist Health Lexington, 1740 Nicholasville Road, Lexington, KY 40503, USA
| | - Andre K Artis
- Department of Cardiology, Methodist Hospitals, 5800 Broadway, Merrillville, IN 46410, USA
| | - Tim Ten Cate
- Department of Cardiology, Radboud University Medical Centre, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, Netherlands
| | - Eric Powers
- Department of Cardiology, MUSCH Health, West Ashley Medical Pavilion, 2060 Sam Rittenberg Blvd., Charleston, SC 29407, USA
| | - Shing-Chiu Wong
- Department of Cardiology, New York-Presbyterian/Weill Cornell Medical Center, 20 E. 70th St., Starr Pavilion, 4th Floor, New York, NY 10021, USA
| | - Joanna Wykrzykowska
- Department of Cardiology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands.,Department of Cardiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, Netherlands
| | - Sandeep Dube
- Department of Cardiology, Community Heart and Vascular Care, 8075 N. Shadeland Ave., Suite 200, Indianapolis, IN 46250, USA
| | - Samer Kazziha
- Department of Cardiology, Henry Ford Macomb Hospital, 15855 19 Mile Rd, Clinton Twp, MI 48038, USA
| | - Martin van der Ent
- Department of Cardiology, Maasstad Ziekenhuis, Maasstadweg 21, 3079 DZ Rotterdam, Netherlands
| | - Priti Shah
- Department of Clinical Research and Regulatory, Infraredx, Inc., 28 Crosby Dr., Bedford, MA 01730, USA
| | - Stephen Sum
- Department of Clinical Research and Regulatory, Infraredx, Inc., 28 Crosby Dr., Bedford, MA 01730, USA
| | - Rebecca Torguson
- Department of Medicine, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA
| | - Carlo Di Mario
- Structural Interventional Cardiology, Department of Clinical and Experimental Medicine, Careggi University Hospital, Largo Giovanni Alessandro Brambilla, 3, 50134 Firenze FI, Italy
| | - Ron Waksman
- Section of Interventional Cardiology, Department of Cardiology, MedStar Washington Hospital Center, 110 Irving St NW, Suite 4B1, Washington, DC 20010, USA
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10
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Kerkmeijer LS, Tijssen R, Hofma S, van der Schaaf R, Arkenbout EK, Weevers A, Garcia-Garcia H, McFadden E, Piek J, de Winter R, Tijssen J, Henriques J, Wykrzykowska J. Four-Year Follow-Up of Absorb BVS Compared to Xience EES in Daily Clinical Practice Shows Continued Accrual of Events. Cardiovascular Revascularization Medicine 2021. [DOI: 10.1016/j.carrev.2021.06.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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11
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Lansky AJ, Kereiakes DJ, Baumbach A, Windecker S, Hussain Y, Pietras C, Dressler O, Issever O, Curtis M, Bertolet B, Zidar JP, Smits PC, Alfonso Jiménez Díaz V, McLaurin B, Hofma S, Cequier Á, Dib N, Benit E, Mathur A, Brogno D, Berland J, Wykrzykowska J, Piegari G, Brugaletta S, Saito S, Leon MB. Novel Supreme Drug-Eluting Stents With Early Synchronized Antiproliferative Drug Delivery to Inhibit Smooth Muscle Cell Proliferation After Drug-Eluting Stents Implantation in Coronary Artery Disease: Results of the PIONEER III Randomized Clinical Trial. Circulation 2021; 143:2143-2154. [PMID: 33820424 DOI: 10.1161/circulationaha.120.052482] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Accelerated endothelial healing after targeted antiproliferative drug delivery may limit the long-term inflammatory response of drug-eluting stents (DESs). The novel Supreme DES is designed to synchronize early drug delivery within 4 to 6 weeks of implantation, leaving behind a prohealing permanent base layer. Whether the Supreme DES is safe and effective in the short term and can improve long-term clinical outcomes is not known. METHODS In an international, 2:1 randomized, single-blind trial, we compared treatment with Supreme DES to durable polymer everolimus-eluting stents (DP-EES) in patients with acute and chronic coronary syndromes. The primary end point was target lesion failure-a composite of cardiac death, target vessel myocardial infarction, or clinically driven target lesion revascularization. The trial was designed to demonstrate noninferiority (margin of 3.58%) of the Supreme DES at 12 months compared with DP-EES (URL: https://www.clinicaltrials.gov; Unique identifier: NCT03168776). RESULTS From October 2017 to July 2019, a total of 1629 patients were randomly assigned (2:1) to the Supreme DES (N=1086) or DP-EES (N=543). At 12 months, target lesion failure occurred in 57 of 1057 patients (5.4%) in the Supreme DES group and in 27 of 532 patients (5.1%) in the DP-EES group (absolute risk difference, 0.32% [95% CI, -1.87 to 2.5]; Pnoninferiority=0.002]. There were no significant differences in rates of device success, clinically driven target lesion revascularization, or stent thrombosis at 12 months, and the safety composite of cardiovascular death and target vessel myocardial infarction was 3.5% versus 4.6% (hazard ratio, 0.76 [95% CI, 0.46-1.25]) with Supreme DES compared with DP-EES, although rates of combined clinically and non-clinically driven target lesion revascularization at 12 months were higher with Supreme DES. CONCLUSIONS Among patients with acute and chronic coronary syndromes undergoing percutaneous coronary intervention, the Supreme DES proved to be noninferior to the standard DP-EES. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03168776.
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Affiliation(s)
- Alexandra J Lansky
- Division of Cardiology, Yale School of Medicine, New Haven, CT (A.J.L., A.B., Y.H., C.P., A.M.).,Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London and Barts Heart Centre, London, United Kingdom (A.J.L., A.B., A.M.)
| | - Dean J Kereiakes
- Christ Hospital Heart and Vascular Center, Cincinnati, OH (D.J.K.)
| | - Andreas Baumbach
- Division of Cardiology, Yale School of Medicine, New Haven, CT (A.J.L., A.B., Y.H., C.P., A.M.).,Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London and Barts Heart Centre, London, United Kingdom (A.J.L., A.B., A.M.)
| | - Stephan Windecker
- Department of Cardiology, Bern University Hospital, Inselspital, University of Bern, Switzerland (S.W.)
| | - Yasin Hussain
- Division of Cardiology, Yale School of Medicine, New Haven, CT (A.J.L., A.B., Y.H., C.P., A.M.)
| | - Cody Pietras
- Division of Cardiology, Yale School of Medicine, New Haven, CT (A.J.L., A.B., Y.H., C.P., A.M.)
| | - Ovidiu Dressler
- Cardiovascular Research Foundation, New York, NY (O.D., O.I., M.B.L.)
| | - Ozgu Issever
- Cardiovascular Research Foundation, New York, NY (O.D., O.I., M.B.L.)
| | | | - Barry Bertolet
- Cardiology Associates of North Mississippi, Tupelo (B.B.)
| | - James P Zidar
- North Carolina Heart and Vascular, University of North Carolina, Raleigh (J.P.Z.)
| | - Pieter C Smits
- Maasstad Ziekenhuis, Rotterdam, The Netherlands (P.C.S.)
| | | | | | - Sjoerd Hofma
- Medisch Centrum Leeuwarden, Hartcentrum Friesland, Leeuwarden, The etherlands (S.H.)
| | - Ángel Cequier
- Bellvitge Hospital, University of Barcelona, IDIBELL, Spain (A.C.)
| | - Nabil Dib
- Mercy Gilbert Medical Center, Gilbert, AZ (N.D.)
| | - Edouard Benit
- Jessa Ziekenhuis, Campus Virga Jesse, Hasselt, Belgium (E.B.)
| | - Anthony Mathur
- Division of Cardiology, Yale School of Medicine, New Haven, CT (A.J.L., A.B., Y.H., C.P., A.M.).,Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London and Barts Heart Centre, London, United Kingdom (A.J.L., A.B., A.M.)
| | - David Brogno
- College of Physicians and Surgeons, Columbia University, New York, NY (D.B., M.B.L.)
| | | | - Joanna Wykrzykowska
- Academic Medical Center, University of Amsterdam, The Netherlands (J.W.).,Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands (J.W.)
| | - Guy Piegari
- Penn State Health Medical Group-Berks Cardiologists, Wyomissing, PA (G.P.)
| | - Salvatore Brugaletta
- Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Spain (S.B.)
| | - Shigeru Saito
- Shonan Kamakura General Hospital, Kamakura, Japan (S.S.)
| | - Martin B Leon
- Cardiovascular Research Foundation, New York, NY (O.D., O.I., M.B.L.).,College of Physicians and Surgeons, Columbia University, New York, NY (D.B., M.B.L.)
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12
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Modolo R, van Mourik M, El Bouziani A, Kawashima H, Rosseel L, Abdelghani M, Aben JP, Slots T, Sahyoun C, Baan J, Henriques JPS, Koch KT, Vis M, Soliman O, Onuma Y, Wykrzykowska J, de Winter R, Serruys PW. Online Quantitative Aortographic Assessment of Aortic Regurgitation After TAVR: Results of the OVAL Study. JACC Cardiovasc Interv 2021; 14:531-538. [PMID: 33582086 DOI: 10.1016/j.jcin.2020.11.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 11/04/2020] [Accepted: 11/10/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the online assessment feasibility of aortography using videodensitometry in the catheterization laboratory during transcatheter aortic valve replacement (TAVR). BACKGROUND Quantitative assessment of regurgitation after TAVR through aortography using videodensitometry is simple, reproducible, and validated in vitro, in vivo, in clinical trials, and in "real-world" patients. However, thus far the assessment has been done offline. METHODS This was a single center, prospective, proof-of-principle, feasibility study. One hundred consecutive patients with aortic stenosis and indications to undergo TAVR were enrolled. All final aortograms were analyzed immediately after acquisition in the catheterization laboratory and were also sent to an independent core laboratory for blinded offline assessment. The primary endpoint of the study was the feasibility of the online assessment of regurgitation (percentage of analyzable cases). The secondary endpoint was the reproducibility of results between the online assessment and the offline analysis by the core laboratory. RESULTS Patients' mean age was 81 ± 7 years, and 56% were men. The implanted valves were either SAPIEN 3 (97%) or SAPIEN 3 Ultra (3%). The primary endpoint of online feasibility of analysis was 92% (95% confidence interval [CI]: 86% to 97%) which was the same feasibility encountered by the core laboratory (92%; 95% CI: 86% to 97%). Reproducibility assessment showed a high correlation between online and core laboratory evaluations (R2 = 0.87, p < 0.001), with an intraclass correlation coefficient of 0.962 (95% CI: 0.942 to 0.975; p < 0.001). CONCLUSIONS This study showed high feasibility of online quantitative assessment of regurgitation and high agreement between the online examiner and core laboratory. These results may pave the way for the application of videodensitometry in the catheterization laboratory after TAVR. (Online Videodensitometric Assessment of Aortic Regurgitation in the Cath-Lab [OVAL]; NCT04047082).
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Affiliation(s)
- Rodrigo Modolo
- Department of Cardiology, Amsterdam UMC, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, the Netherlands; Department of Internal Medicine, Cardiology Division, University of Campinas, Campinas, Brazil; Department of Cardiology, Hospital Vera Cruz de Campinas, Campinas, Brazil
| | - Martijn van Mourik
- Department of Cardiology, Amsterdam UMC, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, the Netherlands
| | - Abdelhak El Bouziani
- Department of Cardiology, Amsterdam UMC, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, the Netherlands
| | - Hideyuki Kawashima
- Department of Cardiology, Amsterdam UMC, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, the Netherlands; Department of Cardiology, National University of Ireland, Galway, Galway, Ireland
| | - Liesbeth Rosseel
- Department of Cardiology, National University of Ireland, Galway, Galway, Ireland
| | - Mohammad Abdelghani
- Department of Cardiology, Amsterdam UMC, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, the Netherlands; Department of Cardiology, Al-Azhar University, Cairo, Egypt
| | | | | | | | - Jan Baan
- Department of Cardiology, Amsterdam UMC, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, the Netherlands
| | - Jose P S Henriques
- Department of Cardiology, Amsterdam UMC, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, the Netherlands
| | - Karel T Koch
- Department of Cardiology, Amsterdam UMC, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, the Netherlands
| | - Marije Vis
- Department of Cardiology, Amsterdam UMC, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, the Netherlands
| | - Osama Soliman
- Department of Cardiology, National University of Ireland, Galway, Galway, Ireland
| | - Yoshinobu Onuma
- Department of Cardiology, National University of Ireland, Galway, Galway, Ireland
| | - Joanna Wykrzykowska
- Department of Cardiology, Amsterdam UMC, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, the Netherlands
| | - Robbert de Winter
- Department of Cardiology, Amsterdam UMC, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, the Netherlands
| | - Patrick W Serruys
- Department of Cardiology, National University of Ireland, Galway, Galway, Ireland; Department of Cardiology, Imperial College of London, London, United Kingdom.
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13
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Chichareon P, Modolo R, Kerkmeijer L, Tomaniak M, Kogame N, Takahashi K, Chang CC, Komiyama H, Moccetti T, Talwar S, Colombo A, Maillard L, Barlis P, Wykrzykowska J, Piek JJ, Garg S, Hamm C, Steg PG, Jüni P, Valgimigli M, Windecker S, Onuma Y, Mehran R, Serruys PW. Association of Sex With Outcomes in Patients Undergoing Percutaneous Coronary Intervention: A Subgroup Analysis of the GLOBAL LEADERS Randomized Clinical Trial. JAMA Cardiol 2021; 5:21-29. [PMID: 31693078 DOI: 10.1001/jamacardio.2019.4296] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Importance Women experience worse ischemic and bleeding outcomes after percutaneous coronary intervention (PCI). Objectives To assess the association of sex with patient outcomes at 2 years after contemporary PCI and with the efficacy and safety of 2 antiplatelet strategies. Design, Setting, and Participants This study is a prespecified subgroup analysis of the investigator-initiated, prospective, randomized GLOBAL LEADERS study evaluating 2 strategies of antiplatelet therapy after PCI in an unselected population including 130 secondary/tertiary care hospitals in different countries. The main study enrolled 15 991 unselected patients undergoing PCI between July 2013 and November 2015. Patients had an outpatient clinic visit at 30 days and 3, 6, 12, 18, and 24 months after the index procedure. Data were analyzed between January 1, 2019, and March 31, 2019. Interventions Eligible patients were randomized to either the experimental or reference antiplatelet strategy. Experimental strategy consisted of 1 month of dual antiplatelet therapy (DAPT) followed by 23 months of ticagrelor monotherapy, while the reference strategy comprised of 12 months of DAPT followed by 12 months of aspirin monotherapy. Main Outcomes and Measures The primary efficacy end point was the composite of all-cause mortality and new Q-wave myocardial infarction at 2 years. The secondary safety end point was Bleeding Academic Research Consortium type 3 or 5 bleeding. Results Of the 15 968 patients included in this study, 3714 (23.3%) were women. The risk of the primary end point at 2 years was similar between women and men (adjusted hazard ratio [HR], 1.00; 95% CI, 0.83-1.20). Compared with men, women had higher risk of Bleeding Academic Research Consortium type 3 or 5 bleeding (adjusted HR, 1.32; 95% CI, 1.04-1.67) and hemorrhagic stroke at 2 years (adjusted HR, 4.76; 95% CI, 1.92-11.81). At 2 years, there was no between-sex difference in the efficacy and safety of the 2 antiplatelet strategies. At 1 year, compared with DAPT, ticagrelor monotherapy was associated with a lower risk of bleeding in men (HR, 0.72; 95% CI, 0.53-0.98) but not in women (HR, 1.23; 95% CI, 0.80-1.89; P for interaction = .045). Conclusions and Relevance Compared with men, women experienced a higher risk of bleeding and hemorrhagic stroke after PCI. The effect of 2 antiplatelet strategies on death and Q-wave myocardial infarction following PCI did not differ between the sexes at 2 years. Trial Registration ClinicalTrials.gov identifier: NCT01813435.
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Affiliation(s)
- Ply Chichareon
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,Cardiology Unit, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Rodrigo Modolo
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,Cardiology Division, Department of Internal Medicine, University of Campinas, Campinas, Brazil
| | - Laura Kerkmeijer
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Mariusz Tomaniak
- Erasmus Medical Center, Erasmus University, Rotterdam, the Netherlands.,First Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Norihiro Kogame
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Kuniaki Takahashi
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Chun-Chin Chang
- Erasmus Medical Center, Erasmus University, Rotterdam, the Netherlands
| | - Hidenori Komiyama
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Tiziano Moccetti
- Department of Cardiology, Fondazione Cardiocentro Ticino, Lugano, Switzerland
| | - Suneel Talwar
- Royal Bournemouth and Christchurch National Health Services Trust, Bournemouth, England
| | - Antonio Colombo
- Division of Interventional Cardiology, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy
| | | | - Peter Barlis
- St Vincent's and Northern Hospitals, Melbourne Medical School, The University of Melbourne, Victoria, Australia
| | - Joanna Wykrzykowska
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Jan J Piek
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Scot Garg
- East Lancashire Hospitals National Health Services Trust, Blackburn, Lancashire, England
| | - Christian Hamm
- Kerckhoff Heart Center, Campus University of Giessen, Bad Nauheim, Germany
| | - Philippe Gabriel Steg
- French Alliance for Cardiovascular Trials; Hôpital Bichat, AP-HP; Université Paris-Diderot; INSERM U-1148; Paris, France.,Royal Brompton Hospital, Imperial College, London, England
| | - Peter Jüni
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, Department of Medicine, University of Toronto, Toronto, Canada
| | - Marco Valgimigli
- Department of Cardiology, Bern University Hospital, Bern, Switzerland
| | - Stephan Windecker
- Department of Cardiology, Bern University Hospital, Bern, Switzerland
| | - Yoshinobu Onuma
- Erasmus Medical Center, Erasmus University, Rotterdam, the Netherlands.,Cardialysis Clinical Trials Management and Core Laboratories, Westblaak 98, Rotterdam, the Netherlands
| | - Roxana Mehran
- Interventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Patrick W Serruys
- National Heart and Lung Institute, Imperial College London, London, England
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14
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Kawashima H, Tomaniak M, Ono M, Wang R, Hara H, Gao C, Takahashi K, Sharif F, Thury A, Suryapranata H, Walsh S, Cotton J, Carrie D, Sabate M, Steinwender C, Leibundgut G, Wykrzykowska J, de Winter RJ, Garg S, Hamm C, Steg PG, Jüni P, Vranckx P, Valgimigli M, Windecker S, Onuma Y, Serruys PW. Safety and Efficacy of 1-Month Dual Antiplatelet Therapy (Ticagrelor + Aspirin) Followed by 23-Month Ticagrelor Monotherapy in Patients Undergoing Staged Percutaneous Coronary Intervention (A Sub-Study from GLOBAL LEADERS). Am J Cardiol 2021; 138:1-10. [PMID: 33065080 DOI: 10.1016/j.amjcard.2020.09.057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/23/2020] [Accepted: 09/28/2020] [Indexed: 12/18/2022]
Abstract
Patients undergoing staged percutaneous coronary intervention (SPCI) are exposed to extended duration of antiplatelet therapy, and a novel aspirin-free antiplatelet regimen after SPCI should be specifically evaluated among these patients. This is a prespecified substudy of the GLOBAL LEADERS which is a randomized, open-label trial, comparing an experimental regimen of 1-month dual antiplatelet therapy (DAPT; ticagrelor and aspirin) followed by 23-month ticagrelor monotherapy to a reference regimen of 12-month DAPT followed by 12-month aspirin monotherapy. Patients were stratified according to whether or not SPCI was performed. The impact of the timing of SPCI on clinical outcomes was also investigated. Of 15,968 randomized patients, 1,651 patients underwent SPCI within 3 months. These patients with SPCI had a significantly higher risk of bleeding and ischemic endpoints than those without SPCI. In patients undergoing SPCI, the primary endpoint (composite of all-cause death or new Q-wave myocardial infarction at 2 years) and secondary safety endpoint (Bleeding Academic Research Consortium [BARC]-defined bleeding 3 or 5) were similar in the 2 regimens. However, in patients presenting with acute coronary syndrome (ACS), the experimental regimen reduced a risk of BARC 3 or 5 bleeding (1.8% vs 4.5%; HR 0.387; 95% CI 0.179 to 0.836; p = 0.016). In patients undergoing SPCI later than 10 days after index procedure, this risk reduction was still prominent (0.8% vs 2.3%; HR 0.321; 95% CI 0.116 to 0.891; p = 0.029). In conclusion, patients undergoing SPCI are at high risk and may need special attention from clinicians. In ACS patients undergoing SPCI, a novel aspirin-free antiplatelet regimen appears to be associated with a lower bleeding risk than with standard DAPT.
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15
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Kawashima H, Hara H, Wang R, Ono M, Gao C, Takahashi K, Suryapranata H, Walsh S, Cotton J, Carrie D, Sabate M, Steinwender C, Leibundgut G, Wykrzykowska J, Hamm C, Jüni P, Vranckx P, Valgimigli M, Windecker S, Winter RJ, Sharif F, Onuma Y, Serruys PW. Usefulness of updated logistic clinical SYNTAX score based on MI‐SYNTAX score in patients with ST‐elevation myocardial infarction. Catheter Cardiovasc Interv 2020; 97:E919-E928. [DOI: 10.1002/ccd.29383] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 10/07/2020] [Accepted: 10/22/2020] [Indexed: 11/07/2022]
Affiliation(s)
- Hideyuki Kawashima
- Heart Center; Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences Amsterdam UMC, University of Amsterdam Amsterdam Netherlands
- Department of Cardiology National University of Ireland, Galway (NUIG) Galway Ireland
| | - Hironori Hara
- Heart Center; Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences Amsterdam UMC, University of Amsterdam Amsterdam Netherlands
- Department of Cardiology National University of Ireland, Galway (NUIG) Galway Ireland
| | - Rutao Wang
- Department of Cardiology National University of Ireland, Galway (NUIG) Galway Ireland
- Department of Cardiology Radboudumc Nijmegen Netherlands
| | - Masafumi Ono
- Heart Center; Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences Amsterdam UMC, University of Amsterdam Amsterdam Netherlands
- Department of Cardiology National University of Ireland, Galway (NUIG) Galway Ireland
| | - Chao Gao
- Department of Cardiology National University of Ireland, Galway (NUIG) Galway Ireland
- Department of Cardiology Radboudumc Nijmegen Netherlands
| | - Kuniaki Takahashi
- Heart Center; Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences Amsterdam UMC, University of Amsterdam Amsterdam Netherlands
| | | | - Simon Walsh
- Department of Cardiology Belfast Health and Social Care Trust Belfast UK
| | - James Cotton
- Heart and Lung Centre New Cross Hospital Wolverhampton UK
| | - Didier Carrie
- Department of Cardiology, Rangueil hospital Paul Sabatier University Toulouse 3 Toulouse France
| | | | - Clemens Steinwender
- Department of Cardiology Kepler University Hospital Linz Medical Faculty Johannes Kepler University Linz Linz Austria
| | - Gregor Leibundgut
- Department of Cardiology Kantonsspital Baselland, Standort Liestal Liestal Switzerland
| | | | - Christian Hamm
- Kerckhoff Heart Center Campus University of Giessen Bad Nauheim Germany
| | - Peter Jüni
- Université Paris‐Diderot, Hôpital Bichat Assistance Publique–Hôpitaux de Paris, INSERM U‐1148, FACT (French Alliance for Cardiovascular Trials) Paris France
| | - Pascal Vranckx
- Jessa Ziekenhuis Faculty of Medicine and Life Sciences at the Hasselt University Hasselt Belgium
| | - Marco Valgimigli
- Department of Cardiology, Bern University Hospital, Inselspital University of Bern Bern Switzerland
| | - Stephan Windecker
- Department of Cardiology, Bern University Hospital, Inselspital University of Bern Bern Switzerland
| | - Robbert J. Winter
- Heart Center; Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences Amsterdam UMC, University of Amsterdam Amsterdam Netherlands
| | - Faisal Sharif
- Department of Cardiology National University of Ireland, Galway (NUIG) Galway Ireland
| | - Yoshinobu Onuma
- Department of Cardiology National University of Ireland, Galway (NUIG) Galway Ireland
| | - Patrick W. Serruys
- Department of Cardiology National University of Ireland, Galway (NUIG) Galway Ireland
- NHLI Imperial College London London UK
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16
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Chichareon P, Modolo R, Kawashima H, Takahashi K, Kogame N, Chang CC, Tomaniak M, Ono M, Walsh S, Suryapranata H, Cotton J, Koning R, Akin I, Kukreja N, Wykrzykowska J, Piek JJ, Garg S, Hamm C, Steg PG, Jüni P, Vranckx P, Valgimigli M, Windecker S, Onuma Y, Serruys PW. DAPT Score and the Impact of Ticagrelor Monotherapy During the Second Year After PCI. JACC Cardiovasc Interv 2020; 13:634-646. [PMID: 32139222 DOI: 10.1016/j.jcin.2019.12.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 12/01/2019] [Accepted: 12/11/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study assessed the ability of the dual-antiplatelet therapy (DAPT) score in stratifying ischemic and bleeding risk in a contemporary percutaneous coronary intervention (PCI) population. BACKGROUND The DAPT score is recommended by guidelines as a tool to stratify ischemic and bleeding risk. Its utility in contemporary PCI is unknown. METHODS The study studied patients in GLOBAL LEADERS (A Clinical Study Comparing Two Forms of Anti-platelet Therapy After Stent Implantation) who were free of major ischemic and bleeding events and adhered to antiplatelet strategy during the first year after PCI. The primary ischemic endpoint was the composite of myocardial infarction or stent thrombosis. The primary bleeding endpoint was Bleeding Academic Research Consortium type 3 or 5. Outcomes from 12 to 24 months after PCI were compared according to the DAPT score. RESULTS Of 11,289 patients that were event-free after the first year, 6,882 and 4,407 patients had low (<2) and high (≥2) DAPT scores, respectively. Compared with a low DAPT score, patients with a high DAPT score had a higher rate of the composites of myocardial infarction or stent thrombosis (0.70% vs. 1.55%; p < 0.0001). The rate of Bleeding Academic Research Consortium type 3 or 5 bleeding was 0.54% and 0.30% in the low and high DAPT score groups, respectively (p = 0.058). The effect of ticagrelor versus aspirin monotherapy on primary ischemic and bleeding endpoints during the second year were no different among the 2 groups. CONCLUSIONS The DAPT score can stratify ischemic but not bleeding risk in a contemporary PCI population during the second year. The score did not provide additional value for selection of antiplatelet strategy beyond the first year.
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Affiliation(s)
- Ply Chichareon
- Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Heart Center, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Cardiology Unit, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Rodrigo Modolo
- Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Heart Center, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Department of Internal Medicine, Cardiology Division, University of Campinas, Campinas, Brazil
| | - Hideyuki Kawashima
- Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Heart Center, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Kuniaki Takahashi
- Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Heart Center, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Norihiro Kogame
- Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Heart Center, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Chun-Chin Chang
- Department of Interventional Cardiology, Erasmus Medical Center, Erasmus University, Rotterdam, the Netherlands
| | - Mariusz Tomaniak
- Department of Interventional Cardiology, Erasmus Medical Center, Erasmus University, Rotterdam, the Netherlands; First Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Masafumi Ono
- Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Heart Center, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Simon Walsh
- Department of Cardiology, Belfast Health and Social Care Trust, Belfast, United Kingdom
| | - Harry Suryapranata
- Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - James Cotton
- Department of Cardiology, Heart and Lung Centre, New Cross Hospital, Wolverhampton, United Kingdom
| | - Rene Koning
- Cardiology Service, Clinique Saint-Hilaire, Rouen, France
| | - Ibrahim Akin
- First Department of Medicine, University Medical Centre Mannheim, Faculty of Medicine Mannheim, University of Heidelberg, European Center for AngioScience and German Center for Cardiovascular Research Partner Site Heidelberg/Mannheim, Mannheim, Germany
| | - Neville Kukreja
- Department of Cardiology, East and North Hertfordshire NHS Trust, Hertfordshire, United Kingdom
| | - Joanna Wykrzykowska
- Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Heart Center, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Jan J Piek
- Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Heart Center, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Scot Garg
- Department of Cardiology, East Lancashire Hospitals NHS Trust, Blackburn, Lancashire, United Kingdom
| | - Christian Hamm
- Kerckhoff Heart Center, University of Giessen, Bad Nauheim, Germany
| | - Philippe Gabriel Steg
- French Alliance for Cardiovascular Trials, INSERM U-1148, Hôpital Bichat, Université Paris-Diderot, Assistance Publique-Hôpitaux de Paris, Paris, France; Imperial College and the Institute of Cardiovascular Medicine and Science, National Heart and Lung Institute, Royal Brompton Hospital, London, United Kingdom
| | - Peter Jüni
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Pascal Vranckx
- Department of Cardiology and Critical Care Medicine, Hartcentrum Hasselt, Jessa Ziekenhuis, Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Marco Valgimigli
- Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Stephan Windecker
- Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Yoshinobu Onuma
- Department of Cardiology, National University of Ireland, Galway, Galway, Ireland
| | - Patrick W Serruys
- Department of Cardiology, National University of Ireland, Galway, Galway, Ireland; International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom.
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17
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Kawashima H, Gao C, Takahashi K, Tomaniak M, Ono M, Hara H, Wang R, Chichareon P, Suryapranata H, Walsh S, Cotton J, Koning R, Rensing B, Wykrzykowska J, de Winter RJ, Garg S, Anderson R, Hamm C, Steg PG, Onuma Y, Serruys PW. Comparative Assessment of Predictive Performance of PRECISE-DAPT, CRUSADE, and ACUITY Scores in Risk Stratifying 30-Day Bleeding Events. Thromb Haemost 2020; 120:1087-1095. [PMID: 32572864 PMCID: PMC8289707 DOI: 10.1055/s-0040-1712449] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background
The utility of the PRECISE-DAPT score in predicting short-term major bleeding, either alone, or in comparison with the CRUSADE and ACUITY scores, has not been investigated. This analysis compared the predictive performances of the three bleeding scores in stratifying the risk of 30-day major bleeding postpercutaneous coronary intervention in patients with dual-antiplatelet therapy.
Methods
In this post hoc subanalysis of the GLOBAL LEADERS trial, the primary safety objective (bleeding according to the Bleeding Academic Research Consortium [BARC] criteria [type 3 or 5]) was assessed at 30 days according to the three scores in the overall population, and in patients with acute (ACS) and chronic coronary syndrome (CCS).
Results
In a total of 15,968 patients, we calculated all three scores in 14,709 (92.1%). Irrespective of clinical presentation, the PRECISE-DAPT (
c
-statistics: 0.648, 0.653, and 0.641, respectively), CRUSADE (
c
-statistics: 0.641, 0.639, and 0.644, respectively), and ACUITY (
c
-statistics: 0.633, 0.638, and 0.623, respectively) scores were no significant between-score differences in discriminatory performance for BARC 3 or 5 bleeding up to 30 days, and similarly the PRECISE-DAPT score had a comparable discriminative capacity according to the integrated discrimination improvement when compared with the other scores. In ACS, the CRUSADE score had a poor calibration ability (Hosmer–Lemeshow goodness-of-fit [GOF] chi-square = 15.561,
p
= 0.049), whereas in CCS, the PRECISE-DAPT score had poor calibration (GOF chi-square = 15.758,
p
= 0.046).
Conclusion
The PRECISE-DAPT score might be clinically useful in the overall population and ACS patients for the prediction of short-term major bleeding considering its discriminative and calibration abilities.
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Affiliation(s)
- Hideyuki Kawashima
- Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Heart Center, Amsterdam, The Netherlands.,Department of Cardiology, National University of Ireland, Galway (NUIG), Galway, Ireland
| | - Chao Gao
- Department of Cardiology, National University of Ireland, Galway (NUIG), Galway, Ireland.,Department of Cardiology, Radboudumc, Nijmegen, The Netherlands
| | - Kuniaki Takahashi
- Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Heart Center, Amsterdam, The Netherlands
| | - Mariusz Tomaniak
- First Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Masafumi Ono
- Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Heart Center, Amsterdam, The Netherlands.,Department of Cardiology, National University of Ireland, Galway (NUIG), Galway, Ireland
| | - Hironori Hara
- Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Heart Center, Amsterdam, The Netherlands
| | - Rutao Wang
- Department of Cardiology, National University of Ireland, Galway (NUIG), Galway, Ireland.,Department of Cardiology, Radboudumc, Nijmegen, The Netherlands
| | - Ply Chichareon
- Cardiology Unit, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | | | - Simon Walsh
- Department of Cardiology, Belfast Health and Social Care Trust, Belfast, United Kingdom
| | - James Cotton
- Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom
| | | | - Benno Rensing
- Sint-Antonius Ziekenhuis, Nieuwegein, The Netherlands
| | - Joanna Wykrzykowska
- Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Heart Center, Amsterdam, The Netherlands
| | - Robbert J de Winter
- Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Heart Center, Amsterdam, The Netherlands
| | - Scot Garg
- East Lancashire Hospitals NHS Trust, Blackburn, Lancashire, United Kingdom
| | | | - Christian Hamm
- Kerckhoff Heart Center, Campus University of Giessen, Bad Nauheim, Germany
| | - Philippe Gabriel Steg
- Assistance Publique-Hôpitaux de Paris, INSERM U-1148, FACT (French Alliance for Cardiovascular Trials), Hôpital Bichat, Université de Paris, Paris, France.,Royal Brompton Hospital, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Yoshinobu Onuma
- Department of Cardiology, National University of Ireland, Galway (NUIG), Galway, Ireland
| | - Patrick W Serruys
- Department of Cardiology, National University of Ireland, Galway (NUIG), Galway, Ireland.,NHLI, Imperial College London, London, United Kingdom
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18
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Modolo RGP, Chang CC, Kawashima H, Ono M, Tateishi H, Miyazaki Y, Pighi M, Abdelghani M, Wykrzykowska J, de Winter R, Ruck A, Chieffo A, Yamaji K, Brito FS, Lemos PA, Al-Kassou B, Piazza N, Tchetche D, Sinning JM, Abdel-Wahab M, Soliman O, Sondergaard L, Onuma Y, Van Mieghem N, Serruys P. QUANTITATIVE ASSESSMENT OF ACUTE REGURGITATION FOLLOWING TRANSCATHETER AORTIC VALVE IMPLANTATION: A MULTICENTER POOLED ANALYSIS OF 2,258 VALVES. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)32741-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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19
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Waksman R, Di Mario C, Torguson R, Ali ZA, Singh V, Skinner WH, Artis AK, Cate TT, Powers E, Kim C, Regar E, Wong SC, Lewis S, Wykrzykowska J, Dube S, Kazziha S, van der Ent M, Shah P, Craig PE, Zou Q, Kolm P, Brewer HB, Garcia-Garcia HM. Identification of patients and plaques vulnerable to future coronary events with near-infrared spectroscopy intravascular ultrasound imaging: a prospective, cohort study. Lancet 2019; 394:1629-1637. [PMID: 31570255 DOI: 10.1016/s0140-6736(19)31794-5] [Citation(s) in RCA: 241] [Impact Index Per Article: 48.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 07/17/2019] [Accepted: 07/22/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Near-infrared spectroscopy (NIRS) intravascular ultrasound imaging can detect lipid-rich plaques (LRPs). LRPs are associated with acute coronary syndromes or myocardial infarction, which can result in revascularisation or cardiac death. In this study, we aimed to establish the relationship between LRPs detected by NIRS-intravascular ultrasound imaging at unstented sites and subsequent coronary events from new culprit lesions. METHODS In this prospective, cohort study (LRP), patients from 44 medical centres were enrolled in Italy, Latvia, Netherlands, Slovakia, UK, and the USA. Patients with suspected coronary artery disease who underwent cardiac catheterisation with possible ad hoc percutaneous coronary intervention were eligible to be enrolled. Enrolled patients underwent scanning of non-culprit segments using NIRS-intravascular ultrasound imaging. The study had two hierarchal primary hypotheses, patient and plaque, each testing the association between maximum 4 mm Lipid Core Burden Index (maxLCBI4mm) and non-culprit major adverse cardiovascular events (NC-MACE). Enrolled patients with large LRPs (≥250 maxLCBI4mm) and a randomly selected half of patients with small LRPs (<250 maxLCBI4mm) were followed up for 24 months. This study is registered with ClinicalTrials.gov, NCT02033694. FINDINGS Between Feb 21, 2014, and March 30, 2016, 1563 patients were enrolled. NIRS-intravascular ultrasound device-related events were seen in six (0·4%) patients. 1271 patients (mean age 64 years, SD 10, 883 [69%] men, 388 [31%]women) with analysable maxLCBI4mm were allocated to follow-up. The 2-year cumulative incidence of NC-MACE was 9% (n=103). Both hierarchical primary hypotheses were met. On a patient level, the unadjusted hazard ratio (HR) for NC-MACE was 1·21 (95% CI 1·09-1·35; p=0·0004) for each 100-unit increase maxLCBI4mm) and adjusted HR 1·18 (1·05-1·32; p=0·0043). In patients with a maxLCBI4mm more than 400, the unadjusted HR for NC-MACE was 2·18 (1·48-3·22; p<0·0001) and adjusted HR was 1·89 (1·26-2·83; p=0·0021). At the plaque level, the unadjusted HR was 1·45 (1·30-1·60; p<0·0001) for each 100-unit increase in maxLCBI4mm. For segments with a maxLCBI4mm more than 400, the unadjusted HR for NC-MACE was 4·22 (2·39-7·45; p<0·0001) and adjusted HR was 3·39 (1·85-6·20; p<0·0001). INTERPRETATION NIRS imaging of non-obstructive territories in patients undergoing cardiac catheterisation and possible percutaneous coronary intervention was safe and can aid in identifying patients and segments at higher risk for subsequent NC-MACE. NIRS-intravascular ultrasound imaging adds to the armamentarium as the first diagnostic tool able to detect vulnerable patients and plaques in clinical practice. FUNDING Infraredx.
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Affiliation(s)
- Ron Waksman
- MedStar Washington Hospital Center, Washington, DC, USA.
| | | | | | - Ziad A Ali
- New York Presbyterian/Columbia University Medical Center, New York, NY & Cardiovascular Research Foundation, New York, NY, USA
| | | | | | | | | | - Eric Powers
- Medical University of South Carolina Hospital, Charleston, SC, USA
| | | | | | - S Chiu Wong
- NewYork-Presbyterian/Weill Cornell Medical Center, New York, NY, USA
| | | | | | - Sandeep Dube
- Community Heart and Vascular, Indianapolis, IN, USA
| | | | | | | | - Paige E Craig
- MedStar Washington Hospital Center, Washington, DC, USA
| | - Quan Zou
- MedStar Washington Hospital Center, Washington, DC, USA
| | - Paul Kolm
- MedStar Washington Hospital Center, Washington, DC, USA
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20
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de Faria AP, Modolo R, Chichareon P, Chang CC, Kogame N, Tomaniak M, Takahashi K, Rademaker-Havinga T, Wykrzykowska J, de Winter RJ, Ferreira RC, Sousa A, Lemos PA, Garg S, Hamm C, Juni P, Vranckx P, Valgimigli M, Windecker S, Onuma Y, Steg PG, Serruys PW. Association of Pulse Pressure With Clinical Outcomes in Patients Under Different Antiplatelet Strategies After Percutaneous Coronary Intervention: Analysis of GLOBAL LEADERS. Can J Cardiol 2019; 36:747-755. [PMID: 32139280 DOI: 10.1016/j.cjca.2019.10.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 10/08/2019] [Accepted: 10/14/2019] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND We evaluated the association of pulse pressure (PP) and different antiplatelet regimes with clinical and safety outcomes in an all-comers percutaneous coronary intervention (PCI) population. METHODS In this analysis of GLOBAL LEADERS (n = 15,936) we compared the experimental therapy of 23 months of ticagrelor after 1 month of dual-antiplatelet therapy (DAPT) vs standard DAPT for 12 months followed by aspirin monotherapy in subjects who underwent PCI and were divided into 2 groups according to the median PP (60 mm Hg). The primary end point (all-cause death or new Q-wave myocardial infarction) and the composite end points: patient-oriented composite end points (POCE), Bleeding Academic Research Consortium (BARC) 3 or 5, and net adverse clinical events (NACE) were evaluated. RESULTS At 2 years, subjects in the high-PP group (n = 7971) had similar rates of the primary end point (4.3% vs 3.9%; P = 0.058), POCE (14.9% vs 12.7%; P = 0.051), and BARC 3 or 5 (2.5% vs 1.7%; P = 0.355) and higher rates of NACE (16.4% vs 13.7%; P = 0.037) compared with the low-PP group (n = 7965). Among patients with PP < 60 mm Hg, the primary end point (3.4% vs 4.4%, adjusted hazard ratio [aHR] 0.77, 95% confidence interval [CI] 0.61-0.96), POCE (11.8% vs 13.5%, aHR 0.86, 95% CI 0.76-0.98), NACE (12.8% vs 14.7%, aHR 0.85, 95% CI 0.76-0.96), and BARC 3 or 5 (1.4% vs 2.1%, aHR 0.69, 95% CI 0.49-0.97) were lower with ticagrelor monotherapy compared with DAPT. The only significant interaction was for BARC 3 or 5 (P = 0.008). CONCLUSIONS After contemporary PCI, subjects with high PP levels experienced high rates of NACE at 2 years. In those with low PP, ticagrelor monotherapy led to a lower risk of bleeding events compared with standard DAPT.
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Affiliation(s)
| | - Rodrigo Modolo
- Department of Cardiology, Amsterdam University Medical Centre, Amsterdam, The Netherlands; Cardiology Division. Department of Internal Medicine, University of Campinas, Campinas, Brazil
| | - Ply Chichareon
- Department of Cardiology, Amsterdam University Medical Centre, Amsterdam, The Netherlands; Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Chun-Chin Chang
- Erasmus Medical Centre, Erasmus University, Rotterdam, The Netherlands
| | - Norihiro Kogame
- Department of Cardiology, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Mariusz Tomaniak
- Erasmus Medical Centre, Erasmus University, Rotterdam, The Netherlands; First Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Kuniaki Takahashi
- Department of Cardiology, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | | | - Joanna Wykrzykowska
- Department of Cardiology, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Rob J de Winter
- Department of Cardiology, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Rui C Ferreira
- Serviço de Cardiologia, Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - Amanda Sousa
- Department of Interventional Cardiology, Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil
| | - Pedro A Lemos
- Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Scot Garg
- East Lancashire Hospitals NHS Trust, Blackburn, Lancashire, United Kingdom
| | - Christian Hamm
- Kerckhoff Heart Center, Campus University of Giessen, Bad Nauheim, Germany
| | - Peter Juni
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, University of Toronto, Toronto, Canada
| | - Pascal Vranckx
- Department of Cardiology and Critical Care Medicine, Hartcentrum Hasselt, Jessa Ziekenhuis, Hasselt, Belgium
| | - Marco Valgimigli
- Department of Cardiology, Bern University Hospital, Inselspital, University of Bern, Switzerland
| | - Stephan Windecker
- Department of Cardiology, Bern University Hospital, Inselspital, University of Bern, Switzerland
| | - Yoshinobu Onuma
- Galway University Hospital, National University of Ireland, Galway, Ireland
| | - Philippe Gabriel Steg
- French Alliance for Cardiovascular Trials, Hopital Bichat, Assistance Publique-Hopitaux de Paris, Universite Paris-Diderot, and Institut National de la Sante et de la Recherche Medicale U-1148, Paris, France; Royal Brompton Hospital, Imperial College, London, United Kingdom
| | - Patrick W Serruys
- Galway University Hospital, National University of Ireland, Galway, Ireland.
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21
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Kerkmeijer L, Tijssen R, Kraak R, Kalkman D, Hofma SH, van der Schaaf R, Arkenbout K, Auke Weevers, Baan J, Vis M, Koch K, Tijssen J, Piek J, Henriques JPS, Wykrzykowska J, de Winter R. TCT-796 A paradox in sex-specific clinical outcomes after bioresorbable scaffold implantation: 2-year results from the AIDA trial. J Am Coll Cardiol 2018. [DOI: 10.1016/j.jacc.2018.08.2030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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22
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Asano T, Serruys PW, Collet C, Miyazaki Y, Takahashi K, Chichareon P, Katagiri Y, Modolo R, Tenekecioglu E, Morel MA, Garg S, Wykrzykowska J, Piek JJ, Sabate M, Morice MC, Chevalier B, Windecker S, Onuma Y. Angiographic late lumen loss revisited: impact on long-term target lesion revascularization. Eur Heart J 2018; 39:3381-3389. [DOI: 10.1093/eurheartj/ehy436] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 07/10/2018] [Indexed: 01/21/2023] Open
Affiliation(s)
- Taku Asano
- Academic Medical Center, University of Amsterdam, Meibergdreef 9, AZ Amsterdam, The Netherlands
- St. Luke's International Hospital, 9-1 Akashicho, Chūō, Tokyo, Japan
| | - Patrick W Serruys
- NHLI, Imperial College London, Dovehouse Street, Chelsea, London, UK
| | - Carlos Collet
- Academic Medical Center, University of Amsterdam, Meibergdreef 9, AZ Amsterdam, The Netherlands
- Department of Cardiology, Universitair Ziekenhuis Brussel, Avenue du Laerbeek 101, Jette, Belgium
| | - Yosuke Miyazaki
- ThoraxCenter, Erasmus Medical Center, Doctor Molewaterplein 40, GD Rotterdam, The Netherlands
| | - Kuniaki Takahashi
- Academic Medical Center, University of Amsterdam, Meibergdreef 9, AZ Amsterdam, The Netherlands
| | - Ply Chichareon
- Academic Medical Center, University of Amsterdam, Meibergdreef 9, AZ Amsterdam, The Netherlands
| | - Yuki Katagiri
- Academic Medical Center, University of Amsterdam, Meibergdreef 9, AZ Amsterdam, The Netherlands
| | - Rodrigo Modolo
- Academic Medical Center, University of Amsterdam, Meibergdreef 9, AZ Amsterdam, The Netherlands
| | - Erhan Tenekecioglu
- ThoraxCenter, Erasmus Medical Center, Doctor Molewaterplein 40, GD Rotterdam, The Netherlands
| | | | - Scot Garg
- East Lancashire Hospitals NHS Trust, Casterton Ave, Burnley, UK
| | - Joanna Wykrzykowska
- Academic Medical Center, University of Amsterdam, Meibergdreef 9, AZ Amsterdam, The Netherlands
| | - Jan J Piek
- Academic Medical Center, University of Amsterdam, Meibergdreef 9, AZ Amsterdam, The Netherlands
| | - Manel Sabate
- Cardiovascular Institute, Hospital Clinic, IDIBAPS, University of Barcelona, Carrer del Rosselló, 149, Barcelona, Spain
| | - Marie-Claude Morice
- Institut Cardiovasculaire Paris Sud, 6 Avenue du Noyer Lambert, Massy, France
| | - Bernard Chevalier
- Institut Cardiovasculaire Paris Sud, 6 Avenue du Noyer Lambert, Massy, France
| | | | - Yoshinobu Onuma
- ThoraxCenter, Erasmus Medical Center, Doctor Molewaterplein 40, GD Rotterdam, The Netherlands
- Cardialysis, Westblaak 98, KM Rotterdam, The Netherlands
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Katagiri Y, Serruys PW, Tenekecioglu E, Asano T, Collet C, Miyazaki Y, Piek JJ, Wykrzykowska J, Chevalier B, Mintz G, Onuma Y. P6374Acute and long-term relocation of minimal lumen area after Absorb bioresorbable scaffold or Xience metallic stent implantation. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Y Katagiri
- Academic Medical Center of Amsterdam, Department of Cardiology, Amsterdam, Netherlands
| | - P W Serruys
- Imperial College London, London, United Kingdom
| | | | - T Asano
- Academic Medical Center of Amsterdam, Department of Cardiology, Amsterdam, Netherlands
| | - C Collet
- Academic Medical Center of Amsterdam, Department of Cardiology, Amsterdam, Netherlands
| | - Y Miyazaki
- Erasmus Medical Center, Rotterdam, Netherlands
| | - J J Piek
- Academic Medical Center of Amsterdam, Department of Cardiology, Amsterdam, Netherlands
| | - J Wykrzykowska
- Academic Medical Center of Amsterdam, Department of Cardiology, Amsterdam, Netherlands
| | - B Chevalier
- Institut Hospitalier Jacques Cartier, Massy, France
| | - G Mintz
- Cardiovascular Research Foundation, New York, United States of America
| | - Y Onuma
- Erasmus Medical Center, Rotterdam, Netherlands
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Daemen J, van Zandvoort L, Dudek D, Weber - Alders J, Christiansen E, Muller D, Kochman J, Lassen JF, Wojdyla R, Wykrzykowska J, Abizaid A. CRT-600.05 Intravascular Ultrasound Findings of the Fantom Bioresorbable Scaffold at 6 and 9 Months Follow-up: Results from the Multicenter FANTOM II Study. JACC Cardiovasc Interv 2018. [DOI: 10.1016/j.jcin.2018.01.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Cassese S, Byrne R, Jüni P, Wykrzykowska J, Puricel S, Ndrepepa G, Schunkert H, Fusaro M, Cook S, Kimura T, Henriques J, Serruys P, Windecker S, Kastrati A. Midterm clinical outcomes with everolimus-eluting bioresorbable scaffolds versus everolimus-eluting metallic stents for percutaneous coronary interventions: a meta-analysis of randomised trials. EUROINTERVENTION 2018; 13:1565-1573. [DOI: 10.4244/eij-d-17-00492] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Kalkman D, Tijssen R, Elias J, van Dongen IM, Kraak R, Woudstra P, Beijk M, Tijssen J, Piek J, Henriques JPS, de Winter R, Wykrzykowska J. TCT-429 Comparison of the clinical performance between COMBO and Xience stent at one year follow-up in all-comers patients. J Am Coll Cardiol 2017. [DOI: 10.1016/j.jacc.2017.09.533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Sotomi Y, Onuma Y, Miyazaki Y, Asano T, Katagiri Y, Tenekecioglu E, Jonker H, Dijkstra J, de Winter R, Wykrzykowska J, Stone G, Popma J, Kozuma K, Tanabe K, Serruys P, Kimura T. Is quantitative coronary angiography reliable in assessing the late lumen loss of the everolimus-eluting bioresorbable polylactide scaffold in comparison with the cobalt-chromium metallic stent? EUROINTERVENTION 2017; 13:e585-e594. [DOI: 10.4244/eij-d-17-00070] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Asano T, Suwannasom P, Katagiri Y, Miyazaki Y, Sotomi Y, Kraak RP, Wykrzykowska J, Rensing BJ, Piek JJ, Gyöngyösi M, Serruys PW, Onuma Y. First-in-Man Trial of SiO 2 Inert-Coated Bare Metal Stent System in Native Coronary Stenosis - The AXETIS FIM Trial. Circ J 2017; 82:477-485. [PMID: 28717068 DOI: 10.1253/circj.cj-17-0337] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND A novel bare metal stent with an SiO2coating was developed to prevent excessive neointimal hyperplasia by inertization of the metallic stent surface. The efficacy of the device was demonstrated in a preclinical model. The aim of this first-in-man trial was to assess the safety and feasibility of the new device.Methods and Results:This prospective non-randomized single-arm trial was designed to enroll 35 patients with a de novo coronary lesion. Quantitative coronary angiography and optical coherence tomography (OCT) were performed at the baseline procedure and at the 6-month follow-up. Stent implantation was performed with OCT guidance according to optimal stent implantation criteria. The trial was terminated upon the advice of the data safety monitoring board after enrolling 14 patients due to the high incidence of re-intervention. Optimal OCT implantation criteria were achieved in only 8.3% of lesions. At 6 months, angiographic in-stent late lumen loss as the primary endpoint was 0.77±0.44 mm, and binary restenosis occurred in 33.3% of lesions. At the 6-month OCT, neointimal volume obstruction was 32.8±15.6% with a neointimal thickness of 237±117 µm. At 12 months, the device-oriented composite endpoint (defined as cardiac death, target vessel myocardial infarction, and clinically indicated target lesion revascularization rate) was 33.3%. CONCLUSIONS In contrast with the preclinical study, the Axetis stent did not efficiently suppress neointimal hyperplasia in humans in this trial.
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Affiliation(s)
- Taku Asano
- AMC Heart Center, Academic Medical Center, University of Amsterdam
| | | | - Yuki Katagiri
- AMC Heart Center, Academic Medical Center, University of Amsterdam
| | | | - Yohei Sotomi
- AMC Heart Center, Academic Medical Center, University of Amsterdam
| | - Robin P Kraak
- AMC Heart Center, Academic Medical Center, University of Amsterdam
| | | | | | - Jan J Piek
- AMC Heart Center, Academic Medical Center, University of Amsterdam
| | | | - Patrick W Serruys
- International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London
| | - Yoshinobu Onuma
- Thorax Center, Erasmus Medical Center, Erasmus University.,Cardialysis
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Suwannasom P, Sotomi Y, Asano T, Koon JNC, Tateishi H, Zeng Y, Tenekecioglu E, Wykrzykowska J, Foin N, de Winter R, Ormiston J, Serruys P, Onuma Y. Change in lumen eccentricity and asymmetry after treatment with Absorb bioresorbable vascular scaffolds in the ABSORB cohort B trial: a five-year serial optical coherence tomography imaging study. EUROINTERVENTION 2017; 12:e2244-e2252. [DOI: 10.4244/eij-d-16-00740] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Kraak R, Elias J, Kalkman D, Koch K, Henriques JPS, Piek J, Baan J, Vis M, Tijssen J, de Winter R, Wykrzykowska J. TCT-439 Increased incidence of revascularization in diabetic patients treated with the ABSORB everolimus-eluting bioresorbable scaffold: 24-months clinical results. J Am Coll Cardiol 2016. [DOI: 10.1016/j.jacc.2016.09.574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sotomi Y, Cavalcante R, Shlofmitz R, Suwannasom P, Tateishi H, Tenekecioglu E, Zheng Y, Abdelghani M, de Winter R, Wykrzykowska J, Onuma Y, Serruys P. Quantification by optical coherence tomography imaging of the ablation volume obtained with the Orbital Atherectomy System in calcified coronary lesions. EUROINTERVENTION 2016; 12:1126-1134. [DOI: 10.4244/eijv12i9a184] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Naber CK, Pyxaras SA, Nef H, IJsselmuiden AJ, Briguori C, Schlundt C, Wykrzykowska J, Eberli FR, Möllmann H, Galatius S, Rieber J, Commeau P, van Geuns RJ, Bouchez D, Mudra H. Final results of a self-apposing paclitaxel-eluting stent fOr the PErcutaNeous treatment of de novo lesions in native bifurcated coronary arteries study. EUROINTERVENTION 2016; 12:356-8. [DOI: 10.4244/eijy15m06_02] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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van de Hoef TP, Nijveldt R, van der Ent M, Neunteufl T, Meuwissen M, Khattab A, Berger R, Kuijt WJ, Wykrzykowska J, Tijssen JG, van Rossum AC, Stone GW, Piek JJ. Pressure-controlled intermittent coronary sinus occlusion (PICSO) in acute ST-segment elevation myocardial infarction: results of the Prepare RAMSES safety and feasibility study. EUROINTERVENTION 2015; 11:37-44. [DOI: 10.4244/eijy15m03_10] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Everaert B, Felix C, Koolen J, den Heijer P, Henriques J, Wykrzykowska J, van der Schaaf R, de Smet B, Hofma S, Diletti R, Van Mieghem N, Regar E, Smits P, van Geuns RJM. Appropriate use of bioresorbable vascular scaffolds in percutaneous coronary interventions: a recommendation from experienced users : A position statement on the use of bioresorbable vascular scaffolds in the Netherlands. Neth Heart J 2015; 23:161-5. [PMID: 25626696 PMCID: PMC4352153 DOI: 10.1007/s12471-015-0651-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Percutaneous coronary interventions (PCI) have become a reliable revascularisation option to treat ischaemic coronary artery disease. Drug-eluting stents (DES) are widely used as first choice devices in many procedures due to their established good medium to long term outcomes. These permanent implants, however, do not have any residual function after vascular healing following the PCI. Beyond this initial healing period, metallic stents may induce new problems, resulting in an average rate of 2 % reinterventions per year. To eliminate this potential late limitation of permanent metallic DES, bioresorbable coronary stents or ‘vascular scaffolds’ (BVS) have been developed. In a parallel publication in this journal, an overview of the current clinical performance of these scaffolds is presented. As these scaffolds are currently CE marked and commercially available in many countries and as clinical evidence is still limited, recommendations for their general usage are needed to allow successful clinical introduction.
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Affiliation(s)
- Bert Everaert
- Thoraxcenter, Erasmus Medical Centre, 's-Gravendijkwal 230, 3015 GE, Rotterdam, The Netherlands,
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Grundeken MJ, Ishibashi Y, Genereux P, Lasalle L, Wykrzykowska J, Morel MA, Tijssen J, de Winter R, Girasis C, Garcia HG, Onuma Y, Leon M, Serruys PW. INTER-CORE LAB VARIABILITY IN ANALYZING QUANTITATIVE CORONARY ANGIOGRAPHY FOR BIFURCATION LESIONS: A POST-HOC ANALYSIS OF A RANDOMIZED TRIAL. J Am Coll Cardiol 2015. [DOI: 10.1016/s0735-1097(15)61883-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Grundeken MJ, Asgedom S, Damman P, Lesiak M, Norell MS, Garcia E, Bethencourt A, Woudstra P, Koch KT, Vis MM, Henriques JP, Onuma Y, Foley D, Bartorelli A, Tijssen J, Stella P, Winter RJD, Wykrzykowska J. TCT@ACC–i2: Invasive and Interventional Cardiology ADDITIONAL SIDE BRANCH STENT PLACEMENT IN PATIENTS WITH LONG SIDE BRANCH LESIONS TREATED WITH A DEDICATED TRYTON SIDE BRANCH STENT. J Am Coll Cardiol 2013. [DOI: 10.1016/s0735-1097(13)61632-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Gutiérrez-Chico JL, Wykrzykowska J, Koch K, Koolen J, Mario CD, Windecker S, Van Es GA, Juni P, Regar E, Serruys P. TCT-290 Vascular tissue reaction to acute malapposition in human coronary arteries: sequential assessment with optical coherence tomography. J Am Coll Cardiol 2012. [DOI: 10.1016/j.jacc.2012.08.314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Gutiérrez-Chico JL, Wykrzykowska J, Nüesch E, van Geuns RJ, Koch KT, Koolen JJ, di Mario C, Windecker S, van Es GA, Gobbens P, Jüni P, Regar E, Serruys PW. Vascular Tissue Reaction to Acute Malapposition in Human Coronary Arteries. Circ Cardiovasc Interv 2012; 5:20-9, S1-8. [DOI: 10.1161/circinterventions.111.965301] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Juan Luis Gutiérrez-Chico
- From the Erasmus Medical Centre–Thoraxcentre, Rotterdam, The Netherlands (J.L.G.-C., J.W., E.R., P.W.S., R.J.v.G.); Institute for Social and Preventive Medicine, University of Bern, Bern, Switzerland (E.N., P.J.); CTU Bern, Bern University Hospital, Bern, Switzerland (E.N., P.J.); Academisch Medisch Centrum, Amsterdam, The Netherlands (K.T.K.); Catharina Ziekenhuis, Eindhoven, The Netherlands (J.J.K.); Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Trust, London, United
| | - Joanna Wykrzykowska
- From the Erasmus Medical Centre–Thoraxcentre, Rotterdam, The Netherlands (J.L.G.-C., J.W., E.R., P.W.S., R.J.v.G.); Institute for Social and Preventive Medicine, University of Bern, Bern, Switzerland (E.N., P.J.); CTU Bern, Bern University Hospital, Bern, Switzerland (E.N., P.J.); Academisch Medisch Centrum, Amsterdam, The Netherlands (K.T.K.); Catharina Ziekenhuis, Eindhoven, The Netherlands (J.J.K.); Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Trust, London, United
| | - Eveline Nüesch
- From the Erasmus Medical Centre–Thoraxcentre, Rotterdam, The Netherlands (J.L.G.-C., J.W., E.R., P.W.S., R.J.v.G.); Institute for Social and Preventive Medicine, University of Bern, Bern, Switzerland (E.N., P.J.); CTU Bern, Bern University Hospital, Bern, Switzerland (E.N., P.J.); Academisch Medisch Centrum, Amsterdam, The Netherlands (K.T.K.); Catharina Ziekenhuis, Eindhoven, The Netherlands (J.J.K.); Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Trust, London, United
| | - Robert Jan van Geuns
- From the Erasmus Medical Centre–Thoraxcentre, Rotterdam, The Netherlands (J.L.G.-C., J.W., E.R., P.W.S., R.J.v.G.); Institute for Social and Preventive Medicine, University of Bern, Bern, Switzerland (E.N., P.J.); CTU Bern, Bern University Hospital, Bern, Switzerland (E.N., P.J.); Academisch Medisch Centrum, Amsterdam, The Netherlands (K.T.K.); Catharina Ziekenhuis, Eindhoven, The Netherlands (J.J.K.); Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Trust, London, United
| | - Karel T. Koch
- From the Erasmus Medical Centre–Thoraxcentre, Rotterdam, The Netherlands (J.L.G.-C., J.W., E.R., P.W.S., R.J.v.G.); Institute for Social and Preventive Medicine, University of Bern, Bern, Switzerland (E.N., P.J.); CTU Bern, Bern University Hospital, Bern, Switzerland (E.N., P.J.); Academisch Medisch Centrum, Amsterdam, The Netherlands (K.T.K.); Catharina Ziekenhuis, Eindhoven, The Netherlands (J.J.K.); Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Trust, London, United
| | - Jacques J. Koolen
- From the Erasmus Medical Centre–Thoraxcentre, Rotterdam, The Netherlands (J.L.G.-C., J.W., E.R., P.W.S., R.J.v.G.); Institute for Social and Preventive Medicine, University of Bern, Bern, Switzerland (E.N., P.J.); CTU Bern, Bern University Hospital, Bern, Switzerland (E.N., P.J.); Academisch Medisch Centrum, Amsterdam, The Netherlands (K.T.K.); Catharina Ziekenhuis, Eindhoven, The Netherlands (J.J.K.); Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Trust, London, United
| | - Carlo di Mario
- From the Erasmus Medical Centre–Thoraxcentre, Rotterdam, The Netherlands (J.L.G.-C., J.W., E.R., P.W.S., R.J.v.G.); Institute for Social and Preventive Medicine, University of Bern, Bern, Switzerland (E.N., P.J.); CTU Bern, Bern University Hospital, Bern, Switzerland (E.N., P.J.); Academisch Medisch Centrum, Amsterdam, The Netherlands (K.T.K.); Catharina Ziekenhuis, Eindhoven, The Netherlands (J.J.K.); Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Trust, London, United
| | - Stephan Windecker
- From the Erasmus Medical Centre–Thoraxcentre, Rotterdam, The Netherlands (J.L.G.-C., J.W., E.R., P.W.S., R.J.v.G.); Institute for Social and Preventive Medicine, University of Bern, Bern, Switzerland (E.N., P.J.); CTU Bern, Bern University Hospital, Bern, Switzerland (E.N., P.J.); Academisch Medisch Centrum, Amsterdam, The Netherlands (K.T.K.); Catharina Ziekenhuis, Eindhoven, The Netherlands (J.J.K.); Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Trust, London, United
| | - Gerrit-Anne van Es
- From the Erasmus Medical Centre–Thoraxcentre, Rotterdam, The Netherlands (J.L.G.-C., J.W., E.R., P.W.S., R.J.v.G.); Institute for Social and Preventive Medicine, University of Bern, Bern, Switzerland (E.N., P.J.); CTU Bern, Bern University Hospital, Bern, Switzerland (E.N., P.J.); Academisch Medisch Centrum, Amsterdam, The Netherlands (K.T.K.); Catharina Ziekenhuis, Eindhoven, The Netherlands (J.J.K.); Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Trust, London, United
| | - Pierre Gobbens
- From the Erasmus Medical Centre–Thoraxcentre, Rotterdam, The Netherlands (J.L.G.-C., J.W., E.R., P.W.S., R.J.v.G.); Institute for Social and Preventive Medicine, University of Bern, Bern, Switzerland (E.N., P.J.); CTU Bern, Bern University Hospital, Bern, Switzerland (E.N., P.J.); Academisch Medisch Centrum, Amsterdam, The Netherlands (K.T.K.); Catharina Ziekenhuis, Eindhoven, The Netherlands (J.J.K.); Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Trust, London, United
| | - Peter Jüni
- From the Erasmus Medical Centre–Thoraxcentre, Rotterdam, The Netherlands (J.L.G.-C., J.W., E.R., P.W.S., R.J.v.G.); Institute for Social and Preventive Medicine, University of Bern, Bern, Switzerland (E.N., P.J.); CTU Bern, Bern University Hospital, Bern, Switzerland (E.N., P.J.); Academisch Medisch Centrum, Amsterdam, The Netherlands (K.T.K.); Catharina Ziekenhuis, Eindhoven, The Netherlands (J.J.K.); Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Trust, London, United
| | - Evelyn Regar
- From the Erasmus Medical Centre–Thoraxcentre, Rotterdam, The Netherlands (J.L.G.-C., J.W., E.R., P.W.S., R.J.v.G.); Institute for Social and Preventive Medicine, University of Bern, Bern, Switzerland (E.N., P.J.); CTU Bern, Bern University Hospital, Bern, Switzerland (E.N., P.J.); Academisch Medisch Centrum, Amsterdam, The Netherlands (K.T.K.); Catharina Ziekenhuis, Eindhoven, The Netherlands (J.J.K.); Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Trust, London, United
| | - Patrick W. Serruys
- From the Erasmus Medical Centre–Thoraxcentre, Rotterdam, The Netherlands (J.L.G.-C., J.W., E.R., P.W.S., R.J.v.G.); Institute for Social and Preventive Medicine, University of Bern, Bern, Switzerland (E.N., P.J.); CTU Bern, Bern University Hospital, Bern, Switzerland (E.N., P.J.); Academisch Medisch Centrum, Amsterdam, The Netherlands (K.T.K.); Catharina Ziekenhuis, Eindhoven, The Netherlands (J.J.K.); Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Trust, London, United
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Granada J, Milewski K, Uribe M, Moncada M, Fernandez A, Blanco G, Kaluza G, Wykrzykowska J, Serruys P, Stone G, Delgado J. First clinical evaluation of a luminal self-expanding shield in patients with intermediate coronary lesions. EUROINTERVENTION 2011; 7:780-8. [DOI: 10.4244/eijv7i7a124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Wykrzykowska J, Serruys P, Buszman P, Linke A, Ischinger T, Klauss V, Eberli F, Corti R, Wijns W, Morice MC, Di Mario C, Van Geuns RJ, Van Es GA, Juni P, Windecker S. The three year follow-up of the randomised “all-comers” trial of a biodegradable polymer biolimus-eluting stent versus permanent polymer sirolimus-eluting stent (LEADERS). EUROINTERVENTION 2011; 7:789-95. [DOI: 10.4244/eijv7i7a125] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Garg S, Serruys PW, Silber S, Wykrzykowska J, van Geuns RJ, Richardt G, Buszman PE, Kelbæk H, van Boven AJ, Hofma SH, Linke A, Klauss V, Wijns W, Macaya C, Garot P, DiMario C, Manoharan G, Kornowski R, Ischinger T, Bartorelli A, Van Remortel E, Ronden J, Windecker S. The prognostic utility of the SYNTAX score on 1-year outcomes after revascularization with zotarolimus- and everolimus-eluting stents: a substudy of the RESOLUTE All Comers Trial. JACC Cardiovasc Interv 2011; 4:432-41. [PMID: 21511223 DOI: 10.1016/j.jcin.2011.01.008] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2010] [Revised: 01/11/2011] [Accepted: 01/20/2011] [Indexed: 12/01/2022]
Abstract
OBJECTIVES This study assessed the ability of the SYNTAX score (SXscore) to stratify risk in patients treated with percutaneous coronary intervention (PCI) using zotarolimus-eluting or everolimus-eluting stents. BACKGROUND The SXscore can identify patients treated with PCI who are at highest risk of adverse events. METHODS The SXscore was calculated prospectively in 2,033 of the 2,292 patients enrolled in the RESOLUTE All Comers study (RESOLUTE III All Comers Trial: A Randomized Comparison of a Zotarolimus-Eluting Stent With an Everolimus-Eluting Stent for Percutaneous Coronary Intervention). Clinical outcomes in terms of a patient-oriented composite endpoint (POCE) of all-cause death, myocardial infarction (MI), and repeat revascularization; the individual components of POCE; target lesion failure (TLF) (a composite of cardiac death, target-vessel MI, and clinically driven target lesion revascularization); and stent thrombosis were subsequently stratified according to SXscore tertiles: SXscore(LOW) ≤ 9 (n = 698), 9 <SXscore(MID) ≤ 17 (n = 676); SXscore(HIGH) >17 (n = 659). RESULTS At 12-month follow-up, rates of POCE, MI, repeat revascularization, TLF, and the composite of death/MI were all significantly higher in patients in the highest SXscore tercile. Rates of stent thrombosis were all highest in the SXscore(HIGH) tertile (p > 0.05). After multivariate adjustment, the SXscore was identified as an independent predictor of POCE, MI, repeat revascularization, and TLF (p < 0.05 for all). At 12-month follow-up, the SXscore, ACEF score, and Clinical SXscore had C-statistics of 0.57, 0.78, and 0.67, respectively, for mortality and of 0.62, 0.56, 0.63, respectively, for POCE. No significant between-stent differences were observed for TLF or POCE in any of the SXscore tertiles. CONCLUSIONS The SYNTAX score is able to stratify risk amongst an all-comers population treated with PCI with second-generation drug-eluting stents (DES); however, improvements can be made with the inclusion of clinical variables. (RESOLUTE III All Comers Trial: A Randomized Comparison of a Zotarolimus-Eluting Stent With an Everolimus-Eluting Stent for Percutaneous Coronary Intervention; NCT00617084).
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Affiliation(s)
- Scot Garg
- Department of Interventional Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands
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Gutiérrez-Chico JL, Regar E, Nüesch E, Okamura T, Wykrzykowska J, di Mario C, Windecker S, van Es GA, Gobbens P, Jüni P, Serruys PW. Delayed Coverage in Malapposed and Side-Branch Struts With Respect to Well-Apposed Struts in Drug-Eluting Stents. Circulation 2011; 124:612-23. [PMID: 21768536 DOI: 10.1161/circulationaha.110.014514] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Background—
Pathology studies on fatal cases of very late stent thrombosis have described incomplete neointimal coverage as common substrate, in some cases appearing at side-branch struts. Intravascular ultrasound studies have described the association between incomplete stent apposition (ISA) and stent thrombosis, but the mechanism explaining this association remains unclear. Whether the neointimal coverage of nonapposed side-branch and ISA struts is delayed with respect to well-apposed struts is unknown.
Methods and Results—
Optical coherence tomography studies from 178 stents implanted in 99 patients from 2 randomized trials were analyzed at 9 to 13 months of follow-up. The sample included 38 sirolimus-eluting, 33 biolimus-eluting, 57 everolimus-eluting, and 50 zotarolimus-eluting stents. Optical coherence tomography coverage of nonapposed side-branch and ISA struts was compared with well-apposed struts of the same stent by statistical pooled analysis with a random-effects model. A total of 34 120 struts were analyzed. The risk ratio of delayed coverage was 9.00 (95% confidence interval, 6.58 to 12.32) for nonapposed side-branch versus well-apposed struts, 9.10 (95% confidence interval, 7.34 to 11.28) for ISA versus well-apposed struts, and 1.73 (95% confidence interval, 1.34 to 2.23) for ISA versus nonapposed side-branch struts. Heterogeneity of the effect was observed in the comparison of ISA versus well-apposed struts (H=1.27; I
2
=38.40) but not in the other comparisons.
Conclusions—
Coverage of ISA and nonapposed side-branch struts is delayed with respect to well-apposed struts in drug-eluting stents, as assessed by optical coherence tomography.
Clinical Trial Registration—
http://www.clinicaltrials.gov
. Unique identifier: NCT00389220, NCT00617084.
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Garg S, Wykrzykowska J, Serruys PW, de Vries T, Buszman P, Trznadel S, Linke A, Lenk K, Ischinger T, Klauss V, Eberli F, Corti R, Wijns W, Morice MC, di Mario C, Tyczynski P, van Geuns RJ, Eerdmans P, van Es GA, Meier B, Jüni P, Windecker S. The outcome of bifurcation lesion stenting using a biolimus-eluting stent with a bio-degradable polymer compared to a sirolimus-eluting stent with a durable polymer. EUROINTERVENTION 2011; 6:928-35. [PMID: 21330239 DOI: 10.4244/eijv6i8a162] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS This study investigated the differences in clinical outcomes between patients with bifurcation lesions (BL) treated with a biolimus-eluting stent (BES) with a biodegradable polymer, and a sirolimus-eluting stent (SES) with a durable polymer. METHODS AND RESULTS The clinical outcomes were assessed in the 497 patients (BES 258, SES 239) enrolled in the multicentre, randomised LEADERS trial who underwent treatment of ≥1 BL (total=534 BL). At 12-months follow-up there was no significant difference in the primary endpoint of MACE, a composite of cardiac death, myocardial infarction and clinically indicated target vessel revascularisation (BES 12.8% vs. SES 16.3%, p=0.31). Patients treated with BES had comparable rates of cardiac death (BES 2.7% vs. SES 2.9%, p=1.00), numerically higher rates of myocardial infarction (BES 8.9% vs. SES 5.4%, p=0.17), and significantly lower rates of clinically indicated target vessel revascularisation (4.3% vs. 11.3%, p=0.004) when compared to those treated with SES. The rate of stent thrombosis at 12-months was 4.3% and 3.8% for BES and SES, respectively (p=0.82). CONCLUSIONS In the treatment of BL the use of BES lead to superior efficacy and comparable safety compared to SES.
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Affiliation(s)
- Scot Garg
- Department of Interventional Cardiology, Erasmus MC, Rotterdam, The Netherlands
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Brugaletta S, Garcia-Garcia HM, Serruys PW, de Boer S, Ligthart J, Gomez-Lara J, Witberg K, Diletti R, Wykrzykowska J, van Geuns RJ, Schultz C, Regar E, Duckers HJ, van Mieghem N, de Jaegere P, Madden SP, Muller JE, van der Steen AF, van der Giessen WJ, Boersma E. NIRS and IVUS for Characterization of Atherosclerosis in Patients Undergoing Coronary Angiography. JACC Cardiovasc Imaging 2011; 4:647-55. [DOI: 10.1016/j.jcmg.2011.03.013] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Revised: 03/07/2011] [Accepted: 03/14/2011] [Indexed: 10/18/2022]
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Magro M, Wykrzykowska J, Serruys PW, Simsek C, Nauta S, Lesiak M, Stanislawska K, Onuma Y, Regar E, van Domburg RT, Grajek S, Geuns RJV. Six-month clinical follow-up of the Tryton side branch stent for the treatment of bifurcation lesions: a two center registry analysis. Catheter Cardiovasc Interv 2011; 77:798-806. [PMID: 20824767 DOI: 10.1002/ccd.22767] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2010] [Accepted: 07/31/2010] [Indexed: 11/11/2022]
Abstract
BACKGROUND Treatment of bifurcation lesions with the Tryton Sidebranch stent has been shown to be feasible with an acceptable clinical outcome and low side branch late loss in the first in man trial. OBJECTIVE To report acute procedural and six month clinical follow-up after the use of the Tryton Sidebranch stent in an "all comer" registry. METHODS The first 100 coronary bifurcation lesions assigned for treatment with the Tryton stent were included in a prospective registry. Procedural and angiographic success rates were determined from patient charts and pre- and postprocedural quantitative coronary angiography. RESULTS Totally, 96 patients with 100 lesions were included in the study. Seventy-two percent presented with stable angina, 25% with unstable angina/NSTEMI, and 3% STEMI. The bifurcation was located in the left main in 8%. Two lesions were chronic total occlusions. Sixty-nine percent were true bifurcation lesions. One failure of stent delivery occurred. Acute gain in SB was 0.76 ± 0.64 mm and three patients had residual stenosis of >30%. Angiographic success rate was 95%; procedural success rate reached 94%. Peri-procedural MI occurred in two and there was one cardiac death during hospitalization. At a median six months follow-up, TLR rate was 4%, MI 3%, and cardiac death 1%. The percentage MACE-free survival at six months was 94%. No cases of definite stent thrombosis occurred. CONCLUSIONS In a real world the use of the Tryton Sidebranch stent is associated with good procedural safety and angiographic success rate and acceptable outcome at six months of follow-up.
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Affiliation(s)
- Michael Magro
- Department of Interventional Cardiology, Thoraxcenter, Erasmus University MC, Rotterdam, The Netherlands
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Sarno G, Garg S, Gomez-Lara J, Garcia Garcia HM, Ligthart J, Bruining N, Onuma Y, Witberg K, van Geuns RJ, de Boer S, Wykrzykowska J, Schultz C, Duckers H, Regar E, de Jaegere P, de Feyter P, van Es GA, Boersma E, van der Giessen W, Serruys PW. Intravascular ultrasound radiofrequency analysis after optimal coronary stenting with initial quantitative coronary angiography guidance: an ATHEROREMO sub-study. EUROINTERVENTION 2011; 6:977-84. [DOI: 10.4244/eijv6i8a169] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Garg S, Sarno G, Garcia-Garcia HM, Girasis C, Wykrzykowska J, Dawkins KD, Serruys PW. A new tool for the risk stratification of patients with complex coronary artery disease: the Clinical SYNTAX Score. Circ Cardiovasc Interv 2010; 3:317-26. [PMID: 20647561 DOI: 10.1161/circinterventions.109.914051] [Citation(s) in RCA: 190] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Presently, no effective risk model exists to predict long-term mortality or other major adverse cardiovascular and cerebrovascular events (MACCE) in those patients undergoing percutaneous coronary intervention (PCI). This study aimed to assess whether the Clinical SYNTAX Score (CSS) calculated by multiplying the SYNTAX Score to a modified ACEF score (age/ejection fraction +1 for each 10 mL the creatinine clearance <60 mL/min per 1.73 m(2)) would improve the ability of either score to predict mortality and MACCE. METHODS AND RESULTS The CSS was calculated in 512 patients enrolled in the ARTS-II study who had serum creatinine levels, ejection fraction, and body weight recorded at baseline. Clinical outcomes in terms of MACCE and mortality at 1- and 5-year follow-up were stratified according to CSS tertiles: CSS(LOW)< or =15.6 (n=170), 15.6<CSS(MID)< or =27.5 (n=171), and CSS(HIGH)>27.5 (n=171). At 1-year follow-up, rates of repeat revascularization and MACCE were significantly higher in the highest tertile group. At 5-year follow-up, CSS(HIGH) had a comparable rate of myocardial infarction, a trend toward a significantly higher rate of death, and significantly higher rates of repeat revascularization and overall MACCE compared with patients in the lower 2 tertiles. The respective C-statistics for the CSS, SYNTAX Score, and ACEF score for 5-year mortality were 0.69, 0.62, and 0.65 and for 5-year MACCE were 0.62, 0.59, and 0.57. CONCLUSIONS An improvement in the ability of the SYNTAX Score to predict MACCE and mortality can be achieved by combining the SYNTAX Score with a simple clinical risk score incorporating age, ejection fraction, and creatinine clearance to produce the Clinical SYNTAX score. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00235170.
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Affiliation(s)
- Scot Garg
- Department of Interventional Cardiology, Erasmus MC, Rotterdam, The Netherlands
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Tyczynski P, Kukreja N, van Geuns RJ, Wykrzykowska J, Sheppard M, Di Mario C. Optical coherence tomography for the assessment of pericardium covered stents for the treatment of degenerated saphenous vein grafts. EUROINTERVENTION 2010. [DOI: 10.4244/eijv6i1a12] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Onuma Y, Wykrzykowska J, Vranckx P, Serruys PW, the ARTS-II Investigators. MULTIVESSEL CORONARY REVASCULARIZATION IN PATIENTS WITH AND WITHOUT DIABETES MELLITUS 5-YEAR FOLLOW-UP OF THE ARTS-II TRIAL (ARTERIAL REVASCULARIZATION THERAPIES STUDY-PART II). J Am Coll Cardiol 2010. [DOI: 10.1016/s0735-1097(10)61722-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Garg S, Sarno G, Girasis C, Garcia-Garcia HM, Wykrzykowska J, Dawkins KD, Serruys PW. A NEW TOOL FOR THE RISK STRATIFICATION OF PATIENTS WITH COMPLEX CORONARY ARTERY DISEASE: THE CLINICAL SYNTAX SCORE. J Am Coll Cardiol 2010. [DOI: 10.1016/s0735-1097(10)61861-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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