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TCT-197 Independent Clinical and Echocardiographic Predictors of Restenosis After Percutaneous Mitral Balloon Commissurotomy Followed for 24 Years. J Am Coll Cardiol 2021. [DOI: 10.1016/j.jacc.2021.09.1050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Cardiovascular Risk Stratification for Patients Treated With Drug-Eluting Stents: Development and Validation of the DESIRE Score. THE JOURNAL OF INVASIVE CARDIOLOGY 2020; 32:E49-E59. [PMID: 32123142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND We sought to develop a risk score to estimate the risk of major adverse cardiac event (MACE) occurrence during the in-hospital and long-term follow-up periods after percutaneous coronary intervention (PCI) with drug-eluting stent (DES) implantation. METHODS This score was developed and validated in a single-center database encompassing all consecutive patients treated with DES between 2007 and 2014 (n = 4061). For the development of the score, we analyzed all patients treated between January 2007 and December 2012 (n = 2863) while the validation was conducted in a cohort treated between January 2013 and December 2014 (n = 1198). MACE was defined as the combination of cardiovascular death, myocardial infarction, and ischemia- driven target-lesion revascularization. Different stratification models were developed for the in-hospital (logistic regression) and late follow-up score (Cox model). RESULTS In-hospital scores ranged from 0 to 37 points and comprised: (a) age; (b) previous coronary artery bypass grafting (CABG); (c) acute coronary syndrome; (d) peripheral vascular disease; (e) treatment of saphenous vein graft; (f) long lesions; (g) small vessels; (h) multivessel disease; and (i) thrombus. The late scores ranged from 0 to 45 points and comprised: (a) previous CABG; (b) diabetes mellitus; (c) acute coronary syndrome; (d) multivessel disease; (e) small vessels; (f) ejection fraction <40%; and (g) treatment of saphenous vein graft. Patients were stratified into low-risk, moderate-risk, and high-risk groups. Both scores had close to 70% accuracy for predicting MACE. CONCLUSION The present score was developed and validated based on contemporary models for assessing periprocedural and long-term MACE risk post PCI, throughout the full spectrum of patient risk, and important patient subgroups.
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TCT-800 Immediate and long-term predictor score of success after percutaneous mitral balloon valvoplasty. J Am Coll Cardiol 2018. [DOI: 10.1016/j.jacc.2018.08.2035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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TCT-801 Predictors of Immediate Success and Long-Term Clinical Outcomes After Percutaneous Mitral Balloon Valvuloplasty in Patients With Rheumatic Mitral Stenosis. J Am Coll Cardiol 2018. [DOI: 10.1016/j.jacc.2018.08.2036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Very Long Term Follow-Up After Percutaneous Balloon Mitral Valvuloplasty. JACC Cardiovasc Interv 2018; 11:1945-1952. [PMID: 30077684 DOI: 10.1016/j.jcin.2018.05.039] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 05/08/2018] [Accepted: 05/22/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES The aim of this study was to assess very long term outcomes after successful percutaneous balloon mitral valvuloplasty (PBMV). BACKGROUND PBMV remains the preferred treatment for patients with severe symptomatic rheumatic mitral stenosis and suitable anatomy. METHODS All consecutive patients who underwent successful PBMV between 1987 and 2010 were included. The primary endpoint was the composite of all-cause mortality, need for mitral surgery, or repeat PBMV up to 23 years. RESULTS Among all 1,582 consecutive patients undergoing PBMV, acute success was achieved in 90.9% (n = 1,438). Independent predictors of acute success included left atrial size (odds ratio: 0.96; 95% confidence interval [CI]: 0.93 to 0.99; p = 0.045), Wilkins score ≤8 (odds ratio: 1.66; 95% CI: 0.48 to 0.93; p = 0.02) and age (odds ratio: 0.97; 95% CI: 0.96 to 0.99; p = 0.006). Very long term follow-up (median 8.3 years, mean 15.6 years) was obtained in 79.1% of successful cases. The incidence of the primary endpoint was 19.1% (95% CI: 17.0% to 21.1%). The rates of overall mortality, need for mitral valve surgery, or repeat PBMV were 0.6% (95% CI: 0.3% to 1.2%), 8.3% (95% CI: 7.0% to 9.9%), and 10.0% (95% CI: 8.5% to 11.7%), respectively. On multivariate analysis, New York Heart Association functional class III or IV (hazard ratio: 1.62; 95% CI: 1.26 to 2.09; p < 0.001), higher age (hazard ratio: 0.97; 95% CI: 0.96 to 0.98; p = 0.028), and mitral valve area ≤1.75 cm2 after the procedure (hazard ratio: 1.67; 95% CI: 1.28 to 2.11; p = 0.028) were independent predictors of the primary endpoint. CONCLUSIONS In very long term follow-up, more than 75% of patients exhibited sustained results. Prediction of late favorable results is multifactorial and strongly determined by age, previous symptoms and post-procedural mitral valve area.
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Progression and Prognosis of Paravalvular Regurgitation After Transcatheter Aortic Valve Implantation. Arq Bras Cardiol 2017; 109:0. [PMID: 29166455 PMCID: PMC5783440 DOI: 10.5935/abc.20170172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Revised: 05/22/2017] [Accepted: 07/05/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The impact of paravalvular regurgitation (PVR) following transcatheter aortic valve implantation (TAVI) remains uncertain. OBJECTIVE To evaluate the impact of PVR on mortality and hospital readmission one year after TAVI. METHODS Between January 2009 and June 2015, a total of 251 patients underwent TAVI with three different prostheses at two cardiology centers. Patients were assessed according to PVR severity after the procedure. RESULTS PVR was classified as absent/trace or mild in 92.0% (n = 242) and moderate/severe in 7.1% (n = 18). The moderate/severe PVR group showed higher levels of aortic calcification (22% vs. 6%, p = 0.03), higher serum creatinine (1.5 ± 0.7 vs. 1.2 ± 0.4 mg/dL, p = 0.014), lower aortic valve area (0.6 ± 0.1 vs. 0.7 ± 0.2 cm2, p = 0.05), and lower left ventricular ejection fraction (49.2 ± 14.8% vs. 58.8 ± 12.1%, p = 0.009). Patients with moderate/severe PVR had more need for post-dilatation (p = 0.025) and use of larger-diameter balloons (p = 0.043). At one year, all-cause mortality was similar in both groups (16.7% vs. 12%, p = 0.08), as well as rehospitalization (11.1% vs. 7.3%, p = 0.915). PVR grade significantly reduced throughout the first year after the procedure (p < 0.01). The presence of moderate/severe PVR was not associated with higher one-year mortality rates (HR: 0.76, 95% CI: 0.27-2.13, p = 0.864), rehospitalization (HR: 1.08, 95% CI: 0.25-4.69, p=0.915), or composite outcome (HR: 0.77, 95% CI: 0.28-2.13, p = 0.613). CONCLUSION In this sample, moderate/severe PVR was not a predictor of long-term mortality or rehospitalization. (Arq Bras Cardiol. 2017; [online].ahead print, PP.0-0).
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INDEPENDENT PREDICTORS OF MACE AT DIFFERENT TIME POINTS AFTER THE TREATMENT OF NON-SELECTED PATIENTS WITH DRUG-ELUTING STENTS: AN ANALYSIS OF THE DESIRE REGISTRY. J Am Coll Cardiol 2017. [DOI: 10.1016/s0735-1097(17)34496-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Progression and Prognosis of Paravalvular Regurgitation After Transcatheter Aortic Valve Implantation. Arq Bras Cardiol 2017. [DOI: 10.5935/abc.20170161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Prospective comparison between three TAVR devices: ACURATE neo vs. CoreValve vs. SAPIEN XT. A single heart team experience in patients with severe aortic stenosis. Catheter Cardiovasc Interv 2016; 90:139-146. [DOI: 10.1002/ccd.26837] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 08/29/2016] [Accepted: 10/08/2016] [Indexed: 11/08/2022]
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TCT-347 Independent Predictors of Mace at Different Time Points After the Treatment of Non-Selected Patients With Drug-Eluting Stents: An Analysis of the Desire Registry. J Am Coll Cardiol 2016. [DOI: 10.1016/j.jacc.2016.09.478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Prognostic value of renal function in patients with aortic stenosis treated with transcatheter aortic valve replacement. Catheter Cardiovasc Interv 2016; 89:452-459. [DOI: 10.1002/ccd.26693] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Revised: 07/05/2016] [Accepted: 07/11/2016] [Indexed: 12/31/2022]
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Long-term clinical follow-up of patients undergoing percutaneous alcohol septal reduction for symptomatic obstructive hypertrophic cardiomyopathy. Catheter Cardiovasc Interv 2016; 88:953-960. [DOI: 10.1002/ccd.26430] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 11/23/2015] [Accepted: 12/31/2015] [Indexed: 01/20/2023]
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CLINICAL OUTCOMES OF A SECOND-GENERATION, SELF-EXPANDING TAVR SYSTEM: A SINGLE-CENTER EXPERIENCE. J Am Coll Cardiol 2016. [DOI: 10.1016/s0735-1097(16)30133-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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INDEPENDENT PREDICTORS OF MACE AT DIFFERENT TIME POINTS AFTER THE TREATMENT OF NON-SELECTED PATIENTS WITH DRUG-ELUTING STENTS: AN ANALYSIS OF THE DESIRE REGISTRY. J Am Coll Cardiol 2016. [DOI: 10.1016/s0735-1097(16)30277-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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CLINICAL IMPACT OF APPROPRIATE USE CRITERIA (AUC) FOR CORONARY REVASCULARIZATION IN CONSECUTIVE, NON-SELECTED PATIENTS TREATED WITH DRUG-ELUTING STENTS: INSIGHTS FROM THE DESIRE REGISTRY. J Am Coll Cardiol 2016. [DOI: 10.1016/s0735-1097(16)30275-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
AIMS To demonstrate the feasibility and efficacy of the novel InSeal VCD for the closure of large puncture holes following percutaneous structural interventions. METHODS AND RESULTS Prospective, non-randomised, single-arm, single-centre study with a series of patients submitted to endovascular treatment of abdominal and thoracic aortic aneurysm as well as transcatheter aortic valve implantation in whom the InSeal VCD was used to close the access site. These patients were followed up for one year with clinical examination, ankle-brachial index and Doppler ultrasound. The primary endpoint was the occurrence of major vascular complications at the puncture site. From a total of nine patients screened, seven were selected to receive the InSeal VCD. Technical and therapeutic successes were achieved in all cases. The sheath profiles used in these procedures ranged from 18 Fr to 25 Fr. No major vascular complications were observed during the follow-up period. Average ankle-brachial index pre-intervention and at one-month follow-up were 0.85 and 0.82, respectively. CONCLUSIONS The InSeal VCD was shown to be effective in achieving acute and chronic haemostasis after usage of higher profile endovascular devices in this study. These results translated into no clinical complications up to one-year clinical follow-up.
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TCT-468 Real-world comparison between 1st and 2nd generation drug-eluting stents: Insights from the DESIRE Registry. J Am Coll Cardiol 2015. [DOI: 10.1016/j.jacc.2015.08.484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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TCT-628 Prospective Non-randomized Comparison Between Three Transcatheter Aortic Valve Replacement Devices: Accurate vs Corevalve vs Sapien XT. A Single Heart Team Experience in Patients With Severe Aortic Stenosis. J Am Coll Cardiol 2015. [DOI: 10.1016/j.jacc.2015.08.647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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TCT-467 Results of Longest Available Clinical Follow-up of a Cohort of “Real-World” Patients Treated Exclusively with Drug-Eluting Stents: the DESIRE (Drug-Eluting Stents In the REal world) Registry. J Am Coll Cardiol 2015. [DOI: 10.1016/j.jacc.2015.08.483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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REAL-WORLD COMPARISON BETWEEN 1ST AND 2ND GENERATION DRUG-ELUTING STENTS: INSIGHTS FROM THE DESIRE REGISTRY. J Am Coll Cardiol 2015. [DOI: 10.1016/s0735-1097(15)61777-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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TCT-647 Predictors of Stent Thrombosis up to 12 Years Follow-up After Drug-Eluting Stent Implantation in Daily Clinical Practice. J Am Coll Cardiol 2014. [DOI: 10.1016/j.jacc.2014.07.715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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TCT-640 MGuard TM Stent Reduces Early Adverse Events In Saphenous Vein Graft Percutaneous Coronary Intervention. J Am Coll Cardiol 2014. [DOI: 10.1016/j.jacc.2014.07.707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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TCT-583 Longest available clinical follow-up of a cohort of “real-world” patients treated exclusively with drug-eluting stents: Results of 12 years of the DESIRE (Drug-Eluting Stents In the REal world) Registry. J Am Coll Cardiol 2014. [DOI: 10.1016/j.jacc.2014.07.646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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TCT-389 Reproducibility of Intracoronary Frequency-Domain Optical Coherence Tomography Quantitative Analysis Using Two Different Software Packages. J Am Coll Cardiol 2014. [DOI: 10.1016/j.jacc.2014.07.437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Initial experience of two national centers in transcatheter aortic prosthesis implantation. Arq Bras Cardiol 2014; 102:336-44. [PMID: 24844875 PMCID: PMC4028937 DOI: 10.5935/abc.20140043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Accepted: 11/28/2013] [Indexed: 01/12/2023] Open
Abstract
Background Transcatheter aortic valve implantation is an effective alternative to
surgical treatment of severe aortic stenosis in patients who are inoperable
or at high surgical risk. Objectives To report the immediate and follow-up clinical and echocardiographic results
of the initial experience of transcatheter aortic valve implantation. Methods From 2009 June to 2013 February, 112 patients underwent transcatheter aortic
valve implantation. Results Mean age was 82.5 ± 6.5 years, and the logistic EuroSCORE was 23.6 ± 13.5.
Procedural success was 84%. After the intervention, a reduction in the mean
systolic gradient was observed (pre: 54.7 ± 15.3 vs. post: 11.7 ± 4.0 mmHg;
p < 0.01). Cerebrovascular accidents occurred in 3.6%, vascular
complications in 19% and permanent pacemaker was required by 13% of the
patients. Thirty-day mortality and at follow-up of 16 ± 11 months was 14%
and 8.9% respectively. The presence of chronic obstructive pulmonary disease
was the only predictor of mortality at 30 days and at follow-up. During
follow up, aortic valve area and mean systolic gradient did not change
significantly. Conclusions Transcatheter aortic valve implantation is an effective and safe procedure
for the treatment of aortic stenosis in high-surgical risk or inoperable
patients. The presence of chronic obstructive pulmonary disease was the only
independent predictor of mortality identified both in the first month
post-intervention and at follow-up.
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12-YEAR CLINICAL OUTCOMES OF PATIENTS TREATED WITH DRUG-ELUTING STENTS IN THE DESIRE REGISTRY: DEFINING INDEPENDENT PREDICTORS OF MAJOR ADVERSE CARDIAC EVENTS. J Am Coll Cardiol 2014. [DOI: 10.1016/s0735-1097(14)61850-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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LATE AND VERY LATE STENT THROMBOSIS WITH SECOND GENERATION DRUG-ELUTING STENTS – A SUBANALYSIS OF THE LARGE, PROSPECTIVE DESIRE (DRUG-ELUTING STENT IN THE REAL WORLD) REGISTRY. J Am Coll Cardiol 2014. [DOI: 10.1016/s0735-1097(14)61877-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Renal denervation using an irrigated catheter in patients with resistant hypertension: a promising strategy? Arq Bras Cardiol 2014; 102:355-63. [PMID: 24652055 PMCID: PMC4028938 DOI: 10.5935/abc.20140034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Accepted: 10/18/2013] [Indexed: 11/20/2022] Open
Abstract
Background Systemic hypertension is an important public health problem and a significant
cause of cardiovascular mortality. Its high prevalence and the low rates of
blood pressure control have resulted in the search for alternative
therapeutic strategies. Percutaneous renal sympathetic denervation emerged
as a perspective in the treatment of patients with resistant hypertension.
Objective To evaluate the feasibility and safety of renal denervation using an
irrigated catheter. Methods Ten patients with resistant hypertension underwent the procedure. The primary
endpoint was safety, as assessed by periprocedural adverse events, renal
function and renal vascular abnormalities at 6 months. The secondary
endpoints were changes in blood pressure levels (office and ambulatory
monitoring) and in the number of antihypertensive drugs at 6 months. Results The mean age was 47.3 (± 12) years, and 90% of patients were women. In the
first case, renal artery dissection occurred as a result of trauma due to
the long sheath; no further cases were observed after technical adjustments,
thus showing an effect of the learning curve. No cases of thrombosis/renal
infarction or death were reported. Elevation of serum creatinine levels was
not observed during follow-up. At 6 months, one case of significant renal
artery stenosis with no clinical consequences was diagnosed. Renal
denervation reduced office blood pressure levels by 14.6/6.6 mmHg, on
average (p = 0.4 both for systolic and diastolic blood pressure). Blood
pressure levels on ambulatory monitoring decreased by 28/17.6 mmHg (p = 0.02
and p = 0.07 for systolic and diastolic blood pressure, respectively). A
mean reduction of 2.1 antihypertensive drugs was observed. Conclusion Renal denervation is feasible and safe in the treatment of resistant systemic
arterial hypertension. Larger studies are required to confirm our
findings.
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Miniaturized self-expanding drug-eluting stent in small coronary arteries: late effectiveness. Arq Bras Cardiol 2013; 101:379-87. [PMID: 24100691 PMCID: PMC4081161 DOI: 10.5935/abc.20130199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Accepted: 04/23/2013] [Indexed: 11/20/2022] Open
Abstract
Background Small vessels represent a risk factor for restenosis in percutaneous coronary
angioplasty (PCA). The Sparrow® self-expanding drug-eluting stent,
which has a lower profile than the current systems, has never been tested in this
scenario. Objectives To evaluate the late effectiveness of the Sparrow® drug-eluting stent,
regarding in-stent late lumen loss (LLL). Methods Patients with ischemia, symptomatic or documented, were submitted to PCA in
vessels with reference diameter < 2.75 mm, divided into two groups regarding
Sparrow® stent type: group 1: Sparrow® drug-eluting stent
(DES), group 2: Sparrow® bare metal stent (BMS). Clinical follow-up
duration was 12 months. Evaluation using quantitative coronary angiography (QCA)
was performed immediately and at 8 months. A decrease of over 65% of in-stent LLL
with DES was estimated to calculate sample size. IBM® SPSS software,
release 19 (Chicago, Illinois, USA) was used for the statistical analysis. Results A total of 24 patients were randomized, 12 in each group. The DES and BMS groups
were similar in age (63.25 ± 10.01 vs. 64.58 ± 11.54, p = 0.765), male gender
(58.3% vs. 33.3%, p = 0.412), risk factors and all angiographs aspects. Immediate
results were satisfactory in both groups. At 8 months in-stent late lumen loss was
significantly lower in DES than in BMS group (DES vs. BMS 0.25 ± 0.16 0.97 ± 0.76,
p = 0.008). Conclusion In small-vessel PCA, the Sparrow® DES determined significant reduction
in in-stent LLL, when compared to Sparrow® BMS.
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TCT-596 Early Vascular Restoration following treatment of single de-novo coronary artery lesions with the DESolve Nx Novolimus Eluting Bioresorbable Coronary Scaffold System (NEBCSS) at 6 months: Insights from the Serial IVUS analysis of the pivotal, prospective, multicentre, DESolve NX Trial. J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.08.1343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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TCT-209 Very-long term (11 years) follow up of a single center, complex cohort of patients treated exclusively with drug-eluting stents. J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.08.943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Vessel remodeling and plaque distribution in side branch of complex coronary bifurcation lesions: a grayscale intravascular ultrasound study. Int J Cardiovasc Imaging 2013; 29:1657-66. [PMID: 23868286 DOI: 10.1007/s10554-013-0263-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Accepted: 07/04/2013] [Indexed: 10/26/2022]
Abstract
To investigate vessel remodeling and plaque distribution in side branch (SB) of true coronary bifurcation lesions with SB disease extending from its ostium. A total of 62 patients with single de novo true bifurcation lesions with SB with severe and extensive disease were enrolled. Of that, 45 patients/lesions underwent pre-intervention intravascular ultrasound (IVUS) at the SB. Left anterior descending was the most prevalent target vessel (>85%). All lesions had significant involvement of both branches of the bifurcation, and the majority were classified as type 1,1,1 according to the Medina classification. Considering the subset with IVUS imaging, mean lesion length, reference diameter and % diameter stenosis in the SB were 8.88 ± 4.61 mm, 2.68 ± 0.59, and 70.2 ± 16.0%, respectively. Also, mean proximal (take-off) and distal (carina) angles were 142.3 ± 21.9° and 60.7 ± 22.4°, respectively. At minimum lumena area (MLA) site, mean external elastic membrane and MLA cross-sectional areas were 6.70 ± 2.08 and 1.87 ± 0.93 mm2, respectively; given that the mean distance measured between the SB origin and MLA site was <1 mm. In addition, mean plaque burden was 67.9% and mean remodeling index was 0.78 ± 0.21. Importantly, only 9 cases out of 45 presented remodeling index > 1.0. Also, plaque distribution analysis within the SB ostium demonstrated preferable plaque positioning in the opposite side to the flow divider. In conclusions, significant negative remodeling is a frequent encounter in SB of complex coronary bifurcation lesions presenting with extensive and severe disease; in addition, plaque distribution in the SB ostium appears to be asymmetric in relation to the parent vessel, as plaque burden is mostly found in regions of low wall shear stress including the opposite side to the flow divider within the bifurcation anatomy.
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Unilateral Renal Artery Sympathetic Denervation May Reduce Blood Pressure in Patients With Resistant Hypertension. J Clin Hypertens (Greenwich) 2013; 15:606. [DOI: 10.1111/jch.12121] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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TEN–YEAR FOLLOW–UP OF THE DESIRE (DRUG–ELUTING STENTS IN THE REAL WORLD) REGISTRY. J Am Coll Cardiol 2013. [DOI: 10.1016/s0735-1097(13)61736-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract
BACKGROUND In some randomized trials comparing revascularization strategies for patients with diabetes, coronary-artery bypass grafting (CABG) has had a better outcome than percutaneous coronary intervention (PCI). We sought to discover whether aggressive medical therapy and the use of drug-eluting stents could alter the revascularization approach for patients with diabetes and multivessel coronary artery disease. METHODS In this randomized trial, we assigned patients with diabetes and multivessel coronary artery disease to undergo either PCI with drug-eluting stents or CABG. The patients were followed for a minimum of 2 years (median among survivors, 3.8 years). All patients were prescribed currently recommended medical therapies for the control of low-density lipoprotein cholesterol, systolic blood pressure, and glycated hemoglobin. The primary outcome measure was a composite of death from any cause, nonfatal myocardial infarction, or nonfatal stroke. RESULTS From 2005 through 2010, we enrolled 1900 patients at 140 international centers. The patients' mean age was 63.1±9.1 years, 29% were women, and 83% had three-vessel disease. The primary outcome occurred more frequently in the PCI group (P=0.005), with 5-year rates of 26.6% in the PCI group and 18.7% in the CABG group. The benefit of CABG was driven by differences in rates of both myocardial infarction (P<0.001) and death from any cause (P=0.049). Stroke was more frequent in the CABG group, with 5-year rates of 2.4% in the PCI group and 5.2% in the CABG group (P=0.03). CONCLUSIONS For patients with diabetes and advanced coronary artery disease, CABG was superior to PCI in that it significantly reduced rates of death and myocardial infarction, with a higher rate of stroke. (Funded by the National Heart, Lung, and Blood Institute and others; FREEDOM ClinicalTrials.gov number, NCT00086450.).
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Serial greyscale and radiofrequency intravascular ultrasound assessment of plaque modification and vessel geometry at proximal and distal edges of bare metal and first-generation drug-eluting stents. EUROINTERVENTION 2012; 8:225-34. [PMID: 22717925 DOI: 10.4244/eijv8i2a36] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Little is known about the correlation between modifications in plaque composition at stent edges and the changes in vessel geometry. This study sought to evaluate, by serial greyscale intravascular ultrasound (IVUS) and Virtual Histology intravascular ultrasound (VH-IVUS), the modifications in plaque composition at the edges of drug-eluting and bare metal stents and the correlation of these findings with changes in the measurements of vessel, lumen and plaque area at those segments. METHODS AND RESULTS Single-centre, prospective and randomised (1:1) evaluation of 40 patients with acute coronary syndrome treated with bare metal (Driver; Medtronic, Santa Clara, CA, USA; n=20 patients) or drug-eluting stents (Cypher; Cordis, Miami Lakes, FL, USA; n=20 patients). IVUS and VH-IVUS assessments were done post-procedure and at nine months. Primary endpoint included the modification in vessel, lumen and plaque area and in the composition of the plaque in the mean time between the baseline and follow-up procedure. At the proximal edge of the vessel treated with the Cypher stent, a trend toward positive vessel remodelling (D=+0.6 mm², p=0.06) was observed while at the distal edge, less plaque growth (D=+0.2 mm² vs. D=+1.1 mm², p<0.001), resulted in a larger lumen area at follow-up. By VH, there was a marked reduction in the percentage of fibrotic tissue and necrotic core at the edges of both stents and a positive correlation was seen between increase in percentage of fibro-fatty component and increase in plaque area (r=0.78, p=0.01). CONCLUSION Patients treated with drug-eluting stents (DES) experienced less plaque growth, especially at the distal edge of the stents. Modifications in plaque composition, with increase in fibrofatty tissue component, may partially explain these findings.
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TCT-306 Intravascular Ultrasound Findings In Complex Coronary Bifurcation Lesions Treated with Single Stenting Versus Double Stenting Strategies. J Am Coll Cardiol 2012. [DOI: 10.1016/j.jacc.2012.08.330] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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TCT-644 Drug eluting stents in the elderly: very long-term clinical outcomes (up to 10 years) of octogenarians in the DESIRE Registry. J Am Coll Cardiol 2012. [DOI: 10.1016/j.jacc.2012.08.681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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TCT-458 Late Outcomes of Patients with Myocardial Infarction Undergoing Drug-Eluting Stent Implantation in Daily Clinical Practice. J Am Coll Cardiol 2012. [DOI: 10.1016/j.jacc.2012.08.490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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TCT-669 Incidence and Correlates of Stent Thrombosis up to 10 Years After Drug-Eluting Stent Implantation in Daily Clinical Practice. J Am Coll Cardiol 2012. [DOI: 10.1016/j.jacc.2012.08.706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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SERIAL GREY-SCALE AND RADIOFREQUENCY INTRAVASCULAR ASSESSMENT OF PLAQUE MODIFICATION AND VESSEL GEOMETRY AT PROXIMAL AND DISTAL EDGES OF BARE-METAL AND DRUG-ELUTING STENTS. J Am Coll Cardiol 2012. [DOI: 10.1016/s0735-1097(12)60142-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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VERY LOW RATES OF STENT THROMBOSIS UP TO 10 YEARS FOLLOWING DRUG-ELUTING STENT IMPLANTATION IN THE REAL WORLD CLINICAL PRACTICE. J Am Coll Cardiol 2012. [DOI: 10.1016/s0735-1097(12)60205-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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TWO-YEAR SUSTAINED EFFICACY OF A NOVEL, POLYMER-FREE SIROLIMUS ELUTING STENT: LATE RESULTS OF THE VESTASYNC II TRIAL. J Am Coll Cardiol 2012. [DOI: 10.1016/s0735-1097(12)60213-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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TEN-YEAR FOLLOW-UP OF THE DESIRE REGISTRY: A SINGLE-CENTER PERSPECTIVE ON DRUG-ELUTING STENTS A DECADE LATER. J Am Coll Cardiol 2012. [DOI: 10.1016/s0735-1097(12)60325-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Impact on Renal Function of Rosuvastatin Preload Prior to Elective Percutaneous Coronary Intervention in Chronic Statin Users. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/s2214-1235(15)30069-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Avaliação do recolhimento elástico tardio de stents farmacológicos de primeira e segunda gerações. ACTA ACUST UNITED AC 2011. [DOI: 10.1590/s2179-83972011000300012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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One-year results of the INSPIRE trial with the novel MGuard stent: Serial analysis with QCA and IVUS. Catheter Cardiovasc Interv 2011; 78:1095-100. [DOI: 10.1002/ccd.22980] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2010] [Accepted: 01/08/2011] [Indexed: 11/10/2022]
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THE IMPACT OF RENAL INSUFFICIENCY DETECTED BY SERUM CREATININE VERSUS ANALYSIS OF CREATININE CLEARANCE IN THE VERY LONG TERM OUTCOMES (UP TO 8 YEARS) OF NON-SELECTED PATIENTS TREATED WITH DRUG-ELUTING STENTS. J Am Coll Cardiol 2011. [DOI: 10.1016/s0735-1097(11)61898-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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PRELIMINARY RESULTS OF THE MULTICENTRIC, DOUBLE-BLINDED, RANDOMIZED, VESTASYNC II TRIAL. J Am Coll Cardiol 2011. [DOI: 10.1016/s0735-1097(11)61831-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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PERCUTANEOUS CORONARY INTERVENTION IN PATIENTS WITH PREVIOUS CORONARY ARTERY BYPASS GRAFTING: INCIDENCE AND BASELINE CHARACTERISTICS OF PATIENTS. J Am Coll Cardiol 2011. [DOI: 10.1016/s0735-1097(11)61138-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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