Progetto GISE Network – Fase operativa avanzata
Il progetto GISE Network si propone di eseguire la raccolta sistematica dei dati di attività che, in un prossimo futuro, diverrà il sistema unico di raccolta dati annuale SICI-GISE. Tale...
In patients with very late stent thrombosis, optical coherence tomography (OCT) often reveals advanced atherosclerosis with thrombosis at the site of neointimal rupture, according to a small observational study published in the June 2013 issue of JACC: Cardiovascular Imaging.
Investigators... -
Postmarketing Registry Data Show MitraClip Safe, Effective for MR 
Percutaneous mitral valve repair is effective and safe in a patient population that is at high surgical risk, elderly, and mainly affected by functional mitral regurgitation (MR), according to a European study scheduled to be published online June 4, 2013, ahead of print in the Journal of the...
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Meta-analysis: Cobalt-Chromium EES Take the Lead Over BMS, Other DES in STEMI
In patients with ST-segment elevation myocardial infarction (STEMI), cobalt-chromium everolimus-eluting stents (EES) result in less death and myocardial infarction (MI) as well as less stent thrombosis than bare-metal stents (BMS), according to results from a study scheduled to be published online...
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Adoption of Radial Access and Comparison of Outcomes to Femoral Access in Percutaneous Coronary Intervention - An Updated Report from the National Cardiovascular Data Registry (2007?2012) 
Background—Radial access for percutaneous coronary intervention (r-PCI) is associated with reduced vascular complications; however, previous reports have shown that <2% of percutaneous coronary intervention (PCI) procedures in the United States are performed via the radial approach....
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Predictors of Mortality and Outcomes of Therapy in Low-Flow Severe Aortic Stenosis - A Placement of Aortic Transcatheter Valves (PARTNER) Trial Analysis
Background—The prognosis and treatment of patients with low-flow (LF) severe aortic stenosis are controversial.
Methods and Results—The Placement of Aortic Transcatheter Valves (PARTNER) trial randomized patients with severe aortic stenosis to medical management versus...
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Histopathology of Embolic Debris Captured During Transcatheter Aortic Valve Replacement
Background—Recent transcatheter aortic valve replacement studies have raised concerns about adverse cerebrovascular events. The etiopathology of the embolized material is currently unknown.
Methods and Results—A total of 40 patients underwent transcatheter aortic valve...
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Side Branch Dilatation Helpful Before T-Stenting of Bifurcation Lesions 
PARIS, France—In treating patients with true bifurcation lesions, predilatation of the side branch before provisional T-stenting improves coronary blood flow and has no adverse consequences, according to findings of a randomized trial presented Thursday, May 23 at EuroPCR 2013.
Manuel Pan,...
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ELISA-3: Early vs. Late Intervention No Different for High-Risk NSTE ACS Patients
PARIS, France—Early invasive treatment is not superior to a delayed strategy in older, high-risk patients with non-ST-segment acute coronary syndromes (NSTE ACS), researchers reported Thursday, May 23 at EuroPCR 2013. The findings, from the randomized ELISA-3 trial, were simultaneously...
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RIPCORD Study: FFR Results Change Path of Patient Management
PARIS, France—Routine assessment of fractional flow reserve (FFR) at the time of diagnostic angiography could change the course of treatment for more than a quarter of patients with stable angina, according to findings presented Thursday, May 23 at EuroPCR 2013.
For the RIPCORD trial, Nick...
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Paclitaxel-eluting Balloon Matches Taxus for Treating DES Restenosis
PARIS, France—Using paclitaxel-eluting balloons to treat drug-eluting stent (DES) restenosis is a noninferior alternative to paclitaxel-eluting stents (PES), obviating the need for additional stent layers, according to data from the PEPCAD China ISR trial presented May 23 at EuroPCR...
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PRAGUE-19 Registry: Bioresorbable Scaffolds an Option for Certain STEMI Patients
PARIS, France—Implantation of bioresorbable vascular scaffolds (BVS) appears feasible and safe in select patients with acute ST-segment elevation myocardial infarction (STEMI), according to early registry results presented Wednesday, May 22, at EuroPCR 2013.
While BVS are safe and...
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Transcatheter Device Closure of Atrial Septal Defects: A Safety Review 
This review discusses the current safety issues related to U.S. Food and Drug Administration approved atrial septal defect devices and proposes a potential avenue to gather additional safety data including factors, which may be involved in device erosion.
Atrial septal defects (ASD) are...
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Final 5-Year Outcomes From the Endeavor Zotarolimus-Eluting Stent Clinical Trial Program - Comparison of Safety and Efficacy With First-Generation Drug-Eluting and Bare-Metal Stents
Objectives The aim of this study was to evaluate late safety and efficacy outcomes among patients enrolled in clinical trials comparing Endeavor zotarolimus-eluting stents (E-ZES) (Medtronic, Inc., Santa Rosa, California) with first-generation drug-eluting stents (DES) and bare-metal...
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Modified Flower Petal Technique A New Technique for the Treatment of Medina Type 1.1.1 Coronary Bifurcation Lesions
Objectives This study sought to propose a new technique for the treatment of Medina type 1.1.1 bifurcation lesions.
Background Although there are many different 2-stent techniques, the optimal strategy for patients with Medina type 1.1.1 bifurcation lesions has not yet been...
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Objectives This study sought to assess the vascular response of overlapping Absorb stents compared with overlapping newer-generation everolimus-eluting metallic platform stents (Xience V [XV]) in a porcine coronary artery model.
Background The everolimus-eluting...
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Very Late Stent Thrombosis 5 Years After Implantation of a Sirolimus-Eluting Stent Observed by Angioscopy and Optical Coherence Tomography
Drug-eluting stents have dramatically reduced the rate of in-stent restenosis (1). However, very late stent thrombosis (VLST) is one of the clinical issues with regard to the safety of drug-eluting stents ((2),3). To date there are no articles that report VLST evaluated by both angioscopy and...
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Objectives This study sought to compare all-cause mortality in patients at intermediate surgical risk undergoing transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR).
Background Physicians are selecting “lower” surgical risk...
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Imaging Detects Vascular Injury Arising from Catheter-Based Renal Denervation
Patients who undergo percutaneous renal nerve ablation for treatment-resistant hypertension show signs of endothelial and vascular injury on optical coherence tomography (OCT), according to a paper published online April 25, 2013, ahead of print in the European Heart Journal.
To prevent...
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Mechanisms of Tissue Uptake and Retention in Zotarolimus-Coated Balloon Therapy
Background—Drug-coated balloons are increasingly used for peripheral vascular disease, and, yet, mechanisms of tissue uptake and retention remain poorly characterized. Most systems to date have used paclitaxel, touting its propensity to associate with various excipients that can optimize...
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ESC Offers Recommendations on Use of New Oral Anticoagulants
With the recent introduction of several novel oral anticoagulants—including dabigatran, rivaroxaban, apixaban, and the still-experimental endoxaban—the European Heart Rhythm Association (EHRA) of the European Society of Cardiology (ESC) has issued a consensus document that offers...
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NEXT Published: Biodegradable Polymer BES Shows Noninferiority to EES
A novel biolimus A9-eluting stent (BES) with a biodegradable polymer appears clinically and angiographically noninferior to a current-generation everolimus-eluting stent (EES), according to results of the randomized NEXT trial scheduled to be published online May 7, 2013, ahead of print in...
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Promising Early Valve-in-Valve Results Seen in Small Nordic Registry
For patients undergoing transcatheter valve-in-valve procedures to replace failed bioprostheses, low rates of 30-day mortality, major complications, and paravalvular leak are encouraging, as is the high 1-year survival rate, according to registry data presented at the American Academy of Thoracic...
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PARADOX Published: Smokers? Paradox Seen with Clopidogrel But not Prasugrel
Cigarette smoking appears to augment the antiplatelet effect of clopidogrel but not prasugrel, according to a study of patients with stable coronary artery disease (CAD) published online April 24, 2013, ahead of print in the Journal of the American College of Cardiology. Prasugrel, however,...
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Meta-analysis: DES Beneficial But May Not Save Limbs, Improve Survival in PAD Patients
In patients with infrapopliteal occlusive disease, drug-eluting stents (DES) result in improved patency and greater freedom from target vessel revascularization (TVR) at 1 year compared with bare-metal stents (BMS), according to a meta-analysis published in the April 2013 issue of the Journal...
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Prevention of Right Ventricular Perforation Due to Temporary Pacemaker Lead During Transcatheter Aortic Valve Replacement
We read with great interest the recently published paper by Rezq et al. (1), which described the experience of the authors with cardiac tamponade complicating transcatheter aortic valve replacement (TAVR). The authors should be congratulated on sharing their experience and techniques to avoid this...
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Objectives. The aim of this study was to describe the process to obtain Food and Drug Administration (FDA) approval for the expanded indication for treatment with the Resolute zotarolimus-eluting stent (R-ZES) (Medtronic, Inc., Santa Rosa, California) in patients with coronary artery disease and...
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Nonemergency PCI at Hospitals with or without On-Site Cardiac Surgery 
BACKGROUND
Emergency surgery has become a rare event after percutaneous coronary intervention (PCI). Whether having cardiac-surgery services available on-site is essential for ensuring the best possible outcomes during and after PCI remains uncertain.
METHODS
We enrolled patients...
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Analysis of Stroke Occurring in the SYNTAX Trial Comparing Coronary Artery Bypass Surgery and Percutaneous Coronary Intervention in the Treatment of Complex Coronary Artery Disease
Objectives. This study sought to analyze stroke rates in the SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) trial's randomized and registry cohorts of patients being treated with coronary artery bypass grafting (CABG) or percutaneous coronary...
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Fibrinolysis or Primary PCI in ST-Segment Elevation Myocardial Infarction
BACKGROUND
It is not known whether prehospital fibrinolysis, coupled with timely coronary angiography, provides a clinical outcome similar to that with primary percutaneous coronary intervention (PCI) early after acute ST-segment elevation myocardial infarction...
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Valvular Heart Disease: Clinical Impact of Persistent Left Bundle-Branch Block After Transcatheter Aortic Valve Implantation With CoreValve Revalving System
Background—Conduction disturbances are relatively common after transcatheter aortic valve implantation. Previous data demonstrated an adverse impact of persistent left bundle-branch block (LBBB) after surgical aortic valve replacement. It is unclear whether new-onset LBBB may also impact...
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A Systematic Review and Meta-Analysis on Primary Percutaneous Coronary Intervention of an Unprotected Left Main Coronary Artery Culprit Lesion in the Setting of Acute Myocardial Infarction
Objectives. This study sought to evaluate 30-day all-cause mortality of patients treated with primary percutaneous coronary intervention (PCI) presenting with an acute myocardial infarction (AMI) due to an unprotected left main coronary artery (ULMCA) culprit lesion. In addition, an average...
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The Final 5-Year Follow-Up From the ENDEAVOR IV Trial Comparing a Zotarolimus-Eluting Stent With a Paclitaxel-Eluting Stent
Objectives. This study sought to report the final 5-year outcomes of the ENDEAVOR IV (A Randomized, Controlled Trial of the Medtronic Endeavor Drug [ABT-578] Eluting Coronary Stent System Versus the Taxus Paclitaxel-Eluting Coronary Stent System in De Novo Native Coronary Artery Lesions) trial...
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The REMEDEE Trial - A Randomized Comparison of a Combination Sirolimus-Eluting Endothelial Progenitor Cell Capture Stent With a Paclitaxel-Eluting Stent
Objectives. This study sought to compare the efficacy and safety results after coronary implantation of a combined sirolimus-eluting CD34 antibody coated Combo stent (OrbusNeich Medical, Ft. Lauderdale, Florida) with the paclitaxel-eluting Taxus Liberté stent (PES) (Boston Scientific,...
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Fractional Flow Reserve Assessment of Left Main Stenosis in the Presence of Downstream Coronary Stenoses
Background—Several studies have shown that fractional flow reserve (FFR) measurement can aid in the assessment of left main coronary stenosis. However, the impact of downstream epicardial stenosis on left main FFR assessment with the pressure wire in the nonstenosed downstream vessel...
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Valvular Heart Disease: Clinical Impact of Persistent Left Bundle-Branch Block After Transcatheter Aortic Valve Implantation With CoreValve Revalving System
Background—Conduction disturbances are relatively common after transcatheter aortic valve implantation. Previous data demonstrated an adverse impact of persistent left bundle-branch block (LBBB) after surgical aortic valve replacement. It is unclear whether new-onset LBBB may also impact...
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Hemorrhagic and Ischemic Outcomes After Bivalirudin Versus Unfractionated Heparin During Carotid Artery Stenting. A Propensity Score Analysis From the NCDR
Background—The direct thrombin inhibitor, bivalirudin, is associated with similar efficacy and superior safety in patients undergoing percutaneous coronary intervention. However, the role of direct thrombin inhibitors in carotid artery stenting is not well defined. The objective of this...
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Effect of Radial Versus Femoral Access on Radiation Dose and the Importance of Procedural Volume-A Substudy of the Multicenter Randomized RIVAL Trial
Objectives The authors sought to compare the radiation dose between radial and femoral access.
Background Small trials have shown an increase in the radiation dose with radial compared with femoral access, but many were performed during the operators' learning curve of...
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Percutaneous Coronary Intervention Versus Optimal Medical Therapy for Prevention of Spontaneous Myocardial Infarction in Subjects With Stable Ischemic Heart Disease
Background
Contemporary studies have shown that spontaneous but not procedural myocardial infarction (MI) is related to subsequent mortality. Whether percutaneous coronary intervention (PCI) reduces spontaneous (nonprocedural) MI is unknown.
Methods and Results
PubMed,...
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Catheter-based Renal Denervation with the Symplicity? System Provides Safe and Durable Blood Pressure Reduction out to Three Years
Background
The Symplicity™ renal denervation catheter uses low power radiofrequency energy to ablate the renal artery nerves and has been shown to lower blood pressure (BP) in patients with treatment-resistant hypertension. Continued follow-up of patients who have undergone renal...
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Treatment Of Coronary Bifurcation Lesions: Stentcovering Of The Side Branch With And Without PCI Of The Side Branch - A Retrospective Analysis Of All Consecutive Patients
Background
Treatment of coronary bifurcation lesions is a complex issue.
Methods
This retrospective observational study included patients (pts) who underwent PCI of a de novo coronary bifurcation lesion between January 2008 - August 2011. We included all consecutive patients...
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Management Of Patients With Or Without Previous Coronary Artery Bypass Surgery (CABG), Presenting With Acute Coronary Syndrome (ACS).
Background
Patients presenting with non ST segment elevation acute coronary syndrome (NSTEMI-ACS) have higher morbidity and mortality, if treated only conservatively in comparison to invasive revascularization strategy.
Coronary artery bypass graft (CABG) surgery is a commonly performed...
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Long term Outcomes of Patients Treated With The Paclitaxel- Versus The Everolimus -eluting Stents in a Consecutive Cohort of Patients at a Tertiary Medical Center
Background
In this study we compare the outcomes of the paclitaxel-eluting stent (PES) versus the everolimus-eluting stent (EES) treated patients at a tertiary medical center and up to two years follow up.
Methods
Unselected consecutive patients were retrospectively recruited...
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Predictors of In-hospital Outcome after Primary PCI of Left Main Coronary Artery Acute Myocardial Infarction with Cardiogenic Shock
Background
In patients with acute myocardial infarction (AMI) and cardiogenic shock, emergency revascularization improves long-time survival. However, predictors of in-hospital outcome after primary PCI of left main coronary artery (LMCA) AMI remain...
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Stenting of Unprotected Left Main Stem Using the Zotarolimus-coated Endeavor?-Stent. A Single Center Registry
Background
The aim of this registry is to demonstrate whether the implantation of a Zotarolimus-eluting (ZES) Endeavor™ stent (Medtronic Corp., USA.) into an unprotected left main stem is both safe and efficiently feasible in the long term, in an unselected patient population with...
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Drug Eluting Stents versus Bare Metal Stents in Non-Insulin Dependent Diabetic Patients with Large Coronary Arteries
Background
It is well known that the risk of restenosis and other adverse cardiac events with bare metal stents (BMS) is increased with smaller stent diameters especially in diabetic patients. Drug eluting stents (DES) have a particular benefit in small vessel disease that been repeatedly...
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Reduction in First and Recurrent Cardiovascular Events With Ticagrelor Compared With Clopidogrel in the PLATO Study
Background
We sought to evaluate the effect of potent platelet inhibition after acute coronary syndrome on total (ie, first and recurrent) occurrences of any of the primary outcome events (eg, cardiovascular death, myocardial infarction, and stroke) as well as on other ischemic events, such...
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Speciale ACC 2013: RELAX: Sildenafil falls short in preserved-EF heart failure 
San Francisco, CA (updated) - It wasn't just the drug's mystique that led to the Phosphodiesterase-5 Inhibition to Improve Clinical Status and Exercise Capacity in Diastolic Heart Failure (RELAX) trial [1]. Nor was it completely exasperation over...
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Speciale ACC 2013: SELECT-ACS: Hints of myocardial sparing with inclacumab in NSTEMI San Francisco, CA - A small, phase 2 study, with a biomarker test for its primary end point, offers some encouraging hints that the P-selectin antagonist inclacumab may be able to reduce myocardial damage in patients undergoing PCI for non-ST-elevation MI [1].
Presenting...
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Speciale ACC 2013: STREAM: First success for fibrinolysis before transport to PCI San Francisco, CA - Fibrinolysis with tenecteplase and contemporary antithrombotic therapy given before transport to a PCI-capable hospital coupled with timely coronary angiography is as effective as primary PCI in STEMI patients presenting within three hours of symptom...
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Speciale ACC 2013: APPOSITION III: Self-expanding stent may cut MACE, deaths in AMI San Francisco - A self-expanding stent, designed to overcome the difficulty of correctly sizing a coronary stent in the setting of AMI, may help reduce rates of mortality and reinfarction in these acute patients, according to one-year results from the APPOSITION...
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Speciale ACC 2013: Hints of renal-denervation side benefit: Fewer ventricular arrhythmias San Francisco, CA - While renal denervation achieved its goals of lowering blood pressure and heart rate in a small series of especially high-risk patients with drug-resistant hypertension, it also lessened their burden of ventricular and supraventricular arrhythmias, according to researchers...
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Speciale ACC 2013: PEITHO: Persuasive for thrombolysis in PE? San Francisco, CA - The addition of the thrombolytic agent tenecteplase to standard treatment with heparin in patients with intermediate-risk pulmonary embolism (PE) significantly reduced the primary end point of death or hemodynamic collapse within seven days of...
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Speciale ACC 2013: MASS COMM: Elective PCI safely performed without surgical backup San Francisco, CA - Nonemergent PCI can be safely performed in community hospitals without on-site cardiac surgery, with Massachusetts investigators reporting that there was no difference in major adverse cardiac events (MACE) at 30 days and 12 months when these patients were compared with...
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Speciale ACC 2013: Minimize weight gain to maximize smoking-cessation benefit San Francisco, CA - A new study of 1000 contemporary smokers shows that those who were able to stop smoking, which was around 40% of the group, gained more weight and had a higher risk of developing impaired fasting glucose (IFG) and type 2 diabetes than those who continued to smoke. The...
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Speciale ACC 2013: Direct renin inhibitor aliskiren flops as add-on therapy in systolic HF: ASTRONAUT San Francisco, CA (updated) - Adding aliskiren (Tekturna, Novartis) on top of other heart-failure medications, starting less than a week after discharge from a hospitalization for low-LVEF heart failure, made no significant difference to CV death or hospitalization at six...
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Speciale ACC 2013: Atherosclerosis evident in four ancient populations, including hunter-gatherers San Francisco, CA - Whole-body computed tomography (CT) scans of mummies from four geographical regions across a period of 4000 years suggest that atherosclerosis was more common in ancient populations than previously believed [1] Studying individuals from ancient Egypt, ancient Peru, ancestral...
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Speciale ACC 2013: Stopping rivaroxaban and warfarin temporarily in AF patients yields similar risks San Francisco, CA - Patients with atrial fibrillation (AF) at moderate to high risk of stroke who briefly stop oral anticoagulation with rivaroxaban (Xarelto, Bayer/Janssen) have similar risks of clinical events as those treated with warfarin. The temporary interruption resulted...
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A Novel Total Endovascular Approach Treating Complex Aortic Arch Aneurysms In High Risk Patients
Objective
To report our early experience with total endovascular repair of aortic arch aneurysm using additional trans-carotidal double chimney-grafts to preserve blood flow to supraaortic arteries.
Patients And Methods
The double chimney-graft technique was performed in six...
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Nicorandil Matches Safety, Efficacy of Adenosine in FFR Assessment 
Nicorandil, a vasodilator, appears to effectively induce hyperemia during fractional flow reserve (FFR) measurement with few adverse events. The drug may prove to be a more convenient, safer alternative to adenosine, according to a paper published online February 8, 2013, ahead of print in...
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Calculation of the Index of Microcirculatory Resistance Without Coronary Wedge Pressure Measurement in the Presence of Epicardial Stenosis
Objectives This study sought to investigate a novel method to calculate the index of microcirculatory resistance (IMR) in the presence of significant epicardial stenosis without the need for balloon dilation to measure the coronary wedge pressure...
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Carotid Artery Stenting of a Contralateral Occlusion and In-Hospital Outcomes Results From the CARE (Carotid Artery Revascularization and Endarterectomy) Registry
Objectives The authors sought to study the characteristics and outcomes of patients with contralateral carotid artery occlusions (CCOs) undergoing elective carotid artery stenting (CAS).
Background CCOs are associated with adverse neurological events following...
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Predictors of Clinical Outcomes in Patients With Severe Aortic Stenosis Undergoing TAVI
Background—Patients with severe aortic stenosis at increased surgical risk continue to experience compromised long-term survival despite successful transcatheter aortic valve implantation. We used time-related pathways in a multistate analysis to identify predictors of adverse long-term...
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Efficacy and Safety of Postdilatation to Reduce Paravalvular Regurgitation During Balloon-Expandable Transcatheter Aortic Valve Replacement
Background—Paravalvular regurgitation (PVR) is common after transcatheter aortic valve replacement (TAVR) and may be associated with adverse outcomes. Postdilatation (PD) has been proposed to treat PVR without being formally studied. We performed a study to evaluate the safety and...
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Contrast-Induced Acute Kidney Injury and Risk of Adverse Clinical Outcomes After Coronary Angiography A Systematic Review and Meta-Analysis
Background—Contrast-induced acute kidney injury (CI-AKI) has been associated with mortality, although it has been suggested this association may be attributable to confounding. We performed a systematic review and meta-analysis to characterize the associations between CI-AKI and...
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Refined Balloon Pulmonary Angioplasty for Inoperable Patients with Chronic Thromboembolic Pulmonary Hypertension
Background—Although balloon pulmonary angioplasty (BPA) for inoperable patients with chronic thromboembolic pulmonary hypertension was first reported over a decade ago, its clinical application has been restricted because of limited efficacy and complications. We have refined the...
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Radial access use has been growing steadily but, despite encouraging results, still varies greatly among operators, hospitals, countries and continents. Twenty years from its introduction, it was felt that the time had come to develop a common evidence-based view on the technical, clinical and...
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Prasugrel Reloading Feasible After Clopidogrel Pretreatment in ACS Patients
Pretreatment with clopidogrel should not prohibit reloading with prasugrel in patients presenting with acute coronary syndromes (ACS) and undergoing percutaneous coronary intervention (PCI), according to a study published online January 2, 2013, ahead of print in the American Journal of...
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A History of Stroke/Transient Ischemic Attack Indicates High Risks of Cardiovascular Event and Hemorrhagic Stroke in Patients with Coronary Artery Disease
Background—Randomized trials of antithrombotics in coronary artery disease (CAD) have identified prior stroke/TIA as a marker of increased intracranial bleeding risk. We aimed to further characterize the risk of ischemic and bleeding events associated with a history of stroke/TIA in patients...
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Spontaneous Coronary Artery Dissection Prevalence of Predisposing Conditions Including Fibromuscular Dysplasia in a Tertiary Center Cohort
Objectives We sought to evaluate the prevalence of fibromuscular dysplasia (FMD) and other predisposing conditions among spontaneous coronary artery dissection (SCAD) patients.
Background Spontaneous coronary artery dissection is considered rare. However, we...
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Intra-Procedural Stent Thrombosis A New Risk Factor for Adverse Outcomes in Patients Undergoing Percutaneous Coronary Intervention for Acute Coronary Syndromes
Objectives The aim of this study was to examine the incidence, correlates, and consequences of intra-procedural stent thrombosis (IPST) in patients with acute coronary syndromes (ACS).
Background Stent thrombosis (ST) is a rare but serious complication of...
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Multivessel Bests Culprit-Only PCI in STEMI Patients with Shock, Cardiac Arrest
More extensive primary percutaneous coronary intervention (PCI) may improve clinical outcomes in critically ill patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease, according to a study published online January 23, 2013, ahead of print in JACC:...
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TROFI Published: No Clear Benefit of Thrombectomy in STEMI Patients Undergoing PCI
Thrombectomy does not appear to reduce thrombus burden in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI), according to results from a multicenter randomized trial published online February 8, 2013, ahead of print in...
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FFR Improves Outcomes in Routine Clinical Practice
In an every-day population, percutaneous coronary intervention (PCI) guided by fractional flow reserve (FFR) measurements improves outcomes compared with angiography guidance alone over long-term follow-up. Results from a large registry study were published online January 23, 2013, ahead of print...
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STEMI Patients with Preinfarction Angina Show Fewer Signs of Myocardial Damage
Angina experienced shortly before ST-segment elevation myocardial infarction (STEMI) may predispose to smaller infarct size and better heart function after percutaneous coronary intervention (PCI). The benefits of preinfarction angina likely stem from preconditioning, according to a paper...
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Atrial Fibrillation and Aortic Stenosis. Impact on Clinical Outcomes Among Patients Undergoing Transcatheter Aortic Valve Implantation
Background—Atrial fibrillation (AF) is an important risk factor for stroke and is common among elderly patients undergoing transcatheter aortic valve implantation. The aim of this study was to assess the impact of AF on clinical outcomes among patients undergoing transcatheter aortic...
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Endovascular Treatment of Resistant and Uncontrolled Hypertension. Therapies on the Horizon The treatment of resistant hypertension has undergone remarkable advancements in recent years. Endovascular radio frequency renal sympathetic denervation (RSD) has shown initial success in treating resistant hypertension by targeting the connection between the brain and renal sympathetic nerves....
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Strategies for Multivessel Revascularization in Patients with Diabetes 
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...
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Bedside Monitoring to Adjust Antiplatelet Therapy for Coronary Stenting
BACKGROUND
Patients' responses to oral antiplatelet therapy are subject to variation. Bedside monitoring offers the opportunity to improve outcomes after coronary stenting by individualizing therapy.
METHODS
We randomly assigned 2440 patients scheduled for coronary...
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Atorvastatin with or without an Antibody to PCSK9 in Primary Hypercholesterolemia
BACKGROUND
Serum proprotein convertase subtilisin/kexin 9 (PCSK9) binds to low-density lipoprotein (LDL) receptors, increasing the degradation of LDL receptors and reducing the rate at which LDL cholesterol is removed from the circulation. REGN727/SAR236553 (designated here as SAR236553), a...
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Background—Studies from the balloon angioplasty and bare metal stent eras have demonstrated that CABG is cost-effective compared with PCI for patients undergoing multivessel coronary revascularization-particularly among patients with complex CAD or diabetes. Whether these results apply in...
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Effect of Platelet Inhibition with Cangrelor during PCI on Ischemic Events
BACKGROUND
The intensity of antiplatelet therapy during percutaneous coronary intervention (PCI) is an important determinant of PCI-related ischemic complications. Cangrelor is a potent intravenous adenosine diphosphate (ADP)–receptor antagonist that acts rapidly and has quickly...
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Fibrinolysis or Primary PCI in ST-Segment Elevation Myocardial Infarction
BACKGROUND
It is not known whether prehospital fibrinolysis, coupled with timely coronary angiography, provides a clinical outcome similar to that with primary percutaneous coronary intervention (PCI) early after acute ST-segment elevation myocardial infarction...
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Timely PCI for STEMI ? Still the Treatment of Choice
Timely primary percutaneous coronary intervention (PCI) is the preferred therapy for ST-segment elevation myocardial infarction (STEMI).1 The challenge, however, lies in the definition of “timely.” In general, the shorter the time from symptom onset to PCI is, the higher the...
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The concept of edge vascular response (EVR) was first introduced with bare-metal stents and later with radioactive stents of various activity levels. Although radioactive stents reduced intra-stent neointimal hyperplasia and thereby the incidence of in-stent restenosis in a dose-dependent...
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Fractional Flow Reserve?Guided Revascularization: Practical Implications of a Diagnostic Gray Zone and Measurement Variability on Clinical Decisions
Objectives This study sought to evaluate the effects of fractional flow reserve (FFR) measurement variability on FFR-guided treatment strategy.
Background Current appropriateness guidelines recommend the utilization of FFR to guide coronary revascularization based on a fixed...
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Speciale ACC 2013: NEXT: Biolimus-eluting stent noninferior to Xience/Promus
San Francisco, CA - A biolimus-eluting coronary stent lined with a biodegradable polymer (Nobori, Terumo) was statistically noninferior to an everolimus-eluting stent (Xience V/Promus, Abbott Vascular/Boston Scientific) with regard to the primary end point of target lesion...
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Speciale ACC 2013: PARTNER 2: New Sapien XT matches first TAVR device, with lower complications
San Francisco, CA (updated) - A lower-profile, next-generation version of the Sapien transcatheter aortic-valve system known as the Sapien XT (Edwards Lifesciences) was associated with similar rates of death and stroke as the first-generation device, results from...
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Speciale ACC 2013: TERISA: A unique benefit of ranolazine in diabetic angina?
San Francisco, CA - The first prospective international randomized controlled study focusing specifically on angina in patients with diabetes has shown that ranolazine (Ranexa, Gilead Sciences) is an effective treatment in this patient population [1].
Results of the Type 2...
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Speciale ACC 2013: Cangrelor cuts complications at PCI vs clopidogrel in CHAMPION-PHOENIX; bleeding a caution
San Francisco, CA (updated) - It was a battle between two ADP-receptor blockers as well as between IV and oral antiplatelet therapy at coronary interventions: a >11 000-patient randomized trial found that intravenous cangrelor (the Medicines Company) cut the risk of...
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Speciale ACC 2013: "If not dead, not healthy": Niacin full results in HPS2-THRIVE aired at ACC
San Francisco, CA - Full results of the Heart Protection Study 2-Treatment of HDL to Reduce the Incidence of Vascular Events (HPS2-THRIVE) study, a large randomized trial testing the use of extended-release niacin and the antiflushing agent laropiprant for the...
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Speciale ACC 2013: Doctors react to ACC PREVAIL cancellation San Francisco, CA - Thousands of attendees packed into the first late-breaking clinical-trial session of the American College of Cardiology (ACC) 2013 Scientific Sessions this morning to hear the first presentation of the PREVAIL study of...
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Speciale ACC 2013: "Alarming" use of unnecessary ECG monitors, ubiquitous, possibly harmful
San Francisco, CA - Beeps, chirps, and alarms are the soundtracks of cardiac care units, but what if all that noise is harming, not helping, patient care?
That is the question at the heart of a new analysis from the PULSE study, addressing what the authors, not entirely...
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Speciale ACC 2013: High obesity, physical inactivity in HCM patients warrant "balanced" risk/benefit advice San Francisco, CA - Patients with hypertrophic cardiomyopathy (HCM) are less physically active than the general US population and have higher rates of obesity, according to new survey results [1]. In addition, the exercise restrictions imposed by HCM have a negative impact on emotional...
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Speciale ACC 2013: PARTNER A: Equal outcomes, many dead for both TAVI, SAVR arms San Francisco, CA - There's good news and bad news in the three-year follow-up from the PARTNER A trial, comparing transcatheter aortic-valve implantation/replacement (TAVI/TAVR) with open surgical aortic-valve replacement (SAVR) in high-risk patients with severe aortic...
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Speciale ACC 2013: Clopidogrel/atorvastatin protect in carotid stenting
San Francisco, CA - A 600 mg clopidogrel loading dose reduced periprocedural ischemic cerebral events and rates of transient ischemic attack (TIA) and stroke at 30 days in patients undergoing carotid stenting in the ARMYDA-9 CAROTID study [1].
The study, presented at the American College of...
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Frequency of Myocardial Infarction and Its Relationship to Angiographic Collateral Flow in Territories Supplied by Chronically Occluded Coronary Arteries
Background—Despite complete interruption of antegrade coronary artery flow in the setting of a chronic total occlusion (CTO), clinical recognition of myocardial infarction is often challenging. Using cardiac MRI, we investigated the frequency and extent of myocardial infarction in...
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Optical Coherence Tomography Versus Intravascular Ultrasound to Evaluate Coronary Artery Disease and Percutaneous Coronary Intervention
Objectives We compared intravascular ultrasound (IVUS) and 2 different generations of optical coherence tomography (OCT)—time-domain OCT (TD-OCT) and frequency-domain OCT (FD-OCT)—for the assessment of coronary disease and percutaneous coronary intervention (PCI) using...
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Objectives The aim of this study was to investigate the incidence and clinical sequelae of small side branch occlusion (SBO) after Absorb (Abbott Vascular, Santa Clara, California) bioresorbable vascular scaffold (BVS) implantation.
Background The thicker strut of metallic...
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Transcatheter Aortic Valve Replacement With the SAPIEN 3: A New Balloon-Expandable Transcatheter Heart Valve
Objectives The aim of this study was to demonstrate the first-in-human feasibility and short-term clinical outcomes with a new balloon-expandable transcatheter heart valve (THV).
Background The SAPIEN 3 (S3) THV incorporates a paravalvular sealing...
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Transcatheter Aortic Valve Replacement With a New Self-Expanding Transcatheter Heart Valve and Motorized Delivery System
Objectives The aim of this study was to demonstrate feasibility and short- and midterm clinical outcomes with a new self-expanding transcatheter heart valve and motorized delivery system.
Background Refining transcatheter aortic valve replacement with newly designed...
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Acute Stent Recoil From Aggressive Post-Dilation of a Second-Generation Drug-Eluting Stent
A 43-year-old man presented with crescendo angina. Coronary angiography demonstrated ambiguous stenosis of ostial left main stem (LM) ((Figure 27_gr1)A and Figure 27_gr1B). After pre-dilation, a 4.0/12 mm Everolimus-eluting stent (Xience Prime, Abbott Vascular, Santa Clara, California) was...
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Percutaneous Delivery of 2 MitraClips With a 24-F Delivery System Through an Inferior Vena Cava Filter
A 66-year-old man was referred for percutaneous mitral edge-to-edge repair for New York Heart Association (NYHA) functional class III heart failure and severe mitral regurgitation. He underwent coronary bypass surgery for a large anterior myocardial infarct 8 years prior, resulting in a...
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Cardiac Ablation and Renal Denervation Systems Have Distinct Purposes and Different Technical Requirements
Ahmed et al. report the use of a cardiac electrophysiology ablation system for renal denervation in a single-center, single-armed, noncontrolled trial of 10 patients with severe refractory hypertension (1). Cardiac ablation and renal denervation systems are designed to comply with distinct...
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Percutaneous Coronary Intervention Versus Optimal Medical Therapy for Prevention of Spontaneous Myocardial Infarction in Subjects With Stable Ischemic Heart Disease
Background—Contemporary studies have shown that spontaneous but not procedural myocardial infarction (MI) is related to subsequent mortality. Whether percutaneous coronary intervention (PCI) reduces spontaneous (nonprocedural) MI is unknown.
Methods and Results—PubMed, EMBASE,...
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Reduction in First and Recurrent Cardiovascular Events With Ticagrelor Compared With Clopidogrel in the PLATO Study
Background—We sought to evaluate the effect of potent platelet inhibition after acute coronary syndrome on total (ie, first and recurrent) occurrences of any of the primary outcome events (eg, cardiovascular death, myocardial infarction, and stroke) as well as on other ischemic events,...
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Speciale ACC 2013: Off-pump/on-pump CABG: Still no consensus
San Francisco, CA - New results from three trials comparing off-pump and on-pump CABG have not been able to make a definitive case that off-pump is better for high-risk patients, despite that still being the belief of all the surgeons leading the studies.
The three trials were presented...
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Frequency of Myocardial Infarction and Its Relationship to Angiographic Collateral Flow in Territories Supplied by Chronically Occluded Coronary Arteries
Background—Despite complete interruption of antegrade coronary artery flow in the setting of a chronic total occlusion (CTO), clinical recognition of myocardial infarction (MI) is often challenging. Using cardiac magnetic resonance imaging (CMR), we investigated the frequency and extent of...
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Percutaneous Closure of Patent Foramen Ovale in Cryptogenic Embolism
Background
The options for secondary prevention of cryptogenic embolism in patients with patent foramen ovale are administration of antithrombotic medications or percutaneous closure of the patent foramen ovale. We investigated whether closure is superior to medical...
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Objectives This study sought to develop a new score specific for patients with non–ST-segment elevation acute coronary syndromes (NSTEACS) undergoing percutaneous coronary intervention (PCI) (the ACUITY-PCI [Acute Catheterization and Urgent Intervention Triage...
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Intra-procedural Stent Thrombosis A New Risk Factor for Adverse Outcomes in Patients Undergoing Percutaneous Coronary Intervention for Acute Coronary Syndromes Objectives The aim of this study was to examine the incidence, correlates, and consequences of intra-procedural stent thrombosis (IPST) in patients with acute coronary syndromes (ACS).
Background Stent thrombosis (ST) is a rare but serious complication of percutaneous...
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High-Speed Rotational Atherectomy Before Paclitaxel-Eluting Stent Implantation in Complex Calcified Coronary Lesions Objectives This study sought to determine the effect of rotational atherectomy (RA) on drug-eluting stent (DES) effectiveness.
Background DES are frequently used in complex lesions, including calcified stenoses, which may challenge DES delivery, expansion, and...
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Clopidogrel Pretreatment Reduces Cardiac Events, Not Mortality, After PCI 
Patients who receive a clopidogrel loading dose prior to percutaneous coronary intervention (PCI) derive protection against major cardiac events as a whole. However, pretreatment is not associated with lower mortality risk, according to a meta-analysis published in the December 19, 2012, issue of...
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MUSTELA Published: Thrombectomy Shows Mixed Results in STEMI
In patients with a high thrombus burden undergoing primary percutaneous coronary intervention (PCI), use of thrombectomy helps resolve ST elevation and improves reperfusion but does not reduce infarct size or provide longer-term clinical benefit, according to a study published in the December 2012...
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Impact of Renal Sympathetic Denervation in a Hispanic Population. A Case Series
Background
Resistant hypertension is defined as uncontrolled blood pressure despite the use of optimal doses of three antihypertensive agents, one of which is a diuretic. recently, catheter-based renal sympathetic denervation (RSD) has been shown to be safe and effective...
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'Top Ten' Advances of 2012 Highlighted by AHA-ASA, ACC
The American Heart Association (AHA) and American Stroke Association (ASA) have continued their annual tradition of listing the foremost research of the year. This year the American College of Cardiology (ACC) followed suit with its own top 10 list of major stories in cardiology.
Both rankings...
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Renal Denervation Shows Sustained BP Improvements at 1 Year
Longer-term results from the Symplicity HTN-2 trial show sustained blood pressure reductions with renal denervation out to 1 year in patients with resistant hypertension. In addition, control patients who crossed over to treatment with the novel catheter-based system experienced BP lowering out to...
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A Validated Risk Score to Predict Outcomes after Carotid Stenting 
Background—Periprocedural outcome has been extensively investigated in patients undergoing carotid artery stenting. However, risk factors contributing to long-term mortality have not been comprehensively assessed. We aimed to establish a validated clinical risk score for...
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Tra le novità interessanti per la valutazione della malattia coronarica presentate quest’anno in occasione delle Scientific Sessions dell’AHA, il Prof. Ciro Indolfi, dell’Università Magna Graecia di Catanzaro ha presentato i risultati preliminari dello studio FORECAST, che ha valutato l’efficacia diagnostica di un nuovo parametro funzionale per lo studio di stenosi coronariche intermedie: il gradiente trans-stenotico a riposo (DFG)
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SPECIALE AHA 2012: Basse dosi di aspirina per prevenire tromboembolia venosa ricorrente E’ stato presentato durante il Congresso AHA 2012 uno studio sulla prevenzione delle recidive di tromboembolia venosa. Sono stati randomizzati 822 pazienti in due gruppi dopo un primo episodio di tromboembolia venosa.
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Prasugrel versus Clopidogrel for Acute Coronary Syndromes without Revascularization
Background
The effect of intensified platelet inhibition for patients with unstable angina or myocardial infarction without ST-segment elevation who do not undergo revascularization has not been delineated.
Methods
In this double-blind, randomized trial, in a primary...
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SPECIALE TCT 2012 - live case da Anversa: the PARACHUTE 
Durante la Main Session, il mattino del 25 ottobre, il PARACHUTE l’ha fatta da padrone, con la procedura di impianto eseguta presso il Cardiovascular Intstitue, ZNA Middlheim Hospital di Anversa da Stefan Verheye e Paul Vermeersch.
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Guidelines: acute and chronic HF 
The aim of this document is to provide practical, evidence-based guidelines for the diagnosis and treatment of heart failure (HF). The principal changes from the 2008 guidelines relate to:
· an expansion of the indication for mineralocorticoid receptor antagonists;
· a new indication for the sinus node inhibitor ivabradine;
· an expanded indication for cardiac resynchronization therapy (CRT);
· new information on the role of coronary revascularization in HF.
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Focused Update on UA/NSTEMI Keeping pace with the stream of new data and evolving evidence on which guideline recommendations are based is an ongoing challenge to timely development of clinical practice guidelines. In an effort to respond promptly to new evidence, the American College of Cardiology Foundation (ACCF)/American Heart Association (AHA) Task Force on Practice Guidelines (Task Force) has created a “focused update” process to revise the existing guideline recommendations that are affected by the evolving data or opinion.
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Lower Mortality With Ticagrelor VS Clopidogrel in CABG
The aim of this study was to investigate the causes of CABG-related death in the PLATO trial by further classifying, in a blinded fashion, all CABG-related deaths according to direct and indirectly related causes.
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Thrombus aspiration in p-PCI
In this large observational study of unselected, consecutive STEMI patients, manual thrombus aspiration during PPCI was associated with a significant reduction in all-cause mortality at one year.
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Early Aggressive VS Initially Conservative Treatment in Elderly Patients With Non–STEACS
The present study does not allow a definite conclusion about the benefit of an EA approach when applied systematically among elderly patients with NSTEACS. The finding of a significant interaction for the treatment effect according to troponin status at baseline should be confirmed in a larger size trial.
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Third Universal Definition of MI The development of even more sensitive assays for markers of myocardial necrosis mandates further revision, particularly when such necrosis occurs in the setting of the critically ill, after percutaneous coronary procedures or after cardiac surgery. The Third Global MI Task Force has continued the Joint ESC/ACCF/AHA/WHF efforts by integrating these insights and new data into the current document, which now recognizes that very small amounts of myocardial injury or necrosis can be detected by biochemical markers and/or imaging.
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ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation The present guidelines pertain to patients presenting with ischaemic symptoms and persistent ST-segment elevation on the electrocardiogram (ECG). Most of these patients will show a typical rise in biomarkers of myocardial necrosis and progress to Q-wave myocardial infarction. Separate guidelines have recently been developed by another Task Force of the ESC for patients presenting with ischaemic symptoms but without persistent ST-segment elevation and for patients undergoing myocardial revascularization in general.
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CLINICAL INTERVENTIONAL FORUM 2012 
ANGIOPLASTICA PRIMARIA: PROBLEMATICHE ORGANIZZATIVE, ATTUALITA’ E PROSPETTIVE FUTURE SU TECNICHE E FARMACI (Palazzo Trecchi, Cremona - 25 Febbraio 2012)
Angioplastica primaria: problematiche organizzative, attualità e prospettive future in Lombardia. Intervento Dott. Stefano De...
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SPECIALE TCT 2012: nuove analisi dello studio PARTNER offrono interessanti spunti di riflessione sulla TAVR In occasione del Summit Internazionale sulle Valvulopatie, tre ricercatori esperti hanno illustrato i nuovi risultati delle recenti sotto-analisi dello studio PARTNER focalizzati sulle differenze di genere, la qualità di vita e la costo-efficacia della procedura di TAVR.
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SPECIALE TCT 2012: L'angioplastica coronarica percutanea (PTCA) è associata ad un minor rischio di stroke rispetto all'intervento chirurgico (CABG). Stando ai dati derivanti da due recenti meta-analisi, l’angioplastica coronarica percutanea (PTCA) sembrerebbe essere associata ad un minor rischio di stroke rispetto all’intervento chirurgico (CABG).
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SPECIALE AHA 2012: Monitorizzazione a letto del paziente della terapia antipiastrinica dopo stenting coronarico: lo studio ARTIC Durante il Congresso dell’American Heart Association, Gilles Montalescot, ha presentato i risultati dello studio ARTIC, pubblicato ieri, 4 Novembre 2012, sul New England Journal of Medicine.
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SPECIALE AHA 2012: FREEDOM: il CABG è superiore alla PCI nei pazienti diabetici con malattia coronarica Fonte di inesauribile discussione è stata ancora una volta all’AHA la valutazione del migliore trattamento per i pazienti diabetici con malattia multivasale.
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SPECIALE AHA 2012: la denervazione delle arterie renali mediante dispositivo multielettrodo appare sicura Presentati oggi, in occasione della riunione scientifica annuale dell’American Heart Association, i risultati del follow-up a sei mesi dello studio multicentrico sulla denervazione renale, che appaiono promettenti.
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SPECIALE AHA 2012 - sottostudio TRILOGY ACS Il sottostudio TRILOGY ACS ha dimostrato una mancanza di associazione tra funzionalità piastrinica e outcome ischemici in pazienti con Sindrome Coronarica Acuta (SCA) trattati con terapia medica.
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SPECIALE TCT 2012: efficacia del dispositivo di chiusura dell’auricola Watchman in pazienti con controindicazione al Warfarin Due presentazioni al TCT 2012 hanno dimostrato che l'uso del dispositivo Watchman per la chiusura dell’auricola sinistra in pazienti con controindicazione al warfarin è sicura ed efficace.
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SPECIALE TCT 2012 - STEMI-RADIAL: l’angioplastica mediante accesso Radiale è migliore rispetto all’accesso femorale nei pazienti con STEMI I pazienti con STEMI traggono beneficio da PCI tramite accesso radiale piuttosto che femorale. Sia i sanguinamenti maggiori che le complicanze del sito di accesso a 30 giorni sono ridotti con l’accesso radiale, secondo i dati dello studio randomizzato STEMI-RADIAL presentati al TCT 2012
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SPECIALE TCT 2012: prospettive future della Denervazione Renale La terapia di denervazione renale è stato uno degli argomenti principali del TCT di quest’anno. Il dottor Horst Sievert, del CardioVascular Center di Francoforte ha presentato una overview sui nuovi sistemi per la denervazione renale, ricordandoci che 60 compagnie stanno lavorando su nuovi dispositivi, alcuni dei quali saranno disponibili in tempi piuttosto brevi
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SPECIALE TCT 2012 - ESPERIENZA CON TAVI: identificazione del rischio per stroke, blocco di branca sinistra e perivalvular leak. L’esperienza di impianto valvolare aortico per via percutanea (TAVI) è in crescita in tutto il mondo e stanno emergendo nuovi dati per identificare i fattori predittivi di eventi clinici avversi, tra cui il rischio di eventi cerebrovascolari, la comparsa di BBSn e la persistenza di insufficienza aortica perivalvolare
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SPECIALE TCT 2012: Mentre il PARTNER continua a dimostrare benefici protratti nel tempo, lo studio STACCATO solleva dubbi sull'efficacia della TAVR per via transapicale I nuovi dati provenienti dal registro non randomizzato del PARTNER in merito all'approccio transfemorale e transapicale dimostrano che i vantaggi ottenuti con la TAVR nei pazienti ad alto rischio arruolati nel trial randomizzato controllato sono sovrapponibili a quelli ottenuti nella popolazione reale degli studi osservazionali
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SPECIALE TCT 2012: studio PARADOX Secondo lo studio PARADOX, presentato al TCT 2012, l’effetto anti-piastrinico del clopidogrel è ridotto nei pazienti non fumatori rispetto ai fumatori. Questo “paradosso” sembra non verificarsi con il prasugrel.
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SPECIALE TCT 2012: confermato fino a 3 anni il beneficio della sopravvivenza con la valvola Edwards Sapien
La Edwards Lifesciences Corporation (NYSE: EW), leader mondiale nella tecnologia delle protesi valvolari aortiche e del monitoraggio emodinamico invasivo, ha diffuso oggi i risultati a 3 anni dello studio pilota del PARTNER Trial (Cohort B) sui pazienti con stenosi valvolare aortica severa inoperabili, sottoposti a TAVR con device transcatetere Edwards SAPIEN.
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SPECIALE TCT 2012 - SYNTAX: DES, CABG Comparable in Left Main Disease Sono stati recentemente presentati al TCT (Transcatheter Cardiovascular Therapeutics, tenutosi a Miami-FL in questi giorni) i risultati a 5 anni del trial SYNTAX, focalizzato ad evidenziare la migliore strategia di rivascolarizzazione in pazienti con malattia di tre vasi coronarici e/o con malattia del tronco comune.
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SPECIALE TCT 2012: studio EVEREST II Il follow up a 3 anni dello studio EVEREST II ha confermato i benefici clinici e una maggiore sicurezza della MitraClip rispetto alla chirurgia, nel trattamento dell’insufficienza mitralica di grado severo.
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SPECIALE TCT 2012: novità da trial randomizzati sul trattamento di lesioni del tratto femoro-popliteo Tra le novità assolute nel panorama della ricerca clinica sui nuovi dispositivi, nel corso del TCT2012 sono stati presentati i risultati di due trial sull’interventistica periferica, che entra finalmente a pieno titolo nel mondo della evidence-based medicine
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Censimento Healthy Cath Lab: online il questionario 
Disponibile online la web survey 'HCL. - Healthy Cath Lab'. Il questionario è disponibile qui
https://epid-prod.ifc.cnr.it/hcl/
Per ulteriori informazioni sullo studio HCL, leggi qui
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NSTE/ACS - ESC Guidelines 2011 Guidelines summarize and evaluate all available evidence, at the time of the writing process, on a particular issue with the aim of assisting physicians in selecting the best management strategies for an individual patient, with a given condition, taking into account the impact on outcome, as well as the risk–benefit ratio of particular diagnostic or therapeutic means.
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Clinical Outcomes Using a New Crossover Balloon Occlusion Technique for Percutaneous Closure After Transfemoral Aortic Valve Implantation Objectives: This study sought to evaluate the technical success and clinical outcomes of an adjunctive crossover balloon occlusion technique (CBOT) combined with the 10-F Prostar percutaneous closure device (PCD) on the incidence of vascular and bleeding complications in patients after transfemoral...
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Percutaneous Coronary Intervention in Native Arteries Versus Bypass Grafts in Prior Coronary Artery Bypass Grafting Patients Objectives: This study examined a large registry to determine the frequency, predictors, and outcomes of native coronary artery versus bypass graft percutaneous coronary intervention (PCI) in patients with prior coronary artery bypass graft surgery (CABG). Background: The PCI target vessel and...
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Randomized Trial of Stents versus Bypass Surgery for Left Main Coronary Artery Disease
Background
Percutaneous coronary intervention (PCI) is increasingly used to treat unprotected left main coronary artery stenosis, although coronary-artery bypass grafting (CABG) has been considered to be the treatment of choice.
Methods
We randomly assigned...
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Healthy Cath Lab al GISE 2012: un progetto a tutela della tua, della nostra salute Healthy Cath Lab si propone come un censimento professionale senza precedenti, di importante significato epidemiologico e clinico. Le informazioni ricavate dallo studio contribuiranno a migliorare la cultura della sicurezza nel laboratorio di emodinamica, minimizzando il danno da radiazioni.
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Myocardial Infarction After Carotid Stenting and Endarterectomy Background— The Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST) found a higher risk of stroke after carotid artery stenting and a higher risk of myocardial infarction (MI) after carotid endarterectomy.
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Randomized Trial of Stents versus Bypass Surgery for Left Main Coronary Artery Disease 
Background
Percutaneous coronary intervention (PCI) is increasingly used to treat unprotected left main coronary artery stenosis, although coronary-artery bypass grafting (CABG) has been considered to be the treatment of choice.
Full Text of...
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Percutaneous Repair or Surgery for Mitral Regurgitation
Background
Mitral-valve repair can be accomplished with an investigational procedure that involves the percutaneous implantation of a clip that grasps and approximates the edges of the mitral leaflets at the origin of the regurgitant jet.
Methods
We randomly...
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Management of Massive and Submassive Pulmonary Embolism, Iliofemoral Deep Vein Thrombosis, and Chronic Thromboembolic Pulmonary Hypertension Venous thromboembolism (VTE) is responsible for the hospitalization of 250 000 Americans annually and represents a significant risk for morbidity and mortality.1 Despite the publication of evidence-based clinical practice guidelines to aid in the management of VTE in its acute and chronic...
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Guidelines For UA/NSTEMI AHA 2011
Introduction
Organization of Committee and
Evidence Review (UPDATED)
For new or updated text, view the 2011 Focused Update.
Text supporting unchanged recommendations has not been
updated.
The ACC/AHA Task Force on Practice Guidelines was
formed to make recommendations regarding the...
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Il Giornale Italiano di Cardiologia Invasiva ed il sito www.gise.it su iPad 
"Il Giornale Italiano di Cardiologia Invasiva" ed il sito “www.gise.it” su iPad
Da venerdì chi possiede un iPad potrà scaricare gratuitamente da Apple Store l'applicazione per leggere Il Giornale Italiano di Cardiologia Invasiva e consultare...
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Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease 2011 
It is essential that the medical profession play a central role in critically evaluating the evidence related to drugs, devices, and procedures for the detection, management, or prevention of disease. Properly applied, rigorous, expert analysis of the available data documenting absolute and...
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IL NUOVO VOLTO DEL SITO DELLA SOCIETA' ITALIANA DI CARDIOLOGIA INVASIVA 
Messo on-line da pochi giorni. Il sito gise.it si è rinnovato con web 2.0. Web 2.0 non significa un vecchio sito con una nuova grafica, significa invece un nuovo approccio alla tecnologia, un nuovo modo di utilizzare le risorse online.
Il sito ha potenzialità elevate, nuovi spazi...
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EAPCI 
Our mission: To reduce the burden of cardiovascular disease in Europe through percutaneous cardiovascular interventions
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Trends in Coronary Revascularization in the United States From 2001 to 2009 Abstract Background There is speculation that the volume of percutaneous coronary interventions (PCIs) has been decreasing over the past several years. Published studies of PCI volume have evaluated regional or hospital trends, but few have captured national data. This study describes...
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Clinical Referral Patterns for Carotid Artery Stenting Versus Carotid Endarterectomy Abstract Background—Carotid artery stenting (CAS) and carotid endarterectomy (CEA) are alternative strategies for stroke prevention in patients with atherosclerotic carotid disease. Although randomized clinical trials are the gold standard for assessing the relative benefits of different...
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Value of Age, Creatinine, and Ejection Fraction (ACEF Score) in Assessing Risk in Patients Undergoing Percutaneous Coronary Interventions in the ‘All-Comers’ LEADERS Trial Abstract Background—The age, creatinine, and ejection fraction (ACEF) score (age/left ventricular ejection fraction+1 if creatinine >2.0 mg/dL) has been established as an effective predictor of clinical outcomes in patients undergoing elective coronary artery bypass surgery; however,...
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FONDAZIONE GISE: "Scuola di Formazione Superiore di Interventistica Cardiovascolare" OBBIETTIVI DEL CORSO Il corso della Scuola di Formazione Permanente GISE si propone di fornire ai partecipanti una adeguata e aggiornata preparazione teorica e pratica nel campo della interventistica cardiovascolare, rendendoli capaci di porre corrette indicazioni di trattamento e di eseguire come...
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Lo studio PARTNER presentato al TCT: Transcatheter Aortic-Valve Implantation for Aortic Stenosis in Patients Who Cannot Undergo Surgery 
Background
Many patients with severe aortic stenosis and coexisting conditions are not candidates for surgical replacement of the aortic valve. Recently, transcatheter aortic-valve implantation (TAVI) has been suggested as a less invasive treatment for high-risk patients with...
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Studio osservazionale per la valutazione comparativa di efficacia dei trattamenti TAVI e AVR 
La Società Italiana di Cardiologia Invasiva (SICI-GISE), in accordo con la Federazione Italiana di Cardiologia (FIC) e con la Società Italiana di Chirurgia Cardiaca (SICCH), in collaborazione con Agenas, Ministero della Salute, Istituto Superiore di Sanità, Regioni...
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A Model for Predicting Mortality in Acute ST-Segment Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention Background Accurate models to predict mortality are needed for risk stratification in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Methods and Results We examined 5745 patients with STEMI undergoing...
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Clinical and Angiographic Predictors of Short- and Long-Term Ischemic Events in Acute Coronary Syndromes Background— Contemporary adjunctive pharmacology and revascularization strategies have improved the prognosis of patients with acute coronary syndromes (ACSs). We sought to identify the clinical and angiographic predictors of cardiac ischemic events in patients with ACSs treated with...
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Drug-Eluting Versus Bare-Metal Stents in Unprotected Left Main Coronary Artery Stenosis Objectives: We undertook a meta-analysis to assess outcomes for drug-eluting stents (DES) and bare-metal stents (BMS) in percutaneous coronary intervention for unprotected left main coronary artery (ULMCA) stenosis. Background: Uncertainty exists regarding the relative performance of DES...
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Prevention and Treatment of Microvascular Obstruction-Related Myocardial Injury and Coronary No-Reflow Following Percutaneous Coronary Intervention Microvascular obstruction (MVO) commonly occurs following percutaneous coronary interventions (PCI), may lead to myocardial injury, and is an independent predictor of adverse outcome. Severe MVO may manifest angiographically as reduced flow in the patent upstream epicardial arteries, a...
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Outcomes of Percutaneous Coronary Intervention in Intermediate Coronary Artery Disease Objectives: This study sought to evaluate the long-term clinical outcomes of a fractional flow reserve (FFR)–guided percutaneous coronary intervention (PCI) strategy compared with intravascular ultrasound (IVUS)–guided PCI for intermediate coronary lesions. Background: Both...
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Clinical and Angiographic Risk Assessment in Patients With Left Main Stem Lesions Percutaneous coronary intervention of unprotected left main stem lesions has been shown to be a suitable alternative to cardiac surgery in selected patients, emphasizing the need for appropriate risk stratification prior to selection of revascularization modality. Several risk models based on...
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Guidelines on myocardial revascularization Introduction Myocardial revascularization has been an established mainstay in the treatment of CAD for almost half a century. Coronary artery bypass grafting (CABG), used in clinical practice since the 1960s, is arguably the most intensively studied surgical procedure ever undertaken, while...
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Comparison of Zotarolimus-Eluting and Everolimus-Eluting Coronary Stents Original Article Comparison of Zotarolimus-Eluting and Everolimus-Eluting Coronary Stents Patrick W. Serruys, M.D., Ph.D., Sigmund Silber, M.D., Ph.D., Scot Garg, M.B., Ch.B., M.R.C.P., Robert Jan van Geuns, M.D., Ph.D., Gert Richardt, M.D., Pawel E. Buszman, M.D.,...
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Addressing disparities in the treatment of cardiovascular care 
Close the Gap, a Boston Scientific educational initiative, addresses disparities in cardiovascular care for women, black Americans and Hispanic/Latino Americans.
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The Stent for Life Initiative (SFL) Celebrates its First Year Anniversary as the ESC 2010 Congress in Stockholm InspireMD Ltd., a medical device company engaged in the development and commercialization of MGuard(TM) novel stent systems, is happy to announce that it has joined the Stent for Life Initiative as a supporting organization. The Stent for Life Initiative aims to improve the delivery and patient access to the life saving indications of PCI and thereby reduce the mortality and morbidity of patients suffering from acute coronary syndromes.
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Relationship Between Arterial and Fibrous Cap Remodeling 
A Serial Three-Vessel Intravascular Ultrasound and Optical Coherence Tomography Study
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While the propensity-matched analysis narrowly missed its primary end point, secondary end points pointed to significant differences in MI rates that tracked with differences in stent thrombosis "Stockholm, Sweden - A nonrandomized comparison of sirolimus-eluting and everolimus-eluting stents is providing some of the strongest evidence yet that so-called "next-generation" drug-eluting stents (DES) may have an edge in terms of safety and efficacy over the first drug-eluting stent on the market.
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Unprotected Left Main Coronary Disease and ST-Segment Elevation Myocardial Infarction: A Contemporary Review and Argument for Percutaneous Coronary Intervention State-of-the-Art Paper
Unprotected Left Main Coronary Disease and ST-Segment Elevation Myocardial Infarction
A Contemporary Review and Argument for Percutaneous Coronary Intervention
Michael S. Lee, MD*,*, Pooya Bokhoor, MD*, Seung-Jung Park, MD, Young-Hak Kim, MD, Gregg W. Stone, MD, Imad Sheiban, MD, Giuseppe Biondi-Zoccai, MD, Dario Sillano, MD, Jonathan Tobis, MD*, David E. Kandzari, MD||
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Effects of CYP2C19 Genotype on Outcomes of Clopidogrel Treatment These investigators found that in patients with acute coronary syndromes or atrial fibrillation, the effect of clopidogrel was consistent, irrespective of CYP2C19 genotype. An increased benefit of clopidogrel was observed in some carriers of gain-of-function alleles.
