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Journal Cover Interventional Cardiology Clinics
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   Full-text available via subscription Subscription journal  (Not entitled to full-text)
   ISSN (Print) 2211-7458 - ISSN (Online) 2211-7466
   Published by Elsevier Homepage  [3030 journals]
  • Endovascular Treatment of Peripheral Artery Disease and Critical Limb
           Ischemia
    • Authors: Ehrin J. Armstrong
      Abstract: Publication date: April 2017
      Source:Interventional Cardiology Clinics, Volume 6, Issue 2
      Author(s): Ehrin J. Armstrong


      PubDate: 2017-03-05T21:37:23Z
      DOI: 10.1016/j.iccl.2017.01.001
       
  • Mechanisms Underlying Drug Delivery to Peripheral Arteries
    • Authors: Jun Li; Rami Tzafriri; Sandeep M. Patel; Sahil A. Parikh
      Pages: 197 - 216
      Abstract: Publication date: April 2017
      Source:Interventional Cardiology Clinics, Volume 6, Issue 2
      Author(s): Jun Li, Rami Tzafriri, Sandeep M. Patel, Sahil A. Parikh
      Teaser Delivery of drugs onto arterial targets via endovascular devices commands several principles: dissolution, diffusion, convection, drug binding, barriers to absorption, and interaction between the drug, delivery vehicle, and accepting arterial wall. The understanding of drug delivery in the coronary vasculature is vast; there is ongoing work needed in the peripheral arteries. There are differences that account for some failures of application of coronary technology into the peripheral vascular space. Breakthroughs in peripheral vascular interventional techniques building on current technologies require investigators willing to acknowledge the similarities and differences between these different vascular territories, while developing technologies adapted for peripheral arteries.

      PubDate: 2017-03-05T21:37:23Z
      DOI: 10.1016/j.iccl.2016.12.004
       
  • Current Role of Atherectomy for Treatment of Femoropopliteal and
           Infrapopliteal Disease
    • Authors: Nicolas W. Shammas
      Pages: 235 - 249
      Abstract: Publication date: April 2017
      Source:Interventional Cardiology Clinics, Volume 6, Issue 2
      Author(s): Nicolas W. Shammas
      Teaser Atherectomy improves the acute procedural success of a procedure whether treating de novo or restenotic (including in-stent) disease. Intermediate follow-up results seem to be in favor of atherectomy in delaying and reducing the need for repeat revascularization in patients with femoropopliteal in-stent restenosis. Recent data suggest that avoiding cutting into the external elastic lamina is an important factor in reducing restenosis. The interplay between directional atherectomy and drug-coated balloons is unclear.

      PubDate: 2017-03-05T21:37:23Z
      DOI: 10.1016/j.iccl.2016.12.007
       
  • Angiosome-Guided Intervention in Critical Limb Ischemia
    • Authors: Matthew C. Bunte; Mehdi H. Shishehbor
      Pages: 271 - 277
      Abstract: Publication date: April 2017
      Source:Interventional Cardiology Clinics, Volume 6, Issue 2
      Author(s): Matthew C. Bunte, Mehdi H. Shishehbor
      Teaser The goals of treatment for critical limb ischemia (CLI) are alleviation of ischemic rest pain, healing of arterial insufficiency ulcers, and improving quality of life, thereby preventing limb loss and CLI-related mortality. Arterial revascularization is the foundation of a contemporary approach to promote amputation-free survival. Angiosome-directed revascularization has become a popular theory of reperfusion, whereby anatomically directed arterial flow is restored straight to the wound bed. Innovations in endovascular revascularization combined with a multidisciplinary strategy of wound care accelerate progress in CLI management. This article highlights advances in CLI management, including the clinical relevance of angiosome-directed revascularization, and provides considerations for future treatment of CLI.

      PubDate: 2017-03-05T21:37:23Z
      DOI: 10.1016/j.iccl.2016.12.010
       
  • Interventional Cardiology Clinics
    • Authors: Matthew J. Price
      Abstract: Publication date: April 2017
      Source:Interventional Cardiology Clinics, Volume 6, Issue 2
      Author(s): Matthew J. Price


      PubDate: 2017-03-05T21:37:23Z
      DOI: 10.1016/s2211-7458(16)30135-3
       
  • Cardiac Resynchronization Therapy for Heart Failure
    • Authors: Amole Ojo; Sohaib Tariq; Prakash Harishkrishnan; Sei Iwai; Jason T. Jacobson
      Abstract: Publication date: Available online 26 April 2017
      Source:Interventional Cardiology Clinics
      Author(s): Amole Ojo, Sohaib Tariq, Prakash Harishkrishnan, Sei Iwai, Jason T. Jacobson
      Teaser Cardiac resynchronization therapy (CRT) has emerged as a valued nonpharmacologic therapy in patients with heart failure, reduced ejection fraction (EF), and ventricular dyssynchrony manifest as left bundle branch block. The mechanisms of benefit include remodeling of the left ventricle leading to decreased dimensions and increased EF, as well as a decrease in the severity of mitral regurgitation. This article reviews the rationale, effects, and indications for CRT, and discusses the patient characteristics that predict response and considerations for nonresponders.

      PubDate: 2017-04-27T22:58:03Z
      DOI: 10.1016/j.iccl.2017.03.010
       
  • Renal Denervation to Modify Hypertension and the Heart Failure State
    • Authors: Ming Zhong; Luke K. Kim; Rajesh V. Swaminathan; Dmitriy N. Feldman
      Abstract: Publication date: Available online 26 April 2017
      Source:Interventional Cardiology Clinics
      Author(s): Ming Zhong, Luke K. Kim, Rajesh V. Swaminathan, Dmitriy N. Feldman
      Teaser Sympathetic overactivation of renal afferent and efferent nerves have been implicated in the development and maintenance of several cardiovascular disease states, including resistant hypertension and heart failure with both reduced and preserved systolic function. With the development of minimally invasive catheter-based techniques, percutaneous renal denervation has become a safe and effective method of attenuating sympathetic overactivation. Percutaneous renal denervation, therefore, has the potential to modify and treat hypertension and congestive heart failure. Although future randomized controlled studies are needed to definitively prove its efficacy, renal denervation has the potential to change the way we view and treat cardiovascular disease.

      PubDate: 2017-04-27T22:58:03Z
      DOI: 10.1016/j.iccl.2017.03.013
       
  • Invasive Hemodynamics of Valvular Heart Disease
    • Authors: Michele Pighi; Anita W. Asgar
      Abstract: Publication date: Available online 25 April 2017
      Source:Interventional Cardiology Clinics
      Author(s): Michele Pighi, Anita W. Asgar
      Teaser In the current era, diagnosis and follow-up of valvular heart disease is performed noninvasively using echocardiography. In some cases, the results of echocardiographic evaluation are inconclusive or discrepant with the patient’s clinical symptoms. In such cases, a well-planned and executed cardiac catheterization is invaluable to clarify the clinical dilemma and assist in planning further management. This article reviews the indications, technique, and interpretation of cardiac catheterization in the setting of valvular stenosis and regurgitation.

      PubDate: 2017-04-27T22:58:03Z
      DOI: 10.1016/j.iccl.2017.03.003
       
  • Integrating Interventional Cardiology and Heart Failure Management for
           Cardiogenic Shock
    • Authors: Navin K. Kapur; Carlos D. Davila; Marwan F. Jumean
      Abstract: Publication date: Available online 22 April 2017
      Source:Interventional Cardiology Clinics
      Author(s): Navin K. Kapur, Carlos D. Davila, Marwan F. Jumean
      Teaser Cardiogenic shock remains one of the most common causes of in-hospital death. Recent data have identified an overall increase in patient complexity, with cardiogenic shock in the setting of acute myocardial infarction. The use of percutaneous acute mechanical circulatory support (AMCS) has steadily grown in the past decade. Guidelines and consensus statements addressing proper patient selection, timing of AMCS implantation, device choice, and postimplantation protocol are appearing. The emerging role of interventional heart failure specialists within the heart team includes integration and understanding of advanced hemodynamic and cathether-based therapies, with the goal of improving outcomes.

      PubDate: 2017-04-27T22:58:03Z
      DOI: 10.1016/j.iccl.2017.03.014
       
  • Alcohol Septal Ablation to Reduce Heart Failure
    • Authors: Joshua McKay; Sherif F. Nagueh
      Abstract: Publication date: Available online 21 April 2017
      Source:Interventional Cardiology Clinics
      Author(s): Joshua McKay, Sherif F. Nagueh
      Teaser Hypertrophic cardiomyopathy is a commonly encountered inheritable cardiac disorder with variable phenotypic expression. Although most patients will have no or mild symptoms, 10% will develop heart failure symptoms refractory to medical management. This article discusses the mechanisms through which hypertrophic cardiomyopathy induces heart failure and how alcohol septal ablation can reverse each of these mechanisms to lead to clinical improvement.

      PubDate: 2017-04-27T22:58:03Z
      DOI: 10.1016/j.iccl.2017.03.012
       
  • Invasive Hemodynamics of Myocardial Disease
    • Authors: Michael Eskander; Morton J. Kern
      Abstract: Publication date: Available online 21 April 2017
      Source:Interventional Cardiology Clinics
      Author(s): Michael Eskander, Morton J. Kern
      Teaser Heart failure is a clinical diagnosis that is supported by various laboratory, imaging, and invasive hemodynamic measures. There is no single diagnostic test. A variety of structural and/or functional myocardial abnormalities can lead to the inability of the heart to fill or eject blood. Despite ejection fraction being the most commonly assessed measure of systolic function in clinical practice, it is a poor measure of contractility because it is susceptible to loading conditions and chamber size. Invasive hemodynamic assessment remains of great importance in the evaluation of patients with myocardial disease or hypertrophic cardiomyopathy.

      PubDate: 2017-04-27T22:58:03Z
      DOI: 10.1016/j.iccl.2017.03.001
       
  • Endovascular Treatment of Peripheral Artery Disease and Critical Limb
           Ischemia
    • Abstract: Publication date: April 2017
      Source:Interventional Cardiology Clinics, Volume 6, Issue 2


      PubDate: 2017-03-05T21:37:23Z
       
  • Current Status and Outcomes of Iliac Artery Endovascular Intervention
    • Authors: Vladimir Lakhter; Vikas Aggarwal
      Abstract: Publication date: Available online 27 January 2017
      Source:Interventional Cardiology Clinics
      Author(s): Vladimir Lakhter, Vikas Aggarwal
      Teaser Aortoiliac occlusive disease (AIOD) is widely prevalent and leads to significant limitations in patient quality of life. All patients with aortoiliac occlusive disease should be managed with approved medical therapies in addition to a supervised exercise program. Persistence of significant symptoms despite noninvasive therapy should prompt further management with endovascular revascularization. Although patients with the most complex cases of AIOD anatomy may ultimately require surgery, advances in endovascular techniques have made it possible to treat most of these patients with AIOD using an endovascular-first approach.

      PubDate: 2017-02-02T02:58:26Z
      DOI: 10.1016/j.iccl.2016.12.001
       
  • Is Common Femoral Artery Stenosis Still a Surgical Disease'
    • Authors: Stephan Heo; Peter Soukas; Herbert D. Aronow
      Abstract: Publication date: Available online 27 January 2017
      Source:Interventional Cardiology Clinics
      Author(s): Stephan Heo, Peter Soukas, Herbert D. Aronow
      Teaser Surgical endarterectomy has long been the standard approach for treating atherosclerotic stenosis in the common femoral artery. Its major advantage is the associated long-term patency, which approaches 95% at 5 years. Nevertheless, recent studies have suggested that percutaneous treatment may be a valid alternative to surgery.

      PubDate: 2017-02-02T02:58:26Z
      DOI: 10.1016/j.iccl.2016.12.002
       
  • Contemporary Outcomes of Endovascular Intervention for Critical Limb
           Ischemia
    • Authors: Pratik K. Dalal; Anand Prasad
      Abstract: Publication date: Available online 27 January 2017
      Source:Interventional Cardiology Clinics
      Author(s): Pratik K. Dalal, Anand Prasad
      Teaser Critical limb ischemia (CLI) remains a significant cause of morbidity and mortality in patients with peripheral arterial disease. Optimal treatment strategies for CLI remain controversial. The only randomized trial comparing surgical with endovascular revascularization suggests no significant difference in limb salvage between open surgical bypass and angioplasty. Although novel endovascular strategies are now available, their efficacies remain largely untested in a randomized fashion. This review provides an overview of the data surrounding contemporary outcomes of endovascular therapy with an emphasis on current knowledge gaps.

      PubDate: 2017-02-02T02:58:26Z
      DOI: 10.1016/j.iccl.2016.12.008
       
  • Current Endovascular Management of Acute Limb Ischemia
    • Authors: Javier A. Valle; Stephen W. Waldo
      Abstract: Publication date: Available online 27 January 2017
      Source:Interventional Cardiology Clinics
      Author(s): Javier A. Valle, Stephen W. Waldo
      Teaser Acute limb ischemia is a vascular emergency, threatening the viability of the affected limb and requiring immediate recognition and treatment. Even with revascularization of the affected extremity, acute limb ischemia is associated with significant morbidity and mortality resulting in up to a 15% risk of amputation during the initial hospitalization and a 1 in 5 risk of mortality within 1 year of the index event. This review summarizes the current management of acute limb ischemia. Understanding the diagnosis and therapeutic options will aid clinicians in treating these critically ill patients.

      PubDate: 2017-02-02T02:58:26Z
      DOI: 10.1016/j.iccl.2016.12.003
       
  • Drug-Coated Balloons
    • Authors: Ananya Kondapalli; Barbara A. Danek; Houman Khalili; Haekyung Jeon-Slaughter; Subhash Banerjee
      Abstract: Publication date: Available online 16 January 2017
      Source:Interventional Cardiology Clinics
      Author(s): Ananya Kondapalli, Barbara A. Danek, Houman Khalili, Haekyung Jeon-Slaughter, Subhash Banerjee
      Teaser Paclitaxel-coated drug-coated balloons have significantly improved short-term and mid-term clinical outcomes in patients with symptomatic femoropopliteal peripheral artery disease. However, long-term results are awaited. Furthermore, the clinical success of drug-coated balloons in the infrapopliteal peripheral arteries has been more modest and overall similar to traditional balloon angioplasty, and remains an area of unmet clinical need. This article provides an overview of the clinical evidence for paclitaxel-coated balloons in the femoropopliteal and infrapopliteal peripheral artery distributions and future directions in this area.

      PubDate: 2017-01-19T21:53:04Z
      DOI: 10.1016/j.iccl.2016.12.005
       
  • Emerging and Future Therapeutic Options for Femoropopliteal and
           Infrapopliteal Endovascular Intervention
    • Authors: Damianos G. Kokkinidis; Ehrin J. Armstrong
      Abstract: Publication date: Available online 13 January 2017
      Source:Interventional Cardiology Clinics
      Author(s): Damianos G. Kokkinidis, Ehrin J. Armstrong
      Teaser Despite recent advances in endovascular therapy for peripheral artery disease, current technologies remain limited by rates of long-term restenosis and application to complex lesion subsets. This article presents data on upcoming therapies, including novel drug-coated balloons, drug-eluting stents, bioresorbable scaffolds, novel drug delivery therapies to target arteries, techniques to limit postangioplasty dissection, and treatment of severely calcified lesions.

      PubDate: 2017-01-19T21:53:04Z
      DOI: 10.1016/j.iccl.2016.12.011
       
  • Inframalleolar Intervention for Limb Preservation
    • Authors: Javier A. Valle; Andrew F. Prouse; Robert K. Rogers
      Abstract: Publication date: Available online 10 January 2017
      Source:Interventional Cardiology Clinics
      Author(s): Javier A. Valle, Andrew F. Prouse, Robert K. Rogers
      Teaser Critical limb ischemia (CLI) is a relatively prevalent and highly morbid condition. Patients with CLI have a poor prognosis, especially in the setting of incomplete revascularization. Traditionally, achieving optimal revascularization has been limited by the high prevalence of small-vessel disease in this population. More recently, advanced endovascular techniques, increased operator experience, and new technologies have enabled complete revascularization of inframalleolar disease with encouraging clinical results. In this article, we present an approach to endovascular therapy for inframalleolar revascularization of patients with CLI.

      PubDate: 2017-01-12T21:23:41Z
      DOI: 10.1016/j.iccl.2016.12.009
       
  • Nitinol Self-Expanding Stents for the Superficial Femoral Artery
    • Authors: Ashwin Nathan; Taisei Kobayashi; Jay Giri
      Abstract: Publication date: Available online 5 January 2017
      Source:Interventional Cardiology Clinics
      Author(s): Ashwin Nathan, Taisei Kobayashi, Jay Giri
      Teaser The superficial femoral artery is a complex artery subject to a unique set of biomechanical loading conditions in its course through the leg. Plain balloon angioplasty and balloon-expandable stents had unacceptably high rates of restenosis, necessitating target vessel revascularization. Nitinol alloy is well suited to provide the strength and flexibility needed of stents to withstand the external forces posed by the environment of the superficial femoral artery. Advances in stent technology with the addition of a slow-releasing antiproliferative agent and changes in scaffold design have shown promise in reducing the rates of stent fracture and in-stent restenosis.

      PubDate: 2017-01-12T21:23:41Z
      DOI: 10.1016/j.iccl.2016.12.006
       
  • Interventional Cardiology Clinics
    • Authors: Matthew J. Price
      Abstract: Publication date: January 2017
      Source:Interventional Cardiology Clinics, Volume 6, Issue 1
      Author(s): Matthew J. Price


      PubDate: 2016-11-26T01:17:12Z
      DOI: 10.1016/s2211-7458(16)30135-3
       
  • Antiplatelet and Anticoagulation Therapy in Percutaneous Coronary
           Intervention
    • Authors: Dominick J. Angiolillo; Matthew J. Price
      Abstract: Publication date: January 2017
      Source:Interventional Cardiology Clinics, Volume 6, Issue 1
      Author(s): Dominick J. Angiolillo, Matthew J. Price


      PubDate: 2016-11-26T01:17:12Z
      DOI: 10.1016/j.iccl.2016.10.001
       
  • Regulation of Platelet Activation and Coagulation and Its Role in Vascular
           Injury and Arterial Thrombosis
    • Authors: Maurizio Tomaiuolo; Lawrence F. Brass; Timothy J. Stalker
      Pages: 1 - 12
      Abstract: Publication date: January 2017
      Source:Interventional Cardiology Clinics, Volume 6, Issue 1
      Author(s): Maurizio Tomaiuolo, Lawrence F. Brass, Timothy J. Stalker
      Teaser Hemostasis requires tightly regulated interaction of the coagulation system, platelets, blood cells, and vessel wall components at a site of vascular injury. Dysregulation of this response may result in excessive bleeding if the response is impaired, and pathologic thrombosis with vessel occlusion and tissue ischemia if the response is robust. Studies have elucidated the major molecular signaling pathways responsible for platelet activation and aggregation. Antithrombotic agents targeting these pathways are in clinical use. This review summarizes research examining mechanisms by which these multiple platelet signaling pathways are integrated at a site of vascular injury to produce an optimal hemostatic response.

      PubDate: 2016-11-26T01:17:12Z
      DOI: 10.1016/j.iccl.2016.08.001
       
  • Pretreatment with Antiplatelet Agents in the Setting of Percutaneous
           Coronary Intervention
    • Authors: Davide Capodanno; Dominick J. Angiolillo
      Pages: 13 - 24
      Abstract: Publication date: January 2017
      Source:Interventional Cardiology Clinics, Volume 6, Issue 1
      Author(s): Davide Capodanno, Dominick J. Angiolillo
      Teaser Administering antiplatelet agents before coronary angiography to patients referred to elective or urgent percutaneous coronary intervention (PCI) requires a careful evaluation of advantages and disadvantages associated with platelet inhibition to avoid overtreatment on one side and undertreatment on the other. The delicate balance between ischemic protection and bleeding demands the ability to undertake risk stratification and individualized decisions, which is particularly challenging in the setting of ad hoc PCI and urgent procedures. This review analyzes the current evidence on pretreatment with oral and intravenous P2Y12 inhibitors in patients undergoing coronary angiography with intent to undergo PCI.

      PubDate: 2016-11-26T01:17:12Z
      DOI: 10.1016/j.iccl.2016.08.002
       
  • Optimal Duration of Dual Antiplatelet Therapy After Percutaneous Coronary
           Intervention
    • Authors: Arjun Majithia; Deepak L. Bhatt
      Pages: 25 - 37
      Abstract: Publication date: January 2017
      Source:Interventional Cardiology Clinics, Volume 6, Issue 1
      Author(s): Arjun Majithia, Deepak L. Bhatt
      Teaser Dual antiplatelet therapy (DAPT) is an essential component of treatment in patients with coronary artery disease treated with percutaneous coronary intervention (PCI). Recommendations for duration of DAPT after PCI should consider patient-specific risk, clinical presentation, stent characteristics, and procedural factors. Prolonged DAPT results in a reduction of stent thrombosis (ST) and myocardial infarction (MI) at the cost of increased bleeding. Studies of shorter-duration DAPT demonstrate similar mortality, MI, ST, and less bleeding when compared with longer DAPT duration. We review current evidence for strategies of prolonged DAPT and abbreviated DAPT following PCI.

      PubDate: 2016-11-26T01:17:12Z
      DOI: 10.1016/j.iccl.2016.08.003
       
  • Cangrelor
    • Authors: Matthew J. Price
      Pages: 39 - 47
      Abstract: Publication date: January 2017
      Source:Interventional Cardiology Clinics, Volume 6, Issue 1
      Author(s): Matthew J. Price
      Teaser In clinical trials that assessed the safety and efficacy of cangrelor during percutaneous coronary intervention (PCI), cangrelor was administered as a 30-μg/kg bolus followed by a 4-μg/kg/min infusion for at least 2 hours or the duration of the PCI, whichever was longer. Cangrelor is currently indicated as an adjunct to PCI to reduce the risk of myocardial infarction, repeat coronary revascularization, and stent thrombosis in patients who have not been treated with a P2Y12 platelet inhibitor and are not being given a glycoprotein IIb/IIIa inhibitor.

      PubDate: 2016-11-26T01:17:12Z
      DOI: 10.1016/j.iccl.2016.08.012
       
  • Ticagrelor
    • Authors: Wael Sumaya; Robert F. Storey
      Pages: 49 - 55
      Abstract: Publication date: January 2017
      Source:Interventional Cardiology Clinics, Volume 6, Issue 1
      Author(s): Wael Sumaya, Robert F. Storey
      Teaser Platelet P2Y12 receptor inhibitors are crucial in the treatment of patients with acute coronary syndrome or undergoing percutaneous coronary intervention. Ticagrelor is a reversibly binding, potent oral P2Y12 inhibitor that also is a weak inhibitor of the equilibrative nucleoside transporter-1 pathway for cellular adenosine uptake. It is hypothesized that ticagrelor has clinically relevant “off-target” effects, independent of its effect on platelet aggregation and thrombosis. This review considers the pleiotropic effects of ticagrelor and some of the possible mechanisms related to these effects.

      PubDate: 2016-11-26T01:17:12Z
      DOI: 10.1016/j.iccl.2016.08.004
       
  • Protease-Activated Receptor-1 Antagonists Post-Percutaneous Coronary
           Intervention
    • Authors: Pierluigi Tricoci
      Pages: 57 - 66
      Abstract: Publication date: January 2017
      Source:Interventional Cardiology Clinics, Volume 6, Issue 1
      Author(s): Pierluigi Tricoci
      Teaser Thrombin is a potent platelet agonist, and protease-activated receptor-1 (PAR-1) is the main thrombin receptor in human platelets and thrombin. PAR-1 antagonism has attracted interest as a potential therapeutic target to reduce atherothrombotic events in patients with atherosclerotic disease, especially coronary artery disease. In this review, the author describes the rationale of PAR-1 antagonism for the reduction of atherothrombotic events and reviews the key phase 3 trial results, with special attention to analyses in percutaneous coronary intervention patients.

      PubDate: 2016-11-26T01:17:12Z
      DOI: 10.1016/j.iccl.2016.08.005
       
  • Switching P2Y12 Receptor Inhibiting Therapies
    • Authors: Fabiana Rollini; Francesco Franchi; Dominick J. Angiolillo
      Pages: 67 - 89
      Abstract: Publication date: January 2017
      Source:Interventional Cardiology Clinics, Volume 6, Issue 1
      Author(s): Fabiana Rollini, Francesco Franchi, Dominick J. Angiolillo
      Teaser Antiplatelet therapy with aspirin and a P2Y12 receptor inhibitor is the cornerstone of treatment of patients with atherothrombotic disease manifestations. Switching between P2Y12 inhibitors occurs commonly in clinical practice for a variety of reasons, including safety, efficacy, adherence, and economic considerations. There are concerns about the optimal approach for switching because of potential drug interactions, which may lead to ineffective platelet inhibition and thrombotic complications, or potential overdosing due to overlap in drug therapy, which might cause excessive platelet inhibition and increased bleeding. This review provides practical considerations of switching based on pharmacodynamic and clinical data available from the literature.

      PubDate: 2016-11-26T01:17:12Z
      DOI: 10.1016/j.iccl.2016.08.006
       
  • Antiplatelet and Antithrombotic Therapy in Patients with Atrial
           Fibrillation Undergoing Coronary Stenting
    • Authors: Mikhail S. Dzeshka; Richard A. Brown; Davide Capodanno; Gregory Y.H. Lip
      Pages: 91 - 117
      Abstract: Publication date: January 2017
      Source:Interventional Cardiology Clinics, Volume 6, Issue 1
      Author(s): Mikhail S. Dzeshka, Richard A. Brown, Davide Capodanno, Gregory Y.H. Lip
      Teaser Stroke prevention is the main priority in the management cascade of atrial fibrillation. Most patients require long-term oral anticoagulation (OAC) and may require percutaneous coronary intervention. Prevention of recurrent cardiac ischemia and stent thrombosis necessitate dual antiplatelet therapy (DAPT) for up to 12 months. Triple antithrombotic therapy with OAC plus DAPT of shortest feasible duration is warranted, followed by dual antithrombotic therapy of OAC and antiplatelet agent, and OAC alone after 12 months. Because of elevated risk of hemorrhagic complications, new-generation drug-eluting stents, lower-intensity OAC, radial access, and routine use of gastric protection with proton pump inhibitors are recommended.

      PubDate: 2016-11-26T01:17:12Z
      DOI: 10.1016/j.iccl.2016.08.007
       
  • Antiplatelet Therapy for Secondary Prevention After Acute Myocardial
           Infarction
    • Authors: Ilaria Cavallari; Marc P. Bonaca
      Pages: 119 - 129
      Abstract: Publication date: January 2017
      Source:Interventional Cardiology Clinics, Volume 6, Issue 1
      Author(s): Ilaria Cavallari, Marc P. Bonaca
      Teaser Patients with prior myocardial infarction (MI) are at long-term heightened risk for recurrent ischemic events. Several large randomized controlled trials have demonstrated the benefit of more intensive antiplatelet strategies for long-term secondary prevention of cardiovascular death, recurrent MI, and stroke in patients with a history of MI at a cost of increased bleeding. The bleeding risk associated with long-term intensive antiplatelet strategies requires careful patient selection and involvement of patients in shared decision making regarding risks and benefits of therapy. Clinical characteristics, adherence to therapy, and integrated risk scores may aid clinicians in translating clinical trials into individualized therapy.

      PubDate: 2016-11-26T01:17:12Z
      DOI: 10.1016/j.iccl.2016.08.008
       
  • Antithrombotic Therapy to Reduce Ischemic Events in Acute Coronary
           Syndromes Patients Undergoing Percutaneous Coronary Intervention
    • Authors: Freek W.A. Verheugt
      Pages: 131 - 140
      Abstract: Publication date: January 2017
      Source:Interventional Cardiology Clinics, Volume 6, Issue 1
      Author(s): Freek W.A. Verheugt
      Teaser Antithrombotic therapy is essential in the prevention of periprocedural death and myocardial infarction during and after percutaneous coronary intervention. In the pathogenesis of acute coronary syndromes (ACS), both platelets and the coagulation cascade play an important role. Therefore, periprocedural antithrombotic therapy is even more important in ACS than in elective PCI. The most used agents are aspirin, platelet P2Y12 blockers, platelet glycoprotein IIb/IIIa blockers, and parenteral anticoagulants. The P2Y12 blockers must be continued at least 12 months. High-risk patients should be treated with glycoprotein IIb/IIIa receptor antagonists, especially those undergoing primary angioplasty for ST-elevation acute coronary syndrome.

      PubDate: 2016-11-26T01:17:12Z
      DOI: 10.1016/j.iccl.2016.08.009
       
  • Genetic Determinants of P2Y12 Inhibitors and Clinical Implications
    • Authors: Larisa H. Cavallari; Aniwaa Owusu Obeng
      Pages: 141 - 149
      Abstract: Publication date: January 2017
      Source:Interventional Cardiology Clinics, Volume 6, Issue 1
      Author(s): Larisa H. Cavallari, Aniwaa Owusu Obeng
      Teaser There is significant interpatient variability in clopidogrel effectiveness, which is due in part to cytochrome P450 (CYP) 2C19 genotype. Approximately 30% of individuals carry CYP2C19 loss-of-function alleles, which have been consistently shown to reduce clopidogrel effectiveness after an acute coronary syndrome and percutaneous coronary intervention. Guidelines recommend consideration of prasugrel or ticagrelor in these patients. A clinical trial examining outcomes with CYP2C19 genotype–guided antiplatelet therapy is ongoing. In the meantime, based on the evidence available to date, several institutions have started clinically implementing CYP2C19 genotyping to assist with antiplatelet selection after percutaneous coronary intervention.

      PubDate: 2016-11-26T01:17:12Z
      DOI: 10.1016/j.iccl.2016.08.010
       
  • Current Role of Platelet Function Testing in Percutaneous Coronary
           Intervention and Coronary Artery Bypass Grafting
    • Authors: Lisa Gross; Dirk Sibbing
      Pages: 151 - 166
      Abstract: Publication date: January 2017
      Source:Interventional Cardiology Clinics, Volume 6, Issue 1
      Author(s): Lisa Gross, Dirk Sibbing
      Teaser There is interindividual variability in the pharmacodynamic response to antiplatelet medications. High on-treatment platelet reactivity, reflecting a failure to achieve adequate platelet inhibition, is associated with a higher risk for thrombotic events. Low on-treatment platelet reactivity, or an enhanced response to antiplatelet medications, has been linked to a higher risk for bleeding. There is evidence for the prognostic value of platelet function testing for risk prediction. This review presents the current evidence regarding platelet function testing in patients undergoing percutaneous cardiac intervention and coronary artery bypass grafting. The possible role of platelet function testing for individualized antiplatelet treatment is highlighted.

      PubDate: 2016-11-26T01:17:12Z
      DOI: 10.1016/j.iccl.2016.08.011
       
  • Despite Dramatic Progress, Significant Controversy and Critical Challenges
           for Patients with ST-Segment Elevation MI
    • Authors: Timothy D. Henry
      Abstract: Publication date: October 2016
      Source:Interventional Cardiology Clinics, Volume 5, Issue 4
      Author(s): Timothy D. Henry


      PubDate: 2016-09-12T01:47:08Z
      DOI: 10.1016/j.iccl.2016.07.001
       
  • Implementation of Regional ST-Segment Elevation Myocardial Infarction
           Systems of Care
    • Authors: Christopher B. Fordyce; Timothy D. Henry; Christopher B. Granger
      Pages: 415 - 425
      Abstract: Publication date: Available online 13 August 2016
      Source:Interventional Cardiology Clinics
      Author(s): Christopher B. Fordyce, Timothy D. Henry, Christopher B. Granger
      Teaser Current guidelines recommend that communities create and maintain a regional system of ST-segment elevation myocardial infarction (STEMI) care that includes assessment and continuous quality improvement of emergency medical services and hospital-based activities. Availability and timely access is a challenge in many areas of the United States. This article reviews clinical trial data supporting the use of primary percutaneous coronary intervention as the optimal reperfusion strategy, and fibrinolysis as an option when this is not possible. It then describes the outcomes and benefits of implementing regional systems of STEMI care, and discusses ongoing challenges for STEMI system implementation, including inadequate data collection and feedback, and hospital and physician competition.

      PubDate: 2016-08-14T12:12:53Z
      DOI: 10.1016/j.iccl.2016.06.001
       
  • Time to Treatment
    • Authors: Juan Russo; Michel R. Le May
      Pages: 427 - 437
      Abstract: Publication date: October 2016
      Source:Interventional Cardiology Clinics, Volume 5, Issue 4
      Author(s): Juan Russo, Michel R. Le May
      Teaser In the modern ST-elevation myocardial infarction (STEMI) system, the use of electrocardiogram by emergency medical services (EMS) personnel and the option to bypass emergency departments on route to a PCI-capable hospital is of particular importance. Through training and a standardized referral process, EMS personnel can now accurately diagnose and refer STEMI patients directly to the catheterization laboratory of a percutaneous coronary intervention–capable hospital. Regional STEMI models have been implemented successfully across North America, resulting in palpable reductions in door-to-balloon time, morbidity, and mortality.

      PubDate: 2016-09-12T01:47:08Z
      DOI: 10.1016/j.iccl.2016.06.003
       
  • Reperfusion Options for ST Elevation Myocardial Infarction Patients with
           Expected Delays to Percutaneous Coronary Intervention
    • Authors: David M. Larson; Peter McKavanagh; Timothy D. Henry; Warren J. Cantor
      Pages: 439 - 450
      Abstract: Publication date: October 2016
      Source:Interventional Cardiology Clinics, Volume 5, Issue 4
      Author(s): David M. Larson, Peter McKavanagh, Timothy D. Henry, Warren J. Cantor
      Teaser Primary percutaneous coronary intervention (PCI) is the preferred reperfusion strategy for ST elevation myocardial infarction (STEMI). However, only one-third of hospitals in the US have PCI availability 24/7. For non-PCI hospitals, transfer remains the optimal strategy. For expected delays of greater than 120 minutes, a pharmacoinvasive strategy is recommended. In patients with evidence of failed reperfusion or hemodynamic instability, immediate rescue PCI should be performed. All other patients should undergo routine cardiac catheterization and PCI within 24 hours after fibrinolysis. A pharmacoinvasive strategy is best implemented within an organized regional STEMI system with prospective standardized transfer protocols.

      PubDate: 2016-09-12T01:47:08Z
      DOI: 10.1016/j.iccl.2016.06.004
       
  • Interventional Cardiology Clinics
    • Authors: Matthew J. Price
      Abstract: Publication date: October 2016
      Source:Interventional Cardiology Clinics, Volume 5, Issue 4
      Author(s): Matthew J. Price


      PubDate: 2016-09-12T01:47:08Z
      DOI: 10.1016/s2211-7458(15)00096-6
       
  • Antiplatelet and Anticoagulation Therapy in PCI
    • Abstract: Publication date: January 2017
      Source:Interventional Cardiology Clinics, Volume 6, Issue 1


      PubDate: 2016-11-26T01:17:12Z
       
  • Controversies in the Management of STEMI
    • Abstract: Publication date: October 2016
      Source:Interventional Cardiology Clinics, Volume 5, Issue 4


      PubDate: 2016-09-12T01:47:08Z
       
 
 
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