Publisher: American Heart Association   (Total: 12 journals)   [Sort by number of followers]

Showing 1 - 12 of 12 Journals sorted alphabetically
Arteriosclerosis, Thrombosis and Vascular Biology     Full-text available via subscription   (Followers: 29, SJR: 3.435, CiteScore: 5)
Circulation     Hybrid Journal   (Followers: 186, SJR: 8.95, CiteScore: 9)
Circulation : Arrhythmia and Electrophysiology     Hybrid Journal   (Followers: 14, SJR: 3.225, CiteScore: 4)
Circulation : Cardiovascular Imaging     Hybrid Journal   (Followers: 18, SJR: 3.242, CiteScore: 4)
Circulation : Cardiovascular Interventions     Hybrid Journal   (Followers: 23, SJR: 4.228, CiteScore: 5)
Circulation : Cardiovascular Quality and Outcomes     Hybrid Journal   (Followers: 14, SJR: 2.743, CiteScore: 3)
Circulation : Genomic and Precision Medicine     Hybrid Journal   (Followers: 12, SJR: 2.661, CiteScore: 4)
Circulation : Heart Failure     Hybrid Journal   (Followers: 27, SJR: 4.2, CiteScore: 5)
Circulation Research     Hybrid Journal   (Followers: 32, SJR: 6.813, CiteScore: 9)
Hypertension     Full-text available via subscription   (Followers: 27)
J. of the American Heart Association     Open Access   (Followers: 19, SJR: 2.674, CiteScore: 4)
Stroke     Hybrid Journal   (Followers: 92, SJR: 3.529, CiteScore: 5)
Similar Journals
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Circulation : Cardiovascular Interventions
Journal Prestige (SJR): 4.228
Citation Impact (citeScore): 5
Number of Followers: 23  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1941-7640 - ISSN (Online) 1941-7632
Published by American Heart Association Homepage  [12 journals]
  • Prognostic Role of Residual Thrombus Burden Following Thrombectomy:
           Insights From the TOTAL Trial

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      Authors: Mohammad Alkhalil Michał Kuzemczak Robin Zhao Charalampos Kavvouras Warren J. Cantor Christopher B. Overgaard Shahar Lavi Vinoda Sharma Saqib Chowdhary Goran Stanković Saško Kedev Ivo Bernat Ravinay Bhindi Tej Sheth Kari Niemela Sanjit S. Jolly Vladimír Džavík Division of Cardiology; Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network, Canada (M.A., M.K., C.K., V.D.). Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne, United Kingdom (M.A.). Translational Faculty of Medicine Pilsen, Czech Republic (I.B.). Royal North Shore Hospital, University of Sydney, Australia (R.B.). Heart Hospital, Tampere, Finland (K.N.).
      Abstract: Circulation: Cardiovascular Interventions, Volume 15, Issue 5, Page e011336, May 1, 2022.
      Background:It is unclear whether more effective forms of thrombus removal than current aspiration catheters would lead to improved outcomes. We sought to evaluate the prognostic role of residual thrombus burden (rTB), after manual thrombectomy, in patients undergoing primary percutaneous coronary intervention with routine manual thrombectomy in the TOTAL trial (Thrombectomy Versus PCI Alone).Methods:This is a single-arm analysis of patients from the TOTAL trial who underwent routine manual aspiration thrombectomy. The rTB was quantified by an angiographic core laboratory using the Thrombolysis in Myocardial Infarction criteria and validated using existing optical coherent tomography data. Large rTB was defined as grade ≥3. The primary outcome was death from cardiovascular causes, recurrent myocardial infarction, cardiogenic shock, or new or worsening heart failure within 180 days.Results:Of 5033 patients randomized to routine thrombectomy, 2869 patients had quantifiable rTB (1014 [35%] had large rTB). Patients with large rTB were more likely to have hypertension, previous percutaneous coronary intervention, myocardial infarction, or Killip class III on presentation but less likely to have Killip class I. The primary outcome occurred more frequently in patients with large rTB, even after adjustment for known risk predictors (8.6% versus 4.6%; adjusted hazard ratio, 1.83 [95% CI, 1.34–2.48]). These patients also had a higher risk of cardiovascular death (adjusted hazard ratio, 1.83 [95% CI, 1.13–2.95]), cardiogenic shock (adjusted hazard ratio, 2.02 [95% CI, 1.08–3.76]), and heart failure (adjusted hazard ratio, 1.74 [95% CI, 1.02–2.96]) but not myocardial infarction or stroke.Conclusions:Large rTB is a common finding in primary percutaneous coronary intervention and is associated with increased risk of adverse cardiovascular outcomes, including cardiovascular death. Future technologies offering better thrombus removal than current devices may decrease or even eliminate the risk associated with rTB. This, potentially, can turn into a strategic option to be studied in clinical trials.Registration:URL:https://www.clinicaltrials.gov; Unique identifier: NCT01149044.
      Citation: Circulation: Cardiovascular Interventions
      PubDate: 2022-05-17T06:00:05Z
      DOI: 10.1161/CIRCINTERVENTIONS.121.011336
      Issue No: Vol. 15, No. 5 (2022)
       
  • Prophylactic Mechanical Circulatory Support Use in Elective Percutaneous
           Coronary Intervention for Patients With Stable Coronary Artery Disease

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      Authors: Michel Zeitouni Guillaume Marquis-Gravel Nathaniel R. Smilowitz Pearl Zakroysky Daniel M. Wojdyla Amin P. Amit Sunil V. Rao Tracy Y. Wang Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (M.Z; G.M.G, P.Z, D.M.W, S.V.R, T.Y.W.). Division of Cardiology, Department of Medicine, NYU Langone Medical Center‚ New York (N.R.S.). Cardiovascular Division, Department of Medicine, Washington University School of Medicine, St. Louis, MO (A.P.A.).
      Abstract: Circulation: Cardiovascular Interventions, Volume 15, Issue 5, Page e011534, May 1, 2022.
      Background:Mechanical circulatory support (MCS) devices can be used in high-risk percutaneous coronary intervention (PCI). Our objective was to describe trends and outcomes of prophylactic MCS use in elective PCI for patients with stable coronary artery disease in the American College of Cardiology National Cardiovascular Data Registry’s CathPCI registry.Methods:Among 2 108 715 consecutive patients with stable coronary artery disease undergoing elective PCI in the CathPCI registry between 2009 and 2018, we examined patterns of prophylactic use of MCS. Propensity score models with inverse probability of treatment weighting compared effectiveness (in-hospital death, cardiogenic shock, or new heart failure) and safety (stroke, tamponade, major bleeding, or vascular complication requiring treatment) between patients treated with intra-aortic balloon pump versus other MCS (Impella or extracorporeal membrane oxygenation).Results:Overall, 6905 (0.3%) patients underwent elective PCI with prophylactic MCS. MCS use trended up from 0.2% of elective PCIs in 2009 to 0.6% in 2018 (P<0.0001), driven by other MCS (P<0.0001), whereas intra-aortic balloon pump use remained low and constant (P=0.12). In-hospital major adverse cardiac events and cardiovascular complications occurred in 7.1% and 18.8% of elective PCI patients with prophylactic MCS use and 0.5% and 2.3% of patients without prophylactic MCS use. Intra-aortic balloon pump use was associated with a higher risk of major adverse cardiac events (9.6% versus 6.0%, adjusted odds ratio, 1.59 [95% CI, 1.32–1.91]) but lower risk of complications (18.2% versus 19.1%, adjusted odds ratio, 0.88 [95% CI, 0.77–0.99]) than use of other MCS.Conclusions:The use of prophylactic MCS has increased over time for elective PCI in patients with stable coronary artery disease. Intra-aortic balloon pump was associated with higher major adverse cardiac events but lower risk of procedural complications compared with other MCS.
      Citation: Circulation: Cardiovascular Interventions
      PubDate: 2022-05-17T06:00:05Z
      DOI: 10.1161/CIRCINTERVENTIONS.121.011534
      Issue No: Vol. 15, No. 5 (2022)
       
  • Role of Quantitative Flow Ratio in Predicting Future Cardiac Allograft
           Vasculopathy in Heart Transplant Recipients

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      Authors: Giosafat Spitaleri Salvatore Brugaletta Luciano Potena Sonia Mirabet José González-Costello Ottavio Zucchetti Marco Masetti Lluis Asmarats Miquel Gual Elena Nardi Domenico Di Girolamo Gianluca Campo Marta Farrero Heart Failure Clinic; Specialty Medicine, University of Bologna, Italy (E.N.). Cardiologia Interventistica, A.O. Sant’Anna e San Sebastiano, Caserta, Italy (D.D.G.). Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (G.C.).
      Abstract: Circulation: Cardiovascular Interventions, Volume 15, Issue 5, Page e011656, May 1, 2022.
      Background:Coronary angiography is the gold standard for cardiac allograft vasculopathy (CAV) diagnosis, but it usually detects the disease at an advanced stage. We investigated the role of quantitative flow ratio (QFR), a noninvasive tool to identify potentially flow-limiting lesions, in predicting CAV development in heart transplant recipients.Methods:Consecutive heart transplant recipients with no evidence of angiographic CAV at baseline coronary angiography were retrospectively included between January 2010 and December 2015, and QFR computation was performed. The relationship between vessel QFR and the occurrence of angiographic vessel-related CAV (≥50% stenosis) was assessed.Results:One hundred forty-three patients were included and QFR computation was feasible in 241 vessels. The median value of QFR at baseline coronary angiography was 0.98 (interquartile range, 0.94–1.00). During a median follow-up of 6.0 years (interquartile range, 4.6–7.8 years), vessel-related CAV occurred in 25 (10.4%) vessels. Receiver-operating characteristic curve analysis identified a QFR best cutoff of≤0.95 (area under the curve, 0.81 [95% CI, 0.71–0.90];P<0.001). QFR≤0.95 was associated with an increased risk of vessel-related CAV (adjusted hazard ratio, 20.87 [95% CI, 5.35–81.43];P<0.001). In an exploratory analysis, QFR≤0.95 in at least 2 vessels was associated with higher incidence of cardiovascular death or late graft dysfunction (71.4% in recipients with 2–3 vessels affected versus 5.1% in recipients with 0–1 vessels affected,P<0.001).Conclusions:In a cohort of heart transplant recipients, QFR computation at baseline coronary angiography may be a safe and reliable tool to predict vessel-related CAV and clinical outcomes at long-term follow-up.
      Citation: Circulation: Cardiovascular Interventions
      PubDate: 2022-05-17T06:00:05Z
      DOI: 10.1161/CIRCINTERVENTIONS.121.011656
      Issue No: Vol. 15, No. 5 (2022)
       
  • Transcatheter Electrosurgical Laceration and Stabilization of Failed
           MitraClip[s]/SAPIEN M3 for Treatment of Failed MitraClip

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      Authors: Errol K. Inci Adam B. Greenbaum Robert J. Lederman Keshav Kohli John C. Lisko Isida Byku Patrick T. Gleason Joe X. Xie Nikoloz Shekiladze Vasilis C. Babaliaros Structural Heart; Emory University, Atlanta (K.K.).
      Abstract: Circulation: Cardiovascular Interventions, Volume 15, Issue 5, Page e012014, May 1, 2022.

      Citation: Circulation: Cardiovascular Interventions
      PubDate: 2022-05-17T06:00:05Z
      DOI: 10.1161/CIRCINTERVENTIONS.122.012014
      Issue No: Vol. 15, No. 5 (2022)
       
  • Letter by Kawashima et al Regarding Article, “Coronary Artery Bypass
           Grafting and Percutaneous Coronary Intervention in Patients With Chronic
           Total Occlusion and Multivessel Disease”

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      Authors: Hideyuki Kawashima Scot Garg Patrick W. Serruys Discipline of Cardiology; Saolta Group, Galway University Hospital, Health Service Executive CORRIB Core Lab, National University of Ireland Galway (NUIG) (H.K., P.W.S.). Department of Cardiology, Academic Medical Centre, University of Amsterdam, the Netherlands (H.K.). Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan (H.K.). Royal Blackburn Hospital, United Kingdom (S.G.). CÚRAM, the SFI Research Centre for Medical Devices, Galway, Ireland (P.W.S.). NHLI, Imperial College London, United Kingdom (P.W.S.).
      Abstract: Circulation: Cardiovascular Interventions, Volume 15, Issue 5, Page e012080, May 1, 2022.

      Citation: Circulation: Cardiovascular Interventions
      PubDate: 2022-05-17T06:00:05Z
      DOI: 10.1161/CIRCINTERVENTIONS.122.012080
      Issue No: Vol. 15, No. 5 (2022)
       
  • Response by Lin et al to Letter Regarding Article, “Coronary Artery
           Bypass Grafting and Percutaneous Coronary Intervention in Patients With
           Chronic Total Occlusion and Multivessel Disease”

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      Authors: Shen Lin Changdong Guan Bo Xu Zhe Zheng National Clinical Research Center of Cardiovascular Diseases; State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases (S.L., C.G., B.X., Z.Z.), Chinese Academy of Medical Sciences Peking Union Medical College, Beijing, People’s Republic of China. National Health Commission Key Laboratory of Cardiovascular Regenerative Medicine, Fuwai Central-China Hospital, Central-China Branch of National Center for Cardiovascular Diseases, Zhengzhou, People’s Republic of China (Z.Z.).
      Abstract: Circulation: Cardiovascular Interventions, Volume 15, Issue 5, Page e012099, May 1, 2022.

      Citation: Circulation: Cardiovascular Interventions
      PubDate: 2022-05-17T06:00:05Z
      DOI: 10.1161/CIRCINTERVENTIONS.122.012099
      Issue No: Vol. 15, No. 5 (2022)
       
  • Just in Case, Just Because, or Just Right'

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      Authors: Alexander G. Truesdell Lindsey Cilia Maya Serhal Virginia Heart/Inova Heart; Women’s Hospital, Boston, MA (L.C.).
      Abstract: Circulation: Cardiovascular Interventions, Volume 15, Issue 5, Page e011999, May 1, 2022.

      Citation: Circulation: Cardiovascular Interventions
      PubDate: 2022-05-17T06:00:05Z
      DOI: 10.1161/CIRCINTERVENTIONS.122.011999
      Issue No: Vol. 15, No. 5 (2022)
       
  • Transcatheter Myotomy to Treat Hypertrophic Cardiomyopathy and Enable
           Transcatheter Mitral Valve Replacement: First-in-Human Report of Septal
           Scoring Along the Midline Endocardium

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      Authors: Adam B. Greenbaum Jaffar M. Khan Christopher G. Bruce George S. Hanzel Patrick T. Gleason Keshav Kohli Errol K. Inci Robert A. Guyton Gaetano Paone Toby Rogers Robert J. Lederman Vasilis C. Babaliaros Emory Structural Heart; Emory University, Atlanta (K.K.).
      Abstract: Circulation: Cardiovascular Interventions, Ahead of Print.

      Citation: Circulation: Cardiovascular Interventions
      PubDate: 2022-05-23T09:00:04Z
      DOI: 10.1161/CIRCINTERVENTIONS.122.012106
       
  • Differential Impact of Coronary Revascularization on Long-Term Clinical
           Outcome According to Coronary Flow Characteristics: Analysis of the
           International ILIAS Registry

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      Authors: Rikuta Hamaya Tim P. van de Hoef Joo Myung Lee Masahiro Hoshino Yoshihisa Kanaji Tadashi Murai Coen K.M. Boerhout Guus A. de Waard Ji-Hyun Jung Seung Hun Lee Hernan Mejia Renteria Mauro Echavarria-Pinto Martijn Meuwissen Hitoshi Matsuo Maribel Madera-Cambero Ashkan Eftekhari Mohamed A. Effat Koen Marques Joon-Hyung Doh Evald H. Christiansen Rupak Banerjee Chang-Wook Nam Giampaolo Niccoli Masafumi Nakayama Nobuhiro Tanaka Eun-Seok Shin Tetsuo Sasano Steven A.J. Chamuleau Paul Knaapen Javier Escaned Bon Kwon Koo Jan J. Piek Tsunekazu Kakuta Division of Preventive Medicine; Department of Medicine, Brigham Dental University, Japan (T.S.). Department of Internal Medicine, Cardiovascular Center, Seoul National University Hospital, Republic of Korea (B.K.K.).
      Abstract: Circulation: Cardiovascular Interventions, Ahead of Print.
      BACKGROUND:Coronary pressure indices such as fractional flow reserve are the standard for guiding elective revascularization. However, considering additional coronary flow parameters could further individualize and optimize the decision on revascularization. We aimed to investigate the potentially differential prognostic associations of elective percutaneous coronary intervention (PCI) according to coronary flow properties represented by coronary flow reserve (CFR), coronary flow capacity (CFC), and baseline CFC (bCFC).METHODS:From the ILIAS Registry (Inclusive Invasive Physiological Assessment in Angina Syndromes) composed of 16 hospitals globally from 7 countries, patients with obstructive coronary artery disease who underwent invasive coronary physiological assessment were included (N=2370 vessels). We assessed effect measure modifications of the association of PCI and 5-year target vessel failure according to CFR, CFC, and bCFC either assessed by Doppler-technique or thermodilution-method.RESULTS:The mean age of the population was 63.3 years, and there were 1322 (73.6%) males. Median fractional flow reserve was 0.85, and PCI was performed in 600 (25.3%) vessels. Reduced CFR, CFC, and abnormal bCFC were defined in 988 (41.7%), 542 (22.9%), and 600 (25.3%) vessels, respectively. Significant effect measure modifications were observed by CFC either in odds ratio (P=0.0018), additive (P=0.029), and hazard ratio scale (P=0.0002). The absolute risk of 5-year target-vessel failure was higher if treated by PCI in vessels with normal CFC by 1.8 (−1.7 to 5.3) percent, while that was lower by −5.9 (−12 to −0.1) percent in those with reduced CFC. CFR and bCFC were not significant effect modifiers in any scales. Similar associations were observed in per-patient analyses, whereas the findings were less robust.CONCLUSIONS:We observed qualitative effect measure modification of PCI and 5-year clinical outcomes according to CFC status in additive scale. CFR and bCFC were not robust effect modifiers. Therefore, CFC could be potentially used to optimize the patient selection for elective PCI treatment combined with fractional flow reserve.
      Citation: Circulation: Cardiovascular Interventions
      PubDate: 2022-05-23T09:00:04Z
      DOI: 10.1161/CIRCINTERVENTIONS.121.011948
       
  • Treatment Gaps in Guideline-Directed Medical Therapy for Patients
           Undergoing Higher-Risk Percutaneous Coronary Intervention

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      Authors: Andre T. Cheng Mahesh V. Madhavan Ioanna Kosmidou Anurag Deeconda Dimitri Karmpaliotis Jeffrey W. Moses Ajay J. Kirtane Division of Cardiology; Department of Medicine, Columbia University Irving Medical Center the New York-Presbyterian Hospital (A.T.C., M.V.M., I.K., D.K., J.W.M., A.J.K.). Cardiovascular Research Foundation, New York, NY (M.V.M., I.K., D.K., J.W.M., A.J.K.). Medical University of South Carolina, Charleston (A.D.).
      Abstract: Circulation: Cardiovascular Interventions, Ahead of Print.

      Citation: Circulation: Cardiovascular Interventions
      PubDate: 2022-05-23T09:00:04Z
      DOI: 10.1161/CIRCINTERVENTIONS.121.011464
       
  • Update from the Longitudinal Assessment of Safety of Femoropopliteal
           Endovascular Treatment With Paclitaxel-Coated Devices Among Medicare
           Beneficiaries: The SAFE-PAD Study

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      Authors: Eric A. Secemsky Yang Song Marc Schermerhorn Robert W. Yeh Richard A.; Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA (M.S.).
      Abstract: Circulation: Cardiovascular Interventions, Ahead of Print.

      Citation: Circulation: Cardiovascular Interventions
      PubDate: 2022-05-20T01:00:01Z
      DOI: 10.1161/CIRCINTERVENTIONS.122.012074
       
  • New Insights Into Long- Versus Short-Term Dual Antiplatelet Therapy
           Duration in Patients After Stenting for Left Main Coronary Artery Disease:
           Findings From a Prospective Observational Study

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      Authors: Hao-Yu Wang Ke-Fei Dou Changdong Guan Lihua Xie Yunfei Huang Rui Zhang Weixian Yang Yongjian Wu Yuejin Yang Shubin Qiao Runlin Gao Bo Xu Department of Cardiology; Cardiometabolic Medicine Center, Coronary Heart Disease Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences Peking Union Medical College, Beijing, China. (C.G., L.X., Y.H., B.X.) State Key Laboratory of Cardiovascular Disease, Beijing, China (H.-Y.W., K.-F.D., R.Z., Y.W., Y.Y.). National Clinical Research Center for Cardiovascular Diseases, Beijing, China (K.-F.D., W.Y., Y.W., Y.Y., S.Q., R.G., B.X.).
      Abstract: Circulation: Cardiovascular Interventions, Ahead of Print.
      BACKGROUND:The appropriate duration of dual antiplatelet therapy (DAPT) and risk-benefit ratio for long-term DAPT in patients with left main (LM) disease undergoing percutaneous coronary intervention remains uncertain.METHODS:Four thousand five hundred sixty-one consecutive patients with stenting of LM disease at a single center from January 2004 to December 2016 were enrolled. Decision to discontinue or remain on DAPT after 12 months was left to an individualized decision-making based on treating physicians by weighing the patient’s risks of ischemia versus bleeding and considering patient preference. The primary outcome was a composite of death, myocardial infarction, stent thrombosis, or stroke at 3 years. Key safety outcome was 3-year rate of Bleeding Academic Research Consortium 2, 3, or 5 bleeding.RESULTS:Of 3865 patients free of ischemic and bleeding events at 12 months, 1727 (44.7%) remained on DAPT (mostly clopidogrel based [97.7%]) beyond 12 months after LM percutaneous coronary intervention. DAPT>12-month versus ≤12-month DAPT was associated with a significant reduced risk of 3-year primary outcome (2.6% versus 4.6%; adjusted hazard ratio: 0.59 [95% CI, 0.41–0.84]). The same trend was found for other ischemic end points: death (0.9% versus 3.0%;Plog-rank<0.001), cardiovascular death (0.5% versus 1.7%;Plog-rank=0.001), myocardial infarction (0.8% versus 1.9%;Plog-rank=0.005), and stent thrombosis (0.4% versus 1.1%;Plog-rank=0.017). The key safety end point was not significantly different between 2 regimens (1.8% versus 1.6%; adjusted hazard ratio: 1.07 [95% CI, 0.65–1.74]). The effect of DAPT>12 month on primary and key safety outcomes was consistent across clinical presentations, high bleeding risk, P2Y12inhibitor, and LM bifurcation percutaneous coronary intervention approach.CONCLUSIONS:In a large cohort of patients free from clinical events during the first year after LM percutaneous coronary intervention and at low apparent future bleeding risk, an individualized patient-tailored approach to longer duration (>12 month) of DAPT with aspirin plus a P2Y12inhibitor (mostly clopidogrel) improved both composite and individual efficacy outcomes by reducing ischemic risk, without a concomitant increase in clinically relevant bleeding.
      Citation: Circulation: Cardiovascular Interventions
      PubDate: 2022-05-18T09:00:02Z
      DOI: 10.1161/CIRCINTERVENTIONS.121.011536
       
  • One-Year Health Status Outcomes Following Early Invasive and Noninvasive
           Treatment in Symptomatic Peripheral Artery Disease

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      Authors: Suveen Angraal Vittal Hejjaji Yuanyuan Tang Kensey L. Gosch Manesh R. Patel Jan Heyligers Christopher J. White Rudolf Tutein Nolthenius Carlos Mena-Hurtado Herbert D. Aronow Gregory L. Moneta Robert Fitridge Peter A. Soukas J. Dawn Abbott Eric A. Secemsky John A. Spertus Kim G. Smolderen Department of Internal Medicine; University of Missouri Kansas City School of Medicine, University of Missouri-Kansas City. (S.A.). Department of Cardiology, Saint Luke’s Mid America Heart Institute, University of Missouri-Kansas City. (V.H., J.A.S.) Department of Biomedical & Health Informatics, University of Missouri-Kansas City. (J.A.S.) Saint Luke’s Mid America Heart Institute, Kansas City, MO (Y.T., K.L.G.). Division of Cardiology, Department of Medicine, Duke University Medical Center, Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (M.R.P.). Department of Vascular Surgery, St. Elisabeth Hospital, Tilburg, the Netherlands (J.H.). Department of Cardiology, Ochsner Clinical School, University of Queensland, AU, Susan F. Smith Center for Outcomes Research in Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA. (E.A.S.)
      Abstract: Circulation: Cardiovascular Interventions, Ahead of Print.
      Background:Lifestyle changes and medications are recommended as the first line of treatment for claudication, with revascularization considered for treatment-resistant symptoms, based on patients’ preferences. Real-world evidence comparing health status outcomes of early invasive with noninvasive management strategies is lacking.Methods:In the international multicenter prospective observational PORTRAIT (Patient-Centered Outcomes Related to Treatment Practices in Peripheral Arterial Disease: Investigating Trajectories) registry, disease-specific health status was assessed by the Peripheral Artery Questionnaire in patients with new-onset or worsening claudication at presentation and 3, 6, and 12 months later. One-year health status trajectories were compared by early revascularization versus noninvasive management on a propensity-matched sample using hierarchical generalized linear models for repeated measures adjusted for baseline health status.Results:In a propensity-matched sample of 1000 patients (67.4±9.3 years, 62.8% male, and 82.4% White), 297 (29.7%) underwent early revascularization and 703 (70.3%) were managed noninvasively. Over 1 year of follow-up, patients who underwent early invasive management reported significantly higher health status than patients managed noninvasively (interaction term for time and treatment strategy;P<0.001 for all Peripheral Artery Questionnaire domains). The average 1-year change in Peripheral Artery Questionnaire summary scores was 30.8±25.2 in those undergoing early invasive, compared with 16.7±23.4 in those treated noninvasively (P<0.001).Conclusions:Patients with claudication undergoing early invasive treatment had greater health status improvements over the course of 1 year than those treated noninvasively. These data can be used to support shared decision-making with patients.REGISTRATION:URL:https://www.clinicaltrials.gov; Unique identifier: NCT01419080.
      Citation: Circulation: Cardiovascular Interventions
      PubDate: 2022-05-17T09:00:03Z
      DOI: 10.1161/CIRCINTERVENTIONS.121.011506
       
  • Percutaneous Coronary Intervention With and Without Intravascular
           Ultrasound for Patients With Complex Lesions: Utilization, Mortality, and
           Target Vessel Revascularization

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      Authors: Edward L. Hannan Ye Zhong Pavan Reddy Alice K. Jacobs Frederick S.K. Ling Spencer B. King Peter B. Berger Ferdinand J. Venditti Gary Walford Jacqueline Tamis-Holland Department of Health Policy‚ Management; Behavior‚ University at Albany, State University of New York (E.L.H., Y.Z.). Department of Cardiology‚ Mount Sinai St. Luke’s Hospital, New York (P.R., J.T.-H.). Department of Cardiology‚ Boston Medical Center, MA (A.K.J.). Department of Cardiology‚ University of Rochester Medical Center, NY (F.S.K.L.). Department of Cardiology‚ Emory Health System, Atlanta, GA (S.B.K.). Department of Administration‚ Albany Medical Center, NY (F.J.V.). Department of Cardiology‚ Johns Hopkins Medical Center, Baltimore, MD (G.W.).
      Abstract: Circulation: Cardiovascular Interventions, Ahead of Print.
      BACKGROUND:Intravascular ultrasound (IVUS) has several benefits during percutaneous coronary interventions (PCIs), including more accurate vessel sizing, improved stent expansion, and better strut apposition. Prior clinical trials have demonstrated a reduction in cardiac events when IVUS is used. However, there is limited information about the utilization of IVUS and the outcomes of IVUS-guided versus angiography-guided PCI in patients with complex lesions in a contemporary population-based setting.METHODS:New York’s PCI registry was used to identify 44 305 patients with complex lesions (lesions that complicate stenting or that require multiple stents) undergoing PCI with and without IVUS guidance and discharged between December 1, 2013 and November 30, 2018. Trends and inter-hospital variation in IVUS use were examined. Risk-adjusted mortality and target vessel revascularization were compared.RESULTS:A total of 6174 (13.9%) PCI patients underwent IVUS-guided PCI. The median follow-up period was 2.5 years. The percent of patients with complex lesions who underwent IVUS-guided PCI rose from 13.4% in 2014 to 16.5% in 2018 (P<0.0001 for trend), with the main increases occurring in the last 2 years of the period. Only 31 of 66 hospitals in the study used IVUS for >5% of their study patients. IVUS-guided PCI patients experienced significantly lower mortality (adjusted hazard ratio=0.89 [0.79–0.98] after adjustment using a Cox proportional hazards model, and HR=0.88 [0.78–0.99] for propensity-matched patients). We also found that IVUS-guided PCI patients had a lower rate of target vessel revascularization (adjusted hazard ratio=0.88 [0.80–0.97]) after adjusting using Cox proportional hazards with competing risk of mortality and after propensity matching (0.88 [0.79–0.99]).CONCLUSIONS:Utilization of IVUS for complex lesions has increased but contemporary rates remain low, and there are large inter-hospital variations. The use of IVUS for complex lesions was associated with lower risk of medium-term mortality and target vessel revascularization.
      Citation: Circulation: Cardiovascular Interventions
      PubDate: 2022-05-11T09:00:02Z
      DOI: 10.1161/CIRCINTERVENTIONS.121.011687
       
  • Intravascular Imaging to Guide Percutaneous Coronary Intervention Will Be
           Mandatory Soon

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      Authors: Akiko Maehara Clinical Trials Center; Cardiovascular Research Foundation, NY. Division of Cardiology, New York-Presbyterian Hospital/Columbia University Irving Medical Center.
      Abstract: Circulation: Cardiovascular Interventions, Ahead of Print.

      Citation: Circulation: Cardiovascular Interventions
      PubDate: 2022-05-11T09:00:02Z
      DOI: 10.1161/CIRCINTERVENTIONS.122.012120
       
  • Coronary Angiographic Features and Major Adverse Cardiac or
           Cerebrovascular Events in People Living With Human Immunodeficiency Virus
           Presenting With Acute Coronary Syndrome

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      Authors: Raphael Robert Yves Cottin Valérie Potard Murielle Mary-Krause Sylvie Lang Emmanuel Teiger Jean Philippe Collet Marion Chauvet-Droit Stéphane Ederhy Laurie Soulat-Dufour Yann Ancedy Saroumadi Adavane-Scheuble Pascal Nhan Philippe Gabriel Steg Christian Funck-Brentano Dominique Costagliola Ariel Cohen Franck Boccara Cardiology Department; University Hospital, PEC 2, Univ. Bourgogne Franche-Comté, Dijon, France (R.R., Y.C.). INSERM, Sorbonne Université, Institut Pierre Louis d’Épidémiologie et de Santé Publique (IPLESP), Paris, France (V.P., M.M.-K., D.C.). AP-HP, Hôpitaux de l’Est Parisien, Hôpital Saint-Antoine, Department of Cardiology, Faculty of Medicine, Sorbonne Université, Paris, France (S.L., M.C.-D., S.E., L.S.-D., Y.A., S.A.-S., P.N., A.C., F.B.). Interventional Cardiology Unit, Henri Mondor University Hospital, Assistance Publique Hôpitaux de Paris, Créteil, France (E.T.). Inserm, CIC 1430 et U955 team 3, Henri Mondor University Hospital, Créteil, France (E.T.). Sorbonne Université, ACTION Study Group, INSERM UMRS_1166, Institut de cardiologie (AP-HP), Paris, France (J.P.C.). Université de Paris, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, FACT (French Alliance for Cardiovascular Trials), INSERM U1148, all in Paris, France (P.G.S.). Imperial College, Royal Brompton Hospital, London, United Kingdom (P.G.S.). Sorbonne Université, INSERM CIC Paris-Est, AP-HP, Pitié-Salpêtrière Hospital, Department of Pharmacology, France (C.F.-B.). Sorbonne Université, GRC n°22, C2MV-Complications Cardiovasculaires et Métaboliques chez les patients vivant avec le Virus de l’immunodéficience humaine, Inserm UMR_S 938, Centre de Recherche Saint-Antoine, Institut Hospitalo-Universitaire de Cardio-métabolisme et Nutrition (ICAN), Paris, France (F.B.).
      Abstract: Circulation: Cardiovascular Interventions, Ahead of Print.

      Citation: Circulation: Cardiovascular Interventions
      PubDate: 2022-05-10T09:00:05Z
      DOI: 10.1161/CIRCINTERVENTIONS.122.011945
       
  • Neonatal Myocardial Infarction: A Proposed Algorithm for Coronary Arterial
           Thrombus Management

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      Authors: Hannah El-Sabrout Srujan Ganta Peter Guyon Kanishka Ratnayaka Gabrielle Vaughn James Perry Amy Kimball Justin Ryan Courtney D. Thornburg Suzanne Tucker Jun Mo Sanjeet Hegde John Nigro Howaida El-Said Division of Pediatric Cardiology, Rady Children’s Hospital/University of California, San Diego. (H. El-Sabrout, P.G; K.R, G.V, J.P, S.H, H. El-Said) Division of Pediatric Cardiac Surgery, Rady Children’s Hospital/University of California, San Diego. (S.G, J.N.) Division of Neonatology, Rady Children’s Hospital/University of California, San Diego. (A.K.) 3D Innovation Lab, Rady Children’s Hospital/University of California, San Diego. (J.R.) Division of Hematology, Rady Children’s Hospital/University of California, San Diego. (C.D.T.) Division of Pathology, Rady Children’s Hospital/University of California, San Diego. (S.T, J.M.)
      Abstract: Circulation: Cardiovascular Interventions, Ahead of Print.
      Background:Neonatal myocardial infarction is rare and is associated with a high mortality of 40% to 50%. We report our experience with neonatal myocardial infarction, including presentation, management, outcomes, and our current patient management algorithm.Methods:We reviewed all infants admitted with a diagnosis of coronary artery thrombosis, coronary ischemia, or myocardial infarction between January 2015 and May 2021.Results:We identified 21 patients (median age, 1 [interquartile range (IQR), 0.25–9.00] day; weight, 3.2 [IQR, 2.9–3.7] kg). Presentation included respiratory distress (16), shock (3), and murmur (2). Regional wall motion abnormalities by echocardiogram were a key criterion for diagnosis and were present in all 21 with varying degrees of depressed left ventricular function (severe [8], moderate [6], mild [2], and low normal [5]). Ejection fraction ranged from 20% to 54% (median, 43% [IQR, 34%–51%]). Mitral regurgitation was present in 19 (90%), left atrial dilation in 15 (71%), and pulmonary hypertension in 18 (86%). ECG was abnormal in 19 (90%). Median troponin I was 0.18 (IQR, 0.12–0.56) ng/mL. Median BNP (B-type natriuretic peptide) was 2100 (IQR, 924–2325) pg/mL. Seventeen had documented coronary thrombosis by cardiac catheterization. Seventeen (81%) were treated with intracoronary tPA (tissue-type plasminogen activator) followed by systemic heparin, AT (antithrombin), and intravenous nitroglycerin, and 4 (19%) were treated with systemic heparin, AT, and intravenous nitroglycerin alone. Nineteen of 21 recovered. One died (also had infradiaphragmatic total anomalous pulmonary venous return). One patient required a ventricular assist device and later underwent heart transplant; this patient was diagnosed late at 5 weeks of age and did not respond to tPA. Nineteen of 21 (90%) regained normal left ventricular function (ejection fraction, 60%–74%; mean, 65% [IQR, 61%–67%]) at latest follow-up (median, 6.8 [IQR, 3.58–14.72] months). Two of 21 (10%) had residual trivial mitral regurgitation. After analysis of these results, we present our current algorithm, which developed and matured over time, to manage neonatal myocardial infarction.Conclusions:We experienced a lower mortality rate for infants with neonatal infarction than that reported in the literature. We propose a post hoc algorithm that may lead to improvement in patient outcomes following coronary artery thrombus.
      Citation: Circulation: Cardiovascular Interventions
      PubDate: 2022-04-29T09:00:26Z
      DOI: 10.1161/CIRCINTERVENTIONS.121.011664
       
  • Thin-Cap Fibroatheroma Rather Than Any Lipid Plaques Increases the Risk of
           Cardiovascular Events in Diabetic Patients: Insights From the COMBINE
           OCT–FFR Trial

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      Authors: Enrico Fabris Balasz Berta Tomasz Roleder-Dylewska Renicus S. Hermanides Alexander J.J. IJsselmuiden Floris Kauer Fernando Alfonso Clemens von Birgelen Javier Escaned Cyril Camaro Mark W. Kennedy Bruno Pereira Michael Magro Holger Nef Sebastian Reith Magda Roleder Pawel Gasior Krzysztof Malinowski Giuseppe De Luca Hector M. Garcia-Garcia Juan F. Granada Wojciech Wojakowski Elvin Kedhi Cardiovascular Department; University of Trieste, Italy (E.F.). Heart Telemedicine, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland (K.M.). Eastern Piedmont University, Novara, Italy (G.D.L.). Interventional Cardiology, MedStar Washington Hospital Center, Washington, D.C. (H.M.G.-G.). Cardiovascular Research Foundation, New York (J.F.G.). Columbia University Medical Center NYC, NY (J.F.G.). Erasmus Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium (E.K.).
      Abstract: Circulation: Cardiovascular Interventions, Ahead of Print.
      Background:Autopsy studies have established that thin-cap fibroatheromas (TCFAs) are the most frequent cause of fatal coronary events. In living patients, optical coherence tomography (OCT) has sufficient resolution to accurately differentiate TCFA from thick-cap fibroatheroma (ThCFA) and not lipid rich plaque (non-LRP). However, the impact of OCT-detected plaque phenotype of nonischemic lesions on future adverse events remains unknown. Therefore, we studied the natural history of OCT-detected TCFA, ThCFA, and non-LRP in patients enrolled in the prospective multicenter COMBINE FFR-OCT trial (Combined Optical Coherence Tomography Morphologic and Fractional Flow Reserve Hemodynamic Assessment of Non-Culprit Lesions to Better Predict Adverse Event Outcomes in Diabetes Mellitus Patients).Methods:In the COMBINE FFR-OCT trial, patients with diabetes and ≥1 lesion with a fractional flow reserve >0.80 underwent OCT evaluation and were clinically followed for 18 months. A composite primary end point of cardiac death, target vessel-related myocardial infarction, target-lesion revascularization, and hospitalization for unstable angina was evaluated in relation to OCT-based plaque morphology.Results:A total of 390 patients (age 67.5±9 years; 63% male) with ≥1 nonischemic lesions underwent OCT evaluation: 284 (73%) had ≥1 LRP and 106 (27%) non-LRP lesions. Among LRP patients, 98 (34.5%) had ≥1 TCFA. The primary end point occurred in 7% of LRP patients compared with 1.9% of non-LRP patients (7.0% versus 1.9%; hazard ratio [HR], 3.9 [95% CI, 0.9–16.5];P=0.068; log rank-P=0.049). However, within LRP patients, TCFA patients had a much higher risk for primary end point compared with ThCFA (13.3% versus 3.8%; HR, 3.8 [95% CI, 1.5–9.5];P<0.01), and to non-LRP patients (13.3% versus 1.9%; HR, 7.7 [95% CI, 1.7–33.9];P<0.01), whereas ThCFA patients had risk similar to non-LRP patients (3.8% versus 1.9%; HR, 2.0 [95% CI, 0.42–9.7];P=0.38). Multivariable analyses identified TCFA as the strongest independent predictor of primary end point (HR, 6.79 [95% CI, 1.50–30.72];P=0.013).Conclusions:Among diabetes patients with fractional flow reserve-negative lesions, patients carrying TCFA lesions represent only one-third of LRP patients and are associated with a high risk of future events while patients carrying LRP-ThCFA and non-LRP lesions portend benign outcomes.REGISTRATION:URL:https://www.clinicaltrials.gov; Unique identifier: NCT02989740.
      Citation: Circulation: Cardiovascular Interventions
      PubDate: 2022-04-29T09:00:26Z
      DOI: 10.1161/CIRCINTERVENTIONS.121.011728
       
  • Transcatheter Myotomy to Relieve Left Ventricular Outflow Tract
           Obstruction: The Septal Scoring Along the Midline Endocardium Procedure in
           Animals

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      Authors: Jaffar M. Khan Christopher G. Bruce Adam B. Greenbaum Vasilis C. Babaliaros Andrea E. Jaimes William H. Schenke Rajiv Ramasawmy Felicia Seemann Daniel A. Herzka Toby Rogers Michael A. Eckhaus Adrienne Campbell-Washburn Robert A. Guyton Robert J. Lederman Cardiovascular Branch; Division of Intramural Research, National Heart Lung Valve Center, Emory University Hospital, Atlanta, GA (A.B.G., V.C.B., R.A.G.). MedStar Washington Hospital Center, Washington, DC (T.R.).
      Abstract: Circulation: Cardiovascular Interventions, Ahead of Print.
      Background:Left ventricular outflow tract obstruction complicates hypertrophic cardiomyopathy and transcatheter mitral valve replacement. Septal reduction therapies including surgical myectomy and alcohol septal ablation are limited by surgical morbidity or coronary anatomy and high pacemaker rates, respectively. We developed a novel transcatheter procedure, mimicking surgical myotomy, called Septal Scoring Along the Midline Endocardium (SESAME).Methods:SESAME was performed in 5 naive pigs and 5 pigs with percutaneous aortic banding–induced left ventricular hypertrophy. Fluoroscopy and intracardiac echocardiography guided the procedures. Coronary guiding catheters and guidewires were used to mechanically enter the basal interventricular septum. Imparting a tip bend to the guidewire enabled intramyocardial navigation with multipledf. The guidewire trajectory determined the geometry of SESAME myotomy. The myocardium was lacerated using transcatheter electrosurgery. Cardiac function and tissue characteristics were assessed by cardiac magnetic resonance at baseline, postprocedure, and at 7- or 30-day follow-up.Results:SESAME myotomy along the intended trajectory was achieved in all animals. The myocardium splayed after laceration, increasing left ventricular outflow tract area (753 to 854 mm2,P=0.008). Two naive pigs developed ventricular septal defects due to excessively deep lacerations in thin baseline septa. No hypertrophy model pig, with increased septal thickness and left ventricular mass compared with naive pigs, developed ventricular septal defects. One animal developed left axis deviation on ECG but no higher conduction block was seen in any animal. Coronary artery branches were intact on angiography with no infarction on cardiac magnetic resonance late gadolinium imaging. Cardiac magnetic resonance chamber volumes, function, flow, and global strain were preserved. No myocardial edema was evident on cardiac magnetic resonance T1 mapping.Conclusions:This preclinical study demonstrated feasibility of SESAME, a novel transcatheter myotomy to relieve left ventricular outflow tract obstruction. This percutaneous procedure using available devices, with a safe surgical precedent, is readily translatable into patients.
      Citation: Circulation: Cardiovascular Interventions
      PubDate: 2022-04-05T09:00:02Z
      DOI: 10.1161/CIRCINTERVENTIONS.121.011686
       
  • Periprocedural Pericardial Effusion Complicating Transcatheter Left Atrial
           Appendage Occlusion: A Report From the NCDR LAAO Registry

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      Authors: Matthew J. Price Miguel Valderrábano Sarah Zimmerman Daniel J. Friedman Saibal Kar Jeptha P. Curtis Frederick A. Masoudi James V. Freeman Division of Cardiovascular Diseases; Scripps Clinic, La Jolla, CA Division of Cardiac Electrophysiology, Houston Methodist Hospital, Houston, TX Center for Outcomes Research Evaluation, Yale-New Haven Hospital, New Haven, CT; Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, CT Ascension Health, St Louis, MO
      Abstract: Circulation: Cardiovascular Interventions, Ahead of Print.
      Background: Pericardial effusion (PE) is a potential complication of transcatheter left atrial appendage occlusion (LAAO). The objective of this study was to investigate the incidence, associated characteristics, and outcomes of PE following LAAO.Methods: Patients in the NCDR LAAO Registry who underwent a Watchman procedure between January 1, 2016 and December 31, 2019 were included. The primary outcome was in-hospital PE requiring intervention (percutaneous drainage or surgery). Odds ratios [ORs] were calculated for adverse event rates associated with PE.Results: The study population consisted of 65,355 patients. The mean patient age was 76.2±8.1 years and the mean CHA2DS2-VASc score was 4.6±1.5. PE occurred in 881 patients (1.35%). Clinical variables independently associated with PE included older age, female sex, left ventricular function, paroxysmal atrial fibrillation, prior bleeding, lower serum albumin, and pre-procedural dual antiplatelet therapy; procedural variables included number of delivery sheaths used, sinus rhythm during the procedure, and moderate sedation rather than general anesthesia. PE was associated with increased risk of in-hospital stroke (OR, 6.58 [95% CI, 3.32 to 13.06], P<0.0001), death (OR, 56.88 [95% CI, 39.79 to 81.32], P<0.0001), and the composite of death, stroke, or systemic embolism (SE) (OR, 28.64 [95% CI, 21.24 to 38.61], P<0.0001). PE during the index hospitalization was associated with increased risk of death (OR 3.52 [95% CI, 2.23 to 5.54], P<0.0001) and the composite of death, stroke, or SE (OR 3.42 [95% CI, 2.31 to 5.07], P<0.0001) between discharge and 45-day follow-up.Conclusions: In-hospital PE during transcatheter LAAO is infrequent but associated with a substantially higher risk of adverse events, including in-hospital and early post-discharge mortality. Strategies to minimize PE are critical to improve the risk-benefit ratio for this therapy.
      Citation: Circulation: Cardiovascular Interventions
      PubDate: 2022-04-02T03:00:01Z
      DOI: 10.1161/CIRCINTERVENTIONS.121.011718
       
 
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