17 results on '"Dan, Kazuhiro"'
Search Results
2. First in-human evaluation of a novel intravascular ultrasound and optical coherence tomography system for intracoronary imaging.
- Author
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Akl E, Pinilla-Echeverri N, Garcia-Garcia HM, Mehta SR, Dan K, Kuku KO, Courtney BK, and Sheth T
- Subjects
- Coronary Vessels diagnostic imaging, Humans, Predictive Value of Tests, Stents, Tomography, Optical Coherence, Treatment Outcome, Ultrasonography, Interventional methods, Coronary Artery Disease diagnostic imaging, Coronary Artery Disease therapy, Percutaneous Coronary Intervention adverse effects, Percutaneous Coronary Intervention methods
- Abstract
Aims: We evaluated the first in-human performance of a novel hybrid imaging catheter that permits simultaneous and co-registered acquisition of intravascular ultrasound (IVUS) and optical coherence tomography (OCT) images., Methods and Results: A total of 17 patients undergoing planned percutaneous coronary intervention (PCI) were imaged between August 2018 and August 2019. Eleven patients with both pre- and post-PCI IVUS and OCT images were included in the offline image analysis. IVUS and OCT images were analyzed separately then together with co-registered images for pre-stent findings, and only separately for post-stent findings. A total of 926 frames were analyzed (218 pre-PCI, 708 post-PCI). There was substantial agreement to detect calcific plaque between co-registered IVUS-OCT and standalone IVUS (Kappa 0.72 [0.65-0.79]) and standalone OCT (Kappa 0.75 [0.68-0.81]) while standalone imaging modalities showed lower agreement to detect lipidic and fibrotic plaques compared with co-registered IVUS-OCT. There were more frames with stent underexpansion on IVUS than OCT [72 (28.7%) vs. 58 (23.1%), respectively, p = 0.039]. Detection rates of incomplete stent apposition (present on 20 OCT frames vs. 2 IVUS frames, p < 0.001) and tissue protrusion (40 vs. 27 frames, p < 0.001) were higher on OCT than IVUS. One stent edge dissection was detected in the image analysis and was seen on OCT but not IVUS. All 177 frames with image artifacts contained at least one co-registered imaging modality with interpretable diagnostic content. There were no study device-related adverse events., Conclusions: Hybrid image acquisition was safe. The availability of both IVUS and OCT changed image interpretation compared to either modality alone, suggesting a complementary role of these two techniques., (© 2021 Wiley Periodicals LLC.)
- Published
- 2022
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3. Ultra-Short Term Evaluation of Coronary Vessel Wall Changes in Reference Segments Adjacent to Culprit Lesions in ST-Segment Elevation Myocardial Infarction.
- Author
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Dan K, Garcia-Garcia HM, Yacob O, Kuku KO, Diaz-Torres MA, Picchi A, Sardella G, Adamo M, Frigoli E, Limbruno U, Rigattieri S, Diletti R, Boccuzzi G, Zimarino M, Contarini M, Russo F, Calabro P, Andò G, Varbella F, Garducci S, Palmieri C, Briguori C, Karagiannis A, Dijkstra J, and Valgimigli M
- Subjects
- Coronary Vessels diagnostic imaging, Coronary Vessels surgery, Humans, Percutaneous Coronary Intervention, ST Elevation Myocardial Infarction diagnosis, ST Elevation Myocardial Infarction surgery
- Abstract
Background: Culprit lesions of ST-segment elevation myocardial infarction (STEMI) patients are friable, soft, and prone to disruption during primary percutaneous coronary intervention (pPCI). The presence of dissections in reference vessel segments (RVSs), adjacent to stented culprit lesions, and dynamic luminal changes in proximal or distal RVSs have not yet been investigated. We therefore sought to assess the healing patterns of edge dissections and the changes of lumen area at RVSs within 1 week post stent implantation in patients with STEMI., Methods: In the MATRIX trial (ClinicalTrials.gov NCT01433627), optical coherence tomography (OCT) was performed at the end of pPCI and within 1 week during staged PCI. The RVS dissection was defined as: type 1 = flap; type 2 = cavity; type 3 = double barrel; and type 4 = fissure. We compared separately the fate of residual dissection and luminal area/dimension by OCT in the target vessel between pPCI and staged PCI, including 1-year clinical outcomes., Results: Out of 151 patients, 46 patients had dissections in 50 RVSs and did not experience worse clinical outcome. Dissections were 44% type 1, 28% type 2, 12% type 3, and 16% type 4. Overall, 18% of the dissections healed. The mean lumen area of the RVS enlarged in 82 patients (59%) from pPCI to staged PCI. Compared with the proximal RVS, there was a significant increase in the lumen diameter at the distal RVS (0.06 ± 0.25 mm vs -0.01 ± 0.21 mm; P=.01)., Conclusion: Dissections occur frequently after pPCI. One-fifth of them heal within 1 week and do not seem to negatively impact clinical outcomes. Distal RVS lumen area increased compared with proximal RVS, likely reflecting a different vasoconstriction pattern over time.
- Published
- 2021
4. Impact of optical coherence tomography findings on clinical outcomes in ST-segment elevation myocardial infarction patients: a MATRIX (Minimizing Adverse Hemorrhagic Events by Trans-radial Access Site and angioX) OCT sub-study.
- Author
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Yacob O, Garcia-Garcia HM, Dan K, Soud M, Adamo M, Picchi A, Sardella G, Frigoli E, Limbruno U, Rigattieri S, Diletti R, Boccuzzi G, Zimarino M, Contarini M, Russo F, Calabro P, Ando G, Varbella F, Garducci S, Palmieri C, Briguori C, Kuku KO, Karagiannis A, and Valgimigli M
- Subjects
- Acute Coronary Syndrome diagnostic imaging, Acute Coronary Syndrome mortality, Aged, Europe, Female, Humans, Male, Middle Aged, Percutaneous Coronary Intervention adverse effects, Percutaneous Coronary Intervention mortality, Predictive Value of Tests, Prospective Studies, ST Elevation Myocardial Infarction diagnostic imaging, ST Elevation Myocardial Infarction mortality, Time Factors, Treatment Outcome, Acute Coronary Syndrome therapy, Coronary Vessels diagnostic imaging, Percutaneous Coronary Intervention instrumentation, ST Elevation Myocardial Infarction therapy, Stents, Tomography, Optical Coherence
- Abstract
Purpose: To investigate the association of the degree of stent expansion, as assessed by optical coherence tomography (OCT), following stent implantation, and clinical outcomes in ST-segment elevation myocardial infarction (STEMI) patients., Methods: STEMI patients from the MATRIX (Minimizing Adverse Haemorrhagic Events by TRansradial Access Site and angioX) OCT study were selected; Clinical outcomes were collected through 1 year. Stent expansion index is a minimum stent area (MSA) divided by average lumen area (average of proximal and distal reference lumen area). The following variables were measured: MSA (< 4.5mm
2 ), dissection (> 200 µm in width and < 5 mm from stent segment), malapposition (> 200 µm distance of stent from vessel wall), a thrombus (area > 5% of lumen area) were compared., Results: A total of 151 patients were included; after excluding patients with suboptimal OCT quality, the population with available OCT was classified into 2 groups: under-expanded < 90% (N = 72, 51%) and well-expanded ≥ 90% (N = 67, 49%). In the well-expanded group, a significant number of the proximal vessels had a lumen area < 4.5mm2 (16.1%, p < 0.001) and a greater thrombus burden within stent (56.7%, p = 0.042). The overall 30 day and 1 year major adverse cardiovascular event (MACE) rates were 5% and 6.1%, respectively., Conclusion: Irrespective of the degree of stent expansion, the OCT findings, in STEMI patients, and the MACE at 30 days and one year follow up was low; further, well-expanded stents led to a more significant residual thrombotic burden within the stent but seemed to have insignificant clinical impact. Acknowledged stent optimization criteria, traditionally related to worse outcomes in stable patients, do not seem to be associated with worse outcomes in this STEMI population.- Published
- 2021
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5. Comparison of Ultrathin, Bioresorbable-Polymer Sirolimus-Eluting Stents and Thin, Durable-Polymer Everolimus-Eluting Stents in Calcified or Small Vessel Lesions.
- Author
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Dan K, Garcia-Garcia HM, Kolm P, Windecker S, Saito S, Kandzari DE, and Waksman R
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- Aged, Coronary Artery Disease diagnostic imaging, Female, Humans, Male, Middle Aged, Multicenter Studies as Topic, Percutaneous Coronary Intervention adverse effects, Prosthesis Design, Randomized Controlled Trials as Topic, Risk Assessment, Risk Factors, Time Factors, Treatment Outcome, Vascular Calcification diagnostic imaging, Absorbable Implants, Cardiovascular Agents administration & dosage, Coronary Artery Disease therapy, Drug-Eluting Stents, Everolimus administration & dosage, Percutaneous Coronary Intervention instrumentation, Sirolimus administration & dosage, Vascular Calcification therapy
- Abstract
Background: The ultrathin-strut bioresorbable-polymer sirolimus-eluting stent (BP-SES) demonstrated comparable performance to durable-polymer everolimus-eluting stent (DP-EES) in randomized controlled trials. The purpose of this study was to evaluate the performance of a BP-SES compared with a DP-EES in calcified or small vessel lesions, which represent higher risk of restenosis., Methods: From the pooled BIOFLOW (BIOFLOW-II, IV, and V; BIOTRONIK - A Prospective Randomized Multicenter Study to Assess the Safety and Effectiveness of the Orsiro Sirolimus Eluting Coronary Stent System in the Treatment of Subjects With up to Three De Novo or Restenotic Coronary Artery Lesions ) randomized controlled trials, a total of 1553 BP-SES and 784 DP-EES patients with valid 1-year follow-up data were available. Coronary lesions were assessed for the presence of moderate-to-severe calcification or small vessels (reference vessel diameter, ≤2.75 mm) by core laboratory analysis. One-year clinical outcomes were assessed with or without the lesion subsets between BP-SES and DP-EES., Results: Baseline characteristics were similar between the groups. Among patients with small vessel disease, target lesion failure (8.0% versus 12.4%; P <0.01) and target vessel myocardial infarction (4.2% versus 7.6%; P <0.01) were significantly lower in BP-SES than in DP-EES. No difference in the outcome between the stents was shown in patients with non-small vessel lesions. In patients with calcified lesions, target lesion failure (12.2% versus 6.9%; P =0.056), and cardiac death (1.9% versus 0.3%; P =0.081) were numerically higher in DP-EES than in BP-SES. In the noncalcified lesion analysis, target vessel myocardial infarction in DP-EES was significantly higher than in BP-SES. Stent thrombosis was similar between the stents in both lesion groups., Conclusions: Among patients with more complex disease representing a higher risk of target lesion failure, the effectiveness of an ultrathin-strut BP-SES compared with a thin-strut DP-EES was maintained through 1 year. Registration: URL: https://www.clinicaltrials.gov. Unique identifiers: NCT01356888, NCT01939249, NCT02389946.
- Published
- 2020
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6. Feasibility of a Porcine Arteriovenous Shunt Model for Assessment of Acute Thrombogenicity in Bifurcation Stenting Technique By Optical Coherence Tomography.
- Author
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Dan K, Garcia-Garcia HM, Shlofmitz E, Okamura T, Kuku KO, Hellinga D, Kolodgie FD, Hideo-Kajita A, Desale S, and Waksman R
- Subjects
- Animals, Carotid Arteries surgery, Drug-Eluting Stents, Feasibility Studies, Jugular Veins surgery, Metals, Models, Animal, Predictive Value of Tests, Proof of Concept Study, Prosthesis Design, Sus scrofa, Thrombosis etiology, Time Factors, Percutaneous Coronary Intervention adverse effects, Percutaneous Coronary Intervention instrumentation, Stents, Thrombosis diagnostic imaging, Tomography, Optical Coherence
- Abstract
Background: Double kissing (DK) crush stenting has been reported as a superior bifurcation stenting strategy compared to culotte stenting. However, the mechanism associated with the reduction of clinical events by DK crush stenting remains unclear. We therefore investigated the thrombogenicity of DK crush stenting and culotte stenting with both bare-metal stents (BMS) and drug-eluting stents (DES) and the feasibility of a novel porcine arteriovenous shunt model., Methods: High-resolution intracoronary imaging with optical coherence tomography (OCT) evaluated the bifurcation stenting models for thrombogenicity., Results: All porcine models retained continuous circulation without blood leakage. Thrombus was macroscopically demonstrated around the bifurcation in all settings. The volume of thrombus (mm
3 ) with BMS using DK crush/culotte and DES using DK crush/culotte were 1.38/1.19 and 0.09/0.15, respectively. Culotte stenting had more thrombus in the proximal main branch, and DK crush stenting had more at the bifurcation. Unlike DK crush stenting, culotte stenting showed malapposition in the proximal main branch and bifurcation segments., Conclusion: The feasibility of a porcine arteriovenous shunt model to assess thrombogenicity by OCT in bifurcation stenting technique was confirmed. OCT detected less thrombogenicity in DES when used in the bifurcation model when compared to BMS., (Copyright © 2019 Elsevier Inc. All rights reserved.)- Published
- 2020
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7. Effects of Cangrelor as Adjunct Therapy to Percutaneous Coronary Intervention.
- Author
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Hideo-Kajita A, Rogers T, Buchanan K, Iantorno M, Gajanana D, Ozaki Y, Dan K, Kolm P, Brathwaite E, Beyene S, Melaku G, Meirovich Y, Dheendsa A, Garcia-Garcia HM, Torguson R, and Waksman R
- Subjects
- Adenosine Monophosphate therapeutic use, Aged, Coronary Angiography, Coronary Thrombosis diagnosis, Female, Follow-Up Studies, Humans, Male, Middle Aged, Purinergic P2Y Receptor Antagonists therapeutic use, Retrospective Studies, Treatment Outcome, Adenosine Monophosphate analogs & derivatives, Coronary Thrombosis therapy, Percutaneous Coronary Intervention methods
- Abstract
Percutaneous coronary intervention (PCI) in patients with angiographic evidence of intracoronary thrombus is associated with in-hospital and 30-day adverse clinical outcomes. Cangrelor, a direct, rapid-onset acting intravenous P2Y
12 receptor inhibitor, has been proved to be effective by reducing peri-PCI ischemic complications in subjects who underwent PCI. This study aimed to assess the angiographic and in-hospital clinical outcomes in all-comer patients receiving cangrelor immediately before PCI at a tertiary care center. The study analyzed consecutive unselected subjects treated with cangrelor at the time the decision was made to proceed with PCI. At the end of the procedure, all patients were transitioned to oral antiplatelet therapy. The target lesion angiographic assessment of Thrombolysis in myocardial infarction flow grade (TIMI-Flow), TIMI-thrombus grade (TIMI-Thrombus), myocardial blush grade, and TIMI-myocardial perfusion grade (TMPG) was performed before and post-PCI. Clinical events were recorded during the procedure and at discharge. In total, 223 patients (244 lesions) were included in the analysis (106, 97, and 20 patientswith TIMI-Flow 0/1, TIMI-Flow 2/3, and cardiogenic shock, respectively). The overall mean age was 63 ± 12 years, 70% men and 38% with diabetes mellitus. Acute myocardial infarction was the main presentation (72%). The use of cangrelor improved TIMI-Flow, MGB, TMPG, and TIMI-Thrombus in patients with initial TIMI-Flow 0 to 2. Major bleeding rate was 2.0%. In conclusion, cangrelor was effective and safe in restoring TIMI-Flow 3, reducing thrombus burden and improving myocardial blush grade and TMPG when administered to unselected subjects who underwent PCI. Therefore, cangrelor should be considered in patients presenting with intracoronary thrombus before intervention., (Copyright © 2019. Published by Elsevier Inc.)- Published
- 2019
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8. Percutaneous Coronary Intervention for Chronic Total Occlusion in Patients With Chronic Kidney Disease: Should Imaging Surveillance Be Mandatory?
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Dan K, Miyoshi T, Nakahama M, Ito H, and Garcia-Garcia HM
- Subjects
- Humans, Acute Kidney Injury, Coronary Occlusion, Percutaneous Coronary Intervention, Renal Insufficiency, Chronic
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- 2019
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9. Using Intravascular Ultrasound in Patients With Acute Coronary Syndrome: Characterizing Attenuated Plaque Is (Im)possible?
- Author
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Dan K, Waksman R, and Garcia-Garcia HM
- Subjects
- Humans, Treatment Outcome, Ultrasonography, Interventional, Acute Coronary Syndrome, Percutaneous Coronary Intervention, Plaque, Atherosclerotic
- Published
- 2018
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10. Stentless strategy in primary PCI setting: An alternative strategy in some clinical scenarios?
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Dan K, Garcia-Garcia HM, Shinoda A, and Waksman R
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- Coronary Angiography, Coronary Thrombosis diagnosis, Coronary Thrombosis drug therapy, Coronary Vessels diagnostic imaging, Humans, Male, Middle Aged, Stents, Coronary Thrombosis surgery, Coronary Vessels surgery, Fibrinolytic Agents therapeutic use, Percutaneous Coronary Intervention methods, Thrombolytic Therapy methods
- Abstract
We described a case of successful stentless percutaneous coronary intervention (PCI) with Thrombolysis in Myocardial Infarction (TIMI) 3 flow in the right coronary artery (RCA) with diffuse large thrombus, and an algorithm of PCI strategy for the cases with similar clinical scenarios in the current PCI era. Theoretically, stentless PCI might be superior to PCI using a stent since it may prevent long-term issues of dual antiplatelet therapy, stent fracture, and stent thrombosis. In particular acute coronary syndrome with diffuse large thrombus in the RCA will make multiple stenting necessary which may be associated with worse outcomes due to distal coronary flow disorder. We present a case that illustrates that stentless PCI is successful in this scenario. Further research in this field is warranted., (Copyright © 2018 Elsevier Inc. All rights reserved.)
- Published
- 2018
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11. Clinical outcomes of complete revascularization using either angiography-guided or fractional flow reserve-guided drug-eluting stent implantation in non-culprit vessels in ST elevation myocardial infarction patients: insights from a study based on a systematic review and meta-analysis.
- Author
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Hideo-Kajita A, Garcia-Garcia HM, Kuku KO, Beyene SS, Azizi V, Meirovich YF, Melaku GD, Dheendsa A, Brathwaite EJ, Desale S, Soud M, Dan K, Ozaki Y, Waksman R, and Lipinski M
- Subjects
- Coronary Angiography, Coronary Artery Disease complications, Coronary Artery Disease diagnostic imaging, Coronary Artery Disease physiopathology, Fractional Flow Reserve, Myocardial, Humans, ST Elevation Myocardial Infarction diagnostic imaging, ST Elevation Myocardial Infarction etiology, ST Elevation Myocardial Infarction physiopathology, Treatment Outcome, Coronary Artery Disease therapy, Drug-Eluting Stents, Myocardial Revascularization methods, Percutaneous Coronary Intervention, ST Elevation Myocardial Infarction therapy
- Abstract
Current guidelines recommend that percutaneous coronary intervention (PCI) should be restricted to the culprit vessel in ST elevation myocardial infarction (STEMI) patients with multi-vessel disease (MVD) and without cardiogenic shock. However, newer data suggests that performing complete revascularization (CR) in MVD patients may lead to better outcomes compared to intervention in the culprit vessel only. The aim of this meta-analysis is to examine the available data to determine if CR (using either angio- or fractional flow reserve guidance-FFR) following primary PCI in STEMI patients without cardiogenic shock impacts clinical outcomes. Meta-analysis was performed by conducting a literature search of PubMed from January 2004 to July 2017. Pooled estimates of outcomes, presented as odds ratios (OR) [95% confidence intervals], were generated using random-effect models. A total of 9 studies (3317 patients) were included. CR showed a significant MACE reduction (OR 0.49, 95% CI 0.36-0.66, p < 0.001); All-cause mortality (OR 0.69, 95% CI 0.48-0.98, p = 0.04) and repeat revascularization (OR 0.38, 95% CI 0.28-0.51, p < 0.001) at ≥ 12 months follow-up. The FFR-guiding CR group presented a MACE reduction (odds ratio 0.52, 95% CI 0.30-0.90, p = 0.02) due to a decrease of repeat revascularization (OR 0.41, 95% CI 0.21-0.80, p = 0.009). Overall, performing complete revascularization in STEMI patients showed a MACE reduction, all-cause death and repeat revascularization. Compared to culprit-only revascularization, treating multi-vessel disease in STEMI patients using FFR guidance is associated with decreased incidence of MACE, due to a decreased rate of revascularization.
- Published
- 2018
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12. Left main true bifurcation PCI: In the aftermath of DKCRUSH V trial: The case for modifying Medina terminology to include complexity of LMCA anatomy.
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Dan K, Waksman R, and Garcia-Garcia HM
- Subjects
- Clinical Decision-Making, Clinical Trials as Topic, Coronary Artery Disease diagnostic imaging, Drug-Eluting Stents, Humans, Patient Selection, Predictive Value of Tests, Risk Factors, Ultrasonography, Interventional, Coronary Artery Disease classification, Coronary Artery Disease surgery, Percutaneous Coronary Intervention adverse effects, Percutaneous Coronary Intervention instrumentation, Terminology as Topic
- Published
- 2018
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13. Impact of Chronic Kidney Disease on Cardiovascular and Renal Events in Patients Undergoing Percutaneous Coronary Intervention with Everolimus-Eluting Stent: Risk Stratification with C-Reactive Protein.
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Dan K, Miyoshi T, Nakahama M, Mizuno T, Kagawa K, Naito Y, Kawada S, and Ito H
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- Aged, Atherosclerosis epidemiology, Atherosclerosis surgery, Biomarkers blood, Coronary Artery Disease epidemiology, Coronary Artery Disease surgery, Disease Progression, Female, Follow-Up Studies, Humans, Immunosuppressive Agents pharmacology, Incidence, Japan epidemiology, Male, Renal Insufficiency, Chronic epidemiology, Retrospective Studies, Risk Assessment, Survival Rate trends, Atherosclerosis etiology, C-Reactive Protein metabolism, Coronary Artery Disease etiology, Drug-Eluting Stents, Everolimus pharmacology, Percutaneous Coronary Intervention methods, Renal Insufficiency, Chronic complications
- Abstract
Background: Chronic kidney disease (CKD) and inflammation play critical roles in atherosclerosis. There is limited evidence regarding the relationship between CKD and patients receiving second-generation drug-eluting stents for coronary artery disease., Objective: This study aimed to investigate the effect of CKD on cardiovascular and renal events in patients undergoing percutaneous coronary intervention (PCI) with everolimus-eluting stents (EES)., Methods: We analyzed 504 consecutive patients with stable angina pectoris and significant coronary artery stenosis treated with EES. CKD was defined as an estimated glomerular filtration rate < 60 mL/min/1.73 m2 before coronary angiography. The primary outcome was the occurrence of major adverse renal and cardiovascular events (MARCE) including cardiac death, revascularization, heart failure, cerebral infarction, worsening renal function > 25% from baseline, and renal replacement therapy at 1 year., Results: Patients were divided into the a MARCE (n = 126) and a non-MARCE (n = 378) group. The incidence of CKD was 51% in all subjects (including those on hemodialysis) and was significantly higher in the MARCE group than in the non-MARCE group (p = 0.00001). Multivariate logistic regression analysis identified that CKD was independently associated with MARCE (adjusted odds ratio 2.03, 95% confidence interval 1.21-3.39, p = 0.007). Patients were divided into four groups based on CKD and C-reactive protein (CRP) level prior to initial coronary angiography. Cox proportional hazards analysis revealed that patients with CKD and high CRP (≥0.3 mg/dL) had the worst prognosis (hazard ratio 4.371, 95% confidence interval 2.634-7.252, p = 0.00001) compared to patients without CKD and with low CRP., Conclusion: CKD combined with CRP predicted more clinical events in patients undergoing PCI with EES., (© 2018 S. Karger AG, Basel.)
- Published
- 2018
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14. Optical Coherence Tomography based treatment approach for patients with Acute Coronary Syndrome.
- Author
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Chezar-Azerrad, Chava, Garcia-Garcia, Hector M., Dan, Kazuhiro, Barriola, Rodrigo, Kuku, Kayode O., Beyene, Solomon S., Melaku, Gebremedhin D., Shlofmitz, Evan, Yerasi, Charan, Case, Brian C., Forrestal, Brian J., Ben-Dor, Itsik, Medranda, Giorgio A., Hashim, Hayder, De Maria, Giovanni Luigi, Campos, Carlos M., Bourantas, Christos, and Waksman, Ron
- Subjects
ACUTE coronary syndrome ,OPTICAL coherence tomography ,PERCUTANEOUS coronary intervention - Abstract
Introduction: Areas covered: In this review, we outline the underlying causes of acute coronary syndrome (ACS) as evaluated by optical coherence tomography (OCT). We report both the definitions of each mechanism and its frequency as reported in the literature to date. Finally, we present an algorithm based on the findings in the review that gives an outlined approach to perform intervention on ACS patients. Expert opinion: Although the most common and most accepted intervention in ACS cases is stent implantation, data suggest a stentless approach in cases of plaque erosion, which generally occurs in younger patients presenting with an acute coronary syndrome that have TIMI flow of 2/3 and either a small or large burden of thrombus and underlying stenosis of less than 50%. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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15. Staged Percutaneous Coronary Intervention with Rotational Atherectomy or Bypass Surgery in Chronic Hemodialysis and Severely Calcified Left Main True Bifurcation Lesion: A Case Report and Literature Review.
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Dan, Kazuhiro, Shinoda, Akira, and Garcia-Garcia, Hector M
- Subjects
- *
ATHERECTOMY , *TREATMENT of chronic kidney failure , *CORONARY artery bypass , *DISEASE complications , *ENDOSCOPIC surgery , *HEMODIALYSIS , *SURGICAL complications , *VASCULAR grafts , *CORONARY restenosis , *TREATMENT effectiveness , *PERCUTANEOUS coronary intervention , *SURGERY - Abstract
Previous observational studies and meta-analyses reported that the optimal strategy of coronary revascularization (percutaneous coronary intervention [PCI] and bypass surgery) for anatomically complex coronary artery lesions in the chronic hemodialysis setting is still controversial because the long-term outcomes were superior with coronary artery bypass grafting, especially with regard to repeat revascularization; however, short-term mortality with PCI was significantly lower because it is less invasive. Moreover, no guidelines show a strategy for this setting. We report the case of a patient with chronic dialysis and calcified left main true bifurcation lesion who underwent staged PCI with rotational atherectomy and minimally invasive direct coronary artery bypass for in-stent restenosis who died of non-occlusive mesenteric ischemia. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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16. TCT-674 Impact of Chronic Kidney Disease on Cardiovascular Events in Patients Undergoing Percutaneous Coronary Intervention with Everolimus-Eluting Stent: Risk stratification with C-reactive Protein.
- Author
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Dan, Kazuhiro, Miyoshi, Toru, Nakahama, Makoto, and Ito, Hiroshi
- Subjects
- *
CARDIOVASCULAR diseases , *PATIENTS , *PERCUTANEOUS coronary intervention , *CHRONIC kidney failure - Published
- 2017
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17. TCTAP A-075 Impact of Chronic Kidney Disease and Inflammation on Cardiovascular Events in Patients Undergoing Percutaneous Coronary Intervention with Everolimus-Eluting Stent.
- Author
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Dan, Kazuhiro and Nakahama, Makoto
- Subjects
- *
CORONARY disease , *KIDNEY diseases , *INFLAMMATION , *PERCUTANEOUS coronary intervention , *EVEROLIMUS , *PATIENTS , *THERAPEUTICS - Published
- 2016
- Full Text
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