634 results on '"Brugaletta, S"'
Search Results
2. Gender gap in medical care in ST segment elevation myocardial infarction networks: Findings from the Catalan network Codi Infart
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Fernández-Rodríguez, D., Regueiro, A., Cevallos, J., Bosch, X., Freixa, X., Trilla, M., Brugaletta, S., Martín-Yuste, V., Sabaté, M., Bosa-Ojeda, F., and Masotti, M.
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- 2017
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3. Brecha de género en los cuidados médicos en las redes de atención al infarto agudo de miocardio con elevación del segmento ST: hallazgos de la red catalana Codi Infart
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Fernández-Rodríguez, D., Regueiro, A., Cevallos, J., Bosch, X., Freixa, X., Trilla, M., Brugaletta, S., Martín-Yuste, V., Sabaté, M., Bosa-Ojeda, F., and Masotti, M.
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- 2017
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4. Capítulo 56 - Cardiopatía isquémica
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Brugaletta, S. and Sabaté Tenas, M.
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- 2024
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5. Device related thrombosis after left atrial appendage occlusion: does thrombus location always predicts its origin?
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Flores-Umanzor, E., Cepas-Guillen, P., Sanchis, L., Regueiro, A., Navarro, R., Brugaletta, S., Vidal, B., Sitges, M., Sabaté, M., and Freixa, Xavier
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- 2021
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6. Presentation, care and outcomes of patients with NSTEMI according to World Bank country income classification: Prospective international multicentre cohort study of the ESC EORP NSTEMI registry
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Nadarajah, R, primary, Ludman, P, additional, Appelman, Y, additional, Brugaletta, S, additional, Budaj, A, additional, Bueno, H, additional, Huber, K, additional, Kunadian, V, additional, Leonardi, S, additional, Lettino, M, additional, Milasinovic, D, additional, and Gale, C P, additional
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- 2023
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7. Bioresorbable vascular scaffolds technology: current use and future developments
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Giacchi G, Ortega-Paz L, Brugaletta S, Ishida K, and Sabaté M
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Absorb GT1 ,Absorb BVS ,bioresorbable vascular scaffold ,BRS ,coronary scaffold ,Medical technology ,R855-855.5 - Abstract
Giuseppe Giacchi, Luis Ortega-Paz, Salvatore Brugaletta, Kohki Ishida, Manel Sabaté Cardiology Department, Clinic Cardiovascular Institute, Hospital Clinic, August Pi and Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain Abstract: Coronary bioresorbable vascular scaffolds are a new appealing therapeutic option in interventional cardiology. The most used and studied is currently the Absorb BVS™. Its backbone is made of poly-l-lactide and coated by a thin layer of poly-d,l-lactide, it releases everolimus and is fully degraded to H2O and CO2 in 2–3 years. Absorb BVS™ seems to offer several theoretical advantages over metallic stent, as it gives temporary mechanical support to vessel wall without permanently caging it. Therefore, long-term endothelial function and structure are not affected. A possible future surgical revascularization is not compromised. Natural vasomotion in response to external stimuli is also recovered. Several observational and randomized trials have been published about BVS clinical outcomes. The main aim of this review is to carry out a systematic analysis about Absorb BVS™ studies, evaluating also the technical improvements of the Absorb GT1 BVS™. Keywords: Absorb GT1, Absorb BVS™, bioresorbable vascular scaffold, BRS, coronary scaffold
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- 2016
8. RAndomized Comparison of raDIal vs. femorAL Access for Routine Catheterization of Heart Transplant Patients (RADIAL – Heart Transplant Study)
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Scalone, G., Brugaletta, S., Martín-Yuste, V., Seixo, F., Cotes, C., Gómez-Monterrosas, O., Alvarez-Contreras, L., Campreciós, M., Mirabet, S., Brossa, V., and Sabaté, M.
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- 2014
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9. Impact of age at the time of the first ST-elevation myocardial infarction on 10-year outcomes. A sub-analysis from the EXAMINATION EXTEND trial
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Arevalos Rivas, V, primary, Spione, F, additional, Gabani, R, additional, Ortega-Paz, L, additional, Gomez-Lara, J, additional, Jimenez-Diaz, V A, additional, Jimenez, M, additional, Jimenez-Quevedo, P, additional, Diletti, R, additional, Pineda, J, additional, Campo, G, additional, Silvestro, A, additional, Maristany, J, additional, Sabate, M, additional, and Brugaletta, S, additional
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- 2022
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10. Analysis of myocardial salvage with cardiac magnetic ressonance and angiography depending on the STEMI revascularization pathway in a PPCI centre
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De Diego Soler, O, primary, Sanabria, A, additional, Morr, I, additional, Alamar, M, additional, Lorenzatti, D, additional, Prat, S, additional, Doltra, A, additional, Millan, I, additional, Sotes, S, additional, Lopez, T, additional, Ortega-Paz, L, additional, Sabate, M, additional, Andrea, R, additional, Brugaletta, S, additional, and Ortiz-Perez, J T, additional
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- 2022
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11. Changes in the treatment strategy following intracoronary pressure wire in a contemporaneous real-life cohort of patients with intermediate coronary stenosis. Results from a nationwide registry
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Rodriguez Leor, O, primary, Toledano, B, additional, Lopez Palop, R, additional, Rivero, F, additional, Brugaletta, S, additional, Linares, J A, additional, Puigfel, M, additional, Sadaba, M, additional, Vaquerizo, B, additional, Rondan, J, additional, Gomez, I, additional, Saez, R, additional, Planas, A, additional, Lozano, F, additional, and Perez De Prado, A, additional
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- 2022
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12. Gender differences on 10-year outcomes following ST-segment elevation myocardial infarction: a subgroup analysis from the examination extend trial
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Gabani, R, primary, Spione, F, additional, Arevalos, V, additional, Ortega, L, additional, Brugaletta, S, additional, Grima Sopesens, N, additional, Sabate, M, additional, Gomez Lara, J, additional, Jimenez, M, additional, and Jimenez Quevedo, P, additional
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- 2022
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13. Long-term effects of coronavirus disease 2019 on the cardiovascular system: the CV COVID-19 registry
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Arevalos Rivas, V, primary, Ortega-Paz, L, additional, Fernandez-Rodriguez, D, additional, Jimenez-Diaz, V A, additional, Baneras Rius, J, additional, Campo, G, additional, Diaz, J F, additional, Scardino, C, additional, Rodriguez-Santamarta, M, additional, Gonzalo, N, additional, Perginotti, A, additional, Alfonso, F, additional, Amat-Santos, I, additional, Sabate, M, additional, and Brugaletta, S, additional
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- 2022
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14. Association of gender on the time of first medical contact primary pci activation for stemi patients at emergency department
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Berga Congost, G, primary, Martinez Momblan, M A M M, additional, Valverde Bernal, J V B, additional, Marquez Lopez, A M L, additional, Ruiz Gabalda, J R G, additional, Garcia Picart, J G P, additional, Puig Campmany, M P C, additional, Marques Sule, E M S, additional, and Brugaletta, S B, additional
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- 2022
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15. Association of age on the time of primary pci activation for stemi patients at emergency department
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Berga Congost, G, primary, Martinez Momblan, M A M M, additional, Valverde Bernal, J V B, additional, Marquez Lopez, A M L, additional, Ruiz Gabalda, J R G, additional, Garcia Picart, J G P, additional, Puig Campmany, M P C, additional, and Brugaletta, S B, additional
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- 2022
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16. Magnesium-based resorbable scaffold vs permanent metallic sirolimus-eluting stent in patients with ST-segment elevation myocardial infarction: 3-year results of the MAGSTEMI randomised controlled trial
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Ortega-Paz L, Brugaletta S, Gomez-Lara J, Alfonso F, Cequier A, Romaní S, Bordes P, Serra A, Iñiguez A, Salinas P, García Del Blanco B, Goicolea J, Hernández-Antolín R, Cuesta J, Gómez-Hospital JA, and Sabaté M
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BACKGROUND: The long-term safety and performance of magnesium-based bioresorbable scaffolds (MgBRS) in ST-segment-elevation myocardial infarction (STEMI) patients are uncertain. AIMS: The aim of this study was to report the 3-year clinical outcomes of the MAGSTEMI trial. METHODS: This investigator-driven, multicentre, randomised, single-blind, controlled trial randomised STEMI patients 1:1 to MgBRS or to permanent metallic sirolimus-eluting stents (SES) at 11 academic centres. The main secondary endpoints included device-oriented composite endpoints (DoCE) and patient-oriented composite endpoints (PoCE), their individual components, any bleeding, and device thrombosis rate. All endpoints were defined according to the Academic Research Consortium. Events were adjudicated by an independent committee. RESULTS: Three-year clinical follow-up was obtained in 142 (90.0%) patients. At 3-year follow-up, MgBRS were associated with a higher rate of DoCE than SES (13 [17.6%] vs 5 [6.6%], diff -11.0 [95% CI: -21.3 to -0.7]; p=0.038). This difference was driven by an increased incidence of DoCE within the first year of follow-up. In the landmark analysis, there was no difference between 1 and 3 years (0 [0.0%] vs 1 [1.4%]; p=1.000). The difference in the rate of DoCE was driven by a higher incidence of target lesion revascularisation (TLR) in the MgBRS group compared to SES (12 [16.2%] vs 4 [5.3%]; diff -10.9% [95% CI: -20.7 to -1.2]; p=0.030). The difference in TLR was observed during the first year, with no further differences observed between 1 and 3 years (0 [0.0%] vs 1 [1.4%]; p=1.000). CONCLUSIONS: At 3-year follow-up, MgBRS were associated with a higher rate of TLR, which was clustered within the first year, compared to SES.
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- 2022
17. Circulating miRNA Fingerprint and Endothelial Function in Myocardial Infarction: Comparison at Acute Event and One-Year Follow-Up
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Mompeon A, Perez-Cremades D, Paes A, Sanchis J, Ortega-Paz L, Andrea R, Brugaletta S, Sabate M, Novella S, Dantas A, and Hermenegildo C
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angiogenesis ,myocardial infarction ,serum biomarker ,endothelial cell ,microRNA profile ,let-7e - Abstract
MicroRNAs (miRNA) are major regulators of intercellular communication and key players in the pathophysiology of cardiovascular disease. This study aimed to determine the miRNA fingerprint in a cohort of 53 patients with acute myocardial infarction (AMI) with non-ST-segment elevation (NSTEMI) relative to miRNA expression in healthy controls (n = 51). miRNA expression was initially profiled by miRNA array in the serum of patients undergoing cardiac catheterization during NSTEMI (n = 8) and 1 year past the event (follow-up, n = 8) and validated in the entire cohort. In total, 58 miRNAs were differentially expressed during AMI (p < 0.05), while 36 were modified at follow-up (Fisher's exact test: p = 0.0138). Enrichment analyses revealed differential regulation of biological processes by miRNA at each specific time point (AMI vs. follow-up). During AMI, the miRNA profile was associated mainly with processes involved in vascular development. However, 1 year after AMI, changes in miRNA expression were partially related to the regulation of cardiac tissue morphogenesis. Linear correlation analysis of miRNA with serum levels of cytokines and chemokines revealed that let-7g-5p, let-7e-5p, and miR-26a-5p expression was inversely associated with serum levels of pro-inflammatory cytokines TNF-alpha, and the chemokines MCP-3 and MDC. Transient transfection of human endothelial cells (HUVEC) with let-7e-5p inhibitor or mimic demonstrated a key role for this miRNA in endothelial function regulation in terms of cell adhesion and angiogenesis capacity. HUVEC transfected with let-7e-5p mimic showed a 20% increase in adhesion capacity, whereas transfection with let-7e-5p inhibitor increased the number of tube-like structures. This study pinpoints circulating miRNA expression fingerprint in NSTEMI patients, specific to the acute event and changes at 1-year follow-up. Additionally, given its involvement in modulating endothelial cell function and vascularization, altered let-7e-5p expression may constitute a therapeutic biomarker and target for ischemic heart disease.
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- 2022
18. The Use of the Acute Pd/Pa Drop After Intracoronary Nitroglycerin Infusion to Rule Out Significant FFR: CANICA (Can Intracoronary Nitroglycerin Predict Fractional Flow Reserve Without Adenosine?) Multicenter Study
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Martin-Reyes, R., de la Torre Hernandez, J. M., Franco-Pelaez, J., Lopez-Palop, R., Telleria Arrieta, M., Amat Santos, I. J., Carrillo Saez, P., Sanchez-Recalde, A., Sanmartin Pena, J. C., Garcia Camarero, T., Brugaletta, S., Gimeno de Carlos, F., Pinero, A., Sorto Sanchez, D. C., Frutos, A., Lasa Larraya, G., Navarro, F., and Farre, J.
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- 2016
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19. Long-term clinical outcomes of patients with chronic total coronary occlusion caused by intra-stent re-stenosis
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Gomez Monterrosas, O, primary, Martin Yuste, V, additional, Freixa, X, additional, Brugaletta, S, additional, Regueiro, A, additional, Masotti, M, additional, and Sabate, M, additional
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- 2021
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20. Rationale and Study Design of The RESERVOIR Trial: A Randomized Trial Comparing Reservoir-Based Polymer-Free Amphilimus-Eluting Stents Versus Everolimus-Eluting Stents With Durable Polymer in Patients With Diabetes Mellitus
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Romaguera, R., Brugaletta, S., Gomez-Lara, J., Pinar, E., Jiménez-Quevedo, P., Gracida, M., Roura, G., Ferreiro, J. L., Teruel, L., Gómez-Hospital, J. A., Montanya, E., Alfonso, F., Valgimigli, M., Sabate, M., and Cequier, A.
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- 2015
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21. 2020 EAPCI core curriculum for percutaneous cardiovascular interventions
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Van Belle, E, Teles, RC, Pyxaras, SA, Kalpak, O, Johnson, T, Barbash, IM, De Luca, G, Kostov, J, Parma, R, Vincent, F, Brugaletta, S, Debry, N, Toth, GG, Ghazzal, Z, Deharo, P, Milasinovic, D, Kaspar, K, Saia, F, Mauri, J, Kammler, J, Muir, D, O'Connor, S, Mehilli, J, Thiele, H, Weilenmann, D, Witt, N, Joshi, F, Kharbanda, R, Piroth, Z, Wojakowski, W, Geppert, A, Di Gioia, G, Pires-Morais, G, Petronio, AS, Estevez-Loureiro, R, Ruzsa, Z, Kefer, J, Kunadian, V, Van Mieghem, N, Windecker, S, Baumbach, A, Haude, M, Dudek, D, NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM), and Centro de Estudos de Doenças Crónicas (CEDOC)
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Cardiology and Cardiovascular Medicine ,Miscellaneous - Abstract
Funding Information: A. Baumbach received institutional research support from Abbott Vascular, consultation and speaker fees from AstraZeneca, Sinomed, MicroPort, Abbott Vascular, Cardinal Health, KSH, and Medtronic. R. Estevez-Loureiro reports grants and personal fees from Abbott Vascular and personal fees from Boston Scientific, outside the submitted work. A. Geppert reports lecture fees from Medtronic, Abbott and Abiomed, consulting fees from Abbott and Abiomed, congress grants from Asahi and Terumo, outside the submitted work. J. Kefer reports proctorship and speaker fees from Medtronic and Abbott, and speaker fees from Servier. D. Milasinovic reports personal fees from Abbot, Biosensors, Terumo, AstraZeneca and Sanofi, outside the submitted work. D. Muir is a proctor and advisory board member for Abbott Vascular, and received proctor, advisory board and speaker fees from Edwards Lifesciences. A.S. Petronio received proctor and advisory board fees from Abbott Vascular, and received proctor, advisory board and speaker fees from Edwards Lifesciences. G. Pires-Morais received speaker fees from Abbott Vascular. S. Pyxaras received consultancy fees from Abiomed and Boston Scientific and proctor fees from Boston Scientific. R. Parma received speaker fees from Boston Scientific, Edwards Lifesciences and Medtronic. F. Saia reports personal fees from Abbott Vascular, Boston Scientific, Edwards, Medtronic, Biotronik, Amgen, AstraZeneca, Daiichi Sankyo, Bayer and Boehringer-Ingelheim, outside the submitted work. N. Van Mieghem reports advisor fees from PulseCath BV and Abiomed. S. Windecker reports grants from Abbott, Amgen, BMS, Bayer, Boston Scientific, Biotronik, Cardinal Health, CSL Behring, Daiichi Sankyo, Edwards Lifesciences, Johnson and Johnson, Medtronic, Quebert, Polares, Sanofi and Terumo, outside the submitted work. E. Van Belle reports personal fees from HeartFlow and Philips, outside the submitted work. The other authors have no conflicts of interest to declare. Publisher Copyright: © Europa Digital & Publishing 2021. All rights reserved. The proposed 2020 Core Curriculum for Percutaneous Cardiovascular Interventions aims to provide an updated European consensus that defines the level of experience and knowledge in the field of percutaneous cardiovascular intervention (PCI). It promotes homogenous education and training programmes among countries, and is the cornerstone of the new EAPCI certification, designed to support the recognition of competencies at the European level and the free movement of certified specialists in the European Community. It is based on a thorough review of the ESC guidelines and of the EAPCI textbook on percutaneous interventional cardiovascular medicine. The structure of the current core curriculum evolved from previous EAPCI core curricula and from the "2013 core curriculum of the general cardiologist"to follow the current ESC recommendations for core curricula. In most subject areas, there was a wide - if not unanimous - consensus among the task force members on the training required for the interventional cardiologist of the future. The document recommends that acquisition of competence in interventional cardiology requires at least two years of postgraduate training, in addition to four years devoted to cardiology. The first part of the curriculum covers general aspects of training and is followed by a comprehensive description of the specific components in 54 chapters. Each of the chapters includes statements of the objectives, and is further subdivided into the required knowledge, skills, behaviours, and attitudes. publishersversion published
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- 2021
22. Predictors of delay in door-to-balloon time in STEMI patients, treated in centers capable in primary PCI
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Berga Congost, G, primary, Martinez Momblan, MA, additional, Valverde Bernal, J, additional, Marquez Lopez, A, additional, Ruiz Gabalda, J, additional, Garcia Picart, J, additional, Puig Campmany, M, additional, and Brugaletta, S, additional
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- 2021
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23. The importance of organizational variables in treatment time for patients with ST-elevation acute myocardial infarction improve delays in STEMI
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Congost, GB, Brugaletta, S, Bernal, JV, Lopez, AM, Gabalda, JR, Garcia-Picart, J, Campmany, MP, and Momblan, MAM
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STEMI ,Myocardial infarction ,Nurses ,cardiovascular diseases ,Triage - Abstract
Background: The time between arrival at the emergency department (ED) and balloon (D2B) in STEMI is one of the best indicators of the quality of care. Our aim is to describe treatment times and evaluate the causes of delay. Methods: This is an observational retrospective study, including all consecutive STEMI code patients >= 18 years old treated in the ED from 2013 to 2016.All the patients were stratified into two groups: delayed group with D2B > 70 min and non-delayed
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- 2021
24. Endothelial Progenitor Cell Function in Patients With Coronary Chronic Total Occlusion and its Relationship With Collateral Circulation
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Flores-Umanzor, E. J., Luis Ortega-Paz, Cepas-Guillen, P. L., Giacchi, G., Padro, T., Badimon, L., Sabaté, M., and Brugaletta, S.
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endothelial progenitor cell count ,collateral circulation - Abstract
Aim. To evaluate the relationship between endothelial progenitor cell (EPC) count and function and collateral circulation in coronary chronic total occlusions (CTOs). Methods. A total of 20 consecutive patients with successfully treated CTO lesions were included during a period of 12 months. EPC count and function were evaluated by flow cytometry and colony-forming unit (CFU) analysis at baseline (before percutaneous coronary intervention) and at 1-year follow-up. Patients were classified, according to Rentrop classification at the baseline angiography, as group 1 (Rentrop 3; n = 7) and group 2 (Rentrop
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- 2021
25. Prognostic Value of QFR Measured Immediately After Successful Stent Implantation: The International Multicenter Prospective HAWKEYE Study
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Biscaglia S., Tebaldi M., Brugaletta S., Cerrato E., Erriquez A., Passarini G., Ielasi A., Spitaleri G., Di Girolamo D., Mezzapelle G., Geraci S., Manfrini M., Pavasini R., Barbato E., Campo G., Biscaglia, S., Tebaldi, M., Brugaletta, S., Cerrato, E., Erriquez, A., Passarini, G., Ielasi, A., Spitaleri, G., Di Girolamo, D., Mezzapelle, G., Geraci, S., Manfrini, M., Pavasini, R., Barbato, E., and Campo, G.
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quantitative flow ratio ,Angiography-based fractional flow reserve ,percutaneous coronary intervention ,outcome ,vessel-oriented composite endpoint ,cardiovascular diseases ,second-generation drug-eluting stent ,NO - Abstract
OBJECTIVES: The aim of this study was to investigate the potential role of post-percutaneous coronary intervention (PCI) quantitative flow ratio (QFR) measurements to predict clinical outcomes in patients with successful PCI. BACKGROUND: The prognostic value of QFR measured immediately after PCI has not been prospectively investigated. METHODS: Patients undergoing complete revascularization with successful PCI and stent implantation were eligible for acquisition of projections for QFR computation. At the end of the procedure, 2 angiographic projections for each vessel treated with PCI were acquired. Computation of QFR was performed offline by an independent core laboratory. The primary outcome was the vessel-oriented composite endpoint, defined as vessel-related cardiovascular death, vessel-related myocardial infarction, and ischemia-driven target vessel revascularization. RESULTS: Seven hundred fifty-one vessels in 602 patients were analyzed. The median value of post-PCI QFR was 0.97 (interquartile range: 0.92 to 0.99). Lesion location in the left anterior descending coronary artery, baseline SYNTAX (Synergy Between PCI With Taxus and Cardiac Surgery) score, lesion length, and post-PCI diameter stenosis were found to be predictors of lower post-PCI QFR. Altogether, 77 events were detected in 53 treated vessels (7%). Post-PCI QFR was significantly lower in vessels with the vessel-oriented composite endpoint during follow-up, compared with those without it (0.88 [interquartile range: 0.81 to 0.99] vs. 0.97 [interquartile range: 0.93 to 0.99], respectively; p < 0.001). Receiver-operating characteristic curve analysis identified a post-PCI QFR best cutoff of ≤0.89 (area under the curve 0.77; 95% confidence interval: 0.74 to 0.80; p < 0.001). After correction for potential confounding factors, post-PCI QFR ≤0.89 was associated with a 3-fold increase in risk for the vessel-oriented composite endpoint (hazard ratio: 2.91; 95% confidence interval: 1.63 to 5.19; p < 0.001). CONCLUSIONS: Lower values of QFR after complete and successful revascularization predict subsequent adverse events (Angio-Based Fractional Flow Reserve to Predict Adverse Events After Stent Implantation [HAWKEYE]; NCT02811796).
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- 2019
26. Disparate miRNA expression in serum and plasma of patients with acute myocardial infarction: a systematic and paired comparative analysis
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Mompeon A, Ortega-Paz L, Vidal-Gomez X, Costa T, Perez-Cremades D, Garcia-Blas S, Brugaletta S, Sanchis J, Sabate M, Novella S, Dantas A, and Hermenegildo C
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Despite the promising value of miRNAs in the diagnostic and prognostic of cardiovascular disease (CVD), recent meta-analyses did not support their potential. Methodological variances in studies may interfere with miRNA profile and affect their results. This study determines if the blood starting material is a source of variance in miRNA profile by performing a paired comparison in plasma and serum of the expression of primary miRNAs associated with CVD. Circulating miRNA yield was similar in both plasma and serum, although a significant increase was observed in patients with Non-ST-elevation myocardial infarction (NSTEMI) compared to control volunteers. When normalized by the expression of miR-484, different patterns of miRNA expression between serum and plasma. Although NSTEMI modified the expression of miR-1 and miR-208 in both serum and plasma, plasma displayed a higher variance than serum (Levene's test p
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- 2020
27. Validation of the all-comers design: Results of the TARGET-AC substudy
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Toth, G.G., Lansky, A., Baumbach, A., Kelbæk, H., Royen, N. van, Holmvang, L., Janssens, L., Brugaletta, S., Barbato, E., Maillard, L., Kiemeneij, F., Naber, C.K., Pucher, F., Laursen, P.N., Ameloot, K., Robles, C., Milkas, A., Sevilla, J., Jensen, C., Wijns, W., Toth, G.G., Lansky, A., Baumbach, A., Kelbæk, H., Royen, N. van, Holmvang, L., Janssens, L., Brugaletta, S., Barbato, E., Maillard, L., Kiemeneij, F., Naber, C.K., Pucher, F., Laursen, P.N., Ameloot, K., Robles, C., Milkas, A., Sevilla, J., Jensen, C., and Wijns, W.
- Abstract
Item does not contain fulltext, BACKGROUND: Results of clinical trials are often criticized by low inclusion rate and potential sampling bias in patient recruitment. The aim of this validation registry is to evaluate how far an all-comers design in the context of clinical research can ensure the representation of the true all-comers population. METHODS: This validation registry is a prospective international multicentre registry, conducted at 10 out of the total 21 centers, participating in TARGET-AC (registered under NCT02520180). During a predefined four-week period data were recorded prospectively on all PCIs performed in the participating centers, whether or not patients were enrolled in TARGET-AC. Data were collected on patient demographics, angiographic lesion- and procedural characteristics. For patients who were not enrolled in the study, operators were asked to declare the reason for not enrolling the patient, using a single-choice questionnaire. RESULTS: A total of 131 patients were enrolled in the TARGET-AC study during the investigated period (ER group), standing as 20% (range 4% and 54%) of all eligible cases per protocol. In the ER group more patients presented with stable angina (61% vs. 43%, respectively; P < .001). Whereas ST-elevation infarction was less common (5% vs. 26%, respectively; P < .001), there was no difference in non-ST elevation acute coronary syndrome (32% vs. 27%, respectively; P = .248). Risk factors and comorbidities did not show any difference between the ER and the non-enrolled (NER) groups, except for greater rate of significant valvular disease in the NER group (12% vs 19%, respectively; P = .037). The NER group presented more thrombotic stenoses than the ER group (20% vs 12%, respectively; P = .040). No difference was found in any other investigated angiographic parameters, like target vessels, bifurcation lesion, severe calcification or chronic total occlusions. Admission during regular working hours and availability of study nurse were associated with mark
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- 2020
28. Randomized comparison of optical coherence tomography versus angiography to guide Bioresorbable vascular scaffold implantation: The OPTICO BVS study
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Ueki, Y., Yamaji, K., Barbato, E., Nef, H., Brugaletta, S., Fasano, Alfonso, Hill, J., Cook, S., Burzotta, Francesco, Karagiannis, A., Windecker, S., Raber, L., Alfonso F., Burzotta F. (ORCID:0000-0002-6569-9401), Ueki, Y., Yamaji, K., Barbato, E., Nef, H., Brugaletta, S., Fasano, Alfonso, Hill, J., Cook, S., Burzotta, Francesco, Karagiannis, A., Windecker, S., Raber, L., Alfonso F., and Burzotta F. (ORCID:0000-0002-6569-9401)
- Abstract
Purpose: We investigated whether optical coherence tomography (OCT)-guided bioresorbable vascular scaffolds (BVS) implantation can improve in-scaffold minimal lumen area (MLA) at 6-month compared with angiography guidance. Methods: The OPTICO BVS was a randomized, international multicenter, assessor blind, superiority trial comparing OCT- versus angiography-guided percutaneous coronary intervention (PCI) (1:1 allocation) in patients with coronary artery disease undergoing Absorb BVS 1.1 implantation. The primary endpoint was in-scaffold MLA at 6-month. Results: The trial was prematurely stopped on May 31, 2017 after enrollment of 38 of 270 planned patients (14%) following the retraction of the device in Europe. Patients were randomly assigned to OCT- (n = 19) or angiography-guided PCI (n = 19). Scaffold diameter (OCT 3.0 ± 0.3 mm vs. angiography 3.1 ± 0.3 mm, P =.333) and length (28.8 ± 13.6 mm vs. 23.8 ± 12.3 mm, P =.223) were comparable. There was no significant difference in in-scaffold MLA at 6 months (4.47mm2 vs. 5.08mm2, P =.692). Scaffold expansion at 6-month was significantly higher in the OCT-guided PCI as compared with angiography-guided PCI (84.5% vs. 76.5%, P =.010). There was no significant difference in clinical outcomes. Conclusions: Although in-scaffold MLA at 6-month did not differ between groups, scaffold expansion was improved following OCT- as compared with angiography-guided PCI. The findings of this study must be interpreted in view of the premature termination with inclusion of 14% of the initially planned study sample.
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- 2020
29. Complete revascularization of non-culprit lesions in stemi is associated with improved myocardial salvage and reduced microvascular obstruction: a cardiac magnetic resonance study
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Calvo, M, primary, Guzman, J, additional, Perez, P, additional, Ortega, L.G, additional, Mendieta, G, additional, Lorenzatti, D, additional, Perez, N, additional, Gavara, J, additional, Marcos Garces, V, additional, Brugaletta, S, additional, Sabate, M, additional, Bodi, V, additional, and Ortiz Perez, J.T, additional
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- 2020
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30. Device related thrombosis after left atrial appendage occlusion: does thrombus location always predicts its origin?
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Flores-Umanzor, E., primary, Cepas-Guillen, P., additional, Sanchis, L., additional, Regueiro, A., additional, Navarro, R., additional, Brugaletta, S., additional, Vidal, B., additional, Sitges, M., additional, Sabaté, M., additional, and Freixa, Xavier, additional
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- 2020
- Full Text
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31. Long-Term Coronary Functional Assessment of the Infarct-Related Artery Treated With Everolimus-Eluting Bioresorbable Scaffolds or Everolimus-Eluting Metallic Stents: Insights of the TROFI II Trial
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Gomez-Lara J., Brugaletta S., Ortega-Paz L., Vandeloo B., Moscarella E., Salas M., Romaguera R., Roura G., Ferreiro J. L., Teruel L., Gracida M., Windecker S., Serruys P. W., Gomez-Hospital J. -A., Sabate M., Cequier A., Gomez-Lara, J., Brugaletta, S., Ortega-Paz, L., Vandeloo, B., Moscarella, E., Salas, M., Romaguera, R., Roura, G., Ferreiro, J. L., Teruel, L., Gracida, M., Windecker, S., Serruys, P. W., Gomez-Hospital, J. -A., Sabate, M., and Cequier, A.
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Male ,optical coherence tomography ,Time Factor ,Microcirculation ,Myocardial Infarction ,Drug-Eluting Stents ,Coronary Artery Disease ,Middle Aged ,drug-eluting stent(s) ,Prosthesis Design ,endothelial dysfunction ,ST-segment elevation myocardial infarction ,Vasodilation ,Everolimu ,Percutaneous Coronary Intervention ,Treatment Outcome ,Cardiovascular Agent ,Coated Materials, Biocompatible ,Vasoconstriction ,Coronary Circulation ,bioresorbable vascular scaffold ,Female ,Aged ,Human ,Randomized Controlled Trials as Topic - Abstract
Objectives: The study sought to compare the vasomotor and microcirculatory function of the infarct-related artery (IRA) between bioresorbable vascular scaffolds (BVS) and everolimus-eluting stents (EES) at 3 years. Background: The ABSORB STEMI TROFI II study showed similar outcomes between BVS and EES in the context of ST-segment elevation myocardial infarction at 3 years. Methods: Sixty-three consecutive event-free patients of the randomized TROFI II study were screened to undergo coronary angiography with vasomotor, microcirculatory, and optical coherence tomography (OCT) examination at 3 years. Vasomotion was defined as >4% change in mean lumen diameter to acetylcholine (ACH) and nitroglycerin as assessed by quantitative angiography. Microcirculatory examination was performed with pressure or thermodilution techniques. Results: A total of 38 patients (20 BVS and 18 EES) were included. At 3 years, ≥60% of patients exhibited paradoxical vasoconstriction to ACH in the periscaffold or stent segments. Vasoconstriction to ACH and vasodilatation to nitroglycerin were more often observed in the scaffold or stent segment with BVS than with EES (77.8% vs. 25.0%; p = 0.008 and 61.1% vs. 18.8%; p = 0.018). The IRA-depending microcirculation showed similar index of resistance (23.8 vs. 22.4; p = 0.781), coronary flow reserve (2.4 vs. 1.9; p = 0.523), fractional flow reserve (0.91 vs. 0.93; p = 0.317), and absolute flow (135.5 ml/min vs. 147.3 ml/min; p = 0.791). OCT showed remaining strut footprints and larger number of intraluminal scaffold dismantling (26.3% vs. 0%; p = 0.049) in the BVS group. Conclusions: Both endothelium-dependent and -independent vasomotion of the IRA were more evident with BVS, as compared with EES, at 3 years. Functional microcirculatory parameters were mostly adequate and similar between BVS and EES. Clinical implications of these findings warrant further investigations.
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- 2018
32. Cell-free DNA and Microvascular Damage in ST-segment Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention
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Sanchis J, García-Blas S, Ortega-Paz L, Dantas AP, Rodríguez E, Abellán L, Brugaletta S, Valero E, Miñana G, Garabito M, Corchón Á, Núñez J, Carratalá A, and Sabaté M
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- 2019
33. MAGnesium-based bioresorbable scaffold and vasomotor function in patients with acute ST segment elevation myocardial infarction: The MAGSTEMI trial: Rationale and design
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Brugaletta S, Cequier A, Alfonso F, Iñiguez A, Romaní S, Serra A, Salinas P, Goicolea J, Bordes P, Del Blanco BG, Hernández-Antolín R, Pernigotti A, Gómez-Lara J, and Sabaté M
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ST-segment elevation myocardial infarction ,surgical procedures, operative ,randomized controlled trial ,vasomotion ,bioresorbable vascular scaffold ,cardiovascular diseases ,drug eluting stent - Abstract
Aim Use of a Bioresorbable Scaffolds (BRS) either in clinical practice or in the setting of an acute myocardial infarction (MI) is controversial. Despite an overall high rate of thrombosis, vascular healing response following BRS implantation tend to superiority as compared to metallic drug-eluting stent in ST-segment elevation myocardial infarction (STEMI) patients. We sought to compare the in-stent/scaffold vasomotion between metallic BRS and sirolimus eluting stent (SES) at 12-month angiographic follow-up in the setting of patients with STEMI treated by primary PCI. Study design This is an investigator-driven, prospective, multicenter, randomized, single blind, two-arm, controlled trial ( number: NCT03234348). This trial will randomize similar to 148 patients 1:1 to SES or BRS. Primary end-point is the in-stent/scaffold change in mean lumen diameter after nitroglycerin administration at 12-month angiographic follow-up. Besides, patient-oriented combined endpoint of all-cause death, any MI, and any revascularization, together with scaffold/stent thrombosis rate and device-oriented endpoint of cardiac death, target vessel (TV)-MI and TVR at 1 year will be also evaluated. Clinical follow-up will be scheduled yearly up to 5 years. Conclusion This trial will shed light on the vascular vasomotion following BRS implantation in the complex scenario of STEMI.
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- 2019
34. Clinical Events After Deferral of LAD Revascularization Following Physiological Coronary Assessment
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Sen, S, Ahmad, Y, Dehbi, H-M, Howard, JP, Iglesias, JF, Al-Lamee, R, Petraco, R, Nijjer, S, Bhindi, R, Lehman, S, Walters, D, Sapontis, J, Janssens, L, Vrints, CJ, Khashaba, A, Laine, M, Van Belle, E, Krackhardt, F, Bojara, W, Going, O, Härle, T, Indolfi, C, Niccoli, G, Ribichini, F, Tanaka, N, Yokoi, H, Takashima, H, Kikuta, Y, Erglis, A, Vinhas, H, Silva, PC, Baptista, SB, Alghamdi, A, Hellig, F, Koo, B-K, Nam, C-W, Shin, E-S, Doh, J-H, Brugaletta, S, Alegria-Barrero, E, Meuwissen, M, Piek, JJ, Van Royen, N, Sezer, M, Di Mario, C, Gerber, RT, Malik, IS, Sharp, ASP, Talwar, S, Tang, K, Samady, H, Altman, J, Seto, AH, Singh, J, Jeremias, A, Matsuo, H, Kharbanda, RK, Patel, MR, Serruys, P, Escaned, J, Davies, JE, The Academy of Medical Sciences, National Institute for Health Research, and Imperial College Healthcare Charity Grant
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Male ,coronary stenosis ,Middle Aged ,Coronary Angiography ,instantaneous wave-free ratio ,1102 Cardiovascular Medicine And Haematology ,Coronary Vessels ,Fractional Flow Reserve, Myocardial ,1117 Public Health And Health Services ,Cardiovascular System & Hematology ,fractional flow reserve ,Myocardial Revascularization ,Humans ,Female ,cardiovascular diseases ,Aged - Abstract
BACKGROUND: Physicians are not always comfortable deferring treatment of a stenosis in the left anterior descending (LAD) artery because of the perception that there is a high risk of major adverse cardiac events (MACE). The authors describe, using the DEFINE-FLAIR (Functional Lesion Assessment of Intermediate Stenosis to Guide Revascularisation) trial, MACE rates when LAD lesions are deferred, guided by physiological assessment using fractional flow reserve (FFR) or the instantaneous wave-free ratio (iFR). OBJECTIVES: The purpose of this study was to establish the safety of deferring treatment in the LAD using FFR or iFR within the DEFINE-FLAIR trial. METHODS: MACE rates at 1 year were compared between groups (iFR and FFR) in patients whose physiological assessment led to LAD lesions being deferred. MACE was defined as a composite of cardiovascular death, myocardial infarction (MI), and unplanned revascularization at 1 year. Patients, and staff performing follow-up, were blinded to whether the decision was made with FFR or iFR. Outcomes were adjusted for age and sex. RESULTS: A total of 872 patients had lesions deferred in the LAD (421 guided by FFR, 451 guided by iFR). The event rate with iFR was significantly lower than with FFR (2.44% vs. 5.26%; adjusted HR: 0.46; 95% confidence interval [CI]: 0.22 to 0.95; p = 0.04). This was driven by significantly lower unplanned revascularization with iFR and numerically lower MI (unplanned revascularization: 2.22% iFR vs. 4.99% FFR; adjusted HR: 0.44; 95% CI: 0.21 to 0.93; p = 0.03; MI: 0.44% iFR vs. 2.14% FFR; adjusted HR: 0.23; 95% CI: 0.05 to 1.07; p = 0.06). CONCLUSIONS: iFR-guided deferral appears to be safe for patients with LAD lesions. Patients in whom iFR-guided deferral was performed had statistically significantly lower event rates than those with FFR-guided deferral.
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- 2019
35. Dual antiplatelet therapy duration after coronary stenting in clinical practice: results of an EAPCI survey
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Valgimigli, M, Costa, F, Byrne, R, Haude, M, Baumbach, A, Windecker, S, Aaroe, J, Aasa, M, Abdel-Salam, Am, Alaarag, Af, Accardi, R, Adel, A, Alcazar De La Torre, E, Alejos, R, Alfonso Jimenez, V, Alhashimi, Hmm, Aljeboury, A, Almeida De Sousa, J, Almusawi, A, Alshaikha, M, Altaf, S, Altahmody, Kea, Alvarez Contreras, Lr, Amarasena, N, Amoroso, G, Anderson, R, Ando, G, Andrade, J, Andreou, Ay, Angulo, J, Antonio, T, Aprigliano, G, Aquilina, M, Arafa, Seo, Aramberry, L, Arampatzis, Ca, Araujo, Jj, Asher, E, Ates, I, Athanasias, D, Auer, J, Auffret, V, Ayala, Fj, Baba, C, Baglioni, P, Bagur, R, Balam-Ortiz, E, Balducelli, M, Bam Pas, G, Barbash, Im, Barbosa, Ahp, Barbosa, R, Barnay, P, Barroso, L, Basti, A, Bax, M, Bayet, G, Beijk, Ma, Beltran, R, Berenguer Jofresa, A, Berroth, R, Berti, S, Berumen Dominguez, Le, Bhasin, A, Bhaya, M, Bianco, M, Biasco, L, Bikicki, M, Bonarjee, Vvs, Bonechi, F, Borges Santos, M, Boshev, M, Bouferrouk, A, Bounartzidi, M, Bousoula, E, Brie, D, Brtko, M, Brugaletta, S, Brull, Dj, Buchter, B, Buendia, R, Burzotta, F, Butz, T, Buzzetti, F, Bychowiec, B, Cadeddu, M, Campanile, A, Carneiro, Jg, Carrilho-Ferreira, P, Carrillo Guevara, Je, Carter, Aj, Casal-Heredia, H, Castiglioni, B, Castro Fabiano, L, Cavalcante Silva, R, Cavalcanti De Oliveira, D, Cavalcanti, Rc, Cavazza, C, Centemero, Mp, Chabane, Hk, Chamie, D, Chatzis, D, Chaves, Aj, Cheng, S, Chinchilla, H, Ciabatti, N, Cirillo, P, Citaku, H, Claeys, Mj, Clifford, C, Coceani, M, Coggiola, J, Cohen, Dj, Conway, Dsg, Cornelis, K, Coroleu, Sf, Corral, Jm, Cortese, B, Coskun, U, Costa, Ra, Coste, P, Coufal, Z, Cox, S, Cozma, A, Crean, P, Crenshaw, Mh, Cristian, U, Cruz-Alvarado, Je, Cuculi, F, Cuenza, L, Cyrne Carvalho, H, D'Ascenzo, F, D'Urbano, M, Damonte, A, Dan Florin, F, Dana, A, Dangoisse, V, De Backer, O, De Cock, D, De Vita, M, Debski, A, Delgado, A, Devadathan, S, Dhamrait, S, Di Lorenzo, E, Di Serafino, D, Diego-Nieto, A, Dievart, F, Diez, Jl, Dimitriadis, K, Dina, C, Doerner, O, Donahue, M, Donis, J, Drieghe, B, Drissi, Mf, Du Fretay, H, Dziewierz, A, Echavarria-Pinto, M, Echeverria Romero, Rg, Economou, F, Eftychiou, C, Egdell, R, El Hosieny, A, El Meguid, K, Elabbassi, W, Elesgerli, S, Elghetany, H, Elizondo, Jc, Elkahlout, A, Elrowiny, R, Elserafy, As, Emam, A, Emara, A, Emmanouil, P, Ercilla, J, Erglis, A, Eslam Taha, E, Esmaeil, S, Esposito, G, Ettori, F, Eugenio, N, Everaert, B, Ezquerra Aguilar, W, Falu, R, Farag, E, Farjalla, J, Feldman, L, Feldman, M, Felice, H, Fernandez-Nofrerias, E, Fernandez-Rodriguez, D, Ferranti, F, Ferreira, Q, Ferrone, M, Fleischmann, C, Flessas, D, Formigli, D, Fozilov, H, Fraccaro, C, Freitas, Jo, Fresco, C, Fridrich, V, Furmaniuk, J, Gagnor, A, Galasso, G, Galeazzi, Gl, Galli, S, Galvez Villacorta, V, Gandolfo, C, Garcia, E, Garcia-Blas, S, Garducci, S, Garg, S, Garro, N, Gatto, L, Georgiou, Mg, Ghanem, I, Ghose, T, Giacchi, G, Giang, Pt, Giesler, T, Giovino, M, Girardi, P, Girasis, C, Giunio, L, Giustino, G, Glatthor, C, Glogar, Hd, Golledge, P, Gomez Moreno, J, Gomez Recio, M, Gommeaux, A, Grantalis, G, Greco, F, Grundeken, Mj, Grunert, S, Gudmundsdottir, I, Guenoun, M, Guerios, E, Gupta, R, Gupta, S, Gutierrez, C, Hafeez, I, Halvorsen, S, Hamed Hussein, Ga, Hammoudeh, A, Hansen, Pr, Harb, S, Hawas, Jm, Hayrapetyan, H, Heintzen, Mp, Hengstenberg, C, Herity, N, Hernandez, F, Heyse, A, Hicham, D, Hildick-Smith, D, Hill, J, Hillani, A, Hiltrop, N, Hiramori, A, Hobson, Ar, Homan, Dj, Hooda, A, Ielasi, A, Ierna, S, Iftikhar, Ak, Ilic, I, Imai, Y, Imperadore, F, Indolfi, C, Iorga, V, Ipek, E, Ito, S, Jacksch, R, Jae-Sik, J, James, S, Jamshidi, P, Jerbi, J, Jimenez Quevedo, P, Jimenez-Navarro, M, Jimenez-Santos, M, Jin, Qh, Joksas, V, Jovic, D, Junejo, S, Kallel, R, Kamal, A, Kamiya, H, Kannan, D, Kantaria, M, Kapetanopoulos, A, Kara Ali, B, Karjalainen, Pp, Karthikeyan, Vj, Kato, R, Katsikis, A, Kefer, J, Keta, D, Ketteler, T, Khan, M, Kharlamov, A, Kinani, A, Kinani, T, Kinnaird, T, Kislo, A, Kiviniemi, T, Kleiban, A, Kluck, B, Kocayigit, I, Kokis, A, Komiyama, N, Konstantinos, L, Kordalis, A, Kozak, M, Krecki, R, Kristensen, Sd, Krizanic, F, Krsticevic, L, Kuex, H, Kukreja, N, Kulic, M, Kulikovskikh, Yv, Kulkarni, P, Kumar, N, Kumar Soni, A, Kuzmenko, E, L'Allier, Pl, Langner, O, Lapin, O, Lauer, B, Leclercq, F, Leibundgut, G, Leon Aliz, E, Leon, C, Leon, K, Leoncini, M, Leone, Am, Leroux, L, Lesiak, M, Letilovic, T, Lev, E, Linares Vicente, Ja, Lindsay, S, Loh, Ph, Loncar, G, Loo, B, Lopez, Mb, Lopez-Cuellar, J, Lozano, I, Luigia, P, Lunde, K, Lyczywek, M, Macdougall, D, Mafrici, A, Magni, V, Magro, M, Mainar, V, Makarovic, Z, Malik, N, Maly, M, Mansour, S, Marenco, Re, Maresta, A, Marinho, Ge, Marino, Rl, Marinucci, L, Martins, Hc, Martins, J, Mashayekhi, K, Masood, A, Maurer, E, Mavrogianni, Ad, Mazurek, T, Medina, A, Mehilli, J, Mellwig, Kp, Mendez, M, Mendiz, Oa, Meneses, A, Mercado, La, Mereuta, A, Mezzapelle, G, Milanovic, N, Mohamed, Sm, Mohanad, A, Mohanty, A, Moorthy, N, Morales, Fj, More, R, Moreno Samos, Jc, Moreno-Martinez, Fl, Moscato, F, Mossmann, M, Mrevlje, B, Muller-Eichelberg, A, Musumeci, G, Nadir Khan, M, Najim, S, Nakamura, S, Nakao, F, Naveri, H, Negus, B, Nerla, R, Nguyen, Ht, Niess, Gs, Nikas, Dn, Niroomand, F, Niva, J, Nogueira, Jw, Nombela-Franco, L, Notrica, M, Nouri, B, Nugue, O, Nunes, Gl, Ober, M, Ochoa, J, J. H., O, Ojeda, S, Oktay Tureli, H, Olowe, Y, Oluseun, A, Opolski, G, Ornelas, Ce, Otasevic, P, Ozturk, A, Padilla, F, Pagny, Jy, Paolantonio, D, Papaioannou, Gi, Parodi, G, Patil, Sn, Pavei, A, Pavia, A, Pavlidis, A, Pell, A, Percoco, Gf, Pernasetti, Lv, Pescoller, F, Petropoulakis, P, Piatti, L, Picardi, E, Pieroni, Dm, Pina, J, Pinheiro, Lf, Pinto, Fj, Pipa, Jl, Piroth, Z, Pisano, F, Podbregar, M, Polak, G, Polimeni, A, Postadzhiyan, A, Postu, M, Poulimenos, Le, Pow Chon Long, F, Poyet, R, Pradhan, A, Predescu, Lm, Prida, Xe, Saad, A, Prog, R, Pulikal, Dga, Qiangzhong, Pi, Radu, Md, Rajendran, D, Ram Anil Raj, Mr, Ramazzotti, V, Rapacciuolo, A, Ratib, K, Raungaard, B, Raviola, E, Reppas, E, Reyes, Ja, Rezek, M, Riess, Gj, Rifaie, O, Rigattieri, S, Rissanen, T, Ristic, Ad, Rittger, H, Roberts, J, Rodriguez Saavedra, A, Roik, M, Roshan Rao, K, Routledge, H, Rubboli, A, Rudolph, T, Rudzitis, A, Ruiters, A, Ruiz Ros, Ja, Ruiz-Garcia, J, Ruiz-Nodar, Jm, Sabate, M, Sabnis, G, Sabouret, P, Sacra, C, Saghatelyan, M, Sahin, M, Said, S, Salachas, Aj, Salas Llamas, Jp, Salih, A, Sanchez, Od, Sanchez-Gila, J, Sanchez-Perez, I, Santarelli, A, Sardovski, Sarenac, D, Sarma, J, Sarno, G, Savonitto, S, Sayied Abdullah, A, Schafer, A, Scherillo, M, Schneider, H, Schuhlen, H, Sciahbasi, A, Seca, L, Sedlon, P, Semenka, J, Serra, La, Sesana, M, Sethi, A, Sgueglia, Ga, Shaheen, S, Shahri, H, Sheiban, I, Shyu, Kg, Silva, Cef, Sionis, D, Siqueira, Da, Siqueira, Mj, Smits, P, Sobhy, M, Sokolov, M, Soliman, S, Somani, An, Sridhar, G, Stakos, D, Stasek, J, Stefanini, G, Steigen, Tk, Stewart, Stipal, R, Stochino, Ml, Stoel, Mg, Subla, Rm, Suliman, A, Summaria, F, Stoyanov, N, Syed, Aa, Tanaka, Y, Tashani, A, Tauzin, S, Tawade, N, Tawfik, M, Tayeh, O, Terzic, I, Testa, L, Thevan, B, Thiam, M, Tiecco, F, Tierala, I, Tilea, I, Tilsted, Hh, Tomasik, Ar, Tonev, I, Torres Bosco, A, Tousek, P, Townend, J, Tran Ngoc, T, Triantafyllou, K, Tsigkas, G, Tsioufis, C, Turri, M, Tyligadis, G, Ugo, F, Ultramari, Ft, Urban, P, Uren, N, Uretsky, Bf, Uribe, Ce, Usman, B, Valadez Molina, F, Van Houwelingen, Kg, Vandormael, M, Varvarovsky, I, Vassilis, V, Velasquez, D, Verdoia, M, Vermeersch, P, Vidal-Perez, R, Vinesh, J, Violini, R, Vista, Jh, Vogt, F, Vogt, M, Vokac, D, Vom Dahl, J, Vranckx, P, Wahab, A, Wang, R, Wang, Td, Wani, S, Weisz, Sh, Werner, Gs, Wilkinson, Jr, Wolf, A, Youssef, A, Yumoto, K, Zaderenko, N, Zaghloul Darwish, Am, Zahn, R, Zaro, T, Zavalloni, D, Zbinden, R, Zekanovic, D, Zhang, B, Zhang, C, Zhang, Yj, Zhonghan, N, Zingarelli, A, Zueco, J, Zuhairy, H, Abbate, A, Abdel Hamid, M, Abdelmegid, Maf, Acuna-Valerio, J, Adriaenssens, T, Agostoni, P, Aikot, H, Alameda, M, Alcaraz, H, Almendro-Delia, M, Altug Cakmak, H, Amir, A, Arjomand, A, Assomull, R, Atalar, E, Avramides, D, Aytek Simsek, M, Aznaouridis, K, Azpeitia, Y, Barnabas, C, Barsness, Gw, Bartorelli, Al, Basoglu, A, Benezet, J, Benincasa, S, Berland, J, Berrocal, Dh, Bett, N, Boskovic, S, Brandao, V, Caporale, R, Caprotta, F, Carrabba, N, Cazaux, P, Cheniti, G, Chinchilla Calix, H, Chung, Wy, Cicco, Na, Cieza, T, Clapp, B, Commeau, P, Cuellar, C, De Benedictis, M, De La Torre Hernandez, Jm, De Vroey, F, Degertekin, M, Eberli, Fr, Eggebrecht, H, Ekicibasi, E, Elmaraghi, M, Elod, P, Ergene, Ao, Fadlalla, Vf, Farah, Ma, Fernandez Vina, R, Ferro, A, Fischer, D, Flore, V, Foley, Dp, Gafoor, S, Gallo, S, Gaspardone, A, Gavrilescu, D, Gentiletti, A, Gilard, M, Giovannelli, F, Gonzalez Pacheco, I, Gonzalo, N, Grajek, S, Gurgel De Medeiros, Jp, Haine, S, Hakim, D, Hakim Vista, Jj, Hallani, H, Hamid, M, Helft, G, Heppell, Rm, Hernandez-Enriquez, M, Hlinomaz, O, Ho Choo, E, Huqi, A, Hurtado, Eo, Iakovou, I, Iosseliani, D, Janssens, L, Jean, M, Jensen, Jk, Jesudason, P, Jimenez Diaz, Va, Karchevsky, D, Karpovskii, A, Katsimagklis, G, Kereiakes, D, Kersanova, Nc, Kesavan, S, Khaled, H, Khalil, Sa, Kiatchoosakun, S, Kim, Ks, Kirma, C, Koltowski, L, Konteva, M, Kozinski, L, Kuehn, Cr, Kumar, S, Kyriakakis, 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F., Acuna-Valerio, J., Adriaenssens, T., Agostoni, P., Aikot, H., Alameda, M., Alcaraz, H., Almendro-Delia, M., Altug Cakmak, H., Amir, A., Arjomand, A., Assomull, R., Atalar, E., Avramides, D., Aytek Simsek, M., Aznaouridis, K., Azpeitia, Y., Barnabas, C., Barsness, G. W., Bartorelli, A. L., Basoglu, A., Benezet, J., Benincasa, S., Berland, J., Berrocal, D. H., Bett, N., Boskovic, S., Brandao, V., Caporale, R., Caprotta, F., Carrabba, N., Cazaux, P., Cheniti, G., Chinchilla Calix, H., Chung, W. Y., Cicco, N. A., Cieza, T., Clapp, B., Commeau, P., Cuellar, C., De Benedictis, M., De La Torre Hernandez, J. M., De Vroey, F., Degertekin, M., Eberli, F. R., Eggebrecht, H., Ekicibasi, E., Elmaraghi, M., Elod, P., Ergene, A. O., Fadlalla, V. F., Farah, M. A., Fernandez Vina, R., Ferro, A., Fischer, D., Flore, V., Foley, D. 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C., Mantyla, P., Mariano, E., Marsit, N., Mcdonough, T. J., Medda, M., Mejia Viana, S., Merigo Azpir, C. A., Mitreski, S., Moreno, R., Moreu, J., Muehler, M., Muir, D., Munoz Molina, R., Musilli, N., Myc, J., Nadra, I., Nagy, C. D., Narayanan, A., Neugebauer, P., Nguyen, M., Nick, H., Nicolino, A., Obradovic, S. D., Paizis, I., Panagiotis, P., Park, S. D., Park, S. J., Pasquetto, G., Patel, D., Paunovic, D., Pedon, L., Pereira Machado, F., Pershukov, H., Petrou, E., Pinton, F. A., Preti, G., Puri, R., Pyxaras, S. A., Quintanilla, J., Rhouati, A., Ribeiro De Oliveira, I., Rivetti, L., Rodriguez, A. E., Rotevatn, S., Rubartelli, P., Sachdeva, R., Sanchez-Perez, H., Sangiorgi, G., Santoro, G. M., Saporito, F., Scappaticci, M., Schmermund, A., Schmidt, J. E., Schmitz, T., Schneider, T. I., Schuchlenz, H., Sepulveda Varela, P., Shaw, E., Silva Marques, J., Skalidis, E., Slhessarenko, J., Spaulding, C., Stankovic, G., Suwannasom, P., Synetos, A., Szuster, E., Taha, S., Tavano, D., Tebet, M., Thury, A., Toutouzas, K., Triantafyllis, A. S., Tsikaderis, D., Tumscitz, C., Tzanogiorgis, I., Udovichenko, A., Ulrike, N., Unikas, R., Valerio, M. G., Van Mieghem, C., Vandendriessche, T., Vavlukis, M., Vigna, C., Vilar, J. V., Vizzari, G., Voudris, V., Wafa, S., Wagner, D. R., Wichter, T., Wiedemann, S., Williams, P. D., Woody, W., Yding, A., Zachow, G., and Webster, M.
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Male ,medicine.medical_specialty ,Time Factors ,Percutaneous ,Time Factor ,Psychological intervention ,Alternative medicine ,MEDLINE ,Practice Patterns ,Drug Administration Schedule ,acute coronary syndrome ,Settore MED/11 ,Percutaneous Coronary Intervention ,Pharmacotherapy ,Drug Therapy ,Physicians ,Surveys and Questionnaires ,drug-eluting stent ,Humans ,Surveys and Questionnaire ,Medicine ,Practice Patterns, Physicians' ,health care economics and organizations ,clopidogrel ,dual antiplatelet therapy (DAPT) ,stable coronary artery disease ,Drug Therapy, Combination ,Evidence-Based Medicine ,Health Care Surveys ,Platelet Aggregation Inhibitors ,Practice Guidelines as Topic ,Practice Patterns, Physicians ,Treatment Outcome ,Stents ,business.industry ,Platelet Aggregation Inhibitor ,Coronary stenting ,Evidence-based medicine ,Middle Aged ,Surgery ,Clinical trial ,Health Care Survey ,Combination ,Emergency medicine ,Female ,Cardiology and Cardiovascular Medicine ,business ,Human - Abstract
AIMS Our aim was to report on a survey initiated by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) concerning opinion on the evidence relating to dual antiplatelet therapy (DAPT) duration after coronary stenting. METHODS AND RESULTS Results from three randomised clinical trials were scheduled to be presented at the American Heart Association Scientific Sessions 2014 (AHA 2014). A web-based survey was distributed to all individuals registered in the EuroIntervention mailing list (n=15,200) both before and after AHA 2014. A total of 1,134 physicians responded to the first (i.e., before AHA 2014) and 542 to the second (i.e., after AHA 2014) survey. The majority of respondents interpreted trial results consistent with a substantial equipoise regarding the benefits and risks of an extended versus a standard DAPT strategy. Two respondents out of ten believed extended DAPT should be implemented in selected patients. After AHA 2014, 46.1% of participants expressed uncertainty about the available evidence on DAPT duration, and 40.0% the need for clinical guidance. CONCLUSIONS This EAPCI survey highlights considerable uncertainty within the medical community with regard to the optimal duration of DAPT after coronary stenting in the light of recent reported trial results. Updated recommendations for practising physicians to guide treatment decisions in routine clinical practice should be provided by international societies.
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- 2015
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36. Safety of granulocyte-colony-stimulating factor in acute myocardial infarction (the Rigenera study)
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Leone, A M, Galiuto, L, Rutella, S, Giannico, M B, Brugaletta, S, Garramone, B, De Stefano, V, Liuzzo, G, Calcagni, M L, Cirillo, F, Giordano, A, Niccoli, G, Biasucci, L M, Rebuzzi, A G, Leone, G, and Crea, F
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- 2006
37. Novel anti-inflammatory effect of statins: reduction of CD4+CD28null T lymphocyte frequency in patients with unstable angina
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Brugaletta, S, Biasucci, L M, Pinnelli, M, Biondi-Zoccai, G, Di Giannuario, G, Trotta, G, Liuzzo, G, and Crea, F
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- 2006
38. 2-Year Clinical Outcomes of an Abluminal Groove-Filled Biodegradable-Polymer Sirolimus-Eluting Stent Compared With a Durable-Polymer Everolimus-Eluting Stent
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Xu, B., Saito, Y., Baumbach, A., Kelbaek, H., Royen, N. van, Zheng, M., Morel, M.A., Knaapen, P., Slagboom, T., Johnson, T.W., Vlachojannis, G., Arkenbout, K.E., Holmvang, L., Janssens, L., Ochala, A., Brugaletta, S., Naber, C.K., Anderson, R., Rittger, H., Berti, S., Barbato, E., Toth, G.G., Maillard, L., Valina, C., Buszman, P., Thiele, H., Schachinger, V., Lansky, A., Wijns, W., Xu, B., Saito, Y., Baumbach, A., Kelbaek, H., Royen, N. van, Zheng, M., Morel, M.A., Knaapen, P., Slagboom, T., Johnson, T.W., Vlachojannis, G., Arkenbout, K.E., Holmvang, L., Janssens, L., Ochala, A., Brugaletta, S., Naber, C.K., Anderson, R., Rittger, H., Berti, S., Barbato, E., Toth, G.G., Maillard, L., Valina, C., Buszman, P., Thiele, H., Schachinger, V., Lansky, A., and Wijns, W.
- Abstract
Item does not contain fulltext, OBJECTIVES: The aim of this study was to assess the 2-year clinical outcomes of the Firehawk stent (Shanghai MicroPort Medical Group, Shanghai, China), a novel abluminal groove-filled biodegradable-polymer sirolimus-eluting coronary stent, compared with XIENCE (Abbott Vascular, Santa Clara, California), a durable-polymer everolimus-eluting coronary stent. BACKGROUND: The long-term outcomes of the Firehawk stent have not been evaluated beyond 1 year in a randomized all-comers clinical trial. METHODS: The TARGET All Comers study is a prospective, multicenter, all-comers, randomized, noninferiority trial conducted in Europe. A total of 1,653 patients were randomly assigned to undergo implantation of either the Firehawk or the XIENCE stent. The primary endpoint was target lesion failure, a composite of cardiac death, target vessel myocardial infarction, or ischemia-driven target lesion revascularization. RESULTS: At 2-year follow-up, the incidence of target lesion failure was 8.7% in the Firehawk group versus 8.6% in the XIENCE group (p = 0.92). The event rates of individual components of the primary endpoint were comparable for the 2 groups. Landmark analyses between 1- and 2-year follow-up revealed no statistically significant difference of TLF for the Firehawk versus the XIENCE stent. Beyond 1 year, very late definite or probable stent thrombosis occurred in 3 patients (0.4%) in the Firehawk group and in 7 patients (0.9%) in the XIENCE group (p = 0.34). CONCLUSIONS: The 2-year follow-up of the TARGET All Comers study confirms comparable safety and efficacy profiles of the Firehawk and XIENCE stents.
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- 2019
39. Sex Differences in Instantaneous Wave-Free Ratio or Fractional Flow Reserve-Guided Revascularization Strategy
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Kim, C.H., Koo, B.K., Dehbi, H.M., Lee, J.M., Doh, J.H., Nam, C.W., Shin, E.S., Cook, C.M., Al-Lamee, R., Petraco, R., Sen, S., Malik, I.S., Nijjer, S.S., Mejia-Renteria, H., Alegria-Barrero, E., Alghamdi, A., Altman, J., Baptista, S.B., Bhindi, R., Bojara, W., Brugaletta, S., Silva, P.C., Mario, C. de, Erglis, A., Gerber, R.T., Going, O., Harle, T., Hellig, F., Indolfi, C., Janssens, L., Jeremias, A., Kharbanda, R.K., Khashaba, A., Kikuta, Y., Krackhardt, F., Laine, M., Lehman, S.J., Matsuo, H., Meuwissen, M., Niccoli, G., Piek, J.J., Ribichini, F., Samady, H., Sapontis, J., Seto, A.H., Sezer, M., Sharp, A.S.P., Singh, J., Takashima, H., Talwar, S., Tanaka, N., Tang, K., Belle, Eric van, Royen, N. van, Vinhas, H., Vrints, C.J., Walters, D., Yokoi, H., Samuels, B., Buller, C., Patel, M.R., Serruys, P.W., Escaned, J., Davies, J.E., Kim, C.H., Koo, B.K., Dehbi, H.M., Lee, J.M., Doh, J.H., Nam, C.W., Shin, E.S., Cook, C.M., Al-Lamee, R., Petraco, R., Sen, S., Malik, I.S., Nijjer, S.S., Mejia-Renteria, H., Alegria-Barrero, E., Alghamdi, A., Altman, J., Baptista, S.B., Bhindi, R., Bojara, W., Brugaletta, S., Silva, P.C., Mario, C. de, Erglis, A., Gerber, R.T., Going, O., Harle, T., Hellig, F., Indolfi, C., Janssens, L., Jeremias, A., Kharbanda, R.K., Khashaba, A., Kikuta, Y., Krackhardt, F., Laine, M., Lehman, S.J., Matsuo, H., Meuwissen, M., Niccoli, G., Piek, J.J., Ribichini, F., Samady, H., Sapontis, J., Seto, A.H., Sezer, M., Sharp, A.S.P., Singh, J., Takashima, H., Talwar, S., Tanaka, N., Tang, K., Belle, Eric van, Royen, N. van, Vinhas, H., Vrints, C.J., Walters, D., Yokoi, H., Samuels, B., Buller, C., Patel, M.R., Serruys, P.W., Escaned, J., and Davies, J.E.
- Abstract
Item does not contain fulltext, OBJECTIVES: This study sought to evaluate sex differences in procedural characteristics and clinical outcomes of instantaneous wave-free ratio (iFR)- and fractional flow reserve (FFR)-guided revascularization strategies. BACKGROUND: An iFR-guided strategy has shown a lower revascularization rate than an FFR-guided strategy, without differences in clinical outcomes. METHODS: This is a post hoc analysis of the DEFINE-FLAIR (Functional Lesion Assessment of Intermediate stenosis to guide Revascularization) study, in which 601 women and 1,891 men were randomized to iFR- or FFR-guided strategy. The primary endpoint was 1-year major adverse cardiac events (MACE), a composite of all-cause death, nonfatal myocardial infarction, or unplanned revascularization. RESULTS: Among the entire population, women had a lower number of functionally significant lesions per patient (0.31 +/- 0.51 vs. 0.43 +/- 0.59; p < 0.001) and less frequently underwent revascularization than men (42.1% vs. 53.1%; p < 0.001). There was no difference in mean iFR value according to sex (0.91 +/- 0.09 vs. 0.91 +/- 0.10; p = 0.442). However, the mean FFR value was lower in men than in women (0.83 +/- 0.09 vs. 0.85 +/- 0.10; p = 0.001). In men, an FFR-guided strategy was associated with a higher rate of revascularization than an iFR-guided strategy (57.1% vs. 49.3%; p = 0.001), but this difference was not observed in women (41.4% vs. 42.6%; p = 0.757). There was no difference in MACE rates between iFR- and FFR-guided strategies in both women (5.4% vs. 5.6%, adjusted hazard ratio: 1.10; 95% confidence interval: 0.50 to 2.43; p = 0.805) and men (6.6% vs. 7.0%, adjusted hazard ratio: 0.98; 95% confidence interval: 0.66 to 1.46; p = 0.919). CONCLUSIONS: An FFR-guided strategy was associated with a higher rate of revascularization than iFR-guided strategy in men, but not in women. However, iFR- and FFR-guided strategies showed comparable clinical outcomes, regardless of sex. (Functional Lesion Assessment of Inter
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- 2019
40. Efficacy and Safety of Stents in ST-Segment Elevation Myocardial Infarction
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Chichareon, P., Modolo, R., Collet, C., Tenekecioglu, E., Vink, Matthijs, Oh, P.C., Ahn, J.M., Musto, C., Llera, L.S. Diaz de la, Cho, Y.S., Violini, R., Park, S.J., Suryapranata, H., Piek, J.J., Winter, R.J. de, Wykrzykowska, J.J., Spaulding, C., Kang, W.C., Slagboom, T., Hofma, S.H., Wijnbergen, I.F., Lorenzo, E. Di, Pijls, N.H., Raber, L., Brugaletta, S., Sabate, M., Stoll, H.P., Stone, G.W., Windecker, S., Onuma, Y., Serruys, P.W., Chichareon, P., Modolo, R., Collet, C., Tenekecioglu, E., Vink, Matthijs, Oh, P.C., Ahn, J.M., Musto, C., Llera, L.S. Diaz de la, Cho, Y.S., Violini, R., Park, S.J., Suryapranata, H., Piek, J.J., Winter, R.J. de, Wykrzykowska, J.J., Spaulding, C., Kang, W.C., Slagboom, T., Hofma, S.H., Wijnbergen, I.F., Lorenzo, E. Di, Pijls, N.H., Raber, L., Brugaletta, S., Sabate, M., Stoll, H.P., Stone, G.W., Windecker, S., Onuma, Y., and Serruys, P.W.
- Abstract
Item does not contain fulltext, BACKGROUND: To date, no specific drug-eluting stent (DES) has fully proven its superiority over others in patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention. OBJECTIVES: The purpose of this study was to compare the safety and efficacy of coronary artery stents in STEMI patients in a patient-level network meta-analysis. METHODS: Eligible studies were dedicated randomized controlled trials comparing different stents in STEMI patients undergoing percutaneous coronary intervention with at least 12 months of clinical follow-up. Of 19 studies identified from the published data, individual patient data were collected in 15 studies with 10,979 patients representing 87.7% of patients in the overall network of evidence. The primary endpoint was the composite of cardiac death, reinfarction, or target lesion revascularization. RESULTS: Overall, 8,487 (77.3%) of 10,979 STEMI patients were male and the mean age was 60.7 years. At a median follow-up of 3 years, compared with bare-metal stents (BMS), patients treated with paclitaxel-, sirolimus-, everolimus-, or biolimus-eluting stents had a significantly lower risk of the primary endpoint (adjusted hazard ratios [HRs]: 0.74 [95% confidence interval (CI): 0.63 to 0.88], 0.65 [95% CI: 0.49 to 0.85], 0.70 [95% CI: 0.53 to 0.91], and 0.66 [95% CI: 0.49 to 0.88], respectively). The risk of primary endpoint was not different between patients treated with BMS and zotarolimus-eluting stents (adjusted HR: 0.83 [95% CI: 0.51 to 1.38]). Among patients treated with DES, no significant difference in the risk of the primary outcome was demonstrated. Treatment with second-generation DES was associated with significantly lower risk of definite or probable stent thrombosis compared with BMS (adjusted HR: 0.61 [95% CI: 0.42 to 0.89]) and first-generation DES (adjusted HR: 0.56 [95% CI: 0.36 to 0.88]). CONCLUSIONS: In STEMI patients, DES were superior to BMS with respect to long-term effica
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- 2019
41. Clinical Events After Deferral of LAD Revascularization Following Physiological Coronary Assessment
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Sen, S., Ahmad, Y., Dehbi, H.M., Howard, J.P., Iglesias, J.F., Al-Lamee, R., Petraco, R., Nijjer, S., Bhindi, R., Lehman, S., Walters, D., Sapontis, J., Janssens, L., Vrints, C.J., Khashaba, A., Laine, M., Belle, E, Krackhardt, F., Bojara, W., Going, O., Harle, T., Indolfi, C., Niccoli, G., Ribichini, F., Tanaka, N., Yokoi, H., Takashima, H., Kikuta, Y., Erglis, A., Vinhas, H., Silva, P.C., Baptista, S.B., Alghamdi, A., Hellig, F., Koo, B.K., Nam, C.W., Shin, E.S., Doh, J.H., Brugaletta, S., Alegria-Barrero, E., Meuwissen, M., Piek, J.J., Royen, N. van, Sezer, M., Mario, C. de, Gerber, R.T., Malik, I.S., Sharp, A.S.P., Talwar, S., Tang, K., Samady, H., Altman, J., Seto, A.H., Singh, J., Jeremias, A., Matsuo, H., Kharbanda, R.K., Patel, M.R., Serruys, P., Escaned, J., Davies, J.E., Sen, S., Ahmad, Y., Dehbi, H.M., Howard, J.P., Iglesias, J.F., Al-Lamee, R., Petraco, R., Nijjer, S., Bhindi, R., Lehman, S., Walters, D., Sapontis, J., Janssens, L., Vrints, C.J., Khashaba, A., Laine, M., Belle, E, Krackhardt, F., Bojara, W., Going, O., Harle, T., Indolfi, C., Niccoli, G., Ribichini, F., Tanaka, N., Yokoi, H., Takashima, H., Kikuta, Y., Erglis, A., Vinhas, H., Silva, P.C., Baptista, S.B., Alghamdi, A., Hellig, F., Koo, B.K., Nam, C.W., Shin, E.S., Doh, J.H., Brugaletta, S., Alegria-Barrero, E., Meuwissen, M., Piek, J.J., Royen, N. van, Sezer, M., Mario, C. de, Gerber, R.T., Malik, I.S., Sharp, A.S.P., Talwar, S., Tang, K., Samady, H., Altman, J., Seto, A.H., Singh, J., Jeremias, A., Matsuo, H., Kharbanda, R.K., Patel, M.R., Serruys, P., Escaned, J., and Davies, J.E.
- Abstract
Contains fulltext : 209410.pdf (publisher's version ) (Open Access), BACKGROUND: Physicians are not always comfortable deferring treatment of a stenosis in the left anterior descending (LAD) artery because of the perception that there is a high risk of major adverse cardiac events (MACE). The authors describe, using the DEFINE-FLAIR (Functional Lesion Assessment of Intermediate Stenosis to Guide Revascularisation) trial, MACE rates when LAD lesions are deferred, guided by physiological assessment using fractional flow reserve (FFR) or the instantaneous wave-free ratio (iFR). OBJECTIVES: The purpose of this study was to establish the safety of deferring treatment in the LAD using FFR or iFR within the DEFINE-FLAIR trial. METHODS: MACE rates at 1 year were compared between groups (iFR and FFR) in patients whose physiological assessment led to LAD lesions being deferred. MACE was defined as a composite of cardiovascular death, myocardial infarction (MI), and unplanned revascularization at 1 year. Patients, and staff performing follow-up, were blinded to whether the decision was made with FFR or iFR. Outcomes were adjusted for age and sex. RESULTS: A total of 872 patients had lesions deferred in the LAD (421 guided by FFR, 451 guided by iFR). The event rate with iFR was significantly lower than with FFR (2.44% vs. 5.26%; adjusted HR: 0.46; 95% confidence interval [CI]: 0.22 to 0.95; p = 0.04). This was driven by significantly lower unplanned revascularization with iFR and numerically lower MI (unplanned revascularization: 2.22% iFR vs. 4.99% FFR; adjusted HR: 0.44; 95% CI: 0.21 to 0.93; p = 0.03; MI: 0.44% iFR vs. 2.14% FFR; adjusted HR: 0.23; 95% CI: 0.05 to 1.07; p = 0.06). CONCLUSIONS: iFR-guided deferral appears to be safe for patients with LAD lesions. Patients in whom iFR-guided deferral was performed had statistically significantly lower event rates than those with FFR-guided deferral.
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- 2019
42. Correlates of non-target vessel-related adverse events in patients with ST-segment elevation myocardial infarction: insights from five-year follow-up of the EXAMINATION trial
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Spitaleri G., Moscarella E., Brugaletta S., Pernigotti A., Ortega-Paz L., Gomez-Lara J., Cequier A., Iniguez A., Serra A., Jimenez-Quevedo P., Mainar V., Campo G., Tespili M., Heijer P. D., Bethencourt A., Vazquez N., Valgimigli M., Serruys P. W., Sabate M., Raber L., Vahanian A., Spitaleri, G., Moscarella, E., Brugaletta, S., Pernigotti, A., Ortega-Paz, L., Gomez-Lara, J., Cequier, A., Iniguez, A., Serra, A., Jimenez-Quevedo, P., Mainar, V., Campo, G., Tespili, M., Heijer, P. D., Bethencourt, A., Vazquez, N., Valgimigli, M., Serruys, P. W., Sabate, M., Raber, L., and Vahanian, A.
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Male ,Time Factors ,medicine.medical_treatment ,Comorbidity ,030204 cardiovascular system & hematology ,Bare metal stent ,Drug-eluting stent ,Multiple vessel disease ,St-elevation myocardial infarction (STEMI) ,law.invention ,0302 clinical medicine ,multiple vessel disease ,Randomized controlled trial ,law ,Recurrence ,Risk Factors ,ST segment ,030212 general & internal medicine ,Myocardial infarction ,610 Medicine & health ,Metal ,Incidence (epidemiology) ,Incidence ,Diabetes Mellitu ,Drug-Eluting Stents ,Middle Aged ,Treatment Outcome ,Metals ,Cardiology ,Female ,Stents ,Cardiology and Cardiovascular Medicine ,Human ,medicine.medical_specialty ,Time Factor ,bare metal stent ,Prosthesis Design ,NO ,03 medical and health sciences ,Percutaneous Coronary Intervention ,Internal medicine ,Diabetes mellitus ,medicine ,drug-eluting stent ,Diabetes Mellitus ,Humans ,Adverse effect ,Aged ,business.industry ,Risk Factor ,Percutaneous coronary intervention ,medicine.disease ,ST-elevation myocardial infarction (STEMI) ,ST Elevation Myocardial Infarction ,business - Abstract
AIMS: The aim of this substudy was to determine the five-year correlates of non-TV-related adverse events (AE) in STEMI patients included in the EXAMINATION trial. METHODS AND RESULTS: The EXAMINATION trial randomised 1,498 STEMI patients to bare metal or everolimus-eluting stent implantation. In this substudy, patients were analysed according to non-TV-related AE, defined as the composite of either non-TV revascularisation (non-TVR) or non-TV-related myocardial infarction (MI). At five-year follow-up, 125 patients (8.3%) exhibited 136 non-TV-related AE (124 [8.3%] non-TVR, 12 [0.8%] non-TV-related MI), accounting for 47.1% of 289 non-fatal cardiac events overall. These patients had a higher incidence of diabetes mellitus (p70% (p=0.042) as compared to the rest. At Cox analysis, previous MI (HR 1.872, 95% CI: 1.004-3.489; p=0.048), incomplete revascularisation (HR 1.746, 95% CI: 1.029-2.963; p=0.039) and diabetes (HR 1.942, 95% CI: 1.292-2.919; p=0.001) were independent correlates of non-TV-related AE. CONCLUSIONS: In STEMI patients undergoing primary percutaneous coronary intervention, previous MI, incomplete revascularisation and diabetes resulted in being independent correlates of five-year non-TV-related AE.
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- 2017
43. Multivessel disease in patients over 75 years old with ST elevated myocardial infarction. Current management strategies and related clinical outcomes in the ESTROFA MI
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de La Torre Hernandez JM, Gomez Hospital JA, Baz JA, Brugaletta S, Perez de Prado A, Linares JA, Lopez Palop R, Cid B, Garcia Camarero T, Diego A, Gutierrez H, Fernandez Diaz JA, Sanchis J, Alfonso F, Blanco R, Botas J, Navarro Cuartero J, Moreu J, Bosa F, Vegas JM, Elizaga J, Arrebola AL, Hernandez F, Salvatella N, Monteagudo M, Gomez Jaume A, Carrillo X, Martin Reyes R, Lozano F, Rumoroso JR, Andraka L, and Dominguez AJ
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cardiovascular diseases - Abstract
Background: In elderly patients with ST elevated myocardial infarction (STEMI) and multivessel disease (MVD the outcomes related with different revascularization strategies are not well known. Methods: Subgroup-analysis of a nation-wide registry of primary angioplasty in the elderly (ESTROFA MI + 75) with 3576 patients over 75 years old from 31 centers. Patients with MVD were analyzed to describe treatment approaches and 2 years outcomes. Results: Of 1830 (51%) with MVD, 847 (46%) underwent multivessel revascularization either in acute (51%), staged (44%) or both procedures (5%). Patients with previous myocardial infarction and those receiving drug-eluting stents or IIb-IIIa inhibitors were more prone to be revascularized, whereas older patients, females and those with Killip III-IV, renal failure and higher ejection fraction were less likely. Survival free of cardiac death and infarction at 2 years was better for those undergoing multivessel PCI (85.8% vs. 80.4%, p < 0.0008), regardless of Killip class. Multivessel PCI was protective of cardiac death and infarction (HR 0.60, 95% CI 0.40-0.89; p = 0.011). Complete revascularization made no difference in outcomes among those patients undergoing multivessel PCI. The best prognosis corresponded to those undergoing multivessel PCI in staged procedures (p < 0.001). A propensity score matching analysis (514 patients in each group) yielded similar results. Conclusions: In elderly patients with STEMI and MVD, multivessel PCI was related with better outcomes especially after staged procedures. Among those undergoing multivessel PCI, anatomically defined completeness of revascularization had not prognostic influence. Summary: We sought to investigate the revascularization strategies applied and their prognostic implications in patients aged over 75 years with ST elevated myocardial infarction showing multivessel disease. Of 1830 patients, 847 (46%) underwent multivessel PCI either in acute (51%), staged (44%) or both procedures (5%). Multivessel PCI was independent predictor of cardiac death and infarction with the best prognosis corresponding to those undergoing staged procedures. (c) 2017 Elsevier Inc. All rights reserved.
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- 2018
44. Clinical, Angiographic, and Procedural Correlates of Very Late Absorb Scaffold Thrombosis: Multistudy Registry Results
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Ellis, S.G., Gori, T., Serruys, P.W., Nef, H., Steffenino, G., Brugaletta, S., Munzel, T., Feliz, C., Schmidt, G, Sabate, M., Onuma, Y., Geuns, R.J.M. van, Gao, R.L., Menichelli, M., Kereiakes, D.J., Stone, G.W., Testa, L., Kimura, T., and Abizaid, A.
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Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] - Abstract
Item does not contain fulltext OBJECTIVES: The aim of this study was to identify independent correlates of very late scaffold thrombosis (VLST) from an analysis of consecutively treated patients from 15 multicenter studies. BACKGROUND: Recent analyses suggest an increased risk for VLST with the Absorb Bioresorbable Vascular Scaffold compared with drug-eluting stents, but insights as to correlates of risk are limited. METHODS: A total of 55 patients were identified with scaffold thrombosis. They were matched 2:1 with control subjects selected randomly from patients without thrombosis from the same study. Quantitative coronary angiography was available for 96.4% of patients. Multiple logistic and Cox regression analysis were used to identify significant independent outcome correlates from 6 pre-specified characteristics. RESULTS: Patients had scaffold thrombosis at a median of 20 months (interquartile range: 17 to 27 months). Control subjects were followed for 36 months (interquartile range: 24 to 38 months). For the combined groups, reference vessel diameter (RVD) was 2.84 +/- 0.50 mm, scaffold length was 26 +/- 16 mm, and post-dilatation was performed in 56%. Univariate correlates of thrombosis were smaller nominal scaffold/RVD ratio (linear p = 0.001; ratio 2.72 mm; odds ratio: 3.4; p = 0.001). Post-dilatation at >/=16 atm, post-dilatation balloon/scaffold ratio, final percentage stenosis, and dual antiplatelet therapy were not correlated with VLST. Only scaffold/RVD ratio remained a significant independent correlate of VLST (p = 0.001), as smaller ratio was correlated with RVD (p < 0.001). Post hoc analysis of 8 other potential covariates revealed no other correlates of outcome. CONCLUSIONS: In the present analysis, the largest to date of its type, relative scaffold undersizing was the strongest determinant of VLST. Given current understanding of "scaffold dismantling," this finding likely has ramifications for all bioresorbable scaffolds.
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- 2018
45. Effects of Ticagrelor, Prasugrel, or Clopidogrel on Endothelial Function and Other Vascular Biomarkers A Randomized Crossover Study
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Ariotti, Sara, Ortega-Paz, L, Leeuwen, M, Brugaletta, S, Leonardi, S, Akkerhuis, Martijn, Rimoldi, SF, Janssens, G, Gianni, U, van den Berge, Jan-Kees, Karagiannis, A, Windecker, S, Valgimigli, M, and Cardiology
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- 2018
46. P5613Proportional relationship between early mobilization of bone marrow progenitor cells and the extent of vascular injury during coronary stenting: insights on the role of systemic mechanisms of vascular
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Jimenez-Quevedo, P, primary, Bernardo, E, additional, Del Trigo, M, additional, Otsuki, S, additional, Nombela Franco, L, additional, Brugaletta, S, additional, Ortega Pozi, A, additional, Salinas, P, additional, Nunez Gil, I, additional, Megia Renteria, H, additional, Fernandez Ortiz, A, additional, Macaya, C, additional, Escaned, J, additional, Sabate, M, additional, and Gonzalo, N, additional
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- 2019
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47. P5474STEMI time presentation, are circadian patterns and week hours related to the outcome?
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Rodriguez Arias, J J, primary, Ortega-Paz, L O, additional, Masotti, M M, additional, Freixa, X F, additional, Regueiro, A R, additional, Sabate, M S, additional, and Brugaletta, S B, additional
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- 2019
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48. P1562Outcomes of nonagenarians with ST elevation myocardial infarction
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Cepas Guillen, P L, primary, Borrego-Rodriguez, J, additional, Flores-Umanzor, E, additional, Fernandez-Valledor, A, additional, Vazquez, S, additional, Echarte Morales, J C, additional, Menendez-Suarez, P, additional, Iglesias Garriz, I, additional, Perez De Prado, A, additional, Regueiro, A, additional, Brugaletta, S, additional, Freixa, X, additional, Masotti, M, additional, Fernandez-Vazquez, F, additional, and Sabate, M, additional
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- 2019
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49. Targeted therapy with a localised abluminal groove, low-dose sirolimus-eluting, biodegradable polymer coronary stent (TARGET All Comers): a multicentre, open-label, randomised non-inferiority trial
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Lansky, A., Wijns, W., Xu, B., Kelbaek, H., Royen, N. van, Zheng, M., Morel, M.A., Knaapen, P., Slagboom, T., Johnson, T.W., Vlachojannis, G., Arkenbout, K.E., Holmvang, L., Janssens, L., Ochala, A., Brugaletta, S., Naber, C.K., Anderson, R., Rittger, H., Berti, S., Barbato, E., Toth, G.G., Maillard, L., Valina, C., Buszman, P., Thiele, H., Schachinger, V., Baumbach, A., Lansky, A., Wijns, W., Xu, B., Kelbaek, H., Royen, N. van, Zheng, M., Morel, M.A., Knaapen, P., Slagboom, T., Johnson, T.W., Vlachojannis, G., Arkenbout, K.E., Holmvang, L., Janssens, L., Ochala, A., Brugaletta, S., Naber, C.K., Anderson, R., Rittger, H., Berti, S., Barbato, E., Toth, G.G., Maillard, L., Valina, C., Buszman, P., Thiele, H., Schachinger, V., and Baumbach, A.
- Abstract
Item does not contain fulltext, BACKGROUND: The FIREHAWK is a drug-eluting stent with a fully biodegradable sirolimus-containing polymer coating localised to recessed abluminal grooves on the stent surface. We investigated clinical outcomes with this targeted, low-dose, biodegradable polymer, sirolimus-eluting stent compared with XIENCE durable polymer, everolimus-eluting stents in an all-comers population. METHODS: The TARGET All Comers study was a prospective, multicentre, open-label randomised non-inferiority trial done at 21 centres in ten European countries. Patients with symptomatic or asymptomatic coronary artery disease and objective evidence of myocardial ischaemia who qualified for percutaneous coronary intervention were randomised 1:1 to undergo implantation of a FIREHAWK or XIENCE. Randomisation was web-based, with random block allocation and stratification by centre and ST elevation myocardial infarction. Outcome assessors were masked to treatment allocation, but treating physicians and patients were not. The primary endpoint was target lesion failure at 12 months, a composite of cardiac death, target vessel myocardial infarction, or ischaemia-driven target lesion revascularisation. The control event rate for XIENCE was assumed to be 7%, the non-inferiority margin was 3.5%, and the primary analysis was in the intention-to-treat population, censoring patients who did not have either an event before 365 days or contact beyond 365 days. Late lumen loss was the primary endpoint of an angiographic substudy designed to investigate the non-inferiority of the FIREHAWK compared with the XIENCE stent. This trial is registered with ClinicalTrials.gov, number NCT02520180. FINDINGS: From Dec 17, 2015, to Oct 14, 2016, 1653 patients were randomly assigned to implantation of the FIREHAWK (n=823) or XIENCE (n=830). 65 patients in the FIREHAWK group and 66 in the XIENCE group had insufficient follow-up data and were excluded from the analyses. At 12 months, target lesion failure occurred in 46 (6.1%)
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- 2018
50. Safety of the Deferral of Coronary Revascularization on the Basis of Instantaneous Wave-Free Ratio and Fractional Flow Reserve Measurements in Stable Coronary Artery Disease and Acute Coronary Syndromes
- Author
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Escaned, J., Ryan, N., Mejia-Renteria, H., Cook, C.M., Dehbi, H.M., Alegria-Barrero, E., Alghamdi, A., Al-Lamee, R., Altman, J., Ambrosia, A., Baptista, S.B., Bertilsson, M., Bhindi, R., Birgander, M., Bojara, W., Brugaletta, S., Buller, C., Calais, F., Silva, P.C., Carlsson, J., Christiansen, E.H., Danielewicz, M., Mario, C. de, Doh, J.H., Erglis, A., Erlinge, D., Gerber, R.T., Going, O., Gudmundsdottir, I., Harle, T., Hauer, D., Hellig, F., Indolfi, C., Jakobsen, L., Janssens, L., Jensen, J., Jeremias, A., Karegren, A., Karlsson, A.C., Kharbanda, R.K., Khashaba, A., Kikuta, Y., Krackhardt, F., Koo, B.K., Koul, S., Laine, M., Lehman, S.J., Lindroos, P., Malik, I.S., Maeng, M., Matsuo, H., Meuwissen, M., Nam, C.W., Niccoli, G., Nijjer, S.S., Olsson, H., Olsson, S.E., Omerovic, E., Panayi, G., Petraco, R., Piek, J.J., Ribichini, F., Samady, H., Samuels, B., Sandhall, L., Sapontis, J., Sen, S., Seto, A.H., Sezer, M., Sharp, A.S.P., Shin, E.S., Singh, J., Takashima, H., Talwar, S., Tanaka, N., Tang, K., Belle, E. van, Royen, N. van, Varenhorst, C., Vinhas, H., Vrints, C.J., Walters, D., Yokoi, H., Frobert, O., Patel, M.R., Serruys, P., Davies, J.E., Gotberg, M., Escaned, J., Ryan, N., Mejia-Renteria, H., Cook, C.M., Dehbi, H.M., Alegria-Barrero, E., Alghamdi, A., Al-Lamee, R., Altman, J., Ambrosia, A., Baptista, S.B., Bertilsson, M., Bhindi, R., Birgander, M., Bojara, W., Brugaletta, S., Buller, C., Calais, F., Silva, P.C., Carlsson, J., Christiansen, E.H., Danielewicz, M., Mario, C. de, Doh, J.H., Erglis, A., Erlinge, D., Gerber, R.T., Going, O., Gudmundsdottir, I., Harle, T., Hauer, D., Hellig, F., Indolfi, C., Jakobsen, L., Janssens, L., Jensen, J., Jeremias, A., Karegren, A., Karlsson, A.C., Kharbanda, R.K., Khashaba, A., Kikuta, Y., Krackhardt, F., Koo, B.K., Koul, S., Laine, M., Lehman, S.J., Lindroos, P., Malik, I.S., Maeng, M., Matsuo, H., Meuwissen, M., Nam, C.W., Niccoli, G., Nijjer, S.S., Olsson, H., Olsson, S.E., Omerovic, E., Panayi, G., Petraco, R., Piek, J.J., Ribichini, F., Samady, H., Samuels, B., Sandhall, L., Sapontis, J., Sen, S., Seto, A.H., Sezer, M., Sharp, A.S.P., Shin, E.S., Singh, J., Takashima, H., Talwar, S., Tanaka, N., Tang, K., Belle, E. van, Royen, N. van, Varenhorst, C., Vinhas, H., Vrints, C.J., Walters, D., Yokoi, H., Frobert, O., Patel, M.R., Serruys, P., Davies, J.E., and Gotberg, M.
- Abstract
Contains fulltext : 196266.pdf (Publisher’s version ) (Open Access), OBJECTIVES: The aim of this study was to investigate the clinical outcomes of patients deferred from coronary revascularization on the basis of instantaneous wave-free ratio (iFR) or fractional flow reserve (FFR) measurements in stable angina pectoris (SAP) and acute coronary syndromes (ACS). BACKGROUND: Assessment of coronary stenosis severity with pressure guidewires is recommended to determine the need for myocardial revascularization. METHODS: The safety of deferral of coronary revascularization in the pooled per-protocol population (n = 4,486) of the DEFINE-FLAIR (Functional Lesion Assessment of Intermediate Stenosis to Guide Revascularisation) and iFR-SWEDEHEART (Instantaneous Wave-Free Ratio Versus Fractional Flow Reserve in Patients With Stable Angina Pectoris or Acute Coronary Syndrome) randomized clinical trials was investigated. Patients were stratified according to revascularization decision making on the basis of iFR or FFR and to clinical presentation (SAP or ACS). The primary endpoint was major adverse cardiac events (MACE), defined as the composite of all-cause death, nonfatal myocardial infarction, or unplanned revascularization at 1 year. RESULTS: Coronary revascularization was deferred in 2,130 patients. Deferral was performed in 1,117 patients (50%) in the iFR group and 1,013 patients (45%) in the FFR group (p < 0.01). At 1 year, the MACE rate in the deferred population was similar between the iFR and FFR groups (4.12% vs. 4.05%; fully adjusted hazard ratio: 1.13; 95% confidence interval: 0.72 to 1.79; p = 0.60). A clinical presentation with ACS was associated with a higher MACE rate compared with SAP in deferred patients (5.91% vs. 3.64% in ACS and SAP, respectively; fully adjusted hazard ratio: 0.61 in favor of SAP; 95% confidence interval: 0.38 to 0.99; p = 0.04). CONCLUSIONS: Overall, deferral of revascularization is equally safe with both iFR and FFR, with a low MACE rate of about 4%. Lesions were more frequently deferred when iFR was used t
- Published
- 2018
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