63 results on '"Piroth Z"'
Search Results
2. Correlation of FFR measured after DES implantation with clinical parameters and long-term clinical outcome
- Author
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Csanadi, B, primary, Fulop, G, additional, Szoke, S, additional, Szonyi, T, additional, Dekany, G, additional, Pinter, T, additional, Takacs, P, additional, Abdelkrim, A, additional, Beres, A, additional, Fontos, G, additional, Andreka, P, additional, Nyolczas, N, additional, and Piroth, Z, additional
- Published
- 2022
- Full Text
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3. 2020 EAPCI core curriculum for percutaneous cardiovascular interventions
- Author
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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)
- Subjects
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
- Published
- 2021
4. Assessing the cardiology community position on transradial intervention and the use of bivalirudin in patients with acute coronary syndrome undergoing invasive management: results of an EAPCI survey
- Author
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Adamo, Marianna, Byrne, Robert A., Baumbach, Andreas, Haude, Michael, Windecker, Stephan, Valgimigli, Marco, Aaroe, J., Abdeltawab, A. A., Accardi, R., Addad, F., Agostoni, P., Alajab, A., Alcázar, E., Alhabil, B., Altug Cakmak, H., Amico, F., Amoroso, G., Anderson, R., Andò, G., Andreou, A. Y., Antoniadis, D., Aquilina, M., Aramberry, L., Auer, J., Auffret, V., Ausiello, A., Austin, D., Avram, A., Ayman, E., Babunashvili, V., Bagur, R., Bakotic, Z., Balducelli, M., Ballesteros, S. M., Baptista, S., Baranauskas, A., Barbeau, G., Bax, M., Benchimol, C., Berroth, R., Biasco, L., Bilal, A., Binias, K., Blanco Mata, R., Boccuzzi, G., Bolognese, L., Boskovic, S., Bourboulis, N., Briguori, C., Bunc, M., Buysschaert, I., Calabro’, P., Campo, G., Candiello, A., Caprotta, U. F., Cardenas, M., Carrilho-Ferreira, P., Carrizo, S., Caruso, M., Cassar, A., Cernigliaro, C., Chacko, G., Chamie, D., Clapp, B., Coceani, M., Colangelo, S., Colombo, A., Comeglio, M., Connaughton, M., Conway, D., Cortese, B., Cosgrave, J., Costa, F., Couvoussis, E., Crimi, G., Crook, R., Cruz-Alvarado, J. E., Curello, S., D’Ascenzo, F., D’Urbano, M., Dana, A., De Backer, O., De Carlo, M., De Cesare, N., De Iaco, G., De La Torre, H. J. M., De Oliveira Netoj, B., Devlin, G. P., Di Lorenzo, E., Díaz, A., Dina, C., Dorsel, T. H., Eberli, F. R., Echeverría, R., Eftychiou, C., Elguindy, A., Ercilla, J., Ernst, A., Esposito, G., Ettori, F., Eufracino, Null, Ezquerra Aguilera, W., Falcone, C., Falu, R. M., Feres, F., Ferlini, M., Fernández, G., Fernández-Rodríguez, D., Fileti, L., Fischetti, D., Florescu, N., Formigli, D., Fouladvand, F., Franco, N., Fresco, C., Frigoli, E., Furmaniuk, J., Gabaldo, K., Galli, M., Galli, S., Garbo, R., Garducci, S., Garg, S., Gavrielatos, G., Gensch, J., Giacchi, G., Giunio, L., Giustino, G., Goldberg, L., Goldsmit, R., Gommeaux, A., González Godínez, H., Gosselin, G., Govorov, A., Grimfjard, P., Gross, E., Grosz, C., Guagliumi, G., Hadad, W., Hadadi, L., Hansen, P. R., Harb, S., Hatrick, R., Hayrapetyan, H. G., Hernández-Enríquez, M., Ho Heo, J., Horvath, I. G., Huan Loh, P., Ibrahim, A. M., Ierna, S., Ilic, I., Imperadore, F., Ionescu-Silva, E., Jacksch, R., James, S., Janiak, B., Jensen, S. E., Jeroen, S., Jugessur, R. K., Kala, P., Kambis, M., Kanakakis, J., Karamasis, G., Karchevsky, D., Karpovskiy, A., Kayaert, P., Kedev, S., Kemala, E., Ketteler, T., Khan, S. Q., Kharlamov, A., Kiernan, T., Kiviniem, T., Koltowski, L., Koskinas, K. C., Kouloumpinis, A., Kraaijeveld, A. O., Krizanic, F., Krötz, B., Kuczmik, W., Kukreja, N., Kuksa, D., Yav, K., Kyriakos, D., Labrunie, A., Laine, M., Lapin, O., Larosa, C., Latib, A., Lattuca, B., Lauer, B., Lefèvre, T., Legrand, V., Lehto, P., Leiva-Pons, J. L., Leone, A. M., Lev, G., Lim, R., Limbruno, U., Linares Vicente, J. A., Lindsay, S., Linnartz, C., Liso, A., Lluberas, R., Locuratolo, N., Lokshyn, S., Lunde, K., Lupi, A., Magnavacchi, P., Maia, F., Mainar, V., Mancone, M., Manolios, M. G., Mansour, S., Mariano, E., Marques, K., Martins, H., Mckenzie, D., Meco, S., Meemook, K., Mehmed, K., Melikyan, A., Mellwig, K. P., Mendiz, O. A., Merkulov, E., Mesquita, H. G., Mezzapelle, G., Miloradovic, V., Mohamed, S., Mohammed, B., Mohammed, F., Mohammed, K., Mohanad, A., Morawiec, B., More, R., Moreno-Martínez, F. L., Mrevlje, B., Muhammad, F., Näveri, H., Nazzaro, M. S., Neary, P., Negus, B. H., Nelson Durval, F. G., Nick, H., Nilva, E., Oldroyd, K. G., Olivares Asencio, C., Omerovic, E., Ortiz, M. A., Ota, H., Otasevic, P., Otieno, H. A., Paizis, I., Papp, E., Pasquetto, G., Patsourakos, N. G., Peels, J., Pelliccia, F., Pennacchi, M., Penzo, C., Perez, P., Perkan, A., Petrou, E., Phipathananunth, W., Pierri, A., Pinheiro, L. F., Pipa, J. L., Piva, T., Polad, J., Porto, I., Poveda, J., Predescu, L., Prog, R., Puri, R., Raco, D. L., Ramazan, O., Ramazzotti, V., Rao, S. V., Raungaard, B., Reczuch, K., Rekik, S., Rhouati, A., Rigattieri, S., Rodríguez-Olivares, R., Roik, M., Romagnoli, E., Román, A. J., Routledge, H., Rubartelli, P., Rubboli, A., Ruiz-García, J., Russo, F., Ruzsa, Z., Ryding, A., Saad, Aly, Sabate, M., Sabouret, P., Sadowski, M., Saia, F., Sanchez Perez, I., Santoro, G. M., Sarenac, D., Saririan, M., Sarma, J., Schuetz, T., Sciahbasi, A., Sebastian, M., Sebik, R., Sesana, M., Hur, Seung-Ho, Sganzerla, P., Shalva, R., Sharma, S., Sheiban, I., Shein, K. K., Shiekh, I. A., Sinha, M., Slhessarenko, J., Smith, D., Smyth, D. W., Sönmez, K., Sood, N., Sourgounis, A., Srdanovic, I., Stables, R. H., Stefanini, G. G., Stewart, J., Stoyanov, N., Suliman, A. A., Suryadevara, R., Suwannasom, P., Tange Veien, K., Tauchert, S., Tebet, M., Testa, L., Thury, A., Tilsted, H. H., Tiroch, K., Torres, A., Tosi, P., Traboulsi, M., Trani, C., Tresoldi, S., Tsigkas, G., Tueller, D., Turri, M., Udovichenko, A. E., Uretsky, B., Van Der Harst, P., Van Houwelingen, K. G., Vandoni, P., Vandormael, M., Varbella, F., Venkitachalam, C. G., Vercellino, M., Vidal-Perez, R., Vigna, C., Vignali, L., Vogt, F., Voudris, V., Vranckx, P., Vrolix, M., Vydt, T., Webster, M., Wijns, W., Woody, W., Wykrzykowska, J., Yazdani, S., Yildiz, A., Yurlevich, D., Zauith, R., Zekanovic, D., Zhao, M., Zimarino, M., Zingarelli, A., Abdelsamad, A. Y., Abo Shaera, E. S., Afshar, M. S., Agatiello, C., Aguiar, P., Ahmad, A. M., Akin, I., Alameda, M., Alegría-Barrero, E., Alejos, R., Alkhashab, K., Alkutshan, R. S. A., Almorraweh, A., Altnji, I., Alvarez Iorio, C., Anchidin, O., Angel, J., Antonopoulos, A., Apshilava, G., Arana, C., Ashikaga, T., Assomull, R., Atef, S. Z., Azmus, A. D., Azzalini, L., Azzouz, A., Baglioni, P., Bampas, G., Basil, M. P., Baumbach, A., Besh, D., Bhushan Sharm, A., Bien Hsien, H., Bihui, L., Bing-Chen, L., Biryukov, S., Blatt, A., Bocchi, E., Boghdady, A., Bonarjee, V. V. S., Bosnjak, I., Bravo Baptista, S., Brinckman, S. L., Buchter, B., Burzotta, F., Cacucci, M., Cagliyan, C. E., Calabrò, P., Cernetti, C., Chávez Mizraym, R., Choo, W. S., Choudhury, R., Cicco, N., Cisneros Clavijo, P., Çitaku, H., Collet, J. P., Consuegra-Sánchez, L., Conte, M., Corral, J. M., Damonte, A., Dangoisse, V., Dastani, M., Della Rosa, F., Deora, S., Devadathan, S., Dharma, S., Di Giorgio, A., Diez, J. L., Dinesha, B., Duplančić, D., El Behwashi, M. F., Elghawaby, H., Elshahawy, O., Eskola, M. J., Etman, A., Eun Gyu, L., Fabiano, L., Facta, A., Fan, Y., Fang-Yang, H., Farag, E., Fathi, Y., Fazeli, N., Federico, P., Fereidoun, M. Z., Fernandez-Nofrerias, E., Flensted Lassen, J., Flessas, D., Fouad, H., Franco-Pelaez, J. A., Fu, Q., Furtado, R., Gadepalli, R., Gallino, R., Gasparetto, V., Gentiletti, A., Gholoobi, A., Ghosh, A. K., Gkizas, S., Golchha, S. K., Goncharov, A., Gössl, M., Götberg, M., Greco, F., Grundeken, M. J., Gupta, D., Gupta, S., Guray, U., Hahalis, G., Hakim Vista, J., Hamid, M. A., Hammoudeh, A., Hasan, A. R. I., Hatsumura, F. E., Heintzen, M. P., Helal, T., Hetherington, S., Hewarathna, U. I., Hioki, H., Hissein, F., Ho-Ping, Y., Homs, S., Huber, K., Ibarra, F. M., Ielasi, A., Ipek, E., Jambunathan, R., Jamshidi, P., Jarrad, I., Javier, W., Jensen, J., Jimenez-Quevedo, P., Kalpak, O., Kan, J., Kanaan, T., Kao, D. H. M., Karamfiloff, K., Karegren, A., Karjalainen, P. P., Kasabov, R., Katsimagklis, G. D., Kaul, U., Khan, A., Kiemeneij, E., Kiviniemi, T., Kleiban, A., Komiyama, N., Konteva, M., Koshy, G., Krepsky, A. M., Kuljit, S., Kulkarni, P., Kumar, V., Kuznetsov, I., Lai, G., Lateef, M. A., Lawand, S., Le Hong, T., Lettieri, C., Levy, G., Lindvall, P., Maitra, A., Makowski, M., Mamas, M. A., Mandal, S. C., Mangalanandan, P., Marin, R., Mashhadi, M., Matsukage, T., Meier, B., Milosavljevic, B., Miro, S. S., Mitov, A., Moeriel, M., Moguel, R., Mohanty, A., Montalescot, G., Mörsdorf, W., Moscato, F., Muniz, A., Muraglia, S., Myć, J., Nada, A., Nair, P., Namazi, M. H., Naraghipour, F., Nguyen, Q. N., Nicosia, A., Nikas, D., Ober, M., Ocaranza-Sánchez, R., Olivecrona, G., Pahlajani, D., Pandey, B. P., Parma, A., Parma, R., Patsilinakos, S. P., Pattam, J., Peddi, S., Perez, P. R., Peruga, J. Z., Pescoller, F., Petrov, I., Piatti, L., Pico-Aracil, F., Pina, J., Piroth, Z., Popa, V., Pourbehi, M. R., Pradhan, A. K., Prida, X. E., Purohit, B. V., Pyun, W. B., Quang Hung, D., Rada, I., Rafizadeh, O., Rahman, M. A., Rai, L., Ramsewak, A., Ravindran, R., Rodriguez De Leiras, O. S., Rodríguez Esteban, M., Roque Figueira, H., Saket, A., Sakhov, O., Saktheeswaran, M. K., Salachas, A., Sallam, A., Sampaolesi, A., Samy, A., Sanchis, J., Santaera, O., Santarelli, A., Santharaj, W. S., Sarango, B., Satheesh, S., Schmitz, T., Schühlen, H., Seewoosagur, R., Segev, A., Seisembekov, V., Semitko, S., Sengottuvelu, G., Sepulveda Varela, P., Sethi, A., Sharma, A., Sharma, R. K., Shi, Hy., Şimşek, M. A., Siqueira, B., Skalidis, E., Slawin, J., Sorokhtey, L., Spaulding, C., Srinivas, B., Srinivasan, M., Stakos, D., Stefanini, G., Stojkovic, S., Tacoy, G., Tawade, M., Tiecco, F., Tondi, S., Torresani, E. M., Tousek, P., Tran, T., Trantalis, G., Triantafyllou, K., Trivedi, R., Trivisonno, A., Tsui, K. L., Türkoğlu, C., Tzung-Dau, W., Ueno, H., Urban, U., Uretsky, B. F., Uscumlic, A., Venugopal, V., Verney, R., Vilar, J. V., Villacorta, V. G., Vishwanath, R., Vlachojannis, G. J., Vlachojannis, M., Vlad, V., Von Birgelen, C., Vukcevic, V., Wahab, A., Waksman, R., Wei-Wen, L., Weisz, G., Whittaker, A., Yadav, A., Yokoi, Y., Zacharoulis, A., Zahran, M., Zamani, J., Ziakas, A., Zimmermann, J. P., Adamo, M., Byrne, R. A., Baumbach, A., Haude, M., Windecker, S., Valgimigli, M., Aaroe, J., Abdeltawab, A. A., Accardi, R., Addad, F., Agostoni, P., Alajab, A., Alcazar, E., Alhabil, B., Altug Cakmak, H., Amico, F., Amoroso, G., Anderson, R., Ando, G., Andreou, A. Y., Antoniadis, D., Aquilina, M., Aramberry, L., Auer, J., Auffret, V., Ausiello, A., Austin, D., Avram, A., Ayman, E., Babunashvili, V., Bagur, R., Bakotic, Z., Balducelli, M., Ballesteros, S. M., Baptista, S., Baranauskas, A., Barbeau, G., Bax, M., Benchimol, C., Berroth, R., Biasco, L., Bilal, A., Binias, K., Blanco Mata, R., Boccuzzi, G., Bolognese, L., Boskovic, S., Bourboulis, N., Briguori, C., Bunc, M., Buysschaert, I., Calabro', P., Campo, G., Candiello, A., Caprotta, U. F., Cardenas, M., Carrilho-Ferreira, P., Carrizo, S., Caruso, M., Cassar, A., Cernigliaro, C., Chacko, G., Chamie, D., Clapp, B., Coceani, M., Colangelo, S., Colombo, A., Comeglio, M., Connaughton, M., Conway, D., Cortese, B., Cosgrave, J., Costa, F., Couvoussis, E., Crimi, G., Crook, R., Cruz-Alvarado, J. E., Curello, S., D'Ascenzo, F., D'Urbano, M., Dana, A., De Backer, O., De Carlo, M., De Cesare, N., De Iaco, G., De La Torre, H. J. M., De Oliveira Netoj, B., Devlin, G. P., Di Lorenzo, E., Diaz, A., Dina, C., Dorsel, T. H., Eberli, F. R., Echeverria, R., Eftychiou, C., Elguindy, A., Ercilla, J., Ernst, A., Esposito, G., Ettori, F., Eufracino, Ezquerra Aguilera, W., Falcone, C., Falu, R. M., Feres, F., Ferlini, M., Fernandez, G., Fernandez-Rodriguez, D., Fileti, L., Fischetti, D., Florescu, N., Formigli, D., Fouladvand, F., Franco, N., Fresco, C., Frigoli, E., Furmaniuk, J., Gabaldo, K., Galli, M., Galli, S., Garbo, R., Garducci, S., Garg, S., Gavrielatos, G., Gensch, J., Giacchi, G., Giunio, L., Giustino, G., Goldberg, L., Goldsmit, R., Gommeaux, A., Gosselin, G., Govorov, A., Gonzalez Godinez, H., Gross, E., Grosz, C., Guagliumi, G., Hadad, W., Hadadi, L., Hansen, P. R., Harb, S., Hatrick, R., Hayrapetyan, H. G., Hernandez-Enriquez, M., Ho Heo, J., Horvath, I. G., Huan Loh, P., Ibrahim, A. M., Ierna, S., Ilic, I., Imperadore, F., Ionescu-Silva, E., Jacksch, R., James, S., Janiak, B., Jensen, S. E., Jeroen, S., Jugessur, R. K., Kala, P., Kambis, M., Kanakakis, J., Karamasis, G., Karchevsky, D., Karpovskiy, A., Kayaert, P., Kedev, S., Kemala, E., Ketteler, T., Khan, S. Q., Kharlamov, A., Kiernan, T., Kiviniem, T., Koltowski, L., Koskinas, K. C., Kouloumpinis, A., Kraaijeveld, A. O., Krizanic, F., Krotz, B., Kuczmik, W., Kukreja, N., Kuksa, D., Yav, K., Kyriakos, D., Labrunie, A., Laine, M., Lapin, O., Larosa, C., Latib, A., Lattuca, B., Lauer, B., Lefevre, T., Legrand, V., Lehto, P., Leiva-Pons, J. L., Leone, A. M., Lev, G., Lim, R., Limbruno, U., Linares Vicente, J. A., Lindsay, S., Linnartz, C., Liso, A., Lluberas, R., Locuratolo, N., Lokshyn, S., Lunde, K., Lupi, A., Magnavacchi, P., Maia, F., Mainar, V., Mancone, M., Manolios, M. G., Mansour, S., Mariano, E., Marques, K., Martins, H., Mckenzie, D., Meco, S., Meemook, K., Mehmed, K., Melikyan, A., Mellwig, K. P., Mendiz, O. A., Merkulov, E., Mesquita, H. G., Mezzapelle, G., Miloradovic, V., Mohamed, S., Mohammed, B., Mohammed, F., Mohammed, K., Mohanad, A., Morawiec, B., More, R., Moreno-Martinez, F. L., Mrevlje, B., Muhammad, F., Naveri, H., Nazzaro, M. S., Neary, P., Negus, B. H., Nelson Durval, F. G., Nick, H., Nilva, E., Oldroyd, K. G., Olivares Asencio, C., Omerovic, E., Ortiz, M. A., Ota, H., Otasevic, P., Otieno, H. A., Paizis, I., Papp, E., Pasquetto, G., Patsourakos, N. G., Peels, J., Pelliccia, F., Pennacchi, M., Penzo, C., Perez, P., Perkan, A., Petrou, E., Phipathananunth, W., Pierri, A., Pinheiro, L. F., Pipa, J. L., Piva, T., Polad, J., Porto, I., Poveda, J., Predescu, L., Prog, R., Puri, R., Raco, D. L., Ramazan, O., Ramazzotti, V., Rao, S. V., Raungaard, B., Reczuch, K., Rekik, S., Rhouati, A., Rigattieri, S., Rodriguez-Olivares, R., Roik, M., Romagnoli, E., Roman, A. J., Routledge, H., Rubartelli, P., Rubboli, A., Ruiz-Garcia, J., Russo, F., Ruzsa, Z., Ryding, A., Saad, A., Sabate, M., Sabouret, P., Sadowski, M., Saia, F., Sanchez Perez, I., Santoro, G. M., Sarenac, D., Saririan, M., Sarma, J., Schuetz, T., Sciahbasi, A., Sebastian, M., Sebik, R., Sesana, M., Hur, S. -H., Sganzerla, P., Shalva, R., Sharma, S., Sheiban, I., Shein, K. K., Shiekh, I. A., Sinha, M., Slhessarenko, J., Smith, D., Smyth, D. W., Sonmez, K., Sood, N., Sourgounis, A., Srdanovic, I., Stables, R. H., Stefanini, G. G., Stewart, J., Stoyanov, N., Suliman, A. A., Suryadevara, R., Suwannasom, P., Tange Veien, K., Tauchert, S., Tebet, M., Testa, L., Thury, A., Tilsted, H. H., Tiroch, K., Torres, A., Tosi, P., Traboulsi, M., Trani, C., Tresoldi, S., Tsigkas, G., Tueller, D., Turri, M., Udovichenko, A. E., Uretsky, B., Van Der Harst, P., Van Houwelingen, K. G., Vandoni, P., Vandormael, M., Varbella, F., Venkitachalam, C. G., Vercellino, M., Vidal-Perez, R., Vigna, C., Vignali, L., Vogt, F., Voudris, V., Vranckx, P., Vrolix, M., Vydt, T., Webster, M., Wijns, W., Woody, W., Wykrzykowska, J., Yazdani, S., Yildiz, A., Yurlevich, D., Zauith, R., Zekanovic, D., Zhao, M., Zimarino, M., Zingarelli, A., Abdelsamad, A. Y., Abo Shaera, E. S., Afshar, M. S., Agatiello, C., Aguiar, P., Ahmad, A. M., Akin, I., Alameda, M., Alegria-Barrero, E., Alejos, R., Alkhashab, K., Alkutshan, R. S. 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J., Etman, A., Eun Gyu, L., Fabiano, L., Facta, A., Fan, Y., Fang-Yang, H., Farag, E., Fathi, Y., Fazeli, N., Federico, P., Fereidoun, M. Z., Fernandez-Nofrerias, E., Flensted Lassen, J., Flessas, D., Fouad, H., Franco-Pelaez, J. A., Fu, Q., Furtado, R., Gadepalli, R., Gallino, R., Gasparetto, V., Gentiletti, A., Gholoobi, A., Ghosh, A. K., Gkizas, S., Golchha, S. K., Goncharov, A., Gossl, M., Gotberg, M., Greco, F., Grundeken, M. J., Gupta, D., Gupta, S., Guray, U., Hahalis, G., Hakim Vista, J., Hamid, M. A., Hammoudeh, A., Hasan, A. R. I., Hatsumura, F. E., Heintzen, M. P., Helal, T., Hetherington, S., Hewarathna, U. I., Hioki, H., Hissein, F., Ho-Ping, Y., Homs, S., Huber, K., Ibarra, F. M., Ielasi, A., Ipek, E., Jambunathan, R., Jamshidi, P., Jarrad, I., Javier, W., Jensen, J., Jimenez-Quevedo, P., Kalpak, O., Kan, J., Kanaan, T., Kao, D. H. M., Karamfiloff, K., Karegren, A., Karjalainen, P. P., Kasabov, R., Katsimagklis, G. 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B., Quang Hung, D., Rada, I., Rafizadeh, O., Rahman, M. A., Rai, L., Ramsewak, A., Ravindran, R., Rodriguez De Leiras, O. S., Rodriguez Esteban, M., Roque Figueira, H., Saket, A., Sakhov, O., Saktheeswaran, M. K., Salachas, A., Sallam, A., Sampaolesi, A., Samy, A., Sanchis, J., Santaera, O., Santarelli, A., Santharaj, W. S., Sarango, B., Satheesh, S., Schmitz, T., Schuhlen, H., Seewoosagur, R., Segev, A., Seisembekov, V., Semitko, S., Sengottuvelu, G., Sepulveda Varela, P., Sethi, A., Sharma, A., Sharma, R. K., Shi, Hy., Simsek, M. A., Siqueira, B., Skalidis, E., Slawin, J., Sorokhtey, L., Spaulding, C., Srinivas, B., Srinivasan, M., Stakos, D., Stojkovic, S., Tacoy, G., Tawade, M., Tiecco, F., Tondi, S., Torresani, E. M., Tousek, P., Tran, T., Trantalis, G., Triantafyllou, K., Trivedi, R., Trivisonno, A., Tsui, K. L., Turkoglu, C., Tzung-Dau, W., Ueno, H., Urban, U., Uretsky, B. F., Uscumlic, A., Venugopal, V., Verney, R., Vilar, J. V., Villacorta, V. G., Vishwanath, R., Vlachojannis, G. J., Vlachojannis, M., Vlad, V., Von Birgelen, C., Vukcevic, V., Wahab, A., Waksman, R., Wei-Wen, L., Weisz, G., Whittaker, A., Yadav, A., Yokoi, Y., Zacharoulis, A., Zahran, M., Zamani, J., Ziakas, A., Zimmermann, J. P., and Cardiology
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Hirudin ,Percutaneous ,Antithrombin ,medicine.medical_treatment ,Psychological intervention ,030204 cardiovascular system & hematology ,medical ,0302 clinical medicine ,Peptide Fragment ,Surveys and Questionnaires ,Surveys and Questionnaire ,Medicine ,Bivalirudin ,030212 general & internal medicine ,Societies, Medical ,Transradial ,Anticoagulant ,Hirudins ,Middle Aged ,Recombinant Protein ,Recombinant Proteins ,Femoral Artery ,Radial Artery ,Cardiology ,acute coronary syndrome ,bivalirudin ,transradial ,adult ,antithrombins ,cardiology ,femoral artery ,hirudins ,humans ,middle aged ,peptide fragments ,percutaneous coronary intervention ,recombinant proteins ,societies, medical ,surveys and questionnaires ,attitude of health personnel ,radial artery ,Acute coronary syndrome ,Cardiology and Cardiovascular Medicine ,Human ,medicine.drug ,Adult ,medicine.medical_specialty ,Attitude of Health Personnel ,medicine.drug_class ,MEDLINE ,Antithrombins ,03 medical and health sciences ,societies ,Percutaneous Coronary Intervention ,Internal medicine ,Humans ,Acute Coronary Syndrome ,Peptide Fragments ,Management of acute coronary syndrome ,business.industry ,Percutaneous coronary intervention ,medicine.disease ,business - Abstract
AIMS Our aim was to report on a survey initiated by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) collecting the opinion of the cardiology community on the invasive management of acute coronary syndrome (ACS), before and after the MATRIX trial presentation at the American College of Cardiology (ACC) 2015 Scientific Sessions. METHODS AND RESULTS A web-based survey was distributed to all individuals registered on the EuroIntervention mailing list (n=15,200). A total of 572 and 763 physicians responded to the pre- and post-ACC survey, respectively. The radial approach emerged as the preferable access site for ACS patients undergoing invasive management with roughly every other responder interpreting the evidence for mortality benefit as definitive and calling for a guidelines upgrade to class I. The most frequently preferred anticoagulant in ACS patients remains unfractionated heparin (UFH), due to higher costs and greater perceived thrombotic risks associated with bivalirudin. However, more than a quarter of participants declared the use of bivalirudin would increase after MATRIX. CONCLUSIONS The MATRIX trial reinforced the evidence for a causal association between bleeding and mortality and triggered consensus on the superiority of the radial versus femoral approach. The belief that bivalirudin mitigates bleeding risk is common, but UFH still remains the preferred anticoagulant based on lower costs and thrombotic risks.
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- 2016
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5. P1811 Prognostic impact of different subtypes of severe aortic stenosis undergoing transcatheter aortic valve implantation
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Pal, M, primary, Dekany, G, additional, Mandzak, A, additional, Piroth, Z S, additional, Fontos, G, additional, and Andreka, P, additional
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- 2020
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6. Dual antiplatelet therapy duration after coronary stenting in clinical practice: results of an EAPCI survey
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V., Pescoller, F., Petropoulakis, P., Piatti, L., Picardi, E., Pieroni, D. M., Pina, J., Pinheiro, L. F., Pinto, F. J., Pipa, J. L., Piroth, Z., Pisano, F., Podbregar, M., Polak, G., Polimeni, A., Postadzhiyan, A., Postu, M., Poulimenos, L. E., Pow Chon Long, F., Poyet, R., Pradhan, A., Predescu, L. M., Prida, X. E., Saad, A., Prog, R., Pulikal, D. G. A., Qiangzhong, P. I., Radu, M. D., Rajendran, D., Ram Anil Raj, M. R., Ramazzotti, V., Rapacciuolo, A., Ratib, K., Raungaard, B., Raviola, E., Reppas, E., Reyes, J. A., Rezek, M., Riess, G. J., Rifaie, O., Rigattieri, S., Rissanen, T., Ristic, A. D., Rittger, H., Roberts, J., Rodriguez Saavedra, A., Roik, M., Roshan Rao, K., Routledge, H., Rubboli, A., Rudolph, T., Rudzitis, A., Ruiters, A., Ruiz Ros, J. A., Ruiz-Garcia, J., Ruiz-Nodar, J. M., Sabate, M., Sabnis, G., Sabouret, P., Sacra, C., Saghatelyan, M., Sahin, M., Said, S., Salachas, A. J., Salas Llamas, J. P., Salih, A., Sanchez, O. 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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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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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7. Five-year outcomes with PCI guided by fractional flow reserve
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Xaplanteris, P., Fournier, S., Pijls, N. H. J., Fearon, W. F., Barbato, E., Tonino, P. A. L., Engstrøm, T., Kääb, S., Dambrink, J. H., Toth, G. G., Rioufol, G., Piroth, Z., Witt, N., Fröbert, O., Kala, P., Linke, A., Jagic, N., Mates, M., Mavromatis, K., Samady, H., Irimpen, A., Oldroyd, K., Campo, G., Rothenbühler, M., Jüni, P., de Bruyne, B., Mulder, Barbara J. M., et al, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National de la Recherche Agronomique (INRA), Department of Cardiology, Örebro University, Cardiovascular Biomechanics, Cardiology, APH - Personalized Medicine, APH - Aging & Later Life, ACS - Heart failure & arrhythmias, Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM), CarMeN, laboratoire, Xaplanteris, Panagioti, Fournier, Stephane, Pijls, Nico H J, Fearon, William F, Barbato, Emanuele, Tonino, Pim A L, Engstrøm, Thoma, Kääb, Stefan, Dambrink, Jan-Henk, Rioufol, Gille, Toth, Gabor G, Piroth, Zsolt, Witt, Nil, Fröbert, Ole, Kala, Petr, Linke, Axel, Jagic, Nicola, Mates, Martin, Mavromatis, Kreton, Samady, Habib, Irimpen, Anand, Oldroyd, Keith, Campo, Gianluca, Rothenbühler, Martina, Jüni, Peter, and De Bruyne, Bernard
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st-segment elevation ,Male ,task-force ,Coronary Stenosi ,Platelet Aggregation Inhibitors/therapeutic use ,medicine.medical_treatment ,[SDV]Life Sciences [q-bio] ,Myocardial Infarction ,Coronary Disease ,Fractional flow reserve ,Kaplan-Meier Estimate ,030204 cardiovascular system & hematology ,Coronary artery disease ,0302 clinical medicine ,Drug-Eluting Stent ,030212 general & internal medicine ,Myocardial infarction ,guidelines ,Medicine (all) ,Angina Pectori ,Hazard ratio ,Drug-Eluting Stents ,General Medicine ,Middle Aged ,Fractional Flow Reserve ,myocardial-infarction ,3. Good health ,[SDV] Life Sciences [q-bio] ,Fractional Flow Reserve, Myocardial ,Antihypertensive Agent ,Coronary Disease/drug therapy ,Aged ,Angina Pectoris ,Antihypertensive Agents ,Coronary Stenosis ,Female ,Follow-Up Studies ,Humans ,Platelet Aggregation Inhibitors ,Retreatment ,Percutaneous Coronary Intervention ,Cardiology ,Platelet aggregation inhibitor ,management ,Human ,medicine.medical_specialty ,Angina Pectoris/therapy ,conservative treatment ,Revascularization ,Follow-Up Studie ,european-society ,NO ,03 medical and health sciences ,Internal medicine ,General & Internal Medicine ,medicine ,Myocardial Infarction/epidemiology ,Myocardial ,coronary ,Antihypertensive Agents/therapeutic use ,business.industry ,Platelet Aggregation Inhibitor ,prospective natural-history ,Percutaneous coronary intervention ,medicine.disease ,medical therapy ,Retreatment/statistics & numerical data ,Conventional PCI ,Coronary Stenosis/drug therapy ,business - Abstract
Background: we hypothesized that fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) would be superior to medical therapy as initial treatment in patients with stable coronary artery disease.Methods: among 1220 patients with angiographically significant stenoses, those in whom at least one stenosis was hemodynamically significant (FFR, ≤0.80) were randomly assigned to FFR-guided PCI plus medical therapy or to medical therapy alone. Patients in whom all stenoses had an FFR of more than 0.80 received medical therapy and were entered into a registry. The primary end point was a composite of death, myocardial infarction, or urgent revascularization.Results: a total of 888 patients underwent randomization (447 patients in the PCI group and 441 in the medical-therapy group). At 5 years, the rate of the primary end point was lower in the PCI group than in the medical-therapy group (13.9% vs. 27.0%; hazard ratio, 0.46; 95% confidence interval [CI], 0.34 to 0.63; PConclusions: in patients with stable coronary artery disease, an initial FFR-guided PCI strategy was associated with a significantly lower rate of the primary composite end point of death, myocardial infarction, or urgent revascularization at 5 years than medical therapy alone. Patients without hemodynamically significant stenoses had a favorable long-term outcome with medical therapy alone. (Funded by St. Jude Medical and others; FAME 2 ClinicalTrials.gov number, NCT01132495 .).
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- 2018
8. 1154FFR guided acute complete revascularization versus culprit lesion only treatment in patients presenting with STEMI and multi vessel disease; final 3-year outcome data from Compare-Acute trial
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Smits, P C, primary, Abdel-Wahab, M, additional, Neumann, F J, additional, Boxma-De Klerk, B M, additional, Laforgia, P L, additional, Lunde, K, additional, Schotborgh, C E, additional, Piroth, Z, additional, Horak, D, additional, Wlodarczak, A, additional, Ong, P J, additional, Hambrecht, R, additional, Angeras, O, additional, Richardt, G, additional, and Omerovic, E, additional
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- 2019
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9. P2267CTEPH patients long term follow-up: results from a single center
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Mladoniczky, S, primary, Szegedi, M, additional, Piroth, Z S, additional, Nemeth, J, additional, Ablonczy, L, additional, Andreka, P, additional, Temesvari, A, additional, and Balint, O H, additional
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- 2019
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10. P5513Impact of fractional flow reserve on surgical coronary revascularization strategy
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Fournier, S, primary, Toth, G G, additional, De Bruyne, B, additional, Kala, P, additional, Ribichini, F L, additional, Casselman, F L, additional, Ramos, R, additional, Piroth, Z, additional, Pellicano, M, additional, Penicka, M, additional, Mates, M, additional, Van Praet, F, additional, Stockman, B, additional, Degriek, I, additional, and Barbato, E, additional
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- 2018
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11. Fractional flow reserve-guided PCI for stable coronary artery disease
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De Bruyne B, Fearon WF, Pijls NH, Tonino P, Piroth Z, Jagic N, Mobius Winckler S, Rioufol G, Witt N, Kala P, MacCarthy P, Engstr?m T, Oldroyd K, Mavromatis K, Manoharan G, Verlee P, Frobert O, Curzen N, Johnson JB, Limacher A, N?esch E, J?ni P, FAME 2 Trial Investigators, BARBATO, EMANUELE, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National de la Recherche Agronomique (INRA), De Bruyne, B, Fearon, Wf, Pijls, Nh, Barbato, Emanuele, Tonino, P, Piroth, Z, Jagic, N, Mobius Winckler, S, Rioufol, G, Witt, N, Kala, P, Maccarthy, P, Engstr?m, T, Oldroyd, K, Mavromatis, K, Manoharan, G, Verlee, P, Frobert, O, Curzen, N, Johnson, Jb, Limacher, A, N?esch, E, J?ni, P, Fame, 2 Trial Investigators, and Cardiovascular Biomechanics
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Coronary Disease/drug therapy/mortality/physiopathology/*therapy ,medicine.medical_specialty ,medicine.medical_treatment ,Fractional Flow Reserve ,[SDV]Life Sciences [q-bio] ,610 Medicine & health ,Fractional flow reserve ,Kaplan-Meier Estimate ,Revascularization ,Coronary artery disease ,360 Social problems & social services ,Internal medicine ,medicine ,Myocardial Infarction/epidemiology/prevention & control ,Humans ,Myocardial ,Myocardial infarction ,Instantaneous wave-free ratio ,Proportional Hazards Models ,business.industry ,Hazard ratio ,Percutaneous coronary intervention ,General Medicine ,medicine.disease ,Adrenergic beta-Antagonists/therapeutic use ,Combined Modality Therapy ,Angiotensin Receptor Antagonists/therapeutic use ,3. Good health ,Surgery ,Angiotensin-Converting Enzyme Inhibitors/therapeutic use ,Conventional PCI ,Cardiology ,Percutaneous Coronary Intervention/adverse effects/*methods ,business - Abstract
International audience; BACKGROUND: We hypothesized that in patients with stable coronary artery disease and stenosis, percutaneous coronary intervention (PCI) performed on the basis of the fractional flow reserve (FFR) would be superior to medical therapy. METHODS: In 1220 patients with stable coronary artery disease, we assessed the FFR in all stenoses that were visible on angiography. Patients who had at least one stenosis with an FFR of 0.80 or less were randomly assigned to undergo FFR-guided PCI plus medical therapy or to receive medical therapy alone. Patients in whom all stenoses had an FFR of more than 0.80 received medical therapy alone and were included in a registry. The primary end point was a composite of death from any cause, nonfatal myocardial infarction, or urgent revascularization within 2 years. RESULTS: The rate of the primary end point was significantly lower in the PCI group than in the medical-therapy group (8.1% vs. 19.5%; hazard ratio, 0.39; 95% confidence interval [CI], 0.26 to 0.57; P\textless0.001). This reduction was driven by a lower rate of urgent revascularization in the PCI group (4.0% vs. 16.3%; hazard ratio, 0.23; 95% CI, 0.14 to 0.38; P\textless0.001), with no significant between-group differences in the rates of death and myocardial infarction. Urgent revascularizations that were triggered by myocardial infarction or ischemic changes on electrocardiography were less frequent in the PCI group (3.4% vs. 7.0%, P=0.01). In a landmark analysis, the rate of death or myocardial infarction from 8 days to 2 years was lower in the PCI group than in the medical-therapy group (4.6% vs. 8.0%, P=0.04). Among registry patients, the rate of the primary end point was 9.0% at 2 years. CONCLUSIONS: In patients with stable coronary artery disease, FFR-guided PCI, as compared with medical therapy alone, improved the outcome. Patients without ischemia had a favorable outcome with medical therapy alone. (Funded by St. Jude Medical; FAME 2 ClinicalTrials.gov number, NCT01132495.).
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- 2014
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12. 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, A. M., Alaarag, A. F., Accardi, R., Adel, A., Alcazar De La Torre, E., Alejos, R., Alfonso Jimenez, V., Alhashimi, H. M. M., Aljeboury, A., Almeida De Sousa, J., Almusawi, A., Alshaikha, M., Altaf, S., Altahmody, K. E. A., Alvarez Contreras, L. R., Amarasena, N., Amoroso, G., Anderson, R., Ando, G., Andrade, J., Andreou, A. Y., Angulo, J., Antonio, T., Aprigliano, G., Aquilina, M., Arafa, S. E. O., Aramberry, L., Arampatzis, C. A., Araujo, J. J., Asher, E., Ates, I., Athanasias, D., Auer, J., Auffret, V., Ayala, F. J., Baba, C., Baglioni, P., Bagur, R., Balam-Ortiz, E., Balducelli, M., Bam Pas, G., Barbash, I. M., Barbosa, A. H. P., Barbosa, R., Barnay, P., Barroso, L., Basti, A., Bax, M., Bayet, G., Beijk, M. A., Beltran, R., Berenguer Jofresa, A., Berroth, R., Berti, S., Berumen Dominguez, L. E., Bhasin, A., Bhaya, M., Bianco, M., Biasco, L., Bikicki, M., Bonarjee, V. V. S., Bonechi, F., Borges Santos, M., Boshev, M., Bouferrouk, A., Bounartzidi, M., Bousoula, E., Brie, D., Brtko, M., Brugaletta, S., Brull, D. J., Buchter, B., Buendia, R., Burzotta, Francesco, Butz, T., Buzzetti, F., Bychowiec, B., Cadeddu, M., Campanile, A., Carneiro, J. G., Carrilho-Ferreira, P., Carrillo Guevara, J. E., Carter, A. J., Casal-Heredia, H., Castiglioni, B., Castro Fabiano, L., Cavalcante Silva, R., Cavalcanti De Oliveira, D., Cavalcanti, R. C., Cavazza, C., Centemero, M. P., Chabane, H. K., Chamie, D., Chatzis, D., Chaves, A. J., Cheng, S., Chinchilla, H., Ciabatti, N., Cirillo, P., Citaku, H., Claeys, M. J., Clifford, C., Coceani, M., Coggiola, J., Cohen, D. J., Conway, D. S. G., Cornelis, K., Coroleu, S. F., Corral, J. M., Cortese, B., Coskun, U., Costa, R. A., Coste, P., Coufal, Z., Cox, S., Cozma, A., Crean, P., Crenshaw, M. H., Cristian, U., Cruz-Alvarado, J. E., 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, J. L., Dimitriadis, K., Dina, C., Doerner, O., Donahue, M., Donis, J., Drieghe, B., Drissi, M. F., Du Fretay, H., Dziewierz, A., Echavarria-Pinto, M., Echeverria Romero, R. G., Economou, F., Eftychiou, C., Egdell, R., El Hosieny, A., El Meguid, K., Elabbassi, W., Elesgerli, S., Elghetany, H., Elizondo, J. C., Elkahlout, A., Elrowiny, R., Elserafy, A. S., 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, J. O., Fresco, C., Fridrich, V., Furmaniuk, J., Gagnor, A., Galasso, G., Galeazzi, G. L., Galli, S., Galvez Villacorta, V., Gandolfo, C., Garcia, E., Garcia-Blas, S., Garducci, S., Garg, S., Garro, N., Gatto, L., Georgiou, M. G., Ghanem, I., Ghose, T., Giacchi, G., Giang, P. T., Giesler, T., Giovino, M., Girardi, P., Girasis, C., Giunio, L., Giustino, G., Glatthor, C., Glogar, H. D., Golledge, P., Gomez Moreno, J., Gomez Recio, M., Gommeaux, A., Grantalis, G., Greco, F., Grundeken, M. J., Grunert, S., Gudmundsdottir, I., Guenoun, M., Guerios, E., Gupta, R., Gupta, S., Gutierrez, C., Hafeez, I., Halvorsen, S., Hamed Hussein, G. A., Hammoudeh, A., Hansen, P. R., Harb, S., Hawas, J. M., Hayrapetyan, H., Heintzen, M. P., Hengstenberg, C., Herity, N., Hernandez, F., Heyse, A., Hicham, D., Hildick-Smith, D., Hill, J., Hillani, A., Hiltrop, N., Hiramori, A., Hobson, A. R., Homan, D. J., Hooda, A., Ielasi, A., Ierna, S., Iftikhar, A. K., 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, Q. H., Joksas, V., Jovic, D., Junejo, S., Kallel, R., Kamal, A., Kamiya, H., Kannan, D., Kantaria, M., Kapetanopoulos, A., Kara Ali, B., Karjalainen, P. P., Karthikeyan, V. J., 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, S. D., Krizanic, F., Krsticevic, L., Kuex, H., Kukreja, N., Kulic, M., Kulikovskikh, Y. V., Kulkarni, P., Kumar, N., Kumar Soni, A., Kuzmenko, E., L'Allier, P. L., Langner, O., Lapin, O., Lauer, B., Leclercq, F., Leibundgut, G., Leon Aliz, E., Leon, C., Leon, K., Leoncini, M., Leone, A. M., Leroux, L., Lesiak, M., Letilovic, T., Lev, E., Linares Vicente, J. A., Lindsay, S., Loh, P. H., Loncar, G., Loo, B., Lopez, M. B., 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, R. E., Maresta, A., Marinho, G. E., Marino, R. L., Marinucci, L., Martins, H. C., Martins, J., Mashayekhi, K., Masood, A., Maurer, E., Mavrogianni, A. D., Mazurek, T., Medina, A., Mehilli, J., Mellwig, K. P., Mendez, M., Mendiz, O. A., Meneses, A., Mercado, L. A., Mereuta, A., Mezzapelle, G., Milanovic, N., Mohamed, S. M., Mohanad, A., Mohanty, A., Moorthy, N., Morales, F. J., More, R., Moreno Samos, J. C., Moreno-Martinez, F. L., 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, H. T., Niess, G. S., Nikas, D. N., Niroomand, F., Niva, J., Nogueira, J. W., Nombela-Franco, L., Notrica, M., Nouri, B., Nugue, O., Nunes, G. L., Ober, M., Ochoa, J., Oh, J. H., Ojeda, S., Oktay Tureli, H., Olowe, Y., Oluseun, A., Opolski, G., Ornelas, C. E., Otasevic, P., Ozturk, A., Padilla, F., Pagny, J. Y., Paolantonio, D., Papaioannou, G. I., Parodi, G., Patil, S. N., Pavei, A., Pavia, A., Pavlidis, A., Pell, A., Percoco, G. F., Pernasetti, L. V., Pescoller, F., Petropoulakis, P., Piatti, L., Picardi, E., Pieroni, D. M., Pina, J., Pinheiro, L. F., Pinto, F. J., Pipa, J. L., Piroth, Z., Pisano, F., Podbregar, M., Polak, G., Polimeni, A., Postadzhiyan, A., Postu, M., Poulimenos, L. E., Pow Chon Long, F., Poyet, R., Pradhan, A., Predescu, L. M., Prida, X. E., Saad, A., Prog, R., Pulikal, D. G. A., Qiangzhong, P. I., Radu, M. D., Rajendran, D., Ram Anil Raj, M. R., Ramazzotti, V., Rapacciuolo, A., Ratib, K., Raungaard, B., Raviola, E., Reppas, E., Reyes, J. A., Rezek, M., Riess, G. J., Rifaie, O., Rigattieri, S., Rissanen, T., Ristic, A. D., Rittger, H., Roberts, J., Rodriguez Saavedra, A., Roik, M., Roshan Rao, K., Routledge, H., Rubboli, A., Rudolph, T., Rudzitis, A., Ruiters, A., Ruiz Ros, J. A., Ruiz-Garcia, J., Ruiz-Nodar, J. M., Sabate, M., Sabnis, G., Sabouret, P., Sacra, C., Saghatelyan, M., Sahin, M., Said, S., Salachas, A. J., Salas Llamas, J. P., Salih, A., Sanchez, O. D., 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, L. A., Sesana, M., Sethi, A., Sgueglia, G. A., Shaheen, S., Shahri, H., Sheiban, I., Shyu, K. G., Silva, C. E. F., Sionis, D., Siqueira, D. A., Siqueira, M. J., Smits, P., Sobhy, M., Sokolov, M., Soliman, S., Somani, A. N., Sridhar, G., Stakos, D., Stasek, J., Stefanini, G., Steigen, T. K., Stewart, Stipal, R., Stochino, M. L., Stoel, M. G., Subla, R. M., Suliman, A., Summaria, F., Stoyanov, N., Syed, A. A., 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, H. H., Tomasik, A. R., 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, F. T., Urban, P., Uren, N., Uretsky, B. F., Uribe, C. E., Usman, B., Valadez Molina, F., Van Houwelingen, K. G., Vandormael, M., Varvarovsky, I., Vassilis, V., Velasquez, D., Verdoia, M., Vermeersch, P., Vidal-Perez, R., Vinesh, J., Violini, R., Vista, J. H., Vogt, F., Vogt, M., Vokac, D., Vom Dahl, J., Vranckx, P., Wahab, A., Wang, R., Wang, T. D., Wani, S., Weisz, S. H., Werner, G. S., Wilkinson, J. R., Wolf, A., Youssef, A., Yumoto, K., Zaderenko, N., Zaghloul Darwish, A. M., Zahn, R., Zaro, T., Zavalloni, D., Zbinden, R., Zekanovic, D., Zhang, B., Zhang, C., Zhang, Y. J., Zhonghan, N., Zingarelli, A., Zueco, J., Zuhairy, H., Abbate, A., Abdel Hamid, M., Abdelmegid, M. A. 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. P., Gafoor, S., Gallo, S., Gaspardone, A., Gavrilescu, D., Gentiletti, A., Gilard, M., Giovannelli, F., Gonzalez Pacheco, I., Gonzalo, N., Grajek, S., Gurgel De Medeiros, J. P., Haine, S., Hakim, D., Hakim Vista, J. J., Hallani, H., Hamid, M., Helft, G., Heppell, R. M., Hernandez-Enriquez, M., Hlinomaz, O., Ho Choo, E., Huqi, A., Hurtado, E. O., Iakovou, I., Iosseliani, D., Janssens, L., Jean, M., Jensen, J. K., Jesudason, P., Jimenez Diaz, V. A., Karchevsky, D., Karpovskii, A., Katsimagklis, G., Kereiakes, D., Kersanova, N. C., Kesavan, S., Khaled, H., Khalil, S. A., Kiatchoosakun, S., Kim, K. S., Kirma, C., Koltowski, L., Konteva, M., Kozinski, L., Kuehn, C. R., Kumar, S., Kyriakakis, C. G., Laanmets, P., Labrunie, A., Ladwiniec, A., Lai, G., Laine, M., Latib, A., Lattuca, B., Lazarevic, A. M., Lee, K. S., Legrand, V., Leiva, G., Lester, N., Levchyshyna, O., Livia, G., Londero, H. F., Luha, O., Lupi, A., Lupkovics, G., Maaliki, S., Maeng, M., Mahr, N. 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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., Webster, M., Burzotta F. (ORCID:0000-0002-6569-9401), Valgimigli, M., Costa, F., Byrne, R., Haude, M., Baumbach, A., Windecker, S., Aaroe, J., Aasa, M., Abdel-Salam, A. M., Alaarag, A. F., Accardi, R., Adel, A., Alcazar De La Torre, E., Alejos, R., Alfonso Jimenez, V., Alhashimi, H. M. M., Aljeboury, A., Almeida De Sousa, J., Almusawi, A., Alshaikha, M., Altaf, S., Altahmody, K. E. A., Alvarez Contreras, L. 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M., Suliman, A., Summaria, F., Stoyanov, N., Syed, A. A., 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, H. H., Tomasik, A. R., 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, F. T., Urban, P., Uren, N., Uretsky, B. F., Uribe, C. E., Usman, B., Valadez Molina, F., Van Houwelingen, K. G., Vandormael, M., Varvarovsky, I., Vassilis, V., Velasquez, D., Verdoia, M., Vermeersch, P., Vidal-Perez, R., Vinesh, J., Violini, R., Vista, J. H., Vogt, F., Vogt, M., Vokac, D., Vom Dahl, J., Vranckx, P., Wahab, A., Wang, R., Wang, T. D., Wani, S., Weisz, S. H., Werner, G. S., Wilkinson, J. R., Wolf, A., Youssef, A., Yumoto, K., Zaderenko, N., Zaghloul Darwish, A. M., Zahn, R., Zaro, T., Zavalloni, D., Zbinden, R., Zekanovic, D., Zhang, B., Zhang, C., Zhang, Y. J., Zhonghan, N., Zingarelli, A., Zueco, J., Zuhairy, H., Abbate, A., Abdel Hamid, M., Abdelmegid, M. A. 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. P., Gafoor, S., Gallo, S., Gaspardone, A., Gavrilescu, D., Gentiletti, A., Gilard, M., Giovannelli, F., Gonzalez Pacheco, I., Gonzalo, N., Grajek, S., Gurgel De Medeiros, J. P., Haine, S., Hakim, D., Hakim Vista, J. J., Hallani, H., Hamid, M., Helft, G., Heppell, R. M., Hernandez-Enriquez, M., Hlinomaz, O., Ho Choo, E., Huqi, A., Hurtado, E. O., Iakovou, I., Iosseliani, D., Janssens, L., Jean, M., Jensen, J. K., Jesudason, P., Jimenez Diaz, V. A., Karchevsky, D., Karpovskii, A., Katsimagklis, G., Kereiakes, D., Kersanova, N. C., Kesavan, S., Khaled, H., Khalil, S. A., Kiatchoosakun, S., Kim, K. S., Kirma, C., Koltowski, L., Konteva, M., Kozinski, L., Kuehn, C. R., Kumar, S., Kyriakakis, C. G., Laanmets, P., Labrunie, A., Ladwiniec, A., Lai, G., Laine, M., Latib, A., Lattuca, B., Lazarevic, A. M., Lee, K. S., Legrand, V., Leiva, G., Lester, N., Levchyshyna, O., Livia, G., Londero, H. F., Luha, O., Lupi, A., Lupkovics, G., Maaliki, S., Maeng, M., Mahr, N. 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., Webster, M., and Burzotta F. (ORCID:0000-0002-6569-9401)
- 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.
- Published
- 2015
13. Thrombin-receptor antagonist vorapaxar in acute coronary syndromes
- Author
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Tricoci, P, Huang, Z, Held, C, Moliterno, Dj, Armstrong, Pw, Van de Werf, F, White, Hd, Aylward, Pe, Wallentin, L, Chen, E, Lokhnygina, Y, Pei, J, Leonardi, S, Rorick, Tl, Kilian, Am, Jennings, Lh, Ambrosio, G, Bode, C, Cequier, A, Cornel, Jh, Diaz, R, Erkan, A, Huber, K, Hudson, Mp, Jiang, L, Jukema, Jw, Lewis, Bs, Lincoff, Am, Montalescot, G, Nicolau, Jc, Ogawa, H, Pfisterer, M, Prieto, Jc, Ruzyllo, W, Sinnaeve, Pr, Storey, Rf, Valgimigli, M, Whellan, Dj, Widimsky, P, Strony, J, Harrington, Ra, Mahaffey, Kw, Huo, Y, Lixin, J, Isaza, D, Grande, P, Laine, M, Wong, L, Ofner, P, Yamaguchi, T, Park, Sj, Nordrehaug, Je, Providencia, L, Cheem, Th, Dalby, A, Betriu, A, Chen, Mf, Verheugt, F, Frye, Rl, Hochman, J, Steg, Pg, Bailey, Kr, Easton, Jd, Lincoff, A, Underwood, Fd, Wrestler, J, Larson, D, Vandyne, B, Kilian, A, Harmelin-Kadouri, R, Layton, L, Lipka, L, Petrauskas, S, Qidwai, M, Sorochuck, C, Temple, T, Mason, D, Sydlowski, D, Gallagher, B, Villasin, A, Beernaert, A, Douglas, S, Garrett, J, Wiering, J, Adriaenssens, T, Ganame, J, Hulselmans, M, Katz, Jn, Kayaert, P, La Gerche, A, Onsea, K, Zalewski, J, Johnson, A, O'Briant, J, Smith, M, Akerblom, A, Armaganijan, L, Bertolami, A, Brennan, M, da Ponte Nacif SA, de Campos Gonzaga, C, Dequadros, A, Déry, Jp, Dev, S, Ducrocq, G, Eapen, Zp, Echenique, L, Eggers, K, Garcia, H, Guimaraes, Hp, Hagstrom, E, Hanet, C, James, S, Jonelid, B, Kolls, Bj, Leiria, T, Leite, R, Lombardi, C, Lopes, Rd, Malagutti, P, Mathews, R, Mehta, Rh, Melloni, C, Piccini, Jp, Rodriques Soares, P, Roe, Mt, Shah, Br, Stashenko, G, Szczech, La, Truffa, A, Varenhorst, C, Vranckx, P, Williams, J, Kilaru, R, White, Ja, Binkowitz, B, He, W, Ramos, Ms, Hasbani, E, Farras, Ha, Luz del Valle, L, Zapata, G, Centeno, Ep, Hominal, M, Beloscar, J, Panno, M, Berli, M, Carlevaro, O, Wasserman, T, Lembo, L, Diez, F, Bettinotti, M, Allall, O, Macin, S, Hii, C, Bett, N, Aroney, C, Roberts-Thomson, P, Arstall, M, Horowitz, J, Prasan, A, Farshid, A, Rankin, J, Duffy, S, Sinhal, A, Hendricks, R, Waites, J, Hill, A, French, J, Adams, M, Soward, A, Dick, R, Jepson, N, Nelson, G, Thompson, P, Neunteufl, T, Pachinger, O, Leisch, F, Siostrzonek, P, Roithinger, F, Pieske, B, Weber, H, Eber, B, Zenker, G, Sinnaeve, P, Roosen, J, Vervoort, G, Coussement, P, Striekwold, H, Boland, J, Van Dorpe, A, Dujardin, K, Mertens, D, Vanneste, L, Celen, H, Lesseliers, H, Vrolix, M, Leone, A, De Maeseneire, S, Hellemans, S, Silva, Fa, Franken, M, Moraes JB Jr, Mora, R, Michalaros, Y, Perin, M, Guimaraes, Ae, da Silva DG, Mattos, Ma, Alves AR Jr, Hernandes, Me, Golin, V, da Silva SA, Ardito, W, Dery, Jp, Mukherjee, A, Tanguay, Jf, Kornder, J, Lutchmedial, S, Degrace, M, Klinke, P, Constance, C, Nogareda, G, Wong, G, Macdonald, P, Senaratne, M, Rupka, D, Halperin, F, Ramanathan, K, Natarajan, M, Lai, C, Brossoit, R, Tymchak, W, Rose, B, Dupuis, R, Mansour, S, Bata, I, Zadra, R, Turek, M, Madan, M, Le May, M, Leon, L, Perez, L, Yovaniniz, P, Pedemonte, O, Campos, P, Pincetti, C, Sepulveda, P, Li, W, Zhao, R, Li, Z, Yang, Y, Chen, J, Li, H, Jiang, Y, Li, D, Qu, P, Sun, Y, Zheng, Y, Zhou, C, Zhang, F, Wei, M, Wang, D, Lemus, J, Fernandez, Rl, Jaramillo, C, Ochoa, J, Velez, S, Cano, N, Lutz, J, Botero, R, Jaramillo, M, Saaib, J, Sanchez, G, Hernandez, H, Mendoza, F, Rizcala, A, Urina, M, Polasek, R, Motovska, Z, Zemanek, D, Ostransky, J, Kettner, J, Spinar, J, Groch, L, Ramik, C, Stumar, J, Linhart, A, Pleva, L, Niedobova, E, Macha, J, Vojacek, J, Stipal, R, Galatius, S, Eggert, S, Mickley, H, Egstrup, K, Pedersen, O, Hvilsted, L, Sykulski, R, Skagen, K, Dodt, K, Klarlund, K, Husted, S, Jensen, G, Melchior, T, Sjoel, A, Steffensen, Fh, Airaksinen, Ke, Laukkanen, Ja, Syvanne, Ms, Kotila, Mj, Mikael, K, Naveri, Hk, Hekkala, Am, Mustonen, Jn, Halkosaari, M, Ohlmann, P, Khalife, K, Dibon, O, Hirsch, Jl, Furber, A, Nguyen-Khac, Jo, Delarche, N, Probst, V, Lim, P, Bayet, G, Dauphin, R, Levai, L, Galinier, M, Belhassane, A, Wiedemann, Jy, Fouche, R, Coisne, D, Henry, P, Schiele, F, Boueri, Z, Vaquette, B, Davy, Jm, Cottin, Y, D'Houdain, F, Danchin, N, Cassat, C, Messner, P, Elbaz, M, Coste, P, Zemour, G, Maupas, E, Feldman, L, Soto, Fx, Ferrari, E, Haltern, G, Heuer, H, Genth-Zotz, S, Loges, C, Stellbrink, C, Terres, W, Ferrar, M, Zeymer, U, Brachmann, J, Mudra, H, Vohringer, Hf, vom Dah, J, Kreuzer, J, Hill, S, Kleinertz, K, Kadel, C, Appel, Kf, Nienabe, C, Behrens, S, Frantz, S, Mehrhof, F, Krings, P, Hengstenberg, C, Lueders, S, Hanefel, C, Krulls-Munch, J, Dorse, T, Leschke, M, Nogai, K, Butter, C, Darius, H, Fichtlscherer, Hp, Schmitt, C, Kasisk, Hp, Dorr, M, Fran, N, Jereczek, M, Wiemer, M, Nickenig, G, Boudriot, E, Werner, G, Altila, T, Strasser, R, Baldus, S, Desaga, M, Buerke, M, Land, S, Schunkert, H, Schulze, Ho, Holmer, S, Sohn, Hy, Burkhardt, W, Lauer, B, Schwimmbeck, P, Schoeller, R, Lapp, H, Gross, M, Kindermann, I, Schuster, P, Yu, Cm, Lee, S, Merkely, B, Apro, D, Lupkovics, G, Edes, I, Ungi, I, Piroth, Z, Csapo, K, Dezsi, Ca, Herczeg, B, Sereg, M, Butnaru, A, Lewis, B, Rosenschein, U, Mosseri, M, Turgeman, Y, Pollak, A, Shotan, A, Hammerman, H, Rozenman, Y, Gottlieb, S, Atar, S, Weiss, A, Marmor, A, Iakobishvili, Z, Mascia, F, De Cesare, N, Piovaccari, G, Ceravolo, R, Fiscella, A, Salvioni, A, Silvestri, O, Moretti, L, Severi, S, Carmina, Mg, De Caterina, R, Fattore, L, Terrosu, P, Trimarco, B, Ardissino, D, Uguccioni, L, Auguadro, C, Gregorio, G, De Ferrari, G, Testa, R, Evola, R, De Servi, S, Sganzerla, P, Vassanelli, C, Brunelli, C, Scherillo, M, Tamburino, C, Limido, A, Luzza, F, Percoco, Gf, Sinagra, G, Volpe, M, Crea, F, Fedele, F, Rasetti, G, Cinelli, F, Merlini, P, Sisto, F, Biancoli, S, Fresco, C, Corrada, E, Casolo, G, Santini, M, D'Alessandro, B, Antoniucci, D, Tuccillo, B, Assennato, P, Puccioni, E, Pasquetto, G, Perna, Gp, Morgagni, G, Takizawa, K, Kato, K, Oshima, S, Yagi, M, Asai, T, Kamiya, H, Hirokami, M, Sakota, S, Sueyoshi, A, Shimomura, H, Hashimoto, T, Miyahara, M, Matsumura, T, Nakao, K, Kakuta, T, Nakamura, S, Nishi, Y, Kawajiri, K, Nagai, Y, Takahashi, A, Ikari, Y, Hara, K, Koga, T, Fujii, K, Tobaru, T, Tsunoda, R, Uchiyama, T, Hirayama, H, Fujimoto, K, Sakurai, S, Tanigawa, T, Ohno, M, Yamamoto, E, Ikuta, S, Kato, A, Kikuta, K, Takami, A, Chong, Wp, Ong, Tk, Yusof, A, Maskon, O, Kahar, A, Breedveld, Rw, Bendermacher, Pe, Hamer, Bj, Oude Ophuis AJ, Nierop, Pr, Westendorp, Ic, Beijerbacht, Hp, Herrman, Jp, van 't Hof AW, Troquay, Rp, van der Meer, P, Peters, Rh, van Rossum, P, Liem, A, Pieterse, Mg, van Eck JW, van der Zwaan, C, Pasupati, S, Elliott, J, Tisch, J, Hart, H, Luke, R, Scott, D, Ternouth, I, White, H, Hamer, A, Harding, S, Wilkins, G, O'Meeghan, T, Harrison, N, Nilsen, D, Thalamus, J, Aaberge, L, Brunvand, H, Lutterbey, G, Omland, Tm, Eritsland, J, Wiseth, R, Aase, O, Campos, C, Horna, M, Toce, L, Salazar, M, Przewlocki, T, Ponikowski, P, Kasprzak, J, Kopaczewski, J, Musial, W, Mazurek, W, Kawecka-Jaszcz, K, Pluta, W, Dobrzycki, S, Loboz-Grudzien, K, Lewczuk, J, Karwowski, D, Grajek, S, Dudek, D, Trusz-Gluza, M, Kornacewicz-Jach, Z, Gil, R, Ferreira, J, Gavina, C, Ferreira, R, Martins, D, Garcia-Rinaldi, R, Ufret, R, Vazquez-Tanus, J, Banchs, H, Wong, A, Tan, Hc, Guerra, M, Ebrahim, I, Roux, J, Blomerus, P, Saaiman, A, Corbett, C, Pillay, T, Freeman, V, Horak, A, Zambakides, C, Burgess, L, Yoon, Jh, Ahn, Th, Gwon, Hc, Seong, Iw, Kim, Hs, Jeong, Mh, Kim, Yd, Chae, Sc, Hernandez, Jm, Pique, M, Fernandez Portales, J, Paz, Ma, Lopez Palop, R, Iniguez, A, Diaz Fernandez, J, Alvarez, P, Sanz, E, Heras, M, Sala, J, Goicolea, J, Cruz Fernandez, J, Serra, A, Fernandez Ortiz, A, Calle, G, Barriales, V, Albarran, A, Curos, A, Molano Casimiro FJ, Suarez, Ma, Franco, Sn, Bayon, J, Suarez, J, Belchi, J, Moreu, J, San Martin, M, Melgares Moreno, R, Aguirre Salcedo, J, Gonzalez Juanatey JR, Martinez Romero, P, Galache Osuna JG, Albertsson, P, Diderholm, E, Lycksell, M, Rasmanis, G, Swahn, E, Cherfan, P, Christensen, K, Lundman, P, Larson, Le, Vasko, P, Pripp, Cm, Johansson, A, Moccetti, T, Corti, R, Pieper, M, Mach, F, Eberli, F, Jeger, R, Rickli, H, Vogt, P, Windecker, S, Wu, Cj, Kao, Hl, Charng, Mj, Chang, Kc, Chen, Zc, Tsa, Cd, Shyu, Kg, Lai, Wt, Hsieh, Ic, Hou, Jy, Yeh, Hi, Ueng, Kc, Yin, Wh, Timurkaynak, T, Yigit, Z, Yilmaz, M, Boyaci, A, Sahin, M, Goktekin, O, Bozkurt, E, Ercan, E, Yildirir, A, Muthusamy, R, Keeling, P, Levy, T, Zaman, A, Cohen, A, Gorog, D, Baumbach, A, Oldroyd, K, Kadr, H, Tait, G, Bellenger, N, Davis, G, Shakespeare, C, Senior, R, Bruce, D, Uren, N, Trouton, T, Ahsan, A, Hamed, A, Malik, I, Sarma, J, Millar-Craig, M, Robson, H, Kennon, S, Sprigings, D, Brodie, B, Kang, Gs, Thomas, G, Cheng, Sc, Espinoza, A, Kassas, S, Jafar, Z, Kumar, P, Izzo, M, Wiseman, A, Chandna, H, Felten, W, D'Urso, M, Gudipati, Cr, Coram, R, Gill, S, Bengtson, J, Chang, M, Raisinghani, A, Blankenship, J, Harbor, Wf, Kraft, P, Ashraf, R, Chambers, J, Albirini, A, Malik, A, Ziada, K, Slepian, M, Taussig, A, Vernon, H, Jetty, P, Islam, Ma, Canaday, D, Martin, T, Burchenal, Jj, Gencheff, N, Nygaard, T, Panchal, V, Merritt, R, Abrahams, L, Lambert, C, Reyes, P, Leimbach, W, Chhabra, A, Caputo, R, Imburgia, M, Erickson, B, Kleiman, N, Hunter, J, Dehning, M, Graham, B, Strain, J, White, Jk, Mcgarvey, J Jr, Henderson, D, Treasure, C 2nd, Mirro, M, Pancholy, S, Helmy, T, Westerhausen, D, Dib, N, Penny, W, Kim, H, Degregorio, M, Jay, D, Kmonicek, J, Berlowitz, M, Starling, M, Langevin, E, Nelson, R, Singer, A, Siachos, A, Gibson, G, Parrott, C, Held, J, Puleo, P, Wolford, T, Omar, B, Brilakis, E, Lewis, S, Heller, L, Brener, S, Addo, T, Lieberman, S, Eisenberg, D, Feldman, R, Waksman, R, Waltman, J, Schulman, S, Bounds, C, Voyce, S, Batchelor, W, Dobies, D, Pasnoori, V, Chandrashekhar, Y, Vetrovec, G, Azrin, M, Spriggs, D, Hirsch, C, Smucker, M, Chetcuti, S, Stella, R, Levite, H, Shoukfeh, M, Vidovich, M, Saucedo, J, Fintel, D, Low, R, Gellman, J, Ahsan, C, Unks, Dm, Tolleson, T, Ceccoli, H, Aggarwal, K, Bhaktaram, V, Olson, C, Decaro, M, Kaluski, E, Mehta, V, Puma, J, Singh, V, Fulmer, J, Lewis, D, Khadra, S, Staniloae, C, East, M, Sundram, Ps, Anderson, J, Wasserman, H, Guy, D, Brill, D, Kruse, K, Ebrahimi, R, Nguyen, T, Keating, F, Srivastava, R, Wassmer, P, Todd, J 3rd, Stein, M, Hamzeh, I, Laxson, D, Hodson, R, Puri, S, Vijayaraghavan, K, Gazmuri, R, Chu, A, Vijay, N, Rabinowitz, A, Block, T, Agarwal, H, Martin, J, Zetterlund, P, Fortuin, D, Macdonell, A 3rd, Zouzoulas, S, Chepuri, V, Schmalfuss, C, Karve, M, Aviles, R, Lieberman, E, Amlani, M, Murphy, S, Shapiro, T, Herzog, E, Ariani, K, Bhagwat, R, Hockstad, E, Kai, W, Saririan, M, Roth, R, Weiland, F, Atassi, K, Harjai, K, Muhlestein, J, Marsh, R, Shokooh, S, Nahhas, A, Labroo, A, Mayor, M, Koshy, S, Tariq, M, Rayos, G, Jones, S, Klugherz, B, Dewey, R, Rashid, Hu, Wohns, D, Feiring, A, Bowles, M, Rohrbeck, S, Monroe, Vs, De Gottlieb, A, Gumm, D, Brown, C 3rd, Chang, D, Kalaria, V, Minisi, A, Joumaa, M, Josephson, R, Kleczka, J, Silver, K, Coleman, P, Brachfeld, C, Saltiel, F, Reiner, J, Carell, E, Hanovich, G, Rosenberg, M, Das, G, Blick, D, and Universitat de Barcelona
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Male ,Pyridines ,medicine.medical_treatment ,Kaplan-Meier Estimate ,law.invention ,Lactones ,Randomized controlled trial ,law ,Thrombin receptor antagonist ,clopidogrel ,placebo ,thienopyridine derivative ,vorapaxar ,antithrombocytic agent ,lactone ,proteinase activated receptor 1 ,pyridine derivative ,Coronary Artery Bypass ,Vorapaxar ,Cardiovascular diseases [NCEBP 14] ,Drugs ,General Medicine ,Middle Aged ,Combined Modality Therapy ,Cardiovascular diseases ,Cardiovascular Diseases ,Cardiology ,Platelet aggregation inhibitor ,Drug Therapy, Combination ,Female ,Plaquetes sanguínies ,Intracranial Hemorrhages ,Major bleeding ,Medicaments ,medicine.drug ,medicine.medical_specialty ,Acute coronary syndrome ,Bypass cardiopulmonary ,Hemorrhage ,Pharmacotherapy ,Blood platelets ,Double-Blind Method ,Angioplasty ,Internal medicine ,medicine ,Humans ,Receptor, PAR-1 ,Acute Coronary Syndrome ,Aged ,business.industry ,Malalties cardiovasculars ,medicine.disease ,Surgery ,Bypass cardiopulmonar ,business ,Platelet Aggregation Inhibitors ,Follow-Up Studies - Abstract
Item does not contain fulltext BACKGROUND: Vorapaxar is a new oral protease-activated-receptor 1 (PAR-1) antagonist that inhibits thrombin-induced platelet activation. METHODS: In this multinational, double-blind, randomized trial, we compared vorapaxar with placebo in 12,944 patients who had acute coronary syndromes without ST-segment elevation. The primary end point was a composite of death from cardiovascular causes, myocardial infarction, stroke, recurrent ischemia with rehospitalization, or urgent coronary revascularization. RESULTS: Follow-up in the trial was terminated early after a safety review. After a median follow-up of 502 days (interquartile range, 349 to 667), the primary end point occurred in 1031 of 6473 patients receiving vorapaxar versus 1102 of 6471 patients receiving placebo (Kaplan-Meier 2-year rate, 18.5% vs. 19.9%; hazard ratio, 0.92; 95% confidence interval [CI], 0.85 to 1.01; P=0.07). A composite of death from cardiovascular causes, myocardial infarction, or stroke occurred in 822 patients in the vorapaxar group versus 910 in the placebo group (14.7% and 16.4%, respectively; hazard ratio, 0.89; 95% CI, 0.81 to 0.98; P=0.02). Rates of moderate and severe bleeding were 7.2% in the vorapaxar group and 5.2% in the placebo group (hazard ratio, 1.35; 95% CI, 1.16 to 1.58; P
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- 2012
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14. Fractional flow reserve-guided PCI for stable coronary artery disease
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de Bruyne, B., Fearon, W.F., Pijls, N.H.J., Barbato, E., Tonino, P., Piroth, Z., Jagic, N., Mobius-Winckler, S., Rioufol, G., Witt, N., Kala, P., MacCarthy, P.A., Engstrøm, T., Oldroyd, K., Mavromatis, K., Manoharan, G., Verlee, P., Frøbert, O., Curzen, N., Johnson, J.B., Limacher, A., Nueesch, E., Jueni, P., de Bruyne, B., Fearon, W.F., Pijls, N.H.J., Barbato, E., Tonino, P., Piroth, Z., Jagic, N., Mobius-Winckler, S., Rioufol, G., Witt, N., Kala, P., MacCarthy, P.A., Engstrøm, T., Oldroyd, K., Mavromatis, K., Manoharan, G., Verlee, P., Frøbert, O., Curzen, N., Johnson, J.B., Limacher, A., Nueesch, E., and Jueni, P.
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- 2014
15. TCT-328 FFR-guided complete revascularization during primary PCI: Preliminary data from the COMPARE ACUTE trial
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Smits, Pieter C., primary, Vlachojannis, Georgios J., additional, Lunde, Ketil, additional, Omerovic, Elmir, additional, Schotborgh, Carl E., additional, Richardt, Gert, additional, Abdel-Wahab, Mohamed, additional, Neumann, Franz-Josef, additional, Hambrecht, Rainer, additional, Wlodarczak, Adrian, additional, Kala, Petr, additional, Piroth, Z., additional, and Nienaber, Christoph A., additional
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- 2014
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16. Fractional flow reserve-guided PCI versus medical therapy in stable coronary disease
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de Bruyne, B., Pijls, N.H.J.., Kalesan, B., Barbato, E., Tonino, P., Piroth, Z., Jagic, N., Mobius-Winckler, S., Rioufol, G., Witt, N., Kala, P., MacCarthy, P.A., Engstrøm, T., Oldroyd, K.G., Mavromatis, K., Manoharan, G., Verlee, P., Frøbert, O., Curzen, N., Johnson, J.B., Jueni, P., Fearon, W.F., de Bruyne, B., Pijls, N.H.J.., Kalesan, B., Barbato, E., Tonino, P., Piroth, Z., Jagic, N., Mobius-Winckler, S., Rioufol, G., Witt, N., Kala, P., MacCarthy, P.A., Engstrøm, T., Oldroyd, K.G., Mavromatis, K., Manoharan, G., Verlee, P., Frøbert, O., Curzen, N., Johnson, J.B., Jueni, P., and Fearon, W.F.
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- 2012
17. Actual FFR value predicts natural history of stenoses in patients with stable coronary disease. A FAME 2 trial subanalysis
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Barbato, E., primary, Toth, G., additional, Pijls, N. H. J., additional, Fearon, W., additional, Tonino, P., additional, Curzen, N., additional, Piroth, Z., additional, Wijns, W., additional, Juni, P., additional, and De Bruyne, B., additional
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- 2013
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18. FAME 2 global ischemic risk score and clinical outcome in patients with stable coronary disease receiving medical therapy alone
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Toth, G., primary, Barbato, E., additional, Pijls, N. H. J., additional, Fearon, W., additional, Tonino, P., additional, Curzen, N., additional, Piroth, Z., additional, Wijns, W., additional, Mavromatis, K. A., additional, and De Bruyne, B., additional
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- 2013
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19. Remote ischaemic postconditioning protects the heart during acute myocardial infarction in pigs
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Andreka, G., primary, Vertesaljai, M., additional, Szantho, G., additional, Font, G., additional, Piroth, Z., additional, Fontos, G., additional, Juhasz, E. D, additional, Szekely, L., additional, Szelid, Z., additional, Turner, M. S, additional, Ashrafian, H., additional, Frenneaux, M. P, additional, and Andreka, P., additional
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- 2007
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20. A Novel Effect of the New Antileukemic Drug, 2-Chloro-2′-deoxyadenosine, in Human Lymphocytes
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Sasvariszekely, M., primary, Piroth, Z., additional, Kazimierczuk, Z., additional, and Staub, M., additional
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- 1994
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21. Fractional Flow Reserve-Guided PCI as Compared with Coronary Bypass Surgery.
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Fearon, W. F., Zimmermann, F. M., De Bruyne, B., Piroth, Z., van Straten, A. H. M., Szekely, L., Davidavicius, G., Kalinauskas, G., Mansour, S., Kharbanda, R., Ostlund-Papadogeorgos, N., Aminian, A., Oldroyd, K. G., Al-Attar, N., Jagic, N., Dambrink, J.-H. E., Kala, P., Angeras, P., MacCarthy, P., and Wendler, O.
- Abstract
Patients with three-vessel coronary artery disease have been found to have better outcomes with coronary-artery bypass grafting (CABG) than with percutaneous coronary intervention (PCI), but studies in which PCI is guided by measurement of fractional flow reserve (FFR) have been lacking. METHODS In this multicenter, international, noninferiority trial, patients with three-vessel coronary artery disease were randomly assigned to undergo CABG or FFR-guided PCI with current-generation zotarolimus-eluting stents. The primary end point was the occurrence within 1 year of a major adverse cardiac or cerebrovascular event, defined as death from any cause, myocardial infarction, stroke, or repeat revascularization. Noninferiority of FFR-guided PCI to CABG was prespecified as an upper boundary of less than 1.65 for the 95% confidence interval of the hazard ratio. Secondary end points included a composite of death, myocardial infarction, or stroke; safety was also assessed. RESULTS A total of 1500 patients underwent randomization at 48 centers. Patients assigned to undergo PCI received a mean (±SD) of 3.7±1.9 stents, and those assigned to undergo CABG received 3.411.0 distal anastomoses. The 1-year incidence of the composite primary end point was 10.6% among patients randomly assigned to undergo FFR-guided PCI and 6.9% among those assigned to undergo CABG (hazard ratio, 1.5; 95% confidence interval [CI], 1.1 to 2.2), findings that were not consistent with noninferiority of FFR-guided PCI (P=0.35 for noninferiority). The incidence of death, myocardial infarction, or stroke was 7.3% in the FFR-guided PCI group and 5.2% in the CABG group (hazard ratio, 1.4; 95% CI, 0.9 to 2.1). The incidences of major bleeding, arrhythmia, and acute kidney injury were higher in the CABG group than in the FFR-guided PCI group. CONCLUSIONS In patients with three-vessel coronary artery disease, FFR-guided PCI was not found to be noninferior to CABG with respect to the incidence of a composite of death, myocardial infarction, stroke, or repeat revascularization at 1 year. (Funded by Medtronic and AbbottVascular; FAME 3 ClinicalTrials.gov number, NCT02100722.) [ABSTRACT FROM AUTHOR]
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- 2022
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22. Fractional flow reserve-guided PCI versus medical therapy in stable coronary disease.
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De Bruyne B, Pijls NH, Kalesan B, Barbato E, Tonino PA, Piroth Z, Jagic N, Mobius-Winckler S, Rioufol G, Witt N, Kala P, MacCarthy P, Engström T, Oldroyd KG, Mavromatis K, Manoharan G, Verlee P, Frobert O, Curzen N, and Johnson JB
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- 2012
23. A prospective natural history study of coronary atherosclerosis using fractional flow reserve
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Gabor G. Toth, Emanuele Barbato, Nick Curzen, Bernard De Bruyne, Nico H.J. Pijls, William F. Fearon, Gilles Rioufol, Zsolt Piroth, Pim A.L. Tonino, Peter Jüni, Nils P. Johnson, Cardiovascular Biomechanics, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National de la Recherche Agronomique (INRA), Barbato, Emanuele, Toth, Gg, Johnson, Np, Pijls, Nhj, Fearon, Wf, Tonino, Pal, Curzen, N, Piroth, Z, Rioufol, G, Juni, P, and De Bruyne, B.
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Male ,medicine.medical_specialty ,stable angina ,Percutaneous ,Time Factors ,[SDV]Life Sciences [q-bio] ,clinical outcome ,Fractional flow reserve ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Coronary Angiography ,Severity of Illness Index ,vessel related ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Percutaneous Coronary Intervention ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,cardiovascular diseases ,fractional flow reserve ,Coronary atherosclerosis ,business.industry ,Middle Aged ,medicine.disease ,Atherosclerosis ,Prognosis ,Coronary Vessels ,3. Good health ,Surgery ,Fractional Flow Reserve, Myocardial ,Stenosis ,Conventional PCI ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Mace ,Natural history study ,Follow-Up Studies - Abstract
International audience; BACKGROUND: In patients with coronary artery disease, clinical outcome depends on the extent of reversible myocardial ischemia. Whether the outcome also depends on the severity of the stenosis as determined by fractional flow reserve (FFR) remains unknown. OBJECTIVES: This study sought to investigate the relationship between FFR values and vessel-related clinical outcome. METHODS: We prospectively studied major adverse cardiovascular events (MACE) at 2 years in 607 patients in whom all stenoses were assessed by FFR and who were treated with medical therapy alone. The relationship between FFR and 2-year MACE was assessed as a continuous function. Logistic and Cox proportional hazards regression models were used to calculate the average decrease in the risk of MACE per 0.05-U increase in FFR. RESULTS: MACE occurred in 272 (26.5%) of 1,029 lesions. Target lesions with diameter stenosis \textgreater/=70% were more often present in the MACE group (p \textless 0.01). Median FFR was significantly lower in the MACE group versus the non-MACE group (0.68 [interquartile range: 0.54 to 0.77] vs. 0.80 [interquartile range: 0.70 to 0.88]; p \textless 0.01). The cumulative incidence of MACE significantly increased with increasing FFR quartiles. An average decrease in MACE per 0.05-unit increase in FFR was statistically significant even after adjustment for all clinical and angiographic features (odds ratio: 0.81; 95% confidence interval: 0.76 to 0.86]). The strongest increase in MACE occurred for FFR values between 0.80 and 0.60. In multivariable Cox regression analysis, FFR was significantly associated with MACE up to 2 years (hazard ratio: 0.87; 95% confidence interval: 0.83 to 0.91]). CONCLUSIONS: In patients with stable coronary disease, stenosis severity as assessed by FFR is a major and independent predictor of lesion-related outcome. (FAME II - Fractional Flow Reserve [FFR] Guided Percutaneous Coronary Intervention [PCI] Plus Optimal Medical Treatment [OMT] Verses OMT; NCT01132495).
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- 2016
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24. Fractional flow reserve-guided PCI versus medical therapy in stable coronary disease
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Bernard, De Bruyne, Nico H J, Pijls, Bindu, Kalesan, Emanuele, Barbato, Pim A L, Tonino, Zsolt, Piroth, Nikola, Jagic, Sven, Möbius-Winkler, Sven, Mobius-Winckler, Gilles, Rioufol, Nils, Witt, Petr, Kala, Philip, MacCarthy, Thomas, Engström, Keith G, Oldroyd, Kreton, Mavromatis, Ganesh, Manoharan, Peter, Verlee, Ole, Frobert, Nick, Curzen, Jane B, Johnson, Peter, Jüni, William F, Fearon, D, Nikolic, De Bruyne, B, Pijls, Nh, Kalesan, B, Barbato, Emanuele, Tonino, Pa, Piroth, Z, Jagic, N, M?bius Winkler, S, Rioufol, G, Witt, N, Kala, P, Maccarthy, P, Engstr?m, T, Oldroyd, Kg, Mavromatis, K, Manoharan, G, Verlee, P, Frobert, O, Curzen, N, Johnson, Jb, J?ni, P, Fearon, Wf, Fame, 2 Trial Investigators, and Cardiovascular Biomechanics
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,Myocardial Infarction ,ComputingMilieux_LEGALASPECTSOFCOMPUTING ,610 Medicine & health ,Angiotensin-Converting Enzyme Inhibitors ,Coronary Disease ,Fractional flow reserve ,Kaplan-Meier Estimate ,Revascularization ,Coronary artery disease ,360 Social problems & social services ,Angioplasty ,Internal medicine ,medicine ,Humans ,Myocardial infarction ,Angioplasty, Balloon, Coronary ,Aged ,Aspirin ,business.industry ,Hazard ratio ,Coronary Stenosis ,Percutaneous coronary intervention ,Drug-Eluting Stents ,General Medicine ,Middle Aged ,medicine.disease ,Adrenergic beta-1 Receptor Antagonists ,Combined Modality Therapy ,Surgery ,Fractional Flow Reserve, Myocardial ,Conventional PCI ,Retreatment ,Cardiology ,Drug Therapy, Combination ,Female ,business ,Platelet Aggregation Inhibitors ,Follow-Up Studies - Abstract
A b s t r ac t Background The preferred initial treatment for patients with stable coronary artery disease is the best available medical therapy. We hypothesized that in patients with functionally significant stenoses, as determined by measurement of fractional flow reserve (FFR), percutaneous coronary intervention (PCI) plus the best available medical therapy would be superior to the best available medical therapy alone. Methods In patients with stable coronary artery disease for whom PCI was being considered, we assessed all stenoses by measuring FFR. Patients in whom at least one stenosis was functionally significant (FFR, ≤0.80) were randomly assigned to FFR-guided PCI plus the best available medical therapy (PCI group) or the best available medical therapy alone (medical-therapy group). Patients in whom all stenoses had an FFR of more than 0.80 were entered into a registry and received the best available medical therapy. The primary end point was a composite of death, myocardial infarction, or urgent revascularization. Results Recruitment was halted prematurely after enrollment of 1220 patients (888 who underwent randomization and 332 enrolled in the registry) because of a significant between-group difference in the percentage of patients who had a primary endpoint event: 4.3% in the PCI group and 12.7% in the medical-therapy group (hazard ratio with PCI, 0.32; 95% confidence interval [CI], 0.19 to 0.53; P
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- 2012
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25. SoutheAsTern eUrope microciRculATION (SATURATION) registry - Design and rationale.
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Odanovic N, Tsioufis K, Dimitriadis K, Sakalidis A, Papafaklis MI, Davlouros P, Ivanov I, Cankovic M, Kalogeropoulos AS, Hamilos M, Sideras E, Konigstein M, Zornitzki L, Kovarnik T, Ruzsa Z, Piroth Z, Zdravkovic M, Mehmedbegovic Z, Miovski Z, Jurin H, Kanovsky J, Regev E, Shah S, and Ilic I
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Background: A considerable number of symptomatic patients leave the cardiac catheterization lab without a definitive diagnosis for their symptoms because no epicardial stenoses are found. The significance of disorders of coronary microvasculature and vasomotion as the cause of symptoms and signs of ischemia has only recently been appreciated. Today we have a wide spectrum of invasive coronary physiology tools but little is known about when and how these tools are used in clinical practice., Study Design and Methodology: SoutheAsTern eUrope microciRculATION (SATURATION) registry will study the regional practice of patient selection for coronary function testing, indications, non-invasive ischemia testing, medications, procedural aspects of invasive physiology evaluation, and treatment changes after testing. The registry is expected to include 1600 patients in participating centers in Southeastern Europe from 2024 to 2029, using the thermodilution technique for evaluation of microcirculation. Major adverse cardiovascular events as well as patient-centered outcomes such as burden of angina and quality of life using Seattle Angina Questionnaire (SAQ) and EQ-5D-5L will be recorded. The study will include patients with different stages of coronary artery disease (presence of disease or degree of stenosis) to elucidate the effect of coronary microcirculation on the outcomes in this broad group., Conclusion: The registry will provide information regarding the current practice of invasive coronary physiology assessment in populations at high cardiovascular risk in Southeastern Europe. This could lead to a better understanding of coronary microvascular dysfunction and its relationship to various degrees of coronary atherosclerosis together with potential interventions that can be beneficial., Competing Interests: Declaration of competing interest Natalija Odanovic: None. Konstantinos Tsioufis: None. Kyriakos Dimitriadis: None. Athanasios Sakalidis: None. Michail I. Papafaklis: None. Periklis Davlouros: None. Igor Ivanov reports receipt of honoraria or consultation fees from Abbott Vascular. Milenko Cankovic reports receipt of honoraria or consultation fees from Abbott Vascular. Andreas S Kalogeropoulos: None. Michalis Hamilos: None. Emanuel Sideras: None. Maayan Konigstein: None. Lior Zornitzki: None. Tomas Kovarnik reports receipt of honoraria or consultation fees from Abbott Vascular. Zoltan Ruzsa: None. Zsolt Piroth: None. Marija Zdravkovic: None. Zlatko Mehmedbegovic: None. Zoran Miovski: None. Hrvoje Jurin reports receipt of honoraria or consultation fees from Abbott Vascular. Jan Kanovsky: None. Ehud Regev: None. Samit Shah receives investigator-initiated research support from Abbott Vascular, research support from the United States Food and Drug Administration, and Women's Health Research at Yale. Ivan Ilic reports research funding from Abbott Vascular., (Copyright © 2024. Published by Elsevier Inc.)
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- 2024
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26. Differential Impact of Fractional Flow Reserve Measured After Coronary Stent Implantation by Left Ventricular Dysfunction.
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Choi KH, Kwon W, Shin D, Lee SH, Hwang D, Zhang J, Nam CW, Shin ES, Doh JH, Chen SL, Kakuta T, Toth GG, Piroth Z, Hakeem A, Uretsky BF, Hokama Y, Tanaka N, Lim HS, Ito T, Matsuo A, Azzalini L, Leesar MA, Daemen J, Collison D, Collet C, De Bruyne B, Koo BK, Park TK, Yang JH, Song YB, Hahn JY, Choi SH, Gwon HC, and Lee JM
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Background: Both left ventricular systolic function and fractional flow reserve (FFR) are prognostic factors after percutaneous coronary intervention (PCI). However, how these prognostic factors are inter-related in risk stratification of patients after PCI remains unclarified., Objectives: This study evaluated differential prognostic implication of post-PCI FFR according to left ventricular ejection fraction (LVEF)., Methods: A total of 2,965 patients with available LVEF were selected from the POST-PCI FLOW (Prognostic Implications of Physiologic Investigation After Revascularization with Stent) international registry of patients with post-PCI FFR measurement. The primary outcome was a composite of cardiac death or target-vessel myocardial infarction (TVMI) at 2 years. The secondary outcome was target-vessel revascularization (TVR) and target vessel failure, which was a composite of cardiac death, TVMI, or TVR., Results: Post-PCI FFR was independently associated with the risk of target vessel failure (per 0.01 decrease: HR
adj : 1.029; 95% CI: 1.009-1.049; P = 0.005). Post-PCI FFR was associated with increased risk of cardiac death or TVMI (HRadj : 1.145; 95% CI: 1.025-1.280; P = 0.017) among patients with LVEF ≤40%, and with that of TVR in patients with LVEF >40% (HRadj : 1.028; 95% CI: 1.005-1.052; P = 0.020). Post-PCI FFR ≤0.80 was associated with increased risk of cardiac death or TVMI in the LVEF ≤40% group and with that of TVR in LVEF >40% group. Prognostic impact of post-PCI FFR for the primary outcome was significantly different according to LVEF ( Pinteraction = 0.019)., Conclusions: Post-PCI FFR had differential prognostic impact according to LVEF. Residual ischemia by post-PCI FFR ≤0.80 was a prognostic indicator for cardiac death or TVMI among patients with patients with LVEF ≤40%, and it was associated with TVR among patients with patients with LVEF>40%. (Prognostic Implications of Physiologic Investigation After Revascularization with Stent [POST-PCI FLOW]; NCT04684043)., Competing Interests: Dr Joo Myung Lee has received an institutional research grant from Abbott Vascular, Boston Scientific, Philips Volcano, Terumo Corporation, Donga-ST, and Zoll Medical. Dr Bon-Kwon Koo has received an institutional research grant from St. Jude Medical (Abbott Vascular) and Philips Volcano. Dr Joon Hyung Doh has received a research grant from Philips Volcano. Dr Shao-Liang Chen is a consultant for Microport and Boston Scientific International; and has received a grant from the National Natural Scientific Foundation of China. Dr Toth receives consultancy fees and unrestricted research grants from Abbott, Medtronic, and Terumo. Dr Johnson has received institutional research support from Volcano/Philips (DEFINE-FLOW, NCT02328820), Abiomed (for study of Impella-related coronary physiology) and St. Jude Medical (CONTRAST, NCT02184117); has an institutional licensing agreement with Boston Scientific for the smart-minimum FFR algorithm commercialized under 510(k) K191008; and has pending patents on diagnostic methods for quantifying aortic stenosis and TAVR physiology, and also algorithms to correct pressure tracings from fluid-filled catheters. Dr Leesar has received an institutional research grant from ACIST. Dr Azzalini has received honoraria from Teleflex, Abiomed, GE Healthcare, Asahi Intecc, Philips, Abbott Vascular, and Cardiovascular System, Inc. Dr Diletti has received an institutional research grant to Erasmus University Medical Center; and has served as a consultant to ACIST Medical Systems. Dr Collison has received consultancy/speaker fees from Abbott. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (© 2024 The Authors.)- Published
- 2023
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27. Functional Assessment of Long-Term Microvascular Cardiac Allograft Vasculopathy.
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Bora N, Balogh O, Ferenci T, and Piroth Z
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Background: Cardiac allograft vasculopathy (CAV) is a leading cause of death and retransplantation following heart transplantation (HTX). Surveillance angiography performed yearly is indicated for the early detection of the disease, but it remains of limited sensitivity., Methods: We performed bolus thermodilution-based coronary flow reserve (CFR) and index of microcirculatory resistance (IMR) and fractional flow reserve (FFR) measurements in HTX patients undergoing yearly surveillance coronary angiography without overt CAV., Results: In total, 27 HTX patients were included who had 52 CFR, IMR, and FFR measurements at a mean of 43 months after HTX. Only five measurements were performed in the first year. CFR decreased significantly by 0.13 every year ( p = 0.04) and IMR tended to increase by 0.98 every year ( p = 0.051), whereas FFR did not change ( p = 0.161) and remained well above 0.80 over time. After one year, CFR decreased significantly ( p = 0.022) and IMR increased significantly ( p = 0.015), whereas FFR remained unchanged ( p = 0.72)., Conclusions: The functional status of the epicardial coronary arteries of transplanted hearts did not deteriorate over time. On the contrary, a significant decrease in CFR was noted. In view of the increasing IMR, this is caused by the deterioration of the function of microvasculature. CFR and IMR measurements may provide an early opportunity to diagnose CAV.
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- 2023
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28. Machine-learning-based prediction of fractional flow reserve after percutaneous coronary intervention.
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Hamaya R, Goto S, Hwang D, Zhang J, Yang S, Lee JM, Hoshino M, Nam CW, Shin ES, Doh JH, Chen SL, Toth GG, Piroth Z, Hakeem A, Uretsky BF, Hokama Y, Tanaka N, Lim HS, Ito T, Matsuo A, Azzalini L, Leesar MA, Collet C, Koo BK, De Bruyne B, and Kakuta T
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- Humans, Treatment Outcome, Coronary Angiography, Predictive Value of Tests, Coronary Artery Disease diagnosis, Coronary Artery Disease therapy, Fractional Flow Reserve, Myocardial, Percutaneous Coronary Intervention
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Background and Aims: Post-percutaneous coronary intervention (PCI) fractional flow reserve (FFR) reflects residual atherosclerotic burden and is associated with future events. How much post-PCI FFR can be predicted based on baseline basic information and the clinical relevance have not been investigated., Methods: We compiled a multicenter registry of patients undergoing pre- and post-PCI FFR. Machine-learning (ML) algorithms were designed to predict post-PCI FFR levels from baseline demographics, quantitative coronary angiography, and pre-PCI FFR. FFR deviation was defined as actual minus ML-predicted post-PCI FFR levels, and its association with incident target vessel failure (TVF) was evaluated., Results: Median (IQR) pre- and post-PCI FFR values were 0.71 (0.61, 0.77) and 0.88 (0.84, 0.93), respectively. The Spearman correlation coefficient of the actual and predicted post-PCI FFR was 0.54 (95% CI: 0.52, 0.57). FFR deviation was non-linearly associated with incident TVF (HR [95% CI] with Q3 as reference: 1.65 [1.14, 2.39] in Q1, 1.42 [0.98, 2.08] in Q2, 0.81 [0.53, 1.26] in Q4, and 1.04 [0.69, 1.56] in Q5). A model with polynomial function of continuous FFR deviation indicated increasing TVF risk for FFR deviation ≤0 but plateau risk with FFR deviation >0., Conclusions: An ML-based algorithm using baseline data moderately predicted post-PCI FFR. The deviation of post-PCI FFR from the predicted value was associated with higher vessel-oriented event., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dr. Koo reported receiving grants from Abbott Vascular and Philips Volcano during the conduct of the study. Dr. Tanaka reported receiving personal fees from Abbott Vascular Japan and personal fees from Daiichi-Sankyo Co Ltd during the conduct of the study. Dr. Azzalini received honoraria from Teleflex, Abiomed, Asahi Intecc, Philips, GE Healthcare, Abbott Vascular, and Cardiovascular System, Inc. No other disclosures were reported. Data described in the manuscript, code book, and analytic code will be made available upon request pending application and approval., (Copyright © 2023 Elsevier B.V. All rights reserved.)
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- 2023
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29. Fractional Flow Reserve-Guided PCI or Coronary Bypass Surgery for 3-Vessel Coronary Artery Disease: 3-Year Follow-Up of the FAME 3 Trial.
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Zimmermann FM, Ding VY, Pijls NHJ, Piroth Z, van Straten AHM, Szekely L, Davidavicius G, Kalinauskas G, Mansour S, Kharbanda R, Östlund-Papadogeorgos N, Aminian A, Oldroyd KG, Al-Attar N, Jagic N, Dambrink JE, Kala P, Angeras O, MacCarthy P, Wendler O, Casselman F, Witt N, Mavromatis K, Miner SES, Sarma J, Engstrøm T, Christiansen EH, Tonino PAL, Reardon MJ, Otsuki H, Kobayashi Y, Hlatky MA, Mahaffey KW, Desai M, Woo YJ, Yeung AC, De Bruyne B, and Fearon WF
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- Humans, Follow-Up Studies, Coronary Artery Bypass adverse effects, Coronary Artery Disease surgery, Fractional Flow Reserve, Myocardial, Percutaneous Coronary Intervention adverse effects, Myocardial Infarction, Stroke epidemiology, Stroke etiology
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Background: Previous studies comparing percutaneous coronary intervention (PCI) with coronary artery bypass grafting (CABG) in patients with multivessel coronary disease not involving the left main have shown significantly lower rates of death, myocardial infarction (MI), or stroke after CABG. These studies did not routinely use current-generation drug-eluting stents or fractional flow reserve (FFR) to guide PCI., Methods: FAME 3 (Fractional Flow Reserve versus Angiography for Multivessel Evaluation) is an investigator-initiated, multicenter, international, randomized trial involving patients with 3-vessel coronary artery disease (not involving the left main coronary artery) in 48 centers worldwide. Patients were randomly assigned to receive FFR-guided PCI using zotarolimus drug-eluting stents or CABG. The prespecified key secondary end point of the trial reported here is the 3-year incidence of the composite of death, MI, or stroke., Results: A total of 1500 patients were randomized to FFR-guided PCI or CABG. Follow-up was achieved in >96% of patients in both groups. There was no difference in the incidence of the composite of death, MI, or stroke after FFR-guided PCI compared with CABG (12.0% versus 9.2%; hazard ratio [HR], 1.3 [95% CI, 0.98-1.83]; P =0.07). The rates of death (4.1% versus 3.9%; HR, 1.0 [95% CI, 0.6-1.7]; P =0.88) and stroke (1.6% versus 2.0%; HR, 0.8 [95% CI, 0.4-1.7]; P =0.56) were not different. MI occurred more frequently after PCI (7.0% versus 4.2%; HR, 1.7 [95% CI, 1.1-2.7]; P =0.02)., Conclusions: At 3-year follow-up, there was no difference in the incidence of the composite of death, MI, or stroke after FFR-guided PCI with current-generation drug-eluting stents compared with CABG. There was a higher incidence of MI after PCI compared with CABG, with no difference in death or stroke. These results provide contemporary data to allow improved shared decision-making between physicians and patients with 3-vessel coronary artery disease., Registration: URL: https://www., Clinicaltrials: gov; Unique identifier: NCT02100722., Competing Interests: Disclosures Dr Pijls receives research funding from Abbott, has consulting relationships with Abbott and Opsens, and has stock or stock options with ASML, General Electric, HeartFlow, Hexacath, and Philips. Dr Mansour has consulting relationships with Abbott Vascular, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Novartis, Pfizer, and Servier Affaires, and received a research grant from Opsens Inc and Abbott Vascular. Dr Kala has a consulting relationship with Boston Scientific, Medtronic, and Servier Affaires, and receives honoraria from AstraZeneca and Bayer. Dr Angeras receives research funding from Abbott Vascular and AstraZeneca and has a consulting relationship with Abbott Vascular and Boston Scientific. Dr Miner has a consulting relationship with Abbott, Amgen, Astra Zeneca, Bayer, Boehringer, Novartis, Opsens, Pfizer, and Servier Affaires Medicales. Dr Engstrøm has a consulting relationship with Abbott Vascular, Bayer, and Novo Nordisk. Dr Christiansen has a consulting relationship with Abbott Vascular and has received research grants from Abbott Vascular. Dr Tonino has received research grants from Biosensors and Opsens. Dr Reardon has a consulting relationship with Boston Scientific and W.L. Gore & Associates. Dr Otsuki has received research grants from the Uehara Memorial Foundation, Abbott, Medtronic, Boston Scientific, and Terumo. Dr Kobayashi has a consulting relationship with Abbott Vascular. Dr Hlatky has a consulting relationship with Blue Cross and Blue Shield and research support from HeartFlow. Dr Mahaffey has received research grants or contracts from the American Heart Association, Apple, Inc, Bayer, California Institute Regenerative Medicine, Eidos, Ferring, Gilead, Google (Verily), Idorsia, Johnson & Johnson, Luitpold, PAC-12, Precordior, and Sanifit; has provided consulting or other services for Amgen, Applied Therapeutics, AstraZeneca, Bayer, CSL Behring, Elsevier, FibroGen, Inova, Johnson & Johnson, Lexicon, MyoKardia, Novartis, Novo Nordisk, Otsuka, PhaseBio, Portola, Quidel, Sanofi, and Theravance; and has equity in Precordior. Dr Yeung has a consulting relationship with Medtronic. Dr De Bruyne has an institutional consulting relationship with Boston Scientific, Abbott Vascular, CathWorks, Siemens, GE Healthcare, and Coroventis Research; receives institutional research grants from Abbott Vascular, Coroventis Research, CathWorks, and Boston Scientific; and holds minor equities in Philips, Siemens, GE Healthcare, CathWorks, Edwards Life Sciences, HeartFlow, Opsens, Celyad, Xenter, Medyria, Bayer, and Sanofi. Dr Fearon receives research funding from Abbott, Medtronic, and Boston Scientific and has a consulting relationship with Siemens and CathWorks and stock options with HeartFlow. The other authors report no conflicts of interest.
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- 2023
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30. Short- and Medium-Term Outcomes Comparison of Native- and Valve-in-Valve TAVI Procedures.
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Bartos PV, Molnar B, Herold Z, Dekany G, Piroth Z, Horvath G, Ahres A, Heesch CM, Czobor NR, Satish S, Pinter T, Fontos G, and Andreka P
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Background: In high-risk patients with degenerated aortic bioprostheses, valve-in-valve (ViV) transcatheter aortic valve implantation (TAVI) has emerged as a less invasive alternative to surgical valve replacement. To compare outcomes of ViV and native valve (NV) TAVI procedures., Methods: 34 aortic ViV-TAVI performed between 2012 and 2022 using self-expanding valves, were included in this retrospective analysis. Propensity score matching (1:2 ratio, 19 criteria) was used to select a comparison NV-TAVI group from a database of 1206 TAVI procedures. Clinical and echocardiographic endpoints, short- and long-term all-cause mortality (ACM) and cardiovascular mortality (CVM) data were obtained. Subgroup analyses were completed according to the true internal diameter, dividing patients into a small ( ≤ 19 mm) valve group (SVG) and a large ( > 19 mm) valve group (LVG)., Results: Clinical outcomes of ViV- and NV-TAVI were comparable, including device success [88.2% vs. 91.1%, p = 0.727], major adverse cardiovascular and cerebrovascular events [5.8% vs. 5.8%, p = 1.000], hemodialysis need [5.8% vs. 2.9%, p = 0.599], pacemaker need [2.9% vs. 11.7%, p = 0.265], major vascular complications [2.9% vs. 1.4%, p = 1.000], life-threatening or major bleeding [2.9% vs. 1.4%, p = 1.000] and in-hospital mortality [8.8% vs. 5.9%, p = 0.556]. There was a significant difference in the immediate post-intervention mean residual aortic valve gradient (MAVG) [14.6 ± 8.5 mm Hg vs. 6.4 ± 4.5 mm Hg, p < 0.0001], which persisted at 1 year [ p = 0.0002]. There were no differences in 12- or 30-month ACM [11.8% vs. 8.8%, p = 0.588; 23.5% vs. 27.9%, p = 0.948], and CVM [11.8% vs. 7.3%, p = 0.441; 23.5% vs. 16.2%, p = 0.239]. Lastly, there was no difference in CVM at 1 year and 30 months [11.1% vs. 12.5%, p = 0.889; 22.2% vs. 25.0%, p = 0.742]., Conclusions: Analyzing a limited group (n = 34) of ViV-TAVI procedures out of 1206 TAVIs done at a single institution, ViV-TAVI appeared to be an acceptable approach in patients not deemed appropriate candidates for redo valve replacement surgery. Clinical outcomes of ViV-TAVI were comparable to TAVI for native valve stenosis., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2023 The Author(s). Published by IMR Press.)
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- 2023
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31. Clinical and Vessel Characteristics Associated With Hard Outcomes After PCI and Their Combined Prognostic Implications.
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Yang S, Hwang D, Zhang J, Park J, Yun JP, Lee JM, Nam CW, Shin ES, Doh JH, Chen SL, Kakuta T, Toth GG, Piroth Z, Johnson NP, Hakeem A, Uretsky BF, Hokama Y, Tanaka N, Lim HS, Ito T, Matsuo A, Azzalini L, Leesar MA, Neleman T, van Mieghem NM, Diletti R, Daemen J, Collison D, Collet C, De Bruyne B, and Koo BK
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- Humans, Middle Aged, Aged, Prognosis, Stroke Volume, Ventricular Function, Left, Drug-Eluting Stents, Fractional Flow Reserve, Myocardial, Percutaneous Coronary Intervention adverse effects, Myocardial Infarction
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Background Cardiac death or myocardial infarction still occurs in patients undergoing contemporary percutaneous coronary intervention (PCI). We aimed to identify adverse clinical and vessel characteristics related to hard outcomes after PCI and to investigate their individual and combined prognostic implications. Methods and Results From an individual patient data meta-analysis of 17 cohorts of patients who underwent post-PCI fractional flow reserve measurement after drug-eluting stent implantation, 2081 patients with available clinical and vessel characteristics were analyzed. The primary outcome was cardiac death or target-vessel myocardial infarction at 2 years. The mean age of patients was 64.2±10.2 years, and the mean angiographic percent diameter stenosis was 63.9%±14.3%. Among 11 clinical and 8 vessel features, 4 adverse clinical characteristics (age ≥65 years, diabetes, chronic kidney disease, and left ventricular ejection fraction <50%) and 2 adverse vessel characteristics (post-PCI fractional flow reserve ≤0.80 and total stent length ≥54 mm) were identified to independently predict the primary outcome (all P <0.05). The number of adverse vessel characteristics had additive predictability for the primary end point to that of adverse clinical characteristics (area under the curve 0.72 versus 0.78; P =0.03) and vice versa (area under the curve 0.68 versus 0.78; P =0.03). The cumulative event rate increased in the order of none, either, and both of adverse clinical characteristics ≥2 and adverse vessel characteristics ≥1 (0.3%, 2.4%, and 5.3%; P for trend <0.01). Conclusions In patients undergoing drug-eluting stent implantation, adverse clinical and vessel characteristics were associated with the risk of cardiac death or target-vessel myocardial infarction. Because these characteristics showed independent and additive prognostic value, their integrative assessment can optimize post-PCI risk stratification. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT04684043. www.crd.york.ac.uk/prospero/. Unique Identifier: CRD42021234748.
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- 2023
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32. Prognostic Value of Measuring Fractional Flow Reserve After Percutaneous Coronary Intervention in Patients With Complex Coronary Artery Disease: Insights From the FAME 3 Trial.
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Piroth Z, Otsuki H, Zimmermann FM, Ferenci T, Keulards DCJ, Yeung AC, Pijls NHJ, De Bruyne B, and Fearon WF
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- Humans, Coronary Angiography methods, Prognosis, Treatment Outcome, Coronary Artery Disease therapy, Coronary Artery Disease surgery, Fractional Flow Reserve, Myocardial, Percutaneous Coronary Intervention adverse effects, Percutaneous Coronary Intervention methods, Myocardial Infarction
- Abstract
Background: We evaluate the prognostic value of measuring fractional flow reserve (FFR) after percutaneous coronary intervention (post-PCI FFR) and intravascular imaging in patients undergoing PCI for 3-vessel coronary artery disease in the FAME 3 trial (Fractional Flow Reserve versus Angiography for Multivessel Evaluation)., Methods: The FAME 3 trial is a multicenter, international, randomized study comparing FFR-guided PCI with coronary artery bypass grafting in patients with multivessel coronary artery disease. PCI was not noninferior with respect to the primary end point of death, myocardial infarction, stroke, or repeat revascularization at 1 year. Post-PCI FFR data were acquired on a patient and vessel-related basis. Intravascular imaging guidance was tracked. The primary end point is a comparison of target vessel failure (TVF) defined as a composite of cardiac death, target vessel myocardial infarction, and target vessel revascularization at 1 year based on post-PCI FFR values. Cox regression with robust SEs was used for analysis., Results: Of the 757 patients randomized to PCI, 461 (61%) had post-PCI FFR measurement and 11.1% had intravascular imaging performed. The median post-PCI FFR was 0.89 [IQR' 0.85-0.94]. On a vessel-level, post-PCI FFR was found to be a significant predictor of TVF univariately (hazard ratio=0.67 [95% CI' 0.48-0.93] for 0.1 unit increase, P =0.0165). On a patient-level, the single lowest post-PCI FFR value was also found to be a significant predictor of TVF univariately (hazard ratio=0.65 [95% CI' 0.48-0.89] for 0.1 unit increase, P =0.0074). Post-PCI FFR was an independent predictor of TVF in multivariable analysis adjusted for key clinical parameters. Outcomes were similar between patients who had intravascular imaging guidance and those who did not., Conclusions: Post-PCI FFR measurement was a significant predictor of TVF on a vessel and patient level and an independent predictor of outcomes in a population with complex 3-vessel coronary artery disease eligible for coronary artery bypass grafting. The limited use of intravascular imaging did not affect outcomes., Registration: URL: https://www., Clinicaltrials: gov; Unique identifier: NCT02100722.
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- 2022
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33. Prognostic Implications of Fractional Flow Reserve After Coronary Stenting: A Systematic Review and Meta-analysis.
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Hwang D, Koo BK, Zhang J, Park J, Yang S, Kim M, Yun JP, Lee JM, Nam CW, Shin ES, Doh JH, Chen SL, Kakuta T, Toth GG, Piroth Z, Johnson NP, Pijls NHJ, Hakeem A, Uretsky BF, Hokama Y, Tanaka N, Lim HS, Ito T, Matsuo A, Azzalini L, Leesar MA, Neleman T, van Mieghem NM, Diletti R, Daemen J, Collison D, Collet C, and De Bruyne B
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- Coronary Angiography, Death, Female, Humans, Male, Middle Aged, Prognosis, Treatment Outcome, Drug-Eluting Stents adverse effects, Fractional Flow Reserve, Myocardial physiology, Myocardial Infarction etiology, Percutaneous Coronary Intervention adverse effects
- Abstract
Importance: Fractional flow reserve (FFR) after percutaneous coronary intervention (PCI) is generally considered to reflect residual disease. Yet the clinical relevance of post-PCI FFR after drug-eluting stent (DES) implantation remains unclear., Objective: To evaluate the clinical relevance of post-PCI FFR measurement after DES implantation., Data Sources: MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched for relevant published articles from inception to June 18, 2022., Study Selection: Published articles that reported post-PCI FFR after DES implantation and its association with clinical outcomes were included., Data Extraction and Synthesis: Patient-level data were collected from the corresponding authors of 17 cohorts using a standardized spreadsheet. Meta-estimates for primary and secondary outcomes were analyzed per patient and using mixed-effects Cox proportional hazard regression with registry identifiers included as a random effect. All processes followed the Preferred Reporting Items for Systematic Review and Meta-analysis of Individual Participant Data., Main Outcomes and Measures: The primary outcome was target vessel failure (TVF) at 2 years, a composite of cardiac death, target vessel myocardial infarction (TVMI), and target vessel revascularization (TVR). The secondary outcome was a composite of cardiac death or TVMI at 2 years., Results: Of 2268 articles identified, 29 studies met selection criteria. Of these, 28 articles from 17 cohorts provided data, including a total of 5277 patients with 5869 vessels who underwent FFR measurement after DES implantation. Mean (SD) age was 64.4 (10.1) years and 4141 patients (78.5%) were men. Median (IQR) post-PCI FFR was 0.89 (0.84-0.94) and 690 vessels (11.8%) had a post-PCI FFR of 0.80 or below. The cumulative incidence of TVF was 340 patients (7.2%), with cardiac death or TVMI occurring in 111 patients (2.4%) at 2 years. Lower post-PCI FFR significantly increased the risk of TVF (adjusted hazard ratio [HR] per 0.01 FFR decrease, 1.04; 95% CI, 1.02-1.05; P < .001). The risk of cardiac death or MI also increased inversely with post-PCI FFR (adjusted HR, 1.03; 95% CI, 1.00-1.07, P = .049). These associations were consistent regardless of age, sex, the presence of hypertension or diabetes, and clinical diagnosis., Conclusions and Relevance: Reduced FFR after DES implantation was common and associated with the risks of TVF and of cardiac death or TVMI. These results indicate the prognostic value of post-PCI physiologic assessment after DES implantation.
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- 2022
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34. Quality of Life After Fractional Flow Reserve-Guided PCI Compared With Coronary Bypass Surgery.
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Fearon WF, Zimmermann FM, Ding VY, Zelis JM, Piroth Z, Davidavicius G, Mansour S, Kharbanda R, Östlund-Papadogeorgos N, Oldroyd KG, Wendler O, Reardon MJ, Woo YJ, Yeung AC, Pijls NHJ, De Bruyne B, Desai M, and Hlatky MA
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- Aged, Angina Pectoris, Canada, Coronary Artery Bypass adverse effects, Coronary Artery Bypass methods, Humans, Quality of Life, Treatment Outcome, Coronary Artery Disease surgery, Fractional Flow Reserve, Myocardial, Percutaneous Coronary Intervention adverse effects, Percutaneous Coronary Intervention methods
- Abstract
Background: Previous studies have shown that quality of life improves after coronary revascularization more so after coronary artery bypass grafting (CABG) than after percutaneous coronary intervention (PCI). This study aimed to evaluate the effect of fractional flow reserve guidance and current generation, zotarolimus drug-eluting stents on quality of life after PCI compared with CABG., Methods: The FAME 3 trial (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation) is a multicenter, international trial including 1500 patients with 3-vessel coronary artery disease who were randomly assigned to either CABG or fractional flow reserve-guided PCI. Quality of life was measured using the European Quality of Life-5 Dimensions (EQ-5D) questionnaire at baseline and 1 and 12 months. The Canadian Cardiovascular Class angina grade and working status were assessed at the same time points and at 6 months. The primary objective was to compare EQ-5D summary index at 12 months. Secondary end points included angina grade and work status., Results: The EQ-5D summary index at 12 months did not differ between the PCI and CABG groups (difference, 0.001 [95% CI, -0.016 to 0.017]; P =0.946). The trajectory of EQ-5D during the 12 months differed ( P <0.001) between PCI and CABG: at 1 month, EQ-5D was 0.063 (95% CI, 0.047 to 0.079) higher in the PCI group. A similar trajectory was found for the EQ (EuroQol) visual analogue scale. The proportion of patients with Canadian Cardiovascular Class 2 or greater angina at 12 months was 6.2% versus 3.1% (odds ratio, 2.5 [95% CI, 0.96-6.8]), respectively, in the PCI group compared with the CABG group. A greater percentage of younger patients (<65 years old) were working at 12 months in the PCI group compared with the CABG group (68% versus 57%; odds ratio, 3.9 [95% CI, 1.7-8.8])., Conclusions: In the FAME 3 trial, quality of life after fractional flow reserve-guided PCI with current generation drug-eluting stents compared with CABG was similar at 1 year. The rate of significant angina was low in both groups and not significantly different. The trajectory of improvement in quality of life was significantly better after PCI, as was working status in those <65 years old., Registration: URL: https://www., Clinicaltrials: gov; Unique identifier: NCT02100722.
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- 2022
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35. Changes in surgical revascularization strategy after fractional flow reserve.
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Fournier S, Toth GG, De Bruyne B, Kala P, Ribichini FL, Casselman F, Ramos R, Piroth Z, Piccoli A, Penicka M, Mates M, Nemec P, Van Praet F, Stockman B, Degriek I, Pellicano M, and Barbato E
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- Coronary Angiography, Coronary Artery Bypass adverse effects, Follow-Up Studies, Humans, Treatment Outcome, Coronary Artery Disease diagnostic imaging, Coronary Artery Disease surgery, Coronary Stenosis diagnostic imaging, Coronary Stenosis surgery, Fractional Flow Reserve, Myocardial
- Abstract
Aims: In the randomized GRAFFITI trial, surgeons drew their strategy based on coronary angiography. When patients were randomized to fractional flow reserve (FFR)-guidance, surgeons were informed of the FFR values and asked to redraw their strategy. The aim of this study was to investigate the changes induced by FFR knowledge., Methods and Results: The intended and performed strategy (before and after FFR) were compared. Among 172 patients, 84 with 300 lesions were randomized to the FFR-guided group. The intended strategy was to bypass 236 stenoses:108 with a venous and 128 with an arterial graft. After disclosing FFR, a change in strategy occurred in 64 lesions (21.3%) of 48 (55%) patients. Among 64 lesions for which the intended strategy was medical therapy, 16 (25%) were bypassed after disclosing FFR. The number of procedures with >1 venous graft planned was significantly reduced from 37 to 27 patients (p = .031). The proportion of on-pump surgery was significantly reduced from 71 to 61 patients (p = .006). The rates of clinical events at 1 year were similar between patients with or without at least one change in strategy., Discussion: FFR-guided CABG is associated with a simplified surgical procedure in 55% of the patients, with similar clinical outcomes., (© 2021 Wiley Periodicals LLC.)
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- 2021
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36. EAPCI Core Curriculum for Percutaneous Cardiovascular Interventions (2020): Committee for Education and Training European Association of Percutaneous Cardiovascular Interventions (EAPCI). A branch of the European Society of Cardiology.
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Van Belle E, Teles RC, Pyxaras SA, Kalpak O, Johnson TW, 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 Ferre J, Kammler J, Muir DF, O'Connor S, Mehilli J, Thiele H, Weilenmann D, Witt N, Joshi F, Kharbanda RK, 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, and Dudek D
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- Consensus, Curriculum, Europe, Humans, Cardiology education, Percutaneous Coronary Intervention
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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.
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- 2021
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37. Selective intracoronary hypothermia in patients with ST-elevation myocardial infarction. Rationale and design of the EURO-ICE trial.
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El Farissi M, Keulards DCJ, van 't Veer M, Zelis JM, Berry C, De Bruyne B, Engstrøm T, Fröbert O, Piroth Z, Oldroyd KG, Tonino PAL, Pijls NHJ, and Otterspoor LC
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- Abciximab, Humans, Treatment Outcome, Angioplasty, Balloon, Coronary, Hypothermia, Percutaneous Coronary Intervention adverse effects, ST Elevation Myocardial Infarction diagnosis, ST Elevation Myocardial Infarction surgery
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- 2021
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38. The prognostic value of immediate post-TAVI hemodynamic evaluation is superior to aortography and transoesophageal echocardiography in predicting patient survival.
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Dekany G, Fontos G, Satish S, Szabo G, Pinter T, Piroth Z, Vertesaljai M, Pal M, Mandzak A, Gulyas Z, Gharehdaghi S, Ferenci T, and Andreka P
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- Aortic Valve diagnostic imaging, Aortic Valve surgery, Aortography, Cardiac Catheterization, Echocardiography, Transesophageal, Hemodynamics, Humans, Prognosis, Severity of Illness Index, Treatment Outcome, Aortic Valve Insufficiency diagnostic imaging, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis surgery, Transcatheter Aortic Valve Replacement
- Abstract
Background: Although post-TAVI PAR is commonly seen, its exact evaluation, grading and the true impact on patients' survival are still debated. This single center study aimed to evaluate the effect of post transcatheter aortic valve implantation (TAVI) paravalvular aortic regurgitation (PAR) on patients' survival. The outcome was evaluated by the three most commonly used techniques just after TAVI in the interventional arena., Methods: 201 high risk patients with severe symptomatic aortic stenosis underwent TAVI with the self-expandable system. The severity of post-TAVI PAR was prospectively evaluated by aortography and transesophageal echocardiography (TEE) using a four-class scheme and hemodynamic evaluation by calculation of the regurgitation index (RI). Median follow up time was 763 days., Results: Post-TAVI PAR results of the three different modalities were concordant with each other (all p < 0.001). Patients with grade 0-I PAR by aortography had better long term outcomes compared to those who had grade II-III PAR (unadjusted HR 1.77 [95% CI, 1.04-3.01], p = 0.03). Although in multivariate analysis neither aortography nor TEE were shown to be significant predictors of survival, hemodynamic assessment using the exact RI result was a significant predictor of survival and its effect was found to be linear (adjusted HR 0.72 [95% CI, 0.52-0.98] for 10% point increase in RI, p = 0.03595)., Conclusions: Among the three modalities that are frequently used to evaluate the outcome, post-TAVI RI showed the highest added predictive value for survival., Competing Interests: Declaration of Competing Interest None., (Copyright © 2020 Elsevier B.V. All rights reserved.)
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- 2021
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39. Fractional flow reserve-guided multivessel angioplasty in myocardial infarction: three-year follow-up with cost benefit analysis of the Compare-Acute trial.
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Smits PC, Laforgia PL, Abdel-Wahab M, Neumann FJ, Richardt G, Boxma-de Klerk B, Lunde K, Schotborgh CE, Piroth Z, Horak D, Wlodarczak A, Frederix GW, and Omerovic E
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- Angioplasty economics, Coronary Angiography, Coronary Artery Disease surgery, Cost-Benefit Analysis, Follow-Up Studies, Humans, Myocardial Infarction economics, Treatment Outcome, Angioplasty methods, Coronary Artery Disease diagnosis, Fractional Flow Reserve, Myocardial physiology, Myocardial Infarction surgery, Percutaneous Coronary Intervention economics, Percutaneous Coronary Intervention methods, ST Elevation Myocardial Infarction
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Aims: The Compare-Acute trial showed superiority of fractional flow reserve (FFR)-guided acute complete revascularisation compared to culprit-only treatment in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease (MVD) at one year. The aim of this study was to investigate the outcome at three years, together with cost analysis of this strategy., Methods and Results: After primary percutaneous coronary intervention (PCI), 885 patients with STEMI and MVD were randomised (1:2 ratio) to FFR-guided complete revascularisation (295 patients) or infarct-related artery (IRA)-only treatment (590 patients). After 36 months, the primary endpoint (composite of death, myocardial infarction, revascularisation, stroke) occurred significantly less frequently in the FFR-guided complete revascularisation group: 46/295 patients (15.6%) versus 178/590 patients (30.2%) (HR 0.46, 95% CI: 0.33-0.64; p<0.001). This benefit was driven mainly by the reduction of revascularisations in the follow-up (12.5% vs 25.2%; HR 0.45, 95% CI: 0.31-0.64; p<0.001). Cost analysis shows benefit of the FFR-guided complete revascularisation strategy, which can reduce the cost per patient by up to 21% at one year (8,150€ vs 10,319€) and by 22% at three years (8,653€ vs 11,100€)., Conclusions: In patients with STEMI and MVD, FFR-guided complete revascularisation is more beneficial in terms of outcome and healthcare costs compared to IRA-only revascularisation at 36 months.
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- 2020
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40. Graft patency after FFR-guided versus angiography-guided coronary artery bypass grafting: the GRAFFITI trial.
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Toth GG, De Bruyne B, Kala P, Ribichini FL, Casselman F, Ramos R, Piroth Z, Fournier S, Piccoli A, Van Mieghem C, Penicka M, Mates M, Nemec P, Van Praet F, Stockman B, Degriek I, and Barbato E
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- Coronary Angiography, Coronary Artery Bypass, Humans, Prospective Studies, Treatment Outcome, Coronary Artery Disease surgery, Coronary Stenosis, Fractional Flow Reserve, Myocardial
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Aims: The aim of this study was to assess prospectively the clinical benefits of fractional flow reserve (FFR) in guiding coronary artery bypass grafting (CABG)., Methods and Results: GRAFFITI is a single-blinded, prospective, multicentre, randomised controlled trial of FFR-guided versus angiography-guided CABG. We enrolled patients undergoing coronary angiography, having a significantly diseased left anterior descending artery or left main stem and at least one more major coronary artery with intermediate stenosis, assessed by FFR. Surgical strategy was defined based on angiography, blinded to FFR values prior to randomisation. After randomisation, patients were operated on either following the angiography-based strategy (angiography-guided group) or according to FFR, i.e., with an FFR ≤0.80 as cut-off for grafting (FFR-guided group). The primary endpoint was graft patency at 12 months. Between March 2012 and December 2016, 172 patients were randomised either to the angiography-guided group (84 patients) or to the FFR-guided group (88 patients). The patients had a median of three [3; 4] lesions; diameter stenosis was 65% (50%; 80%), FFR was 0.72 (0.50; 0.82). Compared to the angiography-guided group, the FFR-guided group received fewer anastomoses (3 [3; 3] vs 2 [2; 3], respectively; p=0.004). One-year angiographic follow-up showed no difference in overall graft patency (126 [80%] vs 113 [81%], respectively; p=0.885). One-year clinical follow-up, available in 98% of patients, showed no difference in the composite of death, myocardial infarction, target vessel revascularisation and stroke., Conclusions: FFR guidance of CABG has no impact on one-year graft patency, but it is associated with a simplified surgical procedure. ClinicalTrials.gov Identifier: NCT01810224.
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- 2019
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41. Fractional Flow Reserve and Quality-of-Life Improvement After Percutaneous Coronary Intervention in Patients With Stable Coronary Artery Disease.
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Nishi T, Piroth Z, De Bruyne B, Jagic N, Möbius-Winkler S, Kobayashi Y, Derimay F, Fournier S, Barbato E, Tonino P, Jüni P, Pijls NHJ, and Fearon WF
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- Aged, Angina, Stable diagnosis, Angina, Stable physiopathology, Cardiac Catheterization, Coronary Angiography, Coronary Artery Disease diagnosis, Coronary Artery Disease physiopathology, Female, Health Status, Humans, Male, Middle Aged, Randomized Controlled Trials as Topic, Recovery of Function, Surveys and Questionnaires, Time Factors, Treatment Outcome, Angina, Stable therapy, Coronary Artery Disease therapy, Fractional Flow Reserve, Myocardial, Percutaneous Coronary Intervention adverse effects, Quality of Life
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Background: Whether the benefit in quality of life (QOL) after percutaneous coronary intervention depends on the severity of the stenosis as determined by fractional flow reserve (FFR) remains unknown. This study sought to investigate the relationship between FFR values and improvement in QOL., Methods: From the FAME 1 and 2 trials (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation), we identified 706 stable patients with coronary artery disease who had at least 1 lesion with an FFR≤0.80 that was treated with percutaneous coronary intervention and 185 patients with coronary artery disease who had no lesion with an FFR≤0.80 and were treated medically who served as a reference group. QOL was assessed by the European Quality of Life-5 Dimensions index at baseline, 1 month, and 1 year. We assessed the relationship between QOL improvement (defined as the change in European Quality of Life-5 Dimensions index from baseline) and FFR as a continuous value and according to abnormal FFR tertile., Results: QOL improved significantly after percutaneous coronary intervention in each abnormal FFR tertile, whereas it did not change in the reference group. The lowest abnormal FFR subgroup had the greatest improvement in QOL at 1 month ( P<0.001). In mixed-effects models for repeated measures, lower FFR ( P=0.002 for 1 month and 0.049 for 1 year), greater delta FFR ( P=0.021 for 1 month and 0.025 for 1 year), and higher angina class ( P=0.001 for 1 month and <0.001 for 1 year) were associated with the greatest magnitude of QOL improvement at both 1 month and 1 year., Conclusions: Among patients with stable coronary artery disease, FFR and angina severity predict QOL improvement after percutaneous coronary intervention., Clinical Trial Registration: URL: https://www.clinicaltrials.gov . Unique identifiers: NCT00267774 and NCT01132495.
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- 2018
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42. Study Design of the Graft Patency After FFR-Guided Versus Angiography-Guided CABG Trial (GRAFFITI).
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Toth GG, De Bruyne B, Kala P, Ribichini FL, Casselman F, Ramos R, Piroth Z, Fournier S, Van Mieghem C, Penicka M, Mates M, Van Praet F, Degriek I, and Barbato E
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- Coronary Artery Disease diagnosis, Coronary Artery Disease physiopathology, Coronary Vessels diagnostic imaging, Coronary Vessels surgery, Female, Follow-Up Studies, Fractional Flow Reserve, Myocardial physiology, Humans, Male, Prospective Studies, Single-Blind Method, Treatment Outcome, Blood Vessel Prosthesis, Coronary Angiography methods, Coronary Artery Bypass methods, Coronary Artery Disease surgery, Coronary Vessels physiopathology, Surgery, Computer-Assisted methods, Vascular Patency
- Abstract
Clinical benefit of invasive functionally guided revascularization has been mostly investigated and proven for percutaneous coronary intervention. It has never been prospectively evaluated whether a systematic fractional flow reserve (FFR) assessment is also beneficial in guiding coronary artery bypass graft surgery (CABG). The objective of the GRAft patency after FFR-guided versus angiography-guIded CABG (GRAFFITI) trial was to compare an FFR-guided revascularization strategy to the traditional angiography-guided revascularization strategy for patients undergoing CABG. Patients were enrolled with significantly diseased left anterior descending or left main stem and at least one major coronary artery with angiographically intermediate stenosis (30-90% diameter stenosis) that was assessed by FFR. Thereafter, while the FFR values were kept concealed, cardiac surgeons decided their intended procedural strategy based on the coronary angiography alone. At this point, patients underwent 1:1 randomization to either an FFR-guided or an angiography-guided CABG strategy. In case the patient was randomized to angiography-guided arm, cardiac surgeons kept their intended procedural strategy, i.e., CABG was guided solely on the basis of the coronary angiography. In case the patient was randomized to the FFR-guided arm, FFR values were disclosed to the surgeons who revised the surgical protocol according to the functional significance of each coronary stenosis. The primary endpoint of the trial was the rate of graft occlusion at 12 months, assessed by coronary computed tomography or coronary angiography. The secondary endpoints were (1) length of postoperative hospital stay; (2) changes in surgical strategy depending upon FFR results (in FFR-guided group only); and (3) rate of major adverse cardiac and cerebrovascular events, i.e., composite of death, myocardial infarction, stroke, and any revascularization during the follow-up period. This study is the first prospective randomized trial investigating potential clinical benefits, associated with FFR-guided surgical revascularization., Trial Registration: NCT01810224.
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- 2018
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43. Five-Year Outcomes with PCI Guided by Fractional Flow Reserve.
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Xaplanteris P, Fournier S, Pijls NHJ, Fearon WF, Barbato E, Tonino PAL, Engstrøm T, Kääb S, Dambrink JH, Rioufol G, Toth GG, Piroth Z, Witt N, Fröbert O, Kala P, Linke A, Jagic N, Mates M, Mavromatis K, Samady H, Irimpen A, Oldroyd K, Campo G, Rothenbühler M, Jüni P, and De Bruyne B
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- Aged, Angina Pectoris therapy, Antihypertensive Agents therapeutic use, Coronary Disease drug therapy, Coronary Disease mortality, Coronary Disease therapy, Coronary Stenosis physiopathology, Drug-Eluting Stents, Female, Follow-Up Studies, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Myocardial Infarction epidemiology, Myocardial Infarction prevention & control, Platelet Aggregation Inhibitors therapeutic use, Retreatment statistics & numerical data, Coronary Stenosis drug therapy, Coronary Stenosis therapy, Fractional Flow Reserve, Myocardial, Percutaneous Coronary Intervention
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Background: We hypothesized that fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) would be superior to medical therapy as initial treatment in patients with stable coronary artery disease., Methods: Among 1220 patients with angiographically significant stenoses, those in whom at least one stenosis was hemodynamically significant (FFR, ≤0.80) were randomly assigned to FFR-guided PCI plus medical therapy or to medical therapy alone. Patients in whom all stenoses had an FFR of more than 0.80 received medical therapy and were entered into a registry. The primary end point was a composite of death, myocardial infarction, or urgent revascularization., Results: A total of 888 patients underwent randomization (447 patients in the PCI group and 441 in the medical-therapy group). At 5 years, the rate of the primary end point was lower in the PCI group than in the medical-therapy group (13.9% vs. 27.0%; hazard ratio, 0.46; 95% confidence interval [CI], 0.34 to 0.63; P<0.001). The difference was driven by urgent revascularizations, which occurred in 6.3% of the patients in the PCI group as compared with 21.1% of those in the medical-therapy group (hazard ratio, 0.27; 95% CI, 0.18 to 0.41). There were no significant differences between the PCI group and the medical-therapy group in the rates of death (5.1% and 5.2%, respectively; hazard ratio, 0.98; 95% CI, 0.55 to 1.75) or myocardial infarction (8.1% and 12.0%; hazard ratio, 0.66; 95% CI, 0.43 to 1.00). There was no significant difference in the rate of the primary end point between the PCI group and the registry cohort (13.9% and 15.7%, respectively; hazard ratio, 0.88; 95% CI, 0.55 to 1.39). Relief from angina was more pronounced after PCI than after medical therapy., Conclusions: In patients with stable coronary artery disease, an initial FFR-guided PCI strategy was associated with a significantly lower rate of the primary composite end point of death, myocardial infarction, or urgent revascularization at 5 years than medical therapy alone. Patients without hemodynamically significant stenoses had a favorable long-term outcome with medical therapy alone. (Funded by St. Jude Medical and others; FAME 2 ClinicalTrials.gov number, NCT01132495 .).
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- 2018
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44. Response by Piroth et al to Letter Regarding Article, "Prognostic Value of Fractional Flow Reserve Measured Immediately After Drug-Eluting Stent Implantation".
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Piroth Z, Toth GG, Tonino PAL, Barbato E, Aghlmandi S, Curzen N, Rioufol G, Pijls NHJ, Fearon WF, Jüni P, and De Bruyne B
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- Prognosis, Drug-Eluting Stents, Fractional Flow Reserve, Myocardial, Percutaneous Coronary Intervention
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- 2017
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45. Prognostic Value of Fractional Flow Reserve Measured Immediately After Drug-Eluting Stent Implantation.
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Piroth Z, Toth GG, Tonino PAL, Barbato E, Aghlmandi S, Curzen N, Rioufol G, Pijls NHJ, Fearon WF, Jüni P, and De Bruyne B
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- Aged, Cohort Studies, Female, Humans, Male, Middle Aged, Percutaneous Coronary Intervention, Predictive Value of Tests, Drug-Eluting Stents, Fractional Flow Reserve, Myocardial
- Abstract
Background: The predictive value of fractional flow reserve (FFR) measured immediately after percutaneous coronary intervention (PCI) with drug-eluting stent placement has not been prospectively investigated. We investigated the potential of post-PCI FFR measurements to predict clinical outcome in patients from FAME 1 and 2 trials (Fractional Flow Reserve or Angiography for Multivessel Evaluation)., Methods and Results: All patients of FAME 1 and FAME 2 who had post-PCI FFR measurement were included. The primary outcome was vessel-oriented composite end point at 2 years, defined as vessel-related cardiovascular death, vessel-related spontaneous myocardial infarction, and ischemia-driven target vessel revascularization. Eight hundred thirty-eight vessels in 639 patients were analyzed. Baseline FFR values did not differ between vessels with versus without vessel-oriented composite end point (0.66±0.11 versus 0.63±0.14, respectively; P =0.207). Post-PCI FFR was significantly lower in vessels with vessel-oriented composite end point (0.88±0.06 versus 0.90±0.06, respectively; P =0.019). Comparing the 2-year outcome of lower and upper tertiles of post-PCI FFR significant difference was found favoring upper tertile in terms of overall vessel-oriented composite end point (9.2% versus 3.8%, respectively; hazard ratio, 1.46; 95% confidence interval, 1.02-2.08; P =0.037) and target vessel revascularization (7.0% versus 2.4%, respectively; hazard ratio, 1.59; 95% confidence interval, 1.03-2.46; P =0.037). When adjusted to sex, hypertension, diabetes mellitus, target vessel, serial stenosis, and baseline percentage diameter stenosis, a strong trend was preserved in terms of target vessel revascularization (harzard ratio, 1.55; 95% confidence interval, 0.97-2.46; P =0.066), favoring the upper tertile. Post-PCI FFR of 0.92 was found to have the highest diagnostic accuracy; however, the positive likelihood ratio remained low (<1.4)., Conclusions: A higher post-PCI FFR value is associated with a better vessel-related outcome. However, its predictive value is too low to advocate its use as a surrogate clinical end point., (© 2017 American Heart Association, Inc.)
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- 2017
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46. Fractional Flow Reserve-Guided Multivessel Angioplasty in Myocardial Infarction.
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Smits PC, Abdel-Wahab M, Neumann FJ, Boxma-de Klerk BM, Lunde K, Schotborgh CE, Piroth Z, Horak D, Wlodarczak A, Ong PJ, Hambrecht R, Angerås O, Richardt G, and Omerovic E
- Subjects
- Aged, Disease-Free Survival, Female, Fractional Flow Reserve, Myocardial, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Percutaneous Coronary Intervention, ST Elevation Myocardial Infarction pathology, Treatment Outcome, Angioplasty, Balloon, Coronary methods, ST Elevation Myocardial Infarction therapy
- Abstract
Background: In patients with ST-segment elevation myocardial infarction (STEMI), the use of percutaneous coronary intervention (PCI) to restore blood flow in an infarct-related coronary artery improves outcomes. The use of PCI in non-infarct-related coronary arteries remains controversial., Methods: We randomly assigned 885 patients with STEMI and multivessel disease who had undergone primary PCI of an infarct-related coronary artery in a 1:2 ratio to undergo complete revascularization of non-infarct-related coronary arteries guided by fractional flow reserve (FFR) (295 patients) or to undergo no revascularization of non-infarct-related coronary arteries (590 patients). The FFR procedure was performed in both groups, but in the latter group, both the patients and their cardiologist were unaware of the findings on FFR. The primary end point was a composite of death from any cause, nonfatal myocardial infarction, revascularization, and cerebrovascular events at 12 months. Clinically indicated elective revascularizations performed within 45 days after primary PCI were not counted as events in the group receiving PCI for an infarct-related coronary artery only., Results: The primary outcome occurred in 23 patients in the complete-revascularization group and in 121 patients in the infarct-artery-only group that did not receive complete revascularization, a finding that translates to 8 and 21 events per 100 patients, respectively (hazard ratio, 0.35; 95% confidence interval [CI], 0.22 to 0.55; P<0.001). Death occurred in 4 patients in the complete-revascularization group and in 10 patients in the infarct-artery-only group (1.4% vs. 1.7%) (hazard ratio, 0.80; 95% CI, 0.25 to 2.56), myocardial infarction in 7 and 28 patients, respectively (2.4% vs. 4.7%) (hazard ratio, 0.50; 95% CI, 0.22 to 1.13), revascularization in 18 and 103 patients (6.1% vs. 17.5%) (hazard ratio, 0.32; 95% CI, 0.20 to 0.54), and cerebrovascular events in 0 and 4 patients (0 vs. 0.7%). An FFR-related serious adverse event occurred in 2 patients (both in the group receiving infarct-related treatment only)., Conclusions: In patients with STEMI and multivessel disease who underwent primary PCI of an infarct-related artery, the addition of FFR-guided complete revascularization of non-infarct-related arteries in the acute setting resulted in a risk of a composite cardiovascular outcome that was lower than the risk among those who were treated for the infarct-related artery only. This finding was mainly supported by a reduction in subsequent revascularizations. (Funded by Maasstad Cardiovascular Research and others; Compare-Acute ClinicalTrials.gov number, NCT01399736 .).
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- 2017
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47. Clinical value of post-percutaneous coronary intervention fractional flow reserve value: A systematic review and meta-analysis.
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Rimac G, Fearon WF, De Bruyne B, Ikeno F, Matsuo H, Piroth Z, Costerousse O, and Bertrand OF
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- Adult, Aged, Coronary Stenosis therapy, Female, Humans, Male, Middle Aged, Stents, Coronary Stenosis physiopathology, Fractional Flow Reserve, Myocardial, Percutaneous Coronary Intervention
- Abstract
Background: Fractional flow reserve (FFR) prior to percutaneous coronary intervention (PCI) is useful to guide treatment. Whether post-PCI FFR assessment might have clinical impact is controversial. The aim of this study is to evaluate the range of post-PCI FFR values and analyze the relationship between post-PCI FFR and clinical outcomes., Methods: We systematically searched the PubMed, EMBASE, and Cochrane Library databases with cross-referencing of articles reporting post-PCI FFR and correlating post-PCI FFR values and clinical outcomes. The outcomes of interest were the immediate post-PCI FFR values and the correlations between post-PCI FFR and the incidence of repeat intervention and major adverse cardiac events (MACE)., Results: From 1995 to 2015, a total of 105 studies (n = 7470) were included, with 46 studies reporting post-PCI FFR and 59 studies evaluating relationship between post-PCI and clinical outcomes up to 30 months after PCI. Overall, post-PCI FFR values demonstrated a normal distribution with a mean value of 0.90 ± 0.04. There was a positive correlation between the percentage of stent use and post-PCI FFR (P < .0001). Meta-regression analysis indicated that higher post-PCI FFR values were associated with reduced rates of repeat intervention (P < .0001) and MACE (P = .0013). A post-PCI FFR ≥0.90 was associated with significantly lower risk of repeat PCI (odds ratio 0.43, 95% CI 0.34-0.56, P < .0001) and MACE (odds ratio 0.71, 95% CI 0.59-0.85, P = .0003)., Conclusions: FFR measurement after PCI was associated with prognostic significance. Further investigation is required to assess the role of post-PCI FFR and validate cutoff values in contemporary clinical practice., (Copyright © 2016 Elsevier Inc. All rights reserved.)
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- 2017
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48. A Prospective Natural History Study of Coronary Atherosclerosis Using Fractional Flow Reserve.
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Barbato E, Toth GG, Johnson NP, Pijls NH, Fearon WF, Tonino PA, Curzen N, Piroth Z, Rioufol G, Jüni P, and De Bruyne B
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- Atherosclerosis diagnosis, Atherosclerosis surgery, Coronary Angiography, Coronary Artery Disease diagnosis, Coronary Artery Disease surgery, Coronary Vessels diagnostic imaging, Coronary Vessels physiopathology, Female, Follow-Up Studies, Humans, Male, Middle Aged, Percutaneous Coronary Intervention methods, Prognosis, Prospective Studies, Severity of Illness Index, Time Factors, Atherosclerosis physiopathology, Coronary Artery Disease physiopathology, Coronary Vessels surgery, Fractional Flow Reserve, Myocardial physiology
- Abstract
Background: In patients with coronary artery disease, clinical outcome depends on the extent of reversible myocardial ischemia. Whether the outcome also depends on the severity of the stenosis as determined by fractional flow reserve (FFR) remains unknown., Objectives: This study sought to investigate the relationship between FFR values and vessel-related clinical outcome., Methods: We prospectively studied major adverse cardiovascular events (MACE) at 2 years in 607 patients in whom all stenoses were assessed by FFR and who were treated with medical therapy alone. The relationship between FFR and 2-year MACE was assessed as a continuous function. Logistic and Cox proportional hazards regression models were used to calculate the average decrease in the risk of MACE per 0.05-U increase in FFR., Results: MACE occurred in 272 (26.5%) of 1,029 lesions. Target lesions with diameter stenosis ≥70% were more often present in the MACE group (p < 0.01). Median FFR was significantly lower in the MACE group versus the non-MACE group (0.68 [interquartile range: 0.54 to 0.77] vs. 0.80 [interquartile range: 0.70 to 0.88]; p < 0.01). The cumulative incidence of MACE significantly increased with increasing FFR quartiles. An average decrease in MACE per 0.05-unit increase in FFR was statistically significant even after adjustment for all clinical and angiographic features (odds ratio: 0.81; 95% confidence interval: 0.76 to 0.86]). The strongest increase in MACE occurred for FFR values between 0.80 and 0.60. In multivariable Cox regression analysis, FFR was significantly associated with MACE up to 2 years (hazard ratio: 0.87; 95% confidence interval: 0.83 to 0.91])., Conclusions: In patients with stable coronary disease, stenosis severity as assessed by FFR is a major and independent predictor of lesion-related outcome. (FAME II - Fractional Flow Reserve [FFR] Guided Percutaneous Coronary Intervention [PCI] Plus Optimal Medical Treatment [OMT] Verses OMT; NCT01132495)., (Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
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- 2016
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49. Five-year outcome of consecutive unprotected left main percutaneous coronary interventions.
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Piroth Z, Ferenci T, Fontos G, Szonyi T, Nemeth J, Szoke S, Chaurasia AK, and Andreka P
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- Aged, Female, Humans, Male, Middle Aged, Time Factors, Treatment Outcome, Coronary Stenosis surgery, Percutaneous Coronary Intervention methods
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- 2016
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50. [Measurement of natriuretic peptides in heart failure: the good laboratory and clinical practice].
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Kovács LG, Nyolczas N, Habon T, Sepp R, Piroth Z, Hajas Á, Boncz I, Tomcsányi J, Kappelmayer J, and Merkely B
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- Acute Disease, Ambulatory Care methods, Ambulatory Care standards, Biomarkers blood, Chronic Disease, Diagnosis, Differential, Heart Failure blood, Heart Failure complications, Heart Failure drug therapy, Heart Failure economics, Humans, Hungary, Natriuretic Peptide, Brain blood, Patient Admission, Patient Discharge, Peptide Fragments blood, Prognosis, Reagent Kits, Diagnostic standards, Respiratory Tract Diseases diagnosis, Severity of Illness Index, Treatment Outcome, Blood Chemical Analysis economics, Blood Chemical Analysis methods, Blood Chemical Analysis standards, Direct Service Costs, Dyspnea etiology, Heart Failure diagnosis, Natriuretic Peptides blood
- Abstract
Cardiac natriuretic peptides (BNP, NT-proBNP) play a pivotal role in cardiovascular homeostasis, mainly due to their roles in vasodilatation, natriuresis, diuresis and due to their antiproliferative properties. Proper measurement of the natriuretic peptide levels may help differentiate between respiratory and cardiac forms of dyspnea, diagnose early forms of heart failure, evaluate severity of heart failure (prognosis) and monitor the efficacy of therapy. In many countries natriuretic peptide levels are being used as one of the earliest diagnostics tools to evaluate the involvement of the heart. Current theoretical and clinical data confirm the importance of natriuretic peptides in routine healthcare. These roles are clearly described in international recommendations and guidelines. In the current review the authors discuss the problems of the measurement of natriuretic peptides in Hungary, including several aspects related to laboratory medicine, cardiology and health economy.
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- 2015
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