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Coronary Intervention & Surgery

 - Stent

A biodegradable drug-eluting stent (DES) proved to be noninferior to durable-polymer DES and both showed benefits over bare-metal stents (BMS) in the BASKET-PROVE II clinical trial. The results published online Nov. 19 in Circulation also raise questions about triggers for late complications.

 - QA

The Dual Antiplatelet Therapy (DAPT) study shed light on an issue that has concerned interventional cardiologists who treat patients with drug-eluting stents. Here’s what it means for practicing physicians.

 - Big Risk

Continuing dual antiplatelet therapy (DAPT) beyond one year reduced the risk of ischemic events in patients treated with drug-eluting stents, but at the cost of an increased bleeding risk, the DAPT study group reported Nov. 16 at the American Heart Association scientific session in Chicago.

 - Smoking Skeleton

Coronary heart disease patients may not understand the risks second-hand smoke have on their health. While 89.7 percent of patients in a study published online Nov. 11 in JAMA: Internal Medicine stated they understood that second-hand tobacco smoke was harmful, only about half realized the relevance to their own lives.

 - ecg, heart, electrophysiology

For multivessel disease, “if it isn’t broken, don’t fix it” may also apply to PCI. A retrospective look at a London cohort points to treating only the culprit vessel of STEMI as the best method for improved patient outcomes through one year.

 

More Stories

Almost half of 30-day readmissions post-PCI deemed preventable

Readmission rates following PCI could be nearly halved, according to research published online Sept. 26 in the Journal of the American Heart Association. The key, researchers wrote, starts with changing clinician behaviors.  

Liberal glucose control proves effective in reducing CABG mortality

In coronary artery bypass surgery (CABG), glucose control has shown to be important for survival. One research team, however, has questioned whether a strict or liberal glucose strategy was as effective or superior for improving survival. 

Unbalanced: Women die more often after STEMI PCI

Women are almost twice as likely as men to die of any cause in hospital after a STEMI-related primary PCI, according to a study published online Sept. 29 in JAMA: Internal Medicine. This disparity occurs in spite of increased awareness of modifiable risks, researchers wrote.

ACC takes revascularization off its ‘beware’ list

The American College of Cardiology (ACC) revised its Choosing Wisely list, removing a recommendation that questioned the necessity of coronary interventions that extend beyond revascularization of a culprit lesion.

Rates of stroke following acute MI drop as treatments improve

Risk of ischemic stroke within one year of acute MI dropped by 20 percent over a 10-year span in the general Swedish population in a study published online Sept. 18 in Stroke.

CABG raises quality of life in patients with ischemic left ventricular dysfunction

When treated for ischemic left ventricular dysfunction, patients who underwent CABG reported better quality-of-life compared with guideline therapy patients at different time points throughout follow-up of nearly five years. The CABG group also had lower depression scores.

Risks higher for women undergoing STEMI PCI

When treating ST-segment elevation myocardial infarction (STEMI) with percutaneous coronary intervention (PCI), does the patient’s sex have a role in their outcomes? According to a study published online Aug. 12 in Catheterization and Cardiovascular Outcomes, the answer is yes.

TCT.14: Stents and TAVR, keynote speakers highlighted

Bioresorbable stents, TAVR trials, and keynote speaker Hillary Clinton are high on the must-see list of presentations at this year’s Transcatheter Cardiovascular Therapeutics (TCT) conference, according to director Gregg W. Stone, MD. 

Did guidelines affect post-stent surgical outcomes?

The American College of Cardiology and the American Heart Association released guidelines in 2007 advising physicians to delay surgery following a cardiac stent placement. But, did they help reduce major adverse cardiac events (MACE) following these secondary surgeries? 

Early ticagrelor treatment safe but it doesn’t improve reperfusion

Administering an antiplatelet agent to patients with STEMI in an ambulance was safe but was no more effective at improving coronary reperfusion than treatment in the hospital, based on results from the ATLANTIC trial. Early administration may prevent stent thrombosis, though.

Biodegradable stent matches gold standard for safety, efficacy

A next-generation biodegradable drug-eluting stent proved noninferior to the standard of care in a randomized clinical trial that imposed minimal exclusion criteria, according to results published online Sept. 1 in The Lancet and simultaneously presented at the European Society of Cardiology meeting in Barcelona.

FAME 2, Act 2: FFR-guided PCI keeps its lead at 2 years

PCI guided by fractional flow reserve (FFR) in patients with stable coronary artery disease who were treated with second-generation drug-eluting stents and medical therapy reduced the need for urgent revascularization compared with medical therapy alone, according to two-year results from FAME 2.

Colchicine provides no sweeping benefit after cardiac surgery

Patients undergoing cardiac surgery had mixed results when using colchicine to reduce the incidence of postpericardiotomy syndrome, postoperative atrial fibrillation or postoperative pericardial or plural effusion, according to a study published online Aug. 30 in JAMA.

Trial patients may not reflect larger MI population

Participants enrolled in cardiovascular clinical trials may be a poor representation of patients with MI, according to an analysis published Aug. 27 in JAMA. Researchers found enrollees generally to be healthier, younger and have a better prognosis than eligible nonparticipants.

Hello? Operator? Cardiologists’ communication styles may confuse PCI patients

Joint PCI decision-making may be a best practice, but it appears physicians aren’t encouraging it through their communication styles, according to a paper published online Aug. 25 in JAMA: Internal Medicine.

Meta-analysis gives clarity to bivalirudin’s risk-benefit profile

Compared with heparin, bivalirudin increases the risk of major adverse cardiac events but reduces the risk of bleeding to varying degrees in patients undergoing PCI, a meta-analysis published in the Aug. 16 issue of The Lancet concluded.

High on high-dose aspirin: Bleeding risk influences dosing only slightly

Aspirin dosing patterns after MI seem to favor high doses, regardless of bleeding risks, according to a study published online Aug. 12 in Circulation: Cardiovascular Quality & Outcomes.

Silent & deadly: Cardiac events occur in CAD patients without ischemic, angina symptoms

While coronary artery disease (CAD) patients with both ischemia and angina proved to have higher risks for mortality, 58.2 percent of patients without symptoms died of cardiovascular- or MI-related causes, according to a study published online Aug. 11 in JAMA: Internal Medicine.

Use of quality measures prevents kidney injuries in 1 in 5 PCI patients

Lowering the amount of contrast used and encouraging more oral hydration before and after a PCI procedure reduced contrast-induced acute kidney injury by 21 percent, according to a study published online July 29 in Circulation: Cardiovascular Quality and Outcomes

Timely care for off-hours STEMI still lags in hospitals

Initiatives to provide timely treatment for patients with acute MI overall appear to making an impact but hospitals still have room to improve in their care of patients who present off-hours, an analysis published online July 29 in Circulation: Cardiovascular Quality and Outcomes suggests.