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Baber U, Li SX, Pinnelas R, Pocock SJ, Krucoff MW, Ariti C, Gibson CM, Steg PG, Weisz G, Witzenbichler B, Henry TD, Kini AS, Stuckey T, Cohen DJ, Iakovou I, Dangas G, Aquino MB, Sartori S, Chieffo A, Moliterno DJ, Colombo A, Mehran R. Incidence, Patterns, and Impact of Dual Antiplatelet Therapy Cessation Among Patients With and Without Chronic Kidney Disease Undergoing Percutaneous Coronary Intervention: Results From the PARIS Registry (Patterns of Non-Adherence to Anti-Platelet Regimens in Stented Patients). Circ Cardiovasc Interv 2019; 11:e006144. [PMID: 29870385 DOI: 10.1161/circinterventions.117.006144] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 02/15/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Patients with chronic kidney disease (CKD) experience high rates of ischemic and bleeding events after percutaneous coronary intervention (PCI), complicating decisions surrounding dual antiplatelet therapy (DAPT). This study aims to determine the pattern and impact of various modes of DAPT cessation for patients with CKD undergoing PCI. METHODS AND RESULTS Patients from the PARIS registry (Patterns of Non-Adherence to Anti-Platelet Regimens in Stented Patients) were grouped based on the presence of CKD defined as creatinine clearance <60 mL/min. After index PCI, time and mode of DAPT cessation (discontinuation, interruption, and disruption) and clinical outcomes (major adverse cardiac events, stent thrombosis, myocardial infarction, and major bleeding [Bleeding Academic Research Consortium type 3 or 5]) were reported. Over 2 years, patients with CKD (n=839) had higher adjusted risks for death (hazard ratio, 3.16; 95% confidence interval, 2.26-4.41), myocardial infarction (hazard ratio, 2.43; 95% confidence interval, 1.65-3.57), and major bleeding (hazard ratio, 2.21; 95% confidence interval, 1.53-3.19) compared with patients without CKD (n=3745). Rates of DAPT discontinuation within the first year after PCI and disruption were significantly higher for patients with CKD. However, DAPT interruption occurred with equal frequency. Associations between DAPT cessation mode and subsequent risk were not modified by CKD status. Findings were unchanged after propensity matching. CONCLUSIONS Patients with CKD display high and comparable risks for both ischemic and bleeding events after PCI. Physicians are more likely to discontinue DAPT within the first year after PCI among patients with CKD, likely reflecting clinical preferences to avoid bleeding. Risks after DAPT cessation, irrespective of underlying mode, are not modified by the presence or absence of CKD.
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Affiliation(s)
- Usman Baber
- From the Mount Sinai School of Medicine, New York, NY (U.B., A.S.K., G.D., M.B.A., S.S., R.M.); Dartmouth Geisel School of Medicine, Hanover, NH (S.X.L.); New York University Medical Center (R.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.J.P., C.A.); Duke University School of Medicine, Durham, NC (M.W.K.); Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts (C.M.G.); Université Paris-Diderot, Sorbonne Paris-Cité, Paris, France (P.G.S.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); Moses Cone Memorial Hospital, Greensboro, NC (T.S.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Onassis Cardiac Surgery Center, Athens, Greece (I.I.); San Raffaele Scientific Institute, Milan, Italy (A. Chieffo, A. Colombo); and University of Kentucky, Lexington (D.J.M.)
| | - Shawn X Li
- From the Mount Sinai School of Medicine, New York, NY (U.B., A.S.K., G.D., M.B.A., S.S., R.M.); Dartmouth Geisel School of Medicine, Hanover, NH (S.X.L.); New York University Medical Center (R.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.J.P., C.A.); Duke University School of Medicine, Durham, NC (M.W.K.); Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts (C.M.G.); Université Paris-Diderot, Sorbonne Paris-Cité, Paris, France (P.G.S.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); Moses Cone Memorial Hospital, Greensboro, NC (T.S.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Onassis Cardiac Surgery Center, Athens, Greece (I.I.); San Raffaele Scientific Institute, Milan, Italy (A. Chieffo, A. Colombo); and University of Kentucky, Lexington (D.J.M.)
| | - Rebecca Pinnelas
- From the Mount Sinai School of Medicine, New York, NY (U.B., A.S.K., G.D., M.B.A., S.S., R.M.); Dartmouth Geisel School of Medicine, Hanover, NH (S.X.L.); New York University Medical Center (R.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.J.P., C.A.); Duke University School of Medicine, Durham, NC (M.W.K.); Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts (C.M.G.); Université Paris-Diderot, Sorbonne Paris-Cité, Paris, France (P.G.S.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); Moses Cone Memorial Hospital, Greensboro, NC (T.S.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Onassis Cardiac Surgery Center, Athens, Greece (I.I.); San Raffaele Scientific Institute, Milan, Italy (A. Chieffo, A. Colombo); and University of Kentucky, Lexington (D.J.M.)
| | - Stuart J Pocock
- From the Mount Sinai School of Medicine, New York, NY (U.B., A.S.K., G.D., M.B.A., S.S., R.M.); Dartmouth Geisel School of Medicine, Hanover, NH (S.X.L.); New York University Medical Center (R.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.J.P., C.A.); Duke University School of Medicine, Durham, NC (M.W.K.); Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts (C.M.G.); Université Paris-Diderot, Sorbonne Paris-Cité, Paris, France (P.G.S.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); Moses Cone Memorial Hospital, Greensboro, NC (T.S.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Onassis Cardiac Surgery Center, Athens, Greece (I.I.); San Raffaele Scientific Institute, Milan, Italy (A. Chieffo, A. Colombo); and University of Kentucky, Lexington (D.J.M.)
| | - Mitchell W Krucoff
- From the Mount Sinai School of Medicine, New York, NY (U.B., A.S.K., G.D., M.B.A., S.S., R.M.); Dartmouth Geisel School of Medicine, Hanover, NH (S.X.L.); New York University Medical Center (R.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.J.P., C.A.); Duke University School of Medicine, Durham, NC (M.W.K.); Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts (C.M.G.); Université Paris-Diderot, Sorbonne Paris-Cité, Paris, France (P.G.S.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); Moses Cone Memorial Hospital, Greensboro, NC (T.S.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Onassis Cardiac Surgery Center, Athens, Greece (I.I.); San Raffaele Scientific Institute, Milan, Italy (A. Chieffo, A. Colombo); and University of Kentucky, Lexington (D.J.M.)
| | - Cono Ariti
- From the Mount Sinai School of Medicine, New York, NY (U.B., A.S.K., G.D., M.B.A., S.S., R.M.); Dartmouth Geisel School of Medicine, Hanover, NH (S.X.L.); New York University Medical Center (R.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.J.P., C.A.); Duke University School of Medicine, Durham, NC (M.W.K.); Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts (C.M.G.); Université Paris-Diderot, Sorbonne Paris-Cité, Paris, France (P.G.S.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); Moses Cone Memorial Hospital, Greensboro, NC (T.S.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Onassis Cardiac Surgery Center, Athens, Greece (I.I.); San Raffaele Scientific Institute, Milan, Italy (A. Chieffo, A. Colombo); and University of Kentucky, Lexington (D.J.M.)
| | - C Michael Gibson
- From the Mount Sinai School of Medicine, New York, NY (U.B., A.S.K., G.D., M.B.A., S.S., R.M.); Dartmouth Geisel School of Medicine, Hanover, NH (S.X.L.); New York University Medical Center (R.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.J.P., C.A.); Duke University School of Medicine, Durham, NC (M.W.K.); Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts (C.M.G.); Université Paris-Diderot, Sorbonne Paris-Cité, Paris, France (P.G.S.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); Moses Cone Memorial Hospital, Greensboro, NC (T.S.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Onassis Cardiac Surgery Center, Athens, Greece (I.I.); San Raffaele Scientific Institute, Milan, Italy (A. Chieffo, A. Colombo); and University of Kentucky, Lexington (D.J.M.)
| | - Philippe Gabriel Steg
- From the Mount Sinai School of Medicine, New York, NY (U.B., A.S.K., G.D., M.B.A., S.S., R.M.); Dartmouth Geisel School of Medicine, Hanover, NH (S.X.L.); New York University Medical Center (R.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.J.P., C.A.); Duke University School of Medicine, Durham, NC (M.W.K.); Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts (C.M.G.); Université Paris-Diderot, Sorbonne Paris-Cité, Paris, France (P.G.S.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); Moses Cone Memorial Hospital, Greensboro, NC (T.S.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Onassis Cardiac Surgery Center, Athens, Greece (I.I.); San Raffaele Scientific Institute, Milan, Italy (A. Chieffo, A. Colombo); and University of Kentucky, Lexington (D.J.M.)
| | - Giora Weisz
- From the Mount Sinai School of Medicine, New York, NY (U.B., A.S.K., G.D., M.B.A., S.S., R.M.); Dartmouth Geisel School of Medicine, Hanover, NH (S.X.L.); New York University Medical Center (R.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.J.P., C.A.); Duke University School of Medicine, Durham, NC (M.W.K.); Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts (C.M.G.); Université Paris-Diderot, Sorbonne Paris-Cité, Paris, France (P.G.S.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); Moses Cone Memorial Hospital, Greensboro, NC (T.S.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Onassis Cardiac Surgery Center, Athens, Greece (I.I.); San Raffaele Scientific Institute, Milan, Italy (A. Chieffo, A. Colombo); and University of Kentucky, Lexington (D.J.M.)
| | - Bernhard Witzenbichler
- From the Mount Sinai School of Medicine, New York, NY (U.B., A.S.K., G.D., M.B.A., S.S., R.M.); Dartmouth Geisel School of Medicine, Hanover, NH (S.X.L.); New York University Medical Center (R.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.J.P., C.A.); Duke University School of Medicine, Durham, NC (M.W.K.); Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts (C.M.G.); Université Paris-Diderot, Sorbonne Paris-Cité, Paris, France (P.G.S.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); Moses Cone Memorial Hospital, Greensboro, NC (T.S.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Onassis Cardiac Surgery Center, Athens, Greece (I.I.); San Raffaele Scientific Institute, Milan, Italy (A. Chieffo, A. Colombo); and University of Kentucky, Lexington (D.J.M.)
| | - Timothy D Henry
- From the Mount Sinai School of Medicine, New York, NY (U.B., A.S.K., G.D., M.B.A., S.S., R.M.); Dartmouth Geisel School of Medicine, Hanover, NH (S.X.L.); New York University Medical Center (R.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.J.P., C.A.); Duke University School of Medicine, Durham, NC (M.W.K.); Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts (C.M.G.); Université Paris-Diderot, Sorbonne Paris-Cité, Paris, France (P.G.S.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); Moses Cone Memorial Hospital, Greensboro, NC (T.S.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Onassis Cardiac Surgery Center, Athens, Greece (I.I.); San Raffaele Scientific Institute, Milan, Italy (A. Chieffo, A. Colombo); and University of Kentucky, Lexington (D.J.M.)
| | - Annapoorna S Kini
- From the Mount Sinai School of Medicine, New York, NY (U.B., A.S.K., G.D., M.B.A., S.S., R.M.); Dartmouth Geisel School of Medicine, Hanover, NH (S.X.L.); New York University Medical Center (R.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.J.P., C.A.); Duke University School of Medicine, Durham, NC (M.W.K.); Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts (C.M.G.); Université Paris-Diderot, Sorbonne Paris-Cité, Paris, France (P.G.S.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); Moses Cone Memorial Hospital, Greensboro, NC (T.S.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Onassis Cardiac Surgery Center, Athens, Greece (I.I.); San Raffaele Scientific Institute, Milan, Italy (A. Chieffo, A. Colombo); and University of Kentucky, Lexington (D.J.M.)
| | - Thomas Stuckey
- From the Mount Sinai School of Medicine, New York, NY (U.B., A.S.K., G.D., M.B.A., S.S., R.M.); Dartmouth Geisel School of Medicine, Hanover, NH (S.X.L.); New York University Medical Center (R.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.J.P., C.A.); Duke University School of Medicine, Durham, NC (M.W.K.); Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts (C.M.G.); Université Paris-Diderot, Sorbonne Paris-Cité, Paris, France (P.G.S.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); Moses Cone Memorial Hospital, Greensboro, NC (T.S.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Onassis Cardiac Surgery Center, Athens, Greece (I.I.); San Raffaele Scientific Institute, Milan, Italy (A. Chieffo, A. Colombo); and University of Kentucky, Lexington (D.J.M.)
| | - David J Cohen
- From the Mount Sinai School of Medicine, New York, NY (U.B., A.S.K., G.D., M.B.A., S.S., R.M.); Dartmouth Geisel School of Medicine, Hanover, NH (S.X.L.); New York University Medical Center (R.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.J.P., C.A.); Duke University School of Medicine, Durham, NC (M.W.K.); Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts (C.M.G.); Université Paris-Diderot, Sorbonne Paris-Cité, Paris, France (P.G.S.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); Moses Cone Memorial Hospital, Greensboro, NC (T.S.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Onassis Cardiac Surgery Center, Athens, Greece (I.I.); San Raffaele Scientific Institute, Milan, Italy (A. Chieffo, A. Colombo); and University of Kentucky, Lexington (D.J.M.)
| | - Ioannis Iakovou
- From the Mount Sinai School of Medicine, New York, NY (U.B., A.S.K., G.D., M.B.A., S.S., R.M.); Dartmouth Geisel School of Medicine, Hanover, NH (S.X.L.); New York University Medical Center (R.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.J.P., C.A.); Duke University School of Medicine, Durham, NC (M.W.K.); Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts (C.M.G.); Université Paris-Diderot, Sorbonne Paris-Cité, Paris, France (P.G.S.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); Moses Cone Memorial Hospital, Greensboro, NC (T.S.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Onassis Cardiac Surgery Center, Athens, Greece (I.I.); San Raffaele Scientific Institute, Milan, Italy (A. Chieffo, A. Colombo); and University of Kentucky, Lexington (D.J.M.)
| | - George Dangas
- From the Mount Sinai School of Medicine, New York, NY (U.B., A.S.K., G.D., M.B.A., S.S., R.M.); Dartmouth Geisel School of Medicine, Hanover, NH (S.X.L.); New York University Medical Center (R.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.J.P., C.A.); Duke University School of Medicine, Durham, NC (M.W.K.); Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts (C.M.G.); Université Paris-Diderot, Sorbonne Paris-Cité, Paris, France (P.G.S.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); Moses Cone Memorial Hospital, Greensboro, NC (T.S.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Onassis Cardiac Surgery Center, Athens, Greece (I.I.); San Raffaele Scientific Institute, Milan, Italy (A. Chieffo, A. Colombo); and University of Kentucky, Lexington (D.J.M.)
| | - Melissa B Aquino
- From the Mount Sinai School of Medicine, New York, NY (U.B., A.S.K., G.D., M.B.A., S.S., R.M.); Dartmouth Geisel School of Medicine, Hanover, NH (S.X.L.); New York University Medical Center (R.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.J.P., C.A.); Duke University School of Medicine, Durham, NC (M.W.K.); Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts (C.M.G.); Université Paris-Diderot, Sorbonne Paris-Cité, Paris, France (P.G.S.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); Moses Cone Memorial Hospital, Greensboro, NC (T.S.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Onassis Cardiac Surgery Center, Athens, Greece (I.I.); San Raffaele Scientific Institute, Milan, Italy (A. Chieffo, A. Colombo); and University of Kentucky, Lexington (D.J.M.)
| | - Samantha Sartori
- From the Mount Sinai School of Medicine, New York, NY (U.B., A.S.K., G.D., M.B.A., S.S., R.M.); Dartmouth Geisel School of Medicine, Hanover, NH (S.X.L.); New York University Medical Center (R.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.J.P., C.A.); Duke University School of Medicine, Durham, NC (M.W.K.); Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts (C.M.G.); Université Paris-Diderot, Sorbonne Paris-Cité, Paris, France (P.G.S.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); Moses Cone Memorial Hospital, Greensboro, NC (T.S.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Onassis Cardiac Surgery Center, Athens, Greece (I.I.); San Raffaele Scientific Institute, Milan, Italy (A. Chieffo, A. Colombo); and University of Kentucky, Lexington (D.J.M.)
| | - Alaide Chieffo
- From the Mount Sinai School of Medicine, New York, NY (U.B., A.S.K., G.D., M.B.A., S.S., R.M.); Dartmouth Geisel School of Medicine, Hanover, NH (S.X.L.); New York University Medical Center (R.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.J.P., C.A.); Duke University School of Medicine, Durham, NC (M.W.K.); Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts (C.M.G.); Université Paris-Diderot, Sorbonne Paris-Cité, Paris, France (P.G.S.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); Moses Cone Memorial Hospital, Greensboro, NC (T.S.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Onassis Cardiac Surgery Center, Athens, Greece (I.I.); San Raffaele Scientific Institute, Milan, Italy (A. Chieffo, A. Colombo); and University of Kentucky, Lexington (D.J.M.)
| | - David J Moliterno
- From the Mount Sinai School of Medicine, New York, NY (U.B., A.S.K., G.D., M.B.A., S.S., R.M.); Dartmouth Geisel School of Medicine, Hanover, NH (S.X.L.); New York University Medical Center (R.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.J.P., C.A.); Duke University School of Medicine, Durham, NC (M.W.K.); Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts (C.M.G.); Université Paris-Diderot, Sorbonne Paris-Cité, Paris, France (P.G.S.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); Moses Cone Memorial Hospital, Greensboro, NC (T.S.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Onassis Cardiac Surgery Center, Athens, Greece (I.I.); San Raffaele Scientific Institute, Milan, Italy (A. Chieffo, A. Colombo); and University of Kentucky, Lexington (D.J.M.)
| | - Antonio Colombo
- From the Mount Sinai School of Medicine, New York, NY (U.B., A.S.K., G.D., M.B.A., S.S., R.M.); Dartmouth Geisel School of Medicine, Hanover, NH (S.X.L.); New York University Medical Center (R.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.J.P., C.A.); Duke University School of Medicine, Durham, NC (M.W.K.); Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts (C.M.G.); Université Paris-Diderot, Sorbonne Paris-Cité, Paris, France (P.G.S.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); Moses Cone Memorial Hospital, Greensboro, NC (T.S.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Onassis Cardiac Surgery Center, Athens, Greece (I.I.); San Raffaele Scientific Institute, Milan, Italy (A. Chieffo, A. Colombo); and University of Kentucky, Lexington (D.J.M.)
| | - Roxana Mehran
- From the Mount Sinai School of Medicine, New York, NY (U.B., A.S.K., G.D., M.B.A., S.S., R.M.); Dartmouth Geisel School of Medicine, Hanover, NH (S.X.L.); New York University Medical Center (R.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.J.P., C.A.); Duke University School of Medicine, Durham, NC (M.W.K.); Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts (C.M.G.); Université Paris-Diderot, Sorbonne Paris-Cité, Paris, France (P.G.S.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); Moses Cone Memorial Hospital, Greensboro, NC (T.S.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Onassis Cardiac Surgery Center, Athens, Greece (I.I.); San Raffaele Scientific Institute, Milan, Italy (A. Chieffo, A. Colombo); and University of Kentucky, Lexington (D.J.M.).
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