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Gallone G, Kang J, Bruno F, Han JK, De Filippo O, Yang HM, Doronzo M, Park KW, Mittone G, Kang HJ, Parma R, Gwon HC, Cerrato E, Chun WJ, Smolka G, Hur SH, Helft G, Han SH, Muscoli S, Song YB, Figini F, Choi KH, Boccuzzi G, Hong SJ, Trabattoni D, Nam CW, Giammaria M, Kim HS, Conrotto F, Escaned J, Di Mario C, D'Ascenzo F, Koo BK, de Ferrari GM. Impact of Left Ventricular Ejection Fraction on Procedural and Long-Term Outcomes of Bifurcation Percutaneous Coronary Intervention. Am J Cardiol 2022; 172:18-25. [PMID: 35365291 DOI: 10.1016/j.amjcard.2022.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 02/03/2022] [Accepted: 02/22/2022] [Indexed: 11/01/2022]
Abstract
The association of left ventricular ejection fraction (LVEF) with procedural and long-term outcomes after state-of-the-art percutaneous coronary intervention (PCI) of bifurcation lesions remains unsettled. A total of 5,333 patients who underwent contemporary coronary bifurcation PCI were included in the intercontinental retrospective combined insights from the unified RAIN (veRy thin stents for patients with left mAIn or bifurcatioN in real life) and COBIS (COronary BIfurcation Stenting) III bifurcation registries. Of 5,003 patients (93.8%) with known baseline LVEF, 244 (4.9%) had LVEF <40% (bifurcation with reduced ejection fraction [BIFrEF] group), 430 (8.6%) had LVEF 40% to 49% (bifurcation with mildly reduced ejection fraction [BIFmEF] group) and 4,329 (86.5%) had ejection fraction (EF) ≥50% (bifurcation with preserved ejection fraction [BIFpEF] group). The primary end point was the Kaplan-Meier estimate of major adverse cardiac events (MACEs) (a composite of all-cause death, myocardial infarction, and target vessel revascularization). Patients with BIFrEF had a more complex clinical profile and coronary anatomy. No difference in procedural (30 days) MACE was observed across EF categories, also after adjustment for in-study outcome predictors (BIFrEF vs BIFmEF: adjusted hazard ratio [adj-HR] 1.39, 95% confidence interval [CI] 0.37 to 5.21, p = 0.626; BIFrEF vs BIFpEF: adj-HR 1.11, 95% CI 0.25 to 2.87, p = 0.883; BIFmEF vs BIFpEF: adj-HR 0.81, 95% CI 0.29 to 2.27, p = 0.683). BIFrEF was independently associated with long-term MACE (median follow-up 21 months, interquartile range 10 to 21 months) than both BIFmEF (adj-HR 2.20, 95% CI 1.41 to 3.41, p <0.001) and BIFpEF (adj-HR 1.91, 95% CI 1.41 to 2.60, p <0.001) groups, although no difference was observed between BIFmEF and BIFpEF groups (adj-HR 0.87, 95% CI 0.61 to 1.24, p = 0.449). In conclusion, in patients who underwent PCI of a coronary bifurcation lesion according to contemporary clinical practice, reduced LVEF (<40%), although a strong predictor of long-term MACEs, does not affect procedural outcomes.
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Leonardo F, Figini F, Pederzoli L, Geremia G, Landi P, Pingitore A. C45 LATE CARDIAC OUTCOMES IN PATIENTS AFTER COVID–19: A CARDIAC MAGNETIC RESONANCE STUDY. Eur Heart J Suppl 2022. [PMCID: PMC9384038 DOI: 10.1093/eurheartj/suac011.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background Myocardial injury can occur in patients with coronavirus disease (COVID)–19. Cardiac magnetic resonance (CMR) provides information on functional and morphological cardiac parameters, as well myocardial tissue characterization. Actually, there are few data on late cardiac outcomes in patients after COVID–19. Aim of the Study To assess late functional, morphological and myocardial tissue parameters in patients positive to COVID–19 Methods 55 patients (age 50±16 yrs, Female n = 17) with a prior diagnosis of COVID 19, without a previous history of cardiac disease were enrolled in the study. Of these, 35 were hospitalized. The time interval between COVID–19 diagnosis and CMR was 418±28 days. Cardiac function and myocardial tissue characterization have been evaluated with the current CMR techniques. In particular, the presence of late gadolinium enhancement (LGE), as a sign of myocarditis outcome has been evaluated. Results LGE was present in 19 patients (34.5%). In all cases, LGE was localized at the level of lateral wall of left ventricle within the myocardium or at the subepicardial level (non–ischemic pattern). Left and right ventricular (LV, RV) ejection fraction were within normal values (mean±SD 65±5% and 65±7%, respectively), as well as volumes (LV endiastolic and endsystolic volumes 71±15 and 27±8 ml/m2; RV endiastolic and endsystolic volumes 72±15 and 25±9 ml/m2). In one case, LGE was associated to regional wall hypokinesia. Among the hospitalized patients, the following factors were associated to the presence of LGE: prone position during assisted ventilation, duration of hospitalization. LGE was present in 67% of patients put in prone position, against 33% of patients not pronated (p = 0.009 Fisher‘s exact test). Duration of hospitalization was 9±5 and 16±7 respectively in patients without and with LGE (p = 0.007) Conclusion LGE, as an outcome of myocarditis, is present in a significant number of patients with a history of COVID–19, but it is not associated with dilatation or global and regional dysfunction of left ventricle. LGE is mainly present in pts with more severe clinical presentation of COVID–19
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Affiliation(s)
- F Leonardo
- OSPEDALE PEDERZOLI, PESCHIERA; OSPEDALE PESCHIERA, PESCHIERA; ISTITUTO DI FISIOLOGIA CLINICA, CNR, PISA
| | - F Figini
- OSPEDALE PEDERZOLI, PESCHIERA; OSPEDALE PESCHIERA, PESCHIERA; ISTITUTO DI FISIOLOGIA CLINICA, CNR, PISA
| | - L Pederzoli
- OSPEDALE PEDERZOLI, PESCHIERA; OSPEDALE PESCHIERA, PESCHIERA; ISTITUTO DI FISIOLOGIA CLINICA, CNR, PISA
| | - G Geremia
- OSPEDALE PEDERZOLI, PESCHIERA; OSPEDALE PESCHIERA, PESCHIERA; ISTITUTO DI FISIOLOGIA CLINICA, CNR, PISA
| | - P Landi
- OSPEDALE PEDERZOLI, PESCHIERA; OSPEDALE PESCHIERA, PESCHIERA; ISTITUTO DI FISIOLOGIA CLINICA, CNR, PISA
| | - A Pingitore
- OSPEDALE PEDERZOLI, PESCHIERA; OSPEDALE PESCHIERA, PESCHIERA; ISTITUTO DI FISIOLOGIA CLINICA, CNR, PISA
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Sheiban I, Figini F, Gasparetto V, D’Ascenzo F, Moretti C, Leonardo F. Side Branch is the Main Determinant Factor of Bifurcation Lesion Complexity: Critical Review with a Proposal Based on Single-centre Experience. Heart Int 2021; 15:67-72. [PMID: 36277829 PMCID: PMC9524656 DOI: 10.17925/hi.2021.15.2.67] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 12/08/2021] [Indexed: 10/25/2023] Open
Abstract
Although bifurcation stenting can be often managed with a simple provisional approach, in some settings, more complex techniques are appropriate. Based on our clinical experience and on data from literature, we propose a simple algorithm that may assist in selecting cases for elective double stenting. We found that, when the side branch is of adequate dimensions and affected by significant disease (longer than 10 mm and/or with presence of ostial calcifications), double stenting is associated with a lower incidence of adverse events, compared with provisional stenting.
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Affiliation(s)
- Imad Sheiban
- Ospedale “Pederzoli”, Peschiera del Garda, Italy
| | | | | | - Fabrizio D’Ascenzo
- Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
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De Filippo O, D'Ascenzo F, Angelini F, Franchin L, Cerrato E, Pennacchi M, Nuñez-Gil I, Wojakowski W, Imori Y, Trabattoni D, Huczek Z, Venuti G, Muscoli S, Iannaccone M, Montabone A, Marengo G, Rognoni A, Parma R, Figini F, Mitomo S, Boccuzzi G, Mattesini A, Quadri G, Wańha W, Smolka G, Rolfo C, Cortese B, Ryan N, Capodanno D, Chieffo A, di Mario C, Varbella F, Romeo F, Sheiban I, Escaned J, Helft G, De Ferrari GM. Performance of Thin-Strut Stents in Non-Left Main Bifurcation Coronary Lesions: A RAIN Subanalysis. J Invasive Cardiol 2021; 33:E890-E899. [PMID: 34735352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVES This study assesses the safety and efficacy of thin-strut stents in non-left main (non-LM) bifurcation coronary lesions. BACKGROUND Thinner struts of recent drug-eluting stent (DES) devices are associated with improved outcomes, but data about their performance in challenging scenarios are scant. METHODS RAIN was a retrospective multicenter registry enrolling patients with coronary bifurcation lesions or left main (LM) disease treated with thin-strut DESs. Target-lesion revascularization (TLR) was the primary endpoint, while major adverse clinical event (MACE) rate, a composite of all-cause death, myocardial infarction (MI), target-vessel revascularization (TVR), TLR, and stent thrombosis (ST), and its single components were the secondary endpoints. Multivariable analysis was performed to identify predictors of TLR. Outcome incidences according to stenting strategy (provisional vs 2-stent technique), use of final kissing balloon (FKB), and intravascular ultrasound/optical coherence tomography optimization were further investigated in prespecified subanalyses. RESULTS A total of 1803 patients (59% acute coronary syndrome, 41% stable coronary artery disease) with non-LM bifurcations were enrolled. After a median follow-up of 12 months, TLR incidence was 2.5% (2.2% for provisional stenting and 3.5% for 2-stent technique). MACE rate was 9.4% (all-cause death, 4.1%; MI, 3.2%; TVR, 3.7%; definite ST, 1.1%). After multivariable adjustment, postdilation (hazard ratio [HR], 0.32; 95% confidence interval [CI], 0.15-0.71; P<.01) and provisional stenting (HR, 0.62; 95% CI, 0.55-0.89; P=.03) were associated with lower TLR rates. FKB was associated with a lower incidence of TLR in the 2-stent subgroup (P=.03). Intracoronary imaging had no significant impact on the primary endpoint. CONCLUSIONS Thin-strut DES options represent an effective choice in bifurcation lesions. Postdilation and provisional stenting are associated with a reduced risk of TLR. FKB should be recommended in 2-stent techniques.
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Affiliation(s)
- Ovidio De Filippo
- Department of Medical Sciences, Division of Cardiology, AOU Città della Salute e della Scienza, University of Turin, Corso Bramante 88/90, 10126, Turin, Italy.
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D'Ascenzo F, Elia E, Marengo G, Wańha W, González Ferreiro R, Truffa A, Trabattoni D, Figini F, Verardi R, Di Palma G, Infusino F, Pivato C, Ochała A, Omedè P, Milewski M, Estevez R, Raporeiras Roubin S, De Filippo O, Conrotto F, Montefusco A, Gili S, Cortese B, Dusi V, Gallone G, Manfredi R, Mancone M, Biondi Zoccai G, Casella G, Templin C, Stefanini G, Wojakowski W, Sheiban I, De Ferrari GM. Long-term (≥15 years) Follow-up of Percutaneous Coronary Intervention of Unprotected Left Main (From the GRAVITY Registry). Am J Cardiol 2021; 156:72-78. [PMID: 34325877 DOI: 10.1016/j.amjcard.2021.06.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 06/04/2021] [Accepted: 06/14/2021] [Indexed: 02/05/2023]
Abstract
Long term survival and its determinants after Percutaneous Coronary Intervention (PCI) on Unprotected Left Main Coronary Artery (ULMCA) remain to be appraised. In 9 European Centers 470 consecutive patients performing PCI on ULMCA between 2002 and 2005 were retrospectively enrolled. Survival from all cause and cardiovascular (CV) death were the primary end points, while their predictors at multivariate analysis the secondary ones. Among the overall cohort 81.5% of patients were male and mean age was 66 ± 12 years. After 15 years (IQR 13 to 16), 223 patients (47%) died, 81 (17.2%) due to CV etiology. At multivariable analysis, older age (HR 1.06, 95%CI 1.02 to 1.11), LVEF < 35% (HR 2.97, 95%CI 1.24 to 7.15) and number of vessels treated during the index PCI (HR 1.75, 95%CI 1.12 to 2.72) were related to all-cause mortality, while only LVEF <35% (HR 4.71, 95%CI 1.90 to 11.66) to CV death. Repeated PCI on ULMCA occurred in 91 (28%) patients during the course of follow up and did not significantly impact on freedom from all-cause or CV mortality. In conclusion, in a large, unselected population treated with PCI on ULMCA, 47% died after 15 years, 17% due to CV causes. Age, number of vessels treated during index PCI and depressed LVEF increased risk of all cause death, while re-PCI on ULMCA did not impact survival.
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Affiliation(s)
- Fabrizio D'Ascenzo
- Department of Medical Science, Città Della Salute e della Scienza, Division of Cardiology, Turin, Italy.
| | - Edoardo Elia
- Department of Medical Science, Città Della Salute e della Scienza, Division of Cardiology, Turin, Italy
| | - Giorgio Marengo
- Department of Medical Science, Città Della Salute e della Scienza, Division of Cardiology, Turin, Italy
| | - Wojciech Wańha
- Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | | | | | | | - Filippo Figini
- Division of Cardiology, Pederzoli Hospital-Peschiera del Garda, Verona, Italy
| | - Roberto Verardi
- Department of Medical Science, Città Della Salute e della Scienza, Division of Cardiology, Turin, Italy; U.O.C. Cardiologia, Ospedale Maggiore, Bologna, Italy
| | - G Di Palma
- Cardiovascular Research Team, San Carlo Clinic, Milan, Italy
| | - Fabio Infusino
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | - Carlo Pivato
- Cardio Center, Humanitas Clinical and Research Center IRCCS, Rozzano-Milan, Italy
| | - Andrzej Ochała
- Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Pierluigi Omedè
- Department of Medical Science, Città Della Salute e della Scienza, Division of Cardiology, Turin, Italy
| | - Marek Milewski
- Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Roi Estevez
- Department of Cardiology, University Hospital Alvaro Cunqueiro, Vigo, Spain
| | | | - O De Filippo
- Department of Medical Science, Città Della Salute e della Scienza, Division of Cardiology, Turin, Italy
| | - Federico Conrotto
- Department of Medical Science, Città Della Salute e della Scienza, Division of Cardiology, Turin, Italy
| | - Antonio Montefusco
- Department of Medical Science, Città Della Salute e della Scienza, Division of Cardiology, Turin, Italy
| | | | | | - Veronica Dusi
- Department of Molecular Medicine, Section of Cardiology, University of Pavia, Pavia, Italy
| | - Guglielmo Gallone
- Department of Medical Science, Città Della Salute e della Scienza, Division of Cardiology, Turin, Italy
| | - Roberto Manfredi
- Department of Medical Science, Città Della Salute e della Scienza, Division of Cardiology, Turin, Italy
| | - Massimo Mancone
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | - G Biondi Zoccai
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy; Mediterranea Cardiocentro, Naples, Italy
| | | | - Christian Templin
- Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland
| | - Giulio Stefanini
- Cardio Center, Humanitas Clinical and Research Center IRCCS, Rozzano-Milan, Italy
| | - Wojciech Wojakowski
- Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Imad Sheiban
- Division of Cardiology, Pederzoli Hospital-Peschiera del Garda, Verona, Italy
| | - G M De Ferrari
- Department of Medical Science, Città Della Salute e della Scienza, Division of Cardiology, Turin, Italy
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Franchin L, Piroli F, D'Ascenzo F, Nuñez-Gil I, Wojakowski W, Imori Y, Trabattoni D, Huczek Z, Venuti G, Muscoli S, Montabone A, Rognoni A, Parma R, Figini F, Mitomo S, Quadri G, Wańha W, Cortese B, De Filippo O, Ryan N, Varbella F, Sheiban I, Helft G, De Ferrari GM. Impact of stent thickness on clinical outcomes in small vessel and bifurcation lesions: a RAIN-CARDIOGROUP VII sub-study. J Cardiovasc Med (Hagerstown) 2021; 22:20-25. [PMID: 32740419 DOI: 10.2459/jcm.0000000000001037] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND The clinical impact of stent strut thickness in coronary bifurcation lesions in small vessels has not been assessed in a real-world population. METHODS All 506 patients enrolled in the RAIN study, undergoing PCI in a vessel with a diameter 2.5 mm or less were retrospectively evaluated and divided into two groups according to stent strut thickness: 74 μm (n = 206) versus 81 μm (n = 300); 87.1% of the lesions involved bifurcations. TLF [defined as a composite of myocardial infarction (MI) and target lesion revascularization (TLR)] was the primary endpoint, with MACE (a composite of death, MI and TLR), its components and stent thrombosis the secondary endpoint. RESULTS After 16 (14-18) months, a lower incidence of TLF (4.3 vs. 9.8%, P = 0.026) and ST (1.0 vs. 3.0%, P = 0.042) was seen in the 74 μm group, whereas MACE occurred in 60 of 506 patients, with no statistical difference between the two groups (9.7 vs. 13.3%, P = 0.070). At multivariate analysis, chronic renal failure increased the risk of TLF while thinner strut was an independent protective factor (hazard ratio 0.51, CI 0.17-0.85, P = 0.005). CONCLUSION In this real-world population, patients being treated for small vessels lesions with thinner strut stents had lower rates of TLF, MI and ST.
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Affiliation(s)
- Luca Franchin
- Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza, Hospital, University of Turin, Turin, Italy
| | - Francesco Piroli
- Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza, Hospital, University of Turin, Turin, Italy
| | - Fabrizio D'Ascenzo
- Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza, Hospital, University of Turin, Turin, Italy
| | - Ivan Nuñez-Gil
- Interventional Cardiology Department, Clinico San Carlos University Hospital, IdISSC, Madrid, Spain
| | - Wojciech Wojakowski
- Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Yoichi Imori
- Department of Cardiovascular Medicine, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
| | - Daniela Trabattoni
- Department of Cardiovascular Sciences, Centro Cardiologico Monzino, IRCCS, Milan, Italy
| | | | - Giuseppe Venuti
- Cardio-thoracic-vascular Department, A.O.U. 'Vittorio Emanuele' Hospital, University of Catania, Catania
| | - Saverio Muscoli
- Department of Cardiovascular Disease, Tor Vergata University of Rome, Rome
| | | | - Andrea Rognoni
- Division of Cardiology, Maggiore della Carità Hospital, Novara
| | - Radoslaw Parma
- Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | | | - Satoru Mitomo
- Unit of Cardiovascular Interventions, IRCCS San Raffaele Hospital, Milan
| | - Giorgio Quadri
- Department of Cardiology, Infermi Hospital, Rivoli.,Department of Cardiology, San Luigi Gonzaga Hospital, Orbassano, Turin
| | - Wojciech Wańha
- Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | | | - Ovidio De Filippo
- Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza, Hospital, University of Turin, Turin, Italy
| | - Nicola Ryan
- Interventional Cardiology Department, Clinico San Carlos University Hospital, IdISSC, Madrid, Spain
| | - Ferdinando Varbella
- Department of Cardiology, Infermi Hospital, Rivoli.,Department of Cardiology, San Luigi Gonzaga Hospital, Orbassano, Turin
| | | | - Gerard Helft
- Sorbonne Université, Institut de Cardiologie, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Paris, France
| | - Gaetano M De Ferrari
- Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza, Hospital, University of Turin, Turin, Italy
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Iannaccone M, D'Ascenzo F, Gatti P, Cerrato E, Nuñez-Gil I, Wojakowski W, Capodanno D, Figini F, Wańha W, Chieffo A, De Ferrari GM, Di Mario C. Impact of the metal-to-artery ratio on clinical outcomes in left main and nonleft main bifurcation: insights the RAIN-CARDIOGROUP VII study (veRy thin stents for patients with left mAIn or bifurcatioN in real life). J Cardiovasc Med (Hagerstown) 2021; 21:669-674. [PMID: 32639328 DOI: 10.2459/jcm.0000000000001010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION The impact on clinical outcomes of the metal coverage on the coronary surface (namely the metal-to-artery ratio) of currently used drug-eluting stents (DESs) has not been defined. METHODS All patients with a left main or bifurcation stenosis treated with percutaneous coronary intervention (PCI) using ultrathin stents (struts thinner than 81 μm) were enrolled with a prospective multicentre fashion. The rate of device-oriented endpoint [DOE, defined as a composite of target lesion revascularization (TLR) and stent thrombosis] was the primary endpoint, while its single components were the secondary ones, evaluated according to the metal-to-artery ratio. RESULTS After 14 ± 10.4 months 62 (7.5%) of 830 patients undergoing PCI on left main experienced a DOE without differences in the metal-to-artery ratio (14.5 ± 2.1 vs. 14.4 ± 1.9, P = 0.51). Fifty out (2.4%) of 2082 patients treated with PCI on a coronary bifurcation other than left main experienced a DOE, with a higher mean metal-to-artery ratio (15.3 ± 2.1 vs. 14.6 ± 2, P = 0.01). At multivariate analysis, together with hypertension and diabetes, the metal-to-artery ratio was an independent predictor of DOE (hazard ratio 1.7 : 1.02-1.34, P = 0.02) in nonleft main PCI. When analysed for diameter, we found a significant correlation with DOE when the stent diameter was inferior to 3.0 mm (hazard ratio 1.21: 1.06-1.38, P < 0.01, all 95% confidence interval); this result was mainly consistent for patients treated with provisional stenting. The metal-to-artery ratio does not impact on outcomes in left main PCI, both in the provisional or two-stent technique, and generally when a drug-eluting stent more than 3.5 mm in diameter is implanted. Regarding nonleft main PCI, it is independently related to DOE and TLR, especially for DES with a diameter of 3.25 mm or less. CONCLUSION The metal-to-artery ratio does not impact on outcomes in left main PCI, both in the provisional or two-stent technique, and generally when a drug-eluting stent more than 3.5 mm in diameter is implanted. Regarding nonleft main PCI, it is independently related to DOE and TLR, especially for DES with a diameter of 3.25 mm or less.
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Affiliation(s)
- Mario Iannaccone
- Division of Cardiology, SS. Annunziata Hospital, ASL CN1, Savigliano
| | - Fabrizio D'Ascenzo
- Division of Cardiology, Città Della Salute e della Scienza Hospital, Turin
| | - Paolo Gatti
- Division of Cardiology, Città Della Salute e della Scienza Hospital, Turin
| | - Enrico Cerrato
- Interventional Cardiology, San Luigi Gonzaga University Hospital, Orbassano and Rivoli Infermi Hospital, Rivoli, Turin
| | - Ivan Nuñez-Gil
- Division of Cardiology, Interventional Cardiology, Hospital Clínico San Carlos, Madrid, Spain
| | - Wojciech Wojakowski
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Davide Capodanno
- C.A.S.T., P.O. Gaspare Rodolico, Azienda-Ospedaliero Universitaria 'Policlinico-Vittorio Emanuele', Catania, Italy
| | - Filippo Figini
- Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan
| | - Wojciech Wańha
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Alaide Chieffo
- Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan
| | | | - Carlo Di Mario
- Structural Interventional Cardiology, Careggi University Hospital, Florence, Italy
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Gallone G, D'Ascenzo F, Conrotto F, Costa F, Capodanno D, Muscoli S, Chieffo A, Yoichi I, Pennacchi M, Quadri G, Nuñez-Gil I, Bocchino PP, Piroli F, De Filippo O, Rolfo C, Wojakowski W, Trabattoni D, Huczek Z, Venuti G, Montabone A, Rognoni A, Parma R, Figini F, Mitomo S, Boccuzzi G, Mattesini A, Cerrato E, Wańha W, Smolka G, Cortese B, Ryan N, Bo M, di Mario C, Varbella F, Burzotta F, Sheiban I, Escaned J, Helft G, De Ferrari GM. Accuracy of the PARIS score and PCI complexity to predict ischemic events in patients treated with very thin stents in unprotected left main or coronary bifurcations. Catheter Cardiovasc Interv 2021; 97:E227-E236. [PMID: 32438488 DOI: 10.1002/ccd.28972] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 04/07/2020] [Accepted: 05/04/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND The PARIS risk score (PARIS-rs) and percutaneous coronary intervention complexity (PCI-c) predict clinical and procedural residual ischemic risk following PCI. Their accuracy in patients undergoing unprotected left main (ULM) or bifurcation PCI has not been assessed. METHODS The predictive performances of the PARIS-rs (categorized as low, intermediate, and high) and PCI-c (according to guideline-endorsed criteria) were evaluated in 3,002 patients undergoing ULM/bifurcation PCI with very thin strut stents. RESULTS After 16 (12-22) months, increasing PARIS-rs (8.8% vs. 14.1% vs. 27.4%, p < .001) and PCI-c (15.2% vs. 11%, p = .025) were associated with higher rates of major adverse cardiac events ([MACE], a composite of death, myocardial infarction [MI], and target vessel revascularization), driven by MI/death for PARIS-rs and target lesion revascularization/stent thrombosis for PCI-c (area under the curves for MACE: PARIS-rs 0.60 vs. PCI-c 0.52, p-for-difference < .001). PCI-c accuracy for MACE was higher in low-clinical-risk patients; while PARIS-rs was more accurate in low-procedural-risk patients. ≥12-month dual antiplatelet therapy (DAPT) was associated with a lower MACE rate in high PARIS-rs patients, (adjusted-hazard ratio 0.42 [95% CI: 0.22-0.83], p = .012), with no benefit in low to intermediate PARIS-rs patients. No incremental benefit with longer DAPT was observed in complex PCI. CONCLUSIONS In the setting of ULM/bifurcation PCI, the residual ischemic risk is better predicted by a clinical risk estimator than by PCI complexity, which rather appears to reflect stent/procedure-related events. Careful procedural risk estimation is warranted in patients at low clinical risk, where PCI complexity may substantially contribute to the overall residual ischemic risk.
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Affiliation(s)
- Guglielmo Gallone
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Fabrizio D'Ascenzo
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Federico Conrotto
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Francesco Costa
- Department of Clinical and Experimental Medicine, Policlinic "G. Martino", University of Messina, Messina, Italy
| | - Davide Capodanno
- Division of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy
| | - Saverio Muscoli
- Department of Cardiovascular Disease, Tor Vergata University of Rome, Rome, Italy
| | - Alaide Chieffo
- Unit of Cardiovascular Interventions, IRCCS San Raffaele Hospital, Milan, Italy
| | - Imori Yoichi
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Mauro Pennacchi
- Department of Cardiovascular, Respiratory and Morphologic Sciences, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Giorgio Quadri
- Department of Cardiology, Infermi Hospital, Rivoli, Italy
| | - Ivan Nuñez-Gil
- Hospital Clínico San Carlos, IDISSC, and Universidad Complutense de Madrid, Madrid, Spain
| | - Pier Paolo Bocchino
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Francesco Piroli
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Ovidio De Filippo
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Cristina Rolfo
- Department of Cardiology, Infermi Hospital, Rivoli, Italy
| | - Wojciech Wojakowski
- Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Daniela Trabattoni
- Department of Cardiovascular Sciences, Centro Cardiologico Monzino, IRCCS, Milan, Italy
| | | | - Giuseppe Venuti
- Division of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy
| | | | - Andrea Rognoni
- Coronary Care Unit and Catheterization Laboratory, A.O.U. Maggiore della Carità, Novara, Italy
| | - Radoslaw Parma
- Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | | | - Satoru Mitomo
- Unit of Cardiovascular Interventions, IRCCS San Raffaele Hospital, Milan, Italy
| | | | - Alessio Mattesini
- Division of Structural Interventional Cardiology, Careggi University Hospital, Florence, Italy
| | - Enrico Cerrato
- Department of Cardiology, Infermi Hospital, Rivoli, Italy
| | - Wojciech Wańha
- Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Grzegorz Smolka
- Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Bernardo Cortese
- Interventional Cardiology Unit, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Nicola Ryan
- Hospital Clínico San Carlos, IDISSC, and Universidad Complutense de Madrid, Madrid, Spain
| | - Mario Bo
- Section of Geriatrics, Department of Medical Sciences, Università degli Studi di Torino, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | - Carlo di Mario
- Division of Structural Interventional Cardiology, Careggi University Hospital, Florence, Italy
| | | | - Francesco Burzotta
- Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy
| | | | - Javier Escaned
- Hospital Clínico San Carlos, IDISSC, and Universidad Complutense de Madrid, Madrid, Spain
| | - Gerard Helft
- Pierre and Marie Curie University, Paris, France
| | - Gaetano Maria De Ferrari
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
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9
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Trabattoni D, Gili S, Teruzzi G, Omedè P, Cerrato E, Templin C, Capodanno D, Lüscher T, Ryan N, Venuti G, Montabone A, Wojakowski W, Rognoni A, Helft G, Gallo D, Biolè CA, Parma R, De Luca L, Figini F, Mitomo S, Mattesini A, Boccuzzi G, Quadri G, Wańha W, Smolka G, Huczek Z, Chieffo A, Nuñez-Gil I, Morbiducci U, Iannaccone M, di Mario C, Moretti C, D'Amico M, Sheiban I, Escaned J, D'Ascenzo F. A Sex-Based Analysis From the RAIN-CARDIOGROUP VII Study (VeRy Thin Stents for Patients With Left MAIn or BifurcatioN in Real Life) on Left Main Stenting. J Invasive Cardiol 2020; 32:342-346. [PMID: 32568097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
INTRODUCTION There is a lack of data on clinical outcomes of percutaneous coronary intervention (PCI) with ultrathin stents on unprotected left main (ULM) coronary artery comparing women and men. METHODS All patients treated with ULM-PCI with ultrathin stents (struts ≤81 μm) enrolled in the RAIN-CARDIOGROUP VII study were analyzed according to a sex-assessment evaluation. Major adverse cardiovascular event (MACE, a composite of all-cause death, myocardial infarction, target-lesion revascularization [TLR], and stent thrombosis) was the primary endpoint, whereas single components of MACE were the secondary endpoints. RESULTS Out of a cohort of 793 patients, a total of 172 women (21.7%) and 621 men (78.3%) were included. Compared with men, women were older and less frequently smokers, had more frequently a history of previous PCI, and presented more frequently with an acute coronary syndrome. Among women, ostial lesions were more prevalent and mean stent diameter was lower compared with men. After 13.4 months (range, 8.4-21.6 months), 32 women (18.6%) and 106 men (17.1%) experienced MACE (P=.64). Censoring follow-up data at 3 years, no differences were observed in MACE (16.9 vs 14.7 per 100•patient-years; log-rank P=.61) and their single components between women and men. At multivariate analysis, chronic kidney disease (hazard ratio [HR], 1.91: 95% confidence interval [CI], 1.23 to -2.95; P<.01) and acute coronary syndrome presentation (HR, 1.84; 95% CI, 1.22-2.77; P=.01) were independent predictors of MACE overall. Larger stent size (HR, 0.65; 95% CI, 0.48-0.89; P<.01) and longer dual-antiplatelet therapy duration (HR, 0.95; 95% CI, 0.90-0.99; P=.03) were associated with a reduced risk of MACE during the subsequent follow-up. CONCLUSION Ultrathin stents offer low rates of MACE and TLR in the overall population without significant differences between sexes.
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Affiliation(s)
- Daniela Trabattoni
- Invasive Cardiology Unit 3, Centro Cardiologico Monzino, IRCCS, Via Parea, 4 - 20138 Milan, Italy.
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10
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Godino C, Melillo F, Bellini B, Mazzucca M, Pivato CA, Rubino F, Figini F, Mazzone P, Della Bella P, Margonato A, Colombo A, Montorfano M. Percutaneous left atrial appendage closure versus non-vitamin K oral anticoagulants in patients with non-valvular atrial fibrillation and high bleeding risk. EUROINTERVENTION 2020; 15:1548-1554. [DOI: 10.4244/eij-d-19-00507] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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11
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Giannini F, Pagnesi M, Campo G, Donahue M, Ferri LA, Briguori C, Stefanini GG, Scardala R, Sardella G, De Rosa S, Figini F, Monello A, Pastormerlo LE, Testa L, Nicolino A, Ielasi A, Durante A, Leone A, Tzanis G, Mangieri A, Ciccarelli G, Briani M, Reimers B, Ceccacci A, Indolfi C, Sheiban I, Palmieri C, Bedogni F, Tespili M, Latib A, Gallo F, Colombo A. Italian Multicenter Registry of Bare Metal Stent Use in Modern Percutaneous Coronary Intervention Era (AMARCORD): A multicenter observational study. Catheter Cardiovasc Interv 2020; 97:411-420. [PMID: 32198845 DOI: 10.1002/ccd.28798] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 01/21/2020] [Accepted: 02/11/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVES We aimed to evaluate the use of bare metal stent (BMS) implantation in current percutaneous coronary intervention (PCI) era, focusing on indications for use and clinical outcomes. BACKGROUND Limited data on BMS usage in current clinical practice are available. METHODS All patients who underwent PCI with at least one BMS implantation in 18 Italian centers from January 1, 2013 to December 31, 2017, were included in our registry. Rates of BMS use and reasons for BMS implantations were reported for the overall study period and for each year. Primary outcomes were mortality, bleeding (Bleeding Academic Research Consortium-BARC and Thrombolysis in Myocardial Infarction-TIMI non-CABG definitions), and major adverse cardiac events (MACE) defined as the composite of all-cause and cardiac death, any myocardial infarction, target vessel revascularization, or any stent thrombosis. RESULTS Among 58,879 patients undergoing PCI in the study period, 2,117 (3.6%) patients (mean age 73 years, 69.7% males, 73.3% acute coronary syndrome) were treated with BMS implantation (2,353 treated lesions). The rate of BMS implantation progressively decreased from 10.1% (2013) to 0.3% (2017). Main reasons for BMS implantation were: ST-elevation myocardial infarction (STEMI) (23.1%), advanced age (24.4%), and physician's perception of high-bleeding risk (34.0%). At a mean follow-up of 2.2 ± 1.5 years, all-cause and cardiac mortality were 25.6 and 12.7%, respectively; MACE rate was 35.3%, any bleeding rate was 13.0% (BARC 3-5 bleeding 6.3%, TIMI non-CABG major bleeding 6.1%). CONCLUSION In a large, contemporary, real-world, multicenter registry, BMS use progressively reduced over the last 5 years. Main reasons for BMS implantation were STEMI, advanced age, and physician's perception of high-bleeding risk. High rates of mortality and MACE were observed in this real-world high-risk population.
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Affiliation(s)
- Francesco Giannini
- Interventional Cardiology Unit, GVM Care & Research Maria Cecilia Hospital, Cotignola, Italy
| | - Matteo Pagnesi
- Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy
| | - Gianluca Campo
- Cardiology Unit, Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy
| | - Michael Donahue
- Interventional Cardiology Unit, Policlinico Casilino, Rome, Italy
| | - Luca A Ferri
- Department of Cardiology, Alessandro Manzoni Hospital, Lecco, Italy.,Department of Cardiology, San Leopoldo Mandic Hospital, Merate, Italy
| | - Carlo Briguori
- Interventional Cardiology Unit, Clinica Mediterranea, Naples, Italy
| | | | | | - Gennaro Sardella
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, Policlinico Umberto I, Rome, Italy
| | - Salvatore De Rosa
- Division of Cardiology, Research Center on Cardiovascular Diseases, Magna Graecia University, Catanzaro, Italy
| | - Filippo Figini
- Division of Cardiology, Pederzoli Hospital-Peschiera del Garda, Verona, Italy
| | - Alberto Monello
- Division of Cardiology, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Luigi E Pastormerlo
- Division of Cardiology, Fondazione Gabriele Monasterio CNR-Regione Toscana, Massa, Italy
| | - Luca Testa
- Department of Cardiology, IRCCS Policlinico San Donato, Milan, Italy
| | | | - Alfonso Ielasi
- Division of Cardiology, ASST Bergamo Est, Bolognini Hospital, Seriate, Italy
| | | | - Angelo Leone
- Division of Cardiology, Ferrari Hospital, Cosenza, Italy
| | - Giorgios Tzanis
- Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy
| | - Antonio Mangieri
- Interventional Cardiology Unit, GVM Care & Research Maria Cecilia Hospital, Cotignola, Italy
| | | | - Martina Briani
- Cardio Center, Humanitas Research Hospital, Rozzano-Milan, Italy
| | - Bernhard Reimers
- Cardio Center, Humanitas Research Hospital, Rozzano-Milan, Italy
| | - Andrea Ceccacci
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, Policlinico Umberto I, Rome, Italy
| | - Ciro Indolfi
- Division of Cardiology, Research Center on Cardiovascular Diseases, Magna Graecia University, Catanzaro, Italy
| | - Imad Sheiban
- Division of Cardiology, Pederzoli Hospital-Peschiera del Garda, Verona, Italy
| | - Cataldo Palmieri
- Division of Cardiology, Fondazione Gabriele Monasterio CNR-Regione Toscana, Massa, Italy
| | - Francesco Bedogni
- Department of Cardiology, IRCCS Policlinico San Donato, Milan, Italy
| | - Maurizio Tespili
- Division of Cardiology, ASST Bergamo Est, Bolognini Hospital, Seriate, Italy
| | - Azeem Latib
- Department of Cardiology, Montefiore Medical Center, New York, New York, USA.,Division of Cardiology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Francesco Gallo
- Interventional Cardiology Unit, GVM Care & Research Maria Cecilia Hospital, Cotignola, Italy
| | - Antonio Colombo
- Interventional Cardiology Unit, GVM Care & Research Maria Cecilia Hospital, Cotignola, Italy
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12
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Gaido L, D’Ascenzo F, Imori Y, Wojakowski W, Saglietto A, Figini F, Mattesini A, Trabattoni D, Rognoni A, Tomassini F, Bernardi A, Ryan N, Muscoli S, Helft G, De Filippo O, Parma R, De Luca L, Ugo F, Cerrato E, Montefusco A, Pennacchi M, Wańha W, Smolka G, de Lio G, Bruno F, Huczek Z, Boccuzzi G, Cortese B, Capodanno D, Omedè P, Mancone M, Nuñez-Gil I, Romeo F, Varbella F, Rinaldi M, Escaned J, Conrotto F, Burzotta F, Chieffo A, Perl L, D’Amico M, di Mario C, Sheiban I, Gagnor A, Giammaria M, De Ferrari GM. Impact of Kissing Balloon in Patients Treated With Ultrathin Stents for Left Main Lesions and Bifurcations. Circ Cardiovasc Interv 2020; 13:e008325. [DOI: 10.1161/circinterventions.119.008325] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Background:
There are limited data regarding the impact of final kissing balloon (FKI) in patients treated with percutaneous coronary intervention using ultrathin stents in left main or bifurcations.
Methods:
All patients undergoing left main or bifurcations percutaneous coronary intervention enrolled in the RAIN registry (Very Thin Stents for Patients With MAIN or BiF in Real Life: The RAIN, a Multicenter Study) evaluating ultrathin stents were included. Major adverse cardiac event (a composite of all-cause death, myocardial infarction, target lesion revascularization, and stent thrombosis) was the primary end point, while its components, along with target vessel revascularization, were the secondary end points. The main analysis was performed comparing patients with and without FKI after adjustment with inverse probability of treatment weighting. Subgroup analyses were performed according to FKI (short [<3 mm] versus long overlap), strategy (provisional versus 2-stent), routine versus bail-out FKI, and the use of imaging and proximal optimization technique.
Results:
Two thousand seven hundred forty-two patients were included. At 16 months (8–20) follow-up, inverse probability of treatment weighting adjusted rates of major adverse cardiac event were similar between FKI and no-FKI group (15.1% versus 15.5%;
P
=0.967), this result did not change with use of imaging, proximal optimization technique, or routine versus bail-out FKI. In the 2-stent subgroup, FKI was associated with lower rates of target vessel revascularization (7.8% versus 15.9%;
P
=0.030) and target lesion revascularization (7.3% versus 15.2%;
P
=0.032). Short overlap FKI was associated with a lower rate of target lesion revascularization compared with no FKI (2.6% versus 5.4%;
P
=0.034), while long overlap was not (6.8% versus 5.4%;
P
=0.567).
Conclusions:
In patients with bifurcations or unprotected left main treated with ultrathin stents, short overlap FKI is associated with less restenosis. In a 2-stent strategy, FKI was associated with less target vessel revascularization and restenosis.
Registration:
URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03544294.
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Affiliation(s)
- Luca Gaido
- Division of Cardiology, Ospedale Maria Vittoria, Turin (L.G., A.G., M.G.)
| | - Fabrizio D’Ascenzo
- Division of Cardiology, Department of Medical Science, Città della Salute e della Scienza, Turin (F.D., A.S., F.F., A. Montefusco, G.d.L., F.B., P.O., M.R., F.C., M.D., G.M.D.F.)
| | - Yoichi Imori
- Department of Cardiovascular Medicine, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, Japan (Y.I.)
| | - Wojciech Wojakowski
- Department of Cardiology, Medical University of Silesia, Katowice, Poland (W. Wojakowski, W. Wańha, G.S.)
| | - Andrea Saglietto
- Division of Cardiology, Department of Medical Science, Città della Salute e della Scienza, Turin (F.D., A.S., F.F., A. Montefusco, G.d.L., F.B., P.O., M.R., F.C., M.D., G.M.D.F.)
| | - Filippo Figini
- Division of Cardiology, Department of Medical Science, Città della Salute e della Scienza, Turin (F.D., A.S., F.F., A. Montefusco, G.d.L., F.B., P.O., M.R., F.C., M.D., G.M.D.F.)
| | - Alessio Mattesini
- Structural Interventional Cardiology, Careggi University Hospital, Florence, Italy (A. Mattesini, C.d.M.)
| | - Daniela Trabattoni
- Department of Cardiovascular Sciences, IRCCS Centro Cardiologico Monzino, University of Milan, Italy (D.T.)
| | - Andrea Rognoni
- Coronary Care Unit and Catheterization laboratory, A.O.U. Maggiore della Carità, Novara, Italy (A.R.)
| | - Francesco Tomassini
- Department of Cardiology, Infermi Hospital, Rivoli, Italy (F.T., E.C., F.V.)
- Department of Cardiology, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy (F.T., E.C., F.V.)
| | - Alessandro Bernardi
- Dipartimento di Cardiologia, Ospedale San Giovanni Bosco, Italy (A.B., F.U., G.B.)
| | - Nicola Ryan
- Department of Cardiology, Hospital Clinico San Carlos, Madrid, Spain (N.R., I.N.-G., J.E.)
| | - Saverio Muscoli
- Department of Medicine, Università degli Studi di Roma ‘Tor Vergata’, Rome, Italy (S.M., F.R.)
| | - Gerard Helft
- Pierre and Marie Curie University, Paris, France (G.H.)
| | | | - Radoslaw Parma
- University Clinical Hospital, Warsaw, Poland (R.P., Z.H.)
| | - Leonardo De Luca
- Division of Cardiology, S. Giovanni Evangelista Hospital, Tivoli, Rome, Italy (L.D.L., M.P.)
| | - Fabrizio Ugo
- Dipartimento di Cardiologia, Ospedale San Giovanni Bosco, Italy (A.B., F.U., G.B.)
| | - Enrico Cerrato
- Department of Cardiology, Infermi Hospital, Rivoli, Italy (F.T., E.C., F.V.)
- Department of Cardiology, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy (F.T., E.C., F.V.)
| | - Antonio Montefusco
- Division of Cardiology, Department of Medical Science, Città della Salute e della Scienza, Turin (F.D., A.S., F.F., A. Montefusco, G.d.L., F.B., P.O., M.R., F.C., M.D., G.M.D.F.)
| | - Mauro Pennacchi
- Division of Cardiology, S. Giovanni Evangelista Hospital, Tivoli, Rome, Italy (L.D.L., M.P.)
| | - Wojciech Wańha
- Department of Cardiology, Medical University of Silesia, Katowice, Poland (W. Wojakowski, W. Wańha, G.S.)
| | - Grzegorz Smolka
- Department of Cardiology, Medical University of Silesia, Katowice, Poland (W. Wojakowski, W. Wańha, G.S.)
| | - Giulia de Lio
- Division of Cardiology, Department of Medical Science, Città della Salute e della Scienza, Turin (F.D., A.S., F.F., A. Montefusco, G.d.L., F.B., P.O., M.R., F.C., M.D., G.M.D.F.)
| | - Francesco Bruno
- Division of Cardiology, Department of Medical Science, Città della Salute e della Scienza, Turin (F.D., A.S., F.F., A. Montefusco, G.d.L., F.B., P.O., M.R., F.C., M.D., G.M.D.F.)
| | - Zenon Huczek
- University Clinical Hospital, Warsaw, Poland (R.P., Z.H.)
| | - Giacomo Boccuzzi
- Dipartimento di Cardiologia, Ospedale San Giovanni Bosco, Italy (A.B., F.U., G.B.)
| | | | - Davide Capodanno
- Division of Cardiology, Cardio-Thoracic-Vascular Department, Azienda Ospedaliero Universitaria “Policlinico-Vittorio Emanuele,” Catania, Italy (D.C.)
| | - Pierluigi Omedè
- Division of Cardiology, Department of Medical Science, Città della Salute e della Scienza, Turin (F.D., A.S., F.F., A. Montefusco, G.d.L., F.B., P.O., M.R., F.C., M.D., G.M.D.F.)
| | - Massimo Mancone
- Università degli Studi di ROMA “La Sapienza” (M.M.), Lazio, Italia
| | - Ivan Nuñez-Gil
- Department of Cardiology, Hospital Clinico San Carlos, Madrid, Spain (N.R., I.N.-G., J.E.)
| | - Francesco Romeo
- Department of Medicine, Università degli Studi di Roma ‘Tor Vergata’, Rome, Italy (S.M., F.R.)
| | - Ferdiando Varbella
- Department of Cardiology, Infermi Hospital, Rivoli, Italy (F.T., E.C., F.V.)
- Department of Cardiology, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy (F.T., E.C., F.V.)
| | - Mauro Rinaldi
- Division of Cardiology, Department of Medical Science, Città della Salute e della Scienza, Turin (F.D., A.S., F.F., A. Montefusco, G.d.L., F.B., P.O., M.R., F.C., M.D., G.M.D.F.)
| | - Javier Escaned
- Department of Cardiology, Hospital Clinico San Carlos, Madrid, Spain (N.R., I.N.-G., J.E.)
| | - Federico Conrotto
- Division of Cardiology, Department of Medical Science, Città della Salute e della Scienza, Turin (F.D., A.S., F.F., A. Montefusco, G.d.L., F.B., P.O., M.R., F.C., M.D., G.M.D.F.)
| | | | | | - Leor Perl
- Rabin Medical Center, Department of Cardiology, Tel Aviv, Israel (L.P.)
| | - Maurizio D’Amico
- Division of Cardiology, Department of Medical Science, Città della Salute e della Scienza, Turin (F.D., A.S., F.F., A. Montefusco, G.d.L., F.B., P.O., M.R., F.C., M.D., G.M.D.F.)
| | - Carlo di Mario
- Structural Interventional Cardiology, Careggi University Hospital, Florence, Italy (A. Mattesini, C.d.M.)
| | - Imad Sheiban
- Pederzoli Hospital, Peschiera del Garda, Italy (I.S.)
| | - Andrea Gagnor
- Division of Cardiology, Ospedale Maria Vittoria, Turin (L.G., A.G., M.G.)
| | - Massimo Giammaria
- Division of Cardiology, Ospedale Maria Vittoria, Turin (L.G., A.G., M.G.)
| | - Gaetano Maria De Ferrari
- Division of Cardiology, Department of Medical Science, Città della Salute e della Scienza, Turin (F.D., A.S., F.F., A. Montefusco, G.d.L., F.B., P.O., M.R., F.C., M.D., G.M.D.F.)
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13
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D'Ascenzo F, Barbero U, Abdirashid M, Trabattoni D, Boccuzzi G, Ryan N, Quadri G, Capodanno D, Venuti G, Muscoli S, Tomassini F, Autelli M, Montabone A, Wojakowski W, Rognoni A, Gallo D, Parma R, De Luca L, Figini F, Mitomo S, Montefusco A, Mattesini A, Wańha W, Protasiewicz M, Smolka G, Huczek Z, Rolfo C, Cortese B, Chieffo A, Kuliczowki W, Nuñez-Gil I, Morbiducci U, Ugo F, Marengo G, Iannaccone M, Cerrato E, Mario CD, Moretti C, D'Amico M, Varbella F, Lüscher TF, Sheiban I, Escaned J, Romeo F, Rinaldi M, De Ferrari GM, Helft G. Incidence of Adverse Events at 3 Months Versus at 12 Months After Dual Antiplatelet Therapy Cessation in Patients Treated With Thin Stents With Unprotected Left Main or Coronary Bifurcations. Am J Cardiol 2020; 125:491-499. [PMID: 31889527 DOI: 10.1016/j.amjcard.2019.10.058] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 10/29/2019] [Accepted: 10/30/2019] [Indexed: 11/29/2022]
Abstract
Incidence and predictors of adverse events after dual antiplatelet therapy (DAPT) cessation in patients treated with thin stents (<100 microns) in unprotected left main (ULM) or coronary bifurcation remain undefined. All consecutive patients presenting with a critical lesion of an ULM or involving a main coronary bifurcation who were treated with very thin strut stents were included. MACE (a composite end point of cardiovascular death, myocardial infarction [MI], target lesion revascularization [TLR], and stent thrombosis [ST]) was the primary endpoint, whereas target vessel revascularization (TVR) was the secondary endpoint, with particular attention to type and occurrence of ST and occurrence of ST, CV death, and MI during DAPT or after DAPT discontinuation. All analyses were performed according to length of DAPT dividing the patients in 3 groups: Short DAPT (3-months), intermediate DAPT (3 to 12 months), and long DAPT (12-months). A total of 117 patients were discharged with an indication for DAPT ≤3 months (median 1: 1 to 2.5), 200 for DAPT between 3 and 12 months (median 8: 7 to 10), and 1,958 with 12 months DAPT. After 12.8 months (8 to 20), MACE was significantly higher in the 3-month group compared with 3 to 12 and 12-month groups (9.4% vs 4.0% vs 7.2%, p ≤0.001), mainly driven by MI (4.4% vs 1.5% vs 3%, p ≤0.001) and overall ST (4.3% vs 1.5% vs 1.8%, p ≤0.001). Independent predictors of MACE were low GFR and a 2 stent strategy. Independent predictors of ST were DAPT duration <3 months and the use of a 2-stent strategy. In conclusion, even stents with very thin strut when implanted in real-life ULM or coronary bifurcation patients discharged with short DAPT have a relevant risk of ST, which remains high although not significant after DAPT cessation.
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Affiliation(s)
- Fabrizio D'Ascenzo
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, Turin, Italy; Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan; Division of Cardioloy, Universityspirtal of Zürich, Zürich, Switzerland
| | - Umberto Barbero
- Ospedale Civile SS. Annunziata, Savigliano, Italiy, Via Ospedali, 9, 12038
| | - Mohamed Abdirashid
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, Turin, Italy.
| | - Daniela Trabattoni
- Department of Cardiovascular Sciences, IRCCS Centro Cardiologico Monzino, Milan, Italy; University of Milan, Milan, Italy
| | | | - Nicola Ryan
- Department of Cardiology, Hospital Clinico San Carlos, Madrid, Spain
| | - Giorgio Quadri
- Department of Cardiology, Infermi Hospital, Rivoli, Italy; Department of Cardiology, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy
| | - Davide Capodanno
- Division of Cardiology, Cardio-Thoracic-Vascular Department, Azienda Ospedaliero Universitaria "Policlinico-Vittorio Emanuele," Catania, Italy
| | - Giuseppe Venuti
- Division of Cardiology, Cardio-Thoracic-Vascular Department, Azienda Ospedaliero Universitaria "Policlinico-Vittorio Emanuele," Catania, Italy
| | - Saverio Muscoli
- San Raffaele Scientific Institute, Milan, Italy; Department of Medicine, Università degli Studi di Roma 'Tor Vergata', Rome, Italy
| | - Francesco Tomassini
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, Turin, Italy
| | - Michele Autelli
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, Turin, Italy
| | - Andrea Montabone
- Structural Interventional Cardiology, Careggi University Hospital, Florence, Italy
| | | | - Andrea Rognoni
- Coronary Care Unit and Catheterization laboratory, A.O.U. Maggiore della Carità, Novara, Italy
| | - Diego Gallo
- Polito(BIO)Med Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, and Royal Brompton and Harefield Hospital Trust and Imperial College, London, United Kingdom
| | | | - Leonardo De Luca
- Division of Cardiology, S. Giovanni Evangelista Hospital, Tivoli, Italy
| | | | - Satoru Mitomo
- San Raffaele Scientific Institute, Milan, Italy; Department of Medicine, Università degli Studi di Roma 'Tor Vergata', Rome, Italy
| | - Antonio Montefusco
- Structural Interventional Cardiology, Careggi University Hospital, Florence, Italy
| | - Alessio Mattesini
- Structural Interventional Cardiology, Careggi University Hospital, Florence, Italy
| | - Wojciech Wańha
- Department of Cardiology, Medical University of Silesia, Katowice, Poland
| | - Marcin Protasiewicz
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, Turin, Italy
| | - Grzegorz Smolka
- Department of Cardiology, Medical University of Silesia, Katowice, Poland
| | | | - Cristina Rolfo
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, Turin, Italy
| | - Bernardo Cortese
- Interventional Cardiology, ASST Fatebenefratelli-Sacco, Milano, Italy
| | | | - Wiktor Kuliczowki
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, Turin, Italy
| | - Ivan Nuñez-Gil
- Department of Cardiology, Hospital Clinico San Carlos, Madrid, Spain
| | - Umberto Morbiducci
- Polito(BIO)Med Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, and Royal Brompton and Harefield Hospital Trust and Imperial College, London, United Kingdom
| | - Fabrizio Ugo
- Dipartimento di Cardiologia, Ospedale San Giovanni Bosco, Italy
| | - Giorgio Marengo
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, Turin, Italy
| | - Mario Iannaccone
- Ospedale Civile SS. Annunziata, Savigliano, Italiy, Via Ospedali, 9, 12038
| | - Enrico Cerrato
- Department of Cardiology, Infermi Hospital, Rivoli, Italy; Department of Cardiology, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy
| | - Carlo di Mario
- Structural Interventional Cardiology, Careggi University Hospital, Florence, Italy
| | - Claudio Moretti
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, Turin, Italy
| | - Maurizio D'Amico
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, Turin, Italy
| | - Ferdinando Varbella
- Department of Cardiology, Infermi Hospital, Rivoli, Italy; Department of Cardiology, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy
| | - Thomas F Lüscher
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, Turin, Italy
| | | | - Javier Escaned
- Department of Cardiology, Hospital Clinico San Carlos, Madrid, Spain
| | - Francesco Romeo
- Department of Medicine, Università degli Studi di Roma 'Tor Vergata', Rome, Italy
| | - Mauro Rinaldi
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, Turin, Italy
| | - Gaetano Maria De Ferrari
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, Turin, Italy
| | - Gerard Helft
- Pierre and Marie Curie University, Paris, France
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14
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Figini F, Chen SL, Sheiban I. ST-elevation Myocardial Infarction and Multivessel Coronary Artery Disease – A Critical Review of Current Practice, Evidence and Meta-analyses. Heart Int 2020; 14:80-85. [DOI: 10.17925/hi.2020.14.2.80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 12/11/2020] [Indexed: 01/09/2023] Open
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15
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Iannaccone M, D'Ascenzo F, Gallone G, Mitomo S, Parma R, Trabattoni D, Ryan N, Muscoli S, Venuti G, Montabone A, De Lio F, Zaccaro L, Quadri G, De Filippo O, Wojakowski W, Rognoni A, Helft G, Gallo D, De Luca L, Figini F, Imori Y, Conrotto F, Boccuzzi G, Mattesini A, Wańha W, Smolka G, Huczek Z, Rolfo C, Pennone M, Cortese B, Capodanno D, Chieffo A, Nuñez-Gil I, Morbiducci U, D'Amico M, Varbella F, Romeo F, Sheiban I, Escaned J, Garbo R, Moretti C, di Mario C, De Ferrari GM. Impact of structural features of very thin stents implanted in unprotected left main or coronary bifurcations on clinical outcomes. Catheter Cardiovasc Interv 2019; 96:1-9. [PMID: 31860158 DOI: 10.1002/ccd.28667] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 10/24/2019] [Accepted: 12/08/2019] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To evaluate the independent clinical impact of stent structural features in a large cohort of patients undergoing unprotected left main (ULM) or coronary bifurcation percutaneous coronary intervention (PCI) with a range of very thin strut stents. BACKGROUND Clinical impact of structural features of contemporary stents remains to be defined. METHODS All consecutive patients enrolled in the veRy thin stents for patients with left mAIn or bifurcatioN in real life (RAIN) registry were included. The following stent structural features were studied: antiproliferative drugs (everolimus vs. sirolimus vs. zotarolimus), strut material (platinum-chromium vs. cobalt-chromium), polymer (bioresorbable vs. durable), number of crowns (<8 vs. ≥8) and number of connectors (<3 vs. ≥3). For small diameter stents (≤2.5 mm), struct thickness (74 vs. 80/81 μm) was also tested. Target lesion failure (TLF), a composite of target lesion revascularization and stent thrombosis, was the primary endpoint. Multivariate analysis was performed with Cox regression models. RESULTS Out of 2,707 patients, 110 (4.1%) experienced a TLF event after 16 months (12-18). After adjustment for confounders, an increased number of connectors (adjusted hazard ratio [adj-HR] 0.62, 95% confidence interval (CI) 0.39-0.99, p = .04) reduced risk of TLF, driven by stents with ≥2.5 mm diameter (HR 0.54, 95% CI 0.32-0.93, p = .02). This independent relationship was lost for stents with diameter <2.5 mm, where only strut thickness appeared to impact. Conversely, no independent relationship of polymer type, number of crowns, and the specific limus-family eluted drug with outcomes was observed. CONCLUSIONS Among a range of contemporary very thin stent models, an increased number of connectors improved device-related outcomes in this investigated high-risk procedural setting.
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Affiliation(s)
- Mario Iannaccone
- Division of Cardiology, SS. Annunziata Hospital, Savigliano, Italy
| | - Fabrizio D'Ascenzo
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Guglielmo Gallone
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Satoru Mitomo
- Unit of Cardiovascular Interventions, IRCCS San Raffaele Hospital, Milan, Italy
| | - Radosław Parma
- Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Daniela Trabattoni
- Department of Cardiovascular Sciences, Centro Cardiologico Monzino, IRCCS, Milan, Italy
| | - Nicola Ryan
- Hospital Clínico San Carlos, IDISSC, and Universidad Complutense de Madrid, Madrid, Spain
| | - Saverio Muscoli
- Department of Cardiovascular Disease, Tor Vergata University of Rome, Rome, Italy
| | - Giuseppe Venuti
- Division of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy
| | | | - Francesca De Lio
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Lorenzo Zaccaro
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Giorgio Quadri
- Department of Cardiology, Infermi Hospital, Rivoli, Italy
| | - Ovidio De Filippo
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Wojciech Wojakowski
- Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Andrea Rognoni
- Coronary Care Unit and Catheterization Laboratory, A.O.U. Maggiore della Carità, Novara, Italy
| | - Gerard Helft
- Pierre and Marie Curie University, Paris, France
| | - Diego Gallo
- PolitoBIOMed Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - Leonardo De Luca
- Division of Cardiology, S. Giovanni Evangelista Hospital, Tivoli, Italy
| | | | - Yoichi Imori
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Federico Conrotto
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | | | - Alessio Mattesini
- Division of Structural Interventional Cardiology, Careggi University Hospital, Florence, Italy
| | - Wojciech Wańha
- Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Grzegorz Smolka
- Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | | | - Cristina Rolfo
- Department of Cardiology, Infermi Hospital, Rivoli, Italy
| | - Mauro Pennone
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Bernardo Cortese
- Interventional Cardiology Unit, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Davide Capodanno
- Division of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy
| | - Alaide Chieffo
- Unit of Cardiovascular Interventions, IRCCS San Raffaele Hospital, Milan, Italy
| | - Ivan Nuñez-Gil
- Hospital Clínico San Carlos, IDISSC, and Universidad Complutense de Madrid, Madrid, Spain
| | - Umberto Morbiducci
- PolitoBIOMed Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - Maurizio D'Amico
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | | | - Francesco Romeo
- Department of Medicine, Università degli Studi di Roma 'Tor Vergata', Rome, Italy
| | | | - Javier Escaned
- Hospital Clínico San Carlos, IDISSC, and Universidad Complutense de Madrid, Madrid, Spain
| | - Roberto Garbo
- Department of Cardiology, S.G. Bosco Hospital, Torino, Italy
| | - Claudio Moretti
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Carlo di Mario
- Division of Structural Interventional Cardiology, Careggi University Hospital, Florence, Italy
| | - Gaetano M De Ferrari
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
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16
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Figini F, Louvard Y, Sheiban I. Stent Enhancement during Percutaneous Coronary Intervention: Current Role, Technical Tips and Case Examples. Cardiovasc Revasc Med 2019; 21:137-143. [PMID: 31213367 DOI: 10.1016/j.carrev.2019.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 03/31/2019] [Accepted: 04/01/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Filippo Figini
- Interventional Cardiology, Ospedale "Pederzoli", Peschiera del Garda, VR, Italy
| | - Yves Louvard
- Interventional Cardiology, Institut Cardiovasculaire Paris Sud, Massy, France
| | - Imad Sheiban
- Interventional Cardiology, Ospedale "Pederzoli", Peschiera del Garda, VR, Italy.
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17
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D'Ascenzo F, Omedè P, De Filippo O, Cerrato E, Autelli M, Trabattoni D, Ryan N, Venuti G, Muscoli S, Montabone A, Wojakowski W, Rognoni A, Helft G, Gallo D, Parma R, De Luca L, Figini F, Mitomo S, Boccuzzi G, Mattesini A, Wańha W, Smolka G, Huczek Z, Cortese B, Sheiban I, Escaned J, Biolè C, Conrotto F, Templin C, Quadri G, Rolfo C, Capodanno D, Chieffo A, Nuñez-Gil I, Morbiducci U, Iannaccone M, Gili S, Mario CD, Moretti C, D'Amico M, Varbella F, Romeo F, Lüscher TF. Impact of Final Kissing Balloon and of Imaging on Patients Treated on Unprotected Left Main Coronary Artery With Thin-Strut Stents (From the RAIN-CARDIOGROUP VII Study). Am J Cardiol 2019; 123:1610-1619. [PMID: 30846212 DOI: 10.1016/j.amjcard.2019.02.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 02/06/2019] [Accepted: 02/13/2019] [Indexed: 11/25/2022]
Abstract
Few data are available about the impact on outcomes of procedural strategies for percutaneous coronary intervention with thin-struts stents on unprotected left main (ULM): 792 patients with an ULM stenosis treated with percutaneous coronary intervention with thin-strut stents were enrolled in the present multicenter registry. Target lesion revascularization (TLR) was the primary end point. MACE (a composite of all-cause death, myocardial infarction, TLR, and stent thrombosis) and its single components, along with target vessel revascularization were the secondary end points. Subgroup analyses were performed according to complex versus noncomplex bifurcation lesions. After 16 months, 5.5% of patients experienced a TLR. At multivariate analysis, provisional stenting (odds ratio [OR] 0.46: 0.85 to 0.23, p = 0.006), use of imaging (OR 0.45: 0.23 to 0.98, p = 0.003) and final kissing balloon (FKB) (OR 0.41: 0.83 to 0.21, p = 0.001) reduced risk of TLR. FKB reduced risk of overall TLR only for 2 stents-strategy (6.2% vs 32.4%, p <0.05), but not for provisional strategy (3.8% vs 3.7%, p = 0.67). Intracoronary imaging reduced risk of overall TLR both for provisional (2.2% vs 5.4%) and for 2-stents strategy (7.3% vs 14.1% p <0.05 for both, all confidence interval 95%). In conclusion, TLR for ULM patients treated with thin-strut stents is infrequent. Provisional stenting was noninferior compared with 2-stents apart from complex lesions. Benefit from intracoronary imaging is consistent for different strategies, whereas that from FKB persists only for 2-stents.
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18
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Biolè C, Huczek Z, Nuñez-Gil I, Boccuzzi G, Autelli M, Montefusco A, Trabattoni D, Ryan N, Venuti G, Imori Y, Takano H, Matsuda J, Shimizu W, Muscoli S, Montabone A, Wojakowski W, Rognoni A, Helft G, Gallo D, Parma R, De Luca L, Figini F, Mitomo S, Pennone M, Mattesini A, Templin C, Quadri G, Wańha W, Cerrato E, Smolka G, Protasiewicz M, Kuliczkowski W, Rolfo C, Cortese B, Capodanno D, Chieffo A, Morbiducci U, Iannaccone M, Gili S, di Mario C, D'Amico M, Romeo F, Lüscher TF, Sheiban I, Escaned J, Varbella F, D'Ascenzo F. Daily risk of adverse outcomes in patients undergoing complex lesions revascularization: A subgroup analysis from the RAIN-CARDIOGROUP VII study (veRy thin stents for patients with left mAIn or bifurcatioN in real life). Int J Cardiol 2019; 290:64-69. [PMID: 30971372 DOI: 10.1016/j.ijcard.2019.03.038] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 02/13/2019] [Accepted: 03/18/2019] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Percutaneous coronary intervention (PCI) for complex lesions, including unprotected left main (ULM) and bifurcations, is gaining a relevant role in treating coronary artery disease with good outcomes, also thanks to new generation stents. The daily risk of adverse cardiovascular events and their temporal distribution after these procedures is not known. METHODS All consecutive patients presenting with a critical lesion of ULM or bifurcation treated with very thin struts stents, enrolled in the RAIN-Cardiogroup VII study, were analyzed. The daily risk of major acute cardiovascular events (MACE), target lesion revascularization (TLR) and stent thrombosis (ST) and their temporal distribution in the first year of follow-up was the primary endpoint. Differences among subgroups (ULM, patient presentation, kind of stent polymer) were the secondary endpoint. RESULTS 2745 patients were included, mean age 68 ± 11 years, 33.3% diabetics, 54.5% had an acute coronary syndrome (ACS); 88.5% of treated lesions were bifurcations, 27.2% ULM. Average daily risk was 0.022% for MACE, 0.005% for TLR and 0.004% for ST, in the first year. Bimodal distribution of adverse events, especially TLR, with an early peak in the first 50 days and a late one after 150 days, was observed. Patients with ULM presented a significantly higher daily risk of events, and ACS patients presented higher MACE risk. No difference emerged according to the type of stent polymer. CONCLUSIONS The daily risk of adverse events in the first year after complex PCI in our study is acceptably low. PCI on ULM carries a higher risk of complications.
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Affiliation(s)
- Carloalberto Biolè
- Division of Cardiology, Departement of Internal Medicine, Città della Salute e della Scienza, Turin, Italy.
| | | | - Ivan Nuñez-Gil
- Department of Cardiology, Hospital Clinico San Carlos, Madrid, Spain
| | | | - Michele Autelli
- Division of Cardiology, Departement of Internal Medicine, Città della Salute e della Scienza, Turin, Italy
| | - Antonio Montefusco
- Division of Cardiology, Departement of Internal Medicine, Città della Salute e della Scienza, Turin, Italy
| | - Daniela Trabattoni
- Department of Cardiovascular Sciences, IRCCS Centro Cardiologico Monzino, Milan, Italy; University of Milan, Milan, Italy
| | - Nicola Ryan
- Department of Cardiology, Hospital Clinico San Carlos, Madrid, Spain
| | - Giuseppe Venuti
- Division of Cardiology, Cardio-Thoracic-Vascular Department, Azienda Ospedaliero Universitaria "Policlinico-Vittorio Emanuele", Catania, Italy
| | - Yoichi Imori
- Department of Cardiovascular Medicine, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, Japan
| | - Hitoshi Takano
- Department of Cardiovascular Medicine, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, Japan
| | - Junya Matsuda
- Department of Cardiovascular Medicine, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, Japan
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, Japan
| | - Saverio Muscoli
- San Raffaele Scientific Institute, Milan, Italy; Department of Medicine, Università degli Studi di Roma 'Tor Vergata', Rome, Italy
| | - Andrea Montabone
- Structural Interventional Cardiology, Careggi University Hospital, Florence, Italy
| | | | - Andrea Rognoni
- Coronary Care Unit and Catheterization Laboratory, A.O.U. Maggiore della Carità, Novara, Italy
| | - Gerard Helft
- Pierre and Marie Curie University, Paris, France
| | - Diego Gallo
- Polito(BIO)Med Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Italy
| | | | - Leonardo De Luca
- Division of Cardiology, S. Giovanni Evangelista Hospital, Tivoli, Rome, Italy
| | | | | | - Mauro Pennone
- Division of Cardiology, Departement of Internal Medicine, Città della Salute e della Scienza, Turin, Italy
| | - Alessio Mattesini
- Structural Interventional Cardiology, Careggi University Hospital, Florence, Italy
| | | | - Giorgio Quadri
- Department of Cardiology, Infermi Hospital, Rivoli, Italy; Department of Cardiology, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy
| | - Wojciech Wańha
- Department of Cardiology, Medical University of Silesia, Katowice, Poland
| | - Enrico Cerrato
- Department of Cardiology, Infermi Hospital, Rivoli, Italy; Department of Cardiology, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy
| | - Grzegorz Smolka
- Department of Cardiology, Medical University of Silesia, Katowice, Poland
| | | | | | - Cristina Rolfo
- Department of Cardiology, Infermi Hospital, Rivoli, Italy; Department of Cardiology, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy
| | - Bernardo Cortese
- Interventional Cardiology, ASST Fatebenefratelli-Sacco, Milano, Italy
| | - Davide Capodanno
- Division of Cardiology, Cardio-Thoracic-Vascular Department, Azienda Ospedaliero Universitaria "Policlinico-Vittorio Emanuele", Catania, Italy
| | | | - Umberto Morbiducci
- Polito(BIO)Med Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Italy
| | - Mario Iannaccone
- Division of Cardiology, Departement of Internal Medicine, Città della Salute e della Scienza, Turin, Italy
| | - Sebastiano Gili
- Division of Cardiology, Universityszpital of Zurich, Switzerland
| | - Carlo di Mario
- Structural Interventional Cardiology, Careggi University Hospital, Florence, Italy
| | - Maurizio D'Amico
- Division of Cardiology, Departement of Internal Medicine, Città della Salute e della Scienza, Turin, Italy
| | - Francesco Romeo
- Department of Medicine, Università degli Studi di Roma 'Tor Vergata', Rome, Italy
| | - Thomas F Lüscher
- Division of Cardiology, Universityszpital of Zurich, Switzerland
| | | | - Javier Escaned
- Department of Cardiology, Hospital Clinico San Carlos, Madrid, Spain
| | - Ferdinando Varbella
- Department of Cardiology, Infermi Hospital, Rivoli, Italy; Department of Cardiology, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy
| | - Fabrizio D'Ascenzo
- Division of Cardiology, Departement of Internal Medicine, Città della Salute e della Scienza, Turin, Italy
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Figini F, Louvard Y, Sheiban I. Use of Stent Enhancement Technique During Percutaneous Coronary Intervention – A Case Series. Heart Int 2019; 13:28-31. [DOI: 10.17925/hi.2019.13.1.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 05/21/2019] [Indexed: 11/24/2022] Open
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Giannini F, Pagnesi M, Campo G, michael donahue, Ferri LA, Briguori C, Stefanini G, Scardala R, Sardella G, De Rosa S, Figini F, Monello A, Pastormerlo LE, Testa L, Nicolino A, Ielasi A, Durante A, Leone A, Ciccarelli G, martina briani, Reimers B, claudio rapetto, Ceccacci A, Indolfi C, Sheiban I, Palmieri C, Bedogni F, Tespili M, Latib A, Colombo A. TCT-273 Italian Multicenter Registry of Bare Metal Stent Use in Modern Percutaneous Coronary Intervention Era: a multicenter observational study. J Am Coll Cardiol 2018. [DOI: 10.1016/j.jacc.2018.08.1407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Figini F, Manjunath CN, Srinivas BC, Sadananda KS, Sreedharan M, Fischer L, Pillai R, Varghese K, Gopal AK, Nagesh CM, Sheiban I. Long-term results of a sirolimus-eluting stent with biodegradable polymer (RAPSTROM™) in de novo coronary stenoses. Cardiovasc Revasc Med 2017; 19:429-432. [PMID: 29174500 DOI: 10.1016/j.carrev.2017.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 10/02/2017] [Accepted: 10/04/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To report long-term results of a novel sirolimus-eluting stent with biodegradable polymer BACKGROUND: Newer generation drug-eluting stents are characterized by thin struts, improved platform design and highly biocompatible polymer carrying the antiproliferative drug. The RapstromTM stent, sharing these features, showed promising outcomes in preclinical models and in a first-in-man trial. METHODS The present study is a multicenter, non-randomized post-market registry, including patients with de novo coronary artery disease treated with implantation of one or more Rapstrom stents. Primary endpoint of the study was the rate of major adverse cardiac events (MACE) at three-year follow-up. RESULTS 1073 patients were enrolled, with a high prevalence of diabetes (35%) and acute coronary syndrome at presentation (82%); at three-year follow up, MACE rate was 14.8%, with a low incidence of definite or probable stent thrombosis (0.75%). CONCLUSIONS These data confirm the good clinical performance of the Rapstrom stent, supporting the concept that the combination of thin struts and biodegradable polymer is associated with positive clinical outcomes.
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Figini F, Mazzone P, Regazzoli D, Porata G, Ruparelia N, Giannini F, Stella S, Ancona F, Agricola E, Sora N, Marzi A, Aurelio A, Trevisi N, Della Bella P, Colombo A, Montorfano M. Left atrial appendage closure: A single center experience and comparison of two contemporary devices. Catheter Cardiovasc Interv 2016; 89:763-772. [PMID: 27567013 DOI: 10.1002/ccd.26678] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Revised: 05/30/2016] [Accepted: 07/02/2016] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To compare indications and clinical outcomes of two contemporary left atrial appendage (LAA) percutaneous closure systems in a "real-world" population. BACKGROUND Percutaneous LAA occlusion is an emerging therapeutic option for stroke prevention in atrial fibrillation. Some questions however remain unanswered, such as the applicability of results of randomized trials to current clinical practice. Moreover, currently available devices have never been directly compared. METHODS We retrospectively analyzed consecutive patients who underwent LAA closure at San Raffaele Hospital, Milan, Italy between 2009 and 2015. Clinical indications and device selection were left to operators' decision; routine clinical and transesophageal echocardiography (TEE) follow-up was performed. RESULTS One-hundred and sixty-five patients were included in the study, of which 99 were treated with the Amplatzer Cardiac Plug (ACP) and 66 with the Watchman system. During the follow-up period (median 15 months, interquartile range 6-26 months) five patients died. The incidence of ischemic events was low, with one patient suffering a transient ischemic attack and no episodes recorded of definitive strokes. Twenty-six leaks ≥1 mm were detected (23%); leaks were less common with the ACP and with periprocedural three-dimensional TEE evaluation, but were not found to correlate with clinical events. Clinical outcomes were comparable between the two devices. CONCLUSIONS Our data show excellent safety and efficacy of LAA closure, irrespectively of the device utilized, in a population at high ischemic and hemorrhagic risk. The use of ACP and 3D-TEE minimized the incidence of residual leaks; however, the clinical relevance of small peri-device flow warrants further investigation. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Filippo Figini
- Interventional Cardiology Department, San Raffaele Hospital, Milan, Italy
- EMO-GVM Centro Cuore Columbus, Milan, Italy
| | - Patrizio Mazzone
- Interventional Cardiology Department, San Raffaele Hospital, Milan, Italy
| | - Damiano Regazzoli
- Interventional Cardiology Department, San Raffaele Hospital, Milan, Italy
| | - Giulia Porata
- Interventional Cardiology Department, San Raffaele Hospital, Milan, Italy
| | - Neil Ruparelia
- Interventional Cardiology Department, San Raffaele Hospital, Milan, Italy
- EMO-GVM Centro Cuore Columbus, Milan, Italy
- Imperial College, London, United Kingdom
| | - Francesco Giannini
- Interventional Cardiology Department, San Raffaele Hospital, Milan, Italy
- EMO-GVM Centro Cuore Columbus, Milan, Italy
| | - Stefano Stella
- Interventional Cardiology Department, San Raffaele Hospital, Milan, Italy
| | - Francesco Ancona
- Interventional Cardiology Department, San Raffaele Hospital, Milan, Italy
| | - Eustachio Agricola
- Interventional Cardiology Department, San Raffaele Hospital, Milan, Italy
| | - Nicoleta Sora
- Interventional Cardiology Department, San Raffaele Hospital, Milan, Italy
| | - Alessandra Marzi
- Interventional Cardiology Department, San Raffaele Hospital, Milan, Italy
| | - Andrea Aurelio
- Interventional Cardiology Department, San Raffaele Hospital, Milan, Italy
| | - Nicola Trevisi
- Interventional Cardiology Department, San Raffaele Hospital, Milan, Italy
| | - Paolo Della Bella
- Interventional Cardiology Department, San Raffaele Hospital, Milan, Italy
| | - Antonio Colombo
- Interventional Cardiology Department, San Raffaele Hospital, Milan, Italy
- EMO-GVM Centro Cuore Columbus, Milan, Italy
| | - Matteo Montorfano
- Interventional Cardiology Department, San Raffaele Hospital, Milan, Italy
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23
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Giannini F, Latib A, Jabbour RJ, Ruparelia N, Aurelio A, Ancona MB, Figini F, Mangieri A, Regazzoli D, Tanaka A, Montalto C, Azzalini L, Monaco F, Agricola E, Chieffo A, Montorfano M, Alfieri O, Colombo A. Impact of post-procedural hyperglycemia on acute kidney injury after transcatheter aortic valve implantation. Int J Cardiol 2016; 221:892-7. [PMID: 27434367 DOI: 10.1016/j.ijcard.2016.07.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 07/04/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Post-operative hyperglycemia, in individuals with and without diabetes, has been identified as a predictor of acute kidney injury (AKI) in patients following cardiac surgery. Whether or not this is also true for patients undergoing transcatheter aortic valve implantation (TAVI) is unknown. OBJECTIVES To evaluate whether post-procedural glucose levels are associated with AKI after TAVI. METHODS AND RESULTS A total of 422 consecutive patients undergoing transfemoral TAVI were included in the analysis. For each patient, plasma glucose levels were assessed at hospital admission, 4h after the procedure and daily during hospitalization. Post-procedural hyperglycemia was defined as 2 consecutive blood glucose readings ≥150mg/dL in the 72-hour period following TAVI. AKI was defined according to the VARC consensus report regarding standardized endpoint definitions. Overall, 137 (32.5%) patients developed post-procedural hyperglycemia and 138 (33%) patients developed AKI. Hyperglycemia was associated with a 2-fold higher incidence of AKI than in patients without hyperglycemia (48% vs. 25%, p<0.001). In-hospital mortality was higher in patients with hyperglycemia than in those without hyperglycemia (9.6% vs. 1.8%, p<0.001). In-hospital mortality rate was also higher in patients who developed AKI (12.7% vs. 2.7%, p<0.001). Patients with acute hyperglycemia that developed AKI had the highest in-hospital and long-term mortality rate (15% and 38%). Post-procedural hyperglycemia was an independent predictor of AKI. CONCLUSIONS Post-procedural hyperglycemia is associated with a higher incidence of AKI and mortality after TAVI. Randomized controlled trials are needed to determine whether meticulous post-procedural glycemic control following TAVI impacts upon clinical outcomes.
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Affiliation(s)
- Francesco Giannini
- Interventional Cardiology, San Raffaele Hospital, Milan, Italy; EMO-GVM Centro Cuore Columbus, Milan, Italy.
| | - Azeem Latib
- Interventional Cardiology, San Raffaele Hospital, Milan, Italy; EMO-GVM Centro Cuore Columbus, Milan, Italy
| | - Richard J Jabbour
- Interventional Cardiology, San Raffaele Hospital, Milan, Italy; EMO-GVM Centro Cuore Columbus, Milan, Italy; Imperial College London, UK
| | - Neil Ruparelia
- Interventional Cardiology, San Raffaele Hospital, Milan, Italy; EMO-GVM Centro Cuore Columbus, Milan, Italy
| | - Andrea Aurelio
- Interventional Cardiology, San Raffaele Hospital, Milan, Italy
| | - Marco B Ancona
- Interventional Cardiology, San Raffaele Hospital, Milan, Italy
| | - Filippo Figini
- Interventional Cardiology, San Raffaele Hospital, Milan, Italy
| | | | | | - Akihito Tanaka
- Interventional Cardiology, San Raffaele Hospital, Milan, Italy; EMO-GVM Centro Cuore Columbus, Milan, Italy
| | | | | | - Fabrizio Monaco
- Interventional Cardiology, San Raffaele Hospital, Milan, Italy
| | | | - Alaide Chieffo
- Interventional Cardiology, San Raffaele Hospital, Milan, Italy
| | | | | | - Antonio Colombo
- Interventional Cardiology, San Raffaele Hospital, Milan, Italy; EMO-GVM Centro Cuore Columbus, Milan, Italy
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Durante A, Foglia Manzillo G, Burzotta F, Trani C, Aurigemma C, Summaria F, Patrizi R, Talarico GP, Latib A, Figini F, Romagnoli E, De Vita M, Fantoni C, My L, Larosa C, Manzoli A, Turturo M, Berni A, Corrado G. Long term follow-up of "full metal jacket" of de novo coronary lesions with new generation Zotarolimus-eluting stents. Int J Cardiol 2016; 221:1008-12. [PMID: 27441483 DOI: 10.1016/j.ijcard.2016.07.050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 06/24/2016] [Accepted: 07/04/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Diffuse coronary artery disease treatment still remains a challenge for interventional cardiologists and cardiac surgeons. There are few data on full metal jacket (FMJ) stenting, especially with new-generation drug-eluting stents. We aimed to assess the efficacy and safety of FMJ with new-generation Zotarolimus-eluting stents (n-ZES). METHODS AND RESULTS All patients who underwent FMJ with n-ZES (≥60mm stent length) in eleven Italian interventional centers participating in the Clinical Service® project were included in this analysis. The project population consisted of 120 patients and 122 lesions. Mean age was 67±10years and 95 (79.2%) patients were male. A chronic total occlusion was present in 34 lesions (27.9%). The number of stents implanted per lesion was 2.9±0.8, and the diameter of the stents was 3.0±0.5mm. Predilation and post-dilatation were performed in 107 (87.7%) and 92 (75.4%) patients, respectively. At 41±21month follow-up there were 2 patients with subacute definite stent thrombosis, 6 patients (5.0%) had cardiac death and 5 patients (4.2%) had non-fatal myocardial infarction. Seven patients (5.8%) underwent clinically-driven target lesion revascularization. Fourteen patients (11.7%) had at least one major adverse cardiac event. CONCLUSION The treatment of diffuse coronary artery disease with FMJ stenting with n-ZES appears to be effective and safe. Late and very-late ST does not seem to be an issue and the rate of restenosis and of major cardiac adverse events after more than 3-year follow-up is rather low.
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Affiliation(s)
- Alessandro Durante
- Unità Operativa Complessa di Cardiologia, Ospedale Valduce, Como, Italy.
| | | | - Francesco Burzotta
- Dipartimento Cardiovascolare, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Carlo Trani
- Dipartimento Cardiovascolare, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Cristina Aurigemma
- Dipartimento Cardiovascolare, Università Cattolica del Sacro Cuore, Roma, Italy
| | | | | | | | - Azeem Latib
- Unità Di Emodinamica e Cardiologia Interventistica, Ospedale San Raffaele, Milan, Italy
| | - Filippo Figini
- Unità Di Emodinamica e Cardiologia Interventistica, Ospedale San Raffaele, Milan, Italy
| | - Enrico Romagnoli
- Unità di Emodinamica e Cardiologia Interventistica - Ospedale di Belcolle, Viterbo, Italy
| | - Mariarosaria De Vita
- Unità Operativa Di Cardiologia, Azienda Ospedaliera Morgagni Pierantoni, Forlì, Italy
| | - Cecilia Fantoni
- Unità Operativa Di Cardiologia, Istituto Clinico Humanitas Mater Domini, Castellanza, Italy
| | - Luigi My
- Unità di Cardiologia, Casa di Cura Villa Verde, Taranto, Italy
| | - Claudio Larosa
- Unità Di Cardiologia, Ospedale Lorenzo Bonomo, Andria, Italy
| | - Alessandro Manzoli
- Unità di Emodinamica e Cardiologia Interventistica, Azienda Ospedaliera San Giovanni Addolorata, Rome, Italy
| | - Maurizio Turturo
- UOC Cardiologia, Presidio Ospedaliero Di Venere, Bari Carbonara, Italy
| | - Andrea Berni
- UOC Cardiologia, Azienda Ospedaliera Sant'Andrea, Roma, Italy
| | - Giovanni Corrado
- Unità Operativa Complessa di Cardiologia, Ospedale Valduce, Como, Italy
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Ruparelia N, Latib A, Kawamoto H, Buzzatti N, Giannini F, Figini F, Mangieri A, Regazzoli D, Stella S, Sticchi A, Tanaka A, Ancona M, Agricola E, Monaco F, Spagnolo P, Chieffo A, Montorfano M, Alfieri O, Colombo A. A Comparison Between First-Generation and Second-Generation Transcatheter Aortic Valve Implantation (TAVI) Devices: A Propensity-Matched Single-Center Experience. J Invasive Cardiol 2016; 28:210-216. [PMID: 27145054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Transcatheter aortic valve implantation (TAVI) is the treatment of choice for high-risk patients presenting with severe symptomatic aortic stenosis. The aim of this study was to investigate the impact of second-generation (2G) devices in comparison to first-generation (1G) devices with regard to procedural and short-term clinical outcomes. METHODS Between November 2007 and May 2015, a total of 449 patients treated with 1G TAVI devices (Edwards Sapien XT, Medtronic CoreValve) were propensity matched (1:1) to 179 patients treated with 2G TAVI devices (Edwards Sapien 3, Medtronic Evolut R, Boston Scientific Lotus, Direct Flow Medical). The primary endpoint was 30-day safety according to the Valve Academic Research Consortium 2 (VARC-2) definition. RESULTS Patients treated with 1G devices suffered more adverse events at 30-day follow-up (freedom of adverse events, 75.3% vs 88.8%; hazard ratio, 2.4; 95% confidence interval (CI), 1.4-4.0; P=.01) and a significantly greater number of minor vascular complications (31.8% vs 10.4%; P<.001) and major vascular complications (3.2% vs 0.6%; P<.001) compared with patients treated with 2G devices. The presence of residual aortic regurgitation ≥2 was also greater in the 1G group (17.5% vs 5.8%; odds ratio, 0.30; 95% CI, 0.13-0.69; P<.001). There were no differences between groups with regard to 30-day all-cause mortality (5.2% vs 3.2%; odds ratio, 0.61; 95% CI, 0.20-1.92; P=.40). CONCLUSION TAVI with contemporary 2G devices was associated with a significant safety benefit at 30 days and reduction of residual moderate or severe paravalvular leak. Longer-term follow-up in more patients is required to determine if these short-term benefits translate into improvements in long-term clinical outcomes.
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Affiliation(s)
| | - Azeem Latib
- EMO-GVM Centro Cuore Columbus, Via Buonarroti 48, 20145, Milan, Italy.
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Buchanan GL, Chieffo A, Bernelli C, Montorfano M, Carlino M, Latib A, Figini F, Giannini F, Durante A, Ielasi A, Castelli A, Colombo A. Two-year outcomes following unprotected left main stenting with first vs. new-generation drug-eluting stents: the FINE registry. EUROINTERVENTION 2016; 9:809-16. [PMID: 24280157 DOI: 10.4244/eijv9i7a134] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS To assess two-year outcomes following first vs. new-generation drug-eluting stent (DES) implantation in unprotected left main (ULMCA) percutaneous coronary intervention. METHODS AND RESULTS All eligible patients from our two-centre registry treated with first and new-generation DES from October 2006 to November 2010 were analysed. The study objective was major adverse cardiac events (MACE), defined as all-cause mortality, target vessel revascularisation (TVR) and myocardial infarction (MI) at two years. In total, 186 patients were included: 93 (50.0%) treated with first vs. 93 (50.0%) with new-generation DES. No differences were observed in baseline clinical characteristics except for higher EuroSCORE with new-generation DES (3.6±2.5 vs. 4.6±2.7; p=0.007). No significant difference was observed in stenting techniques; two stents were used respectively in 53.8% vs. 44.1% (p=0.187). Notably, intravascular ultrasound guidance was more frequent with new-generation DES (46.2% vs. 61.3%; p=0.040). At 730.0 (interquartile range 365.5-1,224.5) days, there was a trend towards improved MACE with new-generation DES (31.2% vs. 19.6%; p=0.070) and a significant reduction in TVR (23.7% vs. 12.0%; p=0.038) and MI (4.3% vs. 0%; p=0.044). Notably, there were four cases of definite stent thrombosis (ST) with first vs. none with new-generation DES (p=0.044). CONCLUSIONS In our study, new-generation DES had a trend for less MACE and improved results with regard to MI, TVR and definite ST at two-year follow-up.
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Miyazaki T, Ruparelia N, Kawamoto H, Figini F, Latib A, Colombo A. Clinical outcomes following "off-label" versus "established" indications of bioresorbable scaffolds for the treatment of coronary artery disease in a real-world population. EUROINTERVENTION 2016; 11:1475-8. [PMID: 27107312 DOI: 10.4244/eijv11i13a286] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS Our aim was to investigate one-year outcomes in patients treated with bioresorbable scaffolds (BRS) for "off-label" versus currently "established" indications. METHODS AND RESULTS Consecutive patients treated with BRS between May 2012 and September 2014 in two centres were retrospectively recruited. Patients who met inclusion criteria as defined by the ABSORB III study were allocated to the established indication group (ESTG; 21 patients with 35 lesions) and the remaining patients to the off-label group (OFLG; 168 patients with 225 lesions). Target vessel failure (TVF) and ischaemia-driven target lesion revascularisation (id-TLR) at one year were evaluated in both groups. Patients in the OFLG had a higher prevalence of diabetes mellitus and longer lesion length. Predilatation, post-dilatation and intracoronary imaging were conducted in the majority of patients. At one-year follow-up, TVF (0% vs. 7.8%, p=0.32) and id-TLR (0% vs. 4.5%, p=0.31) occurred only in the OFLG with no adverse events in the ESTG. Definite stent thrombosis occurred in two OFLG patients (1.3%). CONCLUSIONS In a real-world setting, the majority (88.9%) of patients were treated with BRS for off-label indications. Off-label use of BRS appears to be associated with an acceptable occurrence of outcomes considering the greater complexity of this patient group.
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Affiliation(s)
- Tadashi Miyazaki
- Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy
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Chieffo A, Giustino G, Spagnolo P, Panoulas VF, Montorfano M, Latib A, Figini F, Agricola E, Gerli C, Franco A, Giglio M, Cioni M, Alfieri O, Camici PG, Colombo A. Routine Screening of Coronary Artery Disease With Computed Tomographic Coronary Angiography in Place of Invasive Coronary Angiography in Patients Undergoing Transcatheter Aortic Valve Replacement. Circ Cardiovasc Interv 2016; 8:e002025. [PMID: 26160830 DOI: 10.1161/circinterventions.114.002025] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Coronary artery disease (CAD) screening is required before transcatheter aortic valve implantation (TAVR). Although invasive coronary angiography (CA) remains the gold standard for CAD assessment, computed tomographic CA (CTCA) could be a safe and effective noninvasive alternative for CAD screening in patients undergoing TAVR. METHODS AND RESULTS From November 2007 to May 2013, all patients undergoing TAVR at our institution were included in the study cohort. CTCA was used as first-line imaging tool for CAD screening. Invasive CA was performed when any of the following were present: coronary anatomy at CTCA was not evaluable and presence of significant CAD at CTCA. The primary objective was to compare major adverse cardiovascular and cerebrovascular events at 30 days and 1 year between patients who performed CTCA as only screening test and those who performed CTCA and invasive CA. Of 491 patients treated with TAVR, 375 (76.3%) performed only CTCA, whereas 116 (21.7%) underwent also CA. No differences were present in crude major adverse cardiovascular and cerebrovascular event rates at 30 days and 1 year between the 2 groups. After multivariable adjustment, CTCA performed alone was not associated with higher risk of MACE at 1 year of follow-up (hazard ratio, 0.89; 95% confidence interval, 0.49-1.60; P=0.69). CONCLUSIONS CTCA performed as a routine noninvasive imaging tool in patients undergoing TAVR seems safe and effective allowing, with a single test, acquisition of information on aortic annulus anatomy, peripheral access sites, and evaluation of coronary anatomy.
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Affiliation(s)
- Alaide Chieffo
- From the Interventional Cardiology Unit and Cardiothoracic Department, San Raffaele Scientific Institute (A. Chieffo, G.G., M.M., A.L., F.F., E.A., C.G., A.F., M.C., O.A., A. Colombo), Center for Cardiovascular Prevention (P.S., M.G.), Vita-Salute University (P.G.C.), San Raffaele Scientific Institute, Milan, Italy; and Department of Cardiology, Imperial College London, National Heart and Lung Institute, London, United Kingdom (V.F.P.).
| | - Gennaro Giustino
- From the Interventional Cardiology Unit and Cardiothoracic Department, San Raffaele Scientific Institute (A. Chieffo, G.G., M.M., A.L., F.F., E.A., C.G., A.F., M.C., O.A., A. Colombo), Center for Cardiovascular Prevention (P.S., M.G.), Vita-Salute University (P.G.C.), San Raffaele Scientific Institute, Milan, Italy; and Department of Cardiology, Imperial College London, National Heart and Lung Institute, London, United Kingdom (V.F.P.)
| | - Pietro Spagnolo
- From the Interventional Cardiology Unit and Cardiothoracic Department, San Raffaele Scientific Institute (A. Chieffo, G.G., M.M., A.L., F.F., E.A., C.G., A.F., M.C., O.A., A. Colombo), Center for Cardiovascular Prevention (P.S., M.G.), Vita-Salute University (P.G.C.), San Raffaele Scientific Institute, Milan, Italy; and Department of Cardiology, Imperial College London, National Heart and Lung Institute, London, United Kingdom (V.F.P.)
| | - Vasileios F Panoulas
- From the Interventional Cardiology Unit and Cardiothoracic Department, San Raffaele Scientific Institute (A. Chieffo, G.G., M.M., A.L., F.F., E.A., C.G., A.F., M.C., O.A., A. Colombo), Center for Cardiovascular Prevention (P.S., M.G.), Vita-Salute University (P.G.C.), San Raffaele Scientific Institute, Milan, Italy; and Department of Cardiology, Imperial College London, National Heart and Lung Institute, London, United Kingdom (V.F.P.)
| | - Matteo Montorfano
- From the Interventional Cardiology Unit and Cardiothoracic Department, San Raffaele Scientific Institute (A. Chieffo, G.G., M.M., A.L., F.F., E.A., C.G., A.F., M.C., O.A., A. Colombo), Center for Cardiovascular Prevention (P.S., M.G.), Vita-Salute University (P.G.C.), San Raffaele Scientific Institute, Milan, Italy; and Department of Cardiology, Imperial College London, National Heart and Lung Institute, London, United Kingdom (V.F.P.)
| | - Azeem Latib
- From the Interventional Cardiology Unit and Cardiothoracic Department, San Raffaele Scientific Institute (A. Chieffo, G.G., M.M., A.L., F.F., E.A., C.G., A.F., M.C., O.A., A. Colombo), Center for Cardiovascular Prevention (P.S., M.G.), Vita-Salute University (P.G.C.), San Raffaele Scientific Institute, Milan, Italy; and Department of Cardiology, Imperial College London, National Heart and Lung Institute, London, United Kingdom (V.F.P.)
| | - Filippo Figini
- From the Interventional Cardiology Unit and Cardiothoracic Department, San Raffaele Scientific Institute (A. Chieffo, G.G., M.M., A.L., F.F., E.A., C.G., A.F., M.C., O.A., A. Colombo), Center for Cardiovascular Prevention (P.S., M.G.), Vita-Salute University (P.G.C.), San Raffaele Scientific Institute, Milan, Italy; and Department of Cardiology, Imperial College London, National Heart and Lung Institute, London, United Kingdom (V.F.P.)
| | - Eustachio Agricola
- From the Interventional Cardiology Unit and Cardiothoracic Department, San Raffaele Scientific Institute (A. Chieffo, G.G., M.M., A.L., F.F., E.A., C.G., A.F., M.C., O.A., A. Colombo), Center for Cardiovascular Prevention (P.S., M.G.), Vita-Salute University (P.G.C.), San Raffaele Scientific Institute, Milan, Italy; and Department of Cardiology, Imperial College London, National Heart and Lung Institute, London, United Kingdom (V.F.P.)
| | - Chiara Gerli
- From the Interventional Cardiology Unit and Cardiothoracic Department, San Raffaele Scientific Institute (A. Chieffo, G.G., M.M., A.L., F.F., E.A., C.G., A.F., M.C., O.A., A. Colombo), Center for Cardiovascular Prevention (P.S., M.G.), Vita-Salute University (P.G.C.), San Raffaele Scientific Institute, Milan, Italy; and Department of Cardiology, Imperial College London, National Heart and Lung Institute, London, United Kingdom (V.F.P.)
| | - Annalisa Franco
- From the Interventional Cardiology Unit and Cardiothoracic Department, San Raffaele Scientific Institute (A. Chieffo, G.G., M.M., A.L., F.F., E.A., C.G., A.F., M.C., O.A., A. Colombo), Center for Cardiovascular Prevention (P.S., M.G.), Vita-Salute University (P.G.C.), San Raffaele Scientific Institute, Milan, Italy; and Department of Cardiology, Imperial College London, National Heart and Lung Institute, London, United Kingdom (V.F.P.)
| | - Manuela Giglio
- From the Interventional Cardiology Unit and Cardiothoracic Department, San Raffaele Scientific Institute (A. Chieffo, G.G., M.M., A.L., F.F., E.A., C.G., A.F., M.C., O.A., A. Colombo), Center for Cardiovascular Prevention (P.S., M.G.), Vita-Salute University (P.G.C.), San Raffaele Scientific Institute, Milan, Italy; and Department of Cardiology, Imperial College London, National Heart and Lung Institute, London, United Kingdom (V.F.P.)
| | - Micaela Cioni
- From the Interventional Cardiology Unit and Cardiothoracic Department, San Raffaele Scientific Institute (A. Chieffo, G.G., M.M., A.L., F.F., E.A., C.G., A.F., M.C., O.A., A. Colombo), Center for Cardiovascular Prevention (P.S., M.G.), Vita-Salute University (P.G.C.), San Raffaele Scientific Institute, Milan, Italy; and Department of Cardiology, Imperial College London, National Heart and Lung Institute, London, United Kingdom (V.F.P.)
| | - Ottavio Alfieri
- From the Interventional Cardiology Unit and Cardiothoracic Department, San Raffaele Scientific Institute (A. Chieffo, G.G., M.M., A.L., F.F., E.A., C.G., A.F., M.C., O.A., A. Colombo), Center for Cardiovascular Prevention (P.S., M.G.), Vita-Salute University (P.G.C.), San Raffaele Scientific Institute, Milan, Italy; and Department of Cardiology, Imperial College London, National Heart and Lung Institute, London, United Kingdom (V.F.P.)
| | - Paolo Guido Camici
- From the Interventional Cardiology Unit and Cardiothoracic Department, San Raffaele Scientific Institute (A. Chieffo, G.G., M.M., A.L., F.F., E.A., C.G., A.F., M.C., O.A., A. Colombo), Center for Cardiovascular Prevention (P.S., M.G.), Vita-Salute University (P.G.C.), San Raffaele Scientific Institute, Milan, Italy; and Department of Cardiology, Imperial College London, National Heart and Lung Institute, London, United Kingdom (V.F.P.)
| | - Antonio Colombo
- From the Interventional Cardiology Unit and Cardiothoracic Department, San Raffaele Scientific Institute (A. Chieffo, G.G., M.M., A.L., F.F., E.A., C.G., A.F., M.C., O.A., A. Colombo), Center for Cardiovascular Prevention (P.S., M.G.), Vita-Salute University (P.G.C.), San Raffaele Scientific Institute, Milan, Italy; and Department of Cardiology, Imperial College London, National Heart and Lung Institute, London, United Kingdom (V.F.P.)
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Miyazaki T, Latib A, Ruparelia N, Kawamoto H, Sato K, Figini F, Colombo A. The use of a scoring balloon for optimal lesion preparation prior to bioresorbable scaffold implantation: a comparison with conventional balloon predilatation. EUROINTERVENTION 2016; 11:e1580-8. [DOI: 10.4244/eijv11i14a308] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Latib A, Pedersen W, Maisano F, Lesser J, Ruparelia N, Figini F, Colombo A, Poulose A, Kolbeck J, Mooney M, Schwartz R, Youssef A, Ungs D, Goldenberg I, Sorajja P. Initial findings using the V8 hourglass-shaped valvuloplasty balloon for postdilatation in treating paravalvular leaks associated with transcatheter self-expanding aortic valve prosthesis. Catheter Cardiovasc Interv 2016; 87:1306-13. [PMID: 26945697 DOI: 10.1002/ccd.26462] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Accepted: 01/22/2016] [Indexed: 11/10/2022]
Abstract
OBJECTIVES The aim of this study was to assess the effect of a novel hourglass-shaped balloon on reduction of paravalvular leak (PVL) in patients undergoing transcatheter aortic valve replacement (TAVR) with self-expanding prostheses. BACKGROUND An important limitation of TAVR compared with surgical aortic valve replacement remains the higher incidence of PVL. A commonly used strategy to treat PVL is balloon postdilatation (BPD); however, the optimal technique for treating PVL after TAVR is unknown. METHODS We examined consecutive patients with severe, symptomatic aortic stenosis who underwent TAVR with the Medtronic CoreValve followed by BPD with an InterValve V8 balloon for PVL grade ≥2+. Data from echocardiographic, multidetector computed tomographic, and angiographic images were reviewed. The primary endpoint was successful reduction in PVL to grade 1+ or less as assessed by intraprocedural echocardiography. RESULTS Eleven patients were studied (median age, 82 years; 64% female). Ten patients (91%) demonstrated successful reduction in PVL after V8 BPD. In three patients, PVL was reduced to zero or trace. PVL remained unchanged in one patient (2+). Two patients had complete heart block associated with valve deployment and received permanent pacemakers. There were no occurrences of annular injury or major adverse clinical events. CONCLUSIONS BPD with the V8 hourglass-shaped balloon was feasible in reducing PVL from self-expanding TAVR prostheses. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Azeem Latib
- Interventional Cardiology Unit, San Raffaele Scientific Institute and EMO-GVM Centro Cuore Columbus, Milan, Italy
| | - Wesley Pedersen
- Center for Valve and Structural Heart Disease, Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - Francesco Maisano
- Department of Cardiovascular Surgery, UniversitätsSpital Zürich, Zürich, Switzerland
| | - John Lesser
- Center for Valve and Structural Heart Disease, Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - Neil Ruparelia
- Interventional Cardiology Unit, San Raffaele Scientific Institute and EMO-GVM Centro Cuore Columbus, Milan, Italy
| | - Filippo Figini
- Interventional Cardiology Unit, San Raffaele Scientific Institute and EMO-GVM Centro Cuore Columbus, Milan, Italy
| | - Antonio Colombo
- Interventional Cardiology Unit, San Raffaele Scientific Institute and EMO-GVM Centro Cuore Columbus, Milan, Italy
| | - Anil Poulose
- Center for Valve and Structural Heart Disease, Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - James Kolbeck
- Center for Valve and Structural Heart Disease, Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - Michael Mooney
- Center for Valve and Structural Heart Disease, Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - Robert Schwartz
- Center for Valve and Structural Heart Disease, Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - Alicia Youssef
- Center for Valve and Structural Heart Disease, Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - David Ungs
- Center for Valve and Structural Heart Disease, Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota
| | | | - Paul Sorajja
- Center for Valve and Structural Heart Disease, Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota
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Panoulas VF, Miyazaki T, Sato K, Naganuma T, Sticchi A, Kawamoto H, Figini F, Chieffo A, Carlino M, Montorfano M, Latib A, Colombo A. Procedural outcomes of patients with calcified lesions treated with bioresorbable vascular scaffolds. EUROINTERVENTION 2016; 11:1355-62. [DOI: 10.4244/eijy15m03_11] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Ruparelia N, Latib A, Buzzatti N, Giannini F, Figini F, Mangieri A, Regazzoli D, Stella S, Sticchi A, Kawamoto H, Tanaka A, Agricola E, Monaco F, Castiglioni A, Ancona M, Cioni M, Spagnolo P, Chieffo A, Montorfano M, Alfieri O, Colombo A. Long-Term Outcomes After Transcatheter Aortic Valve Implantation from a Single High-Volume Center (The Milan Experience). Am J Cardiol 2016; 117:813-9. [PMID: 26742477 DOI: 10.1016/j.amjcard.2015.12.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 12/03/2015] [Accepted: 12/03/2015] [Indexed: 12/20/2022]
Abstract
Transcatheter aortic valve implantation (TAVI) is now the treatment of choice for patients with symptomatic aortic stenosis who are inoperable or with high surgical risk. Data with regards to contemporary clinical practice and long-term outcomes are sparse. To evaluate temporal changes in TAVI practice and explore procedural and long-term clinical outcomes of patients in a contemporary "real-world" population, outcomes of 829 patients treated from November 2007 to May 2015, at the San Raffaele Scientific Institute, Milan, Italy, were retrospectively analyzed. Median follow-up was 568 days, with the longest follow-up of 2,677 days. Overall inhospital mortality was 3.5%. During the study period, there was a trend toward treating younger, lower risk patients. Overall mortality rates were 3.5% (30 days), 14% (1 year), 22% (2 years), 29% (3 years), 37% (4 years), 47% (5 years), 53% (6 years), and 72% (7 years). The survival probability at 5 years was significantly higher in patients treated through the transfemoral (TF) route compared to other vascular access sites (log rank p <0.001). Non-TF vascular access and residual paravalvular leak ≥2 (after TAVI) were identified as independent predictors for both all-cause and cardiovascular mortality. No patient required further aortic valve intervention for TAVI prosthesis degeneration. In conclusion, there is a trend toward treating younger, lower-risk patients. Non-TF vascular access approach and ≥2 PVL after TAVI were identified as independent predictors for both overall and cardiovascular mortality with no cases of prosthesis degeneration suggesting acceptable durability.
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Ruparelia N, Latib A, Giannini F, Figini F, Buzzatti N, Mangieri A, Regazzoli D, Stella S, Sticchi A, Agricola E, De Bonis M, Monaco F, Spagnolo P, Chieffo A, Montorfano M, Alfieri O, Colombo A. TCT-154 Patient and Healthcare System Benefits of Contemporary Transcatheter Aortic Valve Implantation (TAVI) Practice. J Am Coll Cardiol 2015. [DOI: 10.1016/j.jacc.2015.08.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Tanaka A, Ruparelia N, Kawamoto H, Sticchi A, Figini F, Carlino M, Chieffo A, Montorfano M, Latib A, Colombo A. Clinical outcomes following target lesion revascularization for bioresorbable scaffold failure. Catheter Cardiovasc Interv 2015; 87:832-6. [DOI: 10.1002/ccd.26171] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 07/27/2015] [Indexed: 11/09/2022]
Affiliation(s)
- Akihito Tanaka
- Interventional Cardiology Unit; EMO-GVM Centro Cuore Columbus; Milan Italy
- Interventional Cardiology Unit; San Raffaele Scientific Institute; Milan Italy
| | - Neil Ruparelia
- Interventional Cardiology Unit; EMO-GVM Centro Cuore Columbus; Milan Italy
- Interventional Cardiology Unit; San Raffaele Scientific Institute; Milan Italy
- Imperial College; London United Kingdom
| | - Hiroyoshi Kawamoto
- Interventional Cardiology Unit; EMO-GVM Centro Cuore Columbus; Milan Italy
- Interventional Cardiology Unit; San Raffaele Scientific Institute; Milan Italy
| | - Alessandro Sticchi
- Interventional Cardiology Unit; San Raffaele Scientific Institute; Milan Italy
| | - Filippo Figini
- Interventional Cardiology Unit; EMO-GVM Centro Cuore Columbus; Milan Italy
- Interventional Cardiology Unit; San Raffaele Scientific Institute; Milan Italy
| | - Mauro Carlino
- Interventional Cardiology Unit; San Raffaele Scientific Institute; Milan Italy
| | - Alaide Chieffo
- Interventional Cardiology Unit; San Raffaele Scientific Institute; Milan Italy
| | - Matteo Montorfano
- Interventional Cardiology Unit; San Raffaele Scientific Institute; Milan Italy
| | - Azeem Latib
- Interventional Cardiology Unit; EMO-GVM Centro Cuore Columbus; Milan Italy
- Interventional Cardiology Unit; San Raffaele Scientific Institute; Milan Italy
| | - Antonio Colombo
- Interventional Cardiology Unit; EMO-GVM Centro Cuore Columbus; Milan Italy
- Interventional Cardiology Unit; San Raffaele Scientific Institute; Milan Italy
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Carlino M, Figini F, Ruparelia N, Uretsky BF, Godino C, Latib A, Bertoldi L, Brilakis E, Karmpaliotis D, Antoniucci D, Margonato A, Colombo A. Predictors of restenosis following contemporary subintimal tracking and reentry technique: The importance of final TIMI flow grade. Catheter Cardiovasc Interv 2015; 87:884-92. [PMID: 26308750 DOI: 10.1002/ccd.26103] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 06/20/2015] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To identify predictors of restenosis after recanalization of chronic total occlusions (CTOs) with the Subintimal Tracking And Reentry (STAR) technique. BACKGROUND STAR is associated with high rates of restenosis but the associated factors are not clear. Understanding the underlying mechanisms may be important to improve STAR outcomes and possibly other contemporary CTO recanalization techniques utilizing extensive subintimal dissection and stenting. METHODS We retrospectively analyzed 211 lesions that underwent a STAR procedure (between 2002 and 2013) with a final Thrombolysis in Myocardial Infarction (TIMI) flow grade 2 or 3. One-hundred and nineteen lesions that received drug eluting stents (DES) and underwent follow-up angiography were included in the final analysis. RESULTS Of the 119 lesions treated with DES following STAR, 75 restenoses were observed (63.0%). Utilizing multivariate analysis, TIMI flow grade in the recanalized artery following stent implantation at the end of the index procedure was the only independent predictor of restenosis. CONCLUSIONS Following recanalization of a CTO with STAR, final TIMI flow predicted future restenosis or reocclusion. As a bailout technique, STAR resulted in a high acute success rate with good safety and acceptable long-term results. When poor flow is observed following recanalization, and prior to stent implantation, a two-step strategy whereby a second procedure is performed at an interval to maximize coronary flow at the end of the procedure may be considered with the goal to reduce the risk of future restenosis or total vessel occlusion following STAR.
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Affiliation(s)
- Mauro Carlino
- Department of Interventional Cardiology, San Raffaele Scientific Institute, Milan, Italy
| | - Filippo Figini
- Department of Interventional Cardiology, San Raffaele Scientific Institute, Milan, Italy.,Department of Interventional Cardiology, EMO-GVM Centro Cuore Columbus, Milan, Italy
| | - Neil Ruparelia
- Department of Interventional Cardiology, San Raffaele Scientific Institute, Milan, Italy.,Department of Interventional Cardiology, EMO-GVM Centro Cuore Columbus, Milan, Italy.,Department of Interventional Cardiology, Imperial College, London, United Kingdom
| | - Barry F Uretsky
- Department of Interventional Cardiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Cosmo Godino
- Department of Interventional Cardiology, San Raffaele Scientific Institute, Milan, Italy
| | - Azeem Latib
- Department of Interventional Cardiology, San Raffaele Scientific Institute, Milan, Italy.,Department of Interventional Cardiology, EMO-GVM Centro Cuore Columbus, Milan, Italy
| | - Letizia Bertoldi
- Department of Interventional Cardiology, San Raffaele Scientific Institute, Milan, Italy
| | - Emmanouil Brilakis
- Department of Interventional Cardiology, VA North Texas Health Care System, Dallas, Texas.,Department of Interventional Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Dimitri Karmpaliotis
- Department of Interventional Cardiology, Presbyterian Hospital/Columbia University Medical Center, New York
| | - David Antoniucci
- Department of Interventional Cardiology, Careggi Hospital, Florence, Italy
| | - Alberto Margonato
- Department of Interventional Cardiology, San Raffaele Scientific Institute, Milan, Italy
| | - Antonio Colombo
- Department of Interventional Cardiology, San Raffaele Scientific Institute, Milan, Italy.,Department of Interventional Cardiology, EMO-GVM Centro Cuore Columbus, Milan, Italy
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Miyazaki S, Agricola E, Panoulas VF, Slavich M, Giustino G, Miyazaki T, Figini F, Latib A, Chieffo A, Montorfano M, Margonato A, Maisano F, Alfieri O, Colombo A. Influence of baseline ejection fraction on the prognostic value of paravalvular leak after transcatheter aortic valve implantation. Int J Cardiol 2015; 190:277-81. [DOI: 10.1016/j.ijcard.2015.04.190] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 04/23/2015] [Indexed: 01/10/2023]
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Kawamoto H, Latib A, Ruparelia N, Miyazaki T, Sticchi A, Naganuma T, Sato K, Figini F, Chieffo A, Carlino M, Montorfano M, Colombo A. Clinical outcomes following bioresorbable scaffold implantation for bifurcation lesions: Overall outcomes and comparison between provisional and planned double stenting strategy. Catheter Cardiovasc Interv 2015; 86:644-52. [DOI: 10.1002/ccd.26045] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 04/16/2015] [Accepted: 05/07/2015] [Indexed: 11/07/2022]
Affiliation(s)
- Hiroyoshi Kawamoto
- Interventional Cardiology Unit, San Raffaele Scientific Institute; Milan Italy
- Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus; Milan Italy
- Interventional Cardiology Unit, New Tokyo Hospital; Chiba Japan
| | - Azeem Latib
- Interventional Cardiology Unit, San Raffaele Scientific Institute; Milan Italy
- Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus; Milan Italy
| | - Neil Ruparelia
- Interventional Cardiology Unit, San Raffaele Scientific Institute; Milan Italy
- Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus; Milan Italy
- Imperial College; London United Kingdom
| | - Tadashi Miyazaki
- Interventional Cardiology Unit, San Raffaele Scientific Institute; Milan Italy
- Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus; Milan Italy
| | - Alessandro Sticchi
- Interventional Cardiology Unit, San Raffaele Scientific Institute; Milan Italy
| | - Toru Naganuma
- Interventional Cardiology Unit, New Tokyo Hospital; Chiba Japan
| | | | - Filippo Figini
- Interventional Cardiology Unit, San Raffaele Scientific Institute; Milan Italy
- Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus; Milan Italy
| | - Alaide Chieffo
- Interventional Cardiology Unit, San Raffaele Scientific Institute; Milan Italy
| | - Mauro Carlino
- Interventional Cardiology Unit, San Raffaele Scientific Institute; Milan Italy
| | - Matteo Montorfano
- Interventional Cardiology Unit, San Raffaele Scientific Institute; Milan Italy
| | - Antonio Colombo
- Interventional Cardiology Unit, San Raffaele Scientific Institute; Milan Italy
- Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus; Milan Italy
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Kawamoto H, Panoulas VF, Sato K, Miyazaki T, Naganuma T, Sticchi A, Figini F, Latib A, Chieffo A, Carlino M, Montorfano M, Colombo A. Impact of Strut Width in Periprocedural Myocardial Infarction: A Propensity-Matched Comparison Between Bioresorbable Scaffolds and the First-Generation Sirolimus-Eluting Stent. JACC Cardiovasc Interv 2015; 8:900-9. [PMID: 26003020 DOI: 10.1016/j.jcin.2015.02.011] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 01/29/2015] [Accepted: 02/12/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study aimed to assess the clinical impact of strut width (evaluated by abluminal strut surface area [ASSA]) on periprocedural myocardial infarction (PMI) and clinical outcomes in patients treated with bioresorbable scaffolds (BRS) versus first-generation sirolimus-eluting stents (SES). BACKGROUND To date, there are no reports on the impact of ASSA on PMI and clinical outcomes. METHODS We compared the impact of ASSA on outcomes and PMI in propensity-matched patients treated with BRS and SES. The primary outcome was the incidence of major adverse cardiac events (MACE), defined as the combination of all-cause mortality, follow-up myocardial infarction, and target vessel revascularization, at 30-days and 1-year follow-ups. The secondary endpoint was the incidence of PMI. RESULTS After propensity-matched analysis, 499 patients (147 BRS patients vs. 352 SES patients) were evaluated. Mean ASSA was higher in patients treated with BRS versus SES (BRS: 132.3 ± 76.7 mm(2) vs. SES: 67.6 ± 48.4 mm(2), p < 0.001). MACE was not significantly different between groups (30-days MACE: BRS: 0% vs. SES: 1.4%, p = 0.16, and 1-year MACE: BRS: 15.7% vs. SES: 11.4%, p = 0.67). The incidence of PMI was significantly higher in the BRS group (BRS: 13.1% vs. SES: 7.5%, p = 0.05). Multivariable analyses indicated that treatment of left anterior descending artery and ASSA were independent predictors of PMI. CONCLUSIONS BRS implantation, compared with SES implantation, was associated with a higher incidence of PMI. MACE at 30 days and 1 year were not significantly different. Left anterior descending artery percutaneous coronary intervention and ASSA were independent predictors of PMI.
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Affiliation(s)
- Hiroyoshi Kawamoto
- Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy; Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy
| | - Vasileios F Panoulas
- Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy; Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy; Interventional Cardiology Unit, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Katsumasa Sato
- Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy; Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy
| | - Tadashi Miyazaki
- Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy; Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy
| | - Toru Naganuma
- Faculty of Medicine, New Tokyo Hospital, Chiba, Japan
| | - Alessandro Sticchi
- Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Filippo Figini
- Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy; Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy
| | - Azeem Latib
- Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy; Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy
| | - Alaide Chieffo
- Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Mauro Carlino
- Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Matteo Montorfano
- Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Antonio Colombo
- Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy; Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy.
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Ielasi A, Latib A, Sacco FM, Costopoulos C, Figini F, Grimaldi A, Naim C, Maisano F, Chieffo A, Montorfano M, Alfieri O, Colombo A. Impact and natural history of postprocedural aortic regurgitation on early and midterm mortality following transcatheter aortic valve implantation in high-risk patients with severe aortic stenosis. J Cardiovasc Med (Hagerstown) 2015; 16:286-95. [PMID: 25643194 DOI: 10.2459/jcm.0000000000000249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Post-procedural aortic regurgitation (AR) negatively impacts the prognosis after trans-catheter aortic valve implantation. However, data evaluating the impact of different post-procedural AR grades (particularly mild) on clinical outcomes are still important. AIM AND METHODS A retrospective cohort analysis was performed on all consecutive patients with severe aortic stenosis who underwent trans-catheter aortic valve implantation between July 2008 and August 2011 in a single Institution. Aim of the study was to evaluate the impact of different post-procedural AR grades on early and mid-term clinical outcomes. RESULTS 322 consecutive patients were evaluated. At post-procedural echocardiographic evaluation: 105 (32.6%) patients had no AR, 204 (63.4%) mild AR and 13 (4%) moderate/severe AR. In-hospital mortality was higher in patients with moderate/severe AR than in those with absent or mild AR (38.5% vs. 2.6%, P < 0.001). At a median clinical follow-up of 342 days [interquartile range 93-485] cardiovascular mortality was 2.9% in patients without AR; 13.2% in the mild AR group (P = 0.004 vs. absent AR) and 46.2% in the moderate/severe AR group (P < 0.001 vs. mild or absent AR). On multivariable analysis, post-procedural AR (hazard ratio = 2.65 absent vs. present any grade, 95% confidence interval = 1.11-6.29; P = 0.027) was an independent predictor of mid-term mortality. CONCLUSIONS The impact of post-procedural AR on outcomes after trans-catheter aortic valve implantation is proportional with its grade even in case of mild post-procedural AR compared to absent. This study confirms that every effort should be made to reduce the grade of post-procedural AR after trans-catheter aortic valve implantation with current devices.
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Affiliation(s)
- Alfonso Ielasi
- aInterventional Cardiology Unit, San Raffaele Scientific Institute bInterventional Cardiology Unit, EMO-GVM Centro Cuore Columbus cDivision of Cardiac Surgery, San Raffaele Scientific Institute, Milan, Italy *Dr Alfonso Ielasi and Dr Azeem Latib contributed equally to the article and are joint first authors
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Panoulas VF, Figini F, Giustino G, Carlino M, Chieffo A, Latib A, Colombo A. A case of an occlusive right coronary artery dissection after stent implantation: dilemmas and challenges. J Invasive Cardiol 2015; 27:E13-E15. [PMID: 25589705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A 53-year-old man with stable angina had a staged percutaneous coronary intervention to a critical focal stenosis of the mid-segment of the right coronary artery (RCA). Two hours after successful RCA stent implantation, the patient re-presented with inferior ST elevation secondary to acute dissection originating at the distal edge of the stent, causing subtotal occlusion of the distal RCA. The patient had TIMI-2 flow in the posterolateral branch and occlusion of the posterior descending artery. This case describes the procedural challenges the operators were faced with and successful use of the "rescue STAR" technique as a last resort.
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Affiliation(s)
- Vasileios F Panoulas
- Imperial College London, National Heart and Lung Institute, Sir Alexander Fleming Building, South Kensington Campus, SW7 2AZ, London, UK.
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Domingos J, Augustine D, Leeson P, Noble J, Doan HL, Boubrit L, Cheikh-Khalifa R, Laveau F, Djebbar M, Pousset F, Isnard R, Hammoudi N, Lisi M, Cameli M, Di Tommaso C, Curci V, Reccia R, Maccherini M, Henein MY, Mondillo S, Leitman M, Vered Z, Rashid H, Yalcin MU, Gurses KM, Kocyigit D, Evranos B, Yorgun H, Sahiner L, Kaya B, Aytemir K, Ozer N, Bertella E, Petulla' M, Baggiano A, Mushtaq S, Russo E, Gripari P, Innocenti E, Andreini D, Tondo C, Pontone G, Necas J, Kovalova S, Hristova K, Shiue I, Bogdanva V, Teixido Tura G, Sanchez V, Rodriguez-Palomares J, Gutierrez L, Gonzalez-Alujas T, Garcia-Dorado D, Forteza A, Evangelista A, Timoteo AT, Aguiar Rosa S, Cruz Ferreira R, Campbell R, Carrick D, Mccombe C, Tzemos N, Berry C, Sonecki P, Noda M, Setoguchi M, Ikenouchi T, Nakamura T, Yamamoto Y, Murakami T, Katou Y, Usui M, Ichikawa K, Isobe M, Kwon B, Roh J, Kim H, Ihm S, Barron AJ, Francis D, Mayet J, Wensel R, Kosiuk J, Dinov B, Bollmann A, Hindricks G, Breithardt O, Rio P, Moura Branco L, Galrinho A, Cacela D, Pinto Teixeira P, Afonso Nogueira M, Pereira-Da-Silva T, Abreu J, Teresa Timoteo A, Cruz Ferreira R, Pavlyukova E, Tereshenkova E, Karpov R, Piatkowski R, Kochanowski J, Opolski G, Barbier P, Mirea O, Guglielmo M, Savioli G, Cefalu C, Pudil R, Horakova L, Rozloznik M, Balestra C, Rimbas R, Enescu O, Calin S, Vinereanu D, Karsenty C, Hascoet S, Hadeed K, Semet F, Dulac Y, Alacoque X, Leobon B, Acar P, Dharma S, Sukmawan R, Soesanto A, Vebiona K, Firdaus I, Danny S, Driessen MMP, Sieswerda G, Post M, Snijder R, Van Dijk A, Leiner T, Meijboom F, Chrysohoou C, Tsitsinakis G, Tsiachris D, Aggelis A, Herouvim E, Vogiatzis I, Pitsavos C, Koulouris G, Stefanadis C, Erdei T, Edwards J, Braim D, Yousef Z, Fraser A, Avenatti E, Magnino C, Omede' P, Presutti D, Moretti C, Iannaccone A, Ravera A, Gaita F, Milan A, Veglio F, Barbier P, Scali M, Simioniuc A, Guglielmo M, Savioli G, Cefalu C, Mirea O, Fusini L, Dini F, Okura H, Murata E, Kataoka T, Zaroui A, Ben Halima M, Mourali M, Mechmeche R, Rodriguez Palomares JF, Gutierrez L, Maldonado G, Garcia G, Otaegui I, Garcia Del Blanco B, Teixido G, Gonzalez Alujas M, Evangelista A, Garcia Dorado D, Godinho AR, Correia A, Rangel I, Rocha A, Rodrigues J, Araujo V, Almeida P, Macedo F, Maciel M, Rekik B, Mghaieth F, Aloui H, Boudiche S, Jomaa M, Ayari J, Tabebi N, Farhati A, Mourali S, Dekleva M, Markovic-Nikolic N, Zivkovic M, Stankovic A, Boljevic D, Korac N, Beleslin B, Arandjelovic A, Ostojic M, Galli E, Guirette Y, Auffret V, Daudin M, Fournet M, Mabo P, Donal E, Chin CWL, Luo E, Hwan J, White A, Newby D, Dweck M, Carstensen HG, Larsen LH, Hassager C, Kofoed KF, Jensen JS, Mogelvang R, Kowalczyk M, Debska M, Kolesnik A, Dangel J, Kawalec W, Migliore R, Adaniya M, Barranco M, Miramont G, Gonzalez S, Tamagusuku H, Davidsen ES, Kuiper KKJ, Matre K, Gerdts E, Igual Munoz B, Maceira Gonzalez A, Erdociain Perales M, Estornell Erill J, Valera Martinez F, Miro Palau V, Piquer Gil M, Sepulveda Sanchez P, Cervera Zamora A, Montero Argudo A, Placido R, Silva Marques J, Magalhaes A, Guimaraes T, Nobre E Menezes M, Goncalves S, Ramalho A, Robalo Martins S, Almeida A, Nunes Diogo A, Abid L, Ben Kahla S, Charfeddine S, Abid D, Kammoun S, Tounsi A, Abid L, Abid D, Charfeddine S, Hammami R, Triki F, Akrout M, Mallek S, Hentati M, Kammoun S, Sirbu CF, Berrebi A, Huber A, Folliguet T, Yang LT, Shih J, Liu Y, Li Y, Tsai L, Luo C, Tsai W, Babukov R, Bartosh F, Bazilev V, Muraru D, Cavalli G, Addetia K, Miglioranza M, Veronesi F, Mihaila S, Tadic M, Cucchini U, Badano L, Lang R, Miyazaki S, Slavich M, Miyazaki T, Figini F, Lativ A, Chieffo A, Montrfano M, Alfieri O, Colombo A, Agricola E, Liu D, Hu K, Herrmann S, Stoerk S, Kramer B, Ertl G, Bijnens B, Weidemann F, Brand M, Butz T, Tzikas S, Van Bracht M, Roeing J, Wennemann R, Christ M, Grett M, Trappe HJ, Scherzer S, Geroldinger A, Krenn L, Roth C, Gangl C, Maurer G, Rosenhek R, Neunteufl T, Binder T, Bergler-Klein J, Martins E, Pinho T, Leite S, Azevedo O, Belo A, Campelo M, Amorim S, Rocha-Goncalves F, Goncalves L, Silva-Cardoso J, Ahn H, Kim K, Jeon H, Youn H, Haland T, Saberniak J, Leren I, Edvardsen T, Haugaa K, Ziolkowska L, Boruc A, Kowalczyk M, Turska-Kmiec A, Zubrzycka M, Kawalec W, Monivas Palomero V, Mingo Santos S, Goirigolzarri Artaza J, Rodriguez Gonzalez E, Rivero Arribas B, Castro Urda V, Dominguez Rodriguez F, Mitroi C, Gracia Lunar I, Fernadez Lozano I, Palecek T, Masek M, Kuchynka P, Fikrle M, Spicka I, Rysava R, Linhart A, Saberniak J, Hasselberg N, Leren I, Haland T, Borgquist R, Platonov P, Edvardsen T, Haugaa K, Ancona R, Comenale Pinto S, Caso P, Coopola M, Arenga F, Rapisarda O, D'onofrio A, Sellitto V, Calabro R, Rosca M, Popescu B, Calin A, Mateescu A, Beladan C, Jalba M, Rusu E, Zilisteanu D, Ginghina C, Pressman G, Cepeda-Valery B, Romero-Corral A, Moldovan R, Saenz A, Orban M, Samuel S, Fijalkowski M, Fijalkowska M, Gilis-Siek N, Blaut K, Galaska R, Sworczak K, Gruchala M, Fijalkowski M, Nowak R, Gilis-Siek N, Fijalkowska M, Galaska R, Gruchala M, Ikonomidis I, Triantafyllidi H, Trivilou P, Tzortzis S, Papadopoulos C, Pavlidis G, Paraskevaidis I, Lekakis J, Kaymaz C, Aktemur T, Poci N, Ozturk S, Akbal O, Yilmaz F, Tokgoz Demircan H, Kirca N, Tanboga I, Ozdemir N, Greiner S, Jud A, Aurich M, Hess A, Hilbel T, Hardt S, Katus H, D'ascenzi F, Cameli M, Alvino F, Lisi M, Focardi M, Solari M, Bonifazi M, Mondillo S, Konopka M, Krol W, Klusiewicz A, Burkhard K, Chwalbinska J, Pokrywka A, Dluzniewski M, Braksator W, King GJ, Coen K, Gannon S, Fahy N, Kindler H, Clarke J, Iliuta L, Rac-Albu M, Placido R, Robalo Martins S, Guimaraes T, Nobre E Menezes M, Cortez-Dias N, Francisco A, Silva G, Goncalves S, Almeida A, Nunes Diogo A, Kyu K, Kong W, Songco G, Galupo M, Castro M, Shin Hnin W, Ronald Lee C, Poh K, Milazzo V, Di Stefano C, Tosello F, Leone D, Ravera A, Sabia L, Sobrero G, Maule S, Veglio F, Milan A, Jamiel AM, Ahmed AM, Farah I, Al-Mallah MH, Petroni R, Magnano R, Bencivenga S, Di Mauro M, Petroni S, Altorio S, Romano S, Penco M, Kumor M, Lipczynska M, Klisiewicz A, Wojcik A, Konka M, Kozuch K, Szymanski P, Hoffman P, Rimbas R, Rimbas M, Enescu O, Mihaila S, Calin S, Vinereanu D, Donal E, Reynaud A, Lund L, Persson H, Hage C, Oger E, Linde C, Daubert J, Maria Oliveira Lima M, Costa H, Gomes Da Silva M, Noman Alencar M, Carmo Pereira Nunes M, Costa Rocha M, Abid L, Charfeddine S, Ben Kahla S, Abid D, Siala A, Hentati M, Kammoun S, Kovalova S, Necas J, Ozawa K, Funabashi N, Takaoka H, Kobayashi Y, Matsumura Y, Wada M, Hirakawa D, Yasuoka Y, Morimoto N, Takeuchi H, Kitaoka H, Sugiura T, Lakkas L, Naka K, Ntounousi E, Gkirdis I, Koutlas V, Bechlioulis A, Pappas K, Katsouras C, Siamopoulos K, Michalis L, Naka K, Evangelou D, Kalaitzidis R, Bechlioulis A, Lakkas L, Gkirdis I, Tzeltzes G, Nakas G, Katsouras C, Michalis L, Generati G, Bandera F, Pellegrino M, Labate V, Alfonzetti E, Guazzi M, Zagatina A, Zhuravskaya N, Al-Mallah M, Alsaileek A, Qureshi W, Karsenty C, Hascoet S, Peyre M, Hadeed K, Alacoque X, Amadieu R, Leobon B, Dulac Y, Acar P, Yamanaka Y, Sotomi Y, Iwakura K, Inoue K, Toyoshima Y, Tanaka K, Oka T, Tanaka N, Orihara Y, Fujii K, Soulat-Dufour L, Lang S, Boyer-Chatenet L, Van Der Vynckt C, Ederhy S, Adavane S, Haddour N, Boccara F, Cohen A, Huitema M, Boerman S, Vorselaars V, Grutters J, Post M, Gopal AS, Saha S, Toole R, Kiotsekoglou A, Cao J, Reichek N, Meyer CG, Altiok E, Al Ateah G, Lehrke M, Becker M, Lotfi S, Autschbach R, Marx N, Hoffmann R, Frick M, Nemes A, Sepp R, Kalapos A, Domsik P, Forster T, Caro Codon J, Blazquez Bermejo Z, Lopez Fernandez T, Valbuena Lopez SC, Iniesta Manjavacas AM, De Torres Alba F, Dominguez Melcon F, Pena Conde L, Moreno Yanguela M, Lopez-Sendon JL, Nemes A, Lengyel C, Domsik P, Kalapos A, Orosz A, Varkonyi T, Forster T, Rendon J, Saldarriaga CI, Duarte N, Nemes A, Domsik P, Kalapos A, Forster T, Nemes A, Domsik P, Kalapos A, Sepp R, Foldeak D, Borbenyi Z, Forster T, Hamdy A, Fereig H, Nabih M, Abdel-Aziz A, Ali A, Broyd C, Wielandts JY, De Buck S, Michielsen K, Louw R, Garweg C, Nuyts J, Ector J, Maes F, Heidbuchel H, Gillis K, Bala G, Tierens S, Cosyns B, Maurovich-Horvat P, Horvath T, Jermendy A, Celeng C, Panajotu A, Bartykowszki A, Karolyi M, Tarnoki A, Jermendy G, Merkely B. Poster session 2: Thursday 4 December 2014, 08:30-12:30 * Location: Poster area. Eur Heart J Cardiovasc Imaging 2014. [DOI: 10.1093/ehjci/jeu252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Shahgaldi K, Hegner T, Da Silva C, Fukuyama A, Takeuchi M, Uema A, Kado Y, Nagata Y, Hayashi A, Otani K, Fukuda S, Yoshitani H, Otsuji Y, Morhy S, Lianza A, Afonso T, Oliveira W, Tavares G, Rodrigues A, Vieira M, Warth A, Deutsch A, Fischer C, Tezynska-Oniszk I, Turska-Kmiec A, Kawalec W, Dangel J, Maruszewski B, Bokiniec R, Burczynski P, Borszewska-Kornacka K, Ziolkowska L, Zuk M, Troshina A, Dzhalilova D, Poteshkina N, Hamitov F, Warita S, Kawasaki M, Tanaka R, Yagasaki H, Minatoguchi S, Wanatabe T, Ono K, Noda T, Wanatabe S, Minatoguchi S, Angelis A, Ageli K, Vlachopoulos C, Felekos I, Ioakimidis N, Aznaouridis K, Vaina S, Abdelrasoul M, Tsiamis E, Stefanadis C, Cameli M, Sparla S, D'ascenzi F, Fineschi M, Favilli R, Pierli C, Henein M, Mondillo S, Lindqvist P, Tossavainen E, Gonzalez M, Soderberg S, Henein M, Holmgren A, Strachinaru M, Catez E, Jousten I, Pavel O, Janssen C, Morissens M, Chatzistamatiou E, Moustakas G, Memo G, Konstantinidis D, Mpampatzeva Vagena I, Manakos K, Traxanas K, Vergi N, Feretou A, Kallikazaros I, Tsai WC, Sun YT, Lee WH, Yang LT, Liu YW, Lee CH, Li WT, Mizariene V, Bieseviciene M, Karaliute R, Verseckaite R, Vaskelyte J, Lesauskaite V, Chatzistamatiou E, Mpampatseva Vagena I, Manakos K, Moustakas G, Konstantinidis D, Memo G, Mitsakis O, Kasakogias A, Syros P, Kallikazaros I, Hristova K, Cornelissen G, Singh R, Shiue I, Coisne D, Madjalian AM, Tchepkou C, Raud Raynier P, Degand B, Christiaens L, Baldenhofer G, Spethmann S, Dreger H, Sanad W, Baumann G, Stangl K, Stangl V, Knebel F, Azzaz S, Kacem S, Ouali S, Risos L, Dedobbeleer C, Unger P, Sinem Cakal S, Elif Eroglu E, Baydar O, Beytullah Cakal B, Mehmet Vefik Yazicioglu M, Mustafa Bulut M, Cihan Dundar C, Kursat Tigen K, Birol Ozkan B, Ali Metin Esen A, Tournoux F, Chequer R, Sroussi M, Hyafil F, Rouzet F, Leguludec D, Baum P, Stoebe S, Pfeiffer D, Hagendorff A, Fang F, Lau M, Zhang Q, Luo X, Wang X, Chen L, Yu C, Zaborska B, Smarz K, Makowska E, Kulakowski P, Budaj A, Bengrid TM, Zhao Y, Henein MY, Caminiti G, D'antoni V, Cardaci V, Conti V, Volterrani M, Warita S, Kawasaki M, Yagasaki H, Minatoguchi S, Nagaya M, Ono K, Noda T, Watanabe S, Houle H, Minatoguchi S, Gillebert TC, Chirinos JA, Claessens TC, Raja MW, De Buyzere ML, Segers P, Rietzschel ER, Kim K, Cha J, Chung H, Kim J, Yoon Y, Lee B, Hong B, Rim S, Kwon H, Choi E, Pyankov V, Aljaroudi W, Matta S, Al-Shaar L, Habib R, Gharzuddin W, Arnaout S, Skouri H, Jaber W, Abchee A, Bouzas Mosquera A, Peteiro J, Broullon F, Constanso Conde I, Bescos Galego H, Martinez Ruiz D, Yanez Wonenburger J, Vazquez Rodriguez J, Alvarez Garcia N, Castro Beiras A, Gunyeli E, Oliveira Da Silva C, Shahgaldi K, Manouras A, Winter R, Meimoun P, Abouth S, Martis S, Boulanger J, Elmkies F, Zemir H, Detienne J, Luycx-Bore A, Clerc J, Rodriguez Palomares JF, Gutierrez L, Maldonado G, Garcia G, Galuppo V, Gruosso D, Teixido G, Gonzalez Alujas M, Evangelista A, Garcia Dorado D, Rechcinski T, Wierzbowska-Drabik K, Wejner-Mik P, Szymanska B, Jerczynska H, Lipiec P, Kasprzak J, El-Touny K, El-Fawal S, Loutfi M, El-Sharkawy E, Ashour S, Boniotti C, Carminati M, Fusini L, Andreini D, Pontone G, Pepi M, Caiani E, Oryshchyn N, Kramer B, Hermann S, Liu D, Hu K, Ertl G, Weidemann F, Ancona F, Miyazaki S, Slavich M, Figini F, Latib A, Chieffo A, Montorfano M, Alfieri O, Colombo A, Agricola E, Nogueira M, Branco L, Rosa S, Portugal G, Galrinho A, Abreu J, Cacela D, Patricio L, Fragata J, Cruz Ferreira R, Igual Munoz B, Erdociain Perales M, Maceira Gonzalez A, Estornell Erill Jordi J, Donate Bertolin L, Vazquez Sanchez Alejandro A, Miro Palau Vicente V, Cervera Zamora A, Piquer Gil M, Montero Argudo A, Girgis HYA, Illatopa V, Cordova F, Espinoza D, Ortega J, Khan U, Islam A, Majumder A, Girgis HYA, Bayat F, Naghshbandi E, Naghshbandi E, Samiei N, Samiei N, Malev E, Omelchenko M, Vasina L, Zemtsovsky E, Piatkowski R, Kochanowski J, Budnik M, Scislo P, Opolski G, Kochanowski J, Piatkowski R, Scislo P, Budnik M, Marchel M, Opolski G, Abid L, Ben Kahla S, Abid D, Charfeddine S, Maaloul I, Ben Jmaa M, Kammoun S, Hashimoto G, Suzuki M, Yoshikawa H, Otsuka T, Isekame Y, Yamashita H, Kawase I, Ozaki S, Nakamura M, Sugi K, Benvenuto E, Leggio S, Buccheri S, Bonura S, Deste W, Tamburino C, Monte IP, Gripari P, Fusini L, Muratori M, Tamborini G, Ghulam Ali S, Bottari V, Cefalu' C, Bartorelli A, Agrifoglio M, Pepi M, Zambon E, Iorio A, Di Nora C, Abate E, Lo Giudice F, Di Lenarda A, Agostoni P, Sinagra G, Timoteo AT, Galrinho A, Moura Branco L, Rio P, Aguiar Rosa S, Oliveira M, Silva Cunha P, Leal A, Cruz Ferreira R, Zemanek D, Tomasov P, Belehrad M, Kostalova J, Kara T, Veselka J, Hassanein M, El Tahan S, El Sharkawy E, Shehata H, Yoon Y, Choi H, Seo H, Lee S, Kim H, Youn T, Kim Y, Sohn D, Choi G, Mielczarek M, Huttin O, Voilliot D, Sellal J, Manenti V, Carillo S, Olivier A, Venner C, Juilliere Y, Selton-Suty C, Butz T, Faber L, Brand M, Piper C, Wiemer M, Noelke J, Sasko B, Langer C, Horstkotte D, Trappe H, Maysou L, Tessonnier L, Jacquier A, Serratrice J, Copel C, Stoppa A, Seguier J, Saby L, Verschueren A, Habib G, Petroni R, Bencivenga S, Di Mauro M, Acitelli A, Cicconetti M, Romano S, Petroni A, Penco M, Maceira Gonzalez AM, Cosin-Sales J, Igual B, Sancho-Tello R, Ruvira J, Mayans J, Choi J, Kim S, Almeida A, Azevedo O, Amado J, Picarra B, Lima R, Cruz I, Pereira V, Marques N, Chatzistamatiou E, Konstantinidis D, Manakos K, Mpampatseva Vagena I, Moustakas G, Memo G, Mitsakis O, Kasakogias A, Syros P, Kallikazaros I, Cho E, Kim J, Hwang B, Kim D, Jang S, Jeon H, Cho J, Chatzistamatiou E, Konstantinidis D, Memo G, Mpapatzeva Vagena I, Moustakas G, Manakos K, Traxanas K, Vergi N, Feretou A, Kallikazaros I, Jedrzejewska I, Konopka M, Krol W, Swiatowiec A, Dluzniewski M, Braksator W, Sefri Noventi S, Sugiri S, Uddin I, Herminingsih S, Arif Nugroho M, Boedijitno S, Caro Codon J, Blazquez Bermejo Z, Valbuena Lopez SC, Lopez Fernandez T, Rodriguez Fraga O, Torrente Regidor M, Pena Conde L, Moreno Yanguela M, Buno Soto A, Lopez-Sendon JL, Stevanovic A, Dekleva M, Kim M, Kim S, Kim Y, Shim J, Park S, Park S, Kim Y, Shim W, Kozakova M, Muscelli E, Morizzo C, Casolaro A, Paterni M, Palombo C, Bayat F, Nazmdeh M, Naghshbandi E, Nateghi S, Tomaszewski A, Kutarski A, Brzozowski W, Tomaszewski M, Nakano E, Harada T, Takagi Y, Yamada M, Takano M, Furukawa T, Akashi Y, Lindqvist G, Henein M, Backman C, Gustafsson S, Morner S, Marinov R, Hristova K, Geirgiev S, Pechilkov D, Kaneva A, Katova T, Pilosoff V, Pena Pena M, Mesa Rubio D, Ruiz Ortin M, Delgado Ortega M, Romo Penas E, Pardo Gonzalez L, Rodriguez Diego S, Hidalgo Lesmes F, Pan Alvarez-Ossorio M, Suarez De Lezo Cruz-Conde J, Gospodinova M, Sarafov S, Guergelcheva V, Vladimirova L, Tournev I, Denchev S, Mozenska O, Segiet A, Rabczenko D, Kosior D, Gao S, Eliasson M, Polte C, Lagerstrand K, Bech-Hanssen O, Morosin M, Piazza R, Leonelli V, Leiballi E, Pecoraro R, Cinello M, Dell' Angela L, Cassin M, Sinagra G, Nicolosi G, Savu O, Carstea N, Stoica E, Macarie C, Moldovan H, Iliescu V, Chioncel O, Moral S, Gruosso D, Galuppo V, Teixido G, Rodriguez-Palomares J, Gutierrez L, Evangelista A, Jansen Klomp WW, Peelen L, Spanjersberg A, Brandon Bravo Bruinsma G, Van 'T Hof A, Laveau F, Hammoudi N, Helft G, Barthelemy O, Michel P, Petroni T, Djebbar M, Boubrit L, Le Feuvre C, Isnard R, Bandera F, Generati G, Pellegrino M, Alfonzetti E, Labate V, Villani S, Gaeta M, Guazzi M, Gabriels C, Lancellotti P, Van De Bruaene A, Voilliot D, De Meester P, Buys R, Delcroix M, Budts W, Cruz I, Stuart B, Caldeira D, Morgado G, Almeida A, Lopes L, Fazendas P, Joao I, Cotrim C, Pereira H, Weissler Snir A, Greenberg G, Shapira Y, Weisenberg D, Monakier D, Nevzorov R, Sagie A, Vaturi M, Bando M, Yamada H, Saijo Y, Takagawa Y, Sawada N, Hotchi J, Hayashi S, Hirata Y, Nishio S, Sata M, Jackson T, Sammut E, Siarkos M, Lee L, Carr-White G, Rajani R, Kapetanakis S, Ciobotaru V, Yagasaki H, Kawasaki M, Tanaka R, Minatoguchi S, Sato N, Amano K, Warita S, Ono K, Noda T, Minatoguchi S, Breithardt OA, Razavi H, Nabutovsky Y, Ryu K, Gaspar T, Kosiuk J, John S, Prinzen F, Hindricks G, Piorkowski C, Nemchyna O, Tovstukha V, Chikovani A, Golikova I, Lutai M, Nemes A, Kalapos A, Domsik P, Lengyel C, Orosz A, Forster T, Nordenfur T, Babic A, Giesecke A, Bulatovic I, Ripsweden J, Samset E, Winter R, Larsson M, Blazquez Bermejo Z, Lopez Fernandez T, Caro Codon J, Valbuena S, Caro Codon J, Mori Junco R, Moreno Yanguela M, Lopez-Sendon J, Pinto-Teixeira P, Branco L, Galrinho A, Oliveira M, Cunha P, Silva T, Rio P, Feliciano J, Nogueira-Silva M, Ferreira R, Shkolnik E, Vasyuk Y, Nesvetov V, Shkolnik L, Varlan G, Bajraktari G, Ronn F, Ibrahimi P, Jashari F, Jensen S, Henein M, Kang MK, Mun HS, Choi S, Cho JR, Han S, Lee N, Cho IJ, Heo R, Chang H, Shin S, Shim C, Hong G, Chung N. Poster session 3: Thursday 4 December 2014, 14:00-18:00 * Location: Poster area. Eur Heart J Cardiovasc Imaging 2014. [DOI: 10.1093/ehjci/jeu253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Grimaldi A, Figini F, Ammirati E, Arioli F, Vermi AC, De Concilio A, Trucco G, D'Arbela PG. Giant single atrium. Int J Cardiol 2014; 177:e37-8. [DOI: 10.1016/j.ijcard.2014.07.276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 07/29/2014] [Indexed: 10/24/2022]
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Giustino G, Latib A, Panoulas VF, Montorfano M, Chieffo A, Spatuzza P, Montanaro C, Taramasso M, Figini F, Sato K, Agricola E, Spagnolo P, Monaco F, Alfieri O, Colombo A. TCT-694 Early Outcomes With Direct Flow Medical Versus 1°-Generation Transcatheter Aortic Valve Devices: A Single-Center Propensity-Matched Analysis. J Am Coll Cardiol 2014. [DOI: 10.1016/j.jacc.2014.07.766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Giustino G, Montorfano M, Agricola E, Chieffo A, Panoulas VF, Figini F, Spagnolo P, Latib A, Alfieri O, Colombo A. TCT-705 Trascatheter Aortic Valve Implantation Outcomes With Self-Expandable and Balloon-Expandable Devices in Patients with Mixed Aortic Valve Stenosis. J Am Coll Cardiol 2014. [DOI: 10.1016/j.jacc.2014.07.777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Kawamoto H, Latib A, Sato K, Miyazaki T, Panoulas VF, Figini F, Chieffo A, Montorfano M, Carlino M, Colombo A. TCT-277 Synergy of Drug Coated Balloons plus Second-generation Drug Eluting Stents versus Second-generation Drug Eluting Stents: A Propensity Matched Analysis. J Am Coll Cardiol 2014. [DOI: 10.1016/j.jacc.2014.07.321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Panoulas VF, Giustino G, Latib A, Montorfano M, Chieffo A, Spatuzza P, Taramasso M, Figini F, Agricola E, Spagnolo P, Alfieri O, Colombo A. TCT-771 Comparison of post TAVR paravalvular regurgitation between Edwards SAPIEN 3 and Edwards SAPIEN XT; early, single center experience. J Am Coll Cardiol 2014. [DOI: 10.1016/j.jacc.2014.07.843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Grimaldi A, Ammirati E, Karam N, Vermi AC, de Concilio A, Trucco G, Aloi F, Arioli F, Figini F, Ferrarello S, Sacco FM, Grottola R, D'Arbela PG, Alfieri O, Marijon E, Freers J, Mirabel M. Cardiac surgery for patients with heart failure due to structural heart disease in Uganda: access to surgery and outcomes. Cardiovasc J Afr 2014; 25:204-11. [PMID: 25073490 PMCID: PMC4241599 DOI: 10.5830/cvja-2014-034] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2014] [Accepted: 06/13/2014] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE Few data are available on heart failure (HF) in sub-Saharan Africa. We aimed to provide a current picture of HF aetiologies in urban Uganda, access to heart surgery, and outcomes. METHODS We prospectively collected clinical and echocardiographic data from 272 consecutive patients referred for suspected heart disease to a tertiary hospital in Kampala during seven non-governmental organisation (NGO) missions from 2009 to 2013. We focused the analysis on 140 patients who fulfilled standardised criteria of HF by echocardiography. RESULTS Rheumatic heart disease (RHD) was the leading cause of HF in 44 (31%) patients. Among the 50 children included (age ≤ 16 years), congenital heart disease (CHD) was the first cause of HF (30 patients, 60%), followed by RHD (16 patients, 32%). RHD was the main cause of HF (30%) among the 90 adults. All 85 patients with RHD and CHD presented with an indication for heart surgery, of which 74 patients were deemed fit for intervention. Surgery was scheduled in 38 patients with RHD [86%, median age 19 years (IQR: 12-31)] and in 36 patients with CHD [88%, median age 4 years (IQR 1-5)]. Twenty-seven candidates (32%) were operated on after a median waiting time of 10 months (IQR 6-21). Sixteen (19%) had died after a median of 38 months (IQR 5-52); 19 (22%) were lost to follow up. CONCLUSION RHD still represents the leading cause of HF in Uganda, in spite of cost-efficient prevention strategies. The majority of surgical candidates, albeit young, do not have access to treatment and present high mortality rates.
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Affiliation(s)
- Antonio Grimaldi
- St Raphael of St Francis, Nsambya Hospital, Kampala, Uganda; Cardiovascular and Thoracic Department, San Raffaele Hospital, Milan, Italy.
| | - Enrico Ammirati
- St Raphael of St Francis, Nsambya Hospital, Kampala, Uganda; Cardiovascular and Thoracic Department, San Raffaele Hospital, Milan, Italy
| | - Nicole Karam
- Paris Cardiovascular Research Centre, INSERM U970, Paris, France
| | - Anna Chiara Vermi
- St Raphael of St Francis, Nsambya Hospital, Kampala, Uganda; Cardiovascular and Thoracic Department, San Raffaele Hospital, Milan, Italy
| | | | - Giorgio Trucco
- St Raphael of St Francis, Nsambya Hospital, Kampala, Uganda
| | - Francesco Aloi
- St Raphael of St Francis, Nsambya Hospital, Kampala, Uganda
| | - Francesco Arioli
- St Raphael of St Francis, Nsambya Hospital, Kampala, Uganda; Cardiovascular and Thoracic Department, San Raffaele Hospital, Milan, Italy
| | - Filippo Figini
- St Raphael of St Francis, Nsambya Hospital, Kampala, Uganda; Cardiovascular and Thoracic Department, San Raffaele Hospital, Milan, Italy
| | - Santo Ferrarello
- St Raphael of St Francis, Nsambya Hospital, Kampala, Uganda; Cardiovascular and Thoracic Department, San Raffaele Hospital, Milan, Italy
| | - Francesco Maria Sacco
- St Raphael of St Francis, Nsambya Hospital, Kampala, Uganda; Cardiovascular and Thoracic Department, San Raffaele Hospital, Milan, Italy
| | | | | | - Ottavio Alfieri
- Cardiovascular and Thoracic Department, San Raffaele Hospital, Milan, Italy
| | - Eloi Marijon
- St Raphael of St Francis, Nsambya Hospital, Kampala, Uganda; Paris Cardiovascular Research Centre, INSERM U970, Paris, France
| | - Juergen Freers
- Division of Cardiology, Department of Medicine, Makerere University, Kampala, Uganda
| | - Mariana Mirabel
- St Raphael of St Francis, Nsambya Hospital, Kampala, Uganda; Paris Cardiovascular Research Centre, INSERM U970, Paris, France
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Miyazaki T, Latib A, Panoulas VF, Sato K, Kawamoto H, Naganuma T, Figini F, Chieffo A, Montorfano M, Carlino M, Colombo A. TCT-244 Real World 1-year Clinical Outcomes of Bioresorbable Vascular Scaffold Implanted in Diabetic Patients. J Am Coll Cardiol 2014. [DOI: 10.1016/j.jacc.2014.07.284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Panoulas VF, Latib A, Naim C, Costopoulos C, Sato K, Tespili M, Sticchi A, Miyazaki T, Figini F, Carlino M, Chieffo A, Montorfano M, Godino C, Ielasi A, Testa L, Bedogni F, Colombo A. TCT-609 Comparison of one year outcomes in real world patients treated with a polymer free amphilimus eluting coronary stent versus second generation everolimus eluting stents. J Am Coll Cardiol 2014. [DOI: 10.1016/j.jacc.2014.07.674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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