1
|
Gin J, Yeoh J, Hamilton G, Ajani A, Dinh D, Brennan A, Reid CM, Freeman M, Oqueli E, Hiew C, Stub D, Chan W, Picardo S, Yudi M, Horrigan M, Farouque O, Clark D. Real-world long-term survival after non-emergent percutaneous coronary intervention to unprotected left main coronary artery - From the Melbourne Interventional Group (MIG) registry. Cardiovasc Revasc Med 2024; 58:1-6. [PMID: 37500394 DOI: 10.1016/j.carrev.2023.07.005] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 07/13/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Current evidence suggests that percutaneous coronary intervention for unprotected left main coronary artery disease (LMPCI) in selected patients is a safe alternative to coronary artery bypass grafting. However, real-world long-term survival data is limited. METHODS We analyzed 24,644 patients from the MIG (Melbourne Interventional Group) registry between 2005 and 2020. We compared baseline clinical and procedural characteristics, in-hospital and 30-day outcomes, and long-term survival between unprotected LMPCI and non-LMPCI among patients without ST-segment elevation myocardial infarction, cardiogenic shock, or cardiac arrest. RESULTS Unprotected LMPCI patients (n = 185) were significantly older (mean age 72.0 vs. 64.6 years, p < 0.001), had higher prevalence of impaired ejection fraction (EF <50 %; 27.3 % vs. 14.9 %, p < 0.001) and lower estimated glomerular filtration rate < 60 ml/min/1.73m2 (40.9 % vs. 21.5 %, p < 0.001), and had greater use of intravascular ultrasound (21 % vs. 1 %, p < 0.001) and drug-eluting stents (p < 0.001). LMPCI was associated with longer hospital stay (4 days vs. 2 days, p < 0.001). There was no significant difference in other in-hospital outcomes, 30-day mortality (0.6 % vs. 0.6 %, p = 0.90), and major adverse cardiac events (1.7 % vs. 3 %, p = 0.28). Although the unadjusted Kaplan-Meier survival to 8 years was significantly less with LMPCI compared to non-LMPCI (p < 0.01), LMPCI was not a predictor of long-term survival up to 8 years after Cox regression analysis (HR 0.67, 95 % CI 0.40-1.13, p = 0.13). CONCLUSION In this study, non-emergent unprotected LMPCI was uncommonly performed, and IVUS was underutilized. Despite greater co-morbidities, LMPCI patients had comparable 30-day outcomes to non-LMPCI, and LMPCI was not an independent predictor of long-term mortality.
Collapse
Affiliation(s)
- Julian Gin
- Department of Cardiology, Austin Health, Melbourne, Victoria, Australia.
| | - Julian Yeoh
- Department of Cardiology, Austin Health, Melbourne, Victoria, Australia
| | - Garry Hamilton
- Department of Cardiology, Austin Health, Melbourne, Victoria, Australia
| | - Andrew Ajani
- Department of Cardiology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Diem Dinh
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Angela Brennan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Christopher M Reid
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Melanie Freeman
- Department of Cardiology, Eastern Health, Melbourne, Victoria, Australia
| | - Ernesto Oqueli
- Department of Cardiology, Grampians Health Ballarat, Ballarat, Victoria, Australia
| | - Chin Hiew
- Department of Cardiology, Barwon Health, Geelong, Victoria, Australia
| | - Dion Stub
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Department of Cardiology, Alfred Health, Melbourne, Victoria, Australia
| | - William Chan
- Department of Cardiology, Alfred Health, Melbourne, Victoria, Australia; Department of Cardiology, Western Health, Melbourne, Victoria, Australia
| | - Sandra Picardo
- Department of Cardiology, Austin Health, Melbourne, Victoria, Australia
| | - Matias Yudi
- Department of Cardiology, Austin Health, Melbourne, Victoria, Australia
| | - Mark Horrigan
- Department of Cardiology, Austin Health, Melbourne, Victoria, Australia
| | - Omar Farouque
- Department of Cardiology, Austin Health, Melbourne, Victoria, Australia
| | - David Clark
- Department of Cardiology, Austin Health, Melbourne, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| |
Collapse
|
2
|
Nogic J, Cailes B, Yeoh J, Yudi M, Tong D, Farouque O, Brennan A, Dinh D, Brown AJ, Clark D. Natural History and Clinical Outcomes After ST-Segment Elevation Myocardial Infarction Without Stent Insertion. Am J Cardiol 2023; 209:60-65. [PMID: 37863114 DOI: 10.1016/j.amjcard.2023.09.096] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/15/2023] [Accepted: 09/25/2023] [Indexed: 10/22/2023]
Abstract
After restoration of coronary perfusion in patients presenting with ST-segment elevation myocardial infarction (STEMI), discrete severe stenotic coronary lesions are not always apparent. There remains ambiguity whether drug-eluting stent (DES) insertion or initial medical management is best practice. We sought to assess short-term clinical outcomes in patients presenting with STEMI without initial stent insertion. Patients who underwent percutaneous coronary intervention for STEMI between 2014 and 2020 were prospectively enrolled and assessed for inclusion. Patients presenting with in-stent restenosis or stent thrombosis, or who did not survive to hospital discharge were excluded. Of 13,871 patients presenting, 456 (3.3%) were treated without initial stenting. These patients were older than those treated with DES (66.1 ± 13.6 vs 62.3 ± 12.4 years, p <0.001), had higher rates of diabetes (23.5% vs 16.0%, p <0.001) and previous revascularization with either percutaneous coronary intervention (14.0% vs 7.3%, p <0.001) or coronary artery bypass graft (3.5% vs 1.8%, p = 0.008). Thirty-day mortality was elevated in patients treated without stenting compared to those receiving DES (4.2% vs 0.9%, p <0.001), as were rates of myocardial infarction (1.3% vs 0.5%, p = 0.026) and major adverse cardiac events (10.5% vs 2.4%, p <0.001). After propensity matching, a trend toward increased mortality remained (4.2% vs 2.0%, p = 0.055). In conclusion, a no-stenting initial strategy, compared with DES insertion, is associated with increased 30-day mortality in those presenting with STEMI without severe stenosis. These data suggest when appropriate, current-generation DES insertion should be undertaken.
Collapse
Affiliation(s)
- Jason Nogic
- Department of Cardiology, Eastern Health, Melbourne, Victoria, Australia; Monash Cardiovascular Research Centre, Monash University and Victorian Heart Hospital, Monash Health, Melbourne, Victoria, Australia; Monash Cardiovascular Research Centre, Monash University and Victorian Heart Hospital, Monash Health, Melbourne, Victoria, Australia.
| | - Benjamin Cailes
- Department of Cardiology, Austin Hospital Clinical School, The University of Melbourne, Melbourne, Victoria, Australia
| | - Julian Yeoh
- Department of Cardiology, Austin Hospital Clinical School, The University of Melbourne, Melbourne, Victoria, Australia
| | - Matias Yudi
- Department of Cardiology, Austin Hospital Clinical School, The University of Melbourne, Melbourne, Victoria, Australia
| | - David Tong
- Department of Cardiology, Eastern Health, Melbourne, Victoria, Australia
| | - Omar Farouque
- Department of Cardiology, Austin Hospital Clinical School, The University of Melbourne, Melbourne, Victoria, Australia
| | | | - Diem Dinh
- Monash University, Melbourne, Victoria, Australia
| | - Adam J Brown
- Monash Cardiovascular Research Centre, Monash University and Victorian Heart Hospital, Monash Health, Melbourne, Victoria, Australia
| | - David Clark
- Department of Cardiology, Austin Hospital Clinical School, The University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
3
|
Murphy A, Farouque HO, Koshy AN, Yudi M. A SMARTPHONE-BASED CARDIOVASCULAR RISK REDUCTION PROGRAM REDUCES SYSTOLIC BLOOD PRESSURE AND WAIST CIRCUMFERENCE IN PATIENTS WITH BREAST CANCER: A SUBANALYSIS FROM THE SMARTBREAST RANDOMIZED CONTROLLED TRIAL. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)02574-3] [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: 03/06/2023]
|
4
|
Murphy A, Koshy AN, Farouque HO, Yudi M. CARDIOVASCULAR DISEASE IN PATIENTS WITH BREAST CANCER TREATED IN THE MODERN ERA. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)02635-9] [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: 03/06/2023]
|
5
|
Kim JS, Thijs V, Yudi M, Toyoda K, Shiozawa M, Zening J, Clapp B, Albers B, Diener HC. Establishment of the Heart and Brain Team for Patent Foramen Ovale Closure in Stroke Patients: An Expert Opinion. J Stroke 2022; 24:345-351. [PMID: 36221937 PMCID: PMC9561221 DOI: 10.5853/jos.2022.02103] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 08/03/2022] [Indexed: 11/24/2022] Open
Abstract
The online 2021 Asian-Pacific Heart and Brain Summit was organized to present and discuss experiences within leading Asian-Pacific centers with regard to institutional heart and brain teams managing the diagnosis, treatment, and follow-up of cryptogenic stroke (CS) patients with patent foramen ovale (PFO). This manuscript presents a narrative review of presentations and discussions during the summit meeting. Percutaneous PFO closure is an established therapy for CS patients in whom PFO is considered to be causal. Guidelines and consensus statements emphasize the importance of multidisciplinary clinical decision-making regarding PFO closure with the involvement of several clinical specialties, including neurology, cardiology, and hematology. It is also recommended that the patient be closely involved in this process. The heart and brain team is a collaborative platform that facilitates such a multidisciplinary decision-making process and patient involvement. It also creates opportunities for education and evaluation of the healthcare provided to patients with CS. This review provides insights into the implementation, composition, organization, and operation of a heart and brain team. Methods and metrics are suggested to evaluate the team’s role. We suggest that an efficient heart and brain team can implement guideline-recommended multidisciplinary clinical decision-making with regard to PFO closure in CS patients and play an important role in the management of these patients.
Collapse
Affiliation(s)
- Jong S. Kim
- Department of Neurology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
- Correspondence: Jong S. Kim Department of Neurology, Gangneung Asan Hospital, University of Ulsan College of Medicine, 38 Bangdong-gil, Gangneung 25440, Korea Tel: +82-33-610-4196 Fax: +82-33-641-8130 E-mail:
| | - Vincent Thijs
- Stroke Theme, Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia
| | - Matias Yudi
- Department of Cardiology, Austin Health, Heidelberg, Australia
| | - Kazunori Toyoda
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Masayuki Shiozawa
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Jin Zening
- Department of Neurology, Beijing Tiantan Hospital, Beijing, China
| | - Brian Clapp
- Interventional Cardiology, St. Thomas’ Hospital, London, UK
| | - Bert Albers
- Albers Clinical Evidence Consultancy, Winterswijk Woold, The Netherlands
| | - Hans-Christoph Diener
- Department of Neuroepidemiology, Institute for Medical Informatics, Biometry and Epidemiology (IMIBE), Medical Faculty of the University Duisburg-Essen, Essen, Germany
| |
Collapse
|
6
|
Murphy A, Koshy A, Farouque O, Yeo B, Roccisano L, Octavia Y, Yudi M. Cardiovascular Disease in Patients With Breast Cancer Treated in the Modern Era. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.490] [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] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
|
7
|
Gin J, Vlachadis-Castles A, Yudi M. Feasibility of Selective Coronary Angiogram and Percutaneous Coronary Intervention Following Self-Expanding Transcatheter Aortic Valve Implantation – A Systematic Review and Meta-Analysis. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.587] [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] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
|
8
|
Murphy A, Farouque O, Koshy A, Yeo B, Dick R, Nadurata V, Roccisano L, Reid C, Yudi M. SMARTphone-based Cardiovascular Risk Reduction in BREAST Cancer Patients [SMART-BREAST]: A Randomised Controlled Trial. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.008] [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] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
9
|
Crane P, Kalsi M, Yudi M, van Gaal W, Sharma N. Paradoxical Low Flow Low Gradient (LFLG) Severe Aortic Stenosis With Preserved Left Ventricular Ejection Fraction—An Under Recognised Entity. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.234] [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] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
10
|
Meehan G, Koshy A, Kunniardy P, Murphy A, Farouque O, Yudi M. A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS ASSESSING SMARTPHONE BASED CARDIAC REHABILITATION IN PATIENTS WITH CORONARY HEART DISEASE. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)32631-0] [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]
|
11
|
Hamilton G, Koshy A, Murphy A, Fulcher J, Theuerle J, Farouque O, Horrigan M, Yudi M. A SYSTEMIC REVIEW AND META-ANALYSIS OF VALVE IN VALVE TRANSCATHETER AORTIC VALVE REPLACEMENT COMPARING BALLOON AND SELF EXPANDING VALVES. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)31880-5] [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: 11/28/2022]
|
12
|
Murphy A, Koshy A, Kunniardy P, Meehan G, Ramchand J, Farouque HO, Clark D, Yudi M. INPATIENT CORONARY ANGIOGRAPHY IS ASSOCIATED WITH REDUCED MORTALITY IN PATIENTS AGED >85 YEARS WITH NON-ST-ELEVATION MYOCARDIAL INFARCTION. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)31779-4] [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]
|
13
|
Murphy A, Koshy A, Kunniardy P, Meehan G, Ramchand J, Farouque HO, Clark D, Yudi M. IS THERE A GENDER DISPARITY IN CHARACTERISTICS AND OUTCOMES FOR PATIENTS OVER 85 YEARS PRESENTING WITH NON-ST-ELEVATION MYOCARDIAL INFARCTION (NSTEMI)? J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)31780-0] [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]
|
14
|
Koshy A, Dinh D, Brennan A, Fulcher J, Murphy A, Duffy S, Ajani A, Oqueli E, Hiew C, Yudi M, Farouque O, Clark D. 809 Comparison of Ischaemia-Guided Versus Angiography-Guided Revascularization in Stable Ischaemic Heart Disease. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.816] [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] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
15
|
Subramanian R, Enayati A, Koshy A, Murphy A, Hamilton G, Kunniardy P, Yudi M. 533 Predictors of Medical Management in an Era of Transcatheter Aortic Valve Replacement. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.540] [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] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
16
|
Koshy A, Murphy A, Farouque O, Horrigan M, Yudi M. 864 Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement in Low-Risk Patients. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.871] [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] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
17
|
Murphy A, Lancefield T, Faroudi F, Chao M, Koshy A, Subramanian R, Undrill S, Yeo B, Yudi M, Kearney L, Farouque O. 183 The Role of Serum Cardiac Biomarkers and Left Ventricular Strain Imaging for Detecting Early Radiation Induced Myocardial Damage in Women Undergoing Left-Sided Breast Radiation Therapy. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.190] [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] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
18
|
Murphy A, Subramanian R, Enayati A, Koshy A, Kunniardy P, Hamilton G, Farouque O, Yudi M. 776 A History of Cancer Does Not Predict Long Term Mortality in Patients With Severe Aortic Stenosis. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.783] [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] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
19
|
Enayati A, Subramanian R, Hamilton G, Koshy A, Murphy A, Kunniardy P, Yudi M. 450 Balloon Aortic Valvuloplasty Alone Compared to Medical Therapy is Associated With Improved Long-Term Survival in Patients With Severe Aortic Stenosis. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.457] [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] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
20
|
Abstract
OBJECTIVES To assess whether specific factors predict the development of ManuScript Rejection sYndrome (MiSeRY) in academic physicians. DESIGN Prospective pilot study; participants self-administered a questionnaire about full manuscript submissions (as first or senior author) rejected at least once during the past 5 years. SETTING Single centre (tertiary institution). PARTICIPANTS Eight academic physician-authors. MAIN OUTCOME MEASURES Duration of grief. MiSeRY was pre-specified as prolonged grief (grief duration longer than the population median). RESULTS Eight participants provided data on 32 manuscripts with a total of 93 rejections (median, two rejections per manuscript; interquartile range [IQR], 1-3 rejections per manuscript). Median age at rejection was 37 years (IQR, 33-45 years); 86% of 80 rejections involved male authors (86%), 56 of the authors providing data about these rejections were first authors (60%). The median journal impact factor was 5.9 (IQR, 5.2-17). In 48 cases of rejection (52%), pre-submission expectations of success had been high, and in 54 cases (58%) the manuscripts had been sent for external review. Median grief duration was 3 hours (IQR, 1-24 h). Multivariate analysis indicated that higher pre-submission expectation (adjusted odds ratio [aOR], 5.0; 95% CI, 1.5-18), first author status (aOR, 9.5; 95% CI, 1.1-77), and external review (aOR, 19.0; 95% CI 2.9-126) were independent predictors of MiSeRY. CONCLUSIONS To help put authors out of their MiSeRY, journal editors could be more selective in the manuscripts they send for external review. Tempering pre-submission expectations and mastering the Coping and reLaxing Mechanisms (CaLM) of senior colleagues are important considerations for junior researchers.
Collapse
Affiliation(s)
| | | | | | | | | | - Andrew W Teh
- Austin Health, Melbourne, VIC.,Eastern Health, Melbourne, VIC
| | | |
Collapse
|
21
|
Murphy A, Koshy A, Cameron W, Horrigan M, Yeo B, Farouque O, Yudi M. TCT-708 Outcomes of Transcatheter Aortic Valve Replacement in Oncology Patients With Severe Aortic Stenosis. J Am Coll Cardiol 2019. [DOI: 10.1016/j.jacc.2019.08.838] [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: 10/25/2022]
|
22
|
Koshy A, Murphy A, Farouque O, Horrigan M, Yudi M. TCT-721 Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement in Low-Risk Patients: A Meta-Analysis of Randomized Controlled Trials. J Am Coll Cardiol 2019. [DOI: 10.1016/j.jacc.2019.08.854] [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: 10/25/2022]
|
23
|
Murphy A, Koshy A, Meehan G, Kunniardy P, Ramchand J, Farouque O, Clark D, Yudi M. TCT-646 Markers of Frailty Predict Conservative Management in Very Elderly (>85 Years) Patients Presenting with Non–ST-Segment Elevation Myocardial Infarction (NSTEMI). J Am Coll Cardiol 2019. [DOI: 10.1016/j.jacc.2019.08.766] [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: 11/29/2022]
|
24
|
Warren J, Nanayakkara S, Andrianopoulos N, Brennan A, Dinh D, Yudi M, Clark D, Ajani AE, Reid CM, Selkrig L, Shaw J, Hiew C, Freeman M, Kaye D, Kingwell BA, Dart AM, Duffy SJ, Reid C, Andrianopoulos N, Brennan A, Dinh D, Reid C, Ajani A, Duffy S, Clark D, Freeman M, Hiew C, Andrianopoulos N, Oqueli E, Brennan A, Duffy S, Shaw J, Walton A, Dart A, Broughton A, Federman J, Keighley C, Hengel C, Peter K, Stub D, Chan W, Warren J, O’Brien J, Selkrig L, Huntington R, Clark D, Farouque O, Horrigan M, Johns J, Oliver L, Brennan J, Chan R, Proimos G, Dortimer T, Chan B, Nadurata V, Huq R, Fernando D, Al-Fiadh A, Yudi M, Sugumar H, Ramchand J, Han H, Picardo S, Brown L, Oqueli E, Hengel C, Sharma A, Zhu B, Ryan N, Harrison T, New G, Roberts L, Freeman M, Rowe M, Proimos G, Cheong Y, Goods C, Fernando D, Teh A, Parfrey S, Ramzy J, Koshy A, Venkataraman P, Flannery D, Hiew C, Sebastian M, Yip T, Mok M, Jaworski C, Hutchinson A, Cimenkaya C, Ngu P, Khialani B, Salehi H, Turner M, Dyson J, McDonald B, Van Den Nouwelant D, Halliburton K, Reid C, Andrianopoulos N, Brennan A, Dinh D, Yan B, Ajani A, Warren R, Eccleston D, Lefkovits J, Iyer R, Gurvitch R, Wilson W, Brooks M, Biswas S, Yeoh J. Impact of Pre-Procedural Blood Pressure on Long-Term Outcomes Following Percutaneous Coronary Intervention. J Am Coll Cardiol 2019; 73:2846-2855. [DOI: 10.1016/j.jacc.2019.03.493] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 03/06/2019] [Accepted: 03/07/2019] [Indexed: 11/28/2022]
|
25
|
Murphy A, Dinh D, Duffy S, Brennan A, Andrianopoulos N, Freeman M, Reid C, Ajani A, Farouque O, Martin L, Dagan M, Blusztein D, Eccleston D, Yudi M, Clark D. Impact of Gender and Door-to-Balloon Times on Long-Term Mortality in Patients Presenting with ST-Elevation Myocardial Infarction (STEMI). Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.627] [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] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
26
|
Kunniardy P, Koshy A, Meehan G, Murphy A, Gayed D, Ramchand J, Clark D, Farouque O, Yudi M. Do Patients Over 85 Years who Present with NSTEMI and Admitted Under General Medical Units Need Cardiology Consultation? Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.372] [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] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
27
|
Omair M, Dinh D, Brennan A, Farouque O, Duffy S, Ajani A, Reid C, Oqueli E, Hutchinson A, Andrianopoulos N, Koshy A, Yudi M, Clark D. Impact of Single-Vessel vs Multi-vessel CAD on Long-Term Mortality in Patients with Diabetes Mellitus Undergoing PCI. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.397] [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] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
28
|
Kunniardy P, Meehan G, Murphy A, Clark D, Farouque O, Yudi M. Management of NSTEMI in Elderly Patients: What do We Know About Conservative vs Invasive Management in the Elderly? Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
29
|
Murphy A, Koshy A, Kunniardy P, Meehan G, Ramchand J, Farouque O, Clark D, Yudi M. The Association Between Type II Myocardial Infarction and Increased In-Hospital Mortality in Patients aged >85 years with Non-ST-Elevation Myocardial Infarction. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.695] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
30
|
Murphy A, Farouque O, Faroudi F, Chao M, Yudi M, Yeo B, Koshy A, Horrigan M, Undrill S, Lancefield T. The Role of Serum Cardiac Biomarkers and Left Ventricular Strain Imaging for Detecting Early Radiation Induced Myocardial Damage in Women Undergoing Left-Sided Breast Radiation Therapy: A Pilot Study. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.141] [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] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
31
|
Murphy A, Koshy A, Meehan G, Kunniardy P, Ramchand J, Farouque O, Clark D, Yudi M. The Impact of Living Situation on Management and Outcomes of Patients Aged >85 Years Presenting with NSTEMI. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.436] [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] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
32
|
Koshy A, Gow P, Cailes B, Sajeev J, Teh A, Lim H, Han H, Jones R, Testro A, Byrne M, Ko J, Clark D, Yudi M, Farouque O. Impact of Cardiovascular Risk Factors on Survival following Liver Transplantation: Results from the Australian & New Zealand Liver Transplant Registry. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.394] [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] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
33
|
Toner L, Scully T, Yeoh J, Yudi M, Farouque O, Clarke D. Safety and Long-Term Clinical Outcomes of Fractional Flow Reserve (FFR): An 8-year Study in a Real-world Setting. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.684] [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] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
34
|
Kunniardy P, Meehan G, Murphy A, Clark D, Farouque O, Yudi M. Inpatient Coronary Angiography is Associated with Reduced Mortality in Patients aged >85 years with Non-ST-Elevation Myocardial Infarction. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.639] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
35
|
Murphy A, Farouque O, Clark D, Ramchand J, Yudi M. Impact of Gender on Meeting Secondary Prevention Targets and Depression Post Acute Coronary Syndromes: Insights from the SMART-REHAB Trial. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.544] [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] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
36
|
Koshy A, Gow P, Sajeev J, Cailes B, Ko J, Ramchand J, Lim H, Teh A, Han H, Jones R, Testro A, Byrne M, Clark D, Yudi M, Farouque O. Rise in Proportional Early Cardiovascular Mortality Following Liver Transplantation: Temporal Trends from the Australian & New Zealand Liver Transplant Registry. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.426] [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] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
37
|
Yudi M, Tang G, Sharma S, Kini A. Coronary Angiography and Percutaneous Coronary Intervention Post Transcatheter Aortic Valve Implantation with Self-Expanding CoreValve. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.599] [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] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
38
|
Murphy A, Koshy A, Farouque O, Clark D, Yeo B, Mousley J, Meehan G, Kunniardy P, Yudi M. Mobile Health (mHealth) Cardiovascular Risk Reduction Strategies in Cancer: A Systematic Review and Meta-Analysis. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.548] [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] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
39
|
Murphy A, Koshy A, Kunniardy P, Meehan G, Ramchand J, Farouque O, Clark D, Yudi M. Is There a Gender Disparity in Characteristics and Outcomes for Patients Over 85 years Presenting with Non-ST-Elevation Myocardial Infarction (NSTEMI)? Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.401] [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] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
40
|
Garg A, Agarwal S, Tang G, Chopra S, Yudi M, Dangas G, Mehran R, Baber U, Narula J, Kini A, Sharma S. Abstract WP171: Predictors and Outcomes of Stroke After Trans-Catheter Aortic Valve Replacement in the United States, 2012-2014. Stroke 2018. [DOI: 10.1161/str.49.suppl_1.wp171] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction:
Stroke is a dreaded complication after transcatheter aortic valve replacement (TAVR) and identifying the patients at risk and their prognosis is important in guiding appropriate patient selection. We sought to estimate the incidence, predictors and outcomes of in-hospital stroke in patients undergoing TAVR.
Methods:
We used the National Inpatient Sample, a 20% random sample of hospital discharges in 1,000 US hospitals to identify the patients who underwent TAVR in 2012-2014. Pertinent variables were identified using hospital discharge codes. Predictors of in-hospital stroke were analyzed using multivariable logistic regression models. In-hospital mortality and length of hospital stay were compared between the patients with and without stroke.
Results:
In-hospital stroke occurred in 2.6% of 41,050 patients undergoing TAVR in the US during 2012-2014. Though the stroke rates declined from 3% in 2012 to 2.3% in 2014, the comorbidities-adjusted difference by year was not statistically significant. In multivariable model, advanced age was positively associated (adjusted odds ratio [adjOR] for every 5-year increment in age=1.17, p<0.05); while hypertension (adjOR=0.69, p<0.05) and coronary artery disease (adjOR=0.64, p<0.01) were negatively associated with stroke. Also, post-procedure bleeding and use of IABP were associated with higher stroke rates. In contrast, hospital characteristics such as, teaching status, bed size and TAVR volume were not associated with occurrence of stroke. Patients with stroke had higher in-hospital mortality (adjOR=3.35, p<0.001), and longer length of hospital stay (adjusted mean difference= +3.8 days, p<0.001) than those without stroke.
Conclusion:
Occurrence of stroke after TAVR is associated with significant mortality, other concurrent complications, and increased length of hospital stay. Further research is needed to define the role of cardio-embolic protection devices in prevention of stroke after TAVR.
Collapse
Affiliation(s)
| | | | | | - Saurav Chopra
- Blood Bank, All India Institute of Med Sciences, Delhi, India
| | | | | | | | | | | | | | | |
Collapse
|
41
|
Yeoh J, Andrianopoulos N, Yudi M, Brennan A, Picardo S, Horrigan M, Duffy S, Freeman M, Fernando D, Sebastian M, Murphy A, O’Brien J, Oqueli E, Ajani A, Farouque O, Clark D. Outcomes After Percutaneous Coronary Intervention in Stable Coronary Artery Disease: A Multi-Centre Australian Registry Review. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.1028] [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] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
42
|
Leong K, Andrianopoulos N, Sharma A, Noaman S, Yudi M, Freeman M, Brennan A, Fernando H, Reid C, Clark D, Sebastian M, Ajani A, Duffy S, Oqueli E. Are Current Bare-Metal Stents Still an Option in Selected Patient Populations? Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.889] [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] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
43
|
Murphy A, Yudi M, Yeoh J, Farouque O, Clark D, Ramchand J, Neef P. Clinical Characteristics of Patients With Stable Coronary Artery Disease Undergoing Angiography by Trans-Femoral Versus Trans-Radial Approach. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.726] [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] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
44
|
Yeoh J, Andrianopoulos N, Yudi M, Brennan A, Picardo S, Horrigan M, Fernando D, Duffy S, Freeman M, Sebastian M, Murphy A, O’Brien J, Oqueli E, Ajani A, Farouque O, Clark D. Long-Term Mortality Following Percutaneous Coronary Intervention to the Proximal Left Anterior Descending Artery: A Multi-Centre Australian Registry Review. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.1027] [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] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
45
|
Khialani B, Andrianopoulos N, Yip T, Ajani A, Yudi M, Freeman M, Jaworski C, Oqueli E, Brennan A, Duffy S, Hutchison A, Hiew C, Sebastian M, Stub D. Trends in Vascular Access for Patients Undergoing Percutaneous Coronary Intervention in Australia: A Report From the Melbourne Interventional Group Cohort. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.1048] [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] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
46
|
Yudi M, Mehran R, Baber U, Crowley A, Ben-Yehuda O, Kappetein AP, Sabik J, Serruys P, Stone G. TCT-839 Prognostic Significance of Established CAD in Patients with Left Main Disease Undergoing Revascularization: Analysis from EXCEL Trial. J Am Coll Cardiol 2017. [DOI: 10.1016/j.jacc.2017.09.1048] [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: 11/24/2022]
|
47
|
Yudi M, Mehran R, Lefevre T, Webb J, Van Belle E, Kini A, Sharma S, Hildick-Smith D, Hambrecht R, Widder J, Sorrentino S, Farhan S, Sartori S, Chandrasekhar J, Anthopoulos P, Hengstenberg C, Dangas G. TCT-791 Impact of Clinical Judgement on Risk Stratification of Patients at High Risk for TAVR: A BRAVO-3 Subgroup Analysis. J Am Coll Cardiol 2017. [DOI: 10.1016/j.jacc.2017.09.674] [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: 11/16/2022]
|
48
|
Yeoh J, Andrianopoulos N, Reid C, Brennan A, Yudi M, Proimos G, Chan R, Noaman S, Oqueli E, Picardo S, Ajani A, Chan W, Farouque O, Clark D. Long-Term Outcomes After Percutaneous Coronary Intervention (PCI) to an Unprotected Left Main Coronary Artery (LMCA) in Cardiogenic Shock: Observations From the Melbourne Interventional Group (MIG) Registry. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.394] [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] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
49
|
Yudi M, Hamilton G, Andrianopoulos N, Brennan A, Farouque O, Ajani A, Yeoh J, Sebastian M, Freeman M, Oqueli E, Reid C, Duffy S, Clark D. Trends and Clinical Outcomes of Patients with Established Coronary Artery Disease Presenting with Acute Coronary Syndromes. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.449] [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] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
50
|
Yeoh J, Andrianopoulos N, Reid C, Brennan A, Yudi M, Proimos G, Chan R, Noaman S, Oqueli E, Picardo S, Ajani A, Chan W, Farouque O, Clark D. Long-Term Outcomes After Percutaneous Coronary Intervention (PCI) to an Unprotected Left Main Coronary Artery (LMCA): 10 Year Observations From the Melbourne Interventional Group (MIG) Registry. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.395] [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] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|