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Freixa X, Arzamendi D, Del Trigo M, Cepas-Guillén PL, Li P, Sanchis L, Barreiro M, Regueiro A, Baz JA, Asmarats L, Calvo F, Moñivas V, Meduiña I, Goicolea J, Sitges M, Estévez-Loureiro R. The TriClip system for edge-to-edge transcatheter tricuspid valve repair. A Spanish multicenter study. Rev Esp Cardiol (Engl Ed) 2022; 75:797-804. [PMID: 35288060 DOI: 10.1016/j.rec.2022.01.007] [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] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 01/28/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION AND OBJECTIVES In patients with tricuspid regurgitation (TR), edge-to-edge transcatheter tricuspid valve repair (TTVR) is the strategy with the highest penetration worldwide. A dedicated edge-to-edge TTVR system has recently become available in Europe. The present study describes the initial experience with the system in Spain. METHODS This multicenter study collected individual data from the centers accepted for the use of the novel system within an initial limited release. Between June 2020 and March 2021, all patients undergoing an edge-to-edge TTVR using the TriClip system in Spain were included in the study. The primary endpoint was the achievement of a TR reduction of at least 1 grade at discharge. RESULTS We included 34 patients. Most of them reported a previous history of atrial fibrillation (91%) and only 1 had a pacemaker lead. The primary endpoint (TR reduction of at least 1 grade at discharge) was met in all patients. Most of the patients required 1 (47%) or 2 clips (44%) with a clear predominance of XT (87%) over NT (13%). The location of the first clip was anteroseptal in >90% of the patients. Only 1 patient had a partial detachment, which was stabilized with additional clips in the same procedure. At discharge, TR severity was≤2 in 91% of patients. At 3 months, mortality was nil. Overall, 88% of patients were in New York Heart Association functional class≤2 and 80% had residual TR≤2. CONCLUSIONS Edge-to-edge TTVR seemed to be effective and safe with a sustained TR reduction at 3 months. Further studies will be needed to confirm our findings.
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Affiliation(s)
- Xavier Freixa
- Departamento de Cardiología, Hospital Clínic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
| | - Dabit Arzamendi
- Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - María Del Trigo
- Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Pedro Luis Cepas-Guillén
- Departamento de Cardiología, Hospital Clínic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Pedro Li
- Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Laura Sanchis
- Departamento de Cardiología, Hospital Clínic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Manuel Barreiro
- Servicio de Cardiología, Hospital Álvaro Cunqueiro, Vigo, Pontevedra, Spain
| | - Ander Regueiro
- Departamento de Cardiología, Hospital Clínic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - José Antonio Baz
- Servicio de Cardiología, Hospital Álvaro Cunqueiro, Vigo, Pontevedra, Spain
| | - Lluis Asmarats
- Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Fran Calvo
- Servicio de Cardiología, Hospital Álvaro Cunqueiro, Vigo, Pontevedra, Spain
| | - Vanessa Moñivas
- Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Irene Meduiña
- Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Javier Goicolea
- Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Marta Sitges
- Departamento de Cardiología, Hospital Clínic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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Ortega-Paz L, Brugaletta S, Gomez-Lara J, Alfonso F, Cequier A, Romaní S, Bordes P, Serra A, Iñiguez A, Salinas P, García Del Blanco B, Goicolea J, Hernández-Antolín R, Cuesta J, Gómez-Hospital JA, Sabaté M. Magnesium-based resorbable scaffold vs permanent metallic sirolimus-eluting stent in patients with ST-segment elevation myocardial infarction: 3-year results of the MAGSTEMI randomised controlled trial. EUROINTERVENTION 2022; 18:e389-e396. [PMID: 35225793 PMCID: PMC10259240 DOI: 10.4244/eij-d-21-00651] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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
BACKGROUND The long-term safety and performance of magnesium-based bioresorbable scaffolds (MgBRS) in ST-segment-elevation myocardial infarction (STEMI) patients are uncertain. AIMS The aim of this study was to report the 3-year clinical outcomes of the MAGSTEMI trial. METHODS This investigator-driven, multicentre, randomised, single-blind, controlled trial randomised STEMI patients 1:1 to MgBRS or to permanent metallic sirolimus-eluting stents (SES) at 11 academic centres. The main secondary endpoints included device-oriented composite endpoints (DoCE) and patient-oriented composite endpoints (PoCE), their individual components, any bleeding, and device thrombosis rate. All endpoints were defined according to the Academic Research Consortium. Events were adjudicated by an independent committee. RESULTS Three-year clinical follow-up was obtained in 142 (90.0%) patients. At 3-year follow-up, MgBRS were associated with a higher rate of DoCE than SES (13 [17.6%] vs 5 [6.6%], diff -11.0 [95% CI: -21.3 to -0.7]; p=0.038). This difference was driven by an increased incidence of DoCE within the first year of follow-up. In the landmark analysis, there was no difference between 1 and 3 years (0 [0.0%] vs 1 [1.4%]; p=1.000). The difference in the rate of DoCE was driven by a higher incidence of target lesion revascularisation (TLR) in the MgBRS group compared to SES (12 [16.2%] vs 4 [5.3%]; diff -10.9% [95% CI: -20.7 to -1.2]; p=0.030). The difference in TLR was observed during the first year, with no further differences observed between 1 and 3 years (0 [0.0%] vs 1 [1.4%]; p=1.000). CONCLUSIONS At 3-year follow-up, MgBRS were associated with a higher rate of TLR, which was clustered within the first year, compared to SES.
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Affiliation(s)
- Luis Ortega-Paz
- Interventional Cardiology Department, Cardiovascular Institute, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Salvatore Brugaletta
- Interventional Cardiology Department, Cardiovascular Institute, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | | | | | - Angel Cequier
- Hospital Universitario de Bellvitge, IDIBELL, Barcelona, Spain
| | | | | | - Antonio Serra
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | | | | | - Javier Goicolea
- Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | | | - Javier Cuesta
- Hospital Universitario de Bellvitge, IDIBELL, Barcelona, Spain
| | | | - Manel Sabaté
- Interventional Cardiology Department, Cardiovascular Institute, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigacíon Biomédica en Red. Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
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Diego-Nieto A, Núñez JC, Miñana G, Amat-Santos IJ, Salinas-Sanguino P, Mohandes M, Regueiro A, Pan M, Lacunza J, Caballero-Borrego J, Fernández-Díaz JA, Fernández Cisnal A, Santos-Martínez S, Gonzalo N, Vaquerizo B, Rivero F, Jurado-Román A, Abellán-Huerta J, Rumiz González E, Rondán-Murillo J, López Benito M, Astorga Burgo JC, Jiménez Mazuecos J, Bosa Ojeda F, Moreno-Ambroj C, Sabaté M, Ojeda S, Valdesuso Aguilar R, López Pérez M, Sanchis J, Campo-Prieto A, Escaned J, Goicolea J, Martín-Moreiras J. Seguridad y viabilidad del acceso radial para intervenciones coronarias percutáneas de oclusiones totales crónicas. Rev Esp Cardiol 2022. [DOI: 10.1016/j.recesp.2022.05.021] [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: 10/15/2022]
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4
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Freixa X, Arzamendi D, del Trigo M, Cepas-Guillén PL, Li P, Sanchis L, Barreiro M, Regueiro A, Baz JA, Asmarats L, Calvo F, Moñivas V, Meduiña I, Goicolea J, Sitges M, Estévez-Loureiro R. El sistema TriClip para la reparación transcatéter de la válvula tricúspide. Estudio multicéntrico español. Rev Esp Cardiol 2022. [DOI: 10.1016/j.recesp.2022.01.018] [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]
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5
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Jurado-Román A, Miñana G, Salinas P, Regueiro A, Caballero-Borrego J, Martín-Moreiras J, Rivero F, Lacunza J, Rondán J, Amat-Santos IJ, Sanchís J, Gonzalo N, Sabaté M, Astorga JC, Mohandes M, Gómez-Menchero A, Fernández Díaz JA, Ojeda S, Paredes E, Vaquerizo B, Vinhas H, López M, Rodríguez S, Rúmiz E, Jiménez-Mazuecos J, Lee DH, Robles J, Gutiérrez A, Morales FJ, Consuegra L, Maristany J, Bosa Ojeda F, Goicolea J, Escaned J, Galeote G. Overlapping versus single long stents in long chronic total occlusions: insights of the Iberian CTO Registry. Minerva Cardiol Angiol 2022; 71:284-293. [PMID: 35420282 DOI: 10.23736/s2724-5683.22.06046-x] [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: 11/08/2022]
Abstract
BACKGROUND It is unknown whether the availability of long drug-eluting stents modify the PCI strategy of long CTO. To describe the contemporary PCI strategy of long chronic total occlusions (CTO) using overlapping (OS) or single long stents (SS) and to analyze its results. METHODS 2842 consecutive CTO PCIs were included. T hose with an occlusion length ≥20 mm in which ≥ 1 DES was implanted were analyzed. We compared procedural characteristics and clinical outcomes of CTO treated with OS or SS. RESULTS 1088 CTO PCIs were analyzed (79.9% males; 64.7±10.6 years). Mean J-score was 2.8 ± 0.9. A SS was used in 38.5% of cases and OS in 61.5%. Total stent length was 64.1±29.9 mm; it was higher in the OS group (OS:79.9±25.5 mm vs SS:38.3±14.7 mm; p<0.0001). Mean number of stents in the OS group was 2.3±1. Very long stents (≥40 mm) were used in 27.4% of cases, more frequently in the OS group (OS:32.4% vs SS:19.3%; p<0.0001). After a mean follow-up of 19±15.9 months, the rate of adverse events (MACE) was 2% (cardiac death:1.6%, myocardial infarction:1.6%, target lesion revascularization:1.9% and stent thrombosis: 0.18%) with no significant differences between both groups. Overlapping was not an independent predictor of MACE. CONCLUSIONS In long CTO PCIs, OS is more frequently used than single stenting, especially in more complex procedures. Clinical outcomes at a mid-term follow-up are favorable. Using newer generation DES, overlapping was not an independent predictor of MACE, however a trend toward a higher event rate was observed in the OS group.
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Affiliation(s)
- Alfonso Jurado-Román
- La Paz University Hospital, Madrid, Spain - .,University General Hospital of Ciudad Real, Ciudad Real, Spain -
| | - Gema Miñana
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), INCLIVA, Hospital Clínic Universitari, University of Valencia, Valencia, Spain
| | - Pablo Salinas
- Hospital Clinico Universitario San Carlos, Madrid, Spain
| | | | | | | | | | - Javier Lacunza
- University Hospital Virgen de la Arrixaca, Murcia, Spain
| | - Juan Rondán
- University Hospital of Cabueñes, Gijón, Spain
| | - Ignacio J Amat-Santos
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Hospital Clínico Universitario, Valladolid, Spain
| | - Juan Sanchís
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), INCLIVA, Hospital Clínic Universitari, University of Valencia, Valencia, Spain
| | - Nieves Gonzalo
- Hospital Clinico Universitario San Carlos, Madrid, Spain
| | | | | | | | | | | | | | | | | | - Hugo Vinhas
- University Hospital of Algarve, Algarve, Portugal
| | | | | | - Eva Rúmiz
- University General Hospital of Valencia, Valencia, Spain
| | | | - Dae-Hyun Lee
- University Hospital Marqués de Valdecilla, Santander, Spain
| | | | | | | | | | | | | | | | - Javier Escaned
- Hospital Clinico Universitario San Carlos, Madrid, Spain
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Delgado-Arana JR, Rumoroso JR, Regueiro A, Martín-Moreiras J, Miñana G, Mohandes M, Pan M, Salinas P, Caballero-Borrego J, Fernández-Díaz JA, Jurado-Román A, Lacunza J, Vaquerizo B, Rivero F, Abellán-Huerta J, Rondán J, Gómez Menchero A, Santos-Martínez S, Subinas A, Arévalos V, Diego Nieto A, Sanchis J, Rojas S, Ojeda S, Gonzalo N, López-Pérez M, Goicolea J, Sádaba M, Gómez-Salvador I, Sabaté M, Núñez García JC, Amat-Santos IJ. Plaque modification in calcified chronic total occlusions: the PLACCTON study. Rev Esp Cardiol (Engl Ed) 2022; 75:213-222. [PMID: 34301507 DOI: 10.1016/j.rec.2021.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 06/10/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION AND OBJECTIVES Severe calcification is present in> 50% of coronary chronic total occlusions (CTOs) undergoing percutaneous intervention. We aimed to describe the contemporary use and outcomes of plaque modification devices (PMDs) in this context. METHODS Patients were included in the prospective, consecutive Iberian CTO registry (32 centers in Spain and Portugal), from 2015 to 2020. Comparison was performed according to the use of PMDs. RESULTS Among 2235 patients, wire crossing was achieved in 1900 patients and PMDs were used in 134 patients (7%), requiring more than 1 PMD in 24 patients (1%). The selected PMDs were rotational atherectomy (35.1%), lithotripsy (5.2%), laser (11.2%), cutting/scoring balloons (27.6%), OPN balloons (2.9%), or a combination of PMDs (18%). PMDs were used in older patients, with greater cardiovascular burden, and higher Syntax and J-CTO scores. This greater complexity was associated with longer procedural time but similar total stent length (52 vs 57mm; P=.105). If the wire crossed, the procedural success rate was 87.2% but increased to 96.3% when PMDs were used (P=.001). Conversely, PMDs were not associated with a higher rate of procedural complications (3.7 vs 3.2%; P=.615). Despite the worse baseline profile, at 2 years of follow-up there were no differences in the survival rate (PMDs: 94.3% vs no-PMDs: 94.3%, respectively; P=.967). CONCLUSIONS Following successful wire crossing in CTOs, PMDs were used in 7% of the lesions with an increased success rate. Mid-term outcomes were comparable despite their worse baseline profile, suggesting that broader use of PMDs in this setting might have potential technical and prognostic benefits.
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Affiliation(s)
- José R Delgado-Arana
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - José R Rumoroso
- Departamento de Cardiología, Hospital Galdakao, Bizkaia, Spain
| | - Ander Regueiro
- Departamento de Cardiología, Hospital Clínic, Instituto de Investigaciones Bioéticas August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Javier Martín-Moreiras
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Cardiología, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | - Gema Miñana
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Cardiología, Hospital Clínico de Valencia, Valencia, Spain
| | - Mohsen Mohandes
- Departamento de Cardiología, Hospital Joan XXIII, Tarragona, Spain
| | - Manuel Pan
- Departamento de Cardiología, Hospital Reina Sofia, Instituto Maimónides de investigación biomédica de Córdoba (IMIBIC), Córdoba, Spain
| | - Pablo Salinas
- Departamento de Cardiología, Hospital Clínico San Carlos, Madrid, Spain
| | | | | | - Alfonso Jurado-Román
- Departamento de Cardiología, Hospital La Paz, Madrid, Spain; Departamento de Cardiología, Hospital de Ciudad Real, Ciudad Real, Spain
| | - Javier Lacunza
- Departamento de Cardiología, Hospital Virgen de la Arrixaca, El Palmar, Murcia, Spain
| | | | - Fernando Rivero
- Departamento de Cardiología, Hospital de La Princesa, Madrid, Spain
| | | | - Juan Rondán
- Departamento de Cardiología, Hospital de Cabueñes, Gijón, Asturias, Spain
| | | | - Sandra Santos-Martínez
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Asier Subinas
- Departamento de Cardiología, Hospital Galdakao, Bizkaia, Spain
| | - Víctor Arévalos
- Departamento de Cardiología, Hospital Clínic, Instituto de Investigaciones Bioéticas August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Alejandro Diego Nieto
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Cardiología, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | - Juan Sanchis
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Cardiología, Hospital Clínico de Valencia, Valencia, Spain
| | - Sergio Rojas
- Departamento de Cardiología, Hospital Joan XXIII, Tarragona, Spain
| | - Soledad Ojeda
- Departamento de Cardiología, Hospital Reina Sofia, Instituto Maimónides de investigación biomédica de Córdoba (IMIBIC), Córdoba, Spain
| | - Nieves Gonzalo
- Departamento de Cardiología, Hospital Clínico San Carlos, Madrid, Spain
| | | | - Javier Goicolea
- Departamento de Cardiología, Hospital Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Mario Sádaba
- Departamento de Cardiología, Hospital Galdakao, Bizkaia, Spain
| | - Itziar Gómez-Salvador
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Manel Sabaté
- Departamento de Cardiología, Hospital Clínic, Instituto de Investigaciones Bioéticas August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Jean Carlos Núñez García
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Cardiología, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | - Ignacio J Amat-Santos
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
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7
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Delgado-Arana JR, Rumoroso JR, Regueiro A, Martín-Moreiras J, Miñana G, Mohandes M, Pan M, Salinas P, Caballero-Borrego J, Fernández-Díaz JA, Jurado-Román A, Lacunza J, Vaquerizo B, Rivero F, Abellán-Huerta J, Rondán J, Gómez Menchero A, Santos-Martínez S, Subinas A, Arévalos V, Diego Nieto A, Sanchis J, Rojas S, Ojeda S, Gonzalo N, López-Pérez M, Goicolea J, Sádaba M, Gómez-Salvador I, Sabaté M, Núñez García JC, Amat-Santos IJ. Dispositivos de modificación de placa en oclusiones coronarias crónicas totales: estudio PLACCTON. Rev Esp Cardiol 2022. [DOI: 10.1016/j.recesp.2021.06.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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8
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Blasco A, Coronado MJ, Vela P, Martin P, Solano J, Ramil E, Mesquida A, Santos A, Cozar B, Royuela A, Garcia D, Camarzana S, Parra C, Oteo JF, Goicolea J, Bellas C. Prognostic implications of Neutrophil Extracellular Traps in coronary thrombi of patients with ST-elevation myocardial infarction. Thromb Haemost 2021; 122:1415-1428. [PMID: 34847588 DOI: 10.1055/a-1709-5271] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AIMS The mechanisms of coronary thrombosis can influence prognosis after STEMI and allow for different treatment groups to be identified; an association between neutrophil extracellular traps (NETs) and unfavorable clinical outcomes has been suggested. Our aim was to determine the role played by NETs in coronary thrombosis and their influence on prognosis. The role of other histological features in prognosis and the association between NETs and bacteria in the coronary thrombi were also explored. METHODS AND RESULTS We studied 406 patients with STEMI in which coronary thrombi were consecutively obtained by aspiration during angioplasty between 2012 and 2018. Analysis of NETs in paraffin-embedded thrombi was based on the colocalization of specific NET components by means of confocal microscopy. Immunohistochemistry stains were used to identify plaque fragments. Fluorescence in situ hybridization was used to detect bacteria. NETs were detected in 51% of the thrombi [NET density, median (IQR): 25% (17-38%)]. The median follow-up was 47 months (95% CI 43-51); 105 (26%) patients experienced major adverse cardiac events (MACE). A significant association was found between the presence of NETs in coronary aspirates and the occurrence of MACE in the first 30 days after infarction (HR 2.82; 95% CI 1.26-6.35, p=.012), mainly due to cardiac deaths and stent thrombosis. CONCLUSIONS The presence of NETs in coronary thrombi was associated with a worse prognosis soon after STEMI. In some patients, NETs could be a treatment target and a feasible way to prevent reinfarction.
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Affiliation(s)
- Ana Blasco
- Cardiology, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Spain
| | - María José Coronado
- Fundación para la Investigación Biomédica del Hospital Universitario Puerta de Hierro Majalahonda, Majadahonda, Spain
| | - Paula Vela
- Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Spain
| | - Paloma Martin
- Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Spain
| | - Jorge Solano
- Consorci Hospital General Universitari de Valencia, Valencia, Spain
| | - Elvira Ramil
- Fundación para la Investigación Biomédica del Hospital Universitario Puerta de Hierro Majalahonda, Majadahonda, Spain
| | - Aina Mesquida
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Adrian Santos
- Fundación para la Investigación Biomédica del Hospital Universitario Puerta de Hierro Majalahonda, Majadahonda, Spain
| | - Beatriz Cozar
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Ana Royuela
- Fundación para la Investigación Biomédica del Hospital Universitario Puerta de Hierro Majalahonda, Majadahonda, Spain
| | - Diego Garcia
- Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Spain
| | - Susana Camarzana
- Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Spain
| | - Carolina Parra
- Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Spain
| | | | - Javier Goicolea
- Cardiology, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Spain
| | - Carmen Bellas
- Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Spain
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Banning AP, Serruys P, De Maria GL, Ryan N, Walsh S, Gonzalo N, Jan van Geuns R, Onuma Y, Sabate M, Davies J, Lesiak M, Moreno R, Cruz-Gonzalez I, Hoole SP, Piek JJ, Appleby C, Fath-Ordoubadi F, Zaman A, Van Mieghem NM, Uren N, Zueco J, Buszman P, Iniguez A, Goicolea J, Hildick-Smith D, Ochala A, Dudek D, de Vries T, Taggart D, Farooq V, Spitzer E, Tijssen J, Escaned J. Five-year outcomes after state-of-the-art percutaneous coronary revascularization in patients with de novo three-vessel disease: final results of the SYNTAX II study. Eur Heart J 2021; 43:1307-1316. [PMID: 34617993 PMCID: PMC8970987 DOI: 10.1093/eurheartj/ehab703] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 08/24/2021] [Accepted: 09/14/2021] [Indexed: 11/14/2022] Open
Abstract
Aims The SYNTAX II study evaluated the impact of advances in percutaneous coronary intervention (PCI), integrated into a single revascularization strategy, on outcomes of patients with de novo three-vessel disease. The study employed decision-making utilizing the SYNTAX score II, use of coronary physiology, thin-strut biodegradable polymer drug-eluting stents, intravascular ultrasound, enhanced treatments of chronic total occlusions, and optimized medical therapy. Patients treated with this approach were compared with predefined patients from the SYNTAX I trial. Methods and results SYNTAX II was a multicentre, single-arm, open-label study of patients requiring revascularization who demonstrated clinical equipoise for treatment with either coronary artery bypass grafting (CABG) or PCI, predicted by the SYNTAX score II. The primary endpoint was major adverse cardiac and cerebrovascular events (MACCE), which included any revascularization. The comparators were a matched PCI cohort trial and a matched CABG cohort, both from the SYNTAX I trial. At 5 years, MACCE rate in SYNTAX II was significantly lower than in the SYNTAX I PCI cohort (21.5% vs. 36.4%, P < 0.001). This reflected lower rates of revascularization (13.8% vs. 23.8%, P < 0.001), and myocardial infarction (MI) (2.7% vs. 10.4%, P < 0.001), consisting of both procedural MI (0.2% vs. 3.8%, P < 0.001) and spontaneous MI (2.3% vs. 6.9%, P = 0.004). All-cause mortality was lower in SYNTAX II (8.1% vs. 13.8%, P = 0.013) reflecting a lower rate of cardiac death (2.8% vs. 8.4%, P < 0.001). Major adverse cardiac and cerebrovascular events’ outcomes at 5 years among patients in SYNTAX II and predefined patients in the SYNTAX I CABG cohort were similar (21.5% vs. 24.6%, P = 0.35). Conclusions Use of the SYNTAX II PCI strategy in patients with de novo three-vessel disease led to improved and durable clinical results when compared to predefined patients treated with PCI in the original SYNTAX I trial. A predefined exploratory analysis found no significant difference in MACCE between SYNTAX II PCI and matched SYNTAX I CABG patients at 5-year follow-up.
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Affiliation(s)
- Adrian P Banning
- Department of Cardiology, John Radcliffe Hospital, Oxford University Hospitals, Headley Way, Oxford OX3 9DU, UK
| | - Patrick Serruys
- Department of Cardiology, National University of Ireland, Galway, Ireland
| | - Giovanni Luigi De Maria
- Department of Cardiology, John Radcliffe Hospital, Oxford University Hospitals, Headley Way, Oxford OX3 9DU, UK
| | - Nicola Ryan
- Hospital Clinico San Carlos IDISSC and Universidad Complutense de Madrid, Madrid 28040, Spain
| | - Simon Walsh
- Department of Cardiology, Belfast Health & Social Care Trust, Belfast BT8*BH, UK
| | - Nieves Gonzalo
- Hospital Clinico San Carlos IDISSC and Universidad Complutense de Madrid, Madrid 28040, Spain
| | | | - Yoshinobu Onuma
- Department of Cardiology, National University of Ireland, Galway, Ireland
| | - Manel Sabate
- Cardiovascular Institute, Hospital Clinic I Provincial de Barcelona, IDIBAPS, Centro de Investigación Biomédica en Red. Enfermedades Cardiovasculares (CIBERCV) CB16/11/00411, Barcelona Spain
| | - Justin Davies
- Department of Cardiology, Imperial College London, Kensington, London SW7 2AZ, UK
| | - Maciej Lesiak
- 1st Department of Cardiology, University of Medical Sciences, Poznan 61-701, Poland
| | - Raul Moreno
- Department of Cardiology, Hospital Universitario la Paz, Paseo de la Castellana, 261, Madrid 28046, Spain
| | - Ignacio Cruz-Gonzalez
- Department of Cardiology, Hospital Universitario de Salamanca, IBSAL, Paseo de San Vicente, 58, Salamanca 37007, Spain
| | - Stephen P Hoole
- Department of Cardiology, Papworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge CB23 3RE, UK
| | - Jan J Piek
- Department of Cardiology, Academic Medical Center of Amsterdam, Amsterdam 1105 AZ, The Netherlands
| | - Clare Appleby
- Liverpool Heart and Chest Hospital, Thomas Dr, Liverpool L14 3PE, UK
| | - Farzin Fath-Ordoubadi
- Manchester Heart Centre, Manchester Royal Infirmary, Central Manchester University Hospitals, Oxford Rd, Manchester M13 9WL, UK
| | - Azfar Zaman
- Department of Cardiology, Freeman Hospital and Newcastle University, High Heaton, Newcastle upon Tyne NE7 7DN, UK
| | - Nicolas M Van Mieghem
- Department of Cardiology, Thoraxcenter, Erasmus MC, 's-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands
| | - Neal Uren
- Department of Cardiology, The Royal Infirmary of Edinburgh, 51 Little France Dr, Edinburgh EH16 4SA, UK
| | - Javier Zueco
- Department of Cardiology, Hospital Universitario Valdecilla, Av. Valdecilla, 25, Santander, Cantabria 39008, Spain
| | - Pawel Buszman
- Department of Cardiology, American Heart of Poland (PAK), Sanatoryjna 1, Ustron 43-450, Poland
| | - Andres Iniguez
- Department of Cardiology, Hospital Álvaro Cunqueiro, c/Clara Campoamor 341, Vigo 36213, Spain
| | - Javier Goicolea
- Department of Cardiology, Hospital Puerta de Hierro, C. Joaquín Rodrigo, 1, Majadahonda 28222, Madrid, Spain
| | - David Hildick-Smith
- Department of Cardiology, Brighton & Sussex University Hospitals NHS Trust, Barry Building, Eastern Rd, Brighton BN2 5BE, UK
| | - Andrzej Ochala
- Department of Cardiology, Gornoslaskie Centrum Medycnze, 45/47, Katowice 40-635, Poland
| | - Dariusz Dudek
- Department of Interventional Cardiology, Jagiellonian University, Gołe, bia 24, Krakow 31-007, Poland
| | - Ton de Vries
- Cardialysis BV, Westblaak 98, 3012 KM Rotterdam, The Netherlands
| | - David Taggart
- Department of Cardiology, John Radcliffe Hospital, Oxford University Hospitals, Headley Way, Oxford OX3 9DU, UK
| | - Vasim Farooq
- Manchester Heart Centre, Manchester Royal Infirmary, Central Manchester University Hospitals, Oxford Rd, Manchester M13 9WL, UK
| | - Ernest Spitzer
- Cardialysis BV, Westblaak 98, 3012 KM Rotterdam, The Netherlands.,European Cardiovascular Research Institute, Westblaak 98, 3012 KM Rotterdam, The Netherlands
| | - Jan Tijssen
- European Cardiovascular Research Institute, Westblaak 98, 3012 KM Rotterdam, The Netherlands
| | - Javier Escaned
- Hospital Clinico San Carlos IDISSC and Universidad Complutense de Madrid, Madrid 28040, Spain
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García-Touchard A, Del Trigo M, Fernández-Díaz JA, Arellano-Serrano C, Goicolea J, Oteo JF. Coronary Guidewire Fractured in the Aorta Outside the Guide Catheter: Acute Stent Thrombosis and Successful Guidewire Retrieval Using a Novel "Spaghetti Technique". Cardiovasc Revasc Med 2021; 28S:121-124. [PMID: 33994098 DOI: 10.1016/j.carrev.2021.04.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/13/2021] [Accepted: 04/28/2021] [Indexed: 11/30/2022]
Affiliation(s)
| | - María Del Trigo
- Interventional Cardiology, Hospital Puerta de Hierro Majadahonda, Spain
| | | | | | - Javier Goicolea
- Interventional Cardiology, Hospital Puerta de Hierro Majadahonda, Spain
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11
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Salinas P, Gonzalo N, Moreno VH, Fuentes M, Santos-Martinez S, Fernandez-Diaz JA, Amat-Santos IJ, Ojeda FB, Borrego JC, Cuesta J, Hernández JMDLT, Diego-Nieto A, Dubois D, Galeote G, Goicolea J, Gutiérrez A, Jiménez-Fernández M, Jiménez-Mazuecos J, Jurado A, Lacunza J, Lee DH, López M, Lozano F, Martin-Moreiras J, Martin-Yuste V, Millán R, Miñana G, Mohandes M, Morales-Ponce FJ, Núñez J, Ojeda S, Pan M, Rivero F, Robles J, Rodríguez-Leiras S, Rojas S, Rondán J, Rumiz E, Sabaté M, Sanchís J, Vaquerizo B, Escaned J. Choice of CTO scores to predict procedural success in clinical practice. A comparison of 4 different CTO PCI scores in a comprehensive national registry including expert and learning CTO operators. PLoS One 2021; 16:e0245898. [PMID: 33798205 PMCID: PMC8018648 DOI: 10.1371/journal.pone.0245898] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 01/10/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND We aimed to compare the performance of the recent CASTLE score to J-CTO, CL and PROGRESS CTO scores in a comprehensive database of percutaneous coronary intervention of chronic total occlusion procedures. METHODS Scores were calculated using raw data from 1,342 chronic total occlusion procedures included in REBECO Registry that includes learning and expert operators. Calibration, discrimination and reclassification were evaluated and compared. RESULTS Mean score values were: CASTLE 1.60±1.10, J-CTO 2.15±1.24, PROGRESS 1.68±0.94 and CL 2.52±1.52 points. The overall percutaneous coronary intervention success rate was 77.8%. Calibration was good for CASTLE and CL, but not for J-CTO or PROGRESS scores. Discrimination: the area under the curve (AUC) of CASTLE (0.633) was significantly higher than PROGRESS (0.557) and similar to J-CTO (0.628) and CL (0.652). Reclassification: CASTLE, as assessed by integrated discrimination improvement, was superior to PROGRESS (integrated discrimination improvement +0.036, p<0.001), similar to J-CTO and slightly inferior to CL score (- 0.011, p = 0.004). Regarding net reclassification improvement, CASTLE reclassified better than PROGRESS (overall continuous net reclassification improvement 0.379, p<0.001) in roughly 20% of cases. CONCLUSION Procedural percutaneous coronary intervention difficulty is not consistently depicted by available chronic total occlusion scores and is influenced by the characteristics of each chronic total occlusion cohort. In our study population, including expert and learning operators, the CASTLE score had slightly better overall performance along with CL score. However, we found only intermediate performance in the c-statistic predicting chronic total occlusion success among all scores.
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Affiliation(s)
- Pablo Salinas
- Cardiology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Nieves Gonzalo
- Cardiology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Víctor H. Moreno
- Cardiology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Manuel Fuentes
- Servicio de Medicina Preventiva, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - Sandra Santos-Martinez
- Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | | | - Ignacio J. Amat-Santos
- Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | | | | | - Javier Cuesta
- Servicio de Cardiología, H. de la Princesa, Madrid, Spain
| | | | - Alejandro Diego-Nieto
- Servicio de Cardiología, Complejo Asistencial Universitario de Salamanca, IBSAL, CIBERCV, Salamanca, España
| | | | | | - Javier Goicolea
- Interventional Cardiology Department, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
| | | | | | | | - Alfonso Jurado
- Servicio de Cardiología, H. la Paz, Madrid, Spain
- Servicio de Cardiología, H. Ciudad Real, Ciudad Real, Spain
| | - Javier Lacunza
- Servicio de Cardiología, H. de la Arrixaca, Murcia, Spain
| | - Dae-Hyun Lee
- Servicio de Cardiología, H. Valdecilla, Santander, Spain
| | - María López
- Servicio de Cardiología, H. León, León, Spain
| | | | - Javier Martin-Moreiras
- Servicio de Cardiología, Complejo Asistencial Universitario de Salamanca, IBSAL, CIBERCV, Salamanca, España
| | - Victoria Martin-Yuste
- CIBER CV, IDIBAPS, Instituto Cardiovascular, Servicio de Cardiología, H. Clinic Barcelona, Spain
| | - Raúl Millán
- Servicio de Cardiología, H. del Mar, Barcelona, Spain
| | - Gema Miñana
- Servicio de Cardiología, H. Clínico de Valencia. Universidad de Valencia, CIBERCV, Valencia, Spain
| | | | | | - Julio Núñez
- Servicio de Cardiología, H. Clínico de Valencia. Universidad de Valencia, CIBERCV, Valencia, Spain
| | - Soledad Ojeda
- Reina Sofia Hospital, Maimonides Institute for Research in Biomedicine of Córdoba (IMIBIC), University of Córdoba, Córdoba, Spain
| | - Manuel Pan
- Reina Sofia Hospital, Maimonides Institute for Research in Biomedicine of Córdoba (IMIBIC), University of Córdoba, Córdoba, Spain
| | | | | | | | - Sergio Rojas
- Servicio de Cardiología, H. Joan XXIII, Tarragona, Spain
| | - Juan Rondán
- Servicio de Cardiología, H. Cabueñes, Gijón, Spain
| | - Eva Rumiz
- Servicio de Cardiología, H. General de Valencia, Valencia, Spain
| | - Manel Sabaté
- CIBER CV, IDIBAPS, Instituto Cardiovascular, Servicio de Cardiología, H. Clinic Barcelona, Spain
| | - Juan Sanchís
- Servicio de Cardiología, H. Clínico de Valencia. Universidad de Valencia, CIBERCV, Valencia, Spain
| | | | - Javier Escaned
- Cardiology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
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12
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Hernández-Pérez FJ, Álvarez-Avelló JM, Forteza A, Gómez-Bueno M, González A, López-Ibor JV, Silva-Melchor L, Goicolea J, Martín CE, Iranzo R, Goirigolzarri-Artaza J, Escudier-Villa JM, Ortega-Marcos J, Oteo-Domínguez JF, Herrero-Cano Á, Moñivas V, Mingo-Santos S, Villar S, Jiménez-Blanco M, Coscia C, Serrano-Fiz S, Alonso-Pulpón L, Segovia-Cubero J. Resultados iniciales de un programa multidisciplinario de atención a pacientes en shock cardiogénico en red. Rev Esp Cardiol 2021. [DOI: 10.1016/j.recesp.2020.01.019] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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13
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Blasco A, Coronado MJ, Hernández-Terciado F, Martín P, Royuela A, Ramil E, García D, Goicolea J, Del Trigo M, Ortega J, Escudier JM, Silva L, Bellas C. Assessment of Neutrophil Extracellular Traps in Coronary Thrombus of a Case Series of Patients With COVID-19 and Myocardial Infarction. JAMA Cardiol 2020; 6:2774536. [PMID: 33372956 PMCID: PMC7772744 DOI: 10.1001/jamacardio.2020.7308] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [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: 10/08/2020] [Accepted: 12/02/2020] [Indexed: 12/25/2022]
Abstract
IMPORTANCE Severe coronavirus disease 2019 (COVID-19) is characterized by the intense formation of neutrophil extracellular traps (NETs), leading to the occlusion of microvessels, as shown in pulmonary samples. The occurrence of ST-elevated myocardial infarction (STEMI) is a serious cardiac manifestation of COVID-19; the intrinsic mechanism of coronary thrombosis appears to still be unknown. OBJECTIVE To determine the role of NETs in coronary thrombosis in patients with COVID-19. DESIGN, SETTING, AND PARTICIPANTS This was a consecutive series of patients with COVID-19 at an academic tertiary hospital in Madrid, Spain, who underwent primary coronary interventions for STEMI in which coronary aspirates were obtained in the catheterization laboratory using a thrombus aspiration device. Patients with COVID-19 who experienced a STEMI between March 23 and April 11, 2020, from whom coronary thrombus samples were aspirated during primary coronary intervention, were included in the analysis. These patients were compared with a series conducted from July 2015 to December 2015 of patients with STEMI. MAIN OUTCOMES AND MEASURES The presence and quantity of NETs in coronary aspirates from patients with STEMI and COVID-19. The method for the analysis of NETs in paraffin-embedded coronary thrombi was based on the use of confocal microscopy technology and image analysis for the colocalization of myeloperoxidase-DNA complexes and citrullinated histone H3. Immunohistochemical analysis of thrombi was also performed. Clinical and angiographic variables were prospectively collected. RESULTS Five patients with COVID-19 were included (4 men [80%]; mean [SD] age, 62 [14] years); the comparison group included 50 patients (44 males [88%]; mean [SD] age, 58 [12] years). NETs were detected in the samples of all 5 patients with COVID-19, and the median density of NETs was 61% (95% CI, 43%-91%). In the historical series of patients with STEMI, NETs were found in 34 of 50 thrombi (68%), and the median NET density was 19% (95% CI, 13%-22%; P < .001). All thrombi from patients with COVID-19 were composed of fibrin and polymorphonuclear cells. None of them showed fragments of atherosclerotic plaque or iron deposits indicative of previous episodes of plaque rupture. CONCLUSIONS AND RELEVANCE In this small case series of patients with COVID-19 and myocardial infarction, NETs seem to play a major role in the pathogenesis of STEMI in COVID-19 disease. Our findings support the idea that targeting intravascular NETs might be a relevant goal of treatment and a feasible way to prevent coronary thrombosis in patients with severe COVID-19 disease.
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Affiliation(s)
- Ana Blasco
- Cardiology Department, Hospital Universitario Puerta de Hierro–Majadahonda, Madrid, Spain
| | - María-José Coronado
- Confocal Microscopy Unit, Instituto de Investigación Puerta de Hierro–Segovia de Arana, Madrid, Spain
| | | | - Paloma Martín
- Pathology Department, Hospital Universitario Puerta de Hierro–Majadahonda, Madrid, Spain
- Center for Biomedical Cancer Research in Network, Madrid, Spain
| | - Ana Royuela
- Biostatistics Unit, Instituto de Investigación Puerta de Hierro–Segovia de Arana, Madrid, Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid, Spain
| | - Elvira Ramil
- Sequencing and Molecular Biology Unit, Instituto de Investigación Puerta de Hierro–Segovia de Arana, Madrid, Spain
| | - Diego García
- Pathology Department, Hospital Universitario Puerta de Hierro–Majadahonda, Madrid, Spain
| | - Javier Goicolea
- Cardiology Department, Hospital Universitario Puerta de Hierro–Majadahonda, Madrid, Spain
| | - María Del Trigo
- Cardiology Department, Hospital Universitario Puerta de Hierro–Majadahonda, Madrid, Spain
| | - Javier Ortega
- Cardiology Department, Hospital Universitario Puerta de Hierro–Majadahonda, Madrid, Spain
| | - Juan M. Escudier
- Cardiology Department, Hospital Universitario Puerta de Hierro–Majadahonda, Madrid, Spain
| | - Lorenzo Silva
- Cardiology Department, Hospital Universitario Puerta de Hierro–Majadahonda, Madrid, Spain
| | - Carmen Bellas
- Pathology Department, Hospital Universitario Puerta de Hierro–Majadahonda, Madrid, Spain
- Center for Biomedical Cancer Research in Network, Madrid, Spain
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Gomez-Lara J, Ortega-Paz L, Brugaletta S, Cuesta J, Romaní S, Serra A, Salinas P, García del Blanco B, Goicolea J, Hernandez-Antolín R, Antuña P, Romaguera R, Regueiro A, Rivero F, Cequier À, Alfonso F, Gómez-Hospital JA, Sabaté M. Bioresorbable scaffolds versus permanent sirolimus-eluting stents in patients with ST-segment elevation myocardial infarction: vascular healing outcomes from the MAGSTEMI trial. EUROINTERVENTION 2020; 16:e913-e921. [DOI: 10.4244/eij-d-20-00198] [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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Armijo G, Estevez-Loureiro R, Carrasco-Chinchilla F, Arzamendi D, Fernández-Vázquez F, Jimenez-Quevedo P, Freixa X, Pascual I, Serrador AM, Mesa D, Alonso-Briales JH, Goicolea J, Hernández-Antolin R, Fernández-Peregrina E, Cid Alvarez AB, Andraka L, Cruz-Gonzalez I, Berenguer A, Sanchis J, Diez Gil JL, Hernández-García JM, Li CH, Benito-González T, de Agustin JA, Avanzas P, Regueiro A, Amat-Santos I, Pan M, Nombela-Franco L. Acute Kidney Injury After Percutaneous Edge-to-Edge Mitral Repair. J Am Coll Cardiol 2020; 76:2463-2473. [DOI: 10.1016/j.jacc.2020.09.582] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 09/18/2020] [Indexed: 12/18/2022]
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16
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Hernández-Pérez FJ, Álvarez-Avelló JM, Forteza A, Gómez-Bueno M, González A, López-Ibor JV, Silva-Melchor L, Goicolea J, Martín CE, Iranzo R, Goirigolzarri-Artaza J, Escudier-Villa JM, Ortega-Marcos J, Oteo-Domínguez JF, Herrero-Cano Á, Moñivas V, Mingo-Santos S, Villar S, Jiménez-Blanco M, Coscia C, Serrano-Fiz S, Alonso-Pulpón L, Segovia-Cubero J. Initial outcomes of a multidisciplinary network for the care of patients with cardiogenic shock. ACTA ACUST UNITED AC 2020; 74:33-43. [PMID: 32448727 DOI: 10.1016/j.rec.2020.03.010] [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: 08/22/2019] [Accepted: 01/16/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION AND OBJECTIVES Mortality remains high in cardiogenic shock (CS), especially in refractory CS involving the use of mechanical circulatory support (MCS) devices. The aim of this study was to analyze the results of a care program for patients in CS after the creation of a multidisciplinary team in our center and a regional network of hospitals in our area. METHODS Observational and retrospective study of patients attended in this program from September 2014 to January 2019. We included patients in refractory CS who required MCS and those who, because of their age and absence of comorbidities, were candidates for advanced therapies. The primary endpoint was survival to discharge. RESULTS A total of 130 patients were included (69 local and 61 transferred patients). The mean age was 52±15 years (72% men). The most frequent causes of CS were acute decompensated heart failure (29%), acute myocardial infarction (26%), and postcardiotomy CS (25%). MCS was used in 105 patients (81%), mostly extracorporeal membrane oxygenation (58%). Survival to discharge was 57% (74 of 130 patients). The most frequent destinations were myocardial recovery and heart transplant. Independent predictors of in-hospital mortality were SAPS II score, lactate level, acute myocardial infarction etiology, and vasoactive-inotropic score. CONCLUSIONS The creation of multidisciplinary teams for patients with mainly refractory CS and a regional network is feasible and allows survival to discharge in more than a half of attended patients with CS.
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Affiliation(s)
| | - José Manuel Álvarez-Avelló
- Servicio de Anestesia y Reanimación, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Alberto Forteza
- Servicio de Cirugía Cardiaca, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Manuel Gómez-Bueno
- Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Instituto Carlos III, Madrid, Spain
| | - Ana González
- Servicio de Anestesia y Reanimación, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Jorge V López-Ibor
- Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Lorenzo Silva-Melchor
- Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Javier Goicolea
- Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Carlos Esteban Martín
- Servicio de Cirugía Cardiaca, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Reyes Iranzo
- Servicio de Anestesia y Reanimación, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | | | | | - Javier Ortega-Marcos
- Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | | | - Ángela Herrero-Cano
- Servicio de Anestesia y Reanimación, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Vanessa Moñivas
- Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Susana Mingo-Santos
- Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Susana Villar
- Servicio de Cirugía Cardiaca, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Marta Jiménez-Blanco
- Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Claudia Coscia
- Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Santiago Serrano-Fiz
- Servicio de Cirugía Cardiaca, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Luis Alonso-Pulpón
- Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Instituto Carlos III, Madrid, Spain
| | - Javier Segovia-Cubero
- Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Instituto Carlos III, Madrid, Spain
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Sánchez R, Vañó E, Fernández Soto JM, Ten JI, Escaned J, Delgado C, García B, Carrera Magariño F, Fernández JFD, Luna RJM, Moreno MAR, Catalán A, Ojeda FB, Rosales Espizua FJ, Moreno JRS, Pifarré X, Goicolea J, Ordiales JM, Nogales JM, Martinez G, García P, Benedicto A, Castillo MFR, Torres LP, Font J, Bethencourt A, Cesteros MJ, Pérez A, Pinar E, Tobarra B. Updating national diagnostic reference levels for interventional cardiology and methodological aspects. Phys Med 2020; 70:169-175. [DOI: 10.1016/j.ejmp.2020.01.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 12/05/2019] [Accepted: 01/14/2020] [Indexed: 10/25/2022] Open
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18
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Werner GS, Martin-Yuste V, Hildick-Smith D, Boudou N, Sianos G, Gelev V, Rumoroso JR, Erglis A, Christiansen EH, Escaned J, di Mario C, Hovasse T, Teruel L, Bufe A, Lauer B, Bogaerts K, Goicolea J, Spratt JC, Gershlick AH, Galassi AR, Louvard Y. A randomized multicentre trial to compare revascularization with optimal medical therapy for the treatment of chronic total coronary occlusions. Eur Heart J 2019; 39:2484-2493. [PMID: 29722796 DOI: 10.1093/eurheartj/ehy220] [Citation(s) in RCA: 326] [Impact Index Per Article: 65.2] [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: 11/18/2017] [Accepted: 04/04/2018] [Indexed: 12/13/2022] Open
Abstract
Aims The clinical value of percutaneous coronary intervention (PCI) for chronic coronary total occlusions (CTOs) is not established by randomized trials. This study should compare the benefit of PCI vs. optimal medical therapy (OMT) on the health status in patients with at least one CTO. Method and results Three hundred and ninety-six patients were enrolled in a prospective randomized, multicentre, open-label, and controlled clinical trial to compare the treatment by PCI with OMT with a 2:1 randomization ratio. The primary endpoint was the change in health status assessed by the Seattle angina questionnaire (SAQ) between baseline and 12 months follow-up. Fifty-two percent of patients have multi-vessel disease in whom all significant non-occlusive lesions were treated before randomization. An intention-to-treat analysis was performed including 13.4% failed procedures in the PCI group and 7.3% cross-overs in the OMT group. At 12 months, a greater improvement of SAQ subscales was observed with PCI as compared with OMT for angina frequency [5.23, 95% confidence interval (CI) 1.75; 8.71; P = 0.003], and quality of life (6.62, 95% CI 1.78-11.46; P = 0.007), reaching the prespecified significance level of 0.01 for the primary endpoint. Physical limitation (P = 0.02) was also improved in the PCI group. Complete freedom from angina was more frequent with PCI 71.6% than OMT 57.8% (P = 0.008). There was no periprocedural death or myocardial infarction. At 12 months, major adverse cardiac events were comparable between the two groups. Conclusion Percutaneous coronary intervention leads to a significant improvement of the health status in patients with stable angina and a CTO as compared with OMT alone. Trial registration NCT01760083.
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Affiliation(s)
- Gerald S Werner
- Klinikum Darmstadt GmbH, Medizinische Klinik I, Grafenstrasse 9, Darmstadt, Germany
| | | | - David Hildick-Smith
- Royal Sussex County Hospital, Sussex Cardiac Centre, Eastern Road, Brighton, UK
| | - Nicolas Boudou
- Hopital de Rangueil CHU Toulouse, Department of Cardiology, 1 avenue Jean Poulhès, Toulouse Cedex 9, France
| | - Georgios Sianos
- AHEPA University Hospital, 1st Department of Cardiology, Stilponos Kyriakidi 1, Thessaloniki, Greece
| | - Valery Gelev
- Cardiology Clinic, MHAT "Tokuda Hospital Sofia", 51B Nikola Vaptsarov Blvd., Sofia, Bulgaria
| | - Jose Ramon Rumoroso
- Hospital Galdakao-Usansolo, Sección de Hemodinámica, barrio de labeaga s/n, Galdakao, Spain
| | - Andrejs Erglis
- Pauls Stradins Clinical University Hospital, Institute of Cardiology and Regenerative Medicine, 13 Pilsonu street, Riga, Latvia
| | | | - Javier Escaned
- Hospital Clinico San Carlos, Unidad de Cardiología Intervencionista, Profesor Martin Lagos s/n, Madrid, Spain
| | - Carlo di Mario
- University Hospital Careggi, Division of Structural Interventional Cardiology, Largo Brambilla 3, Florence, Italy
| | - Thomas Hovasse
- Institut Jacques Cartier, 6 avenue Noyer Lambert, Massy, France
| | - Luis Teruel
- Bellvitge University Hospital, Unidad de Hemodinàmica y Cardiologia, C/ Feixa Llarga s/n, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Alexander Bufe
- HELIOS Klinik Krefeld, Medizinische Klinik I, Lutherplatz 40, Krefeld, Germany
| | - Bernward Lauer
- Zentralklinik Bad Berka, Klinik für Kardiologie, Robert-Koch-Allee 9, Bad Berka, Germany
| | - Kris Bogaerts
- Leuven Biostatistics and Statistical Bioinformatics Centre, L-BioStat. Kapucijnenvoer 35, Leuven, Belgium
| | - Javier Goicolea
- Hospital Universitario Puerta de Hierro, Servicio de hemodinamica y arritmias, Joaquin Rodrigo, 2, Majadahonda, Spain
| | - James C Spratt
- Royal Infirmary of Edinburgh, Department of Cardiology, 51 Little France Crescent, Edinburgh, UK
| | - Anthony H Gershlick
- Glenfield Hospital, Leicester Cardiovascular Biomedical Research Unit, Groby Road, Leicester, UK
| | - Alfredo R Galassi
- Department of Clinical and Experimental Medicine, University of Catania, Via Antonello da Messina 75, Catania, Italy
| | - Yves Louvard
- Institut Jacques Cartier, 6 avenue Noyer Lambert, Massy, France
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Estévez-Loureiro R, Moñivas V, Arellano-Flores C, Forteza A, Martín C, Goicolea J. Reemplazo percutáneo de la válvula tricúspide con prótesis autoexpandible dedicada: sistema GATE. Rev Esp Cardiol 2019. [DOI: 10.1016/j.recesp.2018.12.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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20
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Broyd CJ, Hernández-Pérez F, Segovia J, Echavarría-Pinto M, Quirós-Carretero A, Salas C, Gonzalo N, Jiménez-Quevedo P, Nombela-Franco L, Salinas P, Núñez-Gil I, Del Trigo M, Goicolea J, Alonso-Pulpón L, Fernández-Ortiz A, Parker K, Hughes A, Mayet J, Davies J, Escaned J. Identification of capillary rarefaction using intracoronary wave intensity analysis with resultant prognostic implications for cardiac allograft patients. Eur Heart J 2019; 39:1807-1814. [PMID: 29253131 DOI: 10.1093/eurheartj/ehx732] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 04/11/2017] [Accepted: 12/05/2017] [Indexed: 11/13/2022] Open
Abstract
Aims Techniques for identifying specific microcirculatory structural changes are desirable. As such, capillary rarefaction constitutes one of the earliest changes of cardiac allograft vasculopathy (CAV) in cardiac allograft recipients, but its identification with coronary flow reserve (CFR) or intracoronary resistance measurements is hampered because of non-selective interrogation of the capillary bed. We therefore investigated the potential of wave intensity analysis (WIA) to assess capillary rarefaction and thereby predict CAV. Methods and results Fifty-two allograft patients with unobstructed coronary arteries and normal left ventricular (LV) function were assessed. Adequate aortic pressure and left anterior descending artery flow measurements at rest and with intracoronary adenosine were obtained in 46 of which 2 were lost to follow-up. In a subgroup of 15 patients, simultaneous RV biopsies were obtained and analysed for capillary density. Patients were followed up with 1-3 yearly screening angiography. A significant relationship with capillary density was noted with CFR (r = 0.52, P = 0.048) and the backward decompression wave (BDW) (r = -0.65, P < 0.01). Over a mean follow-up of 9.3 ± 5.2 years patients with a smaller BDW had an increased risk of developing angiographic CAV (hazard ratio 2.89, 95% CI 1.12-7.39; P = 0.03). Additionally, the index BDW was lower in those who went on to have a clinical CAV-events (P = 0.04) as well as more severe disease (P = 0.01). Conclusions Within cardiac transplant patients, WIA is able to quantify the earliest histological changes of CAV and can predict clinical and angiographic outcomes. This proof-of-concept for WIA also lends weight to its use in the assessment of other disease processes in which capillary rarefaction is involved.
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Affiliation(s)
- Christopher J Broyd
- Department of Cardiology, Hospital Clinico San Carlos IDISSC and Universidad Complutense de Madrid, Prof Martin Lagos, 28040 Madrid, Spain.,National Heart and Lung Institute, Imperial College London, Hammersmith Hospital, Du Cane Road, London, W12 0HS, UK
| | - Francisco Hernández-Pérez
- Department of Cardiology, Hospital Puerto de Hierro-Majadahonda, Calle Manuel de Falla, 1, 28222 Majadahonda, Madrid, Spain
| | - Javier Segovia
- Department of Cardiology, Hospital Puerto de Hierro-Majadahonda, Calle Manuel de Falla, 1, 28222 Majadahonda, Madrid, Spain
| | - Mauro Echavarría-Pinto
- Department of Cardiology, Hospital Clinico San Carlos IDISSC and Universidad Complutense de Madrid, Prof Martin Lagos, 28040 Madrid, Spain
| | - Alicia Quirós-Carretero
- Department of Cardiology, Hospital Clinico San Carlos IDISSC and Universidad Complutense de Madrid, Prof Martin Lagos, 28040 Madrid, Spain
| | - Clara Salas
- Department of Cardiology, Hospital Puerto de Hierro-Majadahonda, Calle Manuel de Falla, 1, 28222 Majadahonda, Madrid, Spain
| | - Nieves Gonzalo
- Department of Cardiology, Hospital Clinico San Carlos IDISSC and Universidad Complutense de Madrid, Prof Martin Lagos, 28040 Madrid, Spain
| | - Pilar Jiménez-Quevedo
- Department of Cardiology, Hospital Clinico San Carlos IDISSC and Universidad Complutense de Madrid, Prof Martin Lagos, 28040 Madrid, Spain
| | - Luis Nombela-Franco
- Department of Cardiology, Hospital Clinico San Carlos IDISSC and Universidad Complutense de Madrid, Prof Martin Lagos, 28040 Madrid, Spain
| | - Pablo Salinas
- Department of Cardiology, Hospital Clinico San Carlos IDISSC and Universidad Complutense de Madrid, Prof Martin Lagos, 28040 Madrid, Spain
| | - Ivan Núñez-Gil
- Department of Cardiology, Hospital Clinico San Carlos IDISSC and Universidad Complutense de Madrid, Prof Martin Lagos, 28040 Madrid, Spain
| | - Maria Del Trigo
- Department of Cardiology, Hospital Clinico San Carlos IDISSC and Universidad Complutense de Madrid, Prof Martin Lagos, 28040 Madrid, Spain
| | - Javier Goicolea
- Department of Cardiology, Hospital Puerto de Hierro-Majadahonda, Calle Manuel de Falla, 1, 28222 Majadahonda, Madrid, Spain
| | - Luis Alonso-Pulpón
- Department of Cardiology, Hospital Puerto de Hierro-Majadahonda, Calle Manuel de Falla, 1, 28222 Majadahonda, Madrid, Spain
| | - Antonio Fernández-Ortiz
- Department of Cardiology, Hospital Clinico San Carlos IDISSC and Universidad Complutense de Madrid, Prof Martin Lagos, 28040 Madrid, Spain
| | - Kim Parker
- National Heart and Lung Institute, Imperial College London, Hammersmith Hospital, Du Cane Road, London, W12 0HS, UK
| | - Alun Hughes
- Population Science & Experimental Medicine, Institute of Cardiovascular Science, University College London, 62 Huntley St, Fitzrovia, London, WC1E 6DD, UK
| | - Jamil Mayet
- National Heart and Lung Institute, Imperial College London, Hammersmith Hospital, Du Cane Road, London, W12 0HS, UK
| | - Justin Davies
- National Heart and Lung Institute, Imperial College London, Hammersmith Hospital, Du Cane Road, London, W12 0HS, UK
| | - Javier Escaned
- Department of Cardiology, Hospital Clinico San Carlos IDISSC and Universidad Complutense de Madrid, Prof Martin Lagos, 28040 Madrid, Spain
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Lefèvre T, Haude M, Neumann FJ, Stangl K, Skurk C, Slagboom T, Sabaté M, Goicolea J, Barragan P, Cook S, Macia JC, Windecker S. Comparison of a Novel Biodegradable Polymer Sirolimus-Eluting Stent With a Durable Polymer Everolimus-Eluting Stent: 5-Year Outcomes of the Randomized BIOFLOW-II Trial. JACC Cardiovasc Interv 2019; 11:995-1002. [PMID: 29798778 DOI: 10.1016/j.jcin.2018.04.014] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [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: 12/29/2017] [Revised: 03/12/2018] [Accepted: 04/10/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The authors aimed to compare long-term data of an ultrathin cobalt-chromium stent with passive silicon carbide coating and an active biodegradable polymer that releases sirolimus (O-SES) (Orsiro, BIOTRONIK, Bülach, Switzerland) with the durable polymer-based Xience Prime everolimus-eluting stent (X-EES) (Abbott Vascular, Santa Clara, California). BACKGROUND Biodegradable polymer stents have been developed aiming to overcome long-term detrimental effects of durable polymer stents, ultimately leaving a bare-metal stent in the vessel. METHODS This multicenter, assessor-blinded trial randomized 452 patients with 505 lesions to either O-SES or X-EES in a 2:1 fashion. Endpoints at 5 years were target lesion failure (TLF), its components, and stent thrombosis. RESULTS TLF occurred in 10.4% (n = 30) of O-SES patients versus 12.7% (n = 19) of X-EES patients (p = 0.473), overall stent thrombosis occurred in 0.7% (n = 2) versus 2.8% (n = 4) (p = 0.088), and definite stent thrombosis in 0% versus 0.7% (n = 1) (p = 0.341). Post hoc analysis was performed in diabetic patients (n = 128) and vessels ≤2.75 mm (n = 259). In diabetic patients, the O-SES group had numerically more target lesion revascularizations (13.5% vs. 4.5%; p = 0.138), but fewer cardiac deaths (1.3% vs. 6.9%; p = 0.089) and stent thrombosis (0% vs. 6.9%; p = 0.039). In small vessels, the O-SES group had a significantly lower 5-year mortality (3.7% vs. 11.3%; p = 0.022). CONCLUSIONS At 5 years, the biodegradable polymer O-SES demonstrated low TLF rates comparable to the durable polymer X-EES, confirming its long-term safety and performance. Particularly encouraging is the absence of definite stent thrombosis.
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Affiliation(s)
- Thierry Lefèvre
- Department of Interventional Cardiology, Hopital Jacques Cartier, Massy, France.
| | - Michael Haude
- Medical Clinic I, Städtische Kliniken Neuss, Lukaskrankenhaus, Neuss, Germany
| | - Franz-Josef Neumann
- Department of Cardiology and Angiology, Universitäts-Herzzentrum Freiburg-Bad Krozingen, Bad Krozingen, Germany
| | - Karl Stangl
- Department of Cardiology, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Carsten Skurk
- Department of Cardiology, Charité Campus Benjamin Franklin, Berlin, Germany
| | - Ton Slagboom
- Department of Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands
| | - Manel Sabaté
- Department of Cardiology, Hospital Clínic, Thorax Institute, Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Javier Goicolea
- Department of Cardiology, Hospital Puerta de Hierro, Madrid, Spain
| | - Paul Barragan
- Department of Cardiology, Polyclinique les Fleurs, Ollioules, France
| | - Stéphane Cook
- Department of Cardiology, Hospital and University Fribourg, Switzerland
| | | | - Stephan Windecker
- Department of Cardiology, Bern University Hospital, Bern, Switzerland
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22
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Benito-González T, Estévez-Loureiro R, Garrote-Coloma C, Arellano-Serrano C, Tundidor-Sanz E, Fernández-Lozano I, Toquero J, Pérez de Prado A, Goicolea J, Fernández-Vázquez F. Effect of Successful Edge-to-Edge Mitral Valve Repair on Ventricular Arrhythmic Burden in Patients With Functional Mitral Regurgitation and Implantable Cardiac Devices. Am J Cardiol 2019; 124:1113-1119. [PMID: 31376913 DOI: 10.1016/j.amjcard.2019.06.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 05/12/2019] [Revised: 06/13/2019] [Accepted: 06/18/2019] [Indexed: 12/29/2022]
Abstract
Significant mitral regurgitation (MR) may be present in up to half of patients with heart failure (HF) and it is associated with adverse cardiac remodeling and myocardial stretch. These are potential triggers for ventricular arrhythmias (VA) in patients with HF, and therefore MR may enhance electrical ventricular vulnerability. Our aim was to evaluate VA burden before and after percutaneous mitral valve repair (PMVR) in patients with implantable cardiac devices. We conducted a prospective registry of all consecutive patients (n = 34, age 69.0 ± 12.2 years, 77% male) with significant functional mitral regurgitation (FMR) who underwent MitraClip implantation in 2 centers between June 2014 and July 2018. VA burden was defined as the total number of events during device follow-up before and after PMVR. Among patients presenting VA during follow-up before or after PMVR, device success at hospital discharge was related to a significant reduction in the incidence of Nonsustained ventricular tachycardia (VT, p = 0.002) and any sustained VT or rapid VT/ventricular fibrillation (p = 0.034). Regarding implantable cardiac defibrillator (ICD) therapies, successful PMVR was related to a reduction in incidence of either antitachycardia pacing or appropriate shocks (p = 0.045) and in the occurrence of any defibrillation shocks (p = 0.045). Overall, effective repair lead to a significant reduction in the VA burden, with a significant decrease in the occurrence of any VA (p = 0.004) and any ICD therapies (p = 0.045). In conclusion, device success after PMVR was related to a reduction in overall arrhythmic burden and ICD therapies in our cohort.
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Affiliation(s)
| | - Rodrigo Estévez-Loureiro
- Department of Cardiology, University Hospital of León, León, Spain; Department of Cardiology, University Hospital of Puerta de Hierro, Majadahonda, Madrid, Spain.
| | | | - Carlos Arellano-Serrano
- Department of Cardiology, University Hospital of Puerta de Hierro, Majadahonda, Madrid, Spain
| | | | | | - Jorque Toquero
- Department of Cardiology, University Hospital of Puerta de Hierro, Majadahonda, Madrid, Spain
| | | | - Javier Goicolea
- Department of Cardiology, University Hospital of Puerta de Hierro, Majadahonda, Madrid, Spain
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23
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Sabaté M, Alfonso F, Cequier A, Romaní S, Bordes P, Serra A, Iñiguez A, Salinas P, García Del Blanco B, Goicolea J, Hernández-Antolín R, Cuesta J, Gómez-Hospital JA, Ortega-Paz L, Gomez-Lara J, Brugaletta S. Magnesium-Based Resorbable Scaffold Versus Permanent Metallic Sirolimus-Eluting Stent in Patients With ST-Segment Elevation Myocardial Infarction: The MAGSTEMI Randomized Clinical Trial. Circulation 2019; 140:1904-1916. [PMID: 31553204 DOI: 10.1161/circulationaha.119.043467] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The use of poly-l-lactide acid-based bioresorbable scaffolds is limited in daily clinical practice because of safety concerns and lack of physiological benefit. Magnesium-based bioresorbable scaffold (MgBRS) presents a short resorption period (<1 year) and have the potential of being thromboresistant and exhibiting early restoration of vasomotor function. To date, however, no randomized clinical trial has investigated the performance of MgBRS. Therefore, this study aimed to compare the in-stent/scaffold vasomotion between MgBRS and permanent metallic sirolimus-eluting stent (SES) at 12-month follow-up in ST-segment-elevation myocardial infarction patients. METHODS This investigator-driven, multicenter, randomized, single-blind, controlled trial randomized ST-segment-elevation myocardial infarction patients 1:1 to SES or MgBRS at 11 academic centers. The primary end point was the rate of increase (≥3%) after nitroglycerin in mean lumen diameter of the in-stent/scaffold segment at 12 months with superiority of MgBRS over SES in the as-treated population. The main secondary end points included angiographic parameters of restenosis, device-oriented composite end point, their individual components, and device thrombosis rate. Besides, endothelial-dependent vasomotor response to acetylcholine (ie, endothelial function) was also assessed in a subgroup of patients (n=69). RESULTS Between June 2017 and June 2018, 150 ST-segment-elevation myocardial infarction patients were randomized (MgBRS, n=74; SES, n=76). At 1 year, the primary end point was significantly higher in the MgBRS arm (56.5% versus 33.8%; P=0.010). Conversely, late lumen loss was significantly lower in the SES group (in-segment: 0.39±0.49mm versus 0.02±0.27mm, P<0.001; in-device: 0.61±0.55mm versus 0.06±0.21mm; P<0.001). The device-oriented composite end point was higher in the MgBRS arm driven by an increase in ischemia-driven target lesion revascularization rate (12[16.2%] versus 4[5.2%], P=0.030). Definite thrombosis rate was similar between groups (1[1.4%] in the MgBRS arm versus 2[2.6%] in the SES group; P=1.0). Endothelial function assessment at device segment evidenced a more pronounced vasoconstrictive response to maximal dose of acetylcholine in the MgBRS arm (-8.3±3.5% versus -2.4±1.3% in the SES group, P=0.003). CONCLUSIONS When compared to SES, MgBRS demonstrated a higher capacity of vasomotor response to pharmacological agents (either endothelium-independent or endothelium-dependent) at 1 year. However, MgBRS was associated with a lower angiographic efficacy, a higher rate of target lesion revascularization, without thrombotic safety concerns. CLINICAL TRIAL REGISTRATION URL: https://www.clinicaltrials.gov. Unique identifier: NCT03234348.
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Affiliation(s)
- Manel Sabaté
- Interventional Cardiology Department, Cardiovascular Institute, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain (M.S., S.B.)
| | - Fernando Alfonso
- Hospital Universitario de La Princesa, Madrid, Spain (F.A., J.C.)
| | - Angel Cequier
- Hospital Universitario de Bellvitge, IDIBELL, Barcelona, Spain (A.C., J.A.G.H.)
| | | | | | - Antonio Serra
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain (A.S.)
| | | | | | | | | | | | - Javier Cuesta
- Hospital Universitario de La Princesa, Madrid, Spain (F.A., J.C.)
| | | | - Luis Ortega-Paz
- Barcicore, Cardiac Imaging Corelab, Barcelona, Spain (L.O.P., J.G.L.)
| | - Josep Gomez-Lara
- Barcicore, Cardiac Imaging Corelab, Barcelona, Spain (L.O.P., J.G.L.)
| | - Salvatore Brugaletta
- Interventional Cardiology Department, Cardiovascular Institute, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain (M.S., S.B.)
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Freixa X, Cruz-González I, Regueiro A, Nombela-Franco L, Estévez-Loureiro R, Ruiz-Salmerón R, Bethencourt A, Gutiérrez-García H, Fernández-Díaz JA, Moreno-Samos JC, Jiménez-Quevedo P, Martin-Yuste V, Arnold R, Millan X, Asmarats L, Ronquillo M, Agudelo-Montañez VH, López-Mínguez JR, Goicolea J, Pérez de Prado A, Arzamendi D. Left Atrial Appendage Occlusion as Adjunctive Therapy to Anticoagulation for Stroke Recurrence. J Invasive Cardiol 2019; 31:212-216. [PMID: 31088992] [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: 06/09/2023]
Abstract
BACKGROUND Stroke recurrence despite optimal oral anticoagulation (OAC) might represent a novel indication for left atrial appendage occlusion (LAAO). The heterogeneity of these patients is generally high, as the presence of valvular atrial fibrillation (VAF) is common. The aim of this study was to explore the role of LAAO as an adjunctive therapy to OAC in patients with recurrent stroke despite optimal OAC. METHODS The study screened consecutive patients who underwent percutaneous LAAO at nine centers between 2009 and 2017. Patients with recurrent stroke despite optimal OAC were selected and those with an absolute or relative contraindication to OAC were not included in the study. RESULTS Among 837 patients who underwent LAAO between the study period, a total of 22 (2.6%) met the inclusion criteria. There was a high percentage of VAF (38%) and 59% presented more than one cardioembolic event before LAAO. All patients underwent successful implantation of the device and no procedural major adverse events were reported. In all but 3 patients, anticoagulation was continued after LAAO. With a median clinical follow-up of 1.8 years (range, 0.7-2.8 years), only 1 stroke and 1 transient ischemic attack were reported, translating into a significant reduction of cerebrovascular events before and after LAAO (2.0 ± 1.0 events vs 0.1 ± 0.3 events; P<.01). Imaging follow-up revealed only 1 case of device thrombosis. CONCLUSIONS LAAO as an adjunctive therapy to OAC seems to be feasible and safe in patients with previous cardioembolic events despite optimal OAC. In our series, this strategy was associated with a low rate of cerebrovascular events after LAAO.
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Affiliation(s)
- Xavier Freixa
- Hospital Clinic de Barcelona, c/ Villarroel 170, Escala 3 Planta 6, 08015 Barcelona, Spain.
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Serruys PW, Kogame N, Katagiri Y, Modolo R, Buszman PE, Íñiguez-Romo A, Goicolea J, Hildick-Smith D, Ochala A, Dudek D, Piek JJ, Wykrzykowska JJ, Escaned J, Banning AP, Farooq V, Onuma Y. Clinical outcomes of state-of-the-art percutaneous coronary revascularisation in patients with three-vessel disease: two-year follow-up of the SYNTAX II study. EUROINTERVENTION 2019; 15:e244-e252. [DOI: 10.4244/eij-d-18-00980] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [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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Amat-Santos IJ, Martin-Yuste V, Fernández-Díaz JA, Martin-Moreiras J, Caballero-Borrego J, Salinas P, Ojeda S, Rivero F, Núñez Villota J, Mohandes M, Dubois D, Bosa Ojeda F, Rumiz E, de la Torre Hernández JM, Jiménez-Mazuecos J, Lacunza J, Tejedor P, Gómez I, Goncalves-Ramirez LR, Rojas P, Sabaté M, Goicolea J, Diego Nieto A, Jiménez-Fernández M, Escaned J, Gonzalo N, Pardo L, Cuesta J, Miñana G, Sanchis J, Rojas S, Millán R, Vaquerizo B, Rodríguez S, Lee DH, Morales FJ, Gutiérrez A, López M, Maristany J, Rondán J, Galeote G, Kabbanni Z, Rodríguez S, Teruel L, Sadaba M, Jurado A, Mainar V, Sánchez-Rubio J, Vinhas H, Fernandes R. Procedural, Functional and Prognostic Outcomes Following Recanalization of Coronary Chronic Total Occlusions. Results of the Iberian Registry. ACTA ACUST UNITED AC 2019; 72:373-382. [DOI: 10.1016/j.rec.2018.05.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 03/13/2018] [Indexed: 10/28/2022]
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Brugaletta S, Cequier A, Alfonso F, Iñiguez A, Romaní S, Serra A, Salinas P, Goicolea J, Bordes P, del Blanco BG, Hernández-Antolín R, Pernigotti A, Gómez-Lara J, Sabaté M. MAGnesium-based bioresorbable scaffold and vasomotor function in patients with acute ST segment elevation myocardial infarction: The MAGSTEMI trial: Rationale and design. Catheter Cardiovasc Interv 2019; 93:64-70. [DOI: 10.1002/ccd.27825] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Affiliation(s)
- Salvatore Brugaletta
- Department of Cardiology, Institut Clínic Cardiovascular, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona Spain
| | - Angel Cequier
- Department of Cardiology, Hospital de Bellvitge; Barcelona Spain
| | | | - Andrés Iñiguez
- Department of Cardiology, Hospital Alvaro Cunqueiro; Vigo Spain
| | - Sebastian Romaní
- Department of Cardiology, Hospital San Pedro de Alcántara; Cáceres Spain
| | - Antonio Serra
- Department of Cardiology, Hospital de Sant Pau; Barcelona Spain
| | - Pablo Salinas
- Department of Cardiology, Hospital Clínico San Carlos; Madrid Spain
| | - Javier Goicolea
- Department of Cardiology, Hospital Puerta de Hierro-Majadahonda; Madrid Spain
| | - Pascual Bordes
- Department of Cardiology, Hospital General de Alicante; Alicante Spain
| | | | | | - Alberto Pernigotti
- Department of Cardiology, Institut Clínic Cardiovascular, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona Spain
| | - Josep Gómez-Lara
- Department of Cardiology, Hospital de Bellvitge; Barcelona Spain
| | - Manel Sabaté
- Department of Cardiology, Institut Clínic Cardiovascular, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona Spain
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Santos A, Martín P, Blasco A, Solano J, Cózar B, García D, Goicolea J, Bellas C, Coronado M. NETs detection and quantification in paraffin embedded samples using confocal microscopy. Micron 2018; 114:1-7. [DOI: 10.1016/j.micron.2018.07.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 07/05/2018] [Accepted: 07/06/2018] [Indexed: 02/07/2023]
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Cruz-González I, Freixa X, Fernández-Díaz JA, Moreno-Samos JC, Martín-Yuste V, Goicolea J. Cierre de orejuela con dispositivo LAmbre: experiencia inicial. Rev Esp Cardiol 2018. [DOI: 10.1016/j.recesp.2017.02.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Escaned J, Collet C, Ryan N, De Maria GL, Walsh S, Sabate M, Davies J, Lesiak M, Moreno R, Cruz-Gonzalez I, Hoole SP, Ej West N, Piek JJ, Zaman A, Fath-Ordoubadi F, Stables RH, Appleby C, van Mieghem N, van Geuns RJ, Uren N, Zueco J, Buszman P, Iñiguez A, Goicolea J, Hildick-Smith D, Ochala A, Dudek D, Hanratty C, Cavalcante R, Kappetein AP, Taggart DP, van Es GA, Morel MA, de Vries T, Onuma Y, Farooq V, Serruys PW, Banning AP. Clinical outcomes of state-of-the-art percutaneous coronary revascularization in patients with de novo three vessel disease: 1-year results of the SYNTAX II study. Eur Heart J 2018; 38:3124-3134. [PMID: 29020367 PMCID: PMC5837643 DOI: 10.1093/eurheartj/ehx512] [Citation(s) in RCA: 200] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 08/23/2017] [Indexed: 12/15/2022] Open
Abstract
Aims To investigate if recent technical and procedural developments in percutaneous coronary intervention (PCI) significantly influence outcomes in appropriately selected patients with three-vessel (3VD) coronary artery disease. Methods and results The SYNTAX II study is a multicenter, all-comers, open-label, single arm study that investigated the impact of a contemporary PCI strategy on clinical outcomes in patients with 3VD in 22 centres from four European countries. The SYNTAX-II strategy includes: heart team decision-making utilizing the SYNTAX Score II (a clinical tool combining anatomical and clinical factors), coronary physiology guided revascularisation, implantation of thin strut bioresorbable-polymer drug-eluting stents, intravascular ultrasound (IVUS) guided stent implantation, contemporary chronic total occlusion revascularisation techniques and guideline-directed medical therapy. The rate of major adverse cardiac and cerebrovascular events (MACCE [composite of all-cause death, cerebrovascular event, any myocardial infarction and any revascularisation]) at one year was compared to a predefined PCI cohort from the original SYNTAX-I trial selected on the basis of equipoise 4-year mortality between CABG and PCI. As an exploratory endpoint, comparisons were made with the historical CABG cohort of the original SYNTAX-I trial. Overall 708 patients were screened and discussed within the heart team; 454 patients were deemed appropriate to undergo PCI. At one year, the SYNTAX-II strategy was superior to the equipoise-derived SYNTAX-I PCI cohort (MACCE SYNTAX-II 10.6% vs. SYNTAX-I 17.4%; HR 0.58, 95% CI 0.39–0.85, P = 0.006). This difference was driven by a significant reduction in the incidence of MI (HR 0.27, 95% CI 0.11–0.70, P = 0.007) and revascularisation (HR 0.57, 95% CI 0.37–0.9, P = 0.015). Rates of all-cause death (HR 0.69, 95% CI 0.27–1.73, P = 0.43) and stroke (HR 0.69, 95% CI 0.10–4.89, P = 0.71) were similar. The rate of definite stent thrombosis was significantly lower in SYNTAX-II (HR 0.26, 95% CI 0.07–0.97, P = 0.045). Conclusion At one year, clinical outcomes with the SYNTAX-II strategy were associated with improved clinical results compared to the PCI performed in comparable patients from the original SYNTAX-I trial. Longer term follow-up is awaited and a randomized clinical trial with contemporary CABG is warranted. ClinicalTrials.gov Identifier NCT02015832
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Affiliation(s)
- Javier Escaned
- Hospital Cliinico San Carlos IDISSC and Universidad Complutense de Madrid, Madrid, Spain; Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain
| | - Carlos Collet
- Department of Cardiology, Academic Medical Center of Amsterdam, Cardiology, Amsterdam, the Netherlands; Meibergdreef 9, 1105 AZ Amsterdam-Zuidoost, the Netherlands
| | - Nicola Ryan
- Hospital Cliinico San Carlos IDISSC and Universidad Complutense de Madrid, Madrid, Spain; Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain
| | - Giovanni Luigi De Maria
- Department of Cardiology, John Radcliffe Hospital, Cardiology, Oxford, UK; Headley Way, Headington, Oxford OX3 9DU, UK
| | - Simon Walsh
- Department of Cardiology Belfast Health & Social Care Trust, Belfast, UK; Knockbracken Healthcare Park, Saintfield Rd, Belfast BT8 8BH, UK
| | - Manel Sabate
- Hospital Clinic I Provincial de Barcelona, Barcelona, Spain; Carrer de Villarroel, 170, 08036 Barcelona, Spain
| | - Justin Davies
- Department of Cardiology, Imperial College London, London, UK; Kensington, London SW7 2AZ, UK
| | - Maciej Lesiak
- 1st Department of Cardiology, University of Medical Sciences, Poznan, Poland; Collegium Maius, Fredry 10, 61-701 Poznan, Poland
| | - Raul Moreno
- Department of Cardiology, Hospital Universitario la Paz, Madrid, Spain; Paseo de la Castellana, 261, 28046 Madrid, Spain
| | - Ignacio Cruz-Gonzalez
- Department of Cardiology, Hospital Universitario de Salamanca, IBSAL, Salamanca, Spain; Paseo de San Vicente, 58, 37007 Salamanca, Spain
| | - Stephan P Hoole
- Department of Cardiology, Papworth Hospital NHS Foundation Trust, Cambridge, UK; Papworth Everard, Cambridge CB23 3RE, UK
| | - Nick Ej West
- Department of Cardiology, Papworth Hospital NHS Foundation Trust, Cambridge, UK; Papworth Everard, Cambridge CB23 3RE, UK
| | - J J Piek
- Department of Cardiology, Academic Medical Center of Amsterdam, Cardiology, Amsterdam, the Netherlands; Meibergdreef 9, 1105 AZ Amsterdam-Zuidoost, the Netherlands
| | - Azfar Zaman
- Department of Cardiology, Freeman Hospital and Newcastle University, Newcastle-upon-Tyne, UK; High Heaton, Newcastle upon Tyne NE7 7DN, UK
| | - Farzin Fath-Ordoubadi
- Manchester Heart Centre, Manchester Royal Infirmary, Central Manchester University Hospitals, Manchester, UK; Oxford Rd, Manchester M13 9WL, UK
| | - Rodney H Stables
- Liverpool Heart and Chest Hospital, Liverpool, UK; Thomas Dr, Liverpool L14 3PE, UK
| | - Clare Appleby
- Liverpool Heart and Chest Hospital, Liverpool, UK; Thomas Dr, Liverpool L14 3PE, UK
| | - Nicolas van Mieghem
- Thoraxcenter, Erasmus MC, the Netherlands; 's-Gravendijkwal 230, 3015 CE Rotterdam, the Netherlands
| | - Robert Jm van Geuns
- Thoraxcenter, Erasmus MC, the Netherlands; 's-Gravendijkwal 230, 3015 CE Rotterdam, the Netherlands
| | - Neal Uren
- The Royal Infirmary of Edinburgh, Edinburgh, UK; 51 Little France Dr, Edinburgh EH16 4SA, UK
| | - Javier Zueco
- Department of Cardiology, Hospital Universitario Valdecilla, Cantabria, Spain; Av. Valdecilla, 25, 39008 Santander, Cantabria, Spain
| | - Pawel Buszman
- American Heart of Poland (PAK), Ustrón, Poland; Sanatoryjna 1, 43-450 Ustrón, Poland
| | - Andres Iñiguez
- Department of Cardiology, Hospital Meixoeiro, Pontevedra, Spain; Camiño Meixoeiro, s/n, 36214 Vigo, Pontevedra, Spain
| | - Javier Goicolea
- Department of Cardiology, Hospital Meixoeiro, Pontevedra, Spain; Camiño Meixoeiro, s/n, 36214 Vigo, Pontevedra, Spain
| | - David Hildick-Smith
- Brighton & Sussex University Hospitals NHS Trust, Brighton, UK; Barry Building, Eastern Rd, Brighton BN2 5BE, UK
| | - Andrzej Ochala
- Gornoslaskie Centrum Medycnze, Poland; 45/47, 40-635 Katowice, Poland
| | - Dariusz Dudek
- Department of Interventional Cardiology, Jagiellonian University, Krakow, Poland; Gol?bia 24, 31-007 Kraków, Poland
| | - Colm Hanratty
- Department of Cardiology Belfast Health & Social Care Trust, Belfast, UK; Knockbracken Healthcare Park, Saintfield Rd, Belfast BT8 8BH, UK
| | - Rafael Cavalcante
- Thoraxcenter, Erasmus MC, the Netherlands; 's-Gravendijkwal 230, 3015 CE Rotterdam, the Netherlands
| | - Arie Pieter Kappetein
- Thoraxcenter, Erasmus MC, the Netherlands; 's-Gravendijkwal 230, 3015 CE Rotterdam, the Netherlands
| | - David P Taggart
- Department of Cardiology, John Radcliffe Hospital, Cardiology, Oxford, UK; Headley Way, Headington, Oxford OX3 9DU, UK
| | - Gerrit-Anne van Es
- Cardialysis BV, Rotterdam, the Netherlands; Westblaak 98, 3012 KM, Rotterdam, the Netherlands.,European Cardiovascular Research Institute, Westblaak 98, 3012 KM, Rotterdam, the Netherlands
| | - Marie-Angèle Morel
- Cardialysis BV, Rotterdam, the Netherlands; Westblaak 98, 3012 KM, Rotterdam, the Netherlands
| | - Ton de Vries
- Cardialysis BV, Rotterdam, the Netherlands; Westblaak 98, 3012 KM, Rotterdam, the Netherlands
| | - Yoshinobu Onuma
- Thoraxcenter, Erasmus MC, the Netherlands; 's-Gravendijkwal 230, 3015 CE Rotterdam, the Netherlands.,Cardialysis BV, Rotterdam, the Netherlands; Westblaak 98, 3012 KM, Rotterdam, the Netherlands
| | - Vasim Farooq
- Manchester Heart Centre, Manchester Royal Infirmary, Central Manchester University Hospitals, Manchester, UK; Oxford Rd, Manchester M13 9WL, UK
| | - Patrick W Serruys
- Department of Cardiology, Imperial College London, London, UK; Kensington, London SW7 2AZ, UK
| | - Adrian P Banning
- Department of Cardiology, John Radcliffe Hospital, Cardiology, Oxford, UK; Headley Way, Headington, Oxford OX3 9DU, UK
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Cubedo J, Blasco A, Padró T, Ramaiola I, Juan-Babot O, Goicolea J, Fernández-Díaz J, Oteo J, Badimon L. Molecular signature of coronary stent thrombosis: oxidative stress and innate immunity cells. Thromb Haemost 2017. [DOI: 10.1160/th17-03-069] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
SummaryThe clinical impact of in-stent thrombosis is high because it is associated with high mortality and 20 % of the patients suffer a recurrent event within the two following years. The aim of this study was to characterise the morphologic and proteomic profile of in-stent thrombi (IST) in comparison to thrombi developed on native coronary arteries (CT) to identify a differential molecular signature. The study included 45 patients with ST-elevation-myocardial-infarction (STEMI) treated by primary-percutaneous-intervention and thrombus aspiration: 21 had IST and 24 had CT. Thrombi were characterised by morphologic immunohistochemical analysis and differential proteomic profiling (2-DE+MALDI-TOF/TOF). Bioinformatic analysis revealed differences in proteins related to oxidative-stress and cell death/survival. IST showed a higher content of structural proteins (gelsolin, actin-cytoplasmic-1, tropomyosin, and myosin) together with an imbalance in redox-homeostasis related proteins (increased superoxide-dismutase and decreased peroxiredoxin-2 thrombus content), and a coordinated increase of chaperones (HSP60 and HSC70) and cellular quality control-related proteins (26S–protease-regulatory-subunit-7). These changes were reflected into a significant decrease in HSC70 systemic levels and a significant increase in advanced-oxidation-protein-products (AOPP) indicative of increased oxidative stress-mediated protein damage in IST. Our results reveal an imbalance in redox-related proteins indicative of an exacerbated oxidative-stress that leads to an accumulation of AOPP serum levels in IST. Moreover, the coordinated increase in chaperones and regulatory proteins reflects the activation of intracellular protection mechanisms to maintain protein integrity in IST. The failure to counterbalance the stress situation could trigger cellular apoptosis leading to the destabilization of the thrombus and to a worse prognosis of IST-STEMI-patients.Supplementary Material to this article is available online at www.thrombosis-online.com.
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Lopez-Pais J, Oteo Dominguez JF, Flores CA, Vilches-Soria S, Solano López Morel JM, Martinez Peredo CG, Garcia-Touchard A, Fernandez Diaz JA, Castro V, Toquero J, Goicolea J. TCT-767 Predictors of Pacemaker Dependency After Transcatheter Aortic Valve Implantation. J Am Coll Cardiol 2017. [DOI: 10.1016/j.jacc.2017.09.653] [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: 11/30/2022]
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Goirigolzarri-Artaza J, Casado-Álvarez R, Benítez-Peyrat J, León-Aliz E, Goicolea J, García-Touchard A. Síndrome compartimental agudo de la mano tras un cateterismo transradial. Rev Esp Cardiol 2017. [DOI: 10.1016/j.recesp.2016.09.026] [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] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Goirigolzarri-Artaza J, Casado-Álvarez R, Benítez-Peyrat J, León-Aliz E, Goicolea J, García-Touchard A. Acute Compartment Syndrome of the Hand After Transradial Catheterization. Rev Esp Cardiol (Engl Ed) 2017; 70:672-673. [PMID: 28209303 DOI: 10.1016/j.rec.2016.11.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Accepted: 09/21/2016] [Indexed: 06/06/2023]
Affiliation(s)
| | | | - Jaime Benítez-Peyrat
- Unidad de Cardiología Intervencionista, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Ebrey León-Aliz
- Unidad de Cardiología Intervencionista, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Javier Goicolea
- Unidad de Cardiología Intervencionista, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Arturo García-Touchard
- Unidad de Cardiología Intervencionista, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain.
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Rodríguez-González E, Castanedo-Álvarez M, León-Aliz E, Benitez-Peyrat J, Oteo JF, Hernández-Hernández M, Montes-Uruén A, Gorigolzarri-Artaza J, Restrepo-Córdoba MA, Pifarré-Martínez X, Goicolea J, García-Touchard A. Right lateral versus left lateral view for forearm coronary angiography. An operator radiation exposure and image quality study. J Radiol Prot 2017; 37:450-458. [PMID: 28586317 DOI: 10.1088/1361-6498/aa6b76] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVES The aim of this study was to analyze the operator radiation exposure (ORE) and the image quality in a coronary angiography (CA) of the standard left lateral view (LLV) and compare it with an alternative right lateral view (RLV). BACKGROUND Interventional cardiologists are exposed to high doses of scatter radiation, especially in angulated projections. METHODS We prospectively included consecutive patients who underwent diagnostic CA. A standard +90° LLV and an alternative RLV (-90°) were done in each patient with the same protocol. The operator effective dose rate (mSv/h) was determined for each projection with digital dosimeters located in the collar, waist and knee. The image quality of both the LLV and RLV was analyzed and compared to a standard projection. RESULTS 116 patients were enrolled; left coronary artery (LCA) was assessed in 52 patients and right coronary artery (RCA) in 64 patients. The ORE was significantly lower with the RLV compared to the conventional LLV with a maximum ORE reduction of 91.5% in the operator waist (LLV: 6.84 mSv h-1 versus RLV: 0.58 mSv h-1, p < 0.001). No significant differences in image quality were observed for the RCA in both projections. For the LCA, a slight loss of quality was observed with the RLV. CONCLUSIONS -90° RLV is associated with a significant decrease in ORE compared to the conventional +90° LLV without losing image resolution for the RCA and resulting in a slight quality loss for the LCA evaluation. The RLV should be the first choice for RCA evaluation. For the LCA, the RLV loss of resolution should be balanced with the benefit of minimizing ORE, mainly in cases with long fluoroscopy times, such as complex percutaneous coronary interventional procedures.
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de la Torre Hernandez J, Rumoroso J, Subinas A, Gonzalo N, Ojeda S, Pan M, Martín Yuste V, Suárez A, Hernández F, Teruel L, Moreu J, Cubero J, Cascón J, Vinhas H, Lozano Í, Martin Moreiras J, Pérez de Prado A, Goicolea J, Escaned J. Percutaneous intervention in chronic total coronary occlusions caused by in-stent restenosis: procedural results and long-term clinical outcomes in the TORO (Spanish registry of chronic TOtal occlusion secondary to an occlusive in-stent RestenOsis) multicentre registry. EUROINTERVENTION 2017; 13:e219-e226. [DOI: 10.4244/eij-d-16-00764] [Citation(s) in RCA: 22] [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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Cruz-González I, Freixa X, Fernández-Díaz JA, Moreno-Samos JC, Martín-Yuste V, Goicolea J. Left Atrial Appendage Occlusion With the LAmbre Device: Initial Experience. ACTA ACUST UNITED AC 2017; 71:755-756. [PMID: 28522304 DOI: 10.1016/j.rec.2017.04.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 02/27/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Ignacio Cruz-González
- Servicio de Cardiología, Hospital Universitario de Salamanca, IBSAL, Salamanca, Spain.
| | - Xavier Freixa
- Servicio de Cardiología, Hospital Clínic, Barcelona, Spain
| | | | | | | | - Javier Goicolea
- Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
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García del Blanco B, Jiménez Quevedo P, Diaz J, Hernández F, Rumoroso J, Sabaté M, de la Torre Hernandez JM, Serrador A, Pérez de Prado A, Goicolea J, Trillo R, Pan M. Spain: coronary and structural heart interventions from 2010 to 2015. EUROINTERVENTION 2017; 13:Z64-Z69. [DOI: 10.4244/eij-d-16-00834] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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García E, Arzamendi D, Jimenez-Quevedo P, Sarnago F, Martí G, Sanchez-Recalde A, Lasa-Larraya G, Sancho M, Iñiguez A, Goicolea J, Garcia-San Roman K, Alonso-Briales JH, Molina E, Calabuig J, Freixa X, Berenguer A, Valdes-Chavarri M, Vazquez N, Diaz JF, Cruz-Gonzalez I. Outcomes and predictors of success and complications for paravalvular leak closure: an analysis of the SpanisH real-wOrld paravalvular LEaks closure (HOLE) registry. EUROINTERVENTION 2017; 12:1962-1968. [DOI: 10.4244/eij-d-16-00581] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [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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García-Touchard A, Goicolea J, Sabaté M, Alfonso F, Ruiz-Salmerón R, Bethencourt A, Gonzalo N, Miranda F, García del Blanco B, Jiménez-Mazuecos J, Melgares R, Martínez-Romero P, Hernandez-García J, Lezaún R, Bullones J, Fernández-Portales J, Rumoroso J, Ortas R, Valdés M, Trillo R, Brugaletta S, Otzuki S, Hernández Pérez FJ, Alonso-Pulpón L. A randomised trial of paclitaxel-eluting balloon after bare metal stent implantation vs. bare metal stent in ST-elevation myocardial infarction (the PEBSI study). EUROINTERVENTION 2017; 12:1587-1594. [DOI: 10.4244/eij-d-16-00128] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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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Zeng Y, Cavalcante R, Tenekecioglu E, Suwannasom P, Sotomi Y, Collet C, Abdelghani M, Jonker H, Digne F, Horstkotte D, Zehender M, Indolfi C, Saia F, Fiorilli R, Chevalier B, Bolognese L, Goicolea J, Nie S, Onuma Y, Serruys PW. Comparative assessment of "plaque/media" change on three modalities of IVUS immediately after implantation of either everolimus-eluting bioresorbable vascular scaffold or everolimus-eluting metallic stent in Absorb II study. Int J Cardiovasc Imaging 2016; 33:441-449. [PMID: 28012050 PMCID: PMC5357282 DOI: 10.1007/s10554-016-1033-7] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 11/23/2016] [Indexed: 01/23/2023]
Abstract
The purpose of the study to assess the comparability of immediate changes in plaque/media volume (PV) on three modalities of intravascular ultrasound (IVUS) after implantation of either bioresorbable vascular scaffold (BVS) or everolimus-eluting metallic stent (EES) in Absorb II Study. The two devices have different device volume and ultrasound backscattering that may interfere with the “plaque/media” assessed by three modalities on IVUS: grayscale, backscattering of radiofrequency and brightness function. In a multicenter randomized controlled trial, 501 patients with stable or unstable angina underwent documentary IVUS pre- and post- implantation. The change in plaque/media volume (PV) was categorized into three groups according to the relative PV change in device segment: PV “increased” >+5% (PVI), PV unchanged ±5% (PVU), and PV decreased <−5% (PVD). The change in PV was re-evaluated three times: after subtraction of theoretical device volume, after analysis of echogenicity based on brightness function. In 449 patients, 483 lesions were analyzed pre- and post-implantation. “PVI” was more frequently observed in BVS (53.8%) than EES group (39.4%), p = 0.006. After subtraction of the theoretical device volume, the frequency of “PVI” decreased in both BVS (36.2%) and EES (32.1%) groups and became comparable (p = 0.581). In addition, the percentage of “PVI” was further reduced in both device groups after correction for either radiofrequency backscattering (BVS 34.4% vs. EES 22.6%) or echogenicity (BVS 25.2% vs. EES 9.7%). PV change in device segment was differently affected by BVS and EES devices implantation due to their differences in device volume and ultrasound backscattering. It implies that the lumen volume was also artifactually affected by the type of device implanted. Comparative IVUS assessment of lumen and plaque/media volume changes following implantation of BVS and EES requires specific methodological adjustment.
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Affiliation(s)
- Yaping Zeng
- ThoraxCentre, Erasmus Medical Center, Rotterdam, The Netherlands.,The Emergency & Critical Care Center of Beijing Anzhen Hospital, Capital Medical University, Beijing, People's Republic of China
| | | | | | | | - Yohei Sotomi
- Academic Medical Center, Amsterdam, The Netherlands
| | | | | | | | - Franck Digne
- The Cardiology Department, Centre Cardiologique du Nord, Saint Denis, France
| | - Dieter Horstkotte
- The Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany
| | - Manfred Zehender
- Department of Cardiology and Angiology, Heart Center University of Freiburg, Freiburg, Germany
| | - Ciro Indolfi
- Division of Cardiology, Department of Medical and Surgical Sciences, University Magna Graecia, Campus di Germaneto, Catanzaro, Italy
| | - Francesco Saia
- Cardiology Institute, Policlinico S. Orsola-Malpighi, University of Bologna, Bologna, Italy
| | | | | | - Leonardo Bolognese
- Cardiovascular and Neurological Department, Azienda Ospedaliera Arezzo, Arezzo, Italy
| | - Javier Goicolea
- Department of Interventional Cardiology, Puerta de Hierro University Hospital, Madrid, Spain
| | - Shaoping Nie
- The Emergency & Critical Care Center of Beijing Anzhen Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Yoshinobu Onuma
- ThoraxCentre, Erasmus Medical Center, Rotterdam, The Netherlands.,Cardialysis BV, Rotterdam, The Netherlands
| | - Patrick W Serruys
- International Centre for Circulatory Health, Imperial College London, South Kensington Campus, London, SW7 2AZ, UK. .,, Westblaak 98, 3012KM, Rotterdam, The Netherlands.
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slagboom T, Haude M, Lefevre T, Hayek S, Stangl K, Neumann FJ, Salmeron R, Sabate M, Richardt G, Merkely B, Goicolea J, Bilger J, barragan P, Waksman R, Windecker S. TCT-448 BIOTRONIK-Safety and Clinical Performance of the Drug Eluting Orsiro Stent in the Treatment of Subjects With Single De Novo Coronary Artery Lesions-II (BIOFLOW-II) – 4 Year Clinical Results. J Am Coll Cardiol 2016. [DOI: 10.1016/j.jacc.2016.09.584] [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: 10/20/2022]
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Tuñón J, González-Hernández I, Llanos-Jiménez L, Alonso-Martín J, Escudier-Villa JM, Tarín N, Cristóbal C, Sanz P, Pello AM, Aceña Á, Carda R, Orejas M, Tomás M, Beltrán P, Calero Rueda M, Marcos E, Serrano-Antolín JM, Gutiérrez-Landaluce C, Jiménez R, Cabezudo J, Curcio A, Peces-Barba G, González-Parra E, Muñoz-Siscart R, González-Casaus ML, Lorenzo A, Huelmos A, Goicolea J, Ibáñez B, Hernández G, Alonso-Pulpón LM, Farré J, Lorenzo Ó, Mahíllo-Fernández I, Egido J. Design and rationale of a multicentre, randomised, double-blind, placebo-controlled clinical trial to evaluate the effect of vitamin D on ventricular remodelling in patients with anterior myocardial infarction: the VITamin D in Acute Myocardial Infarction (VITDAMI) trial. BMJ Open 2016; 6:e011287. [PMID: 27496232 PMCID: PMC4985833 DOI: 10.1136/bmjopen-2016-011287] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Decreased plasma vitamin D (VD) levels are linked to cardiovascular damage. However, clinical trials have not demonstrated a benefit of VD supplements on left ventricular (LV) remodelling. Anterior ST-elevation acute myocardial infarction (STEMI) is the best human model to study the effect of treatments on LV remodelling. We present a proof-of-concept study that aims to investigate whether VD improves LV remodelling in patients with anterior STEMI. METHODS AND ANALYSIS The VITamin D in Acute Myocardial Infarction (VITDAMI) trial is a multicentre, randomised, double-blind, placebo-controlled trial. 144 patients with anterior STEMI will be assigned to receive calcifediol 0.266 mg capsules (Hidroferol SGC)/15 days or placebo on a 2:1 basis during 12 months. PRIMARY OBJECTIVE to evaluate the effect of calcifediol on LV remodelling defined as an increase in LV end-diastolic volume ≥10% (MRI). SECONDARY OBJECTIVES change in LV end-diastolic and end-systolic volumes, ejection fraction, LV mass, diastolic function, sphericity index and size of fibrotic area; endothelial function; plasma levels of aminoterminal fragment of B-type natriuretic peptide, galectin-3 and monocyte chemoattractant protein-1; levels of calcidiol (VD metabolite) and other components of mineral metabolism (fibroblast growth factor-23 (FGF-23), the soluble form of its receptor klotho, parathormone and phosphate). Differences in the effect of VD will be investigated according to the plasma levels of FGF-23 and klotho. Treatment safety and tolerability will be assessed. This is the first study to evaluate the effect of VD on cardiac remodelling in patients with STEMI. ETHICS AND DISSEMINATION This trial has been approved by the corresponding Institutional Review Board (IRB) and National Competent Authority (Agencia Española de Medicamentos y Productos Sanitarios (AEMPS)). It will be conducted in accordance with good clinical practice (International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use - Good Clinical Practice (ICH-GCP)) requirements, ethical principles of the Declaration of Helsinki and national laws. The results will be submitted to indexed medical journals and national and international meetings. TRIAL REGISTRATION NUMBER NCT02548364; Pre-results.
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Affiliation(s)
- José Tuñón
- Department of Cardiology, Fundación Jiménez Díaz, Madrid, Spain
- Department of Medicine, Autónoma University, Madrid, Spain
- Vascular Research Laboratory, IIS-Fundación Jiménez Díaz, Madrid, Spain
| | | | | | - Joaquín Alonso-Martín
- Department of Cardiology, University Hospital of Getafe, Madrid, Spain
- Department of Medicine, Rey Juan Carlos University, Alcorcón, Spain
| | | | - Nieves Tarín
- Department of Cardiology, University Hospital of Móstoles, Móstoles, Spain
| | - Carmen Cristóbal
- Department of Medicine, Rey Juan Carlos University, Alcorcón, Spain
- Department of Cardiology, Hospital de Fuenlabrada, Madrid, Spain
| | - Petra Sanz
- Department of Medicine, Rey Juan Carlos University, Alcorcón, Spain
- Department of Cardiology, Hospital Rey Juan Carlos, Madrid, Spain
| | - Ana M Pello
- Department of Cardiology, Fundación Jiménez Díaz, Madrid, Spain
| | - Álvaro Aceña
- Department of Cardiology, Fundación Jiménez Díaz, Madrid, Spain
| | - Rocío Carda
- Department of Cardiology, Fundación Jiménez Díaz, Madrid, Spain
| | - Miguel Orejas
- Department of Cardiology, Fundación Jiménez Díaz, Madrid, Spain
| | - Marta Tomás
- Department of Radiology, Fundación Jiménez Díaz, Madrid, Spain
| | - Paula Beltrán
- Department of Cardiology, Fundación Jiménez Díaz, Madrid, Spain
| | | | - Esther Marcos
- Department of Cardiology, University Hospital of Móstoles, Móstoles, Spain
| | | | | | - Rosa Jiménez
- Department of Cardiology, Hospital de Fuenlabrada, Madrid, Spain
| | - Jorge Cabezudo
- Department of Cardiology, Hospital de Fuenlabrada, Madrid, Spain
| | - Alejandro Curcio
- Department of Cardiology, Hospital de Fuenlabrada, Madrid, Spain
| | - Germán Peces-Barba
- Department of Medicine, Autónoma University, Madrid, Spain
- Department of Pneumology, Fundación Jiménez Díaz, Madrid, Spain
| | - Emilio González-Parra
- Department of Medicine, Autónoma University, Madrid, Spain
- Department of Nephrology, Fundación Jiménez Díaz, Madrid, Spain
| | | | | | - Antonio Lorenzo
- Department of Cardiology, University Hospital of Móstoles, Móstoles, Spain
| | - Ana Huelmos
- Department of Cardiology, Fundación Hospital Alcorcón, Madrid, Spain
| | - Javier Goicolea
- Department of Cardiology, University Hospital Puerta de Hierro, Madrid, Spain
| | - Borja Ibáñez
- Department of Cardiology, Fundación Jiménez Díaz, Madrid, Spain
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain
| | | | - Luis M Alonso-Pulpón
- Department of Medicine, Autónoma University, Madrid, Spain
- Department of Cardiology, University Hospital Puerta de Hierro, Madrid, Spain
| | - Jerónimo Farré
- Department of Cardiology, Fundación Jiménez Díaz, Madrid, Spain
- Department of Medicine, Autónoma University, Madrid, Spain
| | - Óscar Lorenzo
- Department of Medicine, Autónoma University, Madrid, Spain
- Vascular Research Laboratory, IIS-Fundación Jiménez Díaz, Madrid, Spain
| | | | - Jesús Egido
- Department of Medicine, Autónoma University, Madrid, Spain
- Vascular Research Laboratory, IIS-Fundación Jiménez Díaz, Madrid, Spain
- Department of Nephrology, Fundación Jiménez Díaz, Madrid, Spain
- CIBERDEM, Madrid, Spain
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Gilard M, Schlüter M, Snow TM, Dall’Ara G, Eltchaninoff H, Moat N, Goicolea J, Ussia GP, Kala P, Wenaweser P, Zembala M, Nickenig G, Price S, Alegria Barrero E, Iung B, Zamorano P, Schuler G, Corti R, Alfieri O, Prendergast B, Ludman P, Windecker S, Sabate M, Witkowski A, Danenberg H, Schroeder E, Romeo F, Macaya C, Derumeaux G, Laroche C, Pighi M, Serdoz R, Di Mario C. The 2011-2012 pilot European Society of Cardiology Sentinel Registry of Transcatheter Aortic Valve Implantation: 12-month clinical outcomes. EUROINTERVENTION 2016; 12:79-87. [DOI: 10.4244/eijv12i1a15] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [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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Roolvink V, Ibáñez B, Ottervanger JP, Pizarro G, van Royen N, Mateos A, Dambrink JHE, Escalera N, Lipsic E, Albarran A, Fernández-Ortiz A, Fernández-Avilés F, Goicolea J, Botas J, Remkes W, Hernandez-Jaras V, Kedhi E, Zamorano JL, Navarro F, Alfonso F, García-Lledó A, Alonso J, van Leeuwen M, Nijveldt R, Postma S, Kolkman E, Gosselink M, de Smet B, Rasoul S, Piek JJ, Fuster V, van 't Hof AWJ. Early Intravenous Beta-Blockers in Patients With ST-Segment Elevation Myocardial Infarction Before Primary Percutaneous Coronary Intervention. J Am Coll Cardiol 2016; 67:2705-2715. [PMID: 27050189 DOI: 10.1016/j.jacc.2016.03.522] [Citation(s) in RCA: 115] [Impact Index Per Article: 14.4] [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: 03/17/2016] [Revised: 03/24/2016] [Accepted: 03/24/2016] [Indexed: 01/11/2023]
Abstract
BACKGROUND The impact of intravenous (IV) beta-blockers before primary percutaneous coronary intervention (PPCI) on infarct size and clinical outcomes is not well established. OBJECTIVES This study sought to conduct the first double-blind, placebo-controlled international multicenter study testing the effect of early IV beta-blockers before PPCI in a general ST-segment elevation myocardial infarction (STEMI) population. METHODS STEMI patients presenting <12 h from symptom onset in Killip class I to II without atrioventricular block were randomized 1:1 to IV metoprolol (2 × 5-mg bolus) or matched placebo before PPCI. Primary endpoint was myocardial infarct size as assessed by cardiac magnetic resonance imaging (CMR) at 30 days. Secondary endpoints were enzymatic infarct size and incidence of ventricular arrhythmias. Safety endpoints included symptomatic bradycardia, symptomatic hypotension, and cardiogenic shock. RESULTS A total of 683 patients (mean age 62 ± 12 years; 75% male) were randomized to metoprolol (n = 336) or placebo (n = 346). CMR was performed in 342 patients (54.8%). Infarct size (percent of left ventricle [LV]) by CMR did not differ between the metoprolol (15.3 ± 11.0%) and placebo groups (14.9 ± 11.5%; p = 0.616). Peak and area under the creatine kinase curve did not differ between both groups. LV ejection fraction by CMR was 51.0 ± 10.9% in the metoprolol group and 51.6 ± 10.8% in the placebo group (p = 0.68). The incidence of malignant arrhythmias was 3.6% in the metoprolol group versus 6.9% in placebo (p = 0.050). The incidence of adverse events was not different between groups. CONCLUSIONS In a nonrestricted STEMI population, early intravenous metoprolol before PPCI was not associated with a reduction in infarct size. Metoprolol reduced the incidence of malignant arrhythmias in the acute phase and was not associated with an increase in adverse events. (Early-Beta blocker Administration before reperfusion primary PCI in patients with ST-elevation Myocardial Infarction [EARLY-BAMI]; EudraCT no: 2010-023394-19).
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Affiliation(s)
- Vincent Roolvink
- Department of Cardiology, Isala Hospital, Zwolle, the Netherlands
| | - Borja Ibáñez
- Department of Cardiology, Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain; Department of Cardiology, IIS-Fundacion Jimenez Díaz Hospital, Madrid, Spain
| | | | - Gonzalo Pizarro
- Department of Cardiology, Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain; Department of Cardiology, Hospital Universitario Quirón, Universidad Europea de Madrid & Hospital Ruber-Quirónsalud, Madrid, Spain
| | - Niels van Royen
- Department of Cardiology, VU University Medical Center, Amsterdam, the Netherlands
| | - Alonso Mateos
- Department of Cardiology, Servicio de Urgencia Medica de Madrid (SUMMA 112), Madrid, Spain
| | | | - Noemi Escalera
- Department of Cardiology, Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain
| | - Erik Lipsic
- Department of Cardiology, University Medical Center Groningen, Groningen, the Netherlands
| | - Agustín Albarran
- Department of Cardiology, Codigo Infarto, Madrid, Spain; Department of Cardiology, Hospital 12 de Octubre, Madrid, Spain
| | - Antonio Fernández-Ortiz
- Department of Cardiology, Codigo Infarto, Madrid, Spain; Department of Cardiology, Hospital Clínico San Carlos, Madrid, Spain
| | - Francisco Fernández-Avilés
- Department of Cardiology, Codigo Infarto, Madrid, Spain; Department of Cardiology, Hospital Gregorio Marañón, Madrid, Spain
| | - Javier Goicolea
- Department of Cardiology, Codigo Infarto, Madrid, Spain; Department of Cardiology, Hospital Puerta de Hierro, Madrid, Spain
| | - Javier Botas
- Department of Cardiology, Codigo Infarto, Madrid, Spain; Department of Cardiology, Hospital Fundación Alcorcón, Madrid, Spain
| | - Wouter Remkes
- Department of Cardiology, Isala Hospital, Zwolle, the Netherlands
| | | | - Elvin Kedhi
- Department of Cardiology, Isala Hospital, Zwolle, the Netherlands
| | - José L Zamorano
- Department of Cardiology, Codigo Infarto, Madrid, Spain; Department of Cardiology, Hospital Ramón y Cajal, Madrid, Spain
| | - Felipe Navarro
- Department of Cardiology, IIS-Fundacion Jimenez Díaz Hospital, Madrid, Spain; Department of Cardiology, Codigo Infarto, Madrid, Spain
| | - Fernando Alfonso
- Department of Cardiology, Codigo Infarto, Madrid, Spain; Department of Cardiology, Hospital de La Princesa, Madrid, Spain
| | - Alberto García-Lledó
- Department of Cardiology, Codigo Infarto, Madrid, Spain; Department of Cardiology, Hospital Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | - Joaquin Alonso
- Department of Cardiology, Codigo Infarto, Madrid, Spain; Department of Cardiology, Hospital de Getafe, Madrid, Spain
| | - Maarten van Leeuwen
- Department of Cardiology, VU University Medical Center, Amsterdam, the Netherlands
| | - Robin Nijveldt
- Department of Cardiology, VU University Medical Center, Amsterdam, the Netherlands
| | - Sonja Postma
- Diagram, Diagnostic Research and Management, Zwolle, the Netherlands
| | - Evelien Kolkman
- Diagram, Diagnostic Research and Management, Zwolle, the Netherlands
| | - Marcel Gosselink
- Department of Cardiology, Isala Hospital, Zwolle, the Netherlands
| | - Bart de Smet
- Department of Cardiology, Meander Medisch Centrum, Amersfoort, the Netherlands
| | - Saman Rasoul
- Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Jan J Piek
- Department of Cardiology, Academic Medical Center, Amsterdam, the Netherlands
| | - Valentin Fuster
- Department of Cardiology, Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain; The Zena and Michael A Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York
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Sánchez RM, Vano E, Fernández JM, Pifarré X, Ordiales JM, Rovira JJ, Carrera F, Goicolea J, Fernández-Ortiz A. Occupational eye lens doses in interventional cardiology. A multicentric study. J Radiol Prot 2016; 36:133-143. [PMID: 26861214 DOI: 10.1088/0952-4746/36/1/133] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
New European regulation regarding radiological protection of workers and more specifically the new occupational dose limit for the eye lens recently reduced to 20 mSv yr(-1) may affect interventional cardiologists. This paper presents a set of measurements of occupational doses performed in five interventional cardiology centres and then compared with the new dose limit. The measurement of occupational doses was performed over the apron at chest level using electronic dosemeters recording H p(10). In one of the centres, scatter dose at goggles was also measured with optically stimulated luminescence dosemeters calibrated in terms of H p(0.07). An average H p(10) over the apron of 46 μSv/procedure was measured for cardiologists. Lower doses were noted in other professionals like second cardiologists, nurses or anaesthetists. Procedures for valvular and other structural heart diseases involved the highest occupational doses, averaging over 100 μSv/procedure. Important differences in occupational doses among centres may be indicative of different radiation protection habits. The new occupational dose limit for the eye lens is likely to be exceeded by those among the interventionalists who do not use protection tools (ceiling suspended screen and/or goggles) even with standard workloads.
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Affiliation(s)
- R M Sánchez
- Medical Physics, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
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Naranjo Gómez JM, Valdivia Concha D, Servent P, Goicolea J. Use of an Amplatzer® device in a patient with pulmonary sequestration. EUROINTERVENTION 2015; 11:e1-2. [PMID: 26696319 DOI: 10.4244/eijv11i8a193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jose M Naranjo Gómez
- Department of Thoracic Surgery, Puerta de Hierro University Hospital, Madrid, Spain
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48
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Regueiro A, Bosch J, Martín-Yuste V, Rosas A, Faixedas MT, Gómez-Hospital JA, Figueras J, Curós A, Cequier A, Goicolea J, Fernández-Ortiz A, Macaya C, Tresserras R, Pellisé L, Sabaté M. Cost-effectiveness of a European ST-segment elevation myocardial infarction network: results from the Catalan Codi Infart network. BMJ Open 2015; 5:e009148. [PMID: 26656019 PMCID: PMC4679883 DOI: 10.1136/bmjopen-2015-009148] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To evaluate the cost-effectiveness of the ST-segment elevation myocardial infarction (STEMI) network of Catalonia (Codi Infart). DESIGN Cost-utility analysis. SETTING The analysis was from the Catalonian Autonomous Community in Spain, with a population of about 7.5 million people. PARTICIPANTS Patients with STEMI treated within the autonomous community of Catalonia (Spain) included in the IAM CAT II-IV and Codi Infart registries. OUTCOME MEASURES Costs included hospitalisation, procedures and additional personnel and were obtained according to the reperfusion strategy. Clinical outcomes were defined as 30-day avoided mortality and quality-adjusted life-years (QALYs), before (N=356) and after network implementation (N=2140). RESULTS A substitution effect and a technology effect were observed; aggregate costs increased by 2.6%. The substitution effect resulted from increased use of primary coronary angioplasty, a relatively expensive procedure and a decrease in fibrinolysis. Primary coronary angioplasty increased from 31% to 89% with the network, and fibrinolysis decreased from 37% to 3%. Rescue coronary angioplasty declined from 11% to 4%, and no reperfusion from 21% to 4%. The technological effect was related to improvements in the percutaneous coronary intervention procedure that increased efficiency, reducing the average length of the hospital stay. Mean costs per patient decreased from €8306 to €7874 for patients with primary coronary angioplasty. Clinical outcomes in patients treated with primary coronary angioplasty did not change significantly, although 30-day mortality decreased from 7.5% to 5.6%. The incremental cost-effectiveness ratio resulted in an extra cost of €4355 per life saved (30-day mortality) and €495 per QALY. Below a cost threshold of €30,000, results were sensitive to variations in costs and outcomes. CONCLUSIONS The Catalan STEMI network (Codi Infart) is cost-efficient. Further studies are needed in geopolitical different scenarios.
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Affiliation(s)
- Ander Regueiro
- Servicio de Cardiología, Hospital Clínic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer IDIBAPS, Universitat de Barcelona, Barcelona, Spain
- Iniciativa Stent for Life, Spain
| | - Julia Bosch
- Centro de Investigación en Economía y Salud, Universidad Pompeu Fabra, Barcelona, Spain
| | - Victoria Martín-Yuste
- Servicio de Cardiología, Hospital Clínic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - Alba Rosas
- Departament de Salut, Generalitat de Catalunya, Catalonia, Spain
| | | | | | - Jaume Figueras
- Servicio de Cardiología, Hospital Vall d´Hebron, Barcelona, Spain
| | - Antoni Curós
- Servicio de Cardiología, Hospital Universitario Germans Trias i Pujol, Badalona, Spain
| | - Angel Cequier
- Servicio de Cardiología, Hospital Universitari Bellvitge, Barcelona, Spain
| | | | | | | | | | - Laura Pellisé
- Centro de Investigación en Economía y Salud, Universidad Pompeu Fabra, Barcelona, Spain
| | - Manel Sabaté
- Servicio de Cardiología, Hospital Clínic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer IDIBAPS, Universitat de Barcelona, Barcelona, Spain
- Iniciativa Stent for Life, Spain
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Windecker S, Haude M, Neumann FJ, Stangl K, Witzenbichler B, Slagboom T, Sabaté M, Goicolea J, Barragan P, Cook S, Piot C, Richardt G, Merkely B, Schneider H, Bilger J, Erne P, Waksman R, Zaugg S, Jüni P, Lefèvre T. Comparison of a novel biodegradable polymer sirolimus-eluting stent with a durable polymer everolimus-eluting stent: results of the randomized BIOFLOW-II trial. Circ Cardiovasc Interv 2015; 8:e001441. [PMID: 25634905 DOI: 10.1161/circinterventions.114.001441] [Citation(s) in RCA: 152] [Impact Index Per Article: 16.9] [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: 01/15/2023]
Abstract
BACKGROUND Biodegradable polymers for release of antiproliferative drugs from drug-eluting stents aim to improve vascular healing. We assessed noninferiority of a novel ultrathin strut drug-eluting stent releasing sirolimus from a biodegradable polymer (Orsiro, O-SES) compared with the durable polymer Xience Prime everolimus-eluting stent (X-EES) in terms of the primary end point in-stent late lumen loss at 9 months. METHODS AND RESULTS A total of 452 patients were randomly assigned 2:1 to treatment with O-SES (298 patients, 332 lesions) or X-EES (154 patients, 173 lesions) in a multicenter, noninferiority trial. The primary end point was in-stent late loss at 9 months. O-SES was noninferior to X-EES for the primary end point (0.10±0.32 versus 0.11±0.29 mm; difference=0.00063 mm; 95% confidence interval, -0.06 to 0.07; Pnoninferiority<0.0001). Clinical outcome showed similar rates of target-lesion failure at 1 year (O-SES 6.5% versus X-EES 8.0%; hazard ratio=0.82; 95% confidence interval, 0.40-1.68; log-rank test: P=0.58) without cases of stent thrombosis. A subgroup of patients (n=55) underwent serial optical coherence tomography at 9 months, which demonstrated similar neointimal thickness among lesions allocated to O-SES and X-EES (0.10±0.04 mm versus 0.11±0.04 mm; -0.01 [-0.04, -0.01]; P=0.37). Another subgroup of patients (n=56) underwent serial intravascular ultrasound at baseline and 9 months indicating a potential difference in neointimal area at follow-up (O-SES, 0.16±0.33 mm(2) versus X-EES, 0.43±0.56 mm(2); P=0.04). CONCLUSIONS Compared with durable polymer X-EES, novel biodegradable polymer-based O-SES was found noninferior for the primary end point in-stent late lumen loss at 9 months. Clinical event rates were comparable without cases of stent thrombosis throughout 1 year of follow-up. CLINICAL TRIAL REGISTRATION URL http://www.clinicaltrials.gov. Unique identifier: NCT01356888.
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Affiliation(s)
- Stephan Windecker
- From the Department of Cardiology, Bern University Hospital, Bern, Switzerland (S.W.); Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany (M.H.); Universitäts-Herzzentrum Freiburg-Bad Krozingen, Bad Krozingen, Germany (F.-J.N.); Charité-Campus Mitte, Berlin, Germany (K.S.); Charité Campus Benjamin Franklin, Berlin, Germany (B.W.); Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands (T.S.); Hospital Clínic, Thorax Institute, Barcelona, Spain (M.S.); IDIBAPS, University of Barcelona, Barcelona, Spain (M.S.); Hospital Puerta de Hierro, Madrid, Spain (J.G.); Polyclinique les Fleurs, Ollioules, France (P.B.); Hospital and University Fribourg, Switzerland (S.C.); University of Montpellier, Montpellier Cedex 5, France (C.P.); Segeberger Kliniken, Bad Segeberg, Germany (G.R.); Semmelweis University Heart and Vascular Center, Budapest, Hungary (B.M.); Universitätsklinikum Rostock, Rostock, Germany (H.S.); Klinikum Nürnberg Süd, Nürnberg, Germany (J.B.); Lucerne Canton Hospital, Lucerne, Switzerland (P.E.); MedStar Health Research Institute, Washington, DC (R.W.); Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland (S.Z., P.J.); and ICPS, Massy, France (T.L.).
| | - Michael Haude
- From the Department of Cardiology, Bern University Hospital, Bern, Switzerland (S.W.); Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany (M.H.); Universitäts-Herzzentrum Freiburg-Bad Krozingen, Bad Krozingen, Germany (F.-J.N.); Charité-Campus Mitte, Berlin, Germany (K.S.); Charité Campus Benjamin Franklin, Berlin, Germany (B.W.); Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands (T.S.); Hospital Clínic, Thorax Institute, Barcelona, Spain (M.S.); IDIBAPS, University of Barcelona, Barcelona, Spain (M.S.); Hospital Puerta de Hierro, Madrid, Spain (J.G.); Polyclinique les Fleurs, Ollioules, France (P.B.); Hospital and University Fribourg, Switzerland (S.C.); University of Montpellier, Montpellier Cedex 5, France (C.P.); Segeberger Kliniken, Bad Segeberg, Germany (G.R.); Semmelweis University Heart and Vascular Center, Budapest, Hungary (B.M.); Universitätsklinikum Rostock, Rostock, Germany (H.S.); Klinikum Nürnberg Süd, Nürnberg, Germany (J.B.); Lucerne Canton Hospital, Lucerne, Switzerland (P.E.); MedStar Health Research Institute, Washington, DC (R.W.); Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland (S.Z., P.J.); and ICPS, Massy, France (T.L.)
| | - Franz-Josef Neumann
- From the Department of Cardiology, Bern University Hospital, Bern, Switzerland (S.W.); Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany (M.H.); Universitäts-Herzzentrum Freiburg-Bad Krozingen, Bad Krozingen, Germany (F.-J.N.); Charité-Campus Mitte, Berlin, Germany (K.S.); Charité Campus Benjamin Franklin, Berlin, Germany (B.W.); Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands (T.S.); Hospital Clínic, Thorax Institute, Barcelona, Spain (M.S.); IDIBAPS, University of Barcelona, Barcelona, Spain (M.S.); Hospital Puerta de Hierro, Madrid, Spain (J.G.); Polyclinique les Fleurs, Ollioules, France (P.B.); Hospital and University Fribourg, Switzerland (S.C.); University of Montpellier, Montpellier Cedex 5, France (C.P.); Segeberger Kliniken, Bad Segeberg, Germany (G.R.); Semmelweis University Heart and Vascular Center, Budapest, Hungary (B.M.); Universitätsklinikum Rostock, Rostock, Germany (H.S.); Klinikum Nürnberg Süd, Nürnberg, Germany (J.B.); Lucerne Canton Hospital, Lucerne, Switzerland (P.E.); MedStar Health Research Institute, Washington, DC (R.W.); Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland (S.Z., P.J.); and ICPS, Massy, France (T.L.)
| | - Karl Stangl
- From the Department of Cardiology, Bern University Hospital, Bern, Switzerland (S.W.); Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany (M.H.); Universitäts-Herzzentrum Freiburg-Bad Krozingen, Bad Krozingen, Germany (F.-J.N.); Charité-Campus Mitte, Berlin, Germany (K.S.); Charité Campus Benjamin Franklin, Berlin, Germany (B.W.); Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands (T.S.); Hospital Clínic, Thorax Institute, Barcelona, Spain (M.S.); IDIBAPS, University of Barcelona, Barcelona, Spain (M.S.); Hospital Puerta de Hierro, Madrid, Spain (J.G.); Polyclinique les Fleurs, Ollioules, France (P.B.); Hospital and University Fribourg, Switzerland (S.C.); University of Montpellier, Montpellier Cedex 5, France (C.P.); Segeberger Kliniken, Bad Segeberg, Germany (G.R.); Semmelweis University Heart and Vascular Center, Budapest, Hungary (B.M.); Universitätsklinikum Rostock, Rostock, Germany (H.S.); Klinikum Nürnberg Süd, Nürnberg, Germany (J.B.); Lucerne Canton Hospital, Lucerne, Switzerland (P.E.); MedStar Health Research Institute, Washington, DC (R.W.); Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland (S.Z., P.J.); and ICPS, Massy, France (T.L.)
| | - Bernhard Witzenbichler
- From the Department of Cardiology, Bern University Hospital, Bern, Switzerland (S.W.); Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany (M.H.); Universitäts-Herzzentrum Freiburg-Bad Krozingen, Bad Krozingen, Germany (F.-J.N.); Charité-Campus Mitte, Berlin, Germany (K.S.); Charité Campus Benjamin Franklin, Berlin, Germany (B.W.); Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands (T.S.); Hospital Clínic, Thorax Institute, Barcelona, Spain (M.S.); IDIBAPS, University of Barcelona, Barcelona, Spain (M.S.); Hospital Puerta de Hierro, Madrid, Spain (J.G.); Polyclinique les Fleurs, Ollioules, France (P.B.); Hospital and University Fribourg, Switzerland (S.C.); University of Montpellier, Montpellier Cedex 5, France (C.P.); Segeberger Kliniken, Bad Segeberg, Germany (G.R.); Semmelweis University Heart and Vascular Center, Budapest, Hungary (B.M.); Universitätsklinikum Rostock, Rostock, Germany (H.S.); Klinikum Nürnberg Süd, Nürnberg, Germany (J.B.); Lucerne Canton Hospital, Lucerne, Switzerland (P.E.); MedStar Health Research Institute, Washington, DC (R.W.); Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland (S.Z., P.J.); and ICPS, Massy, France (T.L.)
| | - Ton Slagboom
- From the Department of Cardiology, Bern University Hospital, Bern, Switzerland (S.W.); Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany (M.H.); Universitäts-Herzzentrum Freiburg-Bad Krozingen, Bad Krozingen, Germany (F.-J.N.); Charité-Campus Mitte, Berlin, Germany (K.S.); Charité Campus Benjamin Franklin, Berlin, Germany (B.W.); Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands (T.S.); Hospital Clínic, Thorax Institute, Barcelona, Spain (M.S.); IDIBAPS, University of Barcelona, Barcelona, Spain (M.S.); Hospital Puerta de Hierro, Madrid, Spain (J.G.); Polyclinique les Fleurs, Ollioules, France (P.B.); Hospital and University Fribourg, Switzerland (S.C.); University of Montpellier, Montpellier Cedex 5, France (C.P.); Segeberger Kliniken, Bad Segeberg, Germany (G.R.); Semmelweis University Heart and Vascular Center, Budapest, Hungary (B.M.); Universitätsklinikum Rostock, Rostock, Germany (H.S.); Klinikum Nürnberg Süd, Nürnberg, Germany (J.B.); Lucerne Canton Hospital, Lucerne, Switzerland (P.E.); MedStar Health Research Institute, Washington, DC (R.W.); Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland (S.Z., P.J.); and ICPS, Massy, France (T.L.)
| | - Manel Sabaté
- From the Department of Cardiology, Bern University Hospital, Bern, Switzerland (S.W.); Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany (M.H.); Universitäts-Herzzentrum Freiburg-Bad Krozingen, Bad Krozingen, Germany (F.-J.N.); Charité-Campus Mitte, Berlin, Germany (K.S.); Charité Campus Benjamin Franklin, Berlin, Germany (B.W.); Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands (T.S.); Hospital Clínic, Thorax Institute, Barcelona, Spain (M.S.); IDIBAPS, University of Barcelona, Barcelona, Spain (M.S.); Hospital Puerta de Hierro, Madrid, Spain (J.G.); Polyclinique les Fleurs, Ollioules, France (P.B.); Hospital and University Fribourg, Switzerland (S.C.); University of Montpellier, Montpellier Cedex 5, France (C.P.); Segeberger Kliniken, Bad Segeberg, Germany (G.R.); Semmelweis University Heart and Vascular Center, Budapest, Hungary (B.M.); Universitätsklinikum Rostock, Rostock, Germany (H.S.); Klinikum Nürnberg Süd, Nürnberg, Germany (J.B.); Lucerne Canton Hospital, Lucerne, Switzerland (P.E.); MedStar Health Research Institute, Washington, DC (R.W.); Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland (S.Z., P.J.); and ICPS, Massy, France (T.L.)
| | - Javier Goicolea
- From the Department of Cardiology, Bern University Hospital, Bern, Switzerland (S.W.); Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany (M.H.); Universitäts-Herzzentrum Freiburg-Bad Krozingen, Bad Krozingen, Germany (F.-J.N.); Charité-Campus Mitte, Berlin, Germany (K.S.); Charité Campus Benjamin Franklin, Berlin, Germany (B.W.); Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands (T.S.); Hospital Clínic, Thorax Institute, Barcelona, Spain (M.S.); IDIBAPS, University of Barcelona, Barcelona, Spain (M.S.); Hospital Puerta de Hierro, Madrid, Spain (J.G.); Polyclinique les Fleurs, Ollioules, France (P.B.); Hospital and University Fribourg, Switzerland (S.C.); University of Montpellier, Montpellier Cedex 5, France (C.P.); Segeberger Kliniken, Bad Segeberg, Germany (G.R.); Semmelweis University Heart and Vascular Center, Budapest, Hungary (B.M.); Universitätsklinikum Rostock, Rostock, Germany (H.S.); Klinikum Nürnberg Süd, Nürnberg, Germany (J.B.); Lucerne Canton Hospital, Lucerne, Switzerland (P.E.); MedStar Health Research Institute, Washington, DC (R.W.); Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland (S.Z., P.J.); and ICPS, Massy, France (T.L.)
| | - Paul Barragan
- From the Department of Cardiology, Bern University Hospital, Bern, Switzerland (S.W.); Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany (M.H.); Universitäts-Herzzentrum Freiburg-Bad Krozingen, Bad Krozingen, Germany (F.-J.N.); Charité-Campus Mitte, Berlin, Germany (K.S.); Charité Campus Benjamin Franklin, Berlin, Germany (B.W.); Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands (T.S.); Hospital Clínic, Thorax Institute, Barcelona, Spain (M.S.); IDIBAPS, University of Barcelona, Barcelona, Spain (M.S.); Hospital Puerta de Hierro, Madrid, Spain (J.G.); Polyclinique les Fleurs, Ollioules, France (P.B.); Hospital and University Fribourg, Switzerland (S.C.); University of Montpellier, Montpellier Cedex 5, France (C.P.); Segeberger Kliniken, Bad Segeberg, Germany (G.R.); Semmelweis University Heart and Vascular Center, Budapest, Hungary (B.M.); Universitätsklinikum Rostock, Rostock, Germany (H.S.); Klinikum Nürnberg Süd, Nürnberg, Germany (J.B.); Lucerne Canton Hospital, Lucerne, Switzerland (P.E.); MedStar Health Research Institute, Washington, DC (R.W.); Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland (S.Z., P.J.); and ICPS, Massy, France (T.L.)
| | - Stéphane Cook
- From the Department of Cardiology, Bern University Hospital, Bern, Switzerland (S.W.); Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany (M.H.); Universitäts-Herzzentrum Freiburg-Bad Krozingen, Bad Krozingen, Germany (F.-J.N.); Charité-Campus Mitte, Berlin, Germany (K.S.); Charité Campus Benjamin Franklin, Berlin, Germany (B.W.); Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands (T.S.); Hospital Clínic, Thorax Institute, Barcelona, Spain (M.S.); IDIBAPS, University of Barcelona, Barcelona, Spain (M.S.); Hospital Puerta de Hierro, Madrid, Spain (J.G.); Polyclinique les Fleurs, Ollioules, France (P.B.); Hospital and University Fribourg, Switzerland (S.C.); University of Montpellier, Montpellier Cedex 5, France (C.P.); Segeberger Kliniken, Bad Segeberg, Germany (G.R.); Semmelweis University Heart and Vascular Center, Budapest, Hungary (B.M.); Universitätsklinikum Rostock, Rostock, Germany (H.S.); Klinikum Nürnberg Süd, Nürnberg, Germany (J.B.); Lucerne Canton Hospital, Lucerne, Switzerland (P.E.); MedStar Health Research Institute, Washington, DC (R.W.); Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland (S.Z., P.J.); and ICPS, Massy, France (T.L.)
| | - Christophe Piot
- From the Department of Cardiology, Bern University Hospital, Bern, Switzerland (S.W.); Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany (M.H.); Universitäts-Herzzentrum Freiburg-Bad Krozingen, Bad Krozingen, Germany (F.-J.N.); Charité-Campus Mitte, Berlin, Germany (K.S.); Charité Campus Benjamin Franklin, Berlin, Germany (B.W.); Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands (T.S.); Hospital Clínic, Thorax Institute, Barcelona, Spain (M.S.); IDIBAPS, University of Barcelona, Barcelona, Spain (M.S.); Hospital Puerta de Hierro, Madrid, Spain (J.G.); Polyclinique les Fleurs, Ollioules, France (P.B.); Hospital and University Fribourg, Switzerland (S.C.); University of Montpellier, Montpellier Cedex 5, France (C.P.); Segeberger Kliniken, Bad Segeberg, Germany (G.R.); Semmelweis University Heart and Vascular Center, Budapest, Hungary (B.M.); Universitätsklinikum Rostock, Rostock, Germany (H.S.); Klinikum Nürnberg Süd, Nürnberg, Germany (J.B.); Lucerne Canton Hospital, Lucerne, Switzerland (P.E.); MedStar Health Research Institute, Washington, DC (R.W.); Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland (S.Z., P.J.); and ICPS, Massy, France (T.L.)
| | - Gert Richardt
- From the Department of Cardiology, Bern University Hospital, Bern, Switzerland (S.W.); Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany (M.H.); Universitäts-Herzzentrum Freiburg-Bad Krozingen, Bad Krozingen, Germany (F.-J.N.); Charité-Campus Mitte, Berlin, Germany (K.S.); Charité Campus Benjamin Franklin, Berlin, Germany (B.W.); Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands (T.S.); Hospital Clínic, Thorax Institute, Barcelona, Spain (M.S.); IDIBAPS, University of Barcelona, Barcelona, Spain (M.S.); Hospital Puerta de Hierro, Madrid, Spain (J.G.); Polyclinique les Fleurs, Ollioules, France (P.B.); Hospital and University Fribourg, Switzerland (S.C.); University of Montpellier, Montpellier Cedex 5, France (C.P.); Segeberger Kliniken, Bad Segeberg, Germany (G.R.); Semmelweis University Heart and Vascular Center, Budapest, Hungary (B.M.); Universitätsklinikum Rostock, Rostock, Germany (H.S.); Klinikum Nürnberg Süd, Nürnberg, Germany (J.B.); Lucerne Canton Hospital, Lucerne, Switzerland (P.E.); MedStar Health Research Institute, Washington, DC (R.W.); Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland (S.Z., P.J.); and ICPS, Massy, France (T.L.)
| | - Béla Merkely
- From the Department of Cardiology, Bern University Hospital, Bern, Switzerland (S.W.); Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany (M.H.); Universitäts-Herzzentrum Freiburg-Bad Krozingen, Bad Krozingen, Germany (F.-J.N.); Charité-Campus Mitte, Berlin, Germany (K.S.); Charité Campus Benjamin Franklin, Berlin, Germany (B.W.); Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands (T.S.); Hospital Clínic, Thorax Institute, Barcelona, Spain (M.S.); IDIBAPS, University of Barcelona, Barcelona, Spain (M.S.); Hospital Puerta de Hierro, Madrid, Spain (J.G.); Polyclinique les Fleurs, Ollioules, France (P.B.); Hospital and University Fribourg, Switzerland (S.C.); University of Montpellier, Montpellier Cedex 5, France (C.P.); Segeberger Kliniken, Bad Segeberg, Germany (G.R.); Semmelweis University Heart and Vascular Center, Budapest, Hungary (B.M.); Universitätsklinikum Rostock, Rostock, Germany (H.S.); Klinikum Nürnberg Süd, Nürnberg, Germany (J.B.); Lucerne Canton Hospital, Lucerne, Switzerland (P.E.); MedStar Health Research Institute, Washington, DC (R.W.); Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland (S.Z., P.J.); and ICPS, Massy, France (T.L.)
| | - Henrik Schneider
- From the Department of Cardiology, Bern University Hospital, Bern, Switzerland (S.W.); Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany (M.H.); Universitäts-Herzzentrum Freiburg-Bad Krozingen, Bad Krozingen, Germany (F.-J.N.); Charité-Campus Mitte, Berlin, Germany (K.S.); Charité Campus Benjamin Franklin, Berlin, Germany (B.W.); Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands (T.S.); Hospital Clínic, Thorax Institute, Barcelona, Spain (M.S.); IDIBAPS, University of Barcelona, Barcelona, Spain (M.S.); Hospital Puerta de Hierro, Madrid, Spain (J.G.); Polyclinique les Fleurs, Ollioules, France (P.B.); Hospital and University Fribourg, Switzerland (S.C.); University of Montpellier, Montpellier Cedex 5, France (C.P.); Segeberger Kliniken, Bad Segeberg, Germany (G.R.); Semmelweis University Heart and Vascular Center, Budapest, Hungary (B.M.); Universitätsklinikum Rostock, Rostock, Germany (H.S.); Klinikum Nürnberg Süd, Nürnberg, Germany (J.B.); Lucerne Canton Hospital, Lucerne, Switzerland (P.E.); MedStar Health Research Institute, Washington, DC (R.W.); Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland (S.Z., P.J.); and ICPS, Massy, France (T.L.)
| | - Johannes Bilger
- From the Department of Cardiology, Bern University Hospital, Bern, Switzerland (S.W.); Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany (M.H.); Universitäts-Herzzentrum Freiburg-Bad Krozingen, Bad Krozingen, Germany (F.-J.N.); Charité-Campus Mitte, Berlin, Germany (K.S.); Charité Campus Benjamin Franklin, Berlin, Germany (B.W.); Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands (T.S.); Hospital Clínic, Thorax Institute, Barcelona, Spain (M.S.); IDIBAPS, University of Barcelona, Barcelona, Spain (M.S.); Hospital Puerta de Hierro, Madrid, Spain (J.G.); Polyclinique les Fleurs, Ollioules, France (P.B.); Hospital and University Fribourg, Switzerland (S.C.); University of Montpellier, Montpellier Cedex 5, France (C.P.); Segeberger Kliniken, Bad Segeberg, Germany (G.R.); Semmelweis University Heart and Vascular Center, Budapest, Hungary (B.M.); Universitätsklinikum Rostock, Rostock, Germany (H.S.); Klinikum Nürnberg Süd, Nürnberg, Germany (J.B.); Lucerne Canton Hospital, Lucerne, Switzerland (P.E.); MedStar Health Research Institute, Washington, DC (R.W.); Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland (S.Z., P.J.); and ICPS, Massy, France (T.L.)
| | - Paul Erne
- From the Department of Cardiology, Bern University Hospital, Bern, Switzerland (S.W.); Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany (M.H.); Universitäts-Herzzentrum Freiburg-Bad Krozingen, Bad Krozingen, Germany (F.-J.N.); Charité-Campus Mitte, Berlin, Germany (K.S.); Charité Campus Benjamin Franklin, Berlin, Germany (B.W.); Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands (T.S.); Hospital Clínic, Thorax Institute, Barcelona, Spain (M.S.); IDIBAPS, University of Barcelona, Barcelona, Spain (M.S.); Hospital Puerta de Hierro, Madrid, Spain (J.G.); Polyclinique les Fleurs, Ollioules, France (P.B.); Hospital and University Fribourg, Switzerland (S.C.); University of Montpellier, Montpellier Cedex 5, France (C.P.); Segeberger Kliniken, Bad Segeberg, Germany (G.R.); Semmelweis University Heart and Vascular Center, Budapest, Hungary (B.M.); Universitätsklinikum Rostock, Rostock, Germany (H.S.); Klinikum Nürnberg Süd, Nürnberg, Germany (J.B.); Lucerne Canton Hospital, Lucerne, Switzerland (P.E.); MedStar Health Research Institute, Washington, DC (R.W.); Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland (S.Z., P.J.); and ICPS, Massy, France (T.L.)
| | - Ron Waksman
- From the Department of Cardiology, Bern University Hospital, Bern, Switzerland (S.W.); Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany (M.H.); Universitäts-Herzzentrum Freiburg-Bad Krozingen, Bad Krozingen, Germany (F.-J.N.); Charité-Campus Mitte, Berlin, Germany (K.S.); Charité Campus Benjamin Franklin, Berlin, Germany (B.W.); Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands (T.S.); Hospital Clínic, Thorax Institute, Barcelona, Spain (M.S.); IDIBAPS, University of Barcelona, Barcelona, Spain (M.S.); Hospital Puerta de Hierro, Madrid, Spain (J.G.); Polyclinique les Fleurs, Ollioules, France (P.B.); Hospital and University Fribourg, Switzerland (S.C.); University of Montpellier, Montpellier Cedex 5, France (C.P.); Segeberger Kliniken, Bad Segeberg, Germany (G.R.); Semmelweis University Heart and Vascular Center, Budapest, Hungary (B.M.); Universitätsklinikum Rostock, Rostock, Germany (H.S.); Klinikum Nürnberg Süd, Nürnberg, Germany (J.B.); Lucerne Canton Hospital, Lucerne, Switzerland (P.E.); MedStar Health Research Institute, Washington, DC (R.W.); Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland (S.Z., P.J.); and ICPS, Massy, France (T.L.)
| | - Serge Zaugg
- From the Department of Cardiology, Bern University Hospital, Bern, Switzerland (S.W.); Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany (M.H.); Universitäts-Herzzentrum Freiburg-Bad Krozingen, Bad Krozingen, Germany (F.-J.N.); Charité-Campus Mitte, Berlin, Germany (K.S.); Charité Campus Benjamin Franklin, Berlin, Germany (B.W.); Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands (T.S.); Hospital Clínic, Thorax Institute, Barcelona, Spain (M.S.); IDIBAPS, University of Barcelona, Barcelona, Spain (M.S.); Hospital Puerta de Hierro, Madrid, Spain (J.G.); Polyclinique les Fleurs, Ollioules, France (P.B.); Hospital and University Fribourg, Switzerland (S.C.); University of Montpellier, Montpellier Cedex 5, France (C.P.); Segeberger Kliniken, Bad Segeberg, Germany (G.R.); Semmelweis University Heart and Vascular Center, Budapest, Hungary (B.M.); Universitätsklinikum Rostock, Rostock, Germany (H.S.); Klinikum Nürnberg Süd, Nürnberg, Germany (J.B.); Lucerne Canton Hospital, Lucerne, Switzerland (P.E.); MedStar Health Research Institute, Washington, DC (R.W.); Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland (S.Z., P.J.); and ICPS, Massy, France (T.L.)
| | - Peter Jüni
- From the Department of Cardiology, Bern University Hospital, Bern, Switzerland (S.W.); Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany (M.H.); Universitäts-Herzzentrum Freiburg-Bad Krozingen, Bad Krozingen, Germany (F.-J.N.); Charité-Campus Mitte, Berlin, Germany (K.S.); Charité Campus Benjamin Franklin, Berlin, Germany (B.W.); Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands (T.S.); Hospital Clínic, Thorax Institute, Barcelona, Spain (M.S.); IDIBAPS, University of Barcelona, Barcelona, Spain (M.S.); Hospital Puerta de Hierro, Madrid, Spain (J.G.); Polyclinique les Fleurs, Ollioules, France (P.B.); Hospital and University Fribourg, Switzerland (S.C.); University of Montpellier, Montpellier Cedex 5, France (C.P.); Segeberger Kliniken, Bad Segeberg, Germany (G.R.); Semmelweis University Heart and Vascular Center, Budapest, Hungary (B.M.); Universitätsklinikum Rostock, Rostock, Germany (H.S.); Klinikum Nürnberg Süd, Nürnberg, Germany (J.B.); Lucerne Canton Hospital, Lucerne, Switzerland (P.E.); MedStar Health Research Institute, Washington, DC (R.W.); Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland (S.Z., P.J.); and ICPS, Massy, France (T.L.)
| | - Thierry Lefèvre
- From the Department of Cardiology, Bern University Hospital, Bern, Switzerland (S.W.); Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany (M.H.); Universitäts-Herzzentrum Freiburg-Bad Krozingen, Bad Krozingen, Germany (F.-J.N.); Charité-Campus Mitte, Berlin, Germany (K.S.); Charité Campus Benjamin Franklin, Berlin, Germany (B.W.); Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands (T.S.); Hospital Clínic, Thorax Institute, Barcelona, Spain (M.S.); IDIBAPS, University of Barcelona, Barcelona, Spain (M.S.); Hospital Puerta de Hierro, Madrid, Spain (J.G.); Polyclinique les Fleurs, Ollioules, France (P.B.); Hospital and University Fribourg, Switzerland (S.C.); University of Montpellier, Montpellier Cedex 5, France (C.P.); Segeberger Kliniken, Bad Segeberg, Germany (G.R.); Semmelweis University Heart and Vascular Center, Budapest, Hungary (B.M.); Universitätsklinikum Rostock, Rostock, Germany (H.S.); Klinikum Nürnberg Süd, Nürnberg, Germany (J.B.); Lucerne Canton Hospital, Lucerne, Switzerland (P.E.); MedStar Health Research Institute, Washington, DC (R.W.); Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland (S.Z., P.J.); and ICPS, Massy, France (T.L.)
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Orvin K, Carrie D, Richardt G, Desmet W, Assali A, Werner G, Ikari Y, Fujii K, Goicolea J, Dangoisse V, Manari A, Saito S, Wijns W, Kornowski R. Comparison of sirolimus eluting stent with bioresorbable polymer to everolimus eluting stent with permanent polymer in bifurcation lesions: Results from CENTURY II trial. Catheter Cardiovasc Interv 2015; 87:1092-100. [DOI: 10.1002/ccd.26150] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [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: 04/28/2015] [Accepted: 07/21/2015] [Indexed: 11/10/2022]
Affiliation(s)
- K Orvin
- Cardiology Department; Rabin Medical Center, Petah Tikva, Israel and Sackler Faculty of Medicine, Tel Aviv University; Tel Aviv Israel
| | - D. Carrie
- Department of Cardiology; University Toulouse-Rangueil Hospital; France
| | - G. Richardt
- Segeberger Kliniken GmbH; Bad Segeberg Germany
| | - W. Desmet
- Department of Cardiovascular Medicine; University Hospitals Leuven; Leuven Belgium
| | - A. Assali
- Cardiology Department; Rabin Medical Center, Petah Tikva, Israel and Sackler Faculty of Medicine, Tel Aviv University; Tel Aviv Israel
| | - G. Werner
- Medizinische Klinik I; Klinikum Darmstadt GmbH; Darmstadt Germany
| | - Y. Ikari
- Department of Cardiology; Tokai University School of Medicine; Kanagawa Japan
| | - K. Fujii
- Department of Cardiology; Sakurabashi-Watanabe Hospital; Osaka Japan
| | - J. Goicolea
- Interventional Cardiology; Hospital Universitario Puerta De Hierro/Majadahonda; Madrid Spain
| | | | - A. Manari
- Department of Interventional Cardiology; Azienda Ospedaliera-IRCCS S. Maria Nuova; Viale Risorgimento Italy
| | - S. Saito
- Shonan Kamakura General Hospital; Kanagawa Japan
| | - W. Wijns
- Cardiovascular Centre Aalst; OLV Hospital; Belgium
| | - R. Kornowski
- Cardiology Department; Rabin Medical Center, Petah Tikva, Israel and Sackler Faculty of Medicine, Tel Aviv University; Tel Aviv Israel
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