Philippe Généreux, Björn Redfors, Philippe Pibarot, Brian R Lindman, Gennaro Giustino, Alissa Dratch, Shannon Murphy, Soumya Chikermane, Martin B Leon, Suzanne J Baron
{"title":"Health Care Cost and Resource Utilization After Aortic Valve Replacement According to the Extent of Cardiac Damage.","authors":"Philippe Généreux, Björn Redfors, Philippe Pibarot, Brian R Lindman, Gennaro Giustino, Alissa Dratch, Shannon Murphy, Soumya Chikermane, Martin B Leon, Suzanne J Baron","doi":"10.1161/CIRCINTERVENTIONS.124.014945","DOIUrl":"https://doi.org/10.1161/CIRCINTERVENTIONS.124.014945","url":null,"abstract":"<p><strong>Background: </strong>The extent of cardiac damage has been shown to be associated with increased mortality, repeat hospitalization, and decreased quality of life after aortic valve replacement (AVR). However, the association between the extent of cardiac damage at the time of AVR and health care costs and resource utilization has never been described.</p><p><strong>Methods: </strong>The Optum de-identified Market Clarity database was used to identify patients with aortic stenosis treated with AVR between 2016 and 2022. Patients were categorized into 5 groups (stages 0-4) based on their stage of cardiac damage in the year before AVR. Health care costs and resource utilization (including all-cause hospitalizations, heart failure hospitalizations and total inpatient days) were assessed for the AVR hospitalization and the following year. Cost and utilization outcomes by stage of cardiac damage were estimated using covariate-adjusted generalized linear models.</p><p><strong>Results: </strong>A total of 24 644 patients with AVR were included in our analysis. Patients were distributed across the 5 stages of cardiac damage as follows: 8.1% in stage 0, 17.1% in stage 1, 37.3% in stage 2, 36.2% in stage 3, and 1.4% in stage 4. Total costs increased with the extent of cardiac damage (increased by $2746 in stage 1, $19 511 in stage 2, $19 198 in stage 3, and $35 663 in stage 4, compared with stage 0; <i>P</i><0.01). Similarly, length of stay, number of all-cause and heart failure hospitalizations, and all-cause and heart failure days in-hospital significantly increased with the extent of cardiac damage. Risk-adjusted models demonstrated that advanced stages of cardiac damage were associated with both higher cost and resource utilization when compared with patients with stage 0 damage.</p><p><strong>Conclusions: </strong>Among patients undergoing AVR for aortic stenosis, the extent of cardiac damage before AVR was independently associated with increased costs and health care resource utilization during the index AVR admission and through 1 year post-AVR.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e014945"},"PeriodicalIF":6.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Khanjan B Shah, Hanaa Aridi, Michael D Dake, Gheorghe Doros, Alik Farber, Matthew T Menard, Raghu Motaganahalli, Cassius Ochoa Chaar, Kenneth Rosenfield, Salvatore Scali, Samir K Shah, Michael B Strong, Gilbert R Upchurch, William Robinson
{"title":"Age-Related Outcomes After Revascularization for Chronic Limb-Threatening Ischemia: An Analysis of BEST-CLI.","authors":"Khanjan B Shah, Hanaa Aridi, Michael D Dake, Gheorghe Doros, Alik Farber, Matthew T Menard, Raghu Motaganahalli, Cassius Ochoa Chaar, Kenneth Rosenfield, Salvatore Scali, Samir K Shah, Michael B Strong, Gilbert R Upchurch, William Robinson","doi":"10.1161/CIRCINTERVENTIONS.124.014833","DOIUrl":"https://doi.org/10.1161/CIRCINTERVENTIONS.124.014833","url":null,"abstract":"<p><strong>Background: </strong>The impact of age on outcomes after revascularization for chronic limb-threatening ischemia has not been studied in a prospective trial.</p><p><strong>Methods: </strong>A total of 1780 patients were grouped into age quartiles (≤55 years, 55< age ≤65 years, 65< age ≤75 years, and >75 years) and by type of revascularization (open bypass or endovascular). The primary outcome was major adverse limb events (MALE) or death, and the secondary outcomes were above-ankle amputation, reintervention, and major adverse cardiovascular events.</p><p><strong>Results: </strong>Death and major adverse cardiovascular events were significantly higher in the oldest quartile (>75 years), whereas MALE and above-ankle amputation were highest in the youngest cohort (≤55 years). Younger patients (≤55 years) had the lowest adjusted risk of MALE or all-cause death with open bypass compared with endovascular revascularization. There was no difference in MALE or all-cause death by treatment strategy in patients >75 years of age.</p><p><strong>Conclusions: </strong>Older age was associated with the highest risks of death and major adverse cardiovascular events and the lowest risks of MALE and above-ankle amputation among patients enrolled in BEST-CLI (Best Endovascular Versus Best Surgical Therapy in Patients With Chronic Limb-Threatening Ischemia). Age also had a differential impact by revascularization strategy: youngest patients had the lowest risk of MALE and all-cause death with bypass surgery compared with endovascular revascularization, while there was no difference among those >75 years. These data should be used to facilitate shared decision-making in patients with chronic limb-threatening ischemia.</p><p><strong>Registration: </strong>URL: https://biolincc.nhlbi.nih.gov/studies/best_cli/; Unique identifier: HLB02932424a.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e014833"},"PeriodicalIF":6.1,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pier Pasquale Leone, Luca Testa, Antonio Greco, Lee C Yan, Diego Milazzo, Susanna Benincasa, Dario Gattuso, Bernardo Cortese
{"title":"Two-Year Clinical Outcomes in Female and Male Patients After Sirolimus-Coated Balloon Angioplasty for Coronary Artery Disease.","authors":"Pier Pasquale Leone, Luca Testa, Antonio Greco, Lee C Yan, Diego Milazzo, Susanna Benincasa, Dario Gattuso, Bernardo Cortese","doi":"10.1161/CIRCINTERVENTIONS.124.014814","DOIUrl":"https://doi.org/10.1161/CIRCINTERVENTIONS.124.014814","url":null,"abstract":"","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e014814"},"PeriodicalIF":6.1,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Leos Pleva, Pavel Kukla, Tomas Kovarnik, Jana Zapletalova
{"title":"Comparing the Efficacy of Sirolimus and Paclitaxel-Eluting Balloon Catheters in the Treatment of Coronary In-Stent Restenosis: A Prospective Randomized Study (TIS 2 Study).","authors":"Leos Pleva, Pavel Kukla, Tomas Kovarnik, Jana Zapletalova","doi":"10.1161/CIRCINTERVENTIONS.124.014677","DOIUrl":"https://doi.org/10.1161/CIRCINTERVENTIONS.124.014677","url":null,"abstract":"<p><strong>Background: </strong>Current therapy for in-stent restenosis (ISR) is based on drug-eluting stents (DES) or drug-eluting balloon catheters. This prospective randomized study compared the efficacy of a novel sirolimus-eluting balloon (SEB) catheter to that of a paclitaxel-eluting balloon (PEB) catheter for the treatment of bare-metal stent (BMS-ISR) or DES-ISR restenosis.</p><p><strong>Methods: </strong>A total of 145 patients with 158 BMS or DES-ISR lesions were randomly assigned to the treatment with either SEB or PEB. The in-segment late lumen loss at 12 months, the 12-month incidence of binary ISR, and major adverse cardiac events (cardiac death, nonfatal acute myocardial infarction, or target lesion revascularization) were compared between groups.</p><p><strong>Results: </strong>The noninferiority of SEB compared with PEB in the treatment of BMS/DES-ISR with respect to late lumen loss was not demonstrated (Δlate lumen loss, -0.024 mm [95% CI, -0.277 to 0.229]; for a noninferiority margin of 0.20 mm), except in the post hoc subanalysis for the BMS-ISR group (-0.203 mm [95% CI, -0.584 to 0.178]). No significant differences in the incidence of repeated binary ISR (31.6% versus 30.4%, <i>P</i>=0.906) or 12-month major adverse cardiac events (31% for both; <i>P</i>>0.999) between the SEB and PEB groups were observed.</p><p><strong>Conclusions: </strong>The noninferiority of SEB relative to PEB in the treatment of BMS/DES-ISR with respect to late lumen loss was not confirmed.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT03672656.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e014677"},"PeriodicalIF":6.1,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nina Talmor, Claire Graves, Sam Kozloff, Vincent J Major, Yuhe Xia, Binita Shah, Anvar Babaev, Louai Razzouk, Sunil V Rao, Michael Attubato, Frederick Feit, James Slater, Nathaniel R Smilowitz
{"title":"Periprocedural Myocardial Injury Using CKMB Following Elective PCI: Incidence and Associations With Long-Term Mortality.","authors":"Nina Talmor, Claire Graves, Sam Kozloff, Vincent J Major, Yuhe Xia, Binita Shah, Anvar Babaev, Louai Razzouk, Sunil V Rao, Michael Attubato, Frederick Feit, James Slater, Nathaniel R Smilowitz","doi":"10.1161/CIRCINTERVENTIONS.124.014934","DOIUrl":"https://doi.org/10.1161/CIRCINTERVENTIONS.124.014934","url":null,"abstract":"<p><strong>Background: </strong>Myocardial injury detected after percutaneous coronary intervention (PCI) is associated with increased mortality. Predictors of post-PCI myocardial injury are not well established. The long-term prognostic relevance of post-PCI myocardial injury remains uncertain.</p><p><strong>Methods: </strong>Consecutive adults aged ≥18 years with stable ischemic heart disease who underwent elective PCI at NYU Langone Health between 2011 and 2020 were included in a retrospective, observational study. Patients with acute myocardial infarction or creatinine kinase myocardial band (CKMB) or troponin concentrations >99% of the upper reference limit before PCI were excluded. All patients had routine measurement of CKMB concentrations at 1 and 3 hours post-PCI. Post-PCI myocardial injury was defined as a peak CKMB concentration >99% upper reference limit. Linear regression models were used to identify clinical factors associated with post-PCI myocardial injury. Cox proportional hazard models were generated to evaluate relationships between post-PCI myocardial injury and all-cause mortality at long-term follow-up.</p><p><strong>Results: </strong>Among 10 807 patients undergoing elective PCI, the median age was 67 years (interquartile range, 15.6), and 24.9% were of female sex. Post-PCI myocardial injury occurred in 1813 (16.8%) patients. Myocardial injury was less common among female than male patients (14.1% versus 17.7%, <i>P</i><0.001). Older age, longer lesion lengths, multivessel PCI, severe coronary calcification, and thrombectomy device use were independently associated with post-PCI myocardial injury with CKMB levels ≥99th percentile upper limit of normal. Over 46 071 patient-years of follow-up (mean 4.3 years), 472 patients died (4.4%). A greater proportion of patients with versus without post-PCI myocardial injury died during follow-up (7.9% versus 3.6%, <i>P</i><0.001). After adjustment for demographics and clinical covariates, post-PCI myocardial injury was associated with an excess hazard for long-term mortality (hazard ratio, 1.46 [95% CI, 1.20-1.78]).</p><p><strong>Conclusions: </strong>Myocardial injury defined by elevated CKMB early after PCI is common and associated with all-cause, long-term mortality. More complex coronary anatomy is predictive of post-PCI myocardial injury.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e014934"},"PeriodicalIF":6.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jung-Kyu Han, Keehwan Lee, Sang-Hyeon Park, Seokhun Yang, Doyeon Hwang, Jeehoon Kang, Han-Mo Yang, Kyung Woo Park, Hyun-Jae Kang, Bon-Kwon Koo, Seung-Ho Hur, Weon Kim, Sang-Hyun Park, Seung Hwan Han, Sang-Hyun Kim, Yong Hoon Kim, Namho Lee, Seung Jin Lee, Sanghoon Shin, Hyo-Soo Kim
{"title":"Short-Term DAPT After Complex PCI With Third-Generation DES: A Post Hoc Analysis of the HOST-IDEA Trial.","authors":"Jung-Kyu Han, Keehwan Lee, Sang-Hyeon Park, Seokhun Yang, Doyeon Hwang, Jeehoon Kang, Han-Mo Yang, Kyung Woo Park, Hyun-Jae Kang, Bon-Kwon Koo, Seung-Ho Hur, Weon Kim, Sang-Hyun Park, Seung Hwan Han, Sang-Hyun Kim, Yong Hoon Kim, Namho Lee, Seung Jin Lee, Sanghoon Shin, Hyo-Soo Kim","doi":"10.1161/CIRCINTERVENTIONS.124.014623","DOIUrl":"https://doi.org/10.1161/CIRCINTERVENTIONS.124.014623","url":null,"abstract":"<p><strong>Background: </strong>The optimal duration of dual antiplatelet therapy after complex percutaneous coronary intervention (PCI) remains unclear. We aim to investigate the efficacy and safety of 3 to 6 months of dual antiplatelet therapy over 12 months after complex PCI.</p><p><strong>Methods: </strong>A post hoc analysis of the HOST-IDEA (Harmonizing Optimal Strategy for Treatment of Coronary Artery Stenosis-Coronary Intervention With Next-Generation Drug-Eluting Stent Platforms and Abbreviated Dual Antiplatelet Therapy) randomized trial which enrolled patients undergoing PCI with third-generation drug-eluting stents was performed. Complex PCI was defined by any of the following: ≥3 stents implanted, ≥3 lesions treated, bifurcation PCI with 2-stenting, total stent length ≥60 mm, left main PCI, or heavy calcification. The major end points were target lesion failure, a composite of cardiac death, target vessel myocardial infarction, and clinically driven target lesion revascularization for ischemic outcomes, and major bleeding, defined as BARC (Bleeding Academic Research Consortium) type 3 or 5, for bleeding outcomes at 12 months.</p><p><strong>Results: </strong>Among 1992 patients, 624 underwent complex PCI. The complex PCI group had clinical features associated with high bleeding risk. A shortened dual antiplatelet therapy duration did not increase the risk of target lesion failure, with hazard ratios of 0.818 (95% CI, 0.403-1.659) for the complex PCI group and 1.282 (95% CI, 0.506-3.249) for the noncomplex PCI group (<i>P</i><sub>interaction</sub>=0.451). Conversely, it decreased the risk of major bleeding in the complex PCI group (hazard ratio, 0.269 [95% CI, 0.075-0.965]), but not in the noncomplex PCI group (hazard ratio, 1.534 [95% CI, 0.627-3.754], showing a significant interaction; <i>P</i><sub>interaction</sub>=0.029).</p><p><strong>Conclusions: </strong>In patients undergoing complex PCI with a third-generation drug-eluting stent, a 3- to 6-month duration of dual antiplatelet therapy was associated with a reduced risk of bleeding without an increased risk of ischemic events compared with 12-month dual antiplatelet therapy.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique Identifier: NCT02601157.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e014623"},"PeriodicalIF":6.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chidubem Ezenna, Mrinal Murali Krishna, Meghna Joseph, Sammudeen Ibrahim, Vinicius Pereira, Ancy Jenil-Franco, Michael G Nanna, Sripal Bangalore, Andrew M Goldsweig
{"title":"Optical Coherence Tomography vs. Angiography Alone to Guide PCI for Complex Lesions: A Meta-Analysis of Randomized Controlled Trials.","authors":"Chidubem Ezenna, Mrinal Murali Krishna, Meghna Joseph, Sammudeen Ibrahim, Vinicius Pereira, Ancy Jenil-Franco, Michael G Nanna, Sripal Bangalore, Andrew M Goldsweig","doi":"10.1161/CIRCINTERVENTIONS.125.015141","DOIUrl":"https://doi.org/10.1161/CIRCINTERVENTIONS.125.015141","url":null,"abstract":"<p><p><b>Background:</b> Optical coherence tomography (OCT) provides high-resolution intracoronary imaging. However, whether the addition of OCT to angiography to guide percutaneous coronary intervention (PCI) of complex lesions affects clinical outcomes is debated. <b>Methods:</b> A systematic search for randomized controlled trials (RCTs) was conducted using PubMed, Scopus, and Cochrane databases through September 2024. Endpoints included major adverse cardiovascular events (MACE), cardiac death, myocardial infarction (MI), periprocedural MI, all-cause mortality, stent thrombosis (definite or probable), and target vessel revascularization (TVR). The random-effects model was used to generate risk ratios (RRs) and 95% confidence intervals (CIs). <b>Results:</b> A literature search identified 4 RCTs including 5,603 patients with a median follow-up of 2 years. Compared with PCI guided by angiography alone, OCT-guided PCI was associated with lower MACE (RR 0.68; 95%CI 0.55-0.84; p<0.001), cardiac death (RR 0.43; 95%CI 0.24-0.76; p=0.003), MI (RR 0.75; 95%CI 0.59-0.96; p=0.02), all-cause mortality (RR 0.58; 95% CI 0.38-0.87; p=0.009, and stent thrombosis (RR 0.49; 95% CI 0.26-0.90; p=0.02). There was a trend toward lower TVR (RR 0.67; 95% CI 0.44-1.03; p=0.07) and lower periprocedural MI (RR 0.79; 95% CI 0.59-1.06; p=0.11) with OCT guidance compared to angiography alone. <b>Conclusions:</b> The addition of OCT guidance to PCI of complex lesions resulted in better clinical outcomes than angiography guidance alone. Updated guidelines should strengthen recommendations supporting the use of OCT guidance for complex PCI.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sunil V Rao, Maria Mori Brooks, Helen E A D'Agostino, P Gabriel Steg, Tabassome Simon, Herbert D Aronow, Andrew M Goldsweig, Shahbaz Malik, Caroline Alsweiler, Kalon Kl Ho, Payam Dehghani, Adriano Caixeta, Ata R Quraishi, Simon Robinson, Jay H Traverse, Omar Siddiqi, Dean A Fergusson, Brian J Potter, Joshua Schulman-Marcus, Friederike K Keating, Jeffrey L Carson
{"title":"Effect of Red Blood Cell Transfusion Strategy on Clinical Outcomes Among Patients with Acute Myocardial Infarction Undergoing Revascularization: A Prespecified Analysis of the MINT Trial.","authors":"Sunil V Rao, Maria Mori Brooks, Helen E A D'Agostino, P Gabriel Steg, Tabassome Simon, Herbert D Aronow, Andrew M Goldsweig, Shahbaz Malik, Caroline Alsweiler, Kalon Kl Ho, Payam Dehghani, Adriano Caixeta, Ata R Quraishi, Simon Robinson, Jay H Traverse, Omar Siddiqi, Dean A Fergusson, Brian J Potter, Joshua Schulman-Marcus, Friederike K Keating, Jeffrey L Carson","doi":"10.1161/CIRCINTERVENTIONS.125.015249","DOIUrl":"https://doi.org/10.1161/CIRCINTERVENTIONS.125.015249","url":null,"abstract":"<p><p><b>Background:</b> The Myocardial Ischemia and Transfusion (MINT) Trial (N=3504) randomized patients with acute MI and a hemoglobin ≤ 10 g/dL to liberal (maintain Hgb ≥ 10 g/dL) or restrictive (maintain Hgb ≥ 8 g/dL) red blood cell transfusion. The results suggested a benefit on 30-day death or MI with a liberal transfusion strategy. The effect of transfusion in acute MI patients undergoing revascularization is unclear. <b>Methods:</b> In this pre-specified analysis of the MINT trial, patients who underwent revascularization (N=1002) before randomization but during index hospitalization were compared with those who did not (N=2442). The primary outcome was 30-day death or MI; secondary outcomes included 30-day death, recurrent MI, the composite of death, recurrent MI, ischemia driven unscheduled revascularization, or readmission for ischemic cardiac diagnosis, heart failure, and cardiac death. Multivariable log binomial regression was used to determine the relative risks of the primary and secondary outcomes by transfusion strategy for revascularized and non-revascularized patients with interaction terms. <b>Results:</b> Patients undergoing revascularization were younger, more often female, and had fewer comorbidities than those who did not. There was no significant interaction between revascularization and assigned transfusion strategy for any outcome except cardiac death. Compared with liberal transfusion, restrictive transfusion increased the risk of 30-day cardiac death among non-revascularized patients [RR 2.45 (1.58, 3.81)] but not among revascularized patients [(RR 0.97 (0.59, 1.60), interaction p 0.006]. <b>Conclusions:</b> In this analysis of the MINT trial, revascularization did not alter the effect of randomized transfusion strategy on 30-day death or MI. The hypothesis-generating finding that a restrictive transfusion strategy was associated with an increased risk of cardiac death among anemic patients with acute MI who do not undergo revascularization requires confirmation.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sammudeen Ibrahim, Shreyas Singireddy, Chidubem Ezenna, Laura M Romero Acero, Armin Nouri, Zafer Akman, Golsa Babapour, Jennifer Frampton, Andrew M Goldsweig, Abdulla A Damluji, Michael G Nanna
{"title":"Reconsidering Pre-Procedural Fasting for Elective Percutaneous Cardiac Procedures.","authors":"Sammudeen Ibrahim, Shreyas Singireddy, Chidubem Ezenna, Laura M Romero Acero, Armin Nouri, Zafer Akman, Golsa Babapour, Jennifer Frampton, Andrew M Goldsweig, Abdulla A Damluji, Michael G Nanna","doi":"10.1161/CIRCINTERVENTIONS.124.015089","DOIUrl":"10.1161/CIRCINTERVENTIONS.124.015089","url":null,"abstract":"","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e015089"},"PeriodicalIF":6.1,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}