Circulation: Cardiovascular Interventions最新文献

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Large Language Models and Revascularization Decisions: The Newest Member of Your Multidisciplinary Heart Team? 大型语言模型和血管重建决策:多学科心脏团队的最新成员?
IF 6.1 1区 医学
Circulation: Cardiovascular Interventions Pub Date : 2024-11-01 Epub Date: 2024-11-06 DOI: 10.1161/CIRCINTERVENTIONS.124.014775
Emeka C Anyanwu, Alexander C Fanaroff, Thomas M Maddox
{"title":"Large Language Models and Revascularization Decisions: The Newest Member of Your Multidisciplinary Heart Team?","authors":"Emeka C Anyanwu, Alexander C Fanaroff, Thomas M Maddox","doi":"10.1161/CIRCINTERVENTIONS.124.014775","DOIUrl":"10.1161/CIRCINTERVENTIONS.124.014775","url":null,"abstract":"","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e014775"},"PeriodicalIF":6.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582247","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}
引用次数: 0
Three-Year Outcomes Following TAVR in Younger (<75 Years) Low-Surgical-Risk Severe Aortic Stenosis Patients. 年轻(小于 75 岁)低手术风险重度主动脉瓣狭窄患者 TAVR 术后三年的疗效。
IF 6.1 1区 医学
Circulation: Cardiovascular Interventions Pub Date : 2024-11-01 Epub Date: 2024-10-18 DOI: 10.1161/CIRCINTERVENTIONS.124.014018
Thomas Modine, Didier Tchétché, Nicolas M Van Mieghem, G Michael Deeb, Stanley J Chetcuti, Steven J Yakubov, Paul Sorajja, Hemal Gada, Mubashir Mumtaz, Basel Ramlawi, Tanvir Bajwa, John Crouch, Paul S Teirstein, Neal S Kleiman, Ayman Iskander, Rodrigo Bagur, Michael W A Chu, Pierre Berthoumieu, Arnaud Sudre, Rik Adrichem, Saki Ito, Jian Huang, Jeffrey J Popma, John K Forrest, Michael J Reardon
{"title":"Three-Year Outcomes Following TAVR in Younger (<75 Years) Low-Surgical-Risk Severe Aortic Stenosis Patients.","authors":"Thomas Modine, Didier Tchétché, Nicolas M Van Mieghem, G Michael Deeb, Stanley J Chetcuti, Steven J Yakubov, Paul Sorajja, Hemal Gada, Mubashir Mumtaz, Basel Ramlawi, Tanvir Bajwa, John Crouch, Paul S Teirstein, Neal S Kleiman, Ayman Iskander, Rodrigo Bagur, Michael W A Chu, Pierre Berthoumieu, Arnaud Sudre, Rik Adrichem, Saki Ito, Jian Huang, Jeffrey J Popma, John K Forrest, Michael J Reardon","doi":"10.1161/CIRCINTERVENTIONS.124.014018","DOIUrl":"10.1161/CIRCINTERVENTIONS.124.014018","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter aortic valve replacement (TAVR) is an alternative to surgery in patients with severe aortic stenosis, but data are limited on younger, low-risk patients. This analysis compares outcomes in low-surgical-risk patients aged <75 years receiving TAVR versus surgery.</p><p><strong>Methods: </strong>The Evolut Low Risk Trial randomized 1414 low-risk patients to treatment with a supra-annular, self-expanding TAVR or surgery. We compared rates of all-cause mortality or disabling stroke, associated clinical outcomes, and bioprosthetic valve performance at 3 years between TAVR and surgery patients aged <75 years.</p><p><strong>Results: </strong>In patients <75 years, 352 were randomized to TAVR and 351 to surgery. Mean age was 69.1±4.0 years (minimum 51 and maximum 74); Society of Thoracic Surgeons Predicted Risk of Mortality was 1.7±0.6%. At 3 years, all-cause mortality or disabling stroke for TAVR was 5.7% and 8.0% for surgery (<i>P</i>=0.241). Although there was no difference between TAVR and surgery in all-cause mortality, the incidence of disabling stroke was lower with TAVR (0.6%) than surgery (2.9%; <i>P</i>=0.019), while surgery was associated with a lower incidence of pacemaker implantation (7.1%) compared with TAVR (21.0%; <i>P</i><0.001). Valve reintervention rates (TAVR 1.5%, surgery 1.5%, <i>P</i>=0.962) were low in both groups. Valve performance was significantly better with TAVR than surgery with lower mean aortic gradients (<i>P</i><0.001) and lower rates of severe prosthesis-patient mismatch (<i>P</i><0.001). Rates of valve thrombosis and endocarditis were similar between groups. There were no significant differences in rates of residual ≥moderate paravalvular regurgitation.</p><p><strong>Conclusions: </strong>Low-risk patients <75 years treated with supra-annular, self-expanding TAVR had comparable 3-year all-cause mortality and lower disabling stroke compared with patients treated with surgery. There was significantly better valve performance in patients treated with TAVR.</p><p><strong>Registration: </strong>URL: https://clinicaltrials.gov; Unique identifier: NCT02701283.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e014018"},"PeriodicalIF":6.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11573113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Relative Benefit of Dual Versus Single Antiplatelet Therapy Among Patients With Atrial Fibrillation on Oral Anticoagulation According to Time After ACS and PCI: Insights From the AUGUSTUS Trial. 心房颤动患者口服抗凝药的双联与单联抗血小板疗法的相对益处取决于 ACS 和 PCI 后的时间:AUGUSTUS 试验的启示。
IF 6.1 1区 医学
Circulation: Cardiovascular Interventions Pub Date : 2024-11-01 Epub Date: 2024-11-06 DOI: 10.1161/CIRCINTERVENTIONS.123.013596
Alexander C Fanaroff, Daniel M Wojdyla, Christopher B Granger, Shaun G Goodman, Ronald S Aronson, Stephan Windecker, Roxana Mehran, John H Alexander, Renato D Lopes
{"title":"Relative Benefit of Dual Versus Single Antiplatelet Therapy Among Patients With Atrial Fibrillation on Oral Anticoagulation According to Time After ACS and PCI: Insights From the AUGUSTUS Trial.","authors":"Alexander C Fanaroff, Daniel M Wojdyla, Christopher B Granger, Shaun G Goodman, Ronald S Aronson, Stephan Windecker, Roxana Mehran, John H Alexander, Renato D Lopes","doi":"10.1161/CIRCINTERVENTIONS.123.013596","DOIUrl":"10.1161/CIRCINTERVENTIONS.123.013596","url":null,"abstract":"<p><strong>Background: </strong>In the AUGUSTUS trial (An Open-Label, 2 x 2 Factorial, Randomized Controlled, Clinical Trial to Evaluate the Safety of Apixaban vs Vitamin K Antagonist and Aspirin vs Aspirin Placebo in Patients With Atrial Fibrillation and Acute Coronary Syndrome or Percutaneous Coronary Intervention), the combination of dual antiplatelet therapy plus oral anticoagulation increased the risk of bleeding without reducing ischemic events compared with a P2Y12 inhibitor plus oral anticoagulation among patients with atrial fibrillation and acute coronary syndrome or elective percutaneous coronary intervention. However, AUGUSTUS enrolled patients up to 14 days after acute coronary syndrome or percutaneous coronary intervention, and there may be a benefit to dual antiplatelet therapy plus oral anticoagulation early after an ischemic event.</p><p><strong>Methods: </strong>In this secondary analysis of AUGUSTUS, we divided patients into groups based on whether they were enrolled <6 days (early) or ≥6 days (later) after their index acute coronary syndrome or percutaneous coronary intervention, and tested the interaction between time from the index event to enrollment and randomized treatment (apixaban versus vitamin K antagonist and aspirin versus placebo) on 30-day and 6-month clinical outcomes using Cox proportional hazards models.</p><p><strong>Results: </strong>Among 4605 patients enrolled in AUGUSTUS with data available on time from the index event to enrollment, the median time from the index event to enrollment was 6 (range, 0-14) days. There were no significant interactions between time from the index event and aspirin versus placebo on clinical outcomes at 30 days or 6 months, though patients with time from the index event <6 days had a nominally significant reduction in death or ischemic events at 30 days with aspirin (hazard ratio, 0.55 [95% CI, 0.30-0.99]), whereas patients with time from the index event ≥6 days did not (hazard ratio, 0.88 [95% CI, 0.54-1.43]; interaction <i>P</i>=0.23). There were no significant interactions between time from the index event and apixaban versus vitamin K antagonist on clinical outcomes.</p><p><strong>Conclusions: </strong>Among patients with atrial fibrillation with acute coronary syndrome or undergoing percutaneous coronary intervention, there was no difference in the relative benefit of apixaban versus vitamin K antagonist or aspirin versus placebo when patients were enrolled early versus later after their index event.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT02415400.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e013596"},"PeriodicalIF":6.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582255","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}
引用次数: 0
Contemporary State-of-the-Art PCI of Left Main Coronary Artery Disease. 左冠状动脉疾病的当代先进 PCI 技术。
IF 6.1 1区 医学
Circulation: Cardiovascular Interventions Pub Date : 2024-11-01 Epub Date: 2024-11-19 DOI: 10.1161/CIRCINTERVENTIONS.124.014026
Seong-Bong Wee, Jung-Min Ahn, Do-Yoon Kang, Seung-Jung Park, Duk-Woo Park
{"title":"Contemporary State-of-the-Art PCI of Left Main Coronary Artery Disease.","authors":"Seong-Bong Wee, Jung-Min Ahn, Do-Yoon Kang, Seung-Jung Park, Duk-Woo Park","doi":"10.1161/CIRCINTERVENTIONS.124.014026","DOIUrl":"https://doi.org/10.1161/CIRCINTERVENTIONS.124.014026","url":null,"abstract":"<p><p>The left main coronary artery (LMCA) supplies over 70% of the myocardium, and significant LMCA disease is associated with high morbidity and mortality. With remarkable advances in percutaneous coronary intervention (PCI), including stent technology, antithrombotic agents, and evolving procedural techniques, PCI has become an important treatment option in clinical practice guidelines for the revascularization of LMCA disease. In contemporary clinical practice, a heart-team approach to shared decision-making, considering clinical/anatomic factors along with patient preferences, is emphasized for patients with significant LMCA disease requiring myocardial revascularization. Furthermore, recent progress in PCI procedures combined with intravascular imaging or functional guidance has resulted in significant improvements in PCI outcomes, especially for complex lesions, including LMCA disease. Nevertheless, owing to inherent anatomic complexities and frequent multivessel involvement, several unmet issues remain regarding the determination of the appropriate treatment approach for significant LMCA disease, for which further clinical research is required. This contemporary review article provides a comprehensive overview of left main PCI based on current guidelines and underlying trial data, addresses important unresolved diagnostic and therapeutic issues, and identifies future perspectives likely to advance progress in this field.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":"17 11","pages":"e014026"},"PeriodicalIF":6.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675313","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}
引用次数: 0
Impact of a Chronic Total Occlusion on Outcomes After FFR-Guided PCI or Coronary Bypass Surgery: A FAME 3 Substudy. 慢性全闭塞对 FFR 引导的 PCI 或冠状动脉搭桥手术后疗效的影响:FAME 3 子研究。
IF 6.1 1区 医学
Circulation: Cardiovascular Interventions Pub Date : 2024-11-01 Epub Date: 2024-11-06 DOI: 10.1161/CIRCINTERVENTIONS.124.014300
Hisao Otsuki, Kuniaki Takahashi, Frederik M Zimmermann, Kreton Mavromatis, Adel Aminian, Nikola Jagic, Jan-Henk E Dambrink, Petr Kala, Philip MacCarthy, Nils Witt, Yuhei Kobayashi, Tatsunori Takahashi, Y Joseph Woo, Alan C Yeung, Bernard De Bruyne, Nico H J Pijls, William F Fearon
{"title":"Impact of a Chronic Total Occlusion on Outcomes After FFR-Guided PCI or Coronary Bypass Surgery: A FAME 3 Substudy.","authors":"Hisao Otsuki, Kuniaki Takahashi, Frederik M Zimmermann, Kreton Mavromatis, Adel Aminian, Nikola Jagic, Jan-Henk E Dambrink, Petr Kala, Philip MacCarthy, Nils Witt, Yuhei Kobayashi, Tatsunori Takahashi, Y Joseph Woo, Alan C Yeung, Bernard De Bruyne, Nico H J Pijls, William F Fearon","doi":"10.1161/CIRCINTERVENTIONS.124.014300","DOIUrl":"10.1161/CIRCINTERVENTIONS.124.014300","url":null,"abstract":"<p><strong>Background: </strong>The clinical impact of a chronic total occlusion (CTO) in patients with 3-vessel coronary artery disease undergoing fractional flow reserve-guided percutaneous coronary intervention (PCI) with current-generation drug-eluting stents or coronary artery bypass grafting (CABG) is unclear.</p><p><strong>Methods: </strong>The FAME 3 trial (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation 3) compared fractional flow reserve-guided PCI with CABG in patients with 3-vessel coronary artery disease. The primary end point was major adverse cardiac and cerebrovascular events, a composite of death, myocardial infarction, stroke, or repeat revascularization at 1 year. In this substudy, the 3-year outcomes were analyzed in patients with or without a CTO.</p><p><strong>Results: </strong>Of the patients randomized to PCI or CABG in the FAME 3 trial, 305 (21%) had a CTO. In the PCI arm, revascularization of the CTO was attempted in 61% with a procedural success rate of 88%. The incidence of major adverse cardiac and cerebrovascular events at 3 years was not significantly different between those with or without a CTO in both the PCI (15.2% versus 20.1%; adjusted hazard ratio, 0.62 [95% CI, 0.38-1.03]; <i>P</i>=0.07) and the CABG (13.0% versus 12.9%; adjusted hazard ratio, 0.96 [95% CI, 0.55-1.66]; <i>P</i>=0.88) arms. In those without a CTO, PCI was associated with a significantly higher risk of major adverse cardiac and cerebrovascular events compared with CABG (adjusted hazard ratio, 1.61 [95% CI, 1.20-2.17]; <i>P</i><0.01) but not in those with a CTO (adjusted hazard ratio, 1.21 [95% CI, 0.64-2.28]; <i>P</i>=0.56; <i>P</i><sub>interaction</sub>=0.31).</p><p><strong>Conclusions: </strong>The presence of a CTO did not significantly impact the treatment effect of PCI versus CABG at 3 years in patients with 3-vessel coronary artery disease.</p><p><strong>Clinical trial registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT02100722.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e014300"},"PeriodicalIF":6.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582240","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}
引用次数: 0
Transcatheter Mitral Valve Replacement Using Annular Reduction by Cinching With TEER in the Commissure (ARCTIC). 使用瓣环缩紧术和充盈试验(TEER)进行经导管二尖瓣置换术(ARCTIC)。
IF 6.1 1区 医学
Circulation: Cardiovascular Interventions Pub Date : 2024-11-01 Epub Date: 2024-11-06 DOI: 10.1161/CIRCINTERVENTIONS.124.014224
Gregory J Condos, David Elison, Logan L Vincent, Rafael Harari, Cristina Sanina, Srdjan Jelacic, Richard Sheu, Christine J Chung, Gabriel S Aldea, G Burkhard Mackensen, James M McCabe
{"title":"Transcatheter Mitral Valve Replacement Using Annular Reduction by Cinching With TEER in the Commissure (ARCTIC).","authors":"Gregory J Condos, David Elison, Logan L Vincent, Rafael Harari, Cristina Sanina, Srdjan Jelacic, Richard Sheu, Christine J Chung, Gabriel S Aldea, G Burkhard Mackensen, James M McCabe","doi":"10.1161/CIRCINTERVENTIONS.124.014224","DOIUrl":"10.1161/CIRCINTERVENTIONS.124.014224","url":null,"abstract":"<p><strong>Background: </strong>Mitral annular calcification with valve dysfunction remains a challenging syndrome. Operative risk is high, and available transcatheter therapies are limited.</p><p><strong>Methods: </strong>This study describes our initial experience with a novel procedure to address large mitral annuli when no surgical or trial-based transcatheter mitral valve replacement device is available. The rationale was to shorten the intercommissural distance using commissural mitral transcatheter edge-to-edge repair (TEER) followed by valve-in-mitral annular calcification transcatheter mitral valve replacement with a balloon-expandable aortic valve platform. Patients with long intercommissural distances and large mitral annulus areas were selected based on a high perceived risk of transcatheter valve embolization. Patients underwent mitral TEER with MitraClip in a commissural position, followed immediately by transseptal transcatheter mitral valve replacement with a 29 mm SAPIEN 3 valve.</p><p><strong>Results: </strong>Thirteen patients were included. Median intercommissural distance and annular area were 39.1 mm and 930 mm<sup>2</sup>, respectively. Commissural mitral TEER was successful in all patients with no instances of single leaflet detachment. In 10 of 13 instances, an NTW device size was used. In 12 of 13 patients, valve implantation was successful, including 1 case that required a second valve for atrial positioning of the first valve. In 1 case, frank valve embolization into the left atrium occurred. Among the 12 successful cases, paravalvular leak was 1+ or less, and there were no instances of paravalvular leak adjacent to the TEER device.</p><p><strong>Conclusions: </strong>In patients with large annuli and sufficient annular calcium, a hybrid mitral TEER and valve replacement with the SAPIEN platform can be successfully used to facilitate transcatheter mitral valve replacement.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e014224"},"PeriodicalIF":6.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11573076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Enhancing Coronary Revascularization Decisions: The Promising Role of Large Language Models as a Decision-Support Tool for Multidisciplinary Heart Team. 加强冠状动脉血运重建决策:大型语言模型作为多学科心脏团队决策支持工具的前景广阔。
IF 6.1 1区 医学
Circulation: Cardiovascular Interventions Pub Date : 2024-11-01 Epub Date: 2024-11-06 DOI: 10.1161/CIRCINTERVENTIONS.124.014201
Karin Sudri, Iris Motro-Feingold, Roni Ramon-Gonen, Noam Barda, Eyal Klang, Paul Fefer, Sergei Amunts, Zachi Itzhak Attia, Mohamad Alkhouli, Amitai Segev, Michal Cohen-Shelly, Israel Moshe Barbash
{"title":"Enhancing Coronary Revascularization Decisions: The Promising Role of Large Language Models as a Decision-Support Tool for Multidisciplinary Heart Team.","authors":"Karin Sudri, Iris Motro-Feingold, Roni Ramon-Gonen, Noam Barda, Eyal Klang, Paul Fefer, Sergei Amunts, Zachi Itzhak Attia, Mohamad Alkhouli, Amitai Segev, Michal Cohen-Shelly, Israel Moshe Barbash","doi":"10.1161/CIRCINTERVENTIONS.124.014201","DOIUrl":"10.1161/CIRCINTERVENTIONS.124.014201","url":null,"abstract":"<p><strong>Background: </strong>While clinical practice guidelines advocate for multidisciplinary heart team (MDHT) discussions in coronary revascularization, variability in implementation across health care settings remains a challenge. This variability could potentially be addressed by language learning models like ChatGPT, offering decision-making support in diverse health care environments. Our study aims to critically evaluate the concordance between recommendations made by MDHT and those generated by language learning models in coronary revascularization decision-making.</p><p><strong>Methods: </strong>From March 2023 to July 2023, consecutive coronary angiography cases (n=86) that were referred for revascularization (either percutaneous or surgical) were analyzed using both ChatGPT-3.5 and ChatGPT-4. Case presentation formats included demographics, medical background, detailed description of angiographic findings, and SYNTAX score (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery; I and II), which were presented in 3 different formats. The recommendations of the models were compared with those of an MDHT.</p><p><strong>Results: </strong>ChatGPT-4 showed high concordance with decisions made by the MDHT (accuracy 0.82, sensitivity 0.8, specificity 0.83, and kappa 0.59), while ChatGPT-3.5 (0.67, 0.27, 0.84, and 0.12, respectively) showed lower concordance. Entropy and Fleiss kappa of ChatGPT-4 were 0.09 and 0.9, respectively, indicating high reliability and repeatability. The best correlation between ChatGPT-4 and MDHT was achieved when clinical cases were presented in a detailed context. Specific subgroups of patients yielded high accuracy (>0.9) of ChatGPT-4, including those with left main disease, 3 vessel disease, and diabetic patients.</p><p><strong>Conclusions: </strong>The present study demonstrates that advanced language learning models like ChatGPT-4 may be able to predict clinical recommendations for coronary artery disease revascularization with reasonable accuracy, especially in specific patient groups, underscoring their potential role as a supportive tool in clinical decision-making.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e014201"},"PeriodicalIF":6.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582229","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}
引用次数: 0
Symptomatic Benefit of SESAME According to Phenotype. 根据表型确定 SESAME 的症状效益。
IF 6.1 1区 医学
Circulation: Cardiovascular Interventions Pub Date : 2024-11-01 Epub Date: 2024-10-24 DOI: 10.1161/CIRCINTERVENTIONS.124.014440
Hiroki A Ueyama, Robert J Lederman, Errol K Inci, John C Lisko, Joe X Xie, Isida Byku, George S Hanzel, Adam B Greenbaum, Vasilis C Babaliaros, Patrick T Gleason
{"title":"Symptomatic Benefit of SESAME According to Phenotype.","authors":"Hiroki A Ueyama, Robert J Lederman, Errol K Inci, John C Lisko, Joe X Xie, Isida Byku, George S Hanzel, Adam B Greenbaum, Vasilis C Babaliaros, Patrick T Gleason","doi":"10.1161/CIRCINTERVENTIONS.124.014440","DOIUrl":"10.1161/CIRCINTERVENTIONS.124.014440","url":null,"abstract":"","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e014440"},"PeriodicalIF":6.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11576234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparison of Ultrathin- Versus Thin-Strut Stents in Patients With High Bleeding Risk PCI: Results From the COMPARE 60/80 HBR Trial: An Open-Label, Randomized, Controlled Trial. PCI 高出血风险患者使用超薄支架与薄支架的比较:COMPARE 60/80 HBR 试验结果:一项开放标签、随机对照试验。
IF 6.1 1区 医学
Circulation: Cardiovascular Interventions Pub Date : 2024-10-01 DOI: 10.1161/CIRCINTERVENTIONS.123.014042
Pieter C Smits, Pim A L Tonino, Sjoerd H Hofma, Jan-Peter van Kuijk, Fabrizio Spano, Amar Al Mafragi, Ron Pisters, Jawed Polad, Kris Bogaerts, Rohit M Oemrawsingh, Valeria Paradies
{"title":"Comparison of Ultrathin- Versus Thin-Strut Stents in Patients With High Bleeding Risk PCI: Results From the COMPARE 60/80 HBR Trial: An Open-Label, Randomized, Controlled Trial.","authors":"Pieter C Smits, Pim A L Tonino, Sjoerd H Hofma, Jan-Peter van Kuijk, Fabrizio Spano, Amar Al Mafragi, Ron Pisters, Jawed Polad, Kris Bogaerts, Rohit M Oemrawsingh, Valeria Paradies","doi":"10.1161/CIRCINTERVENTIONS.123.014042","DOIUrl":"10.1161/CIRCINTERVENTIONS.123.014042","url":null,"abstract":"<p><strong>Background: </strong>No randomized data exist on ultrathin-strut stents in patients at high bleeding risk (HBR) undergoing an abbreviated dual antiplatelet therapy after coronary stenting. The aim of this study was to compare the safety and effectiveness of the ultrathin-strut biodegradable-polymer sirolimus-eluting Supraflex Cruz stent with the thin-strut biodegradable-polymer sirolimus-eluting Ultimaster Tansei stent in patients at HBR with abbreviated dual antiplatelet therapy after stenting.</p><p><strong>Methods: </strong>In the investigator-initiated, randomized, open-label COMPARE 60/80 HBR trial (Comparison of the Supraflex Cruz 60 Micron Stent Strut Versus the Ultimaster Tansei 80 Micron Stent Strut in HBR Percutaneous Coronary Intervention Population), 741 patients at HBR according to the Academic Research Consortium HBR criteria were randomized to receive either the ultrathin-strut biodegradable-polymer sirolimus-eluting Supraflex Cruz stent or thin-strut biodegradable-polymer sirolimus-eluting Ultimaster Tansei stent. Dual antiplatelet therapy was recommended according to the applicable guidelines and trial data for patients at HBR. The primary outcome was net adverse clinical events, the composite of cardiovascular death, myocardial infarction, target vessel revascularization, stroke, and major bleeding, and was powered for noninferiority with an absolute margin of 4.0% at 1-sided 2.5% alpha.</p><p><strong>Results: </strong>Between September 2020 and August 2022, 371 patients were randomized to the ultrathin-strut biodegradable-polymer sirolimus-eluting Supraflex Cruz stent and 370 patients to the thin-strut biodegradable-polymer sirolimus-eluting Ultimaster Tansei stent at 11 sites in the Netherlands. At 1 year, the primary outcome was observed in 56 (15.4%) patients in the ultrathin-strut biodegradable-polymer sirolimus-eluting Supraflex Cruz stent group and 61 (17.1%) in the thin-strut biodegradable-polymer sirolimus-eluting Ultimaster Tansei stent group (risk difference, -1.65%; upper boundary of the 1-sided 95% CI, 3.74; <i>P</i>=0.02 for noninferiority at a 0.025 significance level and <i>P</i>=0.55 for 2-sided superiority at a 0.05 significance level).</p><p><strong>Conclusions: </strong>Among patients at HBR with abbreviated dual antiplatelet therapy post-stenting, the use of an ultrathin-strut biodegradable-polymer sirolimus-eluting Supraflex Cruz stent was noninferior compared with the use of a thin-strut biodegradable-polymer sirolimus-eluting Ultimaster Tansei stent.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT04500912.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e014042"},"PeriodicalIF":6.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11472898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Unconscious After Arrest and Primary PCI in STEMI: Hold or Go? STEMI 发生后意识不清和初级 PCI:坚持还是放弃?
IF 6.1 1区 医学
Circulation: Cardiovascular Interventions Pub Date : 2024-10-01 Epub Date: 2024-10-15 DOI: 10.1161/CIRCINTERVENTIONS.124.014689
Anna E Bortnick
{"title":"Unconscious After Arrest and Primary PCI in STEMI: Hold or Go?","authors":"Anna E Bortnick","doi":"10.1161/CIRCINTERVENTIONS.124.014689","DOIUrl":"10.1161/CIRCINTERVENTIONS.124.014689","url":null,"abstract":"","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":"17 10","pages":"e014689"},"PeriodicalIF":6.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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