JACC. Cardiovascular interventions最新文献

{"title":"Sex Differences in Patients Undergoing FFR-Guided PCI or CABG in the FAME 3 Trial.","authors":"Kuniaki Takahashi, Hisao Otsuki, Frederik M Zimmermann, Victoria Y Ding, Keith G Oldroyd, Olaf Wendler, Michael J Reardon, Y Joseph Woo, Alan C Yeung, Nico H J Pijls, Bernard De Bruyne, William F Fearon","doi":"10.1016/j.jcin.2024.09.030","DOIUrl":"10.1016/j.jcin.2024.09.030","url":null,"abstract":"<p><strong>Background: </strong>Outcomes in women after fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) using current-generation drug-eluting stents (DES) compared with coronary artery bypass grafting (CABG) are unknown.</p><p><strong>Objectives: </strong>This study sought to evaluate differences in clinical outcomes according to sex after FFR-guided PCI with current generation DES compared with CABG.</p><p><strong>Methods: </strong>The FAME 3 (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation) trial was an investigator-initiated, randomized controlled trial, comparing FFR-guided PCI with current generation DES or CABG in patients with 3-vessel coronary artery disease. This prespecified subgroup analysis compared the incidence of major adverse cardiac and cerebrovascular events (MACCE) according to sex, defined as the composite of all-cause death, myocardial infarction, stroke, or repeat revascularization at 3 years.</p><p><strong>Results: </strong>Of 1,500 patients included in the FAME 3 trial, 265 (17.7%) were women. Women had a significantly higher risk of MACCE at 3 years compared with men after CABG (18.1% vs 11.7%; adjusted HR: 2.07; 95% CI: 1.19-3.60), whereas women had a similar risk of MACCE at 3 years compared with men after PCI (18.2% vs 19.1%; adjusted HR: 1.27; 95% CI: 0.79-2.03). Regarding treatment effects by sex, women undergoing PCI had a similar risk of MACCE at 3 years compared with CABG (adjusted HR: 1.15; 95% CI: 0.62-2.11). By contrast, men undergoing PCI had a higher risk of MACCE at 3 years compared with CABG (adjusted HR: 1.68; 95% CI: 1.25-2.25; P_interaction = 0.142), which was mainly driven by a higher risk of myocardial infarction (adjusted HR: 2.11; 95% CI: 1.26-3.56; P_interaction = 0.102) and repeat revascularization (adjusted HR: 2.26; 95% CI: 1.47-3.47; P_interaction = 0.071).</p><p><strong>Conclusions: </strong>In the FAME 3 trial, at 3 years, women had similar outcomes with FFR-guided PCI compared with CABG, whereas men had improved outcomes with CABG. (A Comparison of Fractional Flow Reserve-Guided Percutaneous Coronary Intervention and Coronary Artery Bypass Graft Surgery in Patients With Multivessel Coronary Artery Disease [FAME 3]; NCT02100722).</p>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":" ","pages":"157-167"},"PeriodicalIF":11.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785543","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}

{"title":"Clinical Relevance of Discordance Between Physiology- and Imaging-Guided PCI Strategies in Intermediate Coronary Stenosis.","authors":"Jinlong Zhang, Wei Yu, Xinyang Hu, Jun Jiang, Changling Li, Yong Sun, Lingjun Zhu, Feng Gao, Liang Dong, Yabin Liu, Jian Shen, Cheng Ni, Kan Wang, Zexin Chen, Haibo Chen, Shiqiang Li, Tonghui Zhao, Seokhun Yang, Jeehoon Kang, Doyeon Hwang, Joo-Yong Hahn, Chang-Wook Nam, Joon-Hyung Doh, Bong-Ki Lee, Weon Kim, Jinyu Huang, Fan Jiang, Hao Zhou, Peng Chen, Lijiang Tang, Wenbing Jiang, Xiaomin Chen, Wenming He, Sung Gyun Ahn, Myeong-Ho Yoon, Ung Kim, Joo Myung Lee, You-Jeong Ki, Eun-Seok Shin, Seung-Jea Tahk, Shengxian Tu, Jian'an Wang, Bon-Kwon Koo","doi":"10.1016/j.jcin.2024.09.045","DOIUrl":"10.1016/j.jcin.2024.09.045","url":null,"abstract":"<p><strong>Background: </strong>Recent randomized clinical trials have demonstrated the benefits of intravascular imaging (IVI)-guided percutaneous coronary intervention (PCI) over angiography-guided PCI. However, the role of angiography-based physiological assessment during IVI-guided PCI remains unclear.</p><p><strong>Objectives: </strong>This study aimed to explore the discrepancies and significance of angiography-based physiological assessments in IVI-guided PCI.</p><p><strong>Methods: </strong>In the international multicenter randomized FLAVOUR (Fractional Flow Reserve and Intravascular Ultrasound for Clinical Outcomes in Patients With Intermediate Stenosis) trial, angiography-based physiological assessment was retrospectively performed using the Murray law-based quantitative flow ratio (μQFR). In this post hoc analysis, patients were categorized based on intravascular ultrasound (IVUS)-guided treatment decisions (PCI or deferral) and μQFR as follows: negative μQFR with deferral of PCI (DEFER), negative μQFR with PCI (PERFORM), and positive μQFR with PCI (REFERENCE). The primary outcome was major adverse cardiovascular events, defined as a composite of death, myocardial infarction, and target vessel revascularization at the 24-month follow-up.</p><p><strong>Results: </strong>Of the 784 patients, 34.4% (270/784), 29.3% (230/784), and 31.5% (247/784) were categorized into the DEFER, PERFORM, and REFERENCE groups, respectively. Physiological assessment led to substantial reclassification, encompassing 48.2% (230/477) of patients who underwent IVUS-guided PCI. The REFERENCE group showed a higher risk for major adverse cardiovascular events at 2 years compared with the PERFORM group (adjusted HR: 2.46; 95% CI: 1.13-5.35; P = 0.023). However, the primary outcomes in the DEFER and PERFORM groups were similar (adjusted HR: 0.88; 95% CI: 0.37-2.11; P = 0.779). The quality of life at 2 years was comparable among the 3 groups (P = 0.198).</p><p><strong>Conclusions: </strong>Angiography-based physiological assessments can offer additional prognostic insights for patients undergoing IVI-guided PCI. IVUS-guided PCI may not be advantageous in patients with functionally insignificant lesions.</p>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":" ","pages":"145-153"},"PeriodicalIF":11.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872115","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}

{"title":"Coronary Events After Transcatheter Aortic Valve Replacement: Insights From the France TAVI Registry.","authors":"Sandra Zendjebil, Mariama Akodad, Bernard Iung, Nicolas Dumonteil, Thomas Cuisset, Hervé le Breton, Sylvain Beurtheret, Florence du Chayla, Manon Leclère, Francesca Sanguineti, Thomas Hovasse, Bernard Chevalier, Antoinette Neylon, Hélène Eltchaninoff, Philippe Garot, Martine Gilard, Hakim Benamer, Thierry Lefèvre","doi":"10.1016/j.jcin.2024.09.005","DOIUrl":"https://doi.org/10.1016/j.jcin.2024.09.005","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of coronary artery disease in patients undergoing transcatheter aortic valve replacement (TAVR) is high. Treatment of a coronary events (CE) after TAVR can be technically challenging.</p><p><strong>Objectives: </strong>The authors sought to assess the incidence and prognostic impact of CE after TAVR.</p><p><strong>Methods: </strong>Patients undergoing TAVR for native aortic stenosis, with balloon-expandable valves (BEV) or self-expandable valves (SEV), included in the France-TAVI registry (Registry of Aortic Valve Bioprostheses Established by Catheter) were studied. The primary endpoint was the rate of first hospitalization for CE at maximal follow-up. The main secondary endpoint was the composite of all-cause mortality or hospitalization for heart failure following CE.</p><p><strong>Results: </strong>Between 2013 and 2021, 64,660 patients were included (BEV 63.8%, SEV 36.2%). CE occurred in 11.6% of cases (1.5%/y). Previous coronary artery disease and known coronary artery stenosis >50% before TAVR were the main predictors of CE. After CE, the composite endpoint was lower in patients who underwent percutaneous coronary intervention (PCI) compared with those who had only coronary angiography or no intervention (79.6%, 85.2%, and 86.5%, respectively; P = 0.002) and higher in SEV than in BEV patients (85.8% vs 83.8%; P = 0.01). Patients admitted to a TAVR center were more likely to have PCI (OR: 1.20 [95% CI: 1.01-1.42]; P = 0.04), even more so if they had a BEV (OR: 1.42 [95% CI: 1.18-1.71]; P = 0.002).</p><p><strong>Conclusions: </strong>The yearly incidence of CE after TAVR is low. In the event of CE, patients who have not undergone PCI have a worse outcome. SEV patients have a higher rate of unfavorable outcomes and are less likely to undergo PCI, especially when admitted to non-TAVR centers.</p>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 2","pages":"229-243"},"PeriodicalIF":11.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065671","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}

{"title":"Personalized Revascularization Strategies: Should Sex Shape PCI vs CABG Choices?","authors":"Enrico Fabris, Roxana Mehran","doi":"10.1016/j.jcin.2024.10.042","DOIUrl":"10.1016/j.jcin.2024.10.042","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":" ","pages":"168-170"},"PeriodicalIF":11.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785527","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}

{"title":"Concordance and Accuracy of Pressure Wire-Derived Indexes in Left Main Coronary Artery Disease.","authors":"Ozan M Demir, Haseeb Rahman, Kalpa De Silva, Cian M Scannell, Matthew Ryan, Kevin O'Gallagher, Narbeh Melikian, Amedeo Chiribiri, Sven Plein, Divaka Perera","doi":"10.1016/j.jcin.2024.10.040","DOIUrl":"10.1016/j.jcin.2024.10.040","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":" ","pages":"279-281"},"PeriodicalIF":11.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142965059","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}

{"title":"The Influence of Extracorporeal Life Support on Patients in Cardiogenic Shock Assessed by Machine Learning: A Machine Learning Subanalysis From the ECLS-SHOCK Trial.","authors":"Karl-Patrik Kresoja, Uwe Zeymer, Tharusan Thevathasan, Tienush Rassaf, Christian Jung, Janine Pöss, Steffen Schneider, Steffen Desch, Anne Freund, Holger Thiele","doi":"10.1016/j.jcin.2024.10.043","DOIUrl":"10.1016/j.jcin.2024.10.043","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":" ","pages":"273-275"},"PeriodicalIF":11.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872122","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}

{"title":"Knuckle Guidewires: The Devil Is in the Details.","authors":"Laura Novelli, Gabriele Luigi Gasparini","doi":"10.1016/j.jcin.2024.11.019","DOIUrl":"https://doi.org/10.1016/j.jcin.2024.11.019","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 2","pages":"271-272"},"PeriodicalIF":11.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065658","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}

{"title":"Aortic Pseudodissection After Stenting of Coarctation of the Aorta.","authors":"Sergio López-Tejero, Mark Osten, Yee Sen Chan Wah Hak, Abhinay Challa, Elsie Nguyen, Eric Horlick","doi":"10.1016/j.jcin.2024.09.040","DOIUrl":"10.1016/j.jcin.2024.09.040","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":" ","pages":"268-270"},"PeriodicalIF":11.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682005","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}

{"title":"See, Touch, Feel: The Need for Modern PCI in TAVR Patients.","authors":"Giulio Stefanini, Francesco Tartaglia","doi":"10.1016/j.jcin.2024.11.008","DOIUrl":"https://doi.org/10.1016/j.jcin.2024.11.008","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 2","pages":"255-259"},"PeriodicalIF":11.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065711","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}

{"title":"Drug-Eluting Stent Delivery Via Nonexternalized Retrograde Wire in Chronic Total Occlusion Intervention: First Report.","authors":"Claudiu Ungureanu, Mihai Cocoi, Lucien Finianos, Tim Noterdaeme, Pieter-Jan Palmers, Giuseppe Colletti, Olivier Gach","doi":"10.1016/j.jcin.2024.10.016","DOIUrl":"10.1016/j.jcin.2024.10.016","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":" ","pages":"263-264"},"PeriodicalIF":11.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785477","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}