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Platelet Function Testing and Genotyping for Tailoring Treatment in Complex PCI Patients. 血小板功能检测和基因分型对复杂PCI患者的针对性治疗
US Cardiology Review Pub Date : 2021-08-04 eCollection Date: 2021-01-01 DOI: 10.15420/usc.2020.33
Athanasios Moulias, Angeliki Papageorgiou, Dimitrios Alexopoulos
{"title":"Platelet Function Testing and Genotyping for Tailoring Treatment in Complex PCI Patients.","authors":"Athanasios Moulias, Angeliki Papageorgiou, Dimitrios Alexopoulos","doi":"10.15420/usc.2020.33","DOIUrl":"10.15420/usc.2020.33","url":null,"abstract":"<p><p>Dual antiplatelet therapy (DAPT), comprising aspirin and a P2Y<sub>12</sub> receptor inhibitor, is considered the cornerstone of treatment in patients who have undergone percutaneous coronary intervention (PCI). Patients with complex PCI (C-PCI) constitute a special PCI subpopulation, characterized by increased ischemic risk. Identifying the optimal DAPT strategy is often challenging and remains controversial in this setting. In an attempt to balance ischemic and bleeding risks in C-PCI patients receiving DAPT, treatment individualization regarding potency and duration has evolved as a feasible approach. Platelet function testing and genotyping have been evaluated in several trials with conflicting and mostly neutral results. The aim of this review is to critically appreciate the role of these tools for antiplatelet treatment tailoring specifically in C-PCI patients. Because existing evidence is limited, dedicated future studies are warranted to elucidate the utility of platelet function testing and genotyping in C-PCI.</p>","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":"1 1","pages":"e14"},"PeriodicalIF":0.0,"publicationDate":"2021-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42682554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Door-to-balloon Time for ST-elevation MI in the Coronavirus Disease 2019 Era. 2019冠状病毒病时代st段抬高心肌梗死的门到球囊时间
US Cardiology Review Pub Date : 2021-07-14 eCollection Date: 2021-01-01 DOI: 10.15420/usc.2021.05
Haytham Mously, Nischay Shah, Zachary Zuzek, Ibrahim Alshaghdali, Adham Karim, Rahul Jaswaney, Steven J Filby, Daniel I Simon, Mehdi H Shishehbor, Farshad Forouzandeh
{"title":"Door-to-balloon Time for ST-elevation MI in the Coronavirus Disease 2019 Era.","authors":"Haytham Mously, Nischay Shah, Zachary Zuzek, Ibrahim Alshaghdali, Adham Karim, Rahul Jaswaney, Steven J Filby, Daniel I Simon, Mehdi H Shishehbor, Farshad Forouzandeh","doi":"10.15420/usc.2021.05","DOIUrl":"10.15420/usc.2021.05","url":null,"abstract":"<p><p>In patients presenting with ST-elevation MI, prompt primary coronary intervention is the preferred treatment modality. Several studies have described improved outcomes in patients with door-to-balloon (D2B) and symptom onset-to-balloon (OTB) times of less than 2 hours, but the specific implications of the coronavirus disease 2019 (COVID-19) pandemic on D2B and OTB times are not well-known. This review aims to evaluate the impact of COVID-19 on D2B time and elucidate both the factors that delay D2B time and strategies to improve D2B time in the contemporary era. The search was directed to identify articles discussing the significance of D2B times before and during COVID-19, from the initialization of the database to December 1, 2020. The majority of studies found that onset-of-symptom to hospital arrival time increased in the COVID-19 era, whereas D2B time and mortality were unchanged in some studies and increased in others.</p>","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":" ","pages":"e13"},"PeriodicalIF":0.0,"publicationDate":"2021-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45460821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Transcatheter Tricuspid Valve Intervention: Current Perspective. 经导管三尖瓣介入治疗的现状
US Cardiology Review Pub Date : 2021-06-30 eCollection Date: 2021-01-01 DOI: 10.15420/usc.2020.26
Trevor J Simard, Mackram F Eleid
{"title":"Transcatheter Tricuspid Valve Intervention: Current Perspective.","authors":"Trevor J Simard, Mackram F Eleid","doi":"10.15420/usc.2020.26","DOIUrl":"10.15420/usc.2020.26","url":null,"abstract":"<p><p>Tricuspid regurgitation (TR) adversely impacts both quality of life and long-term survival, which generates interest in therapeutic approaches to mitigate these effects. Historically, therapeutic options for TR were limited to surgical approaches, which are often complicated by significant morbidity and mortality in elderly patients with multiple comorbidities. This gap in therapeutic options led to the rapid evolution of transcatheter tricuspid valve intervention (TTVI), with a wide variety of approaches pursued and early results suggesting that TTVI improves clinical outcomes. Numerous strategies, including edge-to-edge repair, annular reduction, spacers, caval valve implantation, and transcatheter tricuspid valve replacement form the basis of TTVI today. In this review, the authors discuss the current state of each approach.</p>","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":" ","pages":"e12"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43128578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Optimizing Guideline-directed Medical Therapies for Heart Failure with Reduced Ejection Fraction During Hospitalization. 优化指南指导的心力衰竭住院期间射血分数降低的药物治疗
US Cardiology Review Pub Date : 2021-04-23 eCollection Date: 2021-01-01 DOI: 10.15420/usc.2020.29
Neal M Dixit, Shivani Shah, Boback Ziaeian, Gregg C Fonarow, Jeffrey J Hsu
{"title":"Optimizing Guideline-directed Medical Therapies for Heart Failure with Reduced Ejection Fraction During Hospitalization.","authors":"Neal M Dixit, Shivani Shah, Boback Ziaeian, Gregg C Fonarow, Jeffrey J Hsu","doi":"10.15420/usc.2020.29","DOIUrl":"10.15420/usc.2020.29","url":null,"abstract":"<p><p>Heart failure remains a huge societal concern despite medical advancement, with an annual direct cost of over $30 billion. While guideline-directed medical therapy (GDMT) is proven to reduce morbidity and mortality, many eligible patients with heart failure with reduced ejection fraction (HFrEF) are not receiving one or more of the recommended medications, often due to suboptimal initiation and titration in the outpatient setting. Hospitalization serves as a key point to initiate and titrate GDMT. Four evidence-based therapies have clinical benefit within 30 days of initiation and form a crucial foundation for HFrEF therapy: renin-angiotensin-aldosterone system inhibitors with or without a neprilysin inhibitor, β-blockers, mineralocorticoid-receptor-antagonists, and sodium-glucose cotransporter-2 inhibitors. The authors present a practical guide for the implementation of these four pillars of GDMT during a hospitalization for acute heart failure.</p>","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":"15 1","pages":"e07"},"PeriodicalIF":0.0,"publicationDate":"2021-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45162907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Novel Non-invasive Fractional Flow Reserve from Coronary CT Angiography to Determine Ischemic Coronary Stenosis. 新的冠状动脉CT血管造影无创血流储备分数测定缺血性冠状动脉狭窄
US Cardiology Review Pub Date : 2021-04-23 eCollection Date: 2021-01-01 DOI: 10.15420/usc.2020.24
Lavanya Cherukuri, Divya Birudaraju, Matthew J Budoff
{"title":"Novel Non-invasive Fractional Flow Reserve from Coronary CT Angiography to Determine Ischemic Coronary Stenosis.","authors":"Lavanya Cherukuri, Divya Birudaraju, Matthew J Budoff","doi":"10.15420/usc.2020.24","DOIUrl":"10.15420/usc.2020.24","url":null,"abstract":"<p><p>Coronary artery disease (CAD) patients may have an obstructive disease on invasive coronary angiography, but few of these patients have had flow-limiting obstructive disease diagnosed on invasive fractional flow reserve (FFR). FFR is infrequently performed because of its cost- and time-effectiveness. Advancement in non-invasive imaging has enabled FFR to be derived non-invasively using coronary CT angiography (CCTA), without the need for induction of hyperemia or modification of the standard CCTA acquisition protocol. FFR derived from CCTA (FFR<sub>CT</sub>) has been shown to have excellent correlation with invasive FFR, and remains an effective diagnostic tool in the presence of reduced signal-to-noise ratio, coronary calcification and motion artifact. The utility of FFR<sub>CT</sub> has also helped to deepen our understanding of hemodynamically significant CAD. Hence, there is now interest in exploring the possible interplay between these mechanistic forces and their effect on the development of coronary plaque and the vulnerability of these plaques.</p>","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":" ","pages":"e06"},"PeriodicalIF":0.0,"publicationDate":"2021-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49493633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Type and Duration of Dual Antiplatelet Therapy in Complex Percutaneous Coronary Intervention. 复合经皮冠状动脉介入治疗中双重抗血小板治疗的类型和持续时间
US Cardiology Review Pub Date : 2020-11-23 eCollection Date: 2020-01-01 DOI: 10.15420/usc.2020.13
Dimitrios Alexopoulos, Charalampos Varlamos, Despoina-Rafailia Benetou
{"title":"Type and Duration of Dual Antiplatelet Therapy in Complex Percutaneous Coronary Intervention.","authors":"Dimitrios Alexopoulos, Charalampos Varlamos, Despoina-Rafailia Benetou","doi":"10.15420/usc.2020.13","DOIUrl":"10.15420/usc.2020.13","url":null,"abstract":"<p><p>Complex percutaneous coronary intervention (PCI) patients are a high-risk population for ischemic complications. Antiplatelet therapy in such patients remains controversial, as the beneficial effects of the use of more potent agents or prolonged dual antiplatelet treatment (DAPT) on atherothrombotic complications are hindered by a concomitant increase in bleeding rates. The aim of this article is to describe ischemic and bleeding outcomes associated with complex PCI procedures and to compare different types and durations of DAPT regimens in terms of safety and efficacy outcomes. Issues concerning special patient groups, such as those with left main, chronic total occlusion, or bifurcation lesions, are discussed.</p>","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":"1 1","pages":"e14"},"PeriodicalIF":0.0,"publicationDate":"2020-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43257657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Feasibility, Safety, and Clinical Performance of Self-apposing Stents for Left Main Stenosis. 自贴支架治疗左主干狭窄的可行性、安全性和临床表现
US Cardiology Review Pub Date : 2020-09-29 eCollection Date: 2020-01-01 DOI: 10.15420/usc.2020.11
Krzysztof Pujdak, Jan Kähler, Marc Werner
{"title":"Feasibility, Safety, and Clinical Performance of Self-apposing Stents for Left Main Stenosis.","authors":"Krzysztof Pujdak, Jan Kähler, Marc Werner","doi":"10.15420/usc.2020.11","DOIUrl":"10.15420/usc.2020.11","url":null,"abstract":"<p><p>Drug-eluting stents (DES) are the gold standard for percutaneous coronary interventions (PCI); however, technical and anatomical challenges need to be addressed to ensure optimal apposition and prevent late adverse events. Complex vessel anatomies, including ectatic or aneurysmatic vessels, or significant differences in diameter in left main stenosis of the coronary artery, are clinical indications in which current PCI techniques attempt to shape conventional DES to follow vessel anatomy, thus modifying the original stent scaffold and its properties. However, due to their design, balloon-expandable cobalt-chromium and cobalt-nickel DES have limitations regarding their expansion capacity, which can result in undersizing and malapposition. New stent scaffolds have recently been introduced into clinical practice to address these challenging anatomies, including a drug-eluting nitinol stent platform. The nature of the nitinol device allows conformability to the native vessel, covering complex anatomies without manual adaptation. In this article, the authors present the rationale and current data on self-apposing nitinol DES in left main stenosis, and suggest that the device may be safely and effectively used with comparable rates of adverse cardiovascular events, as seen with second-generation balloon-expandable DES.</p>","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":" ","pages":"e12"},"PeriodicalIF":0.0,"publicationDate":"2020-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49050912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Intravascular Ultrasound-guided Versus Angiography-guided Percutaneous Coronary Intervention: Evidence from Observational Studies and Randomized Controlled Trials. 血管内超声引导与血管造影术引导的经皮冠状动脉介入治疗：来自观察研究和随机对照试验的证据
US Cardiology Review Pub Date : 2020-05-04 eCollection Date: 2020-01-01 DOI: 10.15420/usc.2020.03
Xiao-Fei Gao, Xiang-Quan Kong, Guang-Feng Zuo, Zhi-Mei Wang, Zhen Ge, Jun-Jie Zhang
{"title":"Intravascular Ultrasound-guided Versus Angiography-guided Percutaneous Coronary Intervention: Evidence from Observational Studies and Randomized Controlled Trials.","authors":"Xiao-Fei Gao, Xiang-Quan Kong, Guang-Feng Zuo, Zhi-Mei Wang, Zhen Ge, Jun-Jie Zhang","doi":"10.15420/usc.2020.03","DOIUrl":"10.15420/usc.2020.03","url":null,"abstract":"<p><p>Coronary angiography has been considered the gold standard for the diagnosis of coronary artery disease and guidance of percutaneous coronary intervention (PCI). However, 2D-projection angiography cannot completely reflect the 3D coronary lumen. Intravascular ultrasound (IVUS) can overcome a number of limitations of coronary angiography by providing more information about the dimensions of the vessel lumen, plaque characteristics, stent deployment, and the mechanisms of device failure. Growing data from observational studies and randomized controlled trials have confirmed the clinical benefit of IVUS guidance during PCI. This article summarizes the evidence regarding IVUS guidance to highlight its advantages and to support the use of IVUS during PCI.</p>","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":" ","pages":"e03"},"PeriodicalIF":0.0,"publicationDate":"2020-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44033093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Proximal Side Optimization: A Modification of the Double Kissing Crush Technique. 近端优化：对双吻挤压技术的改进
US Cardiology Review Pub Date : 2020-05-04 eCollection Date: 2020-01-01 DOI: 10.15420/usc.2020.07
Francesco Lavarra
{"title":"Proximal Side Optimization: A Modification of the Double Kissing Crush Technique.","authors":"Francesco Lavarra","doi":"10.15420/usc.2020.07","DOIUrl":"10.15420/usc.2020.07","url":null,"abstract":"<p><p>Coronary bifurcations with significant lesions >10 mm in the side branch (SB) are likely to require two-stent treatment techniques. To date, double kissing Crush (DK-Crush) stenting has demonstrated higher rates of final kissing balloon inflation and better clinical outcomes. The technical iterations that lead to optimal clinical outcomes have been attributed to the first kissing balloon that repairs the distorted proximal segment and fully expands the orifice of the side stent. One potential caution, which relates to all Crush techniques, is the possibility of the guidewire crossing in an inappropriate position toward the Crushed SB stent. When this occurs, the SB stent may be further Crushed, leaving the ostium uncovered, which potentially negates the benefit of the Crush technique. In our experience, proximal side optimization (PSO) during DK-Crush stenting ensures stent size 'accommodation' to the larger vessel diameter in the proximal segment and better strut apposition to the wall, which is particularly important in the ostial segment. The benefits of this additional modification of the established DK-Crush technique are reduction or elimination of the risk of SB stent distortion, increase of the space of optimal wiring, and avoidance of guidewire advancement under the stent struts, even in unfavorable anatomies with extreme angulation. The author describes a step-by-step approach of a proposed PSO technique, which is easy to perform without any additional procedural time or costs.</p>","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":" ","pages":"e02"},"PeriodicalIF":0.0,"publicationDate":"2020-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49563456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
COVID-19 Pandemic and Cardiovascular Disease. COVID-19大流行与心血管疾病
US Cardiology Review Pub Date : 2020-03-25 eCollection Date: 2020-01-01 DOI: 10.15420/usc.2020.14
Aniket S Rali, Andrew J Sauer
{"title":"COVID-19 Pandemic and Cardiovascular Disease.","authors":"Aniket S Rali, Andrew J Sauer","doi":"10.15420/usc.2020.14","DOIUrl":"10.15420/usc.2020.14","url":null,"abstract":"<p><p>There seems to be a unique interplay between 2019 novel coronavirus (SARS-CoV-2) and cardiovascular diseases, although it is predominantly a respiratory illness. Patients with pre-existing cardiovascular co-morbidities appear to be at highest risk for mortality from coronavirus disease 2019 (COVID-19) along with the elderly; COVID-19 also contributes to cardiovascular complications, including acute coronary syndromes, arrhythmias, myocarditis, acute heart failure, and, in the most severe cases, cardiogenic shock and death. Several medications proposed in the treatment of COVID-19 require cardiac monitoring owing to their cardiac-specific adverse effects. Ultimately, the COVID-19 pandemic has jeopardized the safety of heart transplantation and has placed transplant recipients on immunosuppressive therapies at significant risk. In this article, the authors summarize the rapidly emerging data on the cardiovascular implications of SARS-CoV-2 and COVID-19.</p>","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":" ","pages":"e01"},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44649022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","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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