Cardiovascular Revascularization Medicine最新文献

{"title":"Two-step recanalization of chronic total occlusion with IVUS-guided antegrade fenestration re-entry.","authors":"Marouane Boukhris, Amine Mamoun Boutaleb, Pierre Chenard, Giuseppe Colletti, Claudiu Ungureanu, Lorenzo Azzalini","doi":"10.1016/j.carrev.2025.03.005","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.03.005","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing outcomes of endovascular intervention vs bypass surgery for patients with chronic/critical limb ischemia.","authors":"Prasana Ramesh, Mohamed Zghouzi, Roshan Bista, Neel N Patel, Chidubem Ezenna, Timir K Paul, Aravinda Nanjundappa","doi":"10.1016/j.carrev.2025.02.017","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.02.017","url":null,"abstract":"<p><strong>Background: </strong>Chronic Limb Threat Ischemia (CLTI) is a severe form of peripheral arterial disease characterized by various symptoms including nonhealing wounds, ulcers and gangrene ultimately leading to a possible amputation. Therefore, revascularization either through endovascular intervention (EVI) or surgical bypass (SB) is an important step in management. Literature review of various studies including Randomized clinical trials (RCTs), Meta-analysis and observational studies show varied results with some studies suggesting better outcomes with EVI while majority of the others favors superiority of SB. Our Systematic review and meta-analysis aims to ascertain underlying differences between the approaches.</p><p><strong>Methods: </strong>We performed a Meta-analysis of observational studies and RCTs following the PRISMA guidelines. We searched Pubmed, and Cochrane databases. After removing duplicates and studies that did not meet the inclusion criteria, 9 studies were included which comprised of 4 RCTs and 5 observational studies. Outcomes measured include limb salvage, amputation free survival and Mortality. Random effects were applied to calculate Odds ratio (OR) and 95 % confidence Intervals (CI).</p><p><strong>Results: </strong>A total of 6375 patients from 9 studies were included. The pooled analysis from the meta-analysis comparing Endovascular intervention vs Surgical Bypass showed no statistically significant difference between the outcomes. The Pooled OR was 0.990(95%CI 0.913-1.073). Additionally the heterogeneity among the studies was moderate (i² = 34.7 %) suggesting some variability in the study results but not enough to conclude a significant difference. Additionally subgroup analysis was performed for above-knee and infra popliteal interventions which yielded statistically similar results.</p><p><strong>Conclusions: </strong>Based on the results above, neither endovascular intervention nor bypass surgery showed superiority over the other for outcomes such as limb salvage, mortality and amputation free survival. Therefore, effectiveness of both interventions for revascularization is comparable.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal timing for percutaneous coronary intervention in patients undergoing transcatheter aortic valve replacement: A network meta-analysis.","authors":"Pedro E P Carvalho, Bruno Ramos Nascimento, Douglas M Gewehr, Andre Rivera, Mariana Clemente, Marcelo A P Braga, Lucas N Pansani, Lara Almeidinha, Nicole Felix, Thiago M A Veiga, Marco Barbanti, Pedro A Lemos, Marcos Antônio Marino, Maurizio Taramasso, Philippe Garot","doi":"10.1016/j.carrev.2025.03.007","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.03.007","url":null,"abstract":"<p><strong>Background: </strong>The optimal timing for percutaneous coronary intervention (PCI) in patients undergoing transcatheter aortic valve replacement (TAVR) is uncertain.</p><p><strong>Objectives: </strong>To compare different PCI timings in patients with CAD undergoing TAVR.</p><p><strong>Methods: </strong>MEDLINE, Embase, and Cochrane were systematically searched for studies comparing different timings of PCI in patients with aortic stenosis and coronary artery disease (CAD) undergoing TAVR. PCI in a staged procedure to TAVR and PCI concomitantly to TAVR were compared with TAVR alone without PCI. A frequentist random-effects network meta-analysis calculates the odds ratio (OR) with a 95 % confidence interval (CI). Treatments were ranked using P-score analysis.</p><p><strong>Results: </strong>Two randomized controlled trials and 24 observational studies comprising 10,901 patients with aortic stenosis and CAD were included. Compared with PCI and concomitant TAVR, staged PCI was associated with lower rates of stroke (OR 0.54; 95 % CI 0.37-0.78), myocardial infarction (OR 0.54; 95 % CI 0.31-0.91), and all-cause mortality at 30 days (OR 0.62; 95 % CI 0.41-0.95). In addition, a subgroup analysis showed that staged PCI performed after TAVR is associated with the lowest rates of all-cause mortality of all strategies. In P-score analysis, staged PCI presented the highest likelihood of preventing stroke and myocardial infarction.</p><p><strong>Conclusion: </strong>In patients with aortic stenosis and CAD undergoing TAVR, staged PCI is associated with lower rates of stroke, myocardial infarction, and short-term mortality compared with other timings.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of optimal lesion preparation prior to implantation of a magnesium-based bioresorbable scaffold: 12-month results of the OPTIMIS study.","authors":"Kirstine Nørregaard Hansen, Akiko Maehara, Jens Trøan, Manijeh Noori, Mikkel Hougaard, Julia Ellert, Karsten Tange Veien, Anders Junker, Henrik Steen Hansen, Jens Flensted Lassen, Lisette Okkels Jensen","doi":"10.1016/j.carrev.2025.03.003","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.03.003","url":null,"abstract":"<p><strong>Background: </strong>Lumen reduction after bioresorbable scaffold implantation has been reported. This study aimed to assess the influence of pre-dilatation with a scoring balloon versus a standard non-compliant balloon prior to implanting a magnesium-based Magmaris bioresorbable scaffold (MgBRS) on lumen measurements using optical coherence tomography (OCT) and on clinical outcomes after 12 months.</p><p><strong>Method: </strong>In the OPTIMIS-study (Optimal lesion preparation before implantation of a MgBRS in patients with coronary artery stenosis), patients were randomly assigned to pre-dilatation with a scoring balloon or a standard non-compliant balloon before MgBRS implantation. OCT was performed before and after scaffold implantation, and at 6- and 12-month follow-up. Clinical 12-month follow-up was performed for all 82 enrolled patients.</p><p><strong>Results: </strong>Serial pre- and post-procedural, 6- and 12-month OCT were available in 33 lesions (scoring: n = 16 vs. standard: n = 17). Minimal lumen area (MLA) (scoring 4.6 ± 0.5 mm² vs. standard 3.6 ± 0.5 mm², p = 0.16) did not differ significantly at 12 months. In both the scoring and standard non-compliant balloon group, MLA changed significantly over time (post-procedure - 6-month - 12-month) (scoring balloon: 7.2 ± 1.8 mm²-5.1 ± 1.7 mm²-5.0 ± 1.9 mm², p < 0.01, and standard non-compliant balloon: 6.2 ± 1.1 mm²-5.2 ± 1.5 mm²-5.3 ± 2.0 mm², p < 0.01). No target lesion revascularizations (TLR) occurred in the scoring balloon group, compared to 7 TLR in the standard non-compliant balloon group within 12 months.</p><p><strong>Conclusion: </strong>In lesions treated with MgBRS, MLA did not differ significantly after 12 months among lesions pre-dilated with a scoring balloon compared to a standard non-compliant balloon. However, only lesions pre-dilated with a scoring balloon were free from TLR.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"10-year follow-up of patients with titanium-nitride-oxide-coated stents versus everolimus-eluting stents in acute coronary syndrome.","authors":"Jussi Sia, Kari Kervinen, Antti Ylitalo, Bernard De Bruyne, Matti Niemelä, Juhani K E Airaksinen, Hannu Romppanen, Fernando Rivero-Crespo, Pasi P Karjalainen","doi":"10.1016/j.carrev.2025.03.001","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.03.001","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to compare 10-year clinical outcomes of titanium-nitride-oxide-coated (TiNO)-stent versus permanent polymer everolimus-eluting (EES), for the primary endpoint of major adverse cardiac events (MACE) in patients with acute coronary syndrome (ACS).</p><p><strong>Background: </strong>Previous trials with ACS patients have demonstrated non-inferiority of TiNO-stents compared with EES for clinical events up to 5-year follow-up. Long-term data from randomized clinical stent trials are scarce.</p><p><strong>Methods: </strong>BASE-ACS trial randomized 827 ACS patients to receive either TiNO-stent or EES in a 1:1 fashion. The primary endpoint was MACE: a composite of cardiac death, non-fatal myocardial infarction (MI) or ischemia-driven target lesion revascularization (TLR).</p><p><strong>Results: </strong>MACE was significantly lower in the TiNO group compared to EES group (19.2 % vs. 28.3 %; HR 0.72; CI 0.53-0.99; p = 0.04), driven mainly by reduction in MI (8.5 % vs. 13.9 %; HR 0.59; CI 0.37-0.93; p = 0.02) and cardiac death (3.4 % vs. 7.2 %; HR 0.55; CI 0.27-1.14; p = 0.09 (NS). The rate of TLR tended to be less frequent in the TiNO group (10.2 % vs. 15.1 %; HR 0.73; CI 0.48-1.12; p = 0.15 (NS). The rate of definite stent thrombosis was significantly less frequent in the TiNO group (1.8 % vs. 5.4 %; HR 0.32; CI 0.13-0.81; p = 0.01.</p><p><strong>Conclusions: </strong>At 10-year follow-up, the rate of MACE was significantly lower in ACS patients treated with TiNO-stents compared to patients treated with EES.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of acute kidney injury after percutaneous coronary intervention with plaque modification.","authors":"Sant Kumar, Kathleen E Kearney, Christine J Chung, David Elison, Zachary L Steinberg, William L Lombardi, James M McCabe, Lorenzo Azzalini","doi":"10.1016/j.carrev.2025.03.004","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.03.004","url":null,"abstract":"<p><strong>Background: </strong>The use of plaque modification techniques during percutaneous coronary interventions (PCI) has increased. However, these procedures are linked to higher contrast volume and hypotensive episodes, which are risk factors for acute kidney injury (AKI). This study examined the effects of various plaque modification techniques on AKI after PCI.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of patients who underwent PCI at our institution between December 2020 to March 2024, categorizing them into 3 groups based on the plaque modification technique used: atherectomy, intravascular lithotripsy (IVL), or no plaque modification (NPM). The primary endpoint was AKI, and multivariable logistic regression was used to identify independent predictors of AKI. Multivariable analysis and propensity score matching (1:1) were performed to control for confounders.</p><p><strong>Results: </strong>In total, 1758 patients were included. Atherectomy was performed in 268 (15.2 %) patients, IVL in 120 (6.8 %) patients, and 1370 (77.9 %) patients had NPM. Atherectomy patients were older and had worse baseline renal function than the IVL and NPM groups (p < 0.001 for both). Compared with NPM, atherectomy was an independent predictor of AKI (odds ratio [OR] 1.27, 95 % confidence interval [CI] 1.07-1.98, p = 0.037), while IVL was not (OR 1.30, 95 % CI 0.84-2.08, p = 0.209). In a propensity-matched analysis of 101 atherectomy and IVL patient pairs, atherectomy-based PCI remained associated with a higher rate of AKI (11.9 % vs. 2.0 %; p = 0.013).</p><p><strong>Conclusion: </strong>Atherectomy, but not IVL, is associated with a higher risk of AKI after PCI, compared to NPM. This underscores the importance of thoughtfully selecting plaque modification strategies in high-risk patients to reduce renal adverse events following PCI.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long term follow up of patients treated with a polymer coated non drug-eluting stent in the COBRA-REDUCE trial.","authors":"Jola Bresha, Karsten P Hug, Robert A Byrne, Shqipdona Lahu, Salvatore Cassese, Roisin Colleran, Tareq Ibrahim, Erion Xhepa, Isabell Bernlochner, Michael Joner, Karl-Ludwig Laugwitz, Adnan Kastrati, Sebastian Kufner, J J Coughlan","doi":"10.1016/j.carrev.2025.02.014","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.02.014","url":null,"abstract":"<p><strong>Background: </strong>The use of a non-drug eluting coronary stent with a thromboresistant and pro-healing coating may result in long term advantages in comparison to FDA approved drug eluting stents (DES).</p><p><strong>Methods: </strong>In the COBRA REDUCE trial, patients with an indication for OAC undergoing PCI were randomized to treatment with the COBRA-PzF stent followed by 14 days of DAPT or an FDA-approved new generation DES followed by 3- or 6-months of DAPT. In the subset of patients enrolled at the lead site, we collected additional long term follow up. The primary endpoints for the current analysis were a composite thromboembolic endpoint (all-cause death, myocardial infarction, definite or probable stent thrombosis, or ischaemic stroke) and ischemia driven target lesion revascularisation (ID-TLR) through to 4 years follow up.</p><p><strong>Results: </strong>A total of 996 patients underwent randomization in the COBRA REDUCE trial. Of 140 patients randomized in Munich, 71 were randomized to the COBRA PzF stent and 69 to the control group. The primary composite ischemic endpoint occurred in 15/71 patients (21.8 %) in the COBRA PzF group and 15/69 patients (22.4 %) in the control group (hazard ratio [HR], 0.96; 95 % confidence interval [CI], 0.47-1.97, p value = 0.92). ID-TLR occurred in 7/71 patients (10.1 %) in the COBRA PzF group and 3/69 patients (4.5 %) in the control group (HR, 2.30; 95 % CI, 0.60-8.77, p value = 0.22). TLR occurred in 11/71 patients (15.8 %) in the COBRA PzF group and 3/69 patients (4.5 %) in the control group (HR, 3.76; 95 % CI, 1.06 to 13.32, p value = 0.04).</p><p><strong>Conclusion: </strong>Through to 4 year follow up after PCI in patients with an indication for OAC, the COBRA PzF stent did not result in any advantages in comparison to FDA approved DES and was associated with an increased risk of TLR.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Haemodynamic and clinical outcomes at 5 years according to predicted prosthesis-patient mismatch after transcatheter aortic valve replacement","authors":"Yoichi Sugiyama ,&nbsp;Hirokazu Miyashita ,&nbsp;Tomoki Ochiai ,&nbsp;Koki Shishido ,&nbsp;Mikko Jalanko ,&nbsp;Futoshi Yamanaka ,&nbsp;Tommi Vähäsilta ,&nbsp;Shigeru Saito ,&nbsp;Mika Laine ,&nbsp;Noriaki Moriyama","doi":"10.1016/j.carrev.2024.06.011","DOIUrl":"10.1016/j.carrev.2024.06.011","url":null,"abstract":"<div><div>Background/Purpose: Although the impact of predicted prosthesis-patient mismatch (PPM_P) on outcomes after surgical aortic valve replacement is well established, studies on PPM_P in transcatheter aortic valve replacement (TAVR) are limited. This study investigated the effects of PPM_p on haemodynamic and 5-year clinical outcomes after TAVR.</div><div>Methods/Materials: We analysed 1733 patients who underwent TAVR. PPM_p was defined using two different methods: 1) normal reference values of the effective orifice area for each valve type and size indexed to body surface area (PPM_p1; <em>n</em> = 1733) and 2) reference values for aortic annulus area or perimeter assessed with pre-procedural computed tomography indexed to body surface area (PPM_p2; <em>n</em> = 1227). The primary endpoint was the composite of all-cause death and/or rehospitalisation for heart failure at 5 years.</div><div>Results: The incidence of PPM_p1 was 11.7 % and 0.8 % in moderate and severe cases, respectively. PPM_p2 was classified as either moderate (3.8 %) or severe (0 %). Rates of residual mean aortic gradient ≥20 mmHg significantly increased depending on PPM_p1 severity (no PPM_p1: 3.1 % vs. moderate PPM_p1: 26.8 % vs. severe PPM_p1: 53.9 %, <em>p</em> &lt; 0.0001) and PPM_p2 (no PPM_p2: 4.1 % vs. moderate PPM_p2: 12.8 %, <em>p</em> = 0.0049). Neither of PPM_P methods were associated with the composite outcome in total cohort; however, PPM_P1 was significantly related to worse clinical outcomes at 5 years among patients with reduced left ventricular ejection fraction (LVEF) in multivariate analysis (HR: 1.87; 95 % CI: 1.02–3.43).</div><div>Conclusions: The impact of PPM_P on TAVR clinical outcomes may not be negligible in patients with low LVEF.</div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"72 ","pages":"Pages 23-30"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471592","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}

{"title":"Characteristics and outcomes of myocardial infarction among patients with bleeding or hypercoagulable disorders: A nationwide analysis","authors":"Ramy Sedhom ,&nbsp;Adeba Mohammad ,&nbsp;Mohamed Khedr ,&nbsp;Michael Megaly ,&nbsp;Carly Waldman ,&nbsp;Aditya S. Bharadwaj ,&nbsp;Ofer Kobo ,&nbsp;Ahmed Sayed ,&nbsp;Dmitry Abramov","doi":"10.1016/j.carrev.2024.09.011","DOIUrl":"10.1016/j.carrev.2024.09.011","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the characteristics and outcomes of acute myocardial infarction (AMI) in patients with bleeding and/or hypercoagulable disorders.</div></div><div><h3>Background</h3><div>Studies examining the outcomes of AMI in bleeding/hypercoagulable disorders are scarce.</div></div><div><h3>Methods</h3><div>The Nationwide Readmissions Database was utilized to identify hospitalizations with AMI from 2016 to 2020. The study cohort was divided into 4 groups: (1) MI without bleeding or hypercoagulable disorders, (2) MI with bleeding disorders, (3) MI with hypercoagulable disorders and (4) MI with mixed disorders. The main outcome was all-cause in-hospital mortality.</div></div><div><h3>Results</h3><div>A total of 4,206,005 weighted hospitalizations with AMI were identified during the study period, of which 382,118 (9.1 %) had underlying bleeding or hypercoagulable disorders.</div><div>The utilization of invasive strategies for the management of MI was highest in patients without bleeding or hypercoagulable disorders (62.6 %) and lowest in patients with mixed disorders (39.3 %). In-hospital mortality was higher among patients with bleeding (adjusted odds ratio [OR] 1.22; 95 % confidence interval [CI] 1.21, 1.24) and mixed disorders (aOR 3.38; 95 % CI 3.27, 3.49) compared with patients without bleeding or hypercoagulable disorders. Among patients with any bleeding or hypercoagulable disorder, those who underwent invasive strategy had lower adjusted odds of in-hospital mortality (aOR 0.28; 95 % CI 0.27, 0.30), ischemic stroke (aOR 0.60; 95 % CI 0.56, 0.64), bleeding (aOR 0.63; 95 % CI 0.61, 0.65), blood transfusion (aOR 0.95; 95 % CI 0.91, 0.99) and 30-day urgent readmissions (aOR 0.70; 95 % CI 0.68, 0.72).</div></div><div><h3>Conclusions</h3><div>The inpatient management and outcomes of AMI in patients with bleeding/hypercoagulable disorders differ from patients without those disorders.</div><div>Revascularization in the setting of AMI was associated with lower in-hospital mortality, which suggests that patients with bleeding/hypercoagulable disorders can be evaluated for standard approaches to managing AMI; however, confounding by indication may be a concern.</div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"72 ","pages":"Pages 10-15"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142336979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous coronary intervention strategies in non-ST segment elevation acute coronary syndrome patients with multivessel coronary artery disease: Systematic review pairwise and network meta-analysis","authors":"Wilbert Huang ,&nbsp;Samuel Flindy ,&nbsp;Apridya Nurhafizah ,&nbsp;Khairiya Alya Nafisa ,&nbsp;Alvin Frederich ,&nbsp;Januar Wibawa Martha","doi":"10.1016/j.carrev.2024.10.009","DOIUrl":"10.1016/j.carrev.2024.10.009","url":null,"abstract":"<div><h3>Background</h3><div>More than half of NSTEACS patients are presented with multivessel CAD. Culprit vessel only or complete revascularization (CR) guided either by angiography or fractional flow reserve (FFR) is available percutaneous coronary intervention (PCI) options. This study aims to compare different PCI strategies in NSTEACS patients with multivessel CAD.</div></div><div><h3>Methods</h3><div>Observational and RCTs studies are selected and compared for short- and long-term outcomes of all-cause mortality, MACE, and repeat revascularization. Odds ratio (OR) and SUCRA ranking of 4 interventions; (A) culprit vessel only revascularization, (B) single stage CR guided by angiography, (C) single stage CR guided by FFR, and (D) multistage CR guided by angiography are reported as pairwise and pooled network frequentist analysis conducted using RevMan and R software.</div></div><div><h3>Results</h3><div>Thirty- six studies with 213,254 patients were included. Pairwise analysis of A vs B shows no significant difference in short term outcomes. Pooled network analysis demonstrates that B, C, and D resulted in a significantly lower odds of long-term all-cause mortality compared to A (OR 0.42–0.77, 95 % CrI: 0.19–0.91). SUCRA ranking shows that C is more favorable compared to other interventions to reduce long term all-cause mortality and MACE (SUCRA 0.932 and 0.953). Sensitivity analysis with only RCTs and propensity matched scoring observational studies retains the significance and ranking of the interventions.</div></div><div><h3>Conclusion</h3><div>CR is just as safe as culprit vessel revascularization and single stage CR guided by FFR is the most preferable strategy to reduce risk of all- cause mortality and MACE.</div></div><div><h3>PROSPERO ID</h3><div>CRD42023491792.</div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"72 ","pages":"Pages 66-80"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}