Cardiovascular Revascularization Medicine最新文献

{"title":"Editorial: Keeping them honest MAUDE! But can we do better?","authors":"Georges Ephrem","doi":"10.1016/j.carrev.2025.05.017","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.05.017","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095493","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":"Renal denervation for resistant hypertension: A review of current literature.","authors":"Aparna Iyer, Shim Roh, Haris Muhammad, Amer Hammad, Vicky Kumar, Dipal Patel, Jason Sayanlar","doi":"10.1016/j.carrev.2025.05.014","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.05.014","url":null,"abstract":"<p><p>Resistant hypertension is defined by persistently elevated blood pressure (BP) despite being treated with three or more antihypertensive medications including a diuretic, leading to an increased risk of cardiovascular events and mortality. It presents a substantial global health challenge, impacting about 10 % of individuals with hypertension. Renal denervation (RDN) has come up as a promising interventional strategy to address this condition by modulating the renal sympathetic nervous system. This review article explores the mechanisms underlying RDN, its historical evolution, recent procedural advancements, clinical evidence supporting its efficacy, and the existing guidelines guiding its application. Recent advances in RDN research and potential future implications are also discussed, highlighting its role in achieving improved BP control and reducing cardiovascular risks in patients with resistant hypertension.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227255","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":"Prognostic impact of coronary artery disease in patients undergoing transcatheter aortic valve replacement.","authors":"Max B Sayers, Krishnaraj Rathod, Mohammed Akhtar, Asha Pavithran, Michael Michail, Vincenzo Tufaro, Sumanto Mukhopadhyay, Thomas A Treibel, Simon Kennon, Mick Ozkor, Andreas Baumbach, Daniel Jones, Anthony Mathur, Michael J Mullen, Kush P Patel","doi":"10.1016/j.carrev.2025.05.010","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.05.010","url":null,"abstract":"<p><strong>Background: </strong>The prognostic impact of coronary artery disease (CAD) in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR) remains unclear. We assessed the impact of CAD on TAVR procedural safety and long-term adverse outcomes by stratifying patients according to CAD burden.</p><p><strong>Methods: </strong>This single-centre, retrospective study stratified patients into low-, intermediate- and high-burden according to angiographic severity and location. The primary outcome was all-cause mortality. Secondary outcomes were cardiovascular (CV) death, myocardial infarction (MI), hospitalization for heart failure (HHF) and major adverse coronary events (MACE).</p><p><strong>Results: </strong>Of 1803 consecutive patients, low-, intermediate- and high-coronary burden was identified in 1281 (71 %), 382 (21 %) and 140 (8 %) patients, respectively. There were no differences in procedural outcomes or in-hospital mortality between groups. At a median follow-up of 4.8 (3.7-6.1) years, the incidence of all-cause mortality was 49 % vs 54 % vs 62 %, respectively. After adjusting for age and comorbidities, high-burden CAD was associated with all-cause mortality (HR: 1.35, 95 % CI 1.07-1.70, P = 0.011), CV-mortality (HR: 1.54, 95 % CI 1.07-2.17, P = 0.02) and MACE (adjusted HR 1.63, 95 % CI 1.23-2.15, P = 0.001), but not HHF (HR: 1.43, 95 % CI: 0.96-2.13, P = 0.082). Both intermediate- (HR 2.87, CI 1.83-4.50, P < 0.001) and high-burden groups (HR 2.69, 95 % CI 1.38-5.25, P = 0.004) were associated with MI.</p><p><strong>Conclusions: </strong>Increasing CAD burden does not impact TAVR procedural safety and therefore revascularization should not be a pre-requisite before TAVR. High CAD burden is associated with long-term adverse events. This group would benefit from future studies addressing CAD management in TAVR patients.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095496","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":"Editorial: Drug-coated balloons for small vessel disease: Navigating between randomized clinical trials evidence and real-world data.","authors":"Marco Frazzetto, Nicholas Pennza, Bernardo Cortese","doi":"10.1016/j.carrev.2025.05.012","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.05.012","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112289","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":"Periprocedural myocardial injury after recanalization of chronically occluded right coronary arteries, relation to side-branch occlusion and procedural technique.","authors":"Kenji Yaginuma, Thanu Subramoniam, Gerald S Werner","doi":"10.1016/j.carrev.2025.05.011","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.05.011","url":null,"abstract":"<p><strong>Background: </strong>Recanalization of chronic total coronary occlusions (CTO) is associated with a high incidence of periprocedural myocardial ischemia (PMI).</p><p><strong>Aims: </strong>This study should assess its causes with special focus on the relation to side branch occlusions (SBO) of the right coronary artery (RCA) with its specific anatomy of side branches.</p><p><strong>Methods: </strong>1574 recanalizations of a RCA CTO were analyzed with high-sensitive troponin T (hsTnT) drawn before and after the procedure. All angiograms were checked for SBO after the procedure. PMI was defined as hsTnT increase >5× upper limit of normal. Additional thresholds were > 18× (PMI₁₈) and > 35× (PMI₃₅).</p><p><strong>Results: </strong>PMI occurred in 51.6 %, PMI₁₈ in 19.9 %, and PMI₃₅ in 8.9 %. Excluding procedures with major complications (3.1 %), the major determinants of PMI were chronic kidney disease, a long fluoroscopy time, and single and multiple SBO. Overall side branch occlusions occurred in 26.8 % even without PMI, and with increasing rate with higher PMI thresholds up to 56.4 % with PMI₃₅. Proximal SBO caused the highest hsTnT increase, followed by mid and distal location. The highest incidence occurred with retrograde approach (50.8 %) and antegrade dissection re-entry (71.4 %). The combination of PMI and SBO would lead to the diagnosis of type IVa myocardial infarction in 23.4 %, with PMI₁₈ in 10.2 %, and with PMI₃₅ in 4.7 %.</p><p><strong>Conclusions: </strong>SBO occur frequently after CTO PCI of the RCA and are a major determinant of PMI. Even without clinical complications the combination of various thresholds of PMI and SBO would yield a high incidence of type IVa myocardial infarction.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095495","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":"Predictors of extracorporeal membrane oxygenation utilization and survival during cardiopulmonary resuscitation in out and in-hospital cardiac arrest.","authors":"Laith Alhuneafat, Fares Ghanem, Milos Brankovic, Omar Obeidat, Gaspar Del Rio Pertuz, Alejandra Gutierrez, Ahmad Jabri, Dil Patel, Jason Bartos, Andrea Elliott","doi":"10.1016/j.carrev.2025.05.008","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.05.008","url":null,"abstract":"<p><strong>Introduction: </strong>Extracorporeal membrane oxygenation during cardiopulmonary resuscitation (ECPR) has shown promise in managing both out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA).</p><p><strong>Methods: </strong>We analyzed hospital discharge records from the National Inpatient Sample of adult individuals who underwent ECPR between 2016 and 2020. Multivariable regression analyses were conducted to identify factors influencing ECPR utilization and survival.</p><p><strong>Results: </strong>Among 1,585,960 patients (901,470 OHCA, 684,490 IHCA), ECPR utilization rates were 1 % for OHCA and 1.4 % for IHCA, with inpatient mortality rates of 52 % and 67 %, respectively. In OHCA, ECPR was more likely in patients from higher-income areas, those with Medicaid/private insurance, systolic heart failure, shockable rhythms, and Hispanic/other races but less likely in those over 65, with patients with history of atrial fibrillation, diabetes, cerebrovascular accident, or COPD. In IHCA, ECPR was more common in larger hospitals, higher-income areas, and those with private insurance but less frequent in Black patients, those over 65, or with prior cerebrovascular accidents, COPD, diabetes, or end-stage renal disease. In OHCA ECPR, Asian race (aOR: 2.31), diabetes (aOR: 1.29), and liver disease (aOR: 1.77) predicted mortality, while shockable rhythms (aOR: 0.75), systolic heart failure (aOR: 0.67), and treatment in southern states (aOR: 0.72) predicted survival. In IHCA ECPR, acute myocardial infarction (aOR: 0.73) and private insurance (aOR: 0.63) were associated with improved survival, whereas liver disease (aOR: 1.59) predicted higher mortality.</p><p><strong>Conclusion: </strong>We highlight the selective nature of ECPR utilization between OHCA and IHCA and the distinct survival predictors in each setting. Further research is needed to refine selection criteria and optimize patient outcomes.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112291","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":"Transcatheter aortic valve replacement in small aortic annuli: A propensity-matched comparison between intra-annular self-expanding valves and balloon-expandable valves.","authors":"Danial Ahmad, Michel Pompeu Sá, Dustin Kliner, Derek Serna-Gallegos, Catalin Toma, Amber Makani, David West, Yisi Wang, Floyd Thoma, Takuya Ogami, Irsa Hasan, Ibrahim Sultan","doi":"10.1016/j.carrev.2025.05.009","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.05.009","url":null,"abstract":"<p><strong>Background: </strong>Specific transcatheter aortic valve replacement (TAVR) valve superiority is not established in the small aortic annulus (SAA) population. We sought to compare clinical and echocardiographic characteristics between patients with a SAA who underwent TAVR with either intra-annular self-expanding valves (SEV) or balloon-expandable valves (BEV).</p><p><strong>Methods: </strong>This was an observational, retrospective analysis (2013-2023). SAA was defined as an aortic annulus diameter < 23 mm (maximum) and annulus area ≤ 430 mm². Unmatched and propensity-score matched (PSM) populations were compared.</p><p><strong>Results: </strong>We identified 663 patients with SAA who underwent TAVR with SEV (n = 106) or BEV (n = 557). The PSM cohort (96 pairs) was predominantly female (90.6 % and 87.5 %) with a median age of 82.5 and 81.0 years. No statistically significant differences were observed in VARC-3 outcomes (periprocedural mortality, technical success, device success, clinical efficacy). Higher rates of residual mean gradients >20 mmHg were seen in the BEV group at 30 days (SEV 2.1 % vs BEV 21.9 %, P < 0.001) as well as lower median values of indexed effective orifice area (SEV 0.9 vs 0.6 cm²/m²). Severe PPM was also more common in the BEV group (SEV 5.2 % vs BEV 21.9 %, P = 0.002). At 2 years, differences in the rates of all-cause death (SE 11.9 % vs BE 17.1 %, P_log-rank = 0.6794) and stroke (SEV 3.4 % vs BEV 10.2 %, P = 0.7055) were not statistically significant.</p><p><strong>Conclusions: </strong>Intra-annular SEV presented better hemodynamics compared to BEV; however, survival and incidence of stroke were comparable between the groups at 2 years. Potential risk of nonstructural valve deterioration with BEV needs further investigation with longer follow-up.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081332","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":"Ticagrelor vs. clopidogrel in bivalirudin-treated patients with STEMI undergoing primary PCI: The BRIGHT-4 trial.","authors":"Yang Li, Zhenyang Liang, Yi Li, Miaohan Qiu, Xiaojian Feng, Kui Chen, Dingbao Zhang, Yuncheng Zou, Xiaohui Zheng, Gang Zhao, Guohai Su, Shaoliang Chen, Xiaoping Peng, Qing Yang, Yaling Han, Gregg W Stone","doi":"10.1016/j.carrev.2025.05.007","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.05.007","url":null,"abstract":"<p><strong>Background and aims: </strong>The optimal antiplatelet agent regimen in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PPCI) with bivalirudin anticoagulation is uncertain. This analysis sought to evaluate the safety and efficacy of ticagrelor compared with clopidogrel in patients with STEMI treated with PPCI with radial artery access and bivalirudin anticoagulation.</p><p><strong>Methods: </strong>This post-hoc analysis compared bivalirudin plus ticagrelor with bivalirudin plus clopidogrel in 3009 BRIGHT-4 patients that were treated with PPCI. The primary endpoint was all-cause death or Bleeding Academic Research Consortium (BARC) types 3-5 bleeding occurring within 30 days.</p><p><strong>Results: </strong>The 30-day all-cause death or BARC types 3-5 bleeding occurred in 2.0 % of patients treated with ticagrelor vs. 3.9 % of patients treated with clopidogrel (HR 0.51, 95 % CI 0.29 to 0.89; P = 0.02), driven by a reduction in all-cause death with ticagrelor (1.9 % vs. 3.7 %; P = 0.02) with no difference in BARC types 3-5 bleeding (0.1 % vs. 0.3 %; P = 0.34), although BARC type 2 bleeding was increased with ticagrelor (2.7 % vs. 1.2 %; P = 0.02). There was no significant difference between two groups in risk of stent thrombosis and composite of all-cause death, recurrent myocardial infarction, ischemia-driven target vessel revascularization, or stroke.</p><p><strong>Conclusions: </strong>Among patients with STEMI treated with PPCI, the risk of the composite of all-cause mortality and BARC types 3-5 bleeding at 30 days was lower with ticagrelor than with clopidogrel on a background of bivalirudin, without an increase in stent thrombosis and major bleedings.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175220","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":"Editorial: understanding drug coated balloon treatment - not quite that simple.","authors":"Bruno Scheller, Simone Fezzi","doi":"10.1016/j.carrev.2025.05.013","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.05.013","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086878","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":"Editorial: Side ports and stopcocks, not sheath size: flow determinants in reperfusion circuits.","authors":"Sumit R Kumar, Ian C Gilchrist","doi":"10.1016/j.carrev.2025.04.036","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.04.036","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057270","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}