Eurointervention最新文献

{"title":"Prasugrel monotherapy versus standard DAPT in STEMI patients with OCT-guided or angio-guided complete revascularisation: design and rationale of the randomised, multifactorial COMPARE STEMI ONE trial.","authors":"Valeria Paradies, Nicolas M Van Mieghem, Rohit M Oemrawsingh, Gert Richardt, Giovanni Esposito, Gianluca Campo, Francesco Burzotta, Paolo Canova, Axel Linke, Italo Porto, Daniela Trabattoni, Koen Teeuwen, Tom Adriaenssens, Petr Kala, Goran Stankovic, Ria van Vliet, Daniele Giacoppo, Joost Daemen, Pieter C Smits","doi":"10.4244/EIJ-D-24-00829","DOIUrl":"https://doi.org/10.4244/EIJ-D-24-00829","url":null,"abstract":"<p><p>Monotherapy with a potent P2Y₁₂ receptor antagonist after 1 month of dual antiplatelet therapy (DAPT) may reduce bleeding in the absence of increased ischaemic events compared to 12-month DAPT in patients with acute coronary syndrome undergoing percutaneous coronary intervention (PCI). PCI guidance with optical coherence tomography (OCT) may enhance stent expansion. COMPARE STEMI ONE is an international, multicentre, open-label, randomised controlled trial. In 1,656 ST-segment elevation myocardial infarction (STEMI) patients, prasugrel monotherapy after 1 month of DAPT, as compared to standard 12-month prasugrel-based DAPT, will be tested for non-inferiority for the primary composite endpoint of net adverse clinical events - defined as all-cause death, myocardial infarction, stroke, or Bleeding Academic Research Consortium Type 3 or 5 bleeding events - at 11 months after randomisation. Furthermore, an ancillary substudy will test the superiority of OCT-guided versus angiography-guided staged complete revascularisation in achieving a larger minimal stent area (MSA) in non-culprit lesions during staged procedures. COMPARE STEMI ONE is the first randomised controlled trial assessing an abbreviated 1-month DAPT regimen followed by prasugrel monotherapy in the context of STEMI. The trial will also study the value of OCT-guided PCI in terms of the MSA of non-culprit lesions and may elucidate potential synergies between intravascular imaging-guided PCI and abbreviated DAPT regimens. (ClinicalTrials.gov: NCT05491200).</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 10","pages":"571-580"},"PeriodicalIF":7.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082056","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}

{"title":"Ticagrelor-based antiplatelet therapy after percutaneous coronary intervention in chronic coronary syndrome.","authors":"Hirotoshi Watanabe, Takeshi Kimura","doi":"10.4244/EIJ-E-25-00015","DOIUrl":"https://doi.org/10.4244/EIJ-E-25-00015","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 10","pages":"495-496"},"PeriodicalIF":7.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082060","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}

{"title":"Ticagrelor monotherapy versus ticagrelor plus aspirin in patients with chronic coronary syndrome and high ischaemic risk: a post hoc analysis of the TWILIGHT trial.","authors":"Mauro Gitto, Usman Baber, Samantha Sartori, Birgit Vogel, Dominick J Angiolillo, Carlo Briguori, David J Cohen, Timothy Collier, Dariusz Dudek, Angelo Oliva, Javier Escaned, Yihan Feng, C Michael Gibson, Ya-Ling Han, Francesca Maria Di Muro, Richard A Shlofmitz, Kurt Huber, Philippe Gabriel Steg, Samin Sharma, Gennaro Sardella, Adnan Kastrati, Upendra Kaul, Ran Kornowski, Vijay Kunadian, Giulio G Stefanini, Shamir R Mehta, George Dangas, Roxana Mehran","doi":"10.4244/EIJ-D-24-00973","DOIUrl":"https://doi.org/10.4244/EIJ-D-24-00973","url":null,"abstract":"<p><strong>Background: </strong>Short dual antiplatelet therapy (DAPT) followed by ticagrelor monotherapy may be a valuable therapeutic option for patients with chronic coronary syndrome (CCS) and high ischaemic risk (HIR) undergoing percutaneous coronary intervention (PCI).</p><p><strong>Aims: </strong>We aimed to compare ticagrelor monotherapy with ticagrelor-based DAPT in CCS patients with and without HIR undergoing PCI.</p><p><strong>Methods: </strong>The present analysis included the CCS cohort of the TWILIGHT trial, which randomised PCI patients to ticagrelor alone or in combination with aspirin for 12 months after 3 months of ticagrelor-based DAPT. Patients were stratified into HIR and non-HIR based on the 2019 European Society of Cardiology (ESC) CCS guidelines definition. Outcomes of interest were major adverse cardiac and cerebrovascular events (MACCE), a composite of death, myocardial infarction or stroke, and Bleeding Academic Research Consortium (BARC) Type 2-5 bleeding at 1 year.</p><p><strong>Results: </strong>Of the 2,503 CCS patients who underwent randomisation, the ESC definition classified 1,264 (50.5%) as HIR and 1,239 (49.5%) as non-HIR. HIR patients displayed a higher risk of MACCE (3.9% vs 2.3%; p=0.015) and similar rates of BARC Type 2-5 bleeding (5.1% vs 5.7%; p=0.455) as compared to non-HIR patients. Ticagrelor monotherapy and ticagrelor-based DAPT were associated with similar risks of MACCE (HIR: 4.0% vs 3.8%, hazard ratio [HR] 1.06, 95% confidence interval [CI]: 0.60-1.85; non-HIR: 2.1% vs 2.6%, HR 0.80, 95% CI: 0.38-1.66, p_interaction=0.553) and bleeding (HIR: 4.7% vs 5.7%, HR 0.82, 95% CI: 0.50-1.33; non-HIR: 4.9% vs 6.7%, HR 0.71, 95% CI: 0.44-1.14; p_interaction=0.684) in both the HIR and non-HIR groups.</p><p><strong>Conclusions: </strong>In a post hoc analysis of the TWILIGHT trial that included CCS patients undergoing PCI, ticagrelor monotherapy after 3 months of DAPT appeared to be safe and was not associated with increased risks of ischaemic or bleeding events, regardless of baseline HIR status, compared with standard ticagrelor-based DAPT. These findings suggest the potential to expand guideline recommendations for ticagrelor monotherapy in CCS.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 10","pages":"550-559"},"PeriodicalIF":7.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082059","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}

{"title":"Platelet reactivity when switching from cangrelor to oral P2Y12 receptor inhibitors: insights from a real-world registry.","authors":"Francesco Franchi, Claudio Laudani","doi":"10.4244/EIJ-E-25-00008","DOIUrl":"https://doi.org/10.4244/EIJ-E-25-00008","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 10","pages":"497-499"},"PeriodicalIF":7.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082054","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}

{"title":"Long-term structural valve deterioration after TAVI: insights from the EORP ESC Valve Durability TAVI Registry.","authors":"Cristina Giannini, Davide Capodanno, Gabor G Toth, Stephan Windecker, Stefanie Schüpke, Daniel J Blackman, Stéphane Noble, Hélène Eltchaninoff, Claudia Fiorina, Alaide Chieffo, Antonio L Bartorelli, Albrecht Schmidt, Ole De Backer, Martine Gilard, Elizabeth Curtis, Guillaume L'Official, Erwan Donal, Cécile Laroche, Bernard Prendergast, Anna Sonia Petronio, On Behalf The European Valve Durability Tavi Registry Investigators","doi":"10.4244/EIJ-D-24-00662","DOIUrl":"https://doi.org/10.4244/EIJ-D-24-00662","url":null,"abstract":"<p><strong>Background: </strong>Valve durability is a key consideration as the patient population eligible for transcatheter aortic valve implantation (TAVI) expands to include lower-risk and younger individuals who are expected to live many years after the procedure.</p><p><strong>Aims: </strong>This registry aimed to assess the incidence of long-term structural valve deterioration (SVD) beyond 5 years post-TAVI.</p><p><strong>Methods: </strong>Consecutive living patients who underwent TAVI up until 2014 using any commercially available transcatheter heart valve (THV) at 22 participant centres were enrolled in the European Valve Durability TAVI Registry. All patients underwent comprehensive echocardiographic assessments (61% were evaluated independently by a central core laboratory) within 6 months of enrolment and at least 5 years post-TAVI; SVD was defined according to Valve Academic Research Consortium 3 definitions.</p><p><strong>Results: </strong>A total of 597 patients (aged 79.6±7.1 years at the time of TAVI; 47.2% male, mean Society of Thoracic Surgeons score 5.0%) were included. At a median of 6.1 years of follow-up (interquartile range 5.2-7.3 years), the crude incidence of moderate/severe SVD was 9.5% (n=57; moderate: 6.2%, n=37; severe: 3.4%, n=20). Predictors of SVD identified by Cox regression analysis were use of an intra-annular THV (hazard ratio [HR] 38.44, 95% confidence interval [CI]: 10.8-136.3; p<0.001), a small THV size (HR 4.82, 95% CI: 2.42-9.60; p<0.001) and moderate/severe postprocedural paravalvular leak (HR 3.64, 95% CI: 1.59-8.32; p=0.002).</p><p><strong>Conclusions: </strong>The incidence of moderate/severe SVD during long-term follow-up after TAVI is low, with severe SVD being even rarer than moderate SVD. SVD occurs more frequently in patients treated with older-generation intra-annular valves and in those with small-sized THVs.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 10","pages":"537-549"},"PeriodicalIF":7.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082049","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}

{"title":"Transcaval access with an IVUS-assisted aorta-outward puncture.","authors":"Juan Manuel Muñoz Bravo, Gerard Martí Aguasca, Álvaro Calabuig Goena, Vicenç Serra García, Andrea Monastyrski, Neus Bellera Gotarda, Imanol Otaegui Irurueta, Bernat Serra Creus, Yassin Belahnech Pujol, Bruno García Del Blanco","doi":"10.4244/EIJ-D-24-00429","DOIUrl":"https://doi.org/10.4244/EIJ-D-24-00429","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 10","pages":"584-585"},"PeriodicalIF":7.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082061","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}

{"title":"Optical coherence tomography versus intravascular ultrasound- guided PCI in patients with and without acute coronary syndrome: a prespecified subanalysis of the OCTIVUS trial.","authors":"Ju Hyeon Kim, Soon Jun Hong, Subin Lim, Jung-Joon Cha, Hyung Joon Joo, Jae Hyoung Park, Cheol Woong Yu, Do-Sun Lim, Do-Yoon Kang, Jung-Min Ahn, Duk-Woo Park, Seung-Jung Park","doi":"10.4244/EIJ-D-24-00911","DOIUrl":"https://doi.org/10.4244/EIJ-D-24-00911","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 10","pages":"581-583"},"PeriodicalIF":7.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082051","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}

{"title":"Pharmacodynamic effects of cangrelor in patients with acute or chronic coronary syndrome undergoing percutaneous coronary intervention: the POMPEII Registry.","authors":"Giuseppe Gargiulo, Plinio Cirillo, Luca Sperandeo, Domenico Simone Castiello, Lina Manzi, Imma Forzano, Domenico Florimonte, Fiorenzo Simonetti, Mario Enrico Canonico, Marisa Avvedimento, Roberta Paolillo, Alessandra Spinelli, Federica Buongiorno, Luigi Di Serafino, Carmen Anna Maria Spaccarotella, Anna Franzone, Raffaele Piccolo, Eugenio Stabile, Marco Valgimigli, Giovanni Esposito","doi":"10.4244/EIJ-D-24-00757","DOIUrl":"https://doi.org/10.4244/EIJ-D-24-00757","url":null,"abstract":"<p><strong>Background: </strong>Cangrelor is approved for oral P2Y₁₂ inhibitor-naïve patients undergoing percutaneous coronary intervention (PCI). Pharmacodynamic (PD) investigations in various clinical settings, with various assays, have shown contrasting data in terms of the extent of platelet inhibition and rates of high residual platelet reactivity (HRPR).</p><p><strong>Aims: </strong>We aimed to assess the PD effects of cangrelor in all patients receiving it during PCI.</p><p><strong>Methods: </strong>PharmacOdynaMic Effects of Cangrelor in PatiEnts wIth Acute or chronIc Coronary Syndrome Undergoing Percutaneous Coronary Intervention (POMPEII Registry; ClinicalTrials.gov: NCT04790032) is an investigator-initiated, prospective study assessing PD effects at 4 timepoints with 3 assays. Clinical outcomes at 30 days were also assessed.</p><p><strong>Results: </strong>From March 2021 to June 2024, 150 patients undergoing PCI and receiving cangrelor were enrolled (64 patients underwent elective PCI; 30 had non-ST-elevation acute coronary syndrome; and 56 had ST-segment elevation myocardial infarction [STEMI], of whom 24 were pretreated with ticagrelor). Most patients switched from cangrelor to either clopidogrel or ticagrelor. Inhibition of platelet aggregation was moderate during cangrelor infusion (light transmittance aggregometry with adenosine diphosphate 20 μM: 57.6±16.5%), with rates of 3.2% for HRPR and 1.3% for bailout tirofiban. Rates of HRPR were relevant at 3 h (37.9%) and 4-6 h (15.3%), and HRPR occurred significantly more frequently in patients switching to clopidogrel compared with ticagrelor. Rates of ischaemic and bleeding events were low.</p><p><strong>Conclusions: </strong>Cangrelor provided effective platelet inhibition in most patients with ACS or CCS undergoing PCI, including those with STEMI who were pretreated with ticagrelor. Switching from cangrelor to an oral P2Y₁₂ inhibitor, mainly clopidogrel, exposed a large number of patients to a variable period of on-treatment HRPR.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 10","pages":"560-570"},"PeriodicalIF":7.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082052","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}

{"title":"Treatment of patent foramen ovale.","authors":"Christian Pristipino, John Carroll, Jean-Louis Mas, Nina C Wunderlich, Lars Sondergaard","doi":"10.4244/EIJ-D-23-00915","DOIUrl":"https://doi.org/10.4244/EIJ-D-23-00915","url":null,"abstract":"<p><p>After extensive debate, the percutaneous closure of patent foramen ovale (PFO) has been established as a first-line treatment for the secondary prevention of PFO-related stroke in patients between 18 and 60 years old, whereas the role of PFO closure for primary prevention remains controversial. Additionally, in selected cases, PFO closure may be considered beyond these age limits and for other indications such as the treatment of systemic deoxygenation syndromes and the secondary prevention of systemic embolism or decompression sickness, when the PFO has been determined to be causative in the condition. In all cases, an in-depth diagnostic work-up, requiring collaboration among different specialists, is necessary to estimate the likelihood of PFO being related to the clinical condition. Since the first percutaneous closure of an atrial septal defect in 1976, the technique has been adapted and simplified for PFO. It is now well standardised with double-disc occluders, which are widely adopted because of their ease of use and evidence-based efficacy and safety. The procedure is generally straightforward, but some anatomical characteristics may be challenging. The choice of device and drug therapy after the procedure is currently empirical and guided by patient characteristics. Early and late complications of the procedure are infrequent but require early diagnosis. Further evidence is eagerly awaited to improve diagnosis, define other indications, make better procedural choices, and prescribe the most effective drug therapy after closure.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 10","pages":"505-524"},"PeriodicalIF":7.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082062","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}

{"title":"Unblinded trials of transcatheter interventions with subjective endpoints: what are the implications?","authors":"Sanjay Kaul","doi":"10.4244/EIJ-D-24-01198","DOIUrl":"https://doi.org/10.4244/EIJ-D-24-01198","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 10","pages":"502-504"},"PeriodicalIF":7.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082063","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}