Eurointervention最新文献

{"title":"Access site closure after TAVI: invincible sutures.","authors":"Mohamed Abdel-Wahab, Oliver Dumpies","doi":"10.4244/EIJ-E-24-00074","DOIUrl":"10.4244/EIJ-E-24-00074","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 5","pages":"e250-e252"},"PeriodicalIF":7.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543113","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":"A propensity-matched comparison of plug- versus suture-based vascular closure after TAVI.","authors":"David Grundmann, Won Kim, Caroline Kellner, Matti Adam, Daniel Braun, Alexander R Tamm, Max Meertens, Christian W Hamm, Sabine Bleiziffer, Jonas Gmeiner, Alexander Sedaghat, David Leistner, Matthias Renker, Hendrik Wienemann, Efstratios Charitos, Marie Linnemann, Tobias Lerchner, Benjamin Juri, Mostafa Salem, Roman Benetti-Lehmann, Henryk Dreger, Alina Goßling, Awesta Nahif, Lenard Conradi, Niklas Schofer, Andreas Schäfer, Jasmin Popara, Misumasa Sudo, Smita Scholtz, Ralph Stephan von Bardeleben, Marc Vorpahl, Derk Frank, Tanja K Rudolph, Moritz Seiffert","doi":"10.4244/EIJ-D-24-00120","DOIUrl":"10.4244/EIJ-D-24-00120","url":null,"abstract":"<p><strong>Background: </strong>Vascular access site complications are associated with increased morbidity and mortality after transcatheter aortic valve implantation (TAVI). Current results comparing strategies with plug- (P-VCD; MANTA) and suture-based vascular closure devices (S-VCD; Perclose ProGlide) remain inconsistent.</p><p><strong>Aims: </strong>It was our aim to assess the incidence of access-related vascular complications after P-VCD or S-VCD strategies after transfemoral TAVI.</p><p><strong>Methods: </strong>The Plug or sUture based vascuLar cloSurE after TAVI (PULSE) registry retrospectively evaluated 10,120 consecutive patients who had undergone transfemoral TAVI at 10 centres from 2016 to 2021. A propensity score was used to match 900 P-VCD patients with 1,800 S-VCD patients in a 1:2 fashion. The primary outcome measures were major and minor access-related vascular complications at the primary access site, adjudicated according to Valve Academic Research Consortium 3 definitions.</p><p><strong>Results: </strong>The median age was 81.8 years, 46.4% of patients were female, and the median European System for Cardiac Operative Risk Evaluation II was 3.50%. In matched P-VCD and S-VCD groups, large-bore access-related complications occurred in 14.9% vs 10.3% (p<0.001; major: 3.6% vs 4.6%; p=0.218; minor: 11.3% vs 5.8%; p<0.001) of patients. Bleeding accounted for most of these complications (9.6% vs 7.2%; p=0.028) and was treated with endovascular balloon inflation (5.4% vs 2.6%; p<0.001), stent implantation (4.7% vs 0.7%; p<0.001) or surgical repair (0.7% vs 1.7%; p=0.03).</p><p><strong>Conclusions: </strong>P-VCD were associated with higher rates of primary access-related vascular complications, driven by minor complications, compared to S-VCD. Endovascular treatment was more common after P-VCD failure.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 5","pages":"e272-e281"},"PeriodicalIF":7.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542939","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":"Balloon-expandable SAPIEN 3 Ultra valve in intermediate sizing zones: insights from the OPERA-TAVI registry.","authors":"Giuliano Costa, Thomas Pilgrim, Francesco Saia, Flavio Luciano Ribichini, Caterina Gandolfo, Azeem Latib, John G Webb, Mohamed Abdel-Wahab, Darren Mylotte, Marco Barbanti, For The Opera-Tavi","doi":"10.4244/EIJ-D-24-00741","DOIUrl":"10.4244/EIJ-D-24-00741","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 5","pages":"e282-e284"},"PeriodicalIF":7.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543130","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":"The future of complete revascularisation: prioritising imaging-guided non-culprit lesion assessment.","authors":"Roberto Diletti, Jacob J Elscot","doi":"10.4244/EIJ-E-25-00002","DOIUrl":"10.4244/EIJ-E-25-00002","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 4","pages":"e198-e199"},"PeriodicalIF":7.6,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442724","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":"Functional or anatomical assessment of non-culprit lesions in acute myocardial infarction.","authors":"Xueming Xu, Chao Fang, Senqing Jiang, Yuzhu Chen, Jiawei Zhao, Sibo Sun, Yini Wang, Lulu Li, Dongxu Huang, Shuang Li, Huai Yu, Tao Chen, Jinfeng Tan, Xiaohui Liu, Jiannan Dai, Gary S Mintz, Bo Yu","doi":"10.4244/EIJ-D-24-00720","DOIUrl":"10.4244/EIJ-D-24-00720","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have reported the value of quantitative flow ratio (QFR) to assess the physiological significance of non-culprit lesions (NCLs) in acute myocardial infarction (AMI) patients and of optical coherence tomography (OCT)-defined thin-cap fibroatheroma (TCFA) to identify non-culprit vulnerable plaques.</p><p><strong>Aims: </strong>We sought to systematically compare long-term NCL-related clinical prognosis in an AMI population utilising acute Murray fractal law-based QFR (μQFR) values and OCT-defined TCFA.</p><p><strong>Methods: </strong>Three-vessel OCT imaging and μQFR assessment were conducted in 645 AMI patients, identifying 1,320 intermediate NCLs in non-infarct-related arteries. The primary endpoint was a composite of cardiac death, NCL-related non-fatal myocardial infarction (MI), and NCL-related unplanned coronary revascularisation, with follow-up lasting up to 5 years.</p><p><strong>Results: </strong>The primary endpoint occurred in 59 patients (11.1%). OCT-defined TCFA independently predicted patient-level (adjusted hazard ratio [HR] 3.05, 95% confidence interval [CI]: 1.80-5.19) and NCL-specific primary endpoints (adjusted HR 4.46, 95% CI: 2.33-8.56). The highest event rate of 29.6% was observed in patients with NCLs that were TCFA (+) with μQFR ≤0.80, compared to 16.3% in those that were also TCFA (+) but with μQFR>0.80, 6.0% in those that were TCFA (-) with μQFR ≤0.80, and 6.6% in those that were TCFA (-) with μQFR>0.80 (log-rank p<0.001). TCFA was an independent predictor for the primary endpoint in ST-segment elevation MI (STEMI; adjusted HR 3.27, 95% CI: 1.67-6.41) and non-STEMI (adjusted HR 3.26, 95% CI: 1.24-8.54) patients, whereas μQFR ≤0.80 was not.</p><p><strong>Conclusions: </strong>When assessing NCLs during the index procedure in AMI patients, OCT-defined TCFA serves as the dominant prognostic predictor for long-term clinical outcomes, rather than μQFR-determined physiological significance.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 4","pages":"e217-e228"},"PeriodicalIF":7.6,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442717","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":"Completeness, timing, and guidance of percutaneous coronary intervention for myocardial infarction and multivessel disease: a systematic review and network meta-analysis.","authors":"Claudio Laudani, Giovanni Occhipinti, Antonio Greco, Marco Spagnolo, Daniele Giacoppo, Davide Capodanno","doi":"10.4244/EIJ-D-24-00814","DOIUrl":"10.4244/EIJ-D-24-00814","url":null,"abstract":"<p><strong>Background: </strong>Trials assessing the prognostic influence of the completeness, timing, and guidance of percutaneous coronary intervention (PCI) for haemodynamically stable acute myocardial infarction (MI) and multivessel coronary artery disease (MV-CAD) have provided heterogeneous results.</p><p><strong>Aims: </strong>We aimed to comprehensively and simultaneously assess the available evidence on the completeness, timing, and guidance of PCI for acute MI and MV-CAD.</p><p><strong>Methods: </strong>Major electronic databases were screened to identify randomised trials comparing at least two PCI strategies for acute MI and MV-CAD. Recurrent MI and cardiac death were the primary and co-primary outcomes. Frequentist and Bayesian 5- and 3-node network meta-analyses were conducted along with complementary analyses to explore potential sources of heterogeneity.</p><p><strong>Results: </strong>Fourteen trials, including 14,433 patients, were pooled. In the frequentist 5-node analysis, angiography-guided immediate complete revascularisation (CR) reduced MI compared with infarct-related artery (IRA)-only revascularisation (hazard ratio [HR] 0.42, 95% confidence interval [CI]: 0.27-0.66), angiography-guided staged CR (HR 0.56, 95% CI: 0.36-0.87), and functionally guided staged CR (HR 0.37, 95% CI: 0.20-0.69). Functionally guided immediate CR was associated with reduced MI compared with IRA-only revascularisation (HR 0.53, 95% CI 0.34-0.82). The Bayesian analysis confirmed only an advantage of angiography-guided immediate CR over IRA-only revascularisation. In frequentist 3-node analysis, immediate CR reduced MI (HR 0.51, 95% CI: 0.37-0.70) and cardiac death (HR 0.68, 95% CI: 0.50-0.93) compared with IRA-only revascularisation and MI compared with staged CR (HR 0.55, 95% CI: 0.38-0.79). The Bayesian analysis did not confirm the reduction in cardiac death. CR, regardless of the type of guidance and especially when immediate, reduced the rate of any revascularisation compared with IRA-only revascularisation.</p><p><strong>Conclusions: </strong>In haemodynamically stable patients with acute MI and non-complex MV-CAD undergoing PCI, immediate CR following successful culprit lesion treatment reduces recurrent MI compared with IRA-only revascularisation and staged CR. Whether CR is associated with reduced cardiovascular death remains uncertain.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 4","pages":"e203-e216"},"PeriodicalIF":7.6,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442699","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":"Angiography-based radial wall strain in carotid plaques and its association with plaque vulnerability.","authors":"Shiteng Suo, Huilin Zhao, Chunming Li, Mengqiu Cao, Zhiqing Wang, Jin Zhang, Tonglei Han, Daqiao Guo, Weiguo Fu, Yan Zhou, Shengxian Tu","doi":"10.4244/EIJ-D-24-00734","DOIUrl":"10.4244/EIJ-D-24-00734","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 4","pages":"e240-e243"},"PeriodicalIF":7.6,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442555","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":"Do we need to be fully complete in multivessel acute myocardial infarction?","authors":"Pieter C Smits, Valeria Paradies","doi":"10.4244/EIJ-E-25-00003","DOIUrl":"10.4244/EIJ-E-25-00003","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 4","pages":"e196-e197"},"PeriodicalIF":7.6,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442708","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":"Effects of proton pump inhibitors on gastrointestinal bleeding and cardiovascular outcomes in myocardial infarction patients treated with DAPT.","authors":"Danbee Kang, Ki Hong Choi, Hyejeong Park, Jihye Heo, Taek Kyu Park, Joo Myung Lee, Juhee Cho, Jeong Hoon Yang, Young Bin Song, Seung-Hyuk Choi, Hyeon-Cheol Gwon, Joo-Yong Hahn","doi":"10.4244/EIJ-D-24-00673","DOIUrl":"10.4244/EIJ-D-24-00673","url":null,"abstract":"<p><strong>Background: </strong>A discrepancy exists between the European and American guideline recommendations for the routine use of proton pump inhibitors (PPIs) in patients treated with dual antiplatelet therapy (DAPT).</p><p><strong>Aims: </strong>This study aimed to determine the association between the co-prescription of PPIs and DAPT and the occurrence of gastrointestinal bleeding and ischaemic events in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI).</p><p><strong>Methods: </strong>A search was conducted using a nationwide Korean claims database to identify patients with AMI undergoing PCI with DAPT. Patients were matched using a large-scale propensity score (PS) algorithm according to the co-prescription of PPIs. The primary efficacy endpoint was major gastrointestinal bleeding requiring transfusion with hospitalisation within 1 year. The primary safety endpoint was major adverse cardiac and cerebrovascular events (MACCE), a composite of cardiovascular death, spontaneous myocardial infarction, repeat revascularisation and ischaemic stroke within 1 year.</p><p><strong>Results: </strong>Among the total population, 30.0% of patients (n=35,566) received PPIs with DAPT after PCI for AMI. After PS matching, 35,560 pairs were generated. Compared to patients without PPIs, those on PPIs were associated with a significantly lower 1-year risk of major gastrointestinal bleeding (0.7% vs 0.4%, hazard ratio [HR] 0.59, 95% confidence interval [CI]: 0.48-0.73). The 1-year risk of MACCE did not differ significantly between the groups with or without PPIs (13.4% vs 13.1%, HR 0.98, 95% CI: 0.94-1.02). The beneficial effects of PPIs on gastrointestinal bleeding, without increased risk of cardiovascular events, were observed consistently, regardless of P2Y₁₂ inhibitor type, PPI type, or individual bleeding risk.</p><p><strong>Conclusions: </strong>In real-world data from a large study of East Asian patients with AMI undergoing PCI and maintaining DAPT, PPI use significantly reduced the risk of major gastrointestinal bleeding without increasing ischaemic events, irrespective of bleeding risk or type of P2Y₁₂ inhibitor. (ClinicalTrials.gov: NCT06241833).</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 4","pages":"e229-e239"},"PeriodicalIF":7.6,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442711","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":"Gastrointestinal protection with proton pump inhibitors in cardiovascular patients: still misunderstood and underutilised.","authors":"Deepak L Bhatt","doi":"10.4244/EIJ-E-24-00070","DOIUrl":"10.4244/EIJ-E-24-00070","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 4","pages":"e200-e202"},"PeriodicalIF":7.6,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442721","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}