Eurointervention最新文献

{"title":"Left atrial appendage closure with the AnchorMan or Watchman devices: 12-month results of the SAFE-PROTECT randomised trial.","authors":"Binhao Wang, Heng Cai, Yanqing Wu, Manhua Chen, Changqian Wang, Xiaofei Jiang, Siming Tao, Zhixiong Zhong, Jie Zeng, Fengling Wang, Zhongping Ning, Zuyi Yuan, Jiangui He, Dominic P Francese, Alexandra J Lansky, Ben He, Huimin Chu, On Behalf Of The Safe-Protect Investigators","doi":"10.4244/EIJ-D-25-01168","DOIUrl":"10.4244/EIJ-D-25-01168","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous closure of the left atrial appendage (LAA) is an alternative to chronic oral anticoagulation to reduce stroke risk in patients with non-valvular atrial fibrillation (AF).</p><p><strong>Aims: </strong>The SAFE-PROTECT trial was designed to evaluate the safety and efficacy of the AnchorMan, a novel LAA closure device, compared with the Watchman 2.5 device for patients with AF at high risk of ischaemic stroke.</p><p><strong>Methods: </strong>SAFE-PROTECT was a multicentre, open-label, non-inferiority trial of patients with non-valvular AF at high risk of ischaemic stroke, randomised 1:1 to LAA closure with the AnchorMan or the Watchman device. The 12-month primary endpoint was clinical success (freedom from ischaemic/haemorrhagic stroke, systemic embolism, cardiovascular or unexplained death); the secondary efficacy endpoint was echocardiography-defined LAA occlusion (peridevice leak <5 mm) at 12 months.</p><p><strong>Results: </strong>A total of 216 patients were randomised to either an AnchorMan (n=108) or to a Watchman (n=108) device. The AnchorMan was non-inferior to Watchman for the primary endpoint (98.1% vs 98.1%;p>0.99; difference -0.3; 95% confidence interval [CI]: -3.9 to 3.5; p_{non-inferiority}=0.0004) and the powered secondary efficacy endpoint of LAA closure (100% vs 100%; difference 0%; 95% CI: -3.60 to 3.50; p_{non-inferiority}=not applicable). The rates of all-cause death, stroke, major bleeding, and device-related complications were low and similar between groups.</p><p><strong>Conclusions: </strong>Among patients with non-valvular AF at high risk of ischaemic stroke, the AnchorMan device met its prespecified non-inferiority primary clinical success and secondary LAA occlusion endpoints compared with the Watchman 2.5 device.</p><p><strong>Clinicaltrials: </strong>gov: NCT04479722.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 13","pages":"e720-e729"},"PeriodicalIF":9.2,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13330120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392607","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":"Validation of the VARC-HBR consensus for defining high bleeding risk in TAVI.","authors":"Manveer Singh, Davide Capodanno, Roxana Mehran, Marie-Claude Morice, Philippe Garot","doi":"10.4244/EIJ-D-26-00315","DOIUrl":"10.4244/EIJ-D-26-00315","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 13","pages":"e748-e750"},"PeriodicalIF":9.2,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13330113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391803","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":"Outcomes of percutaneous mechanical aspiration in left-sided infective endocarditis.","authors":"Nahyr Sofía Lugo-Fagundo, Ali H Dakroub, Benjamin Hibbert, Pedro Villablanca, Marquand Patton, Sripal Bangalore, Mohammed Qintar, Stephanie El-Hajj, Paul Sorajja, Nadira Hamid, Evin Yucel, Larry Baddour, Pradeep Yadav, Sahil Parikh, Sanjum Sethi, Abdallah El Sabbagh, On Behalf Of The Clear-Ie Investigators","doi":"10.4244/EIJ-D-26-00271","DOIUrl":"10.4244/EIJ-D-26-00271","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":" ","pages":"e751-e753"},"PeriodicalIF":9.2,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13330112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018501","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":"Unloading the clock: when timing meets physiology in STEMI shock.","authors":"Jacob E Møller, Benedikt Schrage","doi":"10.4244/EIJ-D-26-00601","DOIUrl":"10.4244/EIJ-D-26-00601","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 12","pages":"e648-e649"},"PeriodicalIF":9.2,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13245446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254435","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":"Door-to-unload time and mortality in patients with ST-segment elevation myocardial infarction complicated by cardiogenic shock.","authors":"Shin Nagai, Toru Kondo, Shingo Kazama, Asuka Nozaki, Takahiro Imaizumi, Shotaro Komeyama, Chiaki Mizuno, Ryota Ito, Hiroaki Hiraiwa, Ryota Morimoto, Yasunari Hayashi, Tomo Yoshizumi, Masato Mutsuga, Toyoaki Murohara, On Behalf Of The J-Pvad Investigators","doi":"10.4244/EIJ-D-25-01369","DOIUrl":"10.4244/EIJ-D-25-01369","url":null,"abstract":"<p><strong>Background: </strong><span style=\"font-size:12pt\"><span style=\"font-family:Aptos,sans-serif\">Microaxial flow pumps (mAFPs) provide left ventricular unloading and haemodynamic stabilisation, with evidence suggesting a survival benefit in patients with ST-segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock (CS). The prognostic impact of early mAFP placement after hospital arrival remains unclear.</span></span> Aims: <span style=\"font-size:12pt\"><span style=\"font-family:Aptos,sans-serif\">We aimed to investigate the association between door-to-unload time and in-hospital mortality in patients with STEMI-CS.</span></span> Methods: <span style=\"font-size:12pt\"><span style=\"font-family:Aptos,sans-serif\">We analysed data from the Japan Registry for Percutaneous Ventricular Assist Devices, including consecutive patients with STEMI-CS who underwent mAFP placement between February 2020 and December 2023. The primary outcome was in-hospital mortality.</span></span> Results: <span style=\"font-size:12pt\"><span style=\"font-family:Aptos,sans-serif\">Among 1,783 patients, the median door-to-unload time was 99 min. The overall in-hospital mortality rate was 39.2%, and this increased with longer door-to-unload times: 32.9% (≤60 min), 33.0% (61-90 min), 40.1% (91-150 min), and 48.3% (>150 min). Using a 90 min cutoff, delayed placement (>90 min) was associated with higher mortality (adjusted odds ratio 1.56, 95% confidence interval: 1.26-1.95). A restricted cubic spline model showed that mortality remained stable when placement was within 90 min, followed by an increase. When stratified by no prior mechanical circulatory support and prior venoarterial extracorporeal membrane oxygenation (VA-ECMO) only, the patients with prior VA-ECMO only had more severe baseline characteristics and higher mortality; however, the association of longer door-to-unload time with higher mortality was consistent. Predictors of delayed mAFP placement included older age, lower institutional volume, higher heart rate, higher creatinine levels, prior use of an intra-aortic balloon pump or VA-ECMO, and percutaneous coronary intervention before mAFP placement.</span></span> Conclusions: <span style=\"font-size:12pt\"><span style=\"font-family:Aptos,sans-serif\">A shorter door-to-unload time, particularly within 90 min, is associated with better survival in patients with STEMI-CS.</span></span>.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 12","pages":"e678-e689"},"PeriodicalIF":9.2,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13245458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254334","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":"Transcatheter edge-to-edge repair for primary mitral regurgitation: what lies ahead?","authors":"Anna Sonia Petronio, Matteo Mazzola","doi":"10.4244/EIJ-D-26-00394","DOIUrl":"10.4244/EIJ-D-26-00394","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 12","pages":"e650-e652"},"PeriodicalIF":9.2,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13245444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254332","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":"Antithrombotic therapy for secondary prevention in patients with acute coronary syndromes treated with percutaneous coronary intervention: options for personalization to reduce bleeding or ischaemic risks. A Clinical Consensus Statement of the ESC Working Group on Thrombosis, the Association for Acute CardioVascular Care of the ESC, the European Association of Percutaneous Cardiovascular Interventions of the ESC, and the ESC Working Group on Cardiovascular Pharmacology A Clinical Consensus Statement of the ESC Working Group on Thrombosis, the Association for Acute CardioVascular Care of the ESC, the European Association of Percutaneous Cardiovascular Interventions of the ESC, and the ESC Working Group on Cardiovascular Pharmacology.","authors":"Diana A Gorog, Jurriën M Ten Berg, Gianluca Campo, Tobias Geisler, Bruna Gigante, Erik L Grove, Sigrun Halvorsen, Kurt Huber, Young-Hoon Jeong, Gregory Y H Lip, Eliano P Navarese, Andrea Rubboli, Jolanta M Siller Matula, Robert F Storey, Marco Valgimigli, Christophe Vandenbriele, Gemma Vilahur, Ingo Ahrens, Jose Luis Ferreiro","doi":"10.4244/EIJ-E-26-00003","DOIUrl":"10.4244/EIJ-E-26-00003","url":null,"abstract":"<p><p>Dual antiplatelet therapy (DAPT) is required to prevent atherothrombotic events in patients with acute coronary syndrome (ACS) treated with percutaneous coronary intervention (PCI). The default DAPT strategy, namely a potent P2Y₁₂ inhibitor combined with aspirin for 12 months, exposes many patients to excess bleeding risk. Over the past years, alternative antithrombotic regimens have been proposed to reduce bleeding (DAPT abbreviation or de-escalation) or ischaemic (prolonged dual antithrombotic therapy) events. Abbreviation or de-escalation of DAPT is supported by (i) multiple trials showing these strategies to significantly reduce bleeding, particularly for the 20-40% of patients classified as high bleeding risk (HBR); (ii) low prevalence of stent thrombosis and recurrent myocardial infarction beyond 1-3 months post-ACS with the latest generation of drug-eluting stents, and (iii) the recognition that HBR is far more prevalent than high ischaemic risk. Amongst patients at HBR, standard DAPT, in comparison to abbreviated or de-escalated DAPT, increases the net risk of major adverse events, even in the presence of high ischaemic risk. Conversely, amongst patients at high ischaemic risk, without HBR, prolonged dual antithrombotic therapy reduces longer-term thrombotic risk. Recognizing risk factors and assessing the magnitude of bleeding and ischaemic risks are essential. Since there are no ideal scoring systems to balance ischaemic and bleeding risks, and many overlap, focus should be on managing the risk most amenable to modification, namely bleeding, which should dominate the decision-making over ischaemic risk when choosing a DAPT regimen. This document provides practical advice regarding best practice for personalizing DAPT in patients with ACS undergoing PCI, with evidence-based clinical consensus statements on selecting the most appropriate antiplatelet strategy to optimize clinical outcomes.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 12","pages":"e653-e677"},"PeriodicalIF":9.2,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13254929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254343","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":"Outcomes of intraprocedural haemodynamic changes in patients undergoing mitral transcatheter edge-to-edge repair.","authors":"Shingo Kuwata, Masaki Izumo, Tetsu Tanaka, Taishi Okuno, Yoshihiro J Akashi, Masanori Yamamoto, Tetsuro Shimura, Atsushi Sugiura, Shunsuke Kubo, Mike Saji, Yuki Izumi, Yusuke Enta, Shinichi Shirai, Shingo Mizuno, Yusuke Watanabe, Makoto Amaki, Kazuhisa Kodama, Junichi Yamaguchi, Toru Naganuma, Hiroki Bota, Yohei Ohno, Masahiko Asami, Daisuke Hachinohe, Masahiro Yamawaki, Hiroshi Ueno, Gaku Nakazawa, Toshiaki Otsuka, Kentaro Hayashida, On Behalf The Ocean-Mitral Investigators","doi":"10.4244/EIJ-D-26-00084","DOIUrl":"10.4244/EIJ-D-26-00084","url":null,"abstract":"<p><strong>Background: </strong>While the mean left atrial pressure (mLAP) reduction during mitral transcatheter edge-to-edge repair (M-TEER) has been suggested as a potential prognostic marker, comprehensive evidence from large-scale, real-world cohorts is limited, especially with stratification by mitral regurgitation (MR) aetiology.</p><p><strong>Aims: </strong>This study aimed to evaluate the prognostic significance of intraprocedural haemodynamic changes, particularly the mLAP reduction, during M-TEER for MR, using multicentre registry data.</p><p><strong>Methods: </strong>From the OCEAN-Mitral registry, 2,629 patients undergoing M-TEER with intraprocedural direct mLAP measurements were included. A decrease in the mLAP was defined as follows: postprocedural mLAP-preprocedural mLAP<0. The primary outcome was the composite of all-cause mortality and heart failure (HF) rehospitalisation.</p><p><strong>Results: </strong>Among 2,629 patients (degenerative MR [DMR]: 825 [31.4%], functional MR [FMR]: 1,804 [68.6%]), the postprocedural mLAP decreased in 1,548 patients (58.9%). In the DMR cohort, the mLAP reduction was associated with a significantly lower risk of the composite outcome (adjusted hazard ratio [HR] 0.66, 95% confidence interval [CI]: 0.45-0.96; p=0.028), while no such association was observed in the FMR cohort (adjusted HR 0.90, 95% CI: 0.75-1.08; p=0.251). Interaction analysis confirmed a significant difference in prognostic impact based on MR aetiology (p for interaction=0.006). Pulmonary vein flow patterns improved, with systolic waves becoming greater than diastolic waves across both groups; however, their combination with the mLAP reduction predicted better outcomes only in DMR patients.</p><p><strong>Conclusions: </strong>A reduction in the mLAP during M-TEER is independently associated with improved clinical outcomes in patients with DMR but not in those with FMR. These findings underscore the importance of real-time haemodynamic assessment - especially in DMR - as a valuable procedural endpoint that may aid in optimising long-term outcomes beyond anatomical MR reduction alone.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 12","pages":"e690-e700"},"PeriodicalIF":9.2,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13245450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254350","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":"Transcatheter approximation of papillary muscles.","authors":"Lukasz Tekieli, Adam Mazurek, Leszek Drabik, Andrzej Gackowski, Piotr Musiałek","doi":"10.4244/EIJ-D-25-01353","DOIUrl":"10.4244/EIJ-D-25-01353","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 12","pages":"e712-e715"},"PeriodicalIF":9.2,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13245451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254358","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":"Temporal trends in mitral edge-to-edge repair for primary mitral regurgitation.","authors":"Benedikt Koell, Sebastian Ludwig, Jessica Weimann, Dhairya Patel, Lukas Stolz, Tetsu Tanaka, Teresa Trenkwalder, Felix Rudolph, Daryoush Samim, Philipp von Stein, Cristina Giannini, Julien Dreyfus, Andrea Scotti, Jean-Michel Paradis, Marianna Adamo, Nicole Karam, Yohann Bohbot, Anne Bernard, Bruno Melica, Yusuke Kobari, Yoan Lavie-Badie, Mirjam Kessler, Omar Chehab, Simon Redwood, Edith Lubos, Ole de Backer, Marco Metra, Azeem Latib, Chiara Primerano, Christos Iliadis, Fabien Praz, Muhammed Gerçek, Erion Xhepa, Marcel Weber, Raj Makkar, Juan Granada, Thomas Modine, Erwan Donal, Jörg Hausleiter, Augustin Coisne, Daniel Kalbacher, On Behalf Of The Prime-Mr Investigators","doi":"10.4244/EIJ-D-25-01308","DOIUrl":"10.4244/EIJ-D-25-01308","url":null,"abstract":"<p><strong>Background: </strong>The evolving landscape of mitral valve transcatheter edge-to-edge repair (M-TEER) for mitral regurgitation (MR) has seen continuous advancements, driving improvements in therapeutic efficacy. Particularly in primary MR (PMR), contemporary device iterations of M-TEER offer technical advantages for improved management of complex anatomies. However, data on temporal trends in M-TEER for PMR are limited.</p><p><strong>Aims: </strong>The primary objective of our study was to analyse temporal trends in the safety, efficacy, and stability of M-TEER treatment.</p><p><strong>Methods: </strong>The PRIME-MR registry, a retrospective multicentre study, enrolled consecutive patients undergoing M-TEER for PMR at 27 centres in Europe and North America. M-TEER procedures were categorised into four time periods (2009-2013, 2014-2016, 2017-2019, and 2020-2023), to align with major device updates.</p><p><strong>Results: </strong>The analysis included 3,082 consecutive patients (median age 82 years [interquartile range 76.0-85.0], 45.1% female). Patients treated were highly symptomatic (New York Heart Association [NYHA] Class ≥III in 80.4%). Patient characteristics showed a decline in symptomatic severity (NYHA Class ≥III 85.9% in 2009-2013 vs 71.8% in 2020-2023), accompanied by lower mean Society of Thoracic Surgeons scores (5.6% [2009-2013] vs 4.6% [2020-2023]; p for trend<0.0001), and less severe MR. Over time, complication rates decreased (procedures with complications: 42.4% [2009-2013] vs 23.1% [2020-2023]; p for trend<0.0001), whereas technical efficacy increased (residual MR ≤1+: 54.0% [2009-2013] vs 68.4% [2020-2023]; p for trend<0.001). There was an increased occurrence of stable results without any deterioration at one-year follow-up (63.6% [2009-2013] vs 74.4% [2020-2023]; p for trend=0.03).</p><p><strong>Conclusions: </strong>Findings from the PRIME-MR registry highlight substantial reductions in residual MR severity and complication rates over time in PMR patients undergoing M-TEER.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 12","pages":"e701-e711"},"PeriodicalIF":9.2,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13245447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254391","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}