AsiaIntervention最新文献

{"title":"Letter: Deciphering a \"curious\" coronary artery anatomy.","authors":"Andreas Y Andreou","doi":"10.4244/AIJ-D-24-00015","DOIUrl":"https://doi.org/10.4244/AIJ-D-24-00015","url":null,"abstract":"","PeriodicalId":72310,"journal":{"name":"AsiaIntervention","volume":"10 3","pages":"236-237"},"PeriodicalIF":0.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11413565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142336715","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":"Role of physiology in the management of multivessel disease among patients with acute coronary syndrome.","authors":"Nandine Ganzorig, Graziella Pompei, Kenny Jenkins, Wanqi Wang, Francesca Rubino, Kieran Gill, Vijay Kunadian","doi":"10.4244/AIJ-D-24-00051","DOIUrl":"https://doi.org/10.4244/AIJ-D-24-00051","url":null,"abstract":"<p><p>Multivessel coronary artery disease (CAD), defined as ≥50% stenosis in 2 or more epicardial arteries, is associated with a high burden of morbidity and mortality in acute coronary syndrome (ACS) patients. A salient challenge for managing this cohort is selecting the optimal revascularisation strategy, for which the use of coronary physiology has been increasingly recognised. Fractional flow reserve (FFR) is an invasive, pressure wire-based, physiological index measuring the functional significance of coronary lesions. Understanding this can help practitioners evaluate which lesions could induce myocardial ischaemia and, thus, decide which vessels require urgent revascularisation. Non-hyperaemic physiology-based indices, such as instantaneous wave-free ratio (iFR), provide valid alternatives to FFR. While FFR and iFR are recommended by international guidelines in stable CAD, there is ongoing discussion regarding the role of physiology in patients with ACS and multivessel disease (MVD); growing evidence supports FFR use in the latter. Compelling findings show FFR-guided complete percutaneous coronary intervention (PCI) can reduce adverse cardiovascular events, mortality, and repeat revascularisations in ACS and MVD patients compared to angiography-based PCI. However, FFR is limited in identifying non-flow-limiting vulnerable plaques, which can disadvantage high-risk patients. Here, integrating coronary physiology assessment with intracoronary imaging in decision-making can improve outcomes and quality of life. Further research into novel physiology-based tools in ACS and MVD is needed. This review aims to highlight the key evidence surrounding the role of FFR and other functional indices in guiding PCI strategy in ACS and MVD patients.</p>","PeriodicalId":72310,"journal":{"name":"AsiaIntervention","volume":"10 3","pages":"157-168"},"PeriodicalIF":0.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11413640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333632","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":"A hospital lipid-lowering protocol improves 2-year clinical outcomes in patients with acute coronary syndrome.","authors":"Sho Nakao, Takayuki Ishihara, Takuya Tsujimura, Osamu Iida, Yosuke Hata, Taku Toyoshima, Naoko Higashino, Masaya Kusuda, Toshiaki Mano","doi":"10.4244/AIJ-D-23-00056","DOIUrl":"https://doi.org/10.4244/AIJ-D-23-00056","url":null,"abstract":"<p><strong>Background: </strong>Although mortality after acute coronary syndrome (ACS) has improved in the acute phase, cardiovascular events occur at a certain frequency in the chronic phase. A hospital lipid-lowering protocol (HLP) could be effective in providing optimal lipid-lowering therapy to improve long-term clinical outcomes after ACS.</p><p><strong>Aims: </strong>This study investigated the impact of HLP on clinical outcomes in patients with ACS.</p><p><strong>Methods: </strong>We retrospectively analysed 1,114 ACS patients who had undergone successful percutaneous coronary intervention between November 2011 and June 2021. In December 2018, we introduced a HLP that included the prescription of the maximum tolerated dose of statin, ezetimibe, and eicosapentaenoic acid after ACS treatment. We compared 2-year clinical outcomes before (control group: 791 patients) and after the HLP's introduction (HLP group: 323 patients). The primary outcome was the non-target vessel revascularisation (non-TVR) rate. A multivariate Cox proportional hazard model and inverse probability weighting (IPW) based on the propensity score were used to evaluate the effect of HLP on the outcomes.</p><p><strong>Results: </strong>The cumulative 2-year non-TVR incidence was significantly lower in the HLP group than in the control group (8.5% vs 13.8%; p=0.019). Multivariable analysis revealed non-TVR risk was significantly lower in the HLP group than in the control group (adjusted hazard ratio [aHR]: 0.637 [95% confidence interval [CI]: 0.416-0.975]; p=0.038). The IPW analysis confirmed a significant association between the HLP and a lower non-TVR risk (aHR: 0.544 [95% CI: 0.350-0.847]; p=0.007).</p><p><strong>Conclusions: </strong>Implementing HLP for ACS patients improved the 2-year clinical outcome.</p>","PeriodicalId":72310,"journal":{"name":"AsiaIntervention","volume":"10 3","pages":"169-176"},"PeriodicalIF":0.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11413639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333624","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":"Real-world evidence of BioMime sirolimus-eluting stent in obstructive coronary artery disease: the meriT-2 trial.","authors":"Upendra Kaul, Gurpreet S Wander, Ajit Mullasari, Manjunath C Nanjappa, Prabhakar Heggunje-Shetty, Thomas Alexander, Suhas Hardas, Sunita Abraham, Samuel K Mathew, Suresh Vijan, Rohit K Manoj, Udita Chandra, Ashokkumar Thakkar","doi":"10.4244/AIJ-D-24-00007","DOIUrl":"https://doi.org/10.4244/AIJ-D-24-00007","url":null,"abstract":"<p><strong>Background: </strong>The efficacy and safety of the ultrathin BioMime sirolimus-eluting coronary stent (SES) system in treating single or multiple <i>de novo</i> native coronary lesions, in-stent restenosis, and bifurcation lesions have been evidenced at 1 year.</p><p><strong>Aims: </strong>We sought to investigate the long-term safety and efficacy of the BioMime SES in a real-world population with obstructive coronary artery disease (CAD).</p><p><strong>Methods: </strong>The prospective, single-arm, multicentre meriT-2 trial enrolled 250 patients from 11 sites across India. The safety endpoint was the cumulative frequency of major adverse cardiovascular events (MACE) at 5 years, defined as a composite of cardiac death, myocardial infarction (MI), emergent coronary artery bypass grafting or clinically indicated target lesion revascularisation (CI-TLR). Stent thrombosis (ST) was evaluated according to the Academic Research Consortium definitions.</p><p><strong>Results: </strong>A total of 214 (85.6%) subjects completed the 5-year follow-up. The mean age of patients was 57.44±10.75 years, and 82.71% were males. A total of 308 lesions were treated with BioMime SES. Most of the lesions were localised in the left anterior descending artery (45.46%) and were type B2 lesions (44.81%). The cumulative MACE rate at 5 years was 8.9% (n=19), including 0.9% cardiac deaths, 1.9% MI and 6.1% CI-TLR. The rate of ST was only 0.5%. The Kaplan-Meier survivor analysis revealed actuarial survivorship of 95.6% for the intention-to-treat population (n=250) over 5 years.</p><p><strong>Conclusions: </strong>The long-term clinical outcomes of the meriT-2 trial established the safety and efficacy of the ultrathin-strut biodegradable-polymer-based BioMime SES with satisfactory clinical outcomes at 5 years.</p>","PeriodicalId":72310,"journal":{"name":"AsiaIntervention","volume":"10 3","pages":"186-194"},"PeriodicalIF":0.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11413569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333631","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":"First-in-human novel pacing-over-the-wire technique during TAVR with the SENTINEL cerebral protection device: the SENTIPACE pilot study.","authors":"Ivan Wong, Alvin H Y Ko, Michael Chiang, Angus Shing Fung Chui, Alan Ka Chun Chan, Kam Tim Chan, Michael Kang-Yin Lee","doi":"10.4244/AIJ-D-24-00002","DOIUrl":"https://doi.org/10.4244/AIJ-D-24-00002","url":null,"abstract":"","PeriodicalId":72310,"journal":{"name":"AsiaIntervention","volume":"10 3","pages":"233-235"},"PeriodicalIF":0.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11413566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333627","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":"Hybrid strategy of drug-eluting stent and drug-coated balloon in the treatment of de novo coronary artery disease: 1-year clinical outcomes.","authors":"Jassie Teo, Tawfeq Mohd Noor, Nor Faiqah Ahmad, Zulaikha Zainal, Steven Wong, Chan Ho Thum, Faten Aqilah Aris, Khai Chih Teh, Ganapathi Palaniappan, Hui Beng Koh, Aslannif Roslan, Beni Rusani, Kumara Ganesan, Hafidz Hadi","doi":"10.4244/AIJ-D-23-00066","DOIUrl":"https://doi.org/10.4244/AIJ-D-23-00066","url":null,"abstract":"<p><strong>Background: </strong>The hybrid strategy of drug-eluting stent (DES) and drug-coated balloon (DCB) has been increasingly accepted for the treatment of <i>de novo</i> coronary artery disease. However, data regarding the clinical outcome of this practice in a Southeast Asian population are limited.</p><p><strong>Aims: </strong>We aimed to investigate the safety and clinical outcome of this hybrid strategy (DES and DCB) in the treatment of <i>de novo</i> coronary artery disease. The primary endpoint was target lesion failure (TLF) in the DES/DCB-treated segment at 12 months. TLF is defined as the composite of cardiac death, target vessel myocardial infarction (TVMI) and ischaemia-driven target lesion revascularisation (ID-TLR) in the DES- and/or DCB-treated segment.</p><p><strong>Methods: </strong>A total of 401 patients with 458 lesions were treated with the hybrid strategy at the National Heart Institute (IJN), Kuala Lumpur, Malaysia, from 1 July 2021 to 30 June 2022, were retrospectively enrolled in the study. A total of 38 patients (9.5%) were lost to subsequent follow-up, and the remaining 363 patients (90.5%) were included in the outcome analysis. Clinical outcomes at 1 year were analysed.</p><p><strong>Results: </strong>In all, 219 lesions (47.8%) involved the left anterior descending artery, 146 lesions (31.9%) involved the right coronary artery, and 57 lesions (12.4%) involved the left circumflex artery. In all, 87 lesions (19%) were bifurcation lesions. A total of 8 patients (2.2%) had TLF, of whom 3 patients (0.83%) had TVMI, 3 patients (0.83%) had ID-TLR, and 2 patients (0.6%) experienced cardiac death. Four patients died of a non-cardiac cause at 1-year follow-up.</p><p><strong>Conclusions: </strong>A hybrid strategy of DES and DCB for the treatment of <i>de novo</i> coronary artery lesions appears to be feasible and clinically safe according to the 1-year outcomes.</p>","PeriodicalId":72310,"journal":{"name":"AsiaIntervention","volume":"10 3","pages":"212-218"},"PeriodicalIF":0.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11413635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333628","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":"Infective endarteritis of coronaries following percutaneous coronary intervention (stentocarditis) leading to pseudoaneurysm - a retrospective study of eleven cases.","authors":"Rajesh Gopalan Nair, Haridasan Vellani, Kader Muneer, Rajesh Sadanandan Pillai, Prajeesh Thiru Chaithanya, Suhas Alur, Mohammed Ameen, Vidhu Anand","doi":"10.4244/AIJ-D-24-00010","DOIUrl":"10.4244/AIJ-D-24-00010","url":null,"abstract":"<p><strong>Background: </strong>Coronary endarteritis and stent abscess following percutaneous coronary intervention (PCI) are rare and challenging conditions with no clear treatment guidelines available.</p><p><strong>Aims: </strong>This retrospective study aims to present the clinical features, patient and procedural factors, management strategies, and outcomes in 11 consecutive cases referred between 2018 and 2022.</p><p><strong>Methods: </strong>We retrospectively analysed 11 cases of coronary endarteritis and stent abscess post-PCI that were referred from various centres. We recorded clinical features, patient demographics, procedural factors, and management approaches, and evaluated treatment outcomes.</p><p><strong>Results: </strong>Among the 11 patients, 7 (63.6%) were male. PCIs had been performed in the right coronary artery (6, 54.5%), left anterior descending artery (3, 27.3%), and circumflex artery (2, 18.2%). The presenting symptoms included fever, pericarditis with effusion, tamponade, and postinterventional angina due to stent occlusion. Fever occurred in 10 (90.9%) patients, and the majority (70%) of patients experienced fever within one week of PCI. Staphylococcus aureus was the predominant organism (54.5%), followed by Pseudomonas aeruginosa. Transthoracic echocardiography revealed abscess cavities in 10 patients. All patients received vancomycin and piperacillin-tazobactam. Surgery was considered in 7 cases with abscesses >2 cm; one patient refused and responded to antibiotics for 4 weeks. Possible risk factors included repeated use of local sites, reuse of hardware, multiple guidewire manipulations, prolonged catheterisation, inadequate sterility, and diabetes.</p><p><strong>Conclusions: </strong>This study provides insights into coronary endarteritis and stent abscess following PCI. The lack of clear treatment guidelines highlights the challenges in managing this condition. Identifying risk factors may aid in preventive strategies. Further research is needed to develop standardised approaches for effective management.</p>","PeriodicalId":72310,"journal":{"name":"AsiaIntervention","volume":"10 2","pages":"126-134"},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11263884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141790169","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":"RAdiation Dose Attenuation using RADPAD in CATH lab for primary and secondary operators - RADAR-CATH STUDY.","authors":"Sandeepan Saha, Aditya Kapoor, Kamlesh Raut, Arpita Katheria, Harshit Khare, Ankit Sahu, Roopali Khanna, Sudeep Kumar, Naveen Garg, Satyendra Tewari","doi":"10.4244/AIJ-D-23-00058","DOIUrl":"10.4244/AIJ-D-23-00058","url":null,"abstract":"<p><strong>Background: </strong>Radiation injury is an important concern for interventional cardiologists and needs to be addressed. RADPAD is a radiation protection drape that has been shown to reduce the radiation exposure of the primary operator (PO). While Indian data on radiation exposure of the PO in the cath lab are scarce, the exposure of the secondary operator (SO) is even less well studied.</p><p><strong>Aims: </strong>The aim of this study was to evaluate the efficacy of RADPAD drapes in reducing radiation doses in the cath lab for the primary as well as the secondary operator.</p><p><strong>Methods: </strong>A total of 160 patients (40 patients each with single vessel disease [SVD], double vessel disease [DVD] and triple vessel disease [TVD] undergoing coronary angioplasty, and 40 patients undergoing balloon mitral valvuloplasty [BMV]) were randomised in a 1:1 pattern to undergo a procedure with or without the use of RADPAD.</p><p><strong>Results: </strong>For patients with SVD, DVD and TVD undergoing percutaneous coronary intervention (PCI) and those undergoing BMV, the % reduction with the use of RADPAD reduced the PO's received dose (in mrem) by 65%, 54%, 28% and 67%, respectively, as compared to without RADPAD. The % reduction in relative operator exposure for the PO for the 4 groups was 55%, 34%, 18% and 75%, respectively, with the use of RADPAD. The corresponding % reduction for the SO's received dose (in mrem) was 80%, 63%, 33% and 69% and for relative operator exposure was 74%, 46%, 23% and 76% in the 4 groups, respectively.</p><p><strong>Conclusions: </strong>RADPAD significantly reduces the radiation exposure of the primary and secondary operator during prolonged complex PCI and BMV procedures.</p>","PeriodicalId":72310,"journal":{"name":"AsiaIntervention","volume":"10 2","pages":"135-143"},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11261659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141790170","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":"Current status and challenges in the next steps for TAVR in China.","authors":"Samir R Kapadia, Toshiaki Isogai","doi":"10.4244/AIJ-E-24-00001","DOIUrl":"10.4244/AIJ-E-24-00001","url":null,"abstract":"","PeriodicalId":72310,"journal":{"name":"AsiaIntervention","volume":"10 2","pages":"96-97"},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11261654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141790166","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":"A filling defect during primary percutaneous coronary intervention: is it always a thrombus?","authors":"G Dimpu Edwin Jonathan, Somalaram Venkatesh, B Vivek Baliga","doi":"10.4244/AIJ-D-23-00051","DOIUrl":"10.4244/AIJ-D-23-00051","url":null,"abstract":"","PeriodicalId":72310,"journal":{"name":"AsiaIntervention","volume":"10 2","pages":"148-149"},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11263863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141790162","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}