Journal of the Society for Cardiovascular Angiography & Interventions最新文献

{"title":"Long-Term Outcome of Percutaneous Coronary Intervention Using Absorb Bioresorbable Scaffold: A SCAAR Study","authors":"Saman Saidi-Seresht MD ,&nbsp;Sacharias von Koch MD ,&nbsp;David Erlinge MD, PhD ,&nbsp;Stefan James MD, PhD ,&nbsp;Sasha Koul MD, PhD ,&nbsp;Per Grimfjärd MD, PhD","doi":"10.1016/j.jscai.2025.103724","DOIUrl":"10.1016/j.jscai.2025.103724","url":null,"abstract":"<div><h3>Background</h3><div>Bioresorbable scaffolds have been associated with inferior outcomes compared to contemporary permanent metallic drug-eluting stents (DES) for percutaneous coronary intervention, particularly within the initial years after implantation; however, their long-term performance remains uncertain. This study aimed to evaluate the long-term outcomes of Swedish patients treated with Absorb bioresorbable scaffolds (Abbott) vs contemporary DES, assessing device-related complications and examining potential late benefits. The findings seek to clarify the balance between early risks and long-term advantages of bioresorbable scaffolds in clinical practice.</div></div><div><h3>Methods</h3><div>Complete data from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR) was used to identify all patients receiving Absorb bioresorbable scaffolds or contemporary DES from November 4, 2011 to March 2, 2018. After 1:2 propensity score matching against modern DES, stent thrombosis, target lesion revascularization, in-stent restenosis, myocardial infarction, and all-cause mortality were analyzed. Landmark analyses were performed from 3 years onward. All patients were followed until January 17, 2022.</div></div><div><h3>Results</h3><div>Among 1960/2406 propensity score matched patients/stents (583/802 Absorb bioresorbable scaffolds and 1377/1604 contemporary DES), bioresorbable scaffolds were associated with significantly higher early stent thrombosis, target lesion revascularization, and in-stent restenosis rates. All-cause mortality and myocardial infarction rates did not differ significantly over the entire follow-up. Beyond 3 years, the device-related outcomes converged, while myocardial infarction rates were lower with Absorb bioresorbable scaffolds than contemporary DES.</div></div><div><h3>Conclusions</h3><div>Absorb bioresorbable scaffolds showed inferior early clinical performance compared with contemporary DES, but after 3 years, device-related outcomes were similar, while myocardial infarction rates favored Absorb bioresorbable scaffolds. These findings suggest a complex trade-off between early device-related events and potential long-term benefits of bioresorbable scaffold-mediated vascular restoration.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 9","pages":"Article 103724"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145098703","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":"Impact of Pre-PCI Activated Clotting Time on Outcomes of Bivalirudin Versus Heparin During Primary PCI","authors":"Meili Liu MD ,&nbsp;Yi Li MD ,&nbsp;Zhenyang Liang MD ,&nbsp;Miaohan Qiu MD ,&nbsp;Jing Li MD ,&nbsp;Haiyan Sun MD ,&nbsp;Yuzi Li MD ,&nbsp;Yuanzhe Jin MD ,&nbsp;Xiaolei Ma MD ,&nbsp;Feng Li MD ,&nbsp;Qiancai Xiang MD ,&nbsp;Haibo Yang MD ,&nbsp;Lixin Wang MD ,&nbsp;Ming Bai MD ,&nbsp;Jili Fan MD ,&nbsp;Haipeng Cai MD ,&nbsp;Xue Bai MD ,&nbsp;Yaling Han MD, PhD ,&nbsp;Gregg W. Stone MD","doi":"10.1016/j.jscai.2025.103790","DOIUrl":"10.1016/j.jscai.2025.103790","url":null,"abstract":"<div><h3>Background</h3><div>The BRIGHT-4 trial demonstrated that procedural anticoagulation with bivalirudin followed by a median 3-hour high-dose infusion reduced the 30-day composite of all-cause mortality or Bleeding Academic Research Consortium (BARC) types 3 to 5 bleeding compared with heparin alone among patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention (PCI). Whether the pre-PCI activated clotting time (ACT) influences this benefit is unknown. In the study, we aim to investigate whether the pre-PCI ACT levels affected the outcomes with each anticoagulant.</div></div><div><h3>Methods</h3><div>The BRIGHT-4 protocol required a pre-PCI ACT to be assessed 5 minutes after study medications were administered with additional anticoagulant boluses given to achieve an ACT ≥225 seconds. In the present prespecified analysis, 30-day outcomes were analyzed according to the initial pre-PCI ACT level.</div></div><div><h3>Results</h3><div>The initial pre-PCI ACT was &lt;225 seconds in 971 of 5461 (17.8%) patients, including 123 of 2776 (4.4%) after bivalirudin and 848 of 2685 (31.6%) after heparin (<em>P</em> &lt; .0001). Among 4490 of 5461 (82.2%) patients with an initial ACT ≥225 seconds, bivalirudin was associated with a lower incidence of BARC types 3 to 5 bleeding (0.2% vs 0.8%; adjusted hazard ratio, 0.22; 95% CI, 0.08-0.62; <em>P</em> = .004) and stent thrombosis (0.4% vs 1.0%; adjusted hazard ratio, 0.38; 95% CI, 0.18-0.81; <em>P</em> = .01) compared with heparin. Outcomes were not significantly different in bivalirudin and heparin-treated patients with an initial pre-PCI ACT &lt;225 seconds. There were no significant interactions present between pre-PCI ACT strata and the treatment group for the primary end point or any of the secondary end points.</div></div><div><h3>Conclusions</h3><div>Among patients with ST-segment elevation myocardial infarction undergoing PCI with radial artery access, procedural anticoagulation with bivalirudin was associated with lower 30-day rates of mortality, BARC types 3 to 5 bleeding, and stent thrombosis compared with heparin, findings that were consistent regardless of the pre-PCI ACT level.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 9","pages":"Article 103790"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145098705","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":"First-in-Human Experience With the EnCompass F2 Filter, a Novel Cerebral Embolic Protection Device for TAVR","authors":"Isaac George MD ,&nbsp;David Blusztein MBBS ,&nbsp;Irakli Gogorishvili MD, PhD ,&nbsp;Gvantsa Dughashvili MD ,&nbsp;May Nour MD, PhD ,&nbsp;Viktor Szeder MD, PhD ,&nbsp;Keith Woodward MD ,&nbsp;Tamim M. Nazif MD","doi":"10.1016/j.jscai.2025.103608","DOIUrl":"10.1016/j.jscai.2025.103608","url":null,"abstract":"<div><h3>Background</h3><div>Stroke is a feared complication of transcatheter aortic valve replacement (TAVR), and effective cerebral embolic protection devices are an important innovation target. The EnCompass F₂ system is a novel cerebral embolic protection device consisting of a cylindrical, nitinol frame and an electrospun polyurethane deflection filter with 30-μm average pore size. It is deployed across the aortic arch from femoral access to provide complete cerebral embolic protection during TAVR.</div></div><div><h3>Methods</h3><div>This first-in-human study investigated the feasibility and safety of F₂ filter use during TAVR. Subjects had symptomatic severe aortic stenosis and met established clinical indications for TAVR. The primary safety end point was 30-day major adverse cardiac and cerebrovascular events, defined as all-cause death, stroke, major vascular complication, type 2 to 4 bleeding, or acute kidney injury stage 3 to 4. F₂ filter technical and procedure success and new ischemic brain lesion counts and volumes on diffusion-weighted magnetic resonance imaging (DW-MRI) were evaluated.</div></div><div><h3>Results</h3><div>Twelve patients underwent transfemoral TAVR with the F₂ device. Subjects were 58% female with mean age 73.4 ± 5.1 years and mean Society of Thoracic Surgeons score 3.2 ± 2.0%. A balloon-expandable valve was used in 75% (n = 9). A single F₂ device was used in all cases and was delivered ipsilateral to the TAVR sheath in 41.7% (n = 5). Technical and procedure success was achieved in 100% of cases. No major adverse cardiac and cerebrovascular events occurred within 30 days of TAVR, including no strokes. DW-MRI revealed median total new lesion volume 23.4 mm³ (IQR: 13.1-159.8 mm³).</div></div><div><h3>Conclusions</h3><div>In this first-in-human series, cerebral embolic protection with the EnCompass F₂ during TAVR was feasible and safe with very low new brain DW-MRI lesion volumes and no strokes.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 9","pages":"Article 103608"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145098712","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":"Lesion Preparation Before Coronary Intravascular Brachytherapy: A Comparison of Plain Balloon Versus Cutting/Scoring Balloon Angioplasty","authors":"Gal Sella MD ,&nbsp;Chloe Kharsa MD, MSc ,&nbsp;Mangesh Kritya MD ,&nbsp;Devin Olek MS ,&nbsp;Bin S. Teh MD ,&nbsp;Muhammad Faraz Anwaar MD ,&nbsp;Joseph Elias MD ,&nbsp;Elia El Hajj MD ,&nbsp;Albert E. Raizner MD ,&nbsp;Andrew Farach MD ,&nbsp;Neal S. Kleiman MD ,&nbsp;Alpesh Shah MD","doi":"10.1016/j.jscai.2025.103858","DOIUrl":"10.1016/j.jscai.2025.103858","url":null,"abstract":"<div><h3>Background</h3><div>Coronary intravascular brachytherapy (IVBT) has remained as an effective treatment for recurrent in-stent restenosis (ISR). However, optimal lesion preparation techniques prior to radiation delivery remain undefined. This study evaluated the clinical outcomes of IVBT after lesion preparation with either plain balloon angioplasty or cutting/scoring balloon angioplasty.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of 219 patients who underwent vascular brachytherapy for coronary ISR between June 2016 and January 2024 at the Houston Methodist Hospital. Patients were stratified based on the type of balloon used for lesion preparation: plain balloon (n = 140) or cutting/scoring balloon (n = 79). The primary end point was target lesion revascularization (TLR) at 1 year. Secondary end points included major adverse cardiovascular events, stent thrombosis, and bleeding complications.</div></div><div><h3>Results</h3><div>Baseline demographic characteristics were similar between groups, except for older age in the cutting/scoring balloon group (67.0 ± 11.0 vs 64.0 ± 10.3 years; <em>P</em> = .047). Lesion length was comparable (28.01 ± 18.62 vs 26.49 ± 17.16 mm; <em>P</em> = .55). At 1-year follow-up, TLR rates were similar (26.6% vs 17.9%; <em>P</em> = .17), as were major adverse cardiovascular event rates (32.9% vs 35.0%; <em>P</em> = .86).</div></div><div><h3>Conclusions</h3><div>We observed no significant difference in 1-year and 3-year clinical outcomes compared to conventional plain balloon angioplasty. The trend toward higher TLR rates in the cutting/scoring balloon group warrants further investigation in larger, prospective studies. These findings suggest that lesion-specific factors, rather than balloon type alone, may be more important determinants of outcomes after IVBT for ISR.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 9","pages":"Article 103858"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145098892","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":"Early “Scars” and Long-Term Promise of Bioresorbable Scaffolds: A Decade of Evidence From SCAAR","authors":"Jarmanjeet Singh MD, MPH,&nbsp;Pratheesh M. George MD,&nbsp;Gregg W. Stone MD","doi":"10.1016/j.jscai.2025.103813","DOIUrl":"10.1016/j.jscai.2025.103813","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 9","pages":"Article 103813"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145098704","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":"Left-Atrial Angiogram With Transthoracic Echocardiogram-Guided Mitral Transcatheter Edge-to-Edge Repair: A Patient With Tracheostomy and Severe Venous Tortuosity","authors":"Leo Kar Lok Lai MBChB,&nbsp;Hussayn Alrayes DO,&nbsp;Georgi Fram MD,&nbsp;James C. Lee MD,&nbsp;John Dawdy MD,&nbsp;Bryan Zweig MD,&nbsp;Brian P. O’Neill MD,&nbsp;Tiberio M. Frisoli MD,&nbsp;Pedro Engel Gonzalez MD,&nbsp;William W. O’Neill MD,&nbsp;Pedro A. Villablanca MD","doi":"10.1016/j.jscai.2025.103802","DOIUrl":"10.1016/j.jscai.2025.103802","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 9","pages":"Article 103802"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145099337","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":"Long-Term Outcomes of Mechanical Thrombectomy Versus Catheter-Directed Thrombolysis","authors":"Akiva Rosenzveig MD ,&nbsp;Saah Ehsan MD ,&nbsp;Ankit Agrawal MD ,&nbsp;Osamah Badwan MD ,&nbsp;Habib Layoun MD ,&nbsp;Julia Wajsberg MD ,&nbsp;Pulkit Chaudhury MD ,&nbsp;Navneet Sharma MD ,&nbsp;Aravinda Nanjundappa MD ,&nbsp;Leben Tefera MD","doi":"10.1016/j.jscai.2025.103737","DOIUrl":"10.1016/j.jscai.2025.103737","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 9","pages":"Article 103737"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145099339","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":"A Vessel-Specific Analysis of Deferred Lesions Using the Instantaneous Wave-Free Ratio and Fractional Flow Reserve","authors":"Karolina Berntorp MD ,&nbsp;Moman A. Mohammad MD, PhD ,&nbsp;Sasha Koul MD, PhD ,&nbsp;Troels Yndigegn MD, PhD ,&nbsp;Ole Fröbert MD, PhD ,&nbsp;Anna Myredal MD, PhD ,&nbsp;Jonas Persson MD, PhD ,&nbsp;David Erlinge MD, PhD ,&nbsp;Matthias Götberg MD, PhD","doi":"10.1016/j.jscai.2025.103823","DOIUrl":"10.1016/j.jscai.2025.103823","url":null,"abstract":"<div><h3>Background</h3><div>Physiologically guided revascularization improves clinical outcomes. The cutoff values for deferral with fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) are the same across all coronary arteries, despite differences in coronary flow patterns. The objective was to compare deferral rates using either FFR or iFR in the right coronary artery (RCA), left anterior descending artery (LAD), and left circumflex artery (LCx), and compare clinical outcomes in deferred lesions in the RCA, LAD, and LCx.</div></div><div><h3>Methods</h3><div>Right coronary artery, LAD, and LCx lesions in the Swedish Web-System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies registry that were evaluated using either FFR or iFR were included. The composite of major adverse cardiac events (MACE) within 5 years and the individual components of cardiovascular death, noncardiovascular death, myocardial infarction, target segment revascularization, and target vessel revascularization were analyzed.</div></div><div><h3>Results</h3><div>In total, 33,241 lesions were included in the final analysis (RCA, 17.8%; LAD, 62.3%; and LCx, 19.9%). The median follow-up time was 3.4 years. The median age was 69 years, and 73.5% of patients were men. The deferral rates with iFR were 10.6% higher (<em>P</em> &lt; .001) in all coronary arteries combined, 18.7% higher (<em>P</em> &lt; .001) in the RCA, 9.5% higher in the LAD (<em>P</em> &lt; .001), and 5.3% higher in the LCx (<em>P</em> = .007). No significant differences were observed in the MACE rate or its individual components at 5 years between the deferred FFR and iFR groups in any of the investigated vessels.</div></div><div><h3>Conclusions</h3><div>Instantaneous wave-free ratio demonstrated a higher deferral rate across all coronary arteries than those examined with FFR, which was especially pronounced in the RCA, without any associated increased risk of MACE.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 9","pages":"Article 103823"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145098706","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":"The Role of Comprehensive Hybrid Imaging in Identification of Plaque Rupture and Ostial Stent Placement: Case Report","authors":"Natali Sorajja MS ,&nbsp;Khady N. Fall MD, MPH ,&nbsp;Akiko Maehara MD, MBA ,&nbsp;Megha Prasad MD, MS","doi":"10.1016/j.jscai.2025.103814","DOIUrl":"10.1016/j.jscai.2025.103814","url":null,"abstract":"<div><div>A 52-year-old male smoker with multiple risk factors (hypertension, hyperlipidemia, type 2 diabetes mellitus, and end-stage renal disease treated with dialysis), exertional angina, and inferior ischemia was referred for angiography. He was found to have an ostial right coronary artery (RCA) lesion that was thought to be calcified based on angiography. Hybrid imaging was performed with intravenous ultrasound (IVUS) and optical coherence tomography (OCT) using the Novasight Hybrid IVUS-OCT System catheter (Conavi Medical), which helped identify plaque rupture as opposed to calcification. OCT, with its superior resolution, demonstrated plaque rupture that was difficult to appreciate on IVUS. IVUS was used to mark the ostium of the RCA and precisely place a stent in the ostial RCA.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 9","pages":"Article 103814"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145098707","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":"Surgical Risk and Long-Term Mortality With PCI and CABG in Ischemic Left Ventricular Systolic Dysfunction","authors":"Guillaume Marquis-Gravel MD, MSc ,&nbsp;Guangyu Tong PhD ,&nbsp;Matthew Dodd MSc ,&nbsp;Tim Clayton MSc ,&nbsp;Matthew Ryan PhD ,&nbsp;Kieran F. Docherty PhD ,&nbsp;Alicia Williams MS ,&nbsp;Jiaxuan Sun BS ,&nbsp;Stephen E. Fremes MD, MSc ,&nbsp;Alexandra J. Lansky MD ,&nbsp;Eric J. Velazquez MD ,&nbsp;Divaka Perera MD ,&nbsp;Mark C. Petrie MD ,&nbsp;Jean-Lucien Rouleau MD","doi":"10.1016/j.jscai.2025.103820","DOIUrl":"10.1016/j.jscai.2025.103820","url":null,"abstract":"<div><h3>Background</h3><div>Coronary artery bypass grafting (CABG) improves survival compared with optimal medical therapy (OMT) alone in patients with ischemic left ventricular systolic dysfunction (iLVSD), but percutaneous coronary intervention (PCI) did not show clinical benefits in this population. However, the randomized controlled trials (RCT) evaluating these 2 revascularization modalities may differ in terms of baseline surgical risk. The aim is to investigate whether the treatment effects of PCI vs OMT, and of CABG vs OMT, are modified by baseline surgical risk.</div></div><div><h3>Methods</h3><div>A post hoc analysis of the Revascularization for Ischemic Ventricular Dysfunction – British Cardiovascular Intervention Society 2 (REVIVED-BCIS2) and Surgical Treatment for Ischemic Heart Failure (STICH) RCT comparing PCI and CABG vs OMT, respectively, in patients with iLVSD, was conducted. The main outcome was all-cause mortality. Interaction between randomized treatment and baseline surgical risk, estimated by a modified European System for Cardiac Operative Risk Evaluation (EuroSCORE)-II, was quantified.</div></div><div><h3>Results</h3><div>A total of 666 participants from the REVIVED-BCIS2 trial and 1200 participants from the STICH trial were included. Participants from the REVIVED-BCIS2 trial were more likely to be in the highest tertile of baseline EuroSCORE-II (40.4% vs 29.4%, respectively; <em>P</em> &lt; .001). In the REVIVED-BCIS2 trial, PCI had a consistent lack of effect on all-cause mortality vs OMT across baseline EuroSCORE-II tertiles (<em>P</em> for interaction = .79). In the STICH trial, CABG reduced mortality consistently vs OMT across baseline EuroSCORE-II tertiles (<em>P</em> for interaction = .64).</div></div><div><h3>Conclusions</h3><div>In the 2 largest RCT evaluating the impact of revascularization in iLVSD and multivessel coronary disease, the treatment effect of PCI vs OMT, and of CABG vs OMT, was not modified by baseline surgical risk.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 9","pages":"Article 103820"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145098890","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}