American Journal of Cardiology最新文献

{"title":"Paclitaxel-Coated Balloon Versus Uncoated Balloon Angioplasty for Coronary In-Stent Restenosis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","authors":"Ahmad Al-Abdouh MD, MS ,&nbsp;Dealla Samadi MD ,&nbsp;Fares Sukhon MD ,&nbsp;Mohammed Mhanna MD ,&nbsp;Ahmad Jabri MD ,&nbsp;Laith Alhuneafat MD ,&nbsp;Taqwa Alabduh ,&nbsp;Anas Bizanti MD ,&nbsp;Luai Madanat MD ,&nbsp;Mohammad Alqarqaz MD ,&nbsp;Timir K. Paul MD, PhD ,&nbsp;Amartya Kundu MD","doi":"10.1016/j.amjcard.2024.08.028","DOIUrl":"10.1016/j.amjcard.2024.08.028","url":null,"abstract":"<div><div>In-stent restenosis (ISR) accounts for 10% of percutaneous coronary intervention (PCI) in the United States. Paclitaxel-coated balloons (PCBs) have been evaluated as a therapy for coronary ISR in multiple randomized controlled trials (RCTs). We searched PubMed/MEDLINE, Cochrane Library, and ClinicalTrials.gov (from inception to April 1, 2024) for RCTs evaluating PCBs versus uncoated balloon angioplasty (BA) in patients with coronary ISR. The outcomes of interest were target lesion revascularization (TLR), major adverse cardiovascular events (MACEs), all-cause mortality, cardiovascular mortality, myocardial infarction (MI), and stent thrombosis. We pooled the estimates using an inverse variance random-effects model. The effect sizes were reported as risk ratio (RR) with 95% confidence interval (CI). A total of 6 RCTs with 1,343 patients were included. At a follow-up ranging from 6 to 12 months from randomization, the use of PCBs was associated with a statistically significant decrease in TLR (RR 0.28, 95% CI 0.11 to 0.68) and MACE (RR 0.35, 95% CI 0.20 to 0.64) compared with BA for coronary ISR. However, there was no significant difference in risk between PCBs and BA in terms of all-cause mortality (RR 0.56, 95% CI 0.14 to 2.31), cardiovascular mortality (RR 0.61, 95% CI 0.02 to 16.85), MI (RR 0.60, 95% CI 0.27 to 1.31), and stent thrombosis (RR 0.13, 95% CI 0.00 to 5.06). In conclusion, this meta-analysis suggests that PCBs compared with uncoated BA for the treatment of coronary ISR at intermediate-term follow-up of 1 year were associated with a significant decrease in TLR and MACE without any difference in mortality, MI, or stent thrombosis.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142118822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrograde Wire Snaring in Chronic Total Occlusion Percutaneous Coronary Interventions","authors":"Salman S. Allana MD ,&nbsp;Keerthi T. Gondi MD ,&nbsp;Athanasios Rempakos MD ,&nbsp;Spyridon Kostantinis MD ,&nbsp;Michaella Alexandrou MD ,&nbsp;Lorenzo Azzalini MD, PhD ,&nbsp;Farouc A. Jaffer MD, PhD ,&nbsp;Wissam Jaber MD ,&nbsp;Bavana V. Rangan BDS, MPH ,&nbsp;Emmanouil S. Brilakis MD, PhD","doi":"10.1016/j.amjcard.2024.08.019","DOIUrl":"10.1016/j.amjcard.2024.08.019","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden of Atherosclerotic Disease Risk Factors in Patients With and Without Rheumatologic Disease: A Retrospective Cohort Study","authors":"Helene DiGregorio MD ,&nbsp;Eleonora Avenatti MD ,&nbsp;Rakesh Gullapelli MSHI, MPharm ,&nbsp;Kenneth Williams DO ,&nbsp;Elia El Hajj MD, PhD ,&nbsp;Charles Foster MS ,&nbsp;Siddharth Das DO ,&nbsp;Izza Shahid MD, MBBS ,&nbsp;Aayush Shah MD ,&nbsp;Juan Nicolas MA, PhD ,&nbsp;Budhaditya Bose MS ,&nbsp;Kobina Hagan MD ,&nbsp;Shubham Lahan MD ,&nbsp;Nwabunie Nwana PhD, MPH ,&nbsp;Sara Butt MS, MPH ,&nbsp;Zulqarnain Javed MD, PhD ,&nbsp;Lily Romero Karam MD ,&nbsp;Kanika Monga MD ,&nbsp;Myriam Guevara MD ,&nbsp;Brittany Weber MD, PhD ,&nbsp;Khurram Nasir MD, MPH","doi":"10.1016/j.amjcard.2024.08.017","DOIUrl":"10.1016/j.amjcard.2024.08.017","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging Trends in the Care of Type B Aortic Dissections","authors":"John F. Eidt MD ,&nbsp;Angela L. Gucwa MD ,&nbsp;Erin Cha BA ,&nbsp;Steven E. Hohmann MD ,&nbsp;Javier Vasquez Jr. MD","doi":"10.1016/j.amjcard.2024.08.026","DOIUrl":"10.1016/j.amjcard.2024.08.026","url":null,"abstract":"<div><p>Aortic dissection is the most common of the acute aortic syndromes. Acute aortic dissection remains a highly morbid and potentially lethal condition despite contemporary advances in medical and surgical care. Type B aortic dissection (TBAD) is classified as uncomplicated, uncomplicated with high-risk features, and complicated. The role of thoracic endovascular aortic repair (TEVAR) in uncomplicated TBAD remains uncertain and is the topic of ongoing clinical trials. In most complicated cases, TEVAR is effective at restoring visceral and extremity blood flow. TEVAR has also been shown to arrest hemorrhage in the setting of thoracic aortic rupture. TEVAR has been demonstrated to induce satisfactory remodeling in the covered segment of the thoracic aorta, but progressive enlargement of the visceral aorta has led to a variety of techniques designed to promote remodeling in the uncovered aortic segment. There is a need to better define high-risk features so that treatment can be tailored to specific clinical conditions.</p></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Five-Year Outcomes of Measured and Predicted Prosthesis-Patient Mismatch following Transcatheter Aortic Valve Implantation","authors":"Karim Al-Azizi MD ,&nbsp;Ghadi Moubarak MD ,&nbsp;Asim Mohiuddin MD ,&nbsp;Molly Szerlip MD ,&nbsp;Srinivasa Potluri MD ,&nbsp;Katherine Harrington MD ,&nbsp;Justin Schaffer MD ,&nbsp;William Brinkman MD ,&nbsp;Amro Alsaid MD ,&nbsp;Zuyue Wang MD ,&nbsp;Jonathan Ladner BS ,&nbsp;Rahul Gunukula BS ,&nbsp;Colleen Parro BS ,&nbsp;Tsung-Wei Ma PhD ,&nbsp;Robert Stoler MD ,&nbsp;Yashasvi Chugh MD ,&nbsp;Subhash Banerjee MD ,&nbsp;Timothy Mixon MD ,&nbsp;Robert J Widmer MD ,&nbsp;Angel Caldera MD ,&nbsp;Michael J. Mack MD","doi":"10.1016/j.amjcard.2024.08.013","DOIUrl":"10.1016/j.amjcard.2024.08.013","url":null,"abstract":"<div><div>Data on the long-term outcomes of prosthesis patient mismatch (PPM) after transcatheter aortic valve implantation (TAVI) remain controversial. This study aimed to investigate the incidence and clinical outcomes of measured PPM (PPM_M) and predicted PPM (PPM_P) in patients who underwent TAVI. This is a retrospective analysis of 3,016 patients who underwent TAVI at a large health care system between 2012 and 2021. Effective orifice area indexed to body surface area (EOAi) was measured at discharge using the continuity equation. EOAi was predicted according to the published predictive tables for each model and size of the valve. Primary end point was 5-year survival rate. Mean age was 80 years, and 55.6% were male. The mean Society of Thoracic Surgeons risk score was 4.66%. 74.9% of patients received a balloon-expandable valve (BEV), and 25.1% received a self-expanding valve (SEV). The incidence of severe PPM was markedly lower when defined by predicted versus measured EOAi (0.8% vs 6.3%, p &lt;0.001) and when assessed in SEV versus BEV (5.3% vs 6.6%, p = 0.02). Neither severe PPM_p nor severe PPM_M was associated with 5-year mortality (hazard ratio 1.26, 95% confidence interval 0.96 to 1.66, p = 0.095; hazard ratio 1.03, 95% confidence interval 0.42 to 2.49, p = 0.954, respectively), irrespective of the presence of high residual pressure gradient. Neither BEV nor SEV was associated with an increased 5-year mortality, irrespective of PPM definition or severity. In this large health care system analysis, neither severe PPM_P nor severe PPM_M was associated with 5-year all-cause mortality. There was no difference between BEV and SEV in terms of mortality, irrespective of the definition or severity of PPM.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epinephrine for Refractory No-Reflow During Percutaneous Coronary Interventions.","authors":"Fernando Alfonso, Josep Gómez-Lara, Fernando Rivero","doi":"10.1016/j.amjcard.2024.08.023","DOIUrl":"10.1016/j.amjcard.2024.08.023","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to ‘Clinical Impact of Perfusion Balloon for ST-Segment Elevated Myocardial Infarction: RYUSEI Study’ [Am J Cardiol 223 (2024) start 23-51]","authors":"Masami Nishino,&nbsp;Yasuyuki Egami,&nbsp;Hitoshi Nakamura,&nbsp;Masaru Abe,&nbsp;Mizuki Ohsuga,&nbsp;Hiroaki Nohara,&nbsp;Shodai Kawanami,&nbsp;Kohei Ukita,&nbsp;Akito Kawamura,&nbsp;Koji Yasumoto,&nbsp;Masaki Tsuda,&nbsp;Naotaka Okamoto,&nbsp;Yasuharu Matsunaga-Lee,&nbsp;Masamichi Yano","doi":"10.1016/j.amjcard.2024.08.020","DOIUrl":"10.1016/j.amjcard.2024.08.020","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0002914924006222/pdfft?md5=aac87110edc5beaf3f352de56d93e745&pid=1-s2.0-S0002914924006222-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of Coronary Artery Disease With Coronary Computed Tomography Angiography and Stress Testing in Candidates for Liver Transplant","authors":"Rishabh Tandon MBBS ,&nbsp;Dzhalal Agakishiev DO ,&nbsp;Rebecca L. Freese MS ,&nbsp;Julie Thompson MD ,&nbsp;Prabhjot S. Nijjar MD","doi":"10.1016/j.amjcard.2024.08.021","DOIUrl":"10.1016/j.amjcard.2024.08.021","url":null,"abstract":"<div><p>Cardiac complications are the leading cause of morbidity and mortality in recipients of liver transplant (LT). Previous guidelines recommended stress testing to exclude coronary artery disease (CAD), although recent guidelines recommend coronary computed tomography angiography (CCTA). We aimed to assess the prevalence and predictors of CAD on CCTA and compare CCTA with stress testing in consecutive adult candidates for LT who underwent CAD noninvasive assessment between 2020 and 2023. Patients who underwent a stress test between January and December 2020 formed the stress cohort, and patients who underwent CCTA between January 2021 and September 2023 formed the CCTA cohort. There were 141 patients in the stress test cohort and 269 patients in the CCTA cohort. Stress test results were nondiagnostic or inconclusive in 18 patients (12.8%) whereas CCTA was nondiagnostic in 6 patients (2.2%). In patients evaluated with CCTA, mean coronary artery calcium (CAC) score was 332 ± 716 AU, with moderate or greater (&gt;50%) stenosis in 33 patients (12.3%). New CAD was diagnosed in 158 patients (58.7%) using CCTA and in 5 patients (3.5%) using stress tests. Clinically actionable CAD (coronary artery calcium &gt;100) on CCTA was present in 96 patients (35.7%). The number of CAD risk factors was associated with the presence of CAD on CCTA. In conclusion, there was a great burden of CAD, mainly nonobstructive, in a large cohort of candidates for LT who underwent CAD testing over a 4-year period. The current recommended risk-based evaluation of candidates for LT using CCTA as a first-line test was feasible and effective. Diagnosis of clinically actionable CAD on CCTA provides a vast opportunity for optimizing cardiac care in candidates for and recipients of LT.</p></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142091398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variability in the Treatment of High-Risk Type B Aortic Dissection at a Single Center","authors":"Erin Cha BA ,&nbsp;John F. Eidt MD ,&nbsp;Javier Vasquez Jr. MD","doi":"10.1016/j.amjcard.2024.08.025","DOIUrl":"10.1016/j.amjcard.2024.08.025","url":null,"abstract":"<div><p>Although there are established high-risk features in acute type B aortic dissection (TBAD), its management is variable. This study characterizes complicated, uncomplicated, and high-risk TBAD in addition to their management and outcomes to gain insight into the actual significance of these high-risk features and the reality of real-world practice in managing TBAD. A retrospective review of 62 patients was conducted. Patient demographics, management, and outcomes were characterized and evaluated with Pearson's χ<span><span>²</span></span> test, Fisher's exact test, or analysis of variance. Of the 32 high-risk TBADs, 66% (n = 21) received endovascular repair, 31% (n = 10) were medically managed, and 3% (n = 1) received hybrid (open and endovascular) repair. Refractory hypertension and pain (52%, n = 11) were the most common high-risk features in patients with high-risk TBAD who received endovascular repair. A maximum aortic diameter of &gt;40 mm (67%, n = 6) was the most common high-risk feature in patients who received medical management. The most prevalent high-risk feature for all treatment groups in the high-risk TBADs was an aortic diameter of &gt;40 mm (n = 16; 50%). Adverse postoperative outcomes were highest in the high-risk and complicated groups with endoleak as the most common adverse outcome (high-risk 12.9%, complicated 13.6%). Of the 62 patients, 47% (n = 26) had follow-up since their admission with an average follow-up time of 69 ± 166 days. The significance of high-risk features in the management of high-risk TBAD remains unclear. This single-center experience with managing acute TBAD reveals the reality of inadequate follow-up that may be specific to this disease process. This highlights a need to direct more efforts to assess long-term outcomes after treatment.</p></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Frailty on Outcome of Older Patients With Non-ST Elevation Acute Myocardial Infarction Who Undergo Percutaneous Coronary Intervention","authors":"Marco Mele MD ,&nbsp;Ilaria Ragnatela MD ,&nbsp;Matteo Romano MD ,&nbsp;Erika Tabella MD ,&nbsp;Luciano Umberto Rossi MD ,&nbsp;Francesco Mautone MD ,&nbsp;Antonietta Mele MD ,&nbsp;Antonella Liantonio MD ,&nbsp;Paola Imbrici MD ,&nbsp;Michele Correale MD, PhD ,&nbsp;Francesco Santoro MD, PhD ,&nbsp;Natale Daniele Brunetti MD, PhD","doi":"10.1016/j.amjcard.2024.08.016","DOIUrl":"10.1016/j.amjcard.2024.08.016","url":null,"abstract":"<div><p>Frailty status is linked with a poorer clinical outcome, and patients with frailty are often less revascularized, even with percutaneous coronary intervention (PCI). We therefore sought to assess the impact of frailty on the clinical outcome of older patients with non-ST elevation acute myocardial infarction (NSTEMI) who underwent PCI. We prospectively enrolled 141 consecutive older patients (&gt;75 years) admitted for NSTEMI; 104 patients underwent PCI (35 with frailty, 69 without frailty), and 37 were not revascularized (22 with frailty, 15 without). Patients with frailty were older, less frequently male, more affected by dementia and severe left ventricular dysfunction, and less treated with PCI; patients treated with PCI were younger and less affected by dementia. Thirty-day mortality rates were proportionally higher, from 3% in patients without frailty treated with PCI, to 7% in patients without frailty not treated with PCI, 17% in patients with frailty treated with PCI, and 48% in patients with frailty not treated with PCI (p &lt;0.05). Similarly, 6-month mortality rates were proportionally higher (12%, 29%, 37%, and 71%). At multivariable analysis, frail status was associated to a sixfold increased risk of mortality at 30 days; at 6 months, frail status was associated to a 3.4-fold risk of death (p &lt;0.01), but PCI was also associated to a lower risk of mortality (odds ratio 0.2, p &lt;0.01). In an observational study in older patients with NSTEMI, frail status is associated to a poorer outcome, whereas PCI is associated to a better long-term outcome. A careful selection of patient suitable for revascularization by PCI may be useful in improving outcomes of older patients with frailty with NSTEMI.</p></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142071828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}