JACC. Cardiovascular interventions
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JACC Cardiovasc Interv · Jun 2012
Randomized Controlled Trial Multicenter StudyRisk profile and 3-year outcomes from the SYNTAX percutaneous coronary intervention and coronary artery bypass grafting nested registries.
The aim of this study was to evaluate the use of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) in "real-world" patients unsuitable for the alternative treatment. ⋯ The SYNTAX Heart Team concluded that PCI and CABG remained the only treatment options for 6.4% and 35.0% of patients, respectively. Inoperable patients with major comorbidities that underwent PCI had high MACCE rates. In patients not suitable for PCI, surgical results were excellent. (SYNTAX Study: TAXUS Drug-Eluting Stent Versus Coronary Artery Bypass Surgery for the Treatment of Narrowed Arteries, NCT00114972).
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JACC Cardiovasc Interv · Jun 2012
ReviewOptimal treatment of patients surviving out-of-hospital cardiac arrest.
Interest in post-resuscitation care has risen with the development of treatment modalities that can affect long-term survival rates even when begun after the systematic ischemia/reperfusion insult associated with cardiac arrest. Mild therapeutic hypothermia has become the foundation for improvement of neurologically favorable survival after cardiac arrest. Reperfusion therapy, specifically early percutaneous coronary intervention, is becoming an important adjunct to therapeutic hypothermia. ⋯ Increasing clinical experience suggests that resuscitated cardiac arrest victims without an obvious noncardiac etiology should undergo emergency coronary angiography and, where indicated, percutaneous coronary intervention. If comatose, they should receive concurrent therapeutic hypothermia. Such an approach can double long-term survival rates among those successfully resuscitated after out-of-hospital cardiac arrest.
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JACC Cardiovasc Interv · Jun 2012
Multicenter StudyContemporary incidence and predictors of stent thrombosis and other major adverse cardiac events in the year after XIENCE V implantation: results from the 8,061-patient XIENCE V United States study.
The aim of this study was to identify predictors of clinical events after XIENCE V (Abbott Vascular, Santa Clara, California) stenting. ⋯ In this large, real-world population, XIENCE V demonstrated low event rates at 1 year, with several independent predictors. Early DAPT interruption (≤ 30 days) was the most potent predictor of ST, whereas delayed interruption (>30 days) was not predictive. (XIENCE V Everolimus Eluting Coronary Stent System [EECSS] USA Post-Approval Study; NCT00676520).
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JACC Cardiovasc Interv · Jun 2012
Comparative StudyAssessment of left ventricular outflow gradient: hypertrophic cardiomyopathy versus aortic valvular stenosis.
This study examined the relationship between peak-to-peak (common invasive measurement), peak instantaneous (common Doppler measurement), and mean pressure gradients in patients with hypertrophic cardiomyopathy (HCM) and aortic stenosis (AS). ⋯ In HCM, peak instantaneous and peak-to-peak gradient demonstrate excellent correlation. Consequently, both peak instantaneous and peak-to-peak gradients can be used to classify obstruction severity in HCM. By contrast, the mean gradient should direct clinical management in AS.