JACC. Cardiovascular interventions
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JACC Cardiovasc Interv · Feb 2017
Review Meta AnalysisComplete or Culprit-Only Revascularization for Patients With Multivessel Coronary Artery Disease Undergoing Percutaneous Coronary Intervention: A Pairwise and Network Meta-Analysis of Randomized Trials.
The authors sought to compare the effectiveness of the different revascularization strategies in ST-segment elevation myocardial infarction (STEMI) patients with multivessel coronary artery disease undergoing primary percutaneous coronary intervention (PCI). ⋯ Current evidence from randomized trials suggests that the risk of all-cause mortality and spontaneous reinfarction is not different among the various revascularization strategies for multivessel disease. Complete revascularization at the index procedure or as a staged procedure (either during the hospitalization or after discharge) was associated with a reduction of MACE due to reduction in urgent revascularization with no difference between these 3 strategies. Future trials are needed to determine the impact of complete revascularization on the risk of all-cause mortality and spontaneous reinfarction.
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JACC Cardiovasc Interv · Feb 2017
Observational StudyCosts Associated With Access Site and Same-Day Discharge Among Medicare Beneficiaries Undergoing Percutaneous Coronary Intervention: An Evaluation of the Current Percutaneous Coronary Intervention Care Pathways in the United States.
The aim of this study was to examine the independent impact of various care pathways, including those involving transradial intervention (TRI) and same-day discharge (SDD) after elective percutaneous coronary intervention (PCI), on hospital costs. ⋯ Among Medicare beneficiaries, TRI with SDD was independently associated with fewer complications and lower in-hospital costs. These findings have important implications for changing the current PCI care pathways to improve outcomes and reduce costs.
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JACC Cardiovasc Interv · Feb 2017
Incomplete Revascularization Is Associated With an Increased Risk for Major Adverse Cardiovascular Events Among Patients Undergoing Noncardiac Surgery.
The aim of this study was to determine whether incomplete revascularization is associated with a higher risk for major adverse cardiovascular events (MACE) and myocardial infarction (MI) among patients undergoing noncardiac surgery. ⋯ Incomplete revascularization among patients with coronary artery disease is associated with an increased risk for MI after noncardiac surgery.
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JACC Cardiovasc Interv · Feb 2017
Outcomes of Warfarin Therapy for Bioprosthetic Valve Thrombosis of Surgically Implanted Valves: A Prospective Study.
The aim of this study was to assess the efficacy of warfarin in the treatment of bioprosthetic valve thrombosis (BPVT) of surgically implanted valves. ⋯ A trial of anticoagulation was effective in 83% of patients with suspected BPVT, and most patients responded within 3 months. BPVT score was predictive of response to therapy and should be considered during patient selection.
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JACC Cardiovasc Interv · Feb 2017
Randomized Controlled Trial Multicenter Study Comparative StudyComparison of Durable-Polymer Zotarolimus-Eluting and Biodegradable-Polymer Biolimus-Eluting Coronary Stents in Patients With Coronary Artery Disease: 3-Year Clinical Outcomes in the Randomized SORT OUT VI Trial.
The authors sought to compare the safety and efficacy of the biocompatible durable-polymer zotarolimus-eluting stent with the biodegradable-polymer biolimus-eluting stent in unselected coronary patients. ⋯ At 3-year follow-up, the durable-polymer zotarolimus-eluting stent and the biodegradable-polymer biolimus-eluting stent were similar in clinical outcome, with no significant difference in safety and efficacy outcomes, including stent thrombosis.