JACC. Cardiovascular interventions
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JACC Cardiovasc Interv · Oct 2008
Randomized Controlled Trial Comparative StudyPredictors of outcome and the lack of effect of percutaneous coronary intervention across the risk strata in patients with persistent total occlusion after myocardial infarction: Results from the OAT (Occluded Artery Trial) study.
This study sought to determine predictors of outcome and examine the influence of baseline risk on therapeutic impact of late mechanical opening of a persistently occluded infarct related artery after myocardial infarction in stable patients. ⋯ In the OAT study, there was no variation in the effect of PCI on clinical outcomes at different levels of patient risk, including the subset with very high event rates. (Occluded Artery Trial [OAT]; NCT00004562)
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JACC Cardiovasc Interv · Oct 2008
Multicenter Study Comparative StudyStent thrombosis, clinical events, and influence of prolonged clopidogrel use after placement of drug-eluting stent data from an observational cohort study of drug-eluting versus bare-metal stents.
The purpose of this study was to evaluate the risk of stent thrombosis (ST), clinical outcomes, and the benefits of extended clopidogrel use after drug-eluting stent (DES) implantation. ⋯ As compared with BMS, DES showed a similar risk of overall ST, but a higher risk of very late ST. The rates of death, death/myocardial infarction, and target lesion revasuclarization were significantly lower in the DES group. Clopidogrel continuation beyond 1 year did not appear to reduce ST and clinical events after DES implantation.
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JACC Cardiovasc Interv · Oct 2008
Effect of septal ablation on myocardial relaxation and left atrial pressure in hypertrophic cardiomyopathy an invasive hemodynamic study.
The objective of this study was to examine the effects of septal ablation on diastolic function with the use of invasive hemodynamics. ⋯ Septal ablation results in variable effects on left ventricular filling pressure, which are dependent upon the magnitude of reduction in the LVOT gradient. These effects are mediated in part by effects of ablation on myocardial relaxation. These findings shed insight into the pathophysiologic effects of septal reduction therapy in patients with HCM.
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JACC Cardiovasc Interv · Aug 2008
Randomized Controlled Trial Multicenter Study Comparative StudyPrevalence, predictors, and impact of conservative medical management for patients with non-ST-segment elevation acute coronary syndromes who have angiographically documented significant coronary disease.
We sought to characterize the utilization and impact of a conservative medical management strategy for patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS) and significant coronary artery disease on early angiography. ⋯ One-third of patients with NSTE ACS and significant coronary disease on early angiography were managed without in-hospital revascularization in the SYNERGY trial, and these patients had an increased risk of late mortality. These findings highlight the need for novel treatment approaches for NSTE ACS patients who are not candidates for revascularization. (SYNERGY trial; NCT00043784).