The Internal Mammary Artery (IMA) is the preferred conduit for bypassing the left anterior descending artery (LAD) in patients undergoing coronary artery bypass grafting. There is no systematic evaluation of the frequency and predictors of IMA failure or long-term outcomes. The PREVENT IV included 1539 patients receiving IMA-LAD revascularization with 12 and 18 month…
Dual Antiplatelet Therapy after Everolimus Eluting Stenting
Original Title: Benefits and Risks of Extended Dual Antiplatelet Therapy after Everolimus-Eluting Stents. For the Dual Antiplatelet Therapy (DAPT) Study Investigators. Reference: James B. Hermiller et al. JACC: Cardiovascular Interventions 2015, online before print. The DAPT study had shown that continued aspirin plus thienopyridine beyond a year reduces ischemic events. Given the fairly low rate of thrombosis…
Does PCI Improve Survival in Patients with Stable Heart Disease? COURAGE Extended Analysis
Original Title: Effect of PCI on Long-Term Survival in Patients with Stable Ischemic Heart Disease. Reference: Steven P. Sedlis et al. N Engl J Med 2015;373:1937-46. Courtesy of Dr. Santiago Alonso. Centro Cardiológico Americano. Sanatorio Americano. Montevideo, Uruguay. During a median follow up of 4.6 years, with 2287 stable heart disease or silent ischemia patients,…
Increase in Femoral Access Complications in the Transradial Era
Original Title: The Benefits Conferred by Radial Access for Cardiac Catheterization Are Offset by a Paradoxical Increase in the Rate of Vascular Access Site Complications with Femoral Access: The Campeau Radial Paradox. Reference: Lorenzo Azzalini et al. J Am Coll Cardiol Intv. 2015, ONLINE FIRST. The aim of this study was to assess whether the benefit of the radial access…
ABSORB III: Everolimus Eluting Bioresorbable Scaffolds for Coronary Artery Disease
Original Title: Everolimus-Eluting Bioresorbable Scaffolds for Coronary Artery Disease. Reference: Stone, M.D. for the ABSORB III Investigators. N Engl J Med 2015;373:1905-1915. The ABSORB III is part of a series of randomized studies that test bioresorbable scaffolds in the clinical practice (ABSORB II, EVERBIO II, ABSORB Japan, and ABSORB IV). 2008 patients were randomized; 60% had…
Surgery vs. PCI in Diabetic Patients with Multivessel Disease
Original Title: Revascularization in diabetics with multivessel disease: a population-based evaluation of outcomes. Presenter: Ramanathan K. Real-world data support the role of CABG over PCI in diabetic patients with multivessel disease. However, PCI continues to be a common option for this patient population, according to an analysis of 2 Canadian registries. Sourcing data from 2…
PROMISE Subanalysis: Potential Benefits of CT Angiography over Functional Studies in Patients with Symptoms Suggesting CAD
Original Title: Outcomes of anatomical versus functional testing for coronary artery disease. Presenter: Douglas PS. Early this year, the PROMISE trial was not able to confirm that testing patients with chest painusingcomputed tomography angiography (CTA) instead of functional tests, affects clinical outcomes, even though several sub analysis are currently suggesting other additional benefits,including enhanced diagnostic…
IVUS-XPL: IVUS superior to angiography for guiding DES implantation in long lesions
Original Title: Effect of intravascular ultrasound-guided vs angiography-guided everolimus-eluting stent implantation: the IVUS-XPL randomized clinical trial. Presenter: Hong S-J. Patients with long coronary lesions have better clinical results after a year of second generation DES implantation when interventions are guided by IVUS, instead of angiography. The benefit was attributed to a lower revascularization rate of ischemia…
ABSORB EXTEND trial: preliminary report of clinical outcomes at 12 months in the first 512 patients
Original title: The ABSORB EXTEND Study: preliminary report of the twelve-month clinical outcomes in the first 512 patients enrolled. Reference: Alexandre Abizaid et al. EuroIntervention 2015;10:1396-1401. The safety and efficacy of the Absorb Bioresorbable Vascular Scaffold (Absorb BVS) has been previously shown in 131 patients of the ABSORB trial cohorts A and B. Following this trial, the prospective…
Peripheral adenosine infusion versus central access infusion during measurement of FFR
Original title: FFR in the Transradial Era: Will Hand Vein Adenosine Infusion Suffice?A Comparative Study of the Extent, Rapidity, and Stability of Hyperemia From Hand and Femoral Venous Routes of Adenosine Administration. Reference: Peter Scott et al. J Am Coll Cardiol Intv. 2015, online before print. The aim of this study was to compare the administration of…
PCI with everolimus eluting stent or CABG for multivessel coronary artery disease.
Original title: Everolimus-Eluting Stents or Bypass Surgery for Multivessel Coronary Disease. Reference: Sripal Bangalore, M.D. et al. N Engl J Med. 2015 Mar 26;372(13):1213-22. Coronary artery bypass grafting (CABG) have had better outcomes than percutaneous coronary intervention (PCI) in the treatment of multivessel coronary disease. However, this information comes from studies that do not include new generation stents.…