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Coronary Artery Disease: HELP
Articles by Ziad A. Ali
Based on 31 articles published since 2008
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Between 2008 and 2019, Ziad Ali wrote the following 31 articles about Coronary Artery Disease.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Editorial Shining light on calcified lesions, plaque stabilisation and physiologic significance: new insights from intracoronary OCT. 2018

Ali, Ziad A / Galougahi, Keyvan Karimi. ·Center for Interventional Vascular Therapy, Division of Cardiology, Presbyterian Hospital and Columbia University, New York, NY, USA. ·EuroIntervention · Pubmed #29624174.

ABSTRACT: -- No abstract --

2 Editorial The science of stents: angioplasty turns 40. 2017

Ali, Ziad A. ·Division of Cardiology, Center for Interventional Vascular Therapy, 177 Fort Washington Ave, Herbert Irving Pavilion, 6th Floor, New York Presbyterian Hospital and Columbia University, New York, NY 10032, USA. · Cardiovascular Research Foundation, New York, NY, USA. ·Cardiovasc Res · Pubmed #28899003.

ABSTRACT: -- No abstract --

3 Review Assessment and management of coronary artery disease in kidney and pancreas transplant candidates. 2019

Knapper, Joseph T / Raval, Zankhana / Harinstein, Matthew E / Friedewald, John J / Skaro, Anton I / Abecassis, Michael I / Ali, Ziad A / Gheorghiade, Mihai / Flaherty, James D. ·Department of Medicine, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois. · Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York Presbyterian Hospital, New York, New York. · Division of Cardiology, Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. · Department of Medicine, Division of Nephrology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA. · Department of Surgery, Division of Transplantation, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA. · Department of Surgery, Division of General Surgery and Multi-Organ Transplantation, University of Western Ontario, London, Ontario, Canada. ·J Cardiovasc Med (Hagerstown) · Pubmed #30540647.

ABSTRACT: : Patients with end-stage renal disease (ESRD) undergoing evaluation for kidney and/or pancreas transplantation represent a population with unique cardiovascular (CV) profiles and unique therapeutic needs. Coronary artery disease (CAD) is common in patients with ESRD, mediated by both the overrepresentation and higher prognostic value of traditional CV risk factors amongst this population, as well as altered cardiovascular responses to failing renal function, likely mediated by dysregulation of the renin-angiotensin-aldosterone system (RAAS) and abnormal calcium and phosphate metabolism. Within the ESRD population, obstructive CAD correlates highly with adverse coronary events, including during the peri-transplant period, and successful revascularization may attenuate some of that increased risk. Accordingly, peri-transplant coronary risk assessment is critical to ensuring optimal outcomes for these patients. The following provides a review of CAD in patients being evaluated for kidney and/or pancreas transplantation, as well as evidence-based recommendations for appropriate peri-transplant evaluation and management.

4 Review Algorithmic Approach for Optical Coherence Tomography-Guided Stent Implantation During Percutaneous Coronary Intervention. 2018

Shlofmitz, Evan / Shlofmitz, Richard A / Galougahi, Keyvan Karimi / Rahim, Hussein M / Virmani, Renu / Hill, Jonathan M / Matsumura, Mitsuaki / Mintz, Gary S / Maehara, Akiko / Landmesser, Ulf / Stone, Gregg W / Ali, Ziad A. ·Center for Interventional Vascular Therapy, Division of Cardiology, NewYork-Presbyterian Hospital, Columbia University Medical Center, 161 Fort Washington Avenue, New York, NY 10032, USA; Department of Cardiology, St. Francis Hospital, 100 Port Washington Boulevard, Suite 105, Roslyn, NY 11576, USA; Clinical Trials Center, Cardiovascular Research Foundation, 1700 Broadway 9th Floor, New York, NY 10019, USA. · Department of Cardiology, St. Francis Hospital, 100 Port Washington Boulevard, Suite 105, Roslyn, NY 11576, USA. · Center for Interventional Vascular Therapy, Division of Cardiology, NewYork-Presbyterian Hospital, Columbia University Medical Center, 161 Fort Washington Avenue, New York, NY 10032, USA. · CVPath Institute, 19 Firstfield Road, Gaithersburg, MD 20878, USA. · London Bridge Hospital, 2nd Floor, St Olaf House, London SE1 2PR, UK; Department of Cardiology, King's College Hospital, Denmark Hill, London, SE5 9RS, UK. · Clinical Trials Center, Cardiovascular Research Foundation, 1700 Broadway 9th Floor, New York, NY 10019, USA. · Center for Interventional Vascular Therapy, Division of Cardiology, NewYork-Presbyterian Hospital, Columbia University Medical Center, 161 Fort Washington Avenue, New York, NY 10032, USA; Clinical Trials Center, Cardiovascular Research Foundation, 1700 Broadway 9th Floor, New York, NY 10019, USA. · Department of Cardiology, Charité - Universitätsmedizin Berlin, Hindenburgdamm 30, Berlin 12200, Germany. · Center for Interventional Vascular Therapy, Division of Cardiology, NewYork-Presbyterian Hospital, Columbia University Medical Center, 161 Fort Washington Avenue, New York, NY 10032, USA; Department of Cardiology, St. Francis Hospital, 100 Port Washington Boulevard, Suite 105, Roslyn, NY 11576, USA; Clinical Trials Center, Cardiovascular Research Foundation, 1700 Broadway 9th Floor, New York, NY 10019, USA. Electronic address: zaa2112@columbia.edu. ·Interv Cardiol Clin · Pubmed #29983145.

ABSTRACT: Intravascular imaging plays a key role in optimizing outcomes for percutaneous coronary intervention (PCI). Optical coherence tomography (OCT) utilizes a user-friendly interface and provides high-resolution images. OCT can be used as part of daily practice in all stages of a coronary intervention: baseline lesion assessment, stent selection, and stent optimization. Incorporating a standardized, algorithmic approach when using OCT allows for precision PCI.

5 Review Imaging-guided pre-dilatation, stenting, post-dilatation: a protocolized approach highlighting the importance of intravascular imaging for implantation of bioresorbable scaffolds. 2018

Ali, Ziad A / Karimi Galougahi, Keyvan / Shlofmitz, Richard / Maehara, Akiko / Mintz, Gary S / Abizaid, Alexandre / Chamié, Daniel / Hill, Jonathan / Serruys, Patrick W / Onuma, Yoshinobu / Stone, Gregg W. ·a Clinical Trials Center, Cardiovascular Research Foundation , New York , NY , USA. · b Department of Cardiology , NewYork-Presbyterian Hospital/Columbia University Medical Center , New York , NY , USA. · c Department of Cardiology , St Francis Hospital , Roslyn , NY , USA. · d Department of Cardiology , Instituto Dante Pazzanese of Cardiology , São Paulo , Brazil. · e Department of Cardiology , Cardiovascular Research Center , São Paulo , Brazil. · f Department of Cardiology , King's College , London , UK. · g Imperial College of Science, Technology and Medicine , London , UK. · h Thoraxcenter, Erasmus Medical Center , Rotterdam , The Netherlands. ·Expert Rev Cardiovasc Ther · Pubmed #29732926.

ABSTRACT: INTRODUCTION: The advent of the fully bioresorbable vascular scaffold (BVS) is the latest step in a series of advancements in the design of intracoronary stents over the past few decades. The novelty of this technology is in providing temporary vessel scaffolding and local antiproliferative therapy to prevent neointimal hyperplasia after percutaneous coronary intervention followed by gradual resorption of the scaffold to restore the native vessel anatomy and physiology - a process termed vascular reparative therapy. Areas covered: The first generation of BVS has not been able to fully match the high benchmark in safety and efficacy set by contemporary metallic drug-eluting stents. These shortcomings of BVS may be due to factors related to the device itself, the complexity of the underlying lesion, or the implantation technique. Expert commentary: Here, how intravascular imaging may be used to minimize these shortcomings is described and moreover, an imaging-guided step-by-step approach for BVS implantation that integrates the recently described pre-dilatation, stenting, post-dilatation (PSP) strategy is explained.

6 Review Utility of intracoronary imaging in the cardiac catheterization laboratory: comprehensive evaluation with intravascular ultrasound and optical coherence tomography. 2018

Parviz, Yasir / Shlofmitz, Evan / Fall, Khady N / Konigstein, Maayan / Maehara, Akiko / Jeremias, Allen / Shlofmitz, Richard A / Mintz, Gary S / Ali, Ziad A. ·Division of Cardiology, Columbia UniversityMedical Center, New York, NY, USA. · Division of Cardiology, Columbia University Medical Center, New York, NY, USA. · Cardiovascular Research Foundation, New York, NY, USA. · St. Francis Hospital, Roslyn, NY, USA. ·Br Med Bull · Pubmed #29360941.

ABSTRACT: Background: Intracoronary imaging is an important tool for guiding decision making in the cardiac catheterization laboratory. Sources of data: We have reviewed the latest available evidence in the field to highlight the various potential benefits of intravascular imaging. Areas of agreement: Coronary angiography has been considered the gold standard test to appropriately diagnose and manage patients with coronary artery disease, but it has the inherent limitation of being a 2-dimensional x-ray lumenogram of a complex 3-dimensional vascular structure. Areas of controversy: There is well-established inter- and intra-observer variability in reporting coronary angiograms leading to potential variability in various management strategies. Intracoronary imaging improves the diagnostic accuracy while optimizing the results of an intervention. Utilization of intracoronary imaging modalities in routine practice however remains low worldwide. Increased costs, resources, time and expertise have been cited as explanations for low incorporation of these techniques. Growing points: Intracoronary imaging supplements and enhances an operator's decision-making ability based on detailed and objective lesion assessment rather than a subjective visual estimation. The benefits of intravascular imaging are becoming more profound as the complexity of cases suitable for revascularization increases. Areas timely for developing research: While the clinical benefits of intravascular ultrasound have been well validated, optical coherence tomography in comparison is a newer technology, with robust clinical trials assessing its clinical benefit are underway.

7 Review Intracoronary Optical Coherence Tomography 2018: Current Status and Future Directions. 2017

Ali, Ziad A / Karimi Galougahi, Keyvan / Maehara, Akiko / Shlofmitz, Richard A / Ben-Yehuda, Ori / Mintz, Gary S / Stone, Gregg W. ·Center for Interventional Vascular Therapy, Division of Cardiology, Presbyterian Hospital and Columbia University, New York, New York; Cardiovascular Research Foundation, New York, New York. Electronic address: zaa2112@columbia.edu. · Center for Interventional Vascular Therapy, Division of Cardiology, Presbyterian Hospital and Columbia University, New York, New York. · Center for Interventional Vascular Therapy, Division of Cardiology, Presbyterian Hospital and Columbia University, New York, New York; Cardiovascular Research Foundation, New York, New York. · Department of Cardiology, St. Francis Hospital, Roslyn, New York. · Cardiovascular Research Foundation, New York, New York. ·JACC Cardiovasc Interv · Pubmed #29268880.

ABSTRACT: The advent of intravascular imaging has been a significant advancement in visualization of coronary arteries, particularly with optical coherence tomography (OCT) that allows for high-resolution imaging of intraluminal and transmural coronary structures. Accumulating data support a clinical role for OCT in a multitude of clinical scenarios, including assessing the natural history of atherosclerosis and modulating effects of therapies, mechanisms of acute coronary syndromes, mechanistic insights into the effects of novel interventional devices, and optimization of percutaneous coronary intervention. In this state-of-the-art review, we provide an overview of the published data on the clinical utility of OCT, highlighting the areas that need further investigation and the current barriers for further adoption of OCT in interventional cardiology practice.

8 Review IVUS-Guided Versus OCT-Guided Coronary Stent Implantation: A Critical Appraisal. 2017

Maehara, Akiko / Matsumura, Mitsuaki / Ali, Ziad A / Mintz, Gary S / Stone, Gregg W. ·Center for Interventional Vascular Therapy, Division of Cardiology, New York-Presbyterian Hospital/Columbia University Medical Center, New York, New York; Clinical Trials Center, Cardiovascular Research Foundation, New York, New York. Electronic address: amaehara@crf.org. · Clinical Trials Center, Cardiovascular Research Foundation, New York, New York. · Center for Interventional Vascular Therapy, Division of Cardiology, New York-Presbyterian Hospital/Columbia University Medical Center, New York, New York; Clinical Trials Center, Cardiovascular Research Foundation, New York, New York. ·JACC Cardiovasc Imaging · Pubmed #29216976.

ABSTRACT: Procedural guidance with intravascular ultrasound (IVUS) imaging improves the clinical outcomes of patients undergoing percutaneous coronary intervention (PCI) by: 1) informing the necessity for lesion preparation; 2) directing appropriate stent sizing to maximize the final stent area and minimize geographic miss; 3) selecting the optimal stent length to cover residual disease adjacent to the lesion, thus minimizing geographic miss; 4) guiding optimal stent expansion; 5) identifying acute complications (edge dissection, stent malapposition, tissue protrusion); and 6) clarifying the mechanism of late stent failure (stent thrombosis, neointimal hyperplasia, stent underexpansion or fracture, or neoatherosclerosis). Optical coherence tomography (OCT) provides similar information to IVUS (with some important differences), also potentially improving acute and long-term patient outcomes compared to angiography-guided PCI. The purpose of this review is to describe the similarities and differences between IVUS and OCT technologies, and to highlight the evidence supporting their utility to improve PCI outcomes.

9 Review Imaging and Physiology to Guide Venous Graft Interventions Without Contrast Administration in Advanced Renal Failure. 2017

Parviz, Yasir / Fall, Khady / Stone, Gregg W / Maehara, Akiko / Ben-Yehuda, Ori / Mintz, Gary S / Ali, Ziad A. ·Center for Interventional Vascular Therapy, New York-Presbyterian Hospital and Columbia University, 161 Fort Washington Ave, New York, NY 10032 USA. zaa2112@columbia.edu. ·J Invasive Cardiol · Pubmed #29086735.

ABSTRACT: We describe step-by-step "zero-contrast" saphenous vein bypass graft intervention using a modified technique.

10 Review 2-year outcomes with the Absorb bioresorbable scaffold for treatment of coronary artery disease: a systematic review and meta-analysis of seven randomised trials with an individual patient data substudy. 2017

Ali, Ziad A / Serruys, Patrick W / Kimura, Takeshi / Gao, Runlin / Ellis, Stephen G / Kereiakes, Dean J / Onuma, Yoshinobu / Simonton, Charles / Zhang, Zhen / Stone, Gregg W. ·New York Presbyterian Hospital, Columbia University Medical Center and the Cardiovascular Research Foundation, New York, NY, USA. · International Centre for Cardiovascular Health, Imperial College, London, London, UK. · Kyoto University Hospital, Kyoto, Japan. · Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China. · Cleveland Clinic, Cleveland, OH, USA. · The Christ Hospital, Heart and Vascular Center, Lindner Research Center, Cincinnati, OH, USA. · Thoraxcenter, Erasmus Medical Center, Rotterdam, Netherlands. · Abbott Vascular, Santa Clara, CA, USA. · New York Presbyterian Hospital, Columbia University Medical Center and the Cardiovascular Research Foundation, New York, NY, USA. Electronic address: gs2184@columbia.edu. ·Lancet · Pubmed #28732815.

ABSTRACT: BACKGROUND: Bioresorbable vascular scaffolds (BVS) offer the potential to improve long-term outcomes of percutaneous coronary intervention after their complete bioresorption. Randomised trials have shown non-inferiority between BVS and metallic drug-eluting stents at 1 year in composite safety and effectiveness outcomes, although some increases in rates of target vessel-related myocardial infarction and device thrombosis were identified. Outcomes of BVS following the first year after implantation are unknown. We sought to ascertain whether BVS are as safe and effective as drug-eluting stents within 2 years after implantation and between 1 and 2 years. METHODS: We did a systematic review and meta-analysis of randomised trials in which patients were randomly assigned to everolimus-eluting Absorb BVS or metallic everolimus-eluting stents (EES) and followed up for at least 2 years. We searched MEDLINE, the Cochrane database, TCTMD, ClinicalTrials.gov, Clinical Trial Results, CardioSource, and abstracts and presentations from major cardiovascular meetings up to April 1, 2017, to identify relevant studies. The primary efficacy outcome measure was the device-oriented composite endpoint (cardiac mortality, target vessel-related myocardial infarction, or ischaemia-driven target lesion revascularisation) and the primary safety outcome measure was definite or probable device thrombosis. Individual patient data from the four ABSORB trials were used for landmark and subgroup analysis and multivariable modelling. FINDINGS: We identified seven randomised trials in which 5583 patients were randomly assigned to Absorb BVS (n=3261) or metallic EES (n=2322) and followed up for 2 years. BVS had higher 2-year relative risks of the device-oriented composite endpoint than did EES (9·4% [304 of 3217] vs 7·4% [169 of 2299]; relative risk [RR] 1·29 [95% CI 1·08-1·56], p=0·0059). These differences were driven by increased rates of target vessel-related myocardial infarction (5·8% [187 of 3218] vs 3·2% [74 of 2299]; RR 1·68 [95% CI 1·29-2·19], p=0·0003) and ischaemia-driven target lesion revascularisation (5·3% [169 of 3217] vs 3·9% [90 of 2300]; 1·40 [1·09-1·80], p=0·0090) with BVS, with non-significant differences in cardiac mortality. The cumulative 2-year incidence of device thrombosis was higher with BVS than with EES (2·3% [73 of 3187] vs 0·7% [16 of 2281]; RR 3·35 [95% CI 1·96-5·72], p<0·0001). Landmark analysis between 1 and 2 years also showed higher rates of the device-oriented composite endpoint (3·3% [69 of 2100] vs 1·9% [23 of 1193]; RR 1·64 [95% CI 1·03-2·61], p=0·0376) and device thrombosis (0·5% [11 of 2085] vs none [0 of 1183], p<0·0001) in BVS-treated patients than in EES-treated patients. INTERPRETATION: BVS was associated with increased rates of composite device-oriented adverse events and device thrombosis cumulatively at 2 years and between 1 and 2 years of follow-up compared with EES. FUNDING: Abbott Vascular.

11 Clinical Trial Optical Coherence Tomography of De Novo Lesions and In-Stent Restenosis in Coronary Saphenous Vein Grafts (OCTOPUS Study). 2016

Roleder, Tomasz / Pociask, Elżbieta / Wańha, Wojciech / Dobrolińska, Magdalena / Gąsior, Paweł / Smolka, Grzegorz / Walkowicz, Wojciech / Jadczyk, Tomasz / Bochenek, Tomasz / Dudek, Dariusz / Ochała, Andrzej / Mizia-Stec, Katarzyna / Gąsior, Zbigniew / Tendera, Michał / Ali, Ziad A / Wojakowski, Wojciech. ·Third Department of Cardiology, Medical University of Silesia. ·Circ J · Pubmed #27334029.

ABSTRACT: BACKGROUND: The OCTOPUS registry prospectively evaluates the procedural and long-term outcomes of saphenous vein graft (SVG) PCI. The current study assessed the morphology of de novo lesions and in-stent restenosis (ISR) in patients undergoing PCI of SVG. METHODS AND RESULTS: Optical coherence tomography (OCT) of SVG lesions in consecutive patients presenting with stable CAD and ACS was carried out. Thirty-nine patients (32 de novo and 10 ISR lesions) were included in the registry. ISR occurred in 5 BMS and 5 DES. There were no differences in the presence of plaque rupture and thrombus between de novo lesions and ISR. Lipid-rich tissue was identified in both de novo lesions and in ISR (75% vs. 50%, P=0.071) with a higher prevalence in BMS than in DES (23% vs. 7.5%; P=0.048). Calcific de novo lesions were detected in older grafts as compared with non-calcific atheromas (159±57 vs. 90±62 months after CABG, P=0.001). Heterogeneous neointima was found only in ISR (70% vs. 0, P<0.001) and was observed with similar frequency in both BMS and DES (24% vs. 30%, P=0.657). ISR was detected earlier in DES than BMS (median, 50 months; IQR, 18-96 months vs. 27 months; IQR, 13-29 months, P<0.001). CONCLUSIONS: OCT-based characteristics of de novo and ISR lesions in SVG were similar except for heterogeneous tissue, which was observed only in ISR. (Circ J 2016; 80: 1804-1811).

12 Article Three-Year Outcomes With the Absorb Bioresorbable Scaffold: Individual-Patient-Data Meta-Analysis From the ABSORB Randomized Trials. 2018

Ali, Ziad A / Gao, Runlin / Kimura, Takeshi / Onuma, Yoshinobu / Kereiakes, Dean J / Ellis, Stephen G / Chevalier, Bernard / Vu, Minh-Thien / Zhang, Zhen / Simonton, Charles A / Serruys, Patrick W / Stone, Gregg W. ·New York-Presbyterian Hospital/Columbia University Medical Center, New York (Z.A.A., G.W.S.). · Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (Z.A.A., G.W.S.). · Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China (R.G.). · Kyoto University Hospital, Japan (T.K.). · Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands (Y.O.). · The Christ Hospital, Heart and Vascular Center, Lindner Research Center, Cincinnati, OH (D.J.K.). · Cleveland Clinic, OH (S.G.E.). · Institut Cardiovasculaire Paris Sud, Massy, France (B.C.). · Abbott Vascular, Santa Clara, CA (M.-t.V., Z.Z., C.A.S.). · International Centre for Cardiovascular Health, Imperial College, London, UK (P.W.S.). · New York-Presbyterian Hospital/Columbia University Medical Center, New York (Z.A.A., G.W.S.) gs2184@columbia.edu. ·Circulation · Pubmed #29089314.

ABSTRACT: BACKGROUND: The Absorb bioresorbable vascular scaffold (BVS) completely resorbs within 3 years after coronary artery implantation. The safety and effectiveness of BVS through this critical 3-year period have not been characterized. METHODS: We performed an individual-patient-data pooled meta-analysis of the 4 randomized ABSORB trials in which 3389 patients with coronary artery disease were randomly assigned to everolimus-eluting Absorb BVS (n=2164) or cobalt-chromium everolimus-eluting stents (n=1225). The primary efficacy outcome measure was target lesion failure (cardiac mortality, target vessel myocardial infarction, or ischemia-driven target lesion revascularization), and the primary safety outcome measure was device thrombosis. RESULTS: BVS compared with cobalt-chromium everolimus-eluting stents resulted in higher 3-year rates of target lesion failure (11.7% versus 8.1%; risk ratio [RR], 1.38; 95% confidence interval [CI], 1.10-1.73; CONCLUSIONS: In the present individual-patient-data pooled meta-analysis of the ABSORB trials, BVS was associated with increased rates of target lesion failure and device thrombosis between 1 and 3 years and cumulatively through 3 years of follow-up compared with everolimus-eluting stents. CLINICAL TRIAL REGISTRATION: URL: https://clinicaltrials.gov. Unique identifiers: NCT01751906, NCT01844284, NCT01923740, and NCT01425281.

13 Article Mechanisms of Orbital Versus Rotational Atherectomy Plaque Modification in Severely Calcified Lesions Assessed by Optical Coherence Tomography. 2017

Yamamoto, Myong Hwa / Maehara, Akiko / Karimi Galougahi, Keyvan / Mintz, Gary S / Parviz, Yasir / Kim, Sung Sik / Koyama, Kohei / Amemiya, Kisaki / Kim, Song-Yi / Ishida, Masaru / Losquadro, Monica / Kirtane, Ajay J / Haag, Elizabeth / Sosa, Fernando A / Stone, Gregg W / Moses, Jeffery W / Ochiai, Masahiko / Shlofmitz, Richard A / Ali, Ziad A. · ·JACC Cardiovasc Interv · Pubmed #29268891.

ABSTRACT: -- No abstract --

14 Article Relation of Coronary Flow Reserve to Other Findings on Positron Emission Tomography Myocardial Perfusion Imaging and Left Heart Catheterization in Patients With End-stage Renal Disease Being Evaluated for Kidney Transplant. 2017

Paz, Yehuda / Morgenstern, Rachelle / Weinberg, Richard / Chiles, Mariana / Bhatti, Navdeep / Ali, Ziad / Mohan, Sumit / Bokhari, Sabahat. ·Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, New York. Electronic address: yep2103@cumc.columbia.edu. · Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, New York. · Department of Medicine, Division of Nephrology, Columbia University Medical Center, New York, New York; The Columbia University Renal Epidemiology (CURE) Group, New York, New York. · Department of Medicine, Division of Nephrology, Columbia University Medical Center, New York, New York; The Columbia University Renal Epidemiology (CURE) Group, New York, New York; Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York. ·Am J Cardiol · Pubmed #28942939.

ABSTRACT: Cardiovascular disease is the leading cause of death in patients with end-stage renal disease (ESRD) and often goes undetected. Abnormal coronary flow reserve (CFR), which predicts increased risk of cardiac death, may be present in patients with ESRD without other evidence of coronary artery disease (CAD). We prospectively studied 131 patients who had rest and dipyridamole pharmacologic stress N

15 Article Optical Coherence Tomography Characterization of Coronary Lithoplasty for Treatment of Calcified Lesions: First Description. 2017

Ali, Ziad A / Brinton, Todd J / Hill, Jonathan M / Maehara, Akiko / Matsumura, Mitsuaki / Karimi Galougahi, Keyvan / Illindala, Uday / Götberg, Matthias / Whitbourn, Robert / Van Mieghem, Nicolas / Meredith, Ian T / Di Mario, Carlo / Fajadet, Jean. ·Center for Interventional Vascular Therapy, Division of Cardiology, New York Presbyterian Hospital and Columbia University, New York, New York; Cardiovascular Research Foundation, New York, New York. Electronic address: zaa2112@columbia.edu. · Stanford University Hospital and Clinics, Stanford, California. · King's College Hospital NHS Trust, London, United Kingdom. · Center for Interventional Vascular Therapy, Division of Cardiology, New York Presbyterian Hospital and Columbia University, New York, New York; Cardiovascular Research Foundation, New York, New York. · Center for Interventional Vascular Therapy, Division of Cardiology, New York Presbyterian Hospital and Columbia University, New York, New York. · Shockwave Medical, Fremont, California. · Institute of Clinical Sciences, Lund University, Skane University Hospital, Lund, Sweden. · Department of Cardiology, St Vincent's Hospital, Melbourne, Fitzroy, Australia. · VU University Medical Center, Amsterdam, the Netherlands. · Cardiovascular Research Centre, Monash Medical Centre, Clayton, Australia. · Royal Brompton Hospital, London, United Kingdom. · Clinique Pasteur, Toulouse, France. ·JACC Cardiovasc Imaging · Pubmed #28797412.

ABSTRACT: OBJECTIVES: This study sought to determine the mechanistic effects of a novel balloon-based lithoplasty system on heavily calcified coronary lesions and subsequent stent placement using optical coherence tomography (OCT). BACKGROUND: The Shockwave Coronary Rx Lithoplasty System (Shockwave Medical, Fremont, California) delivers localized, lithotripsy-enhanced disruption of calcium within the target lesion (i.e., lithoplasty) for vessel preparation before stent implantation. METHODS: We analyzed OCT findings in 31 patients in whom lithoplasty was used to treat severely calcified stenotic coronary lesions. RESULTS: After lithoplasty, intraplaque calcium fracture was identified in 43% of lesions, with circumferential multiple fractures noted in >25%. The frequency of calcium fractures per lesion increased in the most severely calcified plaques (highest tertile vs. lowest tertile; p = 0.009), with a trend toward greater incidence of calcium fracture (77.8% vs. 22.2%; p = 0.057). Post-lithoplasty, mean acute area gain was 2.1 mm CONCLUSIONS: High-resolution imaging by OCT delineated calcium modification with fracture as a major mechanism of action of lithoplasty in vivo and demonstrated efficacy in the achievement of significant acute area gain and favorable stent expansion.

16 Article Neoatherosclerosis assessed with optical coherence tomography in restenotic bare metal and first- and second-generation drug-eluting stents. 2017

Song, Lei / Mintz, Gary S / Yin, Dong / Yamamoto, Myong Hwa / Chin, Chee Yang / Matsumura, Mitsuaki / Fall, Khady / Kirtane, Ajay J / Parikh, Manish A / Moses, Jeffrey W / Ali, Ziad A / Shlofmitz, Richard A / Maehara, Akiko. ·Cardiovascular Research Foundation, 1700 Broadway, 9th Floor, New York, NY, 10019, USA. · New York-Presbyterian Hospital/Columbia University Medical Center, New York, NY, USA. · Nation Center for Cardiovascular Disease, China Peking Union Medical College, Fuwai Hospital, Beijing, China. · National Heart Centre Singapore, Singapore, Singapore. · St. Francis Hospital, Roslyn, NY, USA. · Cardiovascular Research Foundation, 1700 Broadway, 9th Floor, New York, NY, 10019, USA. amaehara@crf.org. · New York-Presbyterian Hospital/Columbia University Medical Center, New York, NY, USA. amaehara@crf.org. ·Int J Cardiovasc Imaging · Pubmed #28281026.

ABSTRACT: Although reported in bare metal stents (BMS) and first-generation drug-eluting stents (DES), little is known about neoatherosclerosis in second-generation DES. We used optical coherence tomography to evaluate neoatherosclerosis among different stent generations. Overall, 274 in-stent restenosis (ISR) lesions (duration from implantation 56.9 ± 47.2 months) in 274 patients were assessed for the presence of neoatherosclerosis. Neoatherosclerosis was identified in 38.7% of lesions (106/274): 23.0% second-generation DES (38/165), 65.1% first-generation DES (54/83), and 53.8% BMS (14/26). In the neoatherosclerosis cohort (n = 106), more stent underexpansion or fracture/deformation was observed in second-generation DES, whereas thrombus, without plaque rupture, or evagination was more common in first-generation DES. In multivariable analyses, duration from implantation >1 year (OR: 2.44, 95% CI 1.12-5.31; p = 0.03), absence of angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (OR 1.95, 95% CI 1.10-3.44; p = 0.02) or statins at the time of ISR (OR 3.12, 95% CI 1.42-6.84; p = 0.01), and first-generation vs first-generation DES (OR 5.32, 95% CI 2.82-10.10; p < 0.001) correlated with a higher prevalence of neoatherosclerosis. Duration from implantation <1 year (OR 2.17, 95% CI 1.03-4.55; p = 0.04) and thin fibrous cap, thrombus, or rupture (OR 2.72, 95% CI 1.15-6.39; p = 0.02) were independent predictors for acute coronary syndromes presentation. Neoatherosclerosis is an important ISR mechanism, especially in first generation DES.

17 Article Coronary Plaque Characteristics in Hemodialysis-Dependent Patients as Assessed by Optical Coherence Tomography. 2017

Chin, Chee Yang / Matsumura, Mitsuaki / Maehara, Akiko / Zhang, Wenbin / Lee, Cheolmin Tetsumin / Yamamoto, Myong Hwa / Song, Lei / Parviz, Yasir / Jhalani, Nisha B / Mohan, Sumit / Ratner, Lloyd E / Cohen, David J / Ben-Yehuda, Ori / Stone, Gregg W / Shlofmitz, Richard A / Kakuta, Tsunekazu / Mintz, Gary S / Ali, Ziad A. ·Clinical Trials Center, Cardiovascular Research Foundation, New York, New York; Division of Cardiology, New York-Presbyterian Hospital/Columbia University Medical Center, New York, New York; Department of Cardiology, National Heart Centre Singapore, Singapore. · Clinical Trials Center, Cardiovascular Research Foundation, New York, New York. · Clinical Trials Center, Cardiovascular Research Foundation, New York, New York; Division of Cardiology, New York-Presbyterian Hospital/Columbia University Medical Center, New York, New York. · Clinical Trials Center, Cardiovascular Research Foundation, New York, New York; Division of Cardiology, New York-Presbyterian Hospital/Columbia University Medical Center, New York, New York; Department of Cardiology, National Center for Cardiovascular Disease, China Peking Union Medical College, Fuwai Hospital, Beijing, China. · Division of Cardiology, New York-Presbyterian Hospital/Columbia University Medical Center, New York, New York. · Division of Nephrology, New York-Presbyterian Hospital/Columbia University Medical Center, New York, New York. · Department of Surgery, New York-Presbyterian Hospital/Columbia University Medical Center, New York, New York. · St. Francis Hospital and Heart Center, Roslyn, New York. · Department of Cardiology, Tsuchiura Kyodo General Hospital, Tsuchiura, Japan. · Clinical Trials Center, Cardiovascular Research Foundation, New York, New York; Division of Cardiology, New York-Presbyterian Hospital/Columbia University Medical Center, New York, New York. Electronic address: zaa2112@columbia.edu. ·Am J Cardiol · Pubmed #28279437.

ABSTRACT: Coronary arteries in patients with chronic kidney disease (CKD) have been shown to exhibit more extensive atherosclerosis and calcium. We aimed to assess characteristics of coronary plaque in hemodialysis (HD)-dependent patients using optical coherence tomography (OCT). This was a multicenter, retrospective study of 124 patients with stable angina who underwent OCT imaging. Sixty-two HD-dependent patients who underwent pre-intervention OCT for coronary artery disease were compared 1:1 with a cohort of patients without CKD, matched for age, diabetes mellitus, gender, and culprit vessel. Baseline characteristics were comparable. Pre-intervention OCT imaging identified 62 paired culprit, 53 paired non-culprit, and 19 paired distal vessel lesions. Lesion length, minimum lumen area, and area stenosis were similar between groups. The HD-dependent group had greater mean calcium arcs in culprit (54.3° vs 26.4°, p = 0.004) and non-culprit lesions (34.3° vs 24.5°, p = 0.02) and greater maximum calcium arc in distal vessel segments (101.6° vs 0°, p = 0.03). There were no differences in lipid arcs between groups. There was a higher prevalence of thin intimal calcium, defined as an arc of calcium >30° within intima <0.5 mm thick, in patients in the HD-dependent group (41.9% vs 4.8%, p <0.001). There was a higher prevalence of calcified nodules in the HD-dependent group (24.2% vs 9.7%, p = 0.049) but no differences in medial calcification or thin-cap fibroatheroma. In conclusion, in this OCT study, HD-dependent patients, compared with matched patients without CKD, had more extensively distributed coronary calcium and uniquely, a higher prevalence of non-atherosclerotic thin intimal calcium. This thin intimal calcium may cause an overestimation of calcium burden by intravascular ultrasound and may contribute to the lack of correlation between increased coronary artery calcification scores with long-term outcomes in patients with CKD.

18 Article Percutaneous Coronary Intervention With Bioresorbable Scaffolds in a Young Child. 2017

Nazif, Tamim M / Kalra, Sanjog / Ali, Ziad A / Karmpaliotis, Dimitrios / Turner, Mariel E / Starc, Thomas J / Cao, Yang / Marboe, Charles C / Collins, Michael B / Leon, Martin B / Kirtane, Ajay J. ·Division of Cardiology, Columbia University Medical Center, New York, New York2Cardiovascular Research Foundation, New York, New York. · Division of Cardiology, Columbia University Medical Center, New York, New York. · Division of Pediatric Cardiology, Columbia University Medical Center, New York, New York. · Cardiovascular Research Foundation, New York, New York. · Department of Pathology, Columbia University Medical Center, New York, New York. · Division of Cardiology, Columbia University Medical Center, New York, New York2Cardiovascular Research Foundation, New York, New York5Associate Editor, JAMA Cardiology. ·JAMA Cardiol · Pubmed #28030655.

ABSTRACT: Importance: Although much less frequent than in adults, coronary artery disease requiring revascularization may develop in children because of homozygous familial hypercholesterolemia or other underlying conditions. Percutaneous coronary intervention (PCI) with a bioresorbable scaffold (BRS) may have advantages over metallic coronary stents in this population. Objective: To present a case of the successful treatment of unstable, multivessel coronary artery disease in a child with PCI with BRS implantation. This case highlights the limitations of conventional metal stents and the potential benefits of using BRSs in children. Design, Setting, and Participants: This is a case report from an academic tertiary care institution of a 3-year-old boy with homozygous familial hypercholesterolemia and unstable coronary artery disease requiring revascularization. We also briefly review the related literature. Interventions/Exposures: Intravascular imaging-guided PCI of the proximal right coronary artery and the left main and proximal left circumflex arteries was performed with BRSs. Main Outcomes and Measures: The primary outcomes were acute procedural success and survival to liver transplant (3 months after PCI). Results: Following BRS implantation, the patient recovered and remained free of cardiovascular symptoms 3 months after PCI. He subsequently underwent an orthotopic liver transplant for definitive treatment of homozygous familial hypercholesterolemia but died of noncardiac complications. A postmortem examination, including a histological assessment, revealed both BRSs to be patent with nonobstructive neointimal hyperplasia. Conclusions and Relevance: To our knowledge, this is the first report of PCI with BRSs in a child. This represents an application of a BRS with potentially important implications for the future treatment of coronary artery disease in children and warrants further study.

19 Article Utility of near-infrared spectroscopy for detection of thin-cap neoatherosclerosis. 2017

Roleder, Tomasz / Karimi Galougahi, Keyvan / Chin, Chee Yang / Bhatti, Navdeep K / Brilakis, Emmanouil / Nazif, Tamim M / Kirtane, Ajay J / Karmpaliotis, Dimitri / Wojakowski, Wojciech / Leon, Martin B / Mintz, Gary S / Maehara, Akiko / Stone, Gregg W / Ali, Ziad A. ·Center for Interventional Vascular Therapy, Division of Cardiology, New York Presbyterian Hospital and Columbia University, New York, NY, USA. · Cardiovascular Research Foundation, New York, NY, USA. · Third Division of Cardiology, Medical University of Silesia, Katowice, Poland. · Dallas VA Medical Center, Dallas, TX, USA. ·Eur Heart J Cardiovasc Imaging · Pubmed #27679596.

ABSTRACT: Aims: Near-infrared spectroscopy (NIRS) has been employed to assess the composition of the atherosclerotic plaques in native coronary arteries. However, little is known about the detection of neoatherosclerosis by NIRS in in-stent restenosis (ISR). The aim of the study was to assess the relationship between the distribution of lipid determined by NIRS and morphology of ISR on optical coherence tomography (OCT). Methods and results: We performed both NIRS and OCT in 39 drug-eluting stents with ISR. Values of lipid-core burden index (LCBI) derived by NIRS were compared with the OCT-derived thickness of the fibrous cap covering neoatherosclerotic lesions. A total of 22 (49%) in-stent neointimas were identified as lipid rich by both NIRS and OCT. There was good agreement between OCT and NIRS in identifying lipid within in-stent neointima (kappa = 0.60, 95% CI: 0.34-0.86). OCT identified thin-cap neoatheromas (TCNA) (<65 µm) in 12 stents (23%). The minimal cap thickness of in-stent neoatherosclerotic plaque measured by OCT correlated with the maxLCBI4mm (maximal LCBI per 4 mm) within the stent (r = -0.77, P< 0.01). Moreover, maxLCBI4mm was able to accurately predict TCNA with a cut-off value of >144. Conclusion: NIRS correlates with OCT identification of lipids in stented vessels and is able to predict the presence of thin fibrous cap neoatheroma.

20 Article Approaches to percutaneous coronary intervention of right coronary artery chronic total occlusions: insights from a multicentre US registry. 2016

Karatasakis, Aris / Karmpaliotis, Dimitri / Alaswad, Khaldoon / Jaffer, Farouc A / Yeh, Robert W / Patel, Mitul P / Bahadorani, John N / Lombardi, William L / Wyman, R Michael / Grantham, J Aaron / Kandzari, David E / Lembo, Nicholas J / Doing, Anthony H / Toma, Catalin / Moses, Jeffrey W / Kirtane, Ajay J / Ali, Ziad / Parikh, Manish / Garcia, Santiago / Danek, Barbara A / Karacsonyi, Judit / Alame, Aya / Kalsaria, Pratik / Thompson, Craig / Banerjee, Subhash / Brilakis, Emmanouil S. ·VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, TX, USA. ·EuroIntervention · Pubmed #27934609.

ABSTRACT: AIMS: The goal of this study was to describe the procedural characteristics, strategy selection and associated technical and efficiency outcomes for chronic total occlusion (CTO) percutaneous coronary intervention (PCI) of the right coronary artery (RCA). METHODS AND RESULTS: We examined the clinical and angiographic characteristics of patients who underwent RCA CTO PCI between 2012 and 2015 at 11 centres in the USA. The RCA was the CTO target vessel in 739 of 1,308 CTO PCIs (56%). Overall technical and procedural success rates were 90% and 88%, respectively. A major adverse cardiovascular event (MACE) occurred in 19 patients (2.6%). Technical success was most frequently achieved using antegrade wire escalation (38% of successful procedures) followed by retrograde (36%) and antegrade dissection/re-entry (26%). Technical success was similar between various locations of RCA CTOs (p=0.11). Compared with antegrade-only procedures, utilisation of any retrograde approach was associated with lower technical (85% vs. 95%, p<0.001) and procedural (82% vs. 94%, p<0.001) success and a higher MACE rate (3.8% vs. 1.4%, p=0.037). CONCLUSIONS: RCA CTOs represent the majority of CTO target lesions, can be treated with high success and acceptable complication rates, and require frequent use of the retrograde approach and antegrade dissection/re-entry.

21 Article Optical coherence tomography compared with intravascular ultrasound and with angiography to guide coronary stent implantation (ILUMIEN III: OPTIMIZE PCI): a randomised controlled trial. 2016

Ali, Ziad A / Maehara, Akiko / Généreux, Philippe / Shlofmitz, Richard A / Fabbiocchi, Franco / Nazif, Tamim M / Guagliumi, Giulio / Meraj, Perwaiz M / Alfonso, Fernando / Samady, Habib / Akasaka, Takashi / Carlson, Eric B / Leesar, Massoud A / Matsumura, Mitsuaki / Ozan, Melek Ozgu / Mintz, Gary S / Ben-Yehuda, Ori / Stone, Gregg W / Anonymous3900886. ·New York Presbyterian Hospital and Columbia University, New York, NY, USA; Cardiovascular Research Foundation, New York, NY, USA. · Cardiovascular Research Foundation, New York, NY, USA. · St Francis Hospital, Roslyn, New York, NY, USA. · Centro Cardiologico Monzino Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy. · Ospedale Papa Giovanni XXIII, Bergamo, Italy. · Northwell Health, Manhasset, New York, NY, USA. · Hospital Universitario de La Princesa, Madrid, Spain. · Emory University Hospital, Atlanta, GA, USA. · Wakayama Medical University, Wakayama, Japan. · Eastern Cardiology, Greenville, NC, USA. · University of Alabama, Birmingham, AB, USA. · New York Presbyterian Hospital and Columbia University, New York, NY, USA; Cardiovascular Research Foundation, New York, NY, USA. Electronic address: gs2184@columbia.edu. ·Lancet · Pubmed #27806900.

ABSTRACT: BACKGROUND: Percutaneous coronary intervention (PCI) is most commonly guided by angiography alone. Intravascular ultrasound (IVUS) guidance has been shown to reduce major adverse cardiovascular events (MACE) after PCI, principally by resulting in a larger postprocedure lumen than with angiographic guidance. Optical coherence tomography (OCT) provides higher resolution imaging than does IVUS, although findings from some studies suggest that it might lead to smaller luminal diameters after stent implantation. We sought to establish whether or not a novel OCT-based stent sizing strategy would result in a minimum stent area similar to or better than that achieved with IVUS guidance and better than that achieved with angiography guidance alone. METHODS: In this randomised controlled trial, we recruited patients aged 18 years or older undergoing PCI from 29 hospitals in eight countries. Eligible patients had one or more target lesions located in a native coronary artery with a visually estimated reference vessel diameter of 2·25-3·50 mm and a length of less than 40 mm. We excluded patients with left main or ostial right coronary artery stenoses, bypass graft stenoses, chronic total occlusions, planned two-stent bifurcations, and in-stent restenosis. Participants were randomly assigned (1:1:1; with use of an interactive web-based system in block sizes of three, stratified by site) to OCT guidance, IVUS guidance, or angiography-guided stent implantation. We did OCT-guided PCI using a specific protocol to establish stent length, diameter, and expansion according to reference segment external elastic lamina measurements. All patients underwent final OCT imaging (operators in the IVUS and angiography groups were masked to the OCT images). The primary efficacy endpoint was post-PCI minimum stent area, measured by OCT at a masked independent core laboratory at completion of enrolment, in all randomly allocated participants who had primary outcome data. The primary safety endpoint was procedural MACE. We tested non-inferiority of OCT guidance to IVUS guidance (with a non-inferiority margin of 1·0 mm FINDINGS: Between May 13, 2015, and April 5, 2016, we randomly allocated 450 patients (158 [35%] to OCT, 146 [32%] to IVUS, and 146 [32%] to angiography), with 415 final OCT acquisitions analysed for the primary endpoint (140 [34%] in the OCT group, 135 [33%] in the IVUS group, and 140 [34%] in the angiography group). The final median minimum stent area was 5·79 mm INTERPRETATION: OCT-guided PCI using a specific reference segment external elastic lamina-based stent optimisation strategy was safe and resulted in similar minimum stent area to that of IVUS-guided PCI. These data warrant a large-scale randomised trial to establish whether or not OCT guidance results in superior clinical outcomes to angiography guidance. FUNDING: St Jude Medical.

22 Article Imaging Comparisons of Coregistered Native and Stented Coronary Segments by High-Definition 60-MHz Intravascular Ultrasound and Optical Coherence Tomography. 2016

Chin, Chee Yang / Maehara, Akiko / Fall, Khady / Mintz, Gary S / Ali, Ziad A. ·Cardiovascular Research Foundation, New York, New York; Center for Interventional Vascular Therapy, Division of Cardiology, Presbyterian Hospital and Columbia University, New York, New York; Department of Cardiovascular Medicine, National Heart Centre Singapore, Singapore. · Cardiovascular Research Foundation, New York, New York; Center for Interventional Vascular Therapy, Division of Cardiology, Presbyterian Hospital and Columbia University, New York, New York. · Center for Interventional Vascular Therapy, Division of Cardiology, Presbyterian Hospital and Columbia University, New York, New York. · Cardiovascular Research Foundation, New York, New York. · Cardiovascular Research Foundation, New York, New York; Center for Interventional Vascular Therapy, Division of Cardiology, Presbyterian Hospital and Columbia University, New York, New York. Electronic address: zaa2112@cumc.columbia.edu. ·JACC Cardiovasc Interv · Pubmed #27262862.

ABSTRACT: -- No abstract --

23 Article Comparison Between Cardiac Allograft Vasculopathy and Native Coronary Atherosclerosis by Optical Coherence Tomography. 2016

Shan, Peiren / Dong, Liang / Maehara, Akiko / Nazif, Tamim M / Ali, Ziad A / Rabbani, LeRoy E / Apfelbaum, Mark A / Dalton, Kate / Marboe, Charles C / Mancini, Donna M / Mintz, Gary S / Weisz, Giora. ·Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Zhejiang, China; Division of Cardiology, New York-Presbyterian Hospital, Columbia University Medical Center, New York, New York; Clinical Trials Center, Cardiovascular Research Foundation, New York, New York. · Division of Cardiology, New York-Presbyterian Hospital, Columbia University Medical Center, New York, New York; Clinical Trials Center, Cardiovascular Research Foundation, New York, New York; The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, China. · Division of Cardiology, New York-Presbyterian Hospital, Columbia University Medical Center, New York, New York; Clinical Trials Center, Cardiovascular Research Foundation, New York, New York. · Division of Cardiology, New York-Presbyterian Hospital, Columbia University Medical Center, New York, New York. · Clinical Trials Center, Cardiovascular Research Foundation, New York, New York. · Division of Cardiology, New York-Presbyterian Hospital, Columbia University Medical Center, New York, New York; Clinical Trials Center, Cardiovascular Research Foundation, New York, New York; Els & Charles Bendheim Department of Cardiology, Shaare Zedek Medical Center, Jerusalem, Israel. Electronic address: weiszg@szmc.org.il. ·Am J Cardiol · Pubmed #26920081.

ABSTRACT: We sought to explore differences in distribution and morphology of coronary lesions comparing cardiac allograft vasculopathy and native coronary atherosclerosis (NCA) using intravascular imaging with optical coherence tomography (OCT). At the time of routine surveillance angiography, 17 heart transplant (HT) recipients with a history of high-grade cellular rejection (HGR) and 43 HT recipients with none/mild (low)-grade rejection underwent OCT imaging of the left anterior descending and were compared to 60 patients with NCA without HT. Compared with patients with NCA, patients with HGR had similar intima areas but smaller external elastic lamina areas (7.9 mm(2) [6.3, 11.2] versus 6.6 mm(2) [4.8, 7.5], p = 0.02) resulting in smaller lumen areas (4.5 mm(2) [3.4, 6.6] versus 3.3 mm(2) [2.8, 4.7], p = 0.04) in distal segments and smaller lumen diameters in side branches (1.28 mm [1.19, 1.37] versus 1.09 mm [0.94, 1.24], p = 0.04). Compared with patients with NCA, lesions in patients with HT were more homogeneous, involving the entire coronary vascular tree. Patients with HGR had a higher prevalence of macrophages involving ≥1 quadrant in all 3 segments compared with patients with NCA. The number of microvessels was greater in patients with both HGR and LGR HT versus NCA. In conclusion, distinct findings in the distribution and morphology of coronary lesions between HT recipients and patients with NCA are evident by OCT imaging, suggesting that OCT might be useful to help differentiate cardiac allograft vasculopathy from NCA in vivo.

24 Article Comparison of Stent Expansion Guided by Optical Coherence Tomography Versus Intravascular Ultrasound: The ILUMIEN II Study (Observational Study of Optical Coherence Tomography [OCT] in Patients Undergoing Fractional Flow Reserve [FFR] and Percutaneous Coronary Intervention). 2015

Maehara, Akiko / Ben-Yehuda, Ori / Ali, Ziad / Wijns, William / Bezerra, Hiram G / Shite, Junya / Généreux, Philippe / Nichols, Melissa / Jenkins, Paul / Witzenbichler, Bernhard / Mintz, Gary S / Stone, Gregg W. ·Columbia University Medical Center and New York-Presbyterian Hospital, New York, New York; Cardiovascular Research Foundation, New York, New York. · Cardiovascular Center, OLV Hospital, Aalst, Belgium. · UH Case Medical Center, Cleveland, Ohio. · Osaka Saiseikai Nakatsu Hospital, Osaka, Japan. · Columbia University Medical Center and New York-Presbyterian Hospital, New York, New York; Cardiovascular Research Foundation, New York, New York; Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada. · Cardiovascular Research Foundation, New York, New York. · Helios Amper-Klinikum, Dachau, Germany. · Columbia University Medical Center and New York-Presbyterian Hospital, New York, New York; Cardiovascular Research Foundation, New York, New York. Electronic address: gs2184@columbia.edu. ·JACC Cardiovasc Interv · Pubmed #26585621.

ABSTRACT: OBJECTIVES: The present study sought to determine whether optical coherence tomography (OCT) guidance results in a degree of stent expansion comparable to that with intravascular ultrasound (IVUS) guidance. BACKGROUND: The most important predictor of adverse outcomes (thrombosis and restenosis) after stent implantation with IVUS guidance is the degree of stent expansion achieved. METHODS: We compared the relative degree of stent expansion (defined as the minimal stent area divided by the mean of the proximal and distal reference lumen areas) after OCT-guided stenting in patients in the ILUMIEN (Observational Study of Optical Coherence Tomography [OCT] in Patients Undergoing Fractional Flow Reserve [FFR] and Percutaneous Coronary Intervention) (N = 354) and IVUS-guided stenting in patients in the ADAPT-DES (Assessment of Dual Antiplatelet Therapy With Drug-Eluting Stents) study (N = 586). Stent expansion was examined in all 940 patients in a covariate-adjusted analysis as well as in 286 propensity-matched pairs (total N = 572). RESULTS: In the matched-pair analysis, the degree of stent expansion was not significantly different between OCT and IVUS guidance (median [first, third quartiles] = 72.8% [63.3, 81.3] vs. 70.6% [62.3, 78.8], respectively, p = 0.29). Similarly, after adjustment for baseline differences in the entire population, the degree of stent expansion was also not different between the 2 imaging modalities (p = 0.84). Although a higher prevalence of post-PCI stent malapposition, tissue protrusion, and edge dissections was detected by OCT, the rates of major malapposition, tissue protrusion, and dissections were similar after OCT- and IVUS-guided stenting. CONCLUSIONS: In the present post-hoc analysis of 2 prospective studies, OCT and IVUS guidance resulted in a comparable degree of stent expansion. Randomized trials are warranted to compare the outcomes of OCT- and IVUS-guided coronary stent implantation.

25 Article In vivo comparison between cardiac allograft vasculopathy and native atherosclerosis using near-infrared spectroscopy and intravascular ultrasound. 2015

Zheng, Bo / Maehara, Akiko / Mintz, Gary S / Nazif, Tamim M / Waksman, Yarden / Qiu, Fuyu / Jaquez, Luz / Rabbani, LeRoy E / Apfelbaum, Mark A / Ali, Ziad A / Dalton, Kate / Xu, Ke / Marboe, Charles C / Mancini, Donna M / Weisz, Giora. ·NewYork-Presbyterian/Columbia University Medical Center, New York, NY, USA Cardiovascular Research Foundation, New York, NY, USA Peking University First Hospital, Beijing, China. · NewYork-Presbyterian/Columbia University Medical Center, New York, NY, USA Cardiovascular Research Foundation, New York, NY, USA. · Cardiovascular Research Foundation, New York, NY, USA. · NewYork-Presbyterian/Columbia University Medical Center, New York, NY, USA. · NewYork-Presbyterian/Columbia University Medical Center, New York, NY, USA Icahn School of Medicine at Mount Sinai, New York, NY, USA. · NewYork-Presbyterian/Columbia University Medical Center, New York, NY, USA Cardiovascular Research Foundation, New York, NY, USA Department of Cardiology, Shaare Zedek Medical Center, 12 Shmuel (Hans) Beyth Street, Jerusalem 91031, Israel weiszg@szmc.org.il. ·Eur Heart J Cardiovasc Imaging · Pubmed #25719180.

ABSTRACT: AIMS: The aim was to compare cardiac allograft vasculopathy to native atherosclerosis by near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS). METHODS AND RESULTS: Twenty-seven atherosclerotic (non-transplant) patients and 28 heart transplant recipients undergoing routine surveillance coronary angiography underwent NIRS-IVUS imaging of the left anterior descending coronary artery. In each proximal, middle, and distal coronary artery segment, the maxLCBI4mm [4-mm long segment with maximum lipid core burden index (LCBI)] and corresponding IVUS parameters were compared. MaxLCBI4mm was significantly greater among atherosclerotic patients than the transplant patients in both proximal and middle coronary artery segments, but not in the distal segment. There was a positive linear correlation between maxLCBI4mm and maximum plaque burden in both groups, but atherosclerotic patients demonstrated a smaller maxLCBI4mm than transplant recipients among segments with plaque burden <40%. Among segments with a maximum plaque burden ≥40%, native-atherosclerosis patients had a greater maxLCBI4mm compared with transplant patients (P = 0.015). Calcification was present in 72.9% of native atherosclerosis and 14.7% of transplant segments (P< 0.001). Among the 165 analysed segments, prevalence of lipid-rich plaque (LRP) with superficial attenuation (30.9 vs. 1.2%, P < 0.001) or calcified LRP (13.6 vs. 2.4%, P = 0.03) was significantly greater in native atherosclerosis compared with transplant patients. Conversely, the proportion of segments with non-LRP (46.4 vs. 11.1%, P < 0.001) was higher in transplant patients. CONCLUSION: NIRS-IVUS imaging demonstrated early and accelerated lipid accumulation with smaller plaque burden and less calcium in patients after heart transplant when compared with patients with native atherosclerosis.

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