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Coronary Artery Disease: HELP
Articles by Edoardo Camenzind
Based on 12 articles published since 2010
(Why 12 articles?)
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Between 2010 and 2020, Edoardo Camenzind wrote the following 12 articles about Coronary Artery Disease.
 
+ Citations + Abstracts
1 Article Coronary computed tomography angiography for heart team decision-making in multivessel coronary artery disease. 2018

Collet, Carlos / Onuma, Yoshinobu / Andreini, Daniele / Sonck, Jeroen / Pompilio, Giulio / Mushtaq, Saima / La Meir, Mark / Miyazaki, Yosuke / de Mey, Johan / Gaemperli, Oliver / Ouda, Ahmed / Maureira, Juan Pablo / Mandry, Damien / Camenzind, Edoardo / Macron, Laurent / Doenst, Torsten / Teichgräber, Ulf / Sigusch, Holger / Asano, Taku / Katagiri, Yuki / Morel, Marie-Angele / Lindeboom, Wietze / Pontone, Gianluca / Lüscher, Thomas F / Bartorelli, Antonio L / Serruys, Patrick W. ·Department of Cardiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, AZ Amsterdam, the Netherlands. · Department of Cardiology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, Jette, Brussel, Belgium. · Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Doctor Molewaterplein 40, GD Rotterdam, the Netherlands. · Cardialysis BV, Westblaak 98, KM Rotterdam, the Netherlands. · Centro Cardiologico Monzino, University of Milan, Via Carlo Parea, 4, Milano, Italy. · Department of Cardiology, University of Zurich, Rämistrasse 71, Zürich, Switzerland. · Department of Radiology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, Jette, Brussel, Belgium. · Department of Cardiovascular Surgery, University of Zurich, Rämistrasse 71, Zürich, Switzerland. · Department of Cardiovascular Surgery, CHRU Nancy and University of Lorraine, Avenue du Maréchal de Lattre, Rue Charles Welche, Nancy, France. · Department of Radiology, CHRU Nancy and University of Lorraine, Avenue du Maréchal de Lattre, Rue Charles Welche, Nancy, France. · Department of Cardiology, CHRU Nancy and University of Lorraine, Avenue du Maréchal de Lattre, Rue Charles Welche, Nancy, France. · Department of Cardiology, Centre cardiologique du nord, 36 Rue des Moulins Gémeaux, Saint-Denis, France. · Department of Cardiovascular Surgery, Jena University Hospital, Friedrich Schiller University of Jena, Fürstengraben 1, Jena, Germany. · Department of Radiology, Jena University Hospital, Friedrich Schiller University of Jena, Fürstengraben 1, Jena, Germany. · Department of Cardiology, Heinrich Braun Klinikum, Karl-Keil-Straße 35, Zwickau, Germany. · Department of Cardiology, Royal Brompton and Harefield Hospitals, Imperial College of London, Kensington, London, UK. · Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Via Festa del Perdono, 7, Milano MI, Italy. ·Eur Heart J · Pubmed #30312411.

ABSTRACT: Aims: Coronary computed tomography angiography (CTA) has emerged as a non-invasive diagnostic method for patients with suspected coronary artery disease, but its usefulness in patients with complex coronary artery disease remains to be investigated. The present study sought to determine the agreement between separate heart teams on treatment decision-making based on either coronary CTA or conventional angiography. Methods and results: Separate heart teams composed of an interventional cardiologist, a cardiac surgeon, and a radiologist were randomized to assess the coronary artery disease with either coronary CTA or conventional angiography in patients with de novo left main or three-vessel coronary artery disease. Each heart team, blinded for the other imaging modality, quantified the anatomical complexity using the SYNTAX score and integrated clinical information using the SYNTAX Score II to provide a treatment recommendations based on mortality prediction at 4 years: coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), or equipoise between CABG and PCI. The primary endpoint was the agreement between heart teams on the revascularization strategy. The secondary endpoint was the impact of fractional flow reserve derived from coronary CTA (FFRCT) on treatment decision and procedural planning. Overall, 223 patients were included. A treatment recommendation of CABG was made in 28% of the cases with coronary CTA and in 26% with conventional angiography. The agreement concerning treatment decision between coronary CTA and conventional angiography was high (Cohen's kappa 0.82, 95% confidence interval 0.74-0.91). The heart teams agreed on the coronary segments to be revascularized in 80% of the cases. FFRCT was available for 869/1108 lesions (196/223 patients). Fractional flow reserve derived from coronary CTA changed the treatment decision in 7% of the patients. Conclusion: In patients with left main or three-vessel coronary artery disease, a heart team treatment decision-making based on coronary CTA showed high agreement with the decision derived from conventional coronary angiography suggesting the potential feasibility of a treatment decision-making and planning based solely on this non-invasive imaging modality and clinical information. Trial registration number: NCT02813473.

2 Article Coronary Embolism Among ST-Segment-Elevation Myocardial Infarction Patients: Mechanisms and Management. 2018

Popovic, Batric / Agrinier, Nelly / Bouchahda, Nidhal / Pinelli, Samuel / Maigrat, Charles Henry / Metzdorf, Pierre Adrien / Selton Suty, Christine / Juillière, Yves / Camenzind, Edoardo. ·From the Département de Cardiologie (B.P., N.B., S.P., C.H.M., P.A.M., C.S.S., Y.J., E.C.) and Epidémiologie et Evaluation Cliniques (N.A.), CHU Nancy, France. b.popovic@chu-nancy.fr. · From the Département de Cardiologie (B.P., N.B., S.P., C.H.M., P.A.M., C.S.S., Y.J., E.C.) and Epidémiologie et Evaluation Cliniques (N.A.), CHU Nancy, France. ·Circ Cardiovasc Interv · Pubmed #29311288.

ABSTRACT: BACKGROUND: Coronary artery embolism (CE) is recognized as an important nonatherosclerotic cause of ST-segment-elevation myocardial infarction. The objective was to describe clinical characteristics and long-term outcomes and to identify risks factors of CE in a large consecutive series of ST-segment-elevation myocardial infarction patients. METHODS AND RESULTS: We studied 1232 consecutive patients who presented with de novo ST-segment-elevation myocardial infarction. CE was diagnosed based on criteria encompassing clinical, angiographic, and diagnostic imaging findings. A total of 53 patients were identified in the CE group including 12 (22.6%) patients with multisites CE and 9 patients with other extracoronary localization. Compared with the non-CE group, age and coronary risks factors were not significantly different in the CE group except for smoking ( CONCLUSIONS: Etiopathogenesis of ST-segment-elevation myocardial infarction secondary to CE is diverse ranging from cardiac to systemic disease, and patient long-term survival is worse than expected according to the baseline cardiovascular risk.

3 Article Effect of Increasing Stent Length on 3-Year Clinical Outcomes in Women Undergoing Percutaneous Coronary Intervention With New-Generation Drug-Eluting Stents: Patient-Level Pooled Analysis of Randomized Trials From the WIN-DES Initiative. 2018

Chandrasekhar, Jaya / Baber, Usman / Sartori, Samantha / Stefanini, Giulio G / Sarin, Michele / Vogel, Birgit / Farhan, Serdar / Camenzind, Edoardo / Leon, Martin B / Stone, Gregg W / Serruys, Patrick W / Wijns, William / Steg, Philippe G / Weisz, Giora / Chieffo, Alaide / Kastrati, Adnan / Windecker, Stephan / Morice, Marie-Claude / Smits, Pieter C / von Birgelen, Clemens / Mikhail, Ghada W / Itchhaporia, Dipti / Mehta, Laxmi / Kim, Hyo-Soo / Valgimigli, Marco / Jeger, Raban V / Kimura, Takeshi / Galatius, Søren / Kandzari, David / Dangas, George / Mehran, Roxana. ·The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York. · Humanitas Research Hospital, Rozzano, Milan, Italy. · Institut Lorrain du Coeur et des Vaisseaux, Vandoeuvre-lès-Nancy, France. · Columbia University Medical Center, New York, New York. · Imperial College Healthcare NHS Trust, London, United Kingdom. · Cardiovascular Center Aalst, Onze-Lieve-Vrouwziekenhuis Ziekenhuis, Aalst, Belgium. · Département Hospitalo Universitaire, Assistance Publique-Hôpitaux de Paris, Université Paris Diderot, INSERM U114, Paris, France. · Columbia University Medical Center, New York, New York; Shaare Zedek Medical Center, Jerusalem, Israel. · San Raffaele Scientific Institute, Milan, Italy. · Deutsches Herzentrum Munchen, Technische Universitat Munich, Germany. · Bern University Hospital, Bern, Switzerland. · Institut Cardiovasculaire Paris Sud, Ramsay Générale de Santé, Massy, France. · Maasstad Hospital, Rotterdam, the Netherlands. · Thoraxcentrum Twente, Enschede, the Netherlands. · Hoag Memorial Hospital Presbyterian, Newport Beach, California. · Ohio State University Medical Center, Columbus, Ohio. · Seoul National University Hospital, Seoul, Korea. · University of Ferrara, Ferrara, Italy. · University Hospital Basel, Basel, Switzerland. · Kyoto University Graduate School of Medicine, Kyoto, Japan. · Bispebjerg University Hospital, Copenhagen, Denmark. · Piedmont Heart Institute, Atlanta, Georgia. · The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: roxana.mehran@mountsinai.org. ·JACC Cardiovasc Interv · Pubmed #29301648.

ABSTRACT: OBJECTIVES: The aim of this study was to examine whether stent length per patient and stent length per lesion are negative markers for 3-year outcomes in women following percutaneous coronary intervention (PCI) with new-generation drug-eluting stents (DES). BACKGROUND: In the era of advanced stent technologies, whether stent length remains a correlate of adverse outcomes is unclear. METHODS: Women treated with new-generation DES in 14 randomized trials from the WIN-DES (Women in Innovation and Drug-Eluting Stents) pooled database were evaluated. Total stent length per patient, which was available in 5,403 women (quartile 1, 8 to 18 mm; quartile 2, 18 to 24 mm; quartile 3, 24 to 36 mm; quartile 4, ≥36 mm), and stent length per lesion, which was available in 5,232 women (quartile 1, 8 to 18 mm; quartile 2, 18 to 20 mm; quartile 3, 20 to 27 mm; quartile 4, ≥27 mm) were analyzed in quartiles. The primary endpoint was 3-year major adverse cardiovascular events (MACE), defined as a composite of all-cause death, myocardial infarction, or target lesion revascularization. RESULTS: In the per-patient analysis, a stepwise increase was observed with increasing stent length in the adjusted risk for 3-year MACE (p for trend <0.0001), myocardial infarction (p for trend <0.001), cardiac death (p for trend = 0.038), and target lesion revascularization (p for trend = 0.011) but not definite or probable stent thrombosis (p for trend = 0.673). In the per-lesion analysis, an increase was observed in the adjusted risk for 3-year MACE (p for trend = 0.002) and myocardial infarction (p for trend <0.0001) but not other individual endpoints. On landmark analysis for late event rates between 1 and 3 years, stent length per patient demonstrated weak associations with target lesion revascularization (p = 0.0131) and MACE (p = 0.0499), whereas stent length per lesion was not associated with higher risk for any late events, suggesting that risk was established early within the first year after PCI. CONCLUSIONS: In this pooled analysis of women undergoing PCI with new-generation DES, increasing stent length per patient and per lesion were independent predictors of 3-year MACE but were not associated with definite or probable stent thrombosis.

4 Article Long-Term Outcomes of Stenting the Proximal Left Anterior Descending Artery in the PROTECT Trial. 2017

Roguin, Ariel / Camenzind, Edoardo / Kerner, Arthur / Beyar, Rafael / Boersma, Eric / Mauri, Laura / Steg, Ph Gabriel / Wijns, William. ·Rambam Medical Center, Haifa, Israel; Technion-Israel Institute of Technology, Haifa, Israel. Electronic address: aroguin@technion.ac.il. · Institut Lorrain du Coeur et des Vaisseaux, Vandoeuvre-les-Nancy, France; Université de Lorraine, Nancy, France. · Rambam Medical Center, Haifa, Israel; Technion-Israel Institute of Technology, Haifa, Israel. · Erasmus Medical Center, Rotterdam, the Netherlands. · Harvard Medical School, and Brigham and Women's Hospital, Boston, Massachusetts. · Département Hospitalo-Universitaire FIRE, Paris, France; Université Paris-Diderot, Sorbonne-Paris Cité, Paris, France; Assistance Publique - Hôpitaux de Paris, Hôpital Bichat, Paris, France; NHLI Imperial College, ICMS, Royal Brompton Hospital, London, United Kingdom. · Cardiovascular Research Center, OLV Hospital, Aalst, Belgium. ·JACC Cardiovasc Interv · Pubmed #28335893.

ABSTRACT: OBJECTIVES: This study sought to compare the outcomes of patients undergoing drug-eluting stent implantation according to lesion location within or outside the proximal left anterior descending (LAD) artery. BACKGROUND: Proximal LAD artery involvement is considered uniquely in revascularization guidelines. The impact of LAD lesion location on long-term outcomes after revascularization is poorly understood in context of current percutaneous coronary intervention and medical therapy. METHODS: Among 8,709 patients enrolled in PROTECT (Patient Related Outcomes with Endeavor Versus Cypher Stenting Trial), a multicenter percutaneous coronary intervention trial, we compared the outcomes of 2,534 patients (29.1%) (3,871 lesions [31.5%]) with stents implanted in the proximal LAD to 6,172 patients (70.9%) (8,419 lesions [68.5%]) with stents implanted outside the proximal LAD. RESULTS: At the 4-year follow-up, death rates were the same (5.8% vs. 5.8%; p > 0.999), but more myocardial infarctions occurred in the proximal LAD group (6.2% vs. 4.9%; p = 0.015). The rate of clinically driven target vessel failure (TVF) (14.8% vs. 13.5%; p = 0.109), major adverse cardiac event(s) (MACE) (15.0% vs. 13.7%; hazard ratio: 1.1; 95% confidence interval: 0.97 to 1.31; p = 0.139), and stent thrombosis (2.1% vs. 2.0%; p = 0.800) were similar. Drug-eluting stent type had no interaction with MACE or TVF. In multivariate analysis, the proximal LAD was a predictor of myocardial infarction (p = 0.038) but not of TVF (p = 0.149) or MACE (p = 0.069). CONCLUSIONS: In this study of contemporary percutaneous coronary intervention, proximal LAD location was associated with higher rates of myocardial infarction during the long-term follow-up, but there were no differences in stent thrombosis, death, TVF, or overall MACE. This finding may suggest that, in the drug-eluting stent era, proximal LAD no longer confers a different prognosis than other lesion sites. (Randomized Study Comparing Endeavor With Cypher Stents [PROTECT]; NCT00476957).

5 Article Correlates and Impact of Coronary Artery Calcifications in Women Undergoing Percutaneous Coronary Intervention With Drug-Eluting Stents: From the Women in Innovation and Drug-Eluting Stents (WIN-DES) Collaboration. 2016

Giustino, Gennaro / Mastoris, Ioannis / Baber, Usman / Sartori, Samantha / Stone, Gregg W / Leon, Martin B / Serruys, Patrick W / Kastrati, Adnan / Windecker, Stephan / Valgimigli, Marco / Dangas, George D / Von Birgelen, Clemens / Smits, Pieter C / Kandzari, David / Galatius, Soren / Wijns, William / Steg, P Gabriel / Stefanini, Giulio G / Aquino, Melissa / Morice, Marie-Claude / Camenzind, Edoardo / Weisz, Giora / Jeger, Raban V / Kimura, Takeshi / Mikhail, Ghada W / Itchhaporia, Dipti / Mehta, Laxmi / Ortega, Rebecca / Kim, Hyo-Soo / Chieffo, Alaide / Mehran, Roxana. ·Interventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York. · Department of Cardiology, Columbia University Medical Center, New York, New York. · Department of Cardiology, Erasmus MC, Rotterdam, the Netherlands. · Department of Cardiology, Herzzentrum, Munich, Germany. · Department of Cardiology, Bern University Hospital, Bern, Switzerland. · Department of Cardiology, Thoraxcentrum Twente, Enschede, the Netherlands. · Department of Cardiology, Maasstad Hospital, Rotterdam, the Netherlands. · Piedmont Heart Institute, Atlanta, Georgia. · Department of Cardiology, Bispebjerg University Hospital, Copenhagen, Denmark. · Cardiovascular Center Aalst, Onze-Lieve-Vrouwziekenhuis Ziekenhuis, Aalst, Belgium. · Département Hospitalo Universitaire Fibrose, Inflammation et Remodelage, Assistance Publique-Hôpitaux de Paris, Université Paris Diderot, INSERM U114, Paris, France. · Division of Clinical and Interventional Cardiology, Humanitas Research Hospital, Rozzano, Milan, Italy. · Department of Cardiology and Cardiovascular Surgery, Institut Cardiovasculaire Paris Sud, Paris, France. · Department of Cardiology, Institut Lorrain du Coeur et des Vaisseaux University Hospital Nancy - Brabois, Vandoeuvre-lès-Nancy, France. · Department of Cardiology, Shaare Zedek Medical Center, Jerusalem, Israel; Columbia University Medical Center, New York, New York. · Department of Cardiology, University Hospital Basel, Basel, Switzerland. · Department of Cardiology, Kyoto University Graduate School of Medicine, Kyoto, Japan. · Department of Cardiology, Imperial College Healthcare NHS Trust, London, United Kingdom. · Department of Cardiology, Hoag Memorial Hospital Presbyterian, Newport Beach, California. · Department of Cardiology, The Ohio State University Medical Center, Columbus, Ohio. · Duke Clinical Research Institute, Durham, North Carolina. · Department of Cardiology, Seoul National University Main Hospital, Seoul, Korea. · Cardiothoracic Department, San Raffaele Scientific Institute, Milan, Italy. · Interventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: roxana.mehran@mountsinai.org. ·JACC Cardiovasc Interv · Pubmed #27659564.

ABSTRACT: OBJECTIVES: The aim of this study was to investigate the clinical correlates and prognostic impact of coronary artery calcification (CAC) in women undergoing percutaneous coronary intervention with drug-eluting stents (DES). BACKGROUND: The clinical correlates and the prognostic significance of CAC in women undergoing percutaneous coronary intervention with DES remain unclear. METHODS: Patient-level data from female participants in 26 randomized trials of DES were pooled. Study population was categorized according to the presence of moderate or severe versus mild or no target lesion CAC, assessed through coronary angiography. Co-primary endpoints of interest were the composite of death, myocardial infarction (MI), or target lesion revascularization and death, MI, or stent thrombosis at 3-year follow-up. RESULTS: Among 11,557 women included in the pooled dataset, CAC status was available in 6,371 women. Of these, 1,622 (25.5%) had moderate or severe CAC. In fully adjusted models, independent correlates of CAC were age, hypertension, hypercholesterolemia, smoking, previous coronary artery bypass graft surgery, and worse left ventricular and renal function. At 3 years, women with CAC were at higher risk for death, MI, or target lesion revascularization (18.2% vs. 13.1%; adjusted hazard ratio: 1.56; 95% confidence interval: 1.33 to 1.84; p < 0.0001) and death, MI, or stent thrombosis (12.7% vs. 8.6%; adjusted hazard ratio: 1.48; 95% confidence interval: 1.21 to 1.80; p = 0.0001). The adverse effect of CAC on ischemic outcomes appeared to be consistent across clinical and angiographic subsets of women, including new-generation DES. CONCLUSIONS: Women undergoing PCI of calcified lesions tend to have worse clinical profile and remain at increased ischemic risk, irrespective of new-generation DES.

6 Article Frequency of Stent Thrombosis Risk at 5 Years in Women Versus Men With Zotarolimus-Eluting Compared With Sirolimus-Eluting Stent. 2016

Ten Haaf, Monique / Appelman, Yolande / Wijns, William / Steg, Gabriel / Mauri, Laura / Rademaker-Havinga, Tessa / Wetzels, Gwenn / Bousquette, Lisa / Camenzind, Edoardo / Boersma, Eric / Anonymous4110879. ·Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands; Netherlands Heart Institute, Utrecht, The Netherlands. · Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands. · Cardiovascular Center, OLV Hospital, Aalst, Belgium. · Department of Cardiology, Hopital Bichat Assistance Publique, Paris, France. · Department of Cardiology, Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts. · Cardialysis BV, Rotterdam, The Netherlands. · Medtronic Bakken Research Center, Medtronic Cardiovascular, Maastricht, The Netherlands. · Medtronic Cardiovascular, Santa Rosa, California. · Department of Cardiology, University Hospital of Nancy, Vandoeuvre-lès-Nancy, France. · Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands; Cardiovascular research school COEUR, Erasmus MC, Rotterdam, The Netherlands. Electronic address: h.boersma@erasmusmc.nl. ·Am J Cardiol · Pubmed #27569387.

ABSTRACT: The prevalence of factors that are associated with an increased risk of stent thrombosis (ST), including smoking, diabetes mellitus, and small stent size, is different in women and men who underwent percutaneous coronary intervention. Thus, gender may potentially modify the relation between stent type and the incidence of ST during long-term follow-up. We explored the data of Patient Related Outcomes With Endeavor Versus Cypher stenting Trial (PROTECT) to evaluate this hypothesis. PROTECT randomized 2,061 women and 6,648 men who underwent percutaneous coronary intervention for various indications to Endeavor zotarolimus-eluting stenting (E-ZES) or Cypher sirolimus-eluting stenting (C-SES). Dual antiplatelet therapy was prescribed for at least 3 months. Data on study end points were collected until 5 years after randomization, including ST, death, and cardiovascular events. We analyzed end points and treatment effect (E-ZES vs C-SES) in relation to gender. Women were on average 4.7 years older (65.8 vs 61.1), had a higher prevalence of insulin-dependent diabetes mellitus, were less often smokers, and had a shorter total stent length than men. At discharge and throughout follow-up, a slightly lower fraction of women were using dual antiplatelet therapy. During 5-year follow-up, definite or probable ST was observed in 36 women (1.8%) and 152 men (2.4%; log-rank p = 0.15). E-ZES reduced the incidence of ST compared with C-SES in women (hazard ratio 0.58) and men (hazard ratio 0.61), with no evidence of heterogeneity (p = 0.89). In conclusion, in PROTECT, women and men had similar cumulative incidence of ST at 5 years after stent placement. The favorable effect of the study stent E-ZES over C-SES was not modified by gender.

7 Article Safety and Efficacy of New-Generation Drug-Eluting Stents in Women Undergoing Complex Percutaneous Coronary Artery Revascularization: From the WIN-DES Collaborative Patient-Level Pooled Analysis. 2016

Giustino, Gennaro / Baber, Usman / Aquino, Melissa / Sartori, Samantha / Stone, Gregg W / Leon, Martin B / Genereux, Philippe / Dangas, George D / Chandrasekhar, Jaya / Kimura, Takeshi / Salianski, Olga / Stefanini, Giulio G / Steg, P Gabriel / Windecker, Stephan / Wijns, William / Serruys, Patrick W / Valgimigli, Marco / Morice, Marie-Claude / Camenzind, Edoardo / Weisz, Giora / Smits, Pieter C / Kandzari, David E / Galatius, Soren / Von Birgelen, Clemens / Saporito, Robert / Jeger, Raban V / Mikhail, Ghada W / Itchhaporia, Dipti / Mehta, Laxmi / Ortega, Rebecca / Kim, Hyo-Soo / Kastrati, Adnan / Chieffo, Alaide / Mehran, Roxana. ·The Zena and Michael A. Wiener Cardiovascular Institute, Interventional Cardiovascular Research and Clinical Trials Center, Icahn School of Medicine at Mount Sinai, New York, New York. · Division of Cardiology, Columbia University Medical Center, New York, New York. · Cardiovascular Research Foundation, New York, New York; Division of Cardiology, Columbia University Medical Center, New York, New York; Division of Cardiology, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada. · Department of Cardiology, Kyoto University Graduate School of Medicine, Kyoto, Japan. · Division of Clinical and Interventional Cardiology, Humanitas Research Hospital, Rozzano, Milan, Italy. · Département Hospitalo Universitaire Fibrose, Inflammation et REmodelage, Assistance Publique-Hôpitaux de Paris, Université Paris Diderot, INSERM U114, Paris, France. · Department of Cardiology, Bern University Hospital, Bern, Switzerland. · Cardiovascular Center Aalst, Onze-Lieve-Vrouwziekenhuis Ziekenhuis, Aalst, Belgium. · Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands. · Department of Cardiology, University of Ferrara, Ferrara, Italy. · Department of Cardiology and Cardiovascular Surgery, Institut Cardiovasculaire Paris Sud, France. · Department of Cardiology, Institut Lorrain du Coeur et des Vaisseaux University Hospital Nancy, Brabois Vandoeuvre-lès-Nancy, France. · Division of Cardiology, Columbia University Medical Center, New York, New York; Department of Cardiology, Shaare Zedek Medical Center, Jerusalem, Israel. · Department of Cardiology, Maasstad Hospital, Rotterdam, the Netherlands. · Department of Cardiology, Piedmont Heart Institute, Atlanta, Georgia. · Gentofte University Hospital, Hellerup, Denmark. · Department of Cardiology, Thoraxcentrum Twente, Enschede, the Netherlands. · Department of Cardiology, University Hospital Basel, Basel, Switzerland. · Department of Cardiology, Imperial College Healthcare NHS Trust, London, United Kingdom. · Department of Cardiology, Hoag Memorial Hospital Presbyterian, Newport Beach, California. · Department of Cardiology, Ohio State University Medical Center, Columbus, Ohio. · Duke Clinical Research Institute, Center for Educational Excellence, Durham, North Carolina. · Department of Cardiology, Seoul National University Main Hospital, Seoul, Korea. · Department of Cardiology, Herzzentrum, Munich, Germany. · Cardiothoracic Department, San Raffaele Scientific Institute, Milan, Italy. · The Zena and Michael A. Wiener Cardiovascular Institute, Interventional Cardiovascular Research and Clinical Trials Center, Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: Roxana.Mehran@mountsinai.org. ·JACC Cardiovasc Interv · Pubmed #27056305.

ABSTRACT: OBJECTIVES: The purpose of this study was to investigate the safety and efficacy of new-generation drug-eluting stents (DES) versus early-generation DES in women undergoing complex percutaneous coronary intervention (CPCI). BACKGROUND: Whether the benefits of new-generation DES are preserved in women undergoing complex percutaneous revascularization is unknown. METHODS: We pooled patient-level data from women enrolled in 26 randomized trials of DES. Study population was categorized according to the presence or absence of CPCI, which was defined as the composite of total stent length >30 mm, ≥2 stents implanted, ≥2 lesions treated, or bifurcation lesion as target vessel. The primary endpoint was major adverse cardiovascular events (MACE) defined as a composite of all-cause mortality, myocardial infarction, or target lesion revascularization at 3 years of follow-up. RESULTS: Of 10,241 women included in the pooled database, 4,629 (45%) underwent CPCI. Compared with non-CPCI, women who underwent CPCI had a higher 3-year risk of MACE (adjusted hazard ratio [HR]: 1.63; 95% confidence interval [CI]: 1.45 to 1.83; p < 0.0001). In women who underwent CPCI, use of new-generation DES was associated with significantly lower 3-year risk of MACE (adjusted HR: 0.81; 95% CI: 0.68 to 0.96), target lesion revascularization (adjusted HR: 0.74; 95% CI: 0.57 to 0.95), and definite or probable stent thrombosis (ST) (adjusted HR: 0.50; 95% CI: 0.30 to 0.83). The benefit of new-generation DES on efficacy and safety outcomes was uniform between CPCI and non-CPCI groups, without evidence of interaction. By landmark analysis, new-generation DES were associated with low rates (≤0.4%) of very-late ST irrespective of procedural complexity. CONCLUSIONS: Women undergoing CPCI remain at higher risk of adverse events. The long-term ischemic benefits of new-generation DES platforms are uniform among complex and non-complex percutaneous revascularization procedures in women.

8 Article Effect of Chronic Kidney Disease in Women Undergoing Percutaneous Coronary Intervention With Drug-Eluting Stents: A Patient-Level Pooled Analysis of Randomized Controlled Trials. 2016

Baber, Usman / Giustino, Gennaro / Sartori, Samantha / Aquino, Melissa / Stefanini, Giulio G / Steg, P Gabriel / Windecker, Stephan / Leon, Martin B / Wijns, William / Serruys, Patrick W / Valgimigli, Marco / Stone, Gregg W / Dangas, George D / Morice, Marie-Claude / Camenzind, Edoardo / Weisz, Giora / Smits, Pieter C / Kandzari, David / Von Birgelen, Clemens / Mastoris, Ioannis / Galatius, Soren / Jeger, Raban V / Kimura, Takeshi / Mikhail, Ghada W / Itchhaporia, Dipti / Mehta, Laxmi / Ortega, Rebecca / Kim, Hyo-Soo / Kastrati, Adnan / Chieffo, Alaide / Mehran, Roxana. ·The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York City, New York. · Division of Clinical and Interventional Cardiology, Humanitas Research Hospital, Rozzano, Milan, Italy. · Département Hospitalo Universitaire Fibrose, Inflammation et REmodelage, Assistance Publique-Hôpitaux de Paris, Université Paris Diderot, INSERM U698, Paris, France. · Department of Cardiology, Bern University Hospital, Bern, Switzerland. · Division of Cardiology, Columbia University Medical Center, New York City, New York. · Cardiovascular Center Aalst, Onze-Lieve-Vrouwziekenhuis Ziekenhuis, Aalst, Belgium. · Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands. · Department of Cardiology, University of Ferrara, Ferrara, Italy. · Department of Cardiology and Cardiovascular Surgery, Institut Cardiovasculaire Paris Sud, France. · Institut Lorrain du Coeur et des Vaisseaux (ILCV) University Hospital Nancy-Brabois Vandoeuvre-lès-Nancy France. · Department of Cardiology, Maasstad Hospital, Rotterdam, the Netherlands. · Piedmont Heart Institute, Atlanta, Georgia. · Thoraxcentrum Twente, Enschede, the Netherlands. · Department of Cardiology, Bispebjerg University Hospital, Copenhagen, Denmark. · Department of Cardiology, University Hospital Basel, Basel, Switzerland. · Department of Cardiology, Kyoto University Graduate School of Medicine, Kyoto, Japan. · Department of Cardiology, Imperial College Healthcare NHS Trust, London, United Kingdom. · Department of Cardiology, Hoag Memorial Hospital Presbyterian, Newport Beach, California. · Department of Cardiology, Ohio State University Medical Center, Columbus, Ohio. · Society of Cardiovascular Angiography and Interventions, Washington, DC. · Department of Cardiology, Seoul National University Main Hospital, Seoul, South Korea. · Herzzentrum, Munich, Germany. · Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy. · The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York City, New York. Electronic address: Roxana.Mehran@mountsinai.org. ·JACC Cardiovasc Interv · Pubmed #26762908.

ABSTRACT: OBJECTIVES: This study sought to evaluate: 1) the effect of impaired renal function on long-term clinical outcomes in women undergoing percutaneous coronary intervention (PCI) with drug-eluting stent (DES); and 2) the safety and efficacy of new-generation compared with early-generation DES in women with chronic kidney disease (CKD). BACKGROUND: The prevalence and effect of CKD in women undergoing PCI with DES is unclear. METHODS: We pooled patient-level data for women enrolled in 26 randomized trials. The study population was categorized by creatinine clearance (CrCl) <45 ml/min, 45 to 59 ml/min, and ≥60 ml/min. The primary endpoint was the 3-year rate of major adverse cardiovascular events (MACE). Participants for whom baseline creatinine was missing were excluded from the analysis. RESULTS: Of 4,217 women included in the pooled cohort treated with DES and for whom serum creatinine was available, 603 (14%) had a CrCl <45 ml/min, 811 (19%) had a CrCl 45 to 59 ml/min, and 2,803 (66%) had a CrCl ≥60 ml/min. A significant stepwise gradient in risk for MACE was observed with worsening renal function (26.6% vs. 15.8% vs. 12.9%; p < 0.01). Following multivariable adjustment, CrCl <45 ml/min was independently associated with a higher risk of MACE (adjusted hazard ratio: 1.56; 95% confidence interval: 1.23 to 1.98) and all-cause mortality (adjusted hazard ratio: 2.67; 95% confidence interval: 1.85 to 3.85). Compared with older-generation DES, the use of newer-generation DES was associated with a reduction in the risk of cardiac death, myocardial infarction, or stent thrombosis in women with CKD. The effect of new-generation DES on outcomes was uniform, between women with or without CKD, without evidence of interaction. CONCLUSIONS: Among women undergoing PCI with DES, CKD is a common comorbidity associated with a strong and independent risk for MACE that is durable over 3 years. The benefits of newer-generation DES are uniform in women with or without CKD.

9 Article Balancing Long-Term Risks of Ischemic and Bleeding Complications After Percutaneous Coronary Intervention With Drug-Eluting Stents. 2015

Matteau, Alexis / Yeh, Robert W / Camenzind, Edoardo / Steg, P Gabriel / Wijns, William / Mills, Joseph / Gershlick, Anthony / de Belder, Mark / Ducrocq, Gregory / Mauri, Laura. ·Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts. · Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts. · Cardiology Department, University of Geneva, Geneva, Switzerland. · Cardiology Department, DHU-FIRE, Hôpital Bichat, Paris, France; Université Paris-Diderot, Paris, France; INSERM U1148, Paris, France. · Cardiology Department, Cardiovascular Research Center Aalst, OLV Hospital, Aalst, Belgium. · Cardiology Department, Cardiothoracic Centre, Liverpool, United Kingdom. · Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom; NIHR Leicester Cardiovascular Biomedical Research Unit, University Hospitals of Leicester Glenfield Hospital, Leicester, United Kingdom. · Cardiology Department, The James Cook University Hospital, Middlesbrough, United Kingdom. · Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts. Electronic address: lmauri1@partners.org. ·Am J Cardiol · Pubmed #26187674.

ABSTRACT: Although trials comparing antiplatelet strategies after percutaneous coronary intervention report average risks of bleeding and ischemia in a population, there is limited information to guide choices based on individual patient risks, particularly beyond 1 year after treatment. Patient-level data from Patient Related Outcomes With Endeavor vs Cypher Stenting Trial (PROTECT), a broadly inclusive trial enrolling 8,709 subjects treated with drug-eluting stents (sirolimus vs zotarolimus-eluting stent), and PROTECT US, a single-arm study including 1,018 subjects treated with a zotarolimus-eluting stent, were combined. The risk of ischemic events, cardiovascular death/non-periprocedural myocardial infarction (MI)/definite or probable stent thrombosis, and bleeding events, Global Use of Strategies to Open Occluded Arteries moderate or severe bleed, were predicted using logistic regression. At median follow-up of 4.1 years, major bleeding occurred in 260 subjects (2.8%) and ischemic events in 595 (6.3%). Multivariate predictors of bleeding were older age, smoking, diabetes mellitus, congestive heart failure, and chronic kidney disease (all p <0.05). Ischemic events shared all the same predictors with bleeding events and gender, body mass index, previous MI, previous coronary artery bypass graft surgery, ST-segment elevation MI on presentation, stent length, and sirolimus-eluting stent use (all p <0.05). Within individual subjects, bleeding and ischemic risks were strongly correlated; 97% of subjects had a greater risk of ischemic events than bleeding. In conclusion, individual patient risks of ischemia and bleeding are related to many common risk factors, yet the predicted risks of ischemic events are greater than those of major bleeding in the large majority of patients in long-term follow-up.

10 Article Impact of Clinical Presentation (Stable Angina Pectoris vs Unstable Angina Pectoris or Non-ST-Elevation Myocardial Infarction vs ST-Elevation Myocardial Infarction) on Long-Term Outcomes in Women Undergoing Percutaneous Coronary Intervention With Drug-Eluting Stents. 2015

Giustino, Gennaro / Baber, Usman / Stefanini, Giulio Giuseppe / Aquino, Melissa / Stone, Gregg W / Sartori, Samantha / Steg, Philippe Gabriel / Wijns, William / Smits, Pieter C / Jeger, Raban V / Leon, Martin B / Windecker, Stephan / Serruys, Patrick W / Morice, Marie-Claude / Camenzind, Edoardo / Weisz, Giora / Kandzari, David / Dangas, George D / Mastoris, Ioannis / Von Birgelen, Clemens / Galatius, Soren / Kimura, Takeshi / Mikhail, Ghada / Itchhaporia, Dipti / Mehta, Laxmi / Ortega, Rebecca / Kim, Hyo-Soo / Valgimigli, Marco / Kastrati, Adnan / Chieffo, Alaide / Mehran, Roxana. ·The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York City, New York. · Humanitas Research Hospital, Rozzano, Milan, Italy. · Columbia University Medical Center, New York City, New York. · Département Hospitalo Universitaire Fibrose, Inflammation et REmodelage, Assistance Publique-Hôpitaux de Paris, Université Paris Diderot, INSERM U-1148, Paris, France. · Cardiovascular Center Aalst, Onze-Lieve-Vrouwziekenhuis Ziekenhuis, Aalst, Belgium. · Maasstad Hospital, Rotterdam, The Netherlands. · University Hospital Basel, Basel, Switzerland. · Bern University Hospital, Bern, Switzerland. · ErasmusMC, Rotterdam, The Netherlands. · Department of Cardiology and Cardiovascular Surgery, Institut Cardiovasculaire Paris Sud, Paris, France. · University of Geneva, Geneva, Switzerland. · Columbia University Medical Center, New York City, New York; Shaare Zedek Medical Center, Jerusalem, Israel. · Piedmont Heart Institute, Atlanta, Georgia. · Thoraxcentrum Twente, Enschede, The Netherlands. · Gentofte University Hospital, Hellerup, Denmark. · Kyoto University Graduate School of Medicine, Kyoto, Japan. · Imperial College Healthcare NHS Trust, London, United Kingdom. · Hoag Memorial Hospital Presbyterian, Newport Beach, California. · Ohio State University Medical Center, Columbus, Ohio. · Society of Cardiovascular Angiography and Interventions, Washington, DC. · Seoul National University Main Hospital, Seoul, Korea. · University of Ferrara, Ferrara, Italy. · Herzzentrum, Munich, Germany. · San Raffaele Scientific Institute, Milan, Italy. · The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York City, New York. Electronic address: Roxana.Mehran@mountsinai.org. ·Am J Cardiol · Pubmed #26174605.

ABSTRACT: The long-term risk associated with different coronary artery disease (CAD) presentations in women undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DES) is poorly characterized. We pooled patient-level data for women enrolled in 26 randomized clinical trials. Of 11,577 women included in the pooled database, 10,133 with known clinical presentation received a DES. Of them, 5,760 (57%) had stable angina pectoris (SAP), 3,594 (35%) had unstable angina pectoris (UAP) or non-ST-segment-elevation myocardial infarction (NSTEMI), and 779 (8%) had ST-segment-elevation myocardial infarction (STEMI) as clinical presentation. A stepwise increase in 3-year crude cumulative mortality was observed in the transition from SAP to STEMI (4.9% vs 6.1% vs 9.4%; p <0.01). Conversely, no differences in crude mortality rates were observed between 1 and 3 years across clinical presentations. After multivariable adjustment, STEMI was independently associated with greater risk of 3-year mortality (hazard ratio [HR] 3.45; 95% confidence interval [CI] 1.99 to 5.98; p <0.01), whereas no differences were observed between UAP or NSTEMI and SAP (HR 0.99; 95% CI 0.73 to 1.34; p = 0.94). In women with ACS, use of new-generation DES was associated with reduced risk of major adverse cardiac events (HR 0.58; 95% CI 0.34 to 0.98). The magnitude and direction of the effect with new-generation DES was uniform between women with or without ACS (pinteraction = 0.66). In conclusion, in women across the clinical spectrum of CAD, STEMI was associated with a greater risk of long-term mortality. Conversely, the adjusted risk of mortality between UAP or NSTEMI and SAP was similar. New-generation DESs provide improved long-term clinical outcomes irrespective of the clinical presentation in women.

11 Article Safety and efficacy of drug-eluting stents in women: a patient-level pooled analysis of randomised trials. 2013

Stefanini, Giulio G / Baber, Usman / Windecker, Stephan / Morice, Marie-Claude / Sartori, Samantha / Leon, Martin B / Stone, Gregg W / Serruys, Patrick W / Wijns, William / Weisz, Giora / Camenzind, Edoardo / Steg, Philippe G / Smits, Pieter C / Kandzari, David / Von Birgelen, Clemens / Galatius, Søren / Jeger, Raban V / Kimura, Takeshi / Mikhail, Ghada W / Itchhaporia, Dipti / Mehta, Laxmi / Ortega, Rebecca / Kim, Hyo-Soo / Valgimigli, Marco / Kastrati, Adnan / Chieffo, Alaide / Mehran, Roxana. ·Bern University Hospital, Bern, Switzerland. ·Lancet · Pubmed #24007976.

ABSTRACT: BACKGROUND: The safety and efficacy of drug-eluting stents (DES) in the treatment of coronary artery disease have been assessed in several randomised trials. However, none of these trials were powered to assess the safety and efficacy of DES in women because only a small proportion of recruited participants were women. We therefore investigated the safety and efficacy of DES in female patients during long-term follow-up. METHODS: We pooled patient-level data for female participants from 26 randomised trials of DES and analysed outcomes according to stent type (bare-metal stents, early-generation DES, and newer-generation DES). The primary safety endpoint was a composite of death or myocardial infarction. The secondary safety endpoint was definite or probable stent thrombosis. The primary efficacy endpoint was target-lesion revascularisation. Analysis was by intention to treat. FINDINGS: Of 43,904 patients recruited in 26 trials of DES, 11,557 (26·3%) were women (mean age 67·1 years [SD 10·6]). 1108 (9·6%) women received bare-metal stents, 4171 (36·1%) early-generation DES, and 6278 (54·3%) newer-generation DES. At 3 years, estimated cumulative incidence of the composite of death or myocardial infarction occurred in 132 (12·8%) women in the bare-metal stent group, 421 (10·9%) in the early-generation DES group, and 496 (9·2%) in the newer-generation DES group (p=0·001). Definite or probable stent thrombosis occurred in 13 (1·3%), 79 (2·1%), and 66 (1·1%) women in the bare-metal stent, early-generation DES, and newer-generation DES groups, respectively (p=0·01). The use of DES was associated with a significant reduction in the 3 year rates of target-lesion revascularisation (197 [18·6%] women in the bare-metal stent group, 294 [7·8%] in the early-generation DES group, and 330 [6·3%] in the newer-generation DES group, p<0·0001). Results did not change after adjustment for baseline characteristics in the multivariable analysis. INTERPRETATION: The use of DES in women is more effective and safe than is use of bare-metal stents during long-term follow-up. Newer-generation DES are associated with an improved safety profile compared with early-generation DES, and should therefore be thought of as the standard of care for percutaneous coronary revascularisation in women. FUNDING: Women in Innovation Initiative of the Society of Cardiovascular Angiography and Interventions.

12 Article Stent thrombosis and major clinical events at 3 years after zotarolimus-eluting or sirolimus-eluting coronary stent implantation: a randomised, multicentre, open-label, controlled trial. 2012

Camenzind, Edoardo / Wijns, William / Mauri, Laura / Kurowski, Volkhard / Parikh, Keyur / Gao, Runlin / Bode, Christoph / Greenwood, John P / Boersma, Eric / Vranckx, Pascal / McFadden, Eugene / Serruys, Patrick W / O'Neil, William W / Jorissen, Brenda / Van Leeuwen, Frank / Steg, Ph Gabriel / Anonymous760736. ·University of Geneva, Switzerland. edoardo@camenzind-cardio.net ·Lancet · Pubmed #22951082.

ABSTRACT: BACKGROUND: We sought to compare the long-term safety of two devices with different antiproliferative properties: the Endeavor zotarolimus-eluting stent (E-ZES; Medtronic, Inc) and the Cypher sirolimus-eluting stent (C-SES; Cordis, Johnson & Johnson) in a broad group of patients and lesions. METHODS: Between May 21, 2007 and Dec 22, 2008, we recruited 8791 patients from 36 recruiting countries to participate in this open-label, multicentre, randomised, superiority trial. Eligible patients were those aged 18 years or older undergoing elective, unplanned, or emergency procedures in native coronary arteries. Patients were randomly assigned to either receive E-ZES and C-SES (ratio 1:1). Randomisation was stratified per centre with varying block sizes of four, six, or eight patients, and concealed with a central telephone-based or web-based allocation service. The primary outcome was definite or probable stent thrombosis at 3 years and was analysed by intention to treat. Patients and investigators were aware of treatment assignment. This trial is registered with ClinicalTrials.gov, number NCT00476957. FINDINGS: PROTECT randomised 8791 patients, of whom 8709 provided consent to participate and were eligible: 4357 were allocated to the E-ZES group and 4352 patients to the C-SES group. At 3 years, rates of definite or probable stent thrombosis did not differ between groups (1·4% for E-ZES [predicted: 1·5%] vs 1·8% [predicted: 2·5%] for C-SES; hazard ratio [HR] 0·81, 95% CI 0·58-1·14, p=0·22). Dual antiplatelet therapy was used in 8402 (96%) patients at discharge, 7456 (88%) at 1 year, 3041 (37%) at 2 years, and 2364 (30%) at 3 years. INTERPRETATION: No evidence of superiority of E-ZES compared with C-SES in definite or probable stent thrombosis rates was noted at 3 years. Time analysis suggests a difference in definite or probable stent thrombosis between groups is emerging over time, and a longer follow-up is therefore needed given the clinical relevance of stent thrombosis. FUNDING: Medtronic, Inc.