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Coronary Artery Disease: HELP
Articles by Hector Garcia-Garcia
Based on 4 articles published since 2010
(Why 4 articles?)

Between 2010 and 2020, Hector Garcia-Garcia wrote the following 4 articles about Coronary Artery Disease.
+ Citations + Abstracts
1 Review The Lipid-Rich Plaque Study of vulnerable plaques and vulnerable patients: Study design and rationale. 2017

Waksman, Ron / Torguson, Rebecca / Spad, Mia-Ashley / Garcia-Garcia, Hector / Ware, James / Wang, Rui / Madden, Sean / Shah, Priti / Muller, James. ·MedStar Washington Hospital Center, Section of Interventional Cardiology, Washington, DC. Electronic address: ron.waksman@medstar.net. · MedStar Washington Hospital Center, Section of Interventional Cardiology, Washington, DC. · Harvard T.H. Chan School of Public Health, Department of Biostatistics, Boston, MA. · Infraredx, Burlington, MA. · Brigham and Women's Hospital, Division of Cardiovascular Medicine, Boston, MA. ·Am Heart J · Pubmed #28938968.

ABSTRACT: BACKGROUND: It has been hypothesized that the outcome post-PCI could be improved by the detection and subsequent treatment of vulnerable patients and lipid-rich vulnerable coronary plaques (LRP). A near-infrared spectroscopy (NIRS) catheter capable of detecting LRP is being evaluated in The Lipid-Rich Plaque Study. STUDY DESIGN: The LRP Study is an international, multicenter, prospective cohort study conducted in patients with suspected coronary artery disease (CAD) who underwent cardiac catheterization with possible ad hoc PCI for an index event. Patient level and plaque level events were detected by follow-up in the subsequent 2 years. Enrollment began in February 2014 and was completed in March 2016; a total of 1,562 patients were enrolled. Adjudication of new coronary event occurrence and de novo culprit lesion location during the 2-year follow-up is performed by an independent clinical end-points committee (CEC) blinded to NIRS-IVUS findings. The first analysis of the results will be performed when at least 20 de novo events have occurred for which follow-up angiographic data and baseline NIRS-IVUS measurements are available. It is expected that results of the study will be announced in 2018. SUMMARY: The LRP Study will test the hypotheses that NIRS-IVUS imaging to detect LRP in patients can identify vulnerable patients and vulnerable plaques. Identification of vulnerable patients will assist future studies of novel systemic therapies; identification of localized vulnerable plaques would enhance future studies of possible preventive measures.

2 Review Role of invasive imaging in acute and long-term assessment of bioresorbable scaffold technology. 2016

Chamié, Daniel / Garcia-Garcia, Hector / Costa, Ricardo A / Onuma, Yoshinobu / Abizaid, Alexandre / Serruys, Patrick W. ·Department of Interventional Cardiology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil. daniel.chamie@gmail.com. · Cardiovascular Research Center, Sao Paulo, Brazil. daniel.chamie@gmail.com. · Department of Interventional Cardiology, MedStar Heart and Vascular Institute, Washington, DC. · Department of Interventional Cardiology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil. · Cardiovascular Research Center, Sao Paulo, Brazil. · Department of Interventional Cardiology, Erasmus University Medical Center, Thoraxcenter, Rotterdam, The Netherlands. · Cardialysis BV, Rotterdam, The Netherlands. · Hospital Israelita Albert Einstein, Sao Paulo, Brazil. · NHLI, Imperial College London, International Centre for Circulatory Health, London, United Kingdom. ·Catheter Cardiovasc Interv · Pubmed #27797463.

ABSTRACT: Fully bioresorbable scaffolds (BRS) represent a novel approach for the percutaneous treatment of coronary artery stenosis, providing temporary vessel scaffolding with drug-eluting capability during the restenosis-prone phase of the vascular healing. Beyond this initial critical period, when mechanical scaffolding support is no longer necessary, the device is bioresorbed, restoring the normal vascular physiology with the aim to eliminate the long-term safety concerns related to permanent metallic implants. Nonetheless, current BRS technology suffers from limited mechanical properties as compared to available metallic platforms, requiring careful attention to lesion preparation, accurate vessel sizing, and implantation technique. Intravascular imaging has played an important role in providing knowledge on the acute effects after BRS deployment, and it helped refine the current technique of BRS implantation. In addition, extensive work with multiple intravascular imaging modalities have also contributed to the understanding of the unique dynamic vascular changes that are experienced in the treated segment from post-implantation up to complete device bioresorption. In this manuscript, we review the role of invasive imaging modalities-from angiography to sound- and light-based techniques-to guide BRS implantation procedures, to assess its acute results postimplantation, and the changes experienced in the long-term until complete bioresorption has ensued. © 2016 Wiley Periodicals, Inc.

3 Article Left main or proximal left anterior descending coronary artery disease location identifies high-risk patients deriving potentially greater benefit from prolonged dual antiplatelet therapy duration. 2016

Costa, Francesco / Adamo, Marianna / Ariotti, Sara / Ferrante, Giuseppe / Navarese, Eliano Pio / Leonardi, Sergio / Garcia-Garcia, Hector / Vranckx, Pascal / Valgimigli, Marco. ·Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands. ·EuroIntervention · Pubmed #26342472.

ABSTRACT: AIMS: It is currently unclear if the location of coronary artery disease affects decision making with regard to dual antiplatelet therapy (DAPT). We investigated if the presence of at least 30% luminal narrowing in the left main (LM) and/or proximal left anterior descending (pLAD) coronary arteries on angiography is an outcome modifier with respect to DAPT duration. METHODS AND RESULTS: In the Prolonging Dual Antiplatelet Treatment After Grading Stent-Induced Intimal Hyperplasia (PRODIGY) study, 953 (54.3%) patients with and 801 (45.7%) without LM/pLAD lumen narrowing at the qualifying coronary intervention were randomised to six or 24 months of DAPT. Twenty-four month as compared to six-month DAPT reduced the occurrence of definite, probable or possible stent thrombosis by 50% in patients with (2.8% vs. 5.6%; HR 0.45, 95% CI: 0.23-0.89; p=0.02) but not in those without LM/pLAD lumen narrowing, with a highly significant interaction testing (PINT= 0.002). This result remained consistent irrespective of whether stenting was (PINT: 0.01) or was not (PINT: 0.02) performed in the LM/pLAD. CONCLUSIONS: Left main and/or proximal LAD lumen narrowing may be a treatment modifier with respect to the duration of DAPT. Patients fulfilling these angiographic characteristics seem to benefit from a prolonged dual antiplatelet treatment. Trial registration: ClinicalTrials.gov Identifier: NCT00611286

4 Article The CABG SYNTAX Score - an angiographic tool to grade the complexity of coronary disease following coronary artery bypass graft surgery: from the SYNTAX Left Main Angiographic (SYNTAX-LE MANS) substudy. 2013

Farooq, Vasim / Girasis, Chrysafios / Magro, Michael / Onuma, Yoshinobu / Morel, Marie Angèle / Heo, Jung Ho / Garcia-Garcia, Hector / Kappetein, Arie Pieter / van den Brand, Marcel / Holmes, David R / Mack, Michael / Feldman, Ted / Colombo, Antonio / Ståhle, Elisabeth / James, Stefan / Carrié, Didier / Fournial, Gerard / van Es, Gerrit-Anne / Dawkins, Keith D / Mohr, Friedrich W / Morice, Marie-Claude / Serruys, Patrick W. ·Department of Interventional Cardiology, Erasmus University Medical Centre, Thoraxcenter, Rotterdam, The Netherlands. ·EuroIntervention · Pubmed #23537954.

ABSTRACT: AIMS: The SYNTAX Score (SXscore) has established itself as an important prognostic tool in patients undergoing percutaneous coronary intervention (PCI). A limitation of the SXscore is the inability to differentiate outcomes in patients who have undergone prior coronary artery bypass graft (CABG) surgery. The CABG SXscore was devised to address this limitation. METHODS AND RESULTS: In the SYNTAX-LE MANS substudy 115 patients with unprotected left main coronary artery disease (isolated or associated with one, two or three-vessel disease) treated with CABG were prospectively assigned to undergo a 15-month coronary angiogram. An independent core laboratory analysed the baseline SXscore prior to CABG. The 15-month CABG SXscore was calculated by a panel of three interventional cardiologists. The CABG SXscore was calculated by determining the standard SXscore in the "native" coronary vessels ("native SXscore") and deducting points based on the importance of the diseased coronary artery segment (Leaman score) that have a functioning bypass graft anastomosed distally. Points relating to intrinsic coronary disease, such as bifurcation disease or calcification, remain unaltered. The mean 15-month CABG SXscore was significantly lower compared to the mean baseline SXscore (baseline SXscore 31.6, SD 13.1; 15-month CABG SXscore 21.2, SD 11.1; p<0.001). Reproducibility analyses (kappa [k] statistics) indicated a substantial agreement between CABG SXscore measurements (k=0.70; 95% CI [0.50-0.90], p<0.001), with the points deducted to calculate the CABG SXscore the most reproducible measurement (k=0.74; 95% CI [0.53-0.95], p<0.001). Despite the limited power of the study, four-year outcome data (Kaplan-Meier curves) demonstrated a trend towards reduced all-cause death (9.1% vs. 1.8%, p=0.084) and death/CVA/MI (16.4% vs. 7.0%, p=0.126) in the low compared to the high CABG SXscore group. CONCLUSIONS: In this pilot study the calculation of the CABG SXscore appeared feasible, reproducible and may have a long-term prognostic role in patients with complex coronary disease undergoing surgical revascularisation. Validation of this new scoring methodology is required.