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Coronary Artery Disease: HELP
Articles by Michael Magro
Based on 19 articles published since 2010
(Why 19 articles?)
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Between 2010 and 2020, M. Magro wrote the following 19 articles about Coronary Artery Disease.
 
+ Citations + Abstracts
1 Review Dedicated stents for distal left main stenting. 2015

Grundeken, Maik J / Magro, Michael / Gil, Robert / Briguori, Carlo / Sardella, Gennaro / Berland, Jacques / Wykrzykowska, Joanna J / Serruys, Patrick W. ·Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. ·EuroIntervention · Pubmed #25983146.

ABSTRACT: Left main (LM) coronary bifurcation lesions have different anatomic features from non-LM bifurcation lesions. Dedicated bifurcation devices might facilitate percutaneous coronary intervention (PCI) of LM bifurcations and improve procedural and clinical outcomes. In this review we will discuss the available clinical data on dedicated bifurcation devices for the treatment of LM bifurcation lesions. Furthermore, we will try to discuss all the theoretical advantages and potential drawbacks of these devices in terms of their use in the LM.

2 Review Revascularization treatment of stable coronary artery disease. 2011

Magro, Michael / Garg, Scot / Serruys, Patrick W. ·Thoraxcenter, Erasmus MC, Ba-583, Dr Molewaterplein 40, Rotterdam, The Netherlands. ·Expert Opin Pharmacother · Pubmed #21226632.

ABSTRACT: INTRODUCTION: Coronary artery disease (CAD) is the leading cause of mortality in developed countries. Angina, myocardial infarction, heart failure and other clinical manifestations of coronary atherosclerosis lead to considerable patient morbidity and constitute an increasingly heavy burden on health systems worldwide. AREAS COVERED: This article reviews the recent major developments in the treatment of CAD, which can be achieved using medical therapy either in isolation or in combination with revascularization, performed via coronary artery bypass surgery (CABG) or percutaneous coronary intervention (PCI). There is no dispute that optimal medical treatment is the cornerstone of CAD management; however, timely revascularization offers superior symptom control in patients with severe symptoms and may also offer a survival advantage in some patients with diffuse disease and diabetes. Importantly, the advances in PCI technology, especially with the introduction of drug-eluting stents has narrowed the gap between CABG and PCI for the treatment of CAD. EXPERT OPINION: The continuous developments in diagnosis and treatment of CAD call for contemporary trials with detailed analysis to provide evidence that will help in the choice of the best and most cost-effective treatment strategy.

3 Article Rehospitalizations Following Primary Percutaneous Coronary Intervention in Patients With ST-Elevation Myocardial Infarction: Results From a Multi-Center Randomized Trial. 2017

Spitzer, Ernest / Frei, Martina / Zaugg, Serge / Hadorn, Susanne / Kelbaek, Henning / Ostojic, Miodrag / Baumbach, Andreas / Tüller, David / Roffi, Marco / Engstrom, Thomas / Pedrazzini, Giovanni / Vukcevic, Vladan / Magro, Michael / Kornowski, Ran / Lüscher, Thomas F / von Birgelen, Clemens / Heg, Dik / Windecker, Stephan / Räber, Lorenz. ·Department of Cardiology, Bern University Hospital, Bern, Switzerland. · Department of Interventional Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands. · Clinical Trials Unit, University of Bern, Switzerland. · Institute of Social and Preventive Medicine, University of Bern, Switzerland. · Department of Cardiology, Zealand University Hospital, Roskilde, Denmark. · Department of Cardiology, Clinical Center of Serbia, Belgrade, Serbia. · William Harvey Research Institute, Queen Mary University and Barts Heart Centre, London, United Kingdom. · Cardiology Department, Triemlispital, Zurich, Switzerland. · Cardiocentro, Lugano, Switzerland. · Department of Cardiology, Rigshospitalet, Copenhagen, Denmark. · Division of Cardiology, University Hospital, Geneva, Switzerland. · Department of Cardiology, TweeSteden Ziekenhuis, Tilburg, The Netherlands. · Rabin Medical Center, Petach Tikva, Israel. · Tel Aviv University, Tel Aviv, Israel. · Cardiology Department, University Hospital Zurich, Zurich, Switzerland. · Thoraxcentrum Twente, Twente University, Enschede, The Netherlands. · Department of Cardiology, Bern University Hospital, Bern, Switzerland lorenz.raeber@insel.ch. ·J Am Heart Assoc · Pubmed #28780509.

ABSTRACT: BACKGROUND: Rehospitalizations (RHs) after ST-elevation myocardial infarction carry a high economic burden and may deteriorate quality of life. Characterizing patients at higher risk may allow the design of preventive measures. We studied the frequency, reasons, and predictors for unplanned cardiac and noncardiac RHs in ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention. METHODS AND RESULTS: In this post-hoc analysis of the COMFORTABLE AMI (Comparison of Biolimus Eluted From an Erodible Stent Coating With Bare Metal Stents in Acute ST-Elevation Myocardial Infarction; NCT00962416) trial including 1137 patients, unplanned cardiac and noncardiac RHs occurred in 133 (11.7%) and in 79 patients (6.9%), respectively, at 1 year. The most frequent reasons for unplanned cardiac RHs were recurrent chest pain without evidence of ischemia (20.4%), recurrent chest pain with ischemia and coronary intervention (16.9%), and ischemic events (16.9%). Unplanned noncardiac RHs occurred most frequently attributed to bleeding (24.5%), infections (14.3%), and cancer (9.1%). On multivariate analysis, left ventricular ejection fraction (22% increase in the rate of RHs per 10% decrease; CONCLUSIONS: Among ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention in the setting of a randomized, clinical trial, unplanned cardiac RHs occurred in 12% with recurrent chest pain being the foremost reason. Unplanned noncardiac RHs occurred in 7% with bleeding as the leading cause. Left ventricular ejection fraction and Syntax score were independent predictors of unplanned cardiac RHs and identified patient subgroups in need for improved secondary prevention. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00962416.

4 Article Long-term invasive follow-up of the everolimus-eluting bioresorbable vascular scaffold: five-year results of multiple invasive imaging modalities. 2016

Simsek, Cihan / Karanasos, Antonios / Magro, Michael / Garcia-Garcia, Hector M / Onuma, Yoshinobu / Regar, Evelyn / Boersma, Eric / Serruys, Patrick W / van Geuns, Robert J. ·Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands. ·EuroIntervention · Pubmed #25349042.

ABSTRACT: AIMS: Invasive imaging modalities have shown restoration of vasomotion, prevention of restenosis and, most importantly, increase in lumen area between six months and two years after first-generation everolimus-eluting bioresorbable vascular scaffold (Absorb BVS) implantation. Our aim was to assess whether these positive findings were sustained in the long term. METHODS AND RESULTS: Patients included in the ABSORB cohort A from the Thoraxcenter Rotterdam cohort underwent coronary catheterisation including angiography, intravascular ultrasound (IVUS), virtual histology, optical coherence tomography (OCT) and vasomotion testing at five years. Eight out of 16 patients underwent catheterisation and scaffold assessment with multiple imaging modalities. A trend towards an increase in minimum luminal diameter was observed between two and five years by angiography (1.95±0.37 mm vs. 2.14±0.38 mm; p=0.09). IVUS data showed an increase in mean lumen area at five years (6.96±1.13 mm2) compared to six months (6.17±0.74 mm2; p=0.06) and two years (6.56±1.16 mm2; p=0.12), primarily due to a persistent reduction in plaque area size between six months and five years (9.17±1.86 mm2 vs. 7.57±1.63 mm2; p=0.03). The necrotic core area was reduced at five years compared to post-procedural results. In OCT, an increase in mean and minimal luminal area was observed. Moreover, no scaffold struts could be identified and a smooth endoluminal lining was observed. The scaffolded coronary segment did not show signs of endothelial dysfunction with acetylcholine testing. CONCLUSIONS: At five years, the Absorb BVS is no longer discernible by any invasive imaging method and endothelial function is restored. Late luminal enlargement persists up to five years of follow-up without adaptive vessel remodelling.

5 Article Stent thrombosis in early-generation drug-eluting stents versus newer-generation everolimus-eluting stent assorted by LVEF. 2015

van Boven, Nick / Windecker, Stephan / Umans, Victor A / van Domburg, Ron T / Kardys, Isabella / Akkerhuis, K Martijn / van Geuns, Robbert-Jan / Serruys, Patrick W / Magro, Michael / Räber, Lorenz / Boersma, Eric. ·Department of Cardiology, Medical Centre Alkmaar, Alkmaar, The Netherlands Cardiovascular Research School (COEUR), Erasmus university, Rotterdam, The Netherlands. · Department of Cardiology, Bern University Hospital, Bern, Switzerland. · Department of Cardiology, Medical Centre Alkmaar, Alkmaar, The Netherlands. · Erasmus MC, Rotterdam, The Netherlands. ·Heart · Pubmed #25163692.

ABSTRACT: OBJECTIVE: Everolimus drug-eluting stents (EES) are superior to early-generation drug-eluting stents (DES), releasing sirolimus (SES) or paclitaxel (PES) in preventing stent thrombosis (ST). Since an impaired LVEF seems to increase the risk of ST, we aimed to investigate the difference in outcome of patients with varying LVEF using EES versus early-generation DES. METHODS: In a prospective cohort study, we compared the risk of ST in patients in three LVEF subgroups: normal (LVEF >50%), mildly impaired (LVEF >40% and ≤50%) and moderate-severely impaired (LVEF ≤40%). Within these various LVEF groups, we compared EES with SES and PES after adjustment for baseline differences. RESULTS: We assessed a cohort of 5363 patients, with follow-up of up to 4 years and available LVEF. Overall definite ST occurred in 123 (2.3%) patients. ST rates were higher in the LVEF moderate-severely impaired group compared with the normal LVEF group (2.8% vs 2.1%; HR 1.82; CI 1.10 to 3.00). Especially early ST (EST) was more frequent in the moderate-severely impaired LVEF group (HR 2.20; CI 1.06 to 4.53). Overall rates of definite ST were lower in patients using EES compared with patients using SES or PES in all LVEF groups. Interaction terms were not statistically significant. ST rates were higher in the moderate-severely impaired LVEF group compared with the normal LVEF group when using SES or PES, but not significantly different when using EES. CONCLUSIONS: EES was associated with a lower risk of definite ST compared with early-generation DES. This lower risk was independent of LVEF, even though ST rates were higher in patients with a moderate-severely impaired LVEF. TRIAL REGISTRATION NO: MEC-2013-262.

6 Article Procedural and clinical outcomes of the Absorb everolimus-eluting bioresorbable vascular scaffold: one-month results of the Bioresorbable vascular Scaffold Evaluated At Rotterdam Cardiology Hospitals (B-SEARCH). 2014

Simsek, Cihan / Magro, Michael / Onuma, Yoshinobu / Boersma, Eric / Smits, Peter / Dorange, Cecile / Veldhof, Susan / Regar, Evelyn / Serruys, Patrick W / van Geuns, Robert-Jan. ·Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands. ·EuroIntervention · Pubmed #23999210.

ABSTRACT: AIMS: The clinical outcome of patients treated with the everolimus-eluting bioresorbable vascular scaffold (Absorb BVS) in the ABSORB Cohort A and B studies using mandatory intravascular ultrasound (IVUS) imaging showed encouraging results. The ABSORB EXTEND study aimed to include longer lesions, allow overlap and did not oblige IVUS imaging. We assessed the procedural and short-term clinical outcomes in a cohort including these extended criteria. METHODS AND RESULTS: Patients included in three study cohorts (ABSORB Cohort A, Cohort B and EXTEND) at two centres in Rotterdam were systematically followed for major adverse cardiac events (MACE). Clinical data were obtained for 88 patients (mean age 61.2 years, 73% male) with a total of 92 lesions. Lesion length was significantly longer in the ABSORB EXTEND cohort 11.34±4.01 mm (9.20±2.66 mm; p<0.01) and the reference vessel diameter was smaller 2.53±0.34 mm (2.87±0.38 mm; p<0.001) compared to previous cohorts. Predilatation was performed with a balloon diameter of 2.5±0.3 mm and inflated to a maximum pressure of 12.6±3.2 atm. The scaffold was successfully implanted in 90 of the 92 lesions (97.8%) with a maximum pressure of 14.1±2.8 atm. Post-dilatation was performed in 55% of the patients (53% EXTEND vs. 56% Cohort A and B; p=0.7). The acute gain was 1.21±0.37 mm. Absolute recoil was 0.16±0.20 mm with percentage acute recoil of 5.60±6.60%. At one month, none of the patients had a MACE. CONCLUSIONS: This study, which constitutes the largest combined study cohort of patients treated with the Absorb BVS in Rotterdam, shows that treatment of longer lesions and smaller vessels without obligatory IVUS use is safe and efficacious at one month.

7 Article Reproducibility of intravascular ultrasound iMAP for radiofrequency data analysis: implications for design of longitudinal studies. 2014

Heo, Jung Ho / Brugaletta, Salvatore / Garcia-Garcia, Hector M / Gomez-Lara, Josep / Ligthart, Jurgen M R / Witberg, Karen / Magro, Michael / Shin, Eun-Seok / Serruys, Patrick W. ·Department of Interventional Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands. ·Catheter Cardiovasc Interv · Pubmed #22109902.

ABSTRACT: BACKGROUND: iMAP is a new intravascular ultrasound (IVUS) derived technique for tissue characterization using spectral analysis. Since there is a need for reproducibility data to design longitudinal studies, we sought to assess the in vivo reproducibility of this imaging technique. METHODS: iMAP (40 MHz, Boston Scientific Corporation) was performed in patients referred for elective percutaneous intervention and in whom a nonintervened vessel was judged suitable for a safe IVUS analysis. Overall 20 patients with 20 non-angiographically significant lesions were assessed by two independent observers. Five of these 20 patients received an additional iMAP analysis using a new IVUS catheter and using the same catheter after its engagement and reengagement. RESULTS: The interobserver relative difference in plaque area was 2.5%. Limits of agreement for lumen, vessel, and plaque area measurements were 1.62, -2.47 mm(2) ; 2.09, -3.71 mm(2) ; 2.80, -3.72 mm(2) ; respectively. Limits of agreement for fibrotic, lipidic, necrotic, and calcified measurements were 1.32, -1.44 mm(2) ; 0.24, -0.36 mm(2) ; 1.50, -2.26 mm(2) ; 0.09, -0.11 mm(2) ; respectively. The intercatheter and intracatheter relative difference in plaque area were 0.9% and 4.1%, respectively. Although the variability for compositional measurements increased using two different catheters or using the same catheter twice, the variability for compositional measurements keeps always below 10%. CONCLUSIONS: Our analysis demonstrates that the geometrical and compositional iMAP analysis is acceptably reproducible.

8 Article Acute procedural and six-month clinical outcome in patients treated with a dedicated bifurcation stent for left main stem disease: the TRYTON LM multicentre registry. 2013

Magro, Michael / Girasis, Chrysafios / Bartorelli, Antonio L / Tarantini, Giuseppe / Russo, Filippo / Trabattoni, Daniela / D'Amico, Gianpiero / Galli, Mario / Gómez Juame, Alfredo / de Sousa Almeida, Manuel / Simsek, Cihan / Foley, David / Sonck, Jeroen / Lesiak, Maciej / Kayaert, Peter / Serruys, Patrick W / van Geuns, Robert-Jan. ·Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands. ·EuroIntervention · Pubmed #23538155.

ABSTRACT: AIMS: Tryton side branch (SB) reverse culotte stenting has been employed for the treatment of left main (LM) stem bifurcations in patients at high risk for bypass surgery. The aim of this study was to assess acute angiographic results and six-month clinical outcome after implantation of the Tryton stent in the LM. METHODS AND RESULTS: We studied 52 consecutive patients with LM disease treated in nine European centres. Angiographic and clinical data analysis was performed centrally. Fifty-one of 52 patients (age 68±11 yrs, 75% male, 42% unstable angina, SYNTAX score 20±8) were successfully treated with the Tryton stent. Medina class was 1,1,1 in 33 (63%), 1,0,1 in 7 (13%), 1,1,0 in 3 (6%), 0,1,1 in 8 (4%) and 0,0,1 in 1 (2%). The Tryton stent on a stepped balloon (diameter 3.5-2.5 mm) was used in 41/51 (80%) of cases. The mean main vessel stent diameter was 3.4±0.4 mm with an everolimus-eluting stent employed in 30/51 (59%) of cases. Final kissing balloon dilatation was performed in 48/51 (94%). Acute gain was 1.52±0.86 mm in the LM and 0.92±0.47 mm in the SB. The angiographic success rate was 100%; the procedural success rate reached 94%. Periprocedural MI occurred in three patients. At six-month follow-up, the TLR rate was 12%, MI 10% and cardiac death 2%. The hierarchical MACE rate at six months was 22%. No cases of definite stent thrombosis occurred. CONCLUSIONS: The use of the Tryton stent for treatment of LM bifurcation disease in combination with a conventional drug-eluting stent is feasible and achieves an optimal angiographic result. Safety of the procedure and six-month outcome are acceptable in this high-risk lesion PCI. Further safety and efficacy studies with long-term outcome assessment of this strategy are warranted.

9 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.

10 Article Three-dimensional optical frequency domain imaging in conventional percutaneous coronary intervention: the potential for clinical application. 2013

Farooq, Vasim / Gogas, Bill D / Okamura, Takayuki / Heo, Jung Ho / Magro, Michael / Gomez-Lara, Josep / Onuma, Yoshinobu / Radu, Maria D / Brugaletta, Salvatore / van Bochove, Glenda / van Geuns, Robert Jan / Garcìa-Garcìa, Hector M / Serruys, Patrick W. ·Interventional Cardiology Department, Thorax Center, Erasmus University Medical Centre,'s-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands. ·Eur Heart J · Pubmed #22108834.

ABSTRACT: -- No abstract --

11 Article The ability of high dose rosuvastatin to improve plaque composition in non-intervened coronary arteries: rationale and design of the Integrated Biomarker and Imaging Study-3 (IBIS-3). 2012

Simsek, Cihan / Garcia-Garcia, Hector M / van Geuns, Robert-Jan / Magro, Michael / Girasis, Chrysafios / van Mieghem, Nicolas / Lenzen, Mattie / de Boer, Sanneke / Regar, Evelyn / van der Giessen, Willem / Raichlen, Joel / Duckers, Henricus J / Zijlstra, Felix / van der Steen, Ton / Boersma, Eric / Serruys, Patrick W / Anonymous3920729. ·Thoraxcenter, Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands. ·EuroIntervention · Pubmed #22717926.

ABSTRACT: AIMS: Acute coronary syndromes (ACS) are often caused by rupture of non-flow limiting "vulnerable" atherosclerotic plaque, characterised by a large necrotic core pool and a thin, inflamed fibrous cap that are unidentifiable with diagnostic coronary angiography. The implementation of novel invasive imaging modalities, such as intravascular ultrasound-virtual histology (IVUS-VH) and near-infrared spectroscopy (NIRS), could help identify high-risk patients who are in need of aggressive medical therapy. The intake of high dose rosuvastatin has been shown to reduce plaque containing necrotic core in the carotid arteries, however it remains unknown whether there is a similar effect in the coronary arteries. METHODS AND RESULTS: The IBIS-3 study is a single centre, non-randomised study designed to evaluate the ability of 12-months high dose rosuvastatin treatment (40 mg daily po) to reduce the necrotic core of a non-intervened coronary segment assessed with IVUS-VH. All patients undergoing diagnostic angiography or percutaneous coronary intervention (PCI) are eligible for participation. Recruitment started in early 2010 and will continue until 350 patients are included. The effect on the lipid core containing plaque will be assessed with near-infrared spectroscopy (NIRS) at 12-months. In addition, multiple biomarkers will be measured and their levels correlated with the imaging results. CONCLUSIONS: IBIS-3 will assess the efficacy of high dose rosuvastatin to reduce the necrotic core in a coronary segment of patients who have undergone diagnostic angiography or PCI.

12 Article Impact of renal insufficiency on safety and efficacy of drug-eluting stents compared to bare-metal stents at 6 years. 2012

Simsek, Cihan / Magro, Michael / Boersma, Eric / Onuma, Yoshinobu / Nauta, Sjoerd / Valstar, Gideon / van Geuns, Robert-Jan / van der Giessen, Willem / van Domburg, Ron / Serruys, Patrick / Anonymous4150699. ·Thoraxcenter, Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands. ·Catheter Cardiovasc Interv · Pubmed #21735520.

ABSTRACT: BACKGROUND: There is few information on the long-term efficacy and safety of sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES) compared to bare metal stents (BMS) in all-comer percutaneous coronary intervention (PCI)-patients complicated by renal insufficiency (RI). OBJECTIVE: Our aim was to assess the 6-year clinical outcome of PCI-patients with RI treated exclusively with BMS, SES, or PES in our academic hospital. METHODS: A total of 1382 patients, included in three cohorts of consecutive PCI-patients (BMS = 392; SES = 498; PES = 492), were categorized by creatinine clearance calculated by the Cockroft-Gault formula (normal kidney function ≥ 90; mild RI = 60-89; moderate RI < 60) and systematically followed for the occurrence of major adverse cardiac events (MACE). RESULTS: Mortality rates were significantly higher for patients with moderate RI compared to mild RI and normal kidney function at 6 years (Kaplan-Meier estimate: moderate RI (34%) vs. mild RI (12%), P < 0.001; moderate RI (34%) vs. normal kidney function (8%), P < 0.001). After multivariate Cox-regression analysis, SES and PES decreased the occurrence of target-vessel revascularization (TVR) and MACE at 6 years in patients with a normal creatinine clearance compared to BMS [adjusted hazard ratio (aHR) = 0.48, 95% CI: 0.28-0.84; aHR = 0.75, 95% CI: 0.57-0.97, respectively] with no significant effect on mortality. Safety- and efficacy end points were comparable for the three stent types in patients with mild- and moderate renal function. CONCLUSION: Patients with a normal creatinine clearance had significant improvement in TVR and MACE rates after SES- or PES implantation compared to BMS at 6 years. However, there was no superiority of both drug-eluting stents over BMS in safety and efficacy end points for patients with impaired renal function.

13 Article Six-month clinical follow-up of the Tryton side branch stent for the treatment of bifurcation lesions: a two center registry analysis. 2011

Magro, Michael / Wykrzykowska, Joanna / Serruys, Patrick W / Simsek, Cihan / Nauta, Sjoerd / Lesiak, Maciej / Stanislawska, Katarzyna / Onuma, Yoshinobu / Regar, Evelyn / van Domburg, Ron T / Grajek, Stefan / Geuns, Robert-Jan Van. ·Department of Interventional Cardiology, Thoraxcenter, Erasmus University MC, Rotterdam, The Netherlands. ·Catheter Cardiovasc Interv · Pubmed #20824767.

ABSTRACT: BACKGROUND: Treatment of bifurcation lesions with the Tryton Sidebranch stent has been shown to be feasible with an acceptable clinical outcome and low side branch late loss in the first in man trial. OBJECTIVE: To report acute procedural and six month clinical follow-up after the use of the Tryton Sidebranch stent in an "all comer" registry. METHODS: The first 100 coronary bifurcation lesions assigned for treatment with the Tryton stent were included in a prospective registry. Procedural and angiographic success rates were determined from patient charts and pre- and postprocedural quantitative coronary angiography. RESULTS: Totally, 96 patients with 100 lesions were included in the study. Seventy-two percent presented with stable angina, 25% with unstable angina/NSTEMI, and 3% STEMI. The bifurcation was located in the left main in 8%. Two lesions were chronic total occlusions. Sixty-nine percent were true bifurcation lesions. One failure of stent delivery occurred. Acute gain in SB was 0.76 ± 0.64 mm and three patients had residual stenosis of >30%. Angiographic success rate was 95%; procedural success rate reached 94%. Peri-procedural MI occurred in two and there was one cardiac death during hospitalization. At a median six months follow-up, TLR rate was 4%, MI 3%, and cardiac death 1%. The percentage MACE-free survival at six months was 94%. No cases of definite stent thrombosis occurred. CONCLUSIONS: In a real world the use of the Tryton Sidebranch stent is associated with good procedural safety and angiographic success rate and acceptable outcome at six months of follow-up.

14 Article TheTryton side branch stent. 2010

Magro, Michael / van Geuns, Robert-Jan. ·Department of Interventional Cardiology, Thoraxcenter, Erasmus MC, Dr. Molewaterplein 40, Rotterdam, The Netherlands. ·EuroIntervention · Pubmed #21930481.

ABSTRACT: The Tryton Side Branch Stent (Tryton Medical, Durham, NC, USA) is a dedicated bare metal stent developed to enhance the safety and efficacy of the two stent technique for the treatment of bifurcation lesions. The stenting technique, a "reverse culotte", secures the side branch (SB) with the placement of this dedicated stent in the proximal main vessel, across to the side branch while it facilitates the positioning of a conventional stent in the proximal to distal main vessel. The First-In-Man trial showed minimal SB late loss (0.17±0.35 mm) at six months while real world registry data reported target vessel revascularisation rates as low as 4% at the same time points and no stent thrombosis. The simplicity of the technique as well as the promising results have led to its widespread utilisation in Europe while in the US, a randomised trial is imminent and will serve for the device approval by the Food and Drug Administration.

15 Article The unrestricted use of sirolimus- and paclitaxel-eluting stents results in better clinical outcomes during 6-year follow-up than bare-metal stents: an analysis of the RESEARCH (Rapamycin-Eluting Stent Evaluated At Rotterdam Cardiology Hospital) and T-SEARCH (Taxus-Stent Evaluated At Rotterdam Cardiology Hospital) registries. 2010

Simsek, Cihan / Magro, Michael / Boersma, Eric / Onuma, Yoshinobu / Nauta, Sjoerd T / Gaspersz, Marcia P / van der Giessen, Willem J / van Domburg, Ron T / Serruys, Patrick W / Anonymous4730675. ·Thoraxcenter, Department of Cardiology, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands. ·JACC Cardiovasc Interv · Pubmed #20965464.

ABSTRACT: OBJECTIVES: The aim of this study was to assess the 6-year clinical outcome after unrestricted use of sirolimus-eluting stents (SES) or paclitaxel-eluting stents (PES) as compared with bare-metal stents (BMS) in consecutive de novo patients undergoing percutaneous coronary intervention (PCI). BACKGROUND: SES and PES have been shown to significantly decrease target vessel revascularization (TVR) rates compared with BMS in "real-world" registries. However, possible higher rates of very-late stent thrombosis and a restenosis "catch-up" trend might jeopardize the benefit. METHODS: Three PCI cohorts, each with exclusive use of 1 stent type (BMS = 450; SES = 508; PES = 576), were systematically followed for the occurrence of major adverse cardiac events (MACE). RESULTS: Very-late stent thrombosis was more common in SES and PES patients than BMS patients (2.4% vs. 0.9% vs. 0.4%, respectively; p = 0.02); however, there were no significant differences between the stent types for all-cause mortality and all-cause mortality/myocardial infarction at 6-year follow-up. Sixty-nine SES patients (Kaplan-Meier estimate 14%) and 72 PES patients (14%) had a TVR, as compared with 79 BMS patients (18%; log-rank p = 0.02), which maintained significance after adjustment for (potential) confounders. Multivariate analysis showed that DES implantation is associated with lower incidence of TVR and MACE than BMS implantation (hazard ratio: 0.65, 95% confidence interval: 0.49 to 0.86; p = 0.003; hazard ratio: 0.79, 95% confidence interval: 0.65 to 0.97; p = 0.02, respectively). Incidence of MACE was also lower in SES and PES patients (30% and 30%, respectively) than in BMS patients (34%); however, significance was borderline. CONCLUSIONS: The unrestricted use of both DES resulted in a sustained advantage in decreasing TVR and, to a lesser extent, MACE compared with BMS at 6 years. The SES and PES are equally safe and effective in the treatment of coronary lesions.

16 Article Four-year clinical outcome of sirolimus- and paclitaxel-eluting stents compared to bare-metal stents for the percutaneous treatment of stable coronary artery disease. 2010

Simsek, Cihan / Onuma, Yoshinobu / Magro, Michael / de Boer, Sanneke / Battes, Linda / van Domburg, Ron T / Boersma, Eric / Serruys, Patrick W / Anonymous5210655. ·Department of Cardiology, Thoraxcenter, Erasmus Medical Center Rotterdam, Dr. Molewaterplein 40, Rotterdam, The Netherlands. p.w.j.c.serruys@erasmusmc.nl ·Catheter Cardiovasc Interv · Pubmed #20310019.

ABSTRACT: BACKGROUND: There are limited data on the long-term safety and efficacy profile of coronary stent implantation in patients with stable coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI). OBJECTIVE: We aimed to assess the 4-year clinical outcome in patients who received a bare-metal stent (BMS), sirolimus-eluting stent (SES), or a paclitaxel-eluting stent (PES) for the percutaneous treatment of stable angina in our center during 2000-2005. METHODS: In the study period, a total of 2,449 consecutive patients (BMS = 1,005; SES = 373; and PES = 1071) underwent a PCI as part of three historical PCI-cohorts for stable angina and were routinely followed for the occurrence of major adverse cardiac events (MACE). RESULTS: At 4 years follow-up, 264 BMS patients (26.8%) had a MACE, compared to 75 SES patients (20.9%) and 199 PES patients (23.9%). Multivariate analysis showed that SES and PES were superior to BMS with respect to MACE [hazard ratio (HR) = 0.62, 95% confidence interval (CI): 0.47-0.81; HR = 0.67, 95% CI: 0.55-0.82, respectively]. The occurrence of MACE was significantly lower in the SES and PES population, primarily due to less target-vessel revascularization (TVR) procedures (HR = 0.53, 95% CI: 0.37-0.75; HR = 0.71, 95% CI: 0.62-0.81, respectively). The occurrence of early, late, and very late stent thrombosis was equally rare with each stent type. There were no significant differences between SES and PES on death, myocardial infarction, TVR, and MACE. CONCLUSION: These findings suggest that SES and PES result in decreased TVR procedures and MACE compared to BMS at 4 years follow-up. SES or PES implantation should be the preferred choice over BMS for patients with stable CAD undergoing PCI.

17 Minor Plaque compositional Syntax score: combining angiography and lipid burden in coronary artery disease. 2012

Brugaletta, Salvatore / Magro, Michael / Simsek, Cihan / Heo, Jung He / de Boer, Sanneke / Ligthart, Jurgen / Witberg, Karen / Farooq, Vasim / van Geuns, Robert-Jan / Schultz, Carl / van Mieghem, Nicolas / Regar, Evelyn / Zijlstra, Felix / Duckers, Henricus J / de Jaegere, Peter / Muller, James E / van der Steen, Antonius F / Boersma, Eric / Garcia-Garcia, Hector M / Serruys, Patrick W. · ·JACC Cardiovasc Imaging · Pubmed #22421226.

ABSTRACT: -- No abstract --

18 Minor Change in near-infrared spectroscopy of a coronary artery after 1-year treatment with high dose rosuvastatin. 2012

Simsek, C / van Geuns, R J / Magro, M / Boersma, E / Garcia-Garcia, H M / Serruys, P W. · ·Int J Cardiol · Pubmed #22000422.

ABSTRACT: -- No abstract --

19 Minor 3D reconstructions of optical frequency domain imaging to improve understanding of conventional PCI. 2011

Farooq, Vasim / Okamura, Takayuki / Gogas, Bill D / Heo, Jung Ho / Magro, Michael / Gomez-Lara, Josep / Brugaletta, Salvatore / Onuma, Yoshinobu / Radu, Maria / Garcìa-Garcìa, Hector M / Serruys, Patrick W. · ·JACC Cardiovasc Imaging · Pubmed #21920344.

ABSTRACT: -- No abstract --