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Coronary Artery Disease: HELP
Articles by Roxana Mehran
Based on 149 articles published since 2008
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Between 2008 and 2019, R. Mehran wrote the following 149 articles about Coronary Artery Disease.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6
1 Guideline 2016 ACC/AHA guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. 2016

Levine, Glenn N / Bates, Eric R / Bittl, John A / Brindis, Ralph G / Fihn, Stephan D / Fleisher, Lee A / Granger, Christopher B / Lange, Richard A / Mack, Michael J / Mauri, Laura / Mehran, Roxana / Mukherjee, Debabrata / Newby, L Kristin / O'Gara, Patrick T / Sabatine, Marc S / Smith, Peter K / Smith, Sidney C / Halperin, Jonathan L / Levine, Glenn N / Al-Khatib, Sana M / Birtcher, Kim K / Bozkurt, Biykem / Brindis, Ralph G / Cigarroa, Joaquin E / Curtis, Lesley H / Fleisher, Lee A / Gentile, Federico / Gidding, Samuel / Hlatky, Mark A / Ikonomidis, John S / Joglar, José A / Pressler, Susan J / Wijeysundera, Duminda N. · ·J Thorac Cardiovasc Surg · Pubmed #27751237.

ABSTRACT: -- No abstract --

2 Guideline 2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients With Coronary Artery Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. 2016

Levine, Glenn N / Bates, Eric R / Bittl, John A / Brindis, Ralph G / Fihn, Stephan D / Fleisher, Lee A / Granger, Christopher B / Lange, Richard A / Mack, Michael J / Mauri, Laura / Mehran, Roxana / Mukherjee, Debabrata / Newby, L Kristin / O'Gara, Patrick T / Sabatine, Marc S / Smith, Peter K / Smith, Sidney C. · ·J Am Coll Cardiol · Pubmed #27036918.

ABSTRACT: -- No abstract --

3 Guideline 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. 2013

Levine, Glenn N / Bates, Eric R / Blankenship, James C / Bailey, Steven R / Bittl, John A / Cercek, Bojan / Chambers, Charles E / Ellis, Stephen G / Guyton, Robert A / Hollenberg, Steven M / Khot, Umesh N / Lange, Richard A / Mauri, Laura / Mehran, Roxana / Moussa, Issam D / Mukherjee, Debabrata / Nallamothu, Brahmajee K / Ting, Henry H / Anonymous5470709 / Anonymous5480709 / Anonymous5490709. · ·Catheter Cardiovasc Interv · Pubmed #22065485.

ABSTRACT: -- No abstract --

4 Guideline ACCF/SCAI/AATS/AHA/ASE/ASNC/HFSA/HRS/SCCM/SCCT/SCMR/STS 2012 appropriate use criteria for diagnostic catheterization: American College of Cardiology Foundation Appropriate Use Criteria Task Force Society for Cardiovascular Angiography and Interventions American Association for Thoracic Surgery American Heart Association, American Society of Echocardiography American Society of Nuclear Cardiology Heart Failure Society of America Heart Rhythm Society, Society of Critical Care Medicine Society of Cardiovascular Computed Tomography Society for Cardiovascular Magnetic Resonance Society of Thoracic Surgeons. 2012

Patel, Manesh R / Bailey, Steven R / Bonow, Robert O / Chambers, Charles E / Chan, Paul S / Dehmer, Gregory J / Kirtane, Ajay J / Wann, L Samuel / Ward, R Parker / Douglas, Pamela S / Patel, Manesh R / Bailey, Steven R / Altus, Philip / Barnard, Denise D / Blankenship, James C / Casey, Donald E / Dean, Larry S / Fazel, Reza / Gilchrist, Ian C / Kavinsky, Clifford J / Lakoski, Susan G / Le, D Elizabeth / Lesser, John R / Levine, Glenn N / Mehran, Roxana / Russo, Andrea M / Sorrentino, Matthew J / Williams, Mathew R / Wong, John B / Wolk, Michael J / Bailey, Steven R / Douglas, Pamela S / Hendel, Robert C / Kramer, Christopher M / Min, James K / Patel, Manesh R / Shaw, Leslee / Stainback, Raymond F / Allen, Joseph M. ·Society for Cardiovascular Angiography and Interventions Representative. ·Catheter Cardiovasc Interv · Pubmed #22678595.

ABSTRACT: The American College of Cardiology Foundation, in collaboration with the Society for Cardiovascular Angiography and Interventions and key specialty and subspecialty societies, conducted a review of common clinical scenarios where diagnostic catheterization is frequently considered. The indications (clinical scenarios) were derived from common applications or anticipated uses, as well as from current clinical practice guidelines and results of studies examining the implementation of noninvasive imaging appropriate use criteria. The 166 indications in this document were developed by a diverse writing group and scored by a separate independent technical panel on a scale of 1 to 9, to designate appropriate use (median 7 to 9), uncertain use (median 4 to 6), and inappropriate use (median 1 to 3). Diagnostic catheterization may include several different procedure components. The indications developed focused primarily on 2 aspects of diagnostic catheterization. Many indications focused on the performance of coronary angiography for the detection of coronary artery disease with other procedure components (e.g., hemodynamic measurements, ventriculography) at the discretion of the operator. The majority of the remaining indications focused on hemodynamic measurements to evaluate valvular heart disease, pulmonary hypertension, cardiomyopathy, and other conditions, with the use of coronary angiography at the discretion of the operator. Seventy-five indications were rated as appropriate, 49 were rated as uncertain, and 42 were rated as inappropriate. The appropriate use criteria for diagnostic catheterization have the potential to impact physician decision making, healthcare delivery, and reimbursement policy. Furthermore, recognition of uncertain clinical scenarios facilitates identification of areas that would benefit from future research. © 2012 Wiley Periodicals, Inc.

5 Guideline 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. 2012

Levine, Glenn N / Bates, Eric R / Blankenship, James C / Bailey, Steven R / Bittl, John A / Cercek, Bojan / Chambers, Charles E / Ellis, Stephen G / Guyton, Robert A / Hollenberg, Steven M / Khot, Umesh N / Lange, Richard A / Mauri, Laura / Mehran, Roxana / Moussa, Issam D / Mukherjee, Debabrata / Nallamothu, Brahmajee K / Ting, Henry H / Anonymous640718 / Anonymous650718 / Anonymous660718. · ·Catheter Cardiovasc Interv · Pubmed #22328235.

ABSTRACT: -- No abstract --

6 Editorial Equal sex-based outcomes in unprotected left main PCI: No advantage for men. 2018

Chandrasekhar, Jaya / Mehran, Roxana. ·Icahn School of Medicine at Mount Sinai, United States. · Icahn School of Medicine at Mount Sinai, United States. Electronic address: Roxana.mehran@mountsinai.org. ·Int J Cardiol · Pubmed #29306472.

ABSTRACT: -- No abstract --

7 Editorial Improving Outcomes in High-Risk Percutaneous Coronary Interventions and Newer-Generation Drug-Eluting Stents: Good, But Not Good Enough. 2017

Baber, Usman / Mehran, Roxana. ·Icahn School of Medicine at Mount Sinai, New York, NY, USA. ·Cardiology · Pubmed #28609767.

ABSTRACT: -- No abstract --

8 Editorial CABG Beats Vintage PCI: Does Contemporary PCI Stand a Chance to EXCEL? 2016

Mehran, Roxana / Faggioni, Michela. ·Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: roxana.mehran@mountsinai.org. · Icahn School of Medicine at Mount Sinai, New York, New York; Cardiothoracic Department, Division of Cardiology, University Hospital of Pisa, Pisa, Italy. ·JACC Cardiovasc Interv · Pubmed #28007202.

ABSTRACT: -- No abstract --

9 Editorial Radial artery occlusion: preventing insult to injury. 2015

Chandrasekhar, Jaya / Mehran, Roxana. ·Icahn School of Medicine at Mount Sinai, New York, New York. ·Catheter Cardiovasc Interv · Pubmed #25789731.

ABSTRACT: Intra-arterial nitroglycerin prior to transradial sheath removal may reduce the incidence of radial artery occlusion (RAO). Operators must observe careful attention to all aspects of transradial catheterization, particularly patent hemostasis; as well as independently monitor the institutional incidence of RAO to prompt improvements in practice. Future studies on the impact of pre-puncture ultrasound, novel sheaths, hemostatic devices, and potent oral and intravenous antithrombotic therapy on 30-day RAO diagnosed by ultrasound may allow further reduction of RAO in a real-world practice.

10 Editorial A rocky road to LV recovery post TAVI. 2015

Chandrasekhar, Jaya / Mehran, Roxana. ·Icahn School of Medicine at Mount Sinai, The Zena and Michael A. Wiener Cardiovascular Institute, New York, New York. ·Catheter Cardiovasc Interv · Pubmed #25684722.

ABSTRACT: -- No abstract --

11 Editorial The OPERA study: the tenor or baritone of shorter duration of DAPT? 2014

Warren, Josephine L / Mehran, Roxana. ·Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, New York. ·Catheter Cardiovasc Interv · Pubmed #25142422.

ABSTRACT: -- No abstract --

12 Editorial Polymer-free stents in diabetic patients-not so sweet after all! 2014

Bansilal, Sameer / Mehran, Roxana. ·The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai. ·Catheter Cardiovasc Interv · Pubmed #24497456.

ABSTRACT: -- No abstract --

13 Editorial Impending savior: Impella 2.5 circulatory support system in high-risk PCI. 2012

Kherada, Nisharahmed / Mehran, Roxana. · ·Catheter Cardiovasc Interv · Pubmed #23097284.

ABSTRACT: -- No abstract --

14 Editorial Evaluating the bite of the BARC. 2012

Rao, Sunil V / Mehran, Roxana. · ·Circulation · Pubmed #22344038.

ABSTRACT: -- No abstract --

15 Editorial The fork in the road: a dedicated turn or a provisional one? 2011

Mehran, Roxana. · ·Catheter Cardiovasc Interv · Pubmed #21520382.

ABSTRACT: -- No abstract --

16 Editorial Sex-related outcomes after drug-eluting stent: should we "never mind" or "mind" the gap? 2010

Mehran, Roxana / Kini, Annapoorna S. · ·JACC Cardiovasc Interv · Pubmed #21232719.

ABSTRACT: -- No abstract --

17 Review Assessing and minimizing the risk of percutaneous coronary intervention in patients with chronic kidney disease. 2018

Guedeney, Paul / Sorrentino, Sabato / Vogel, Birgit / Baber, Usman / Claessen, Bimmer E / Mehran, Roxana. ·a The Icahn School of Medicine at Mount Sinai , The Zena and Michael A. Wiener Cardiovascular Institute , New York , New York , USA. · b Department of Cardiology , ACTION Study Group, Sorbonne Université - Univ Paris 06 (UPMC), INSERM UMRS 1166, Institut de Cardiologie , Paris , France. · c Division of Cardiology, Department of Medical and Surgical Sciences , Magna Graecia University , Catanzaro , Italy. ·Expert Rev Cardiovasc Ther · Pubmed #30324814.

ABSTRACT: INTRODUCTION: Chronic kidney disease (CKD) is commonly present in patients undergoing percutaneous coronary intervention (PCI). These patients frequently present with more complex coronary artery disease (CAD) and higher risk of peri-procedural and post-procedural adverse events, including bleeding, thrombotic events, and contrast-induced acute kidney injury (CI-AKI). This article contains updated knowledge and management of patients with CKD undergoing PCI. Areas covered: In this article, the pathophysiological mechanisms behind the association of CKD, complex CAD lesions, and complications of PCI are reviewed and the different risk scores available to assess the occurrence of CI-AKI are detailed. Furthermore, various strategies developed to prevent or reduce the impact of complications of PCI are described. Expert commentary: Patients with CKD have remained a challenge in the field of PCI. Several strategies have been evaluated in the last 20 years, with uneven results. Intravascular expansion therapy remains the cornerstone of CI-AKI prevention although recent studies have emphasized the benefit of guided hydration rather than a one-size-fits-all model. N-acetylcysteine and sodium bicarbonate have recently been challenged while pretreatment with high-dose statins may be of interest. Finally, recent studies based on intravascular ultrasound and minimal-to-no-use of contrast media have yielded promising results.

18 Review Gender differences on benefits and risks associated with oral antithrombotic medications for coronary artery disease. 2018

Romano, Sara / Buccheri, Sergio / Mehran, Roxana / Angiolillo, Dominick J / Capodanno, Davide. ·a Division of Cardiology , CAST, P.O. "Rodolico", Azienda Ospedaliero-Universitaria "Policlinico-Vittorio Emanuele", University of Catania , Catania , Italy. · b Cardiovascular Institute, Icahn School of Medicine at Mount Sinai , New York , NY , USA. · c University of Florida, College of Medicine , Jacksonville , FL , USA. ·Expert Opin Drug Saf · Pubmed #30223690.

ABSTRACT: INTRODUCTION: Despite the significant advances in the pharmacological and interventional management of patients with cardiovascular disease (CVD) over the last decades, cardiovascular mortality remains the leading cause of death. Large randomized clinical trials have investigated the efficacy and safety of different antithrombotic medications in patients with CVD. Although female gender is generally underrepresented in these clinical trials, most analyses clearly indicate that both men and women may accrue therapeutic benefits from antithrombotic management strategies. AREAS COVERED: This review aims to provide a comprehensive and focused update on gender-related comparative clinical studies of antithrombotic therapies in patients suffering from CVD. EXPERT OPINION: Current evidence supports the understanding of a similar therapeutic effect between genders with signals of an increased risk of bleeding in women. However, important gaps in evidence exist due to the overall limited percentage of women that have been enrolled in randomized controlled trials. A greater awareness of gender-related issues in antithrombotic therapy should be promoted among physicians and further evidence from large clinical trials looking at the safety and efficacy balance of different antithrombotic strategies in women is warranted.

19 Review Current evidence for the safety and efficacy of the bio-engineered dual therapy COMBO stent. 2018

Kalkman, Deborah N / Chandrasekhar, Jaya / de Winter, Robbert J / Mehran, Roxana. ·Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA. · Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. · Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA - Roxana.Mehran@mountsinai.org. ·Minerva Cardioangiol · Pubmed #29381028.

ABSTRACT: The novel dual-therapy COMBO stent aims to promote vessel healing after percutaneous coronary intervention (PCI) in patients with coronary artery disease. The pro-healing technique consists of an anti-CD34+ antibody layer that attracts circulating endothelial progenitor cells (EPCs), which bind to the stent surface and allow rapid endothelialization by differentiation of the EPCs into normal endothelial cells. The COMBO stent combines this pro-healing technique with an abluminal drug elution of sirolimus. The promise of this dual-therapy stent is that it may safely allow a shortened duration of dual-antiplatelet therapy (DAPT) after stent placement. Moreover, with a mature endothelial layer, lower rates of in-stent restenosis may be expected. Clinical outcomes after COMBO stent implantation have been recently evaluated in both randomized trials and large, prospective, multicenter registries, showing low clinical event rates of in-stent restenosis and stent thrombosis. Randomized clinical trials (HARMONEE and RECOVERY) have demonstrated the non-inferiority of COMBO versus "first in class" second generation and newer generation drug-eluting stents. Safety and efficacy of 3 months of DAPT after COMBO stent placement in patients presenting with acute coronary syndrome has been evaluated in the large REDUCE randomized controlled trial, showing non-inferiority to standard duration of 12-month DAPT. In this review we provide an overview of the current pre-clinical and clinical evidence for the performance of the COMBO stent.

20 Review Outcomes of Saphenous Vein Graft Intervention With and Without Embolic Protection Device: A Comprehensive Review and Meta-Analysis. 2017

Paul, Timir K / Bhatheja, Samit / Panchal, Hemang B / Zheng, Shimin / Banerjee, Subhash / Rao, Sunil V / Guzman, Luis / Beohar, Nirat / Zhao, David / Mehran, Roxana / Mukherjee, Debabrata. ·From the Division of Cardiology, Department of Internal Medicine (T.K.P., H.B.P.) and Department of Biostatistics and Epidemiology, College of Public Health (S.Z.), East Tennessee State University, Johnson City · The Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (S.B., R.M.) · VA North Texas Health Care System, University of Texas Southwestern Medical Center at Dallas (S.B.) · The Duke Clinical Research Institute, Durham, NC (S.V.R.) · Virginia Commonwealth University, Richmond (L.G.) · Nirat Beohar, Columbia University Division of Cardiology at the Mount Sinai Medical Center, Miami Beach, FL (N.B.) · Wake Forest University, Winston-Salem, NC (D.Z.) · and Division of Cardiology, Department of Internal Medicine, Texas Tech University, El Paso (D.M.). ·Circ Cardiovasc Interv · Pubmed #29246912.

ABSTRACT: BACKGROUND: Current guidelines give a class I recommendation to use of embolic protection devices (EPD) for saphenous vein graft (SVG) intervention; however, studies have shown conflicting results. The objective of this meta-analysis is to compare all-cause mortality, major adverse cardiovascular events, myocardial infarction (MI), or target vessel revascularization in SVG intervention with and without EPD. METHODS AND RESULTS: Literature was searched through October 2016. Eight studies (n=52 893) comparing SVG intervention performed with EPD (n=11 506) and without EPD (n=41 387) were included. There was no significant difference in all-cause mortality (odds ratio [OR], 0.79; confidence interval [CI], 0.55-1.12; CONCLUSIONS: This study including 52 893 patients suggests no apparent benefit in routine use of EPD during SVG intervention in the contemporary real-world practice. Further randomized clinical trials are needed in current era to evaluate long-term outcomes in routine use of EPD, and meanwhile, current guideline recommendations on EPD use should be revisited.

21 Review Atrial fibrillation, bleeding, and coronary intervention: current recommendations. 2017

Farhan, Serdar / Mehran, Roxana. ·Interventional Cardiovascular Research and Clinical Trials, Icahn School of Medicine at Mount Sinai, The Zena and Michael A. Wiener Cardiovascular Institute, New York City, New York, USA. ·Coron Artery Dis · Pubmed #28938240.

ABSTRACT: The patient population with the need for oral anticoagulation to reduce stroke risk associated with atrial fibrillation (AF) and dual antiplatelet therapy to prevent stent thrombosis and myocardial infarction after percutaneous coronary intervention is increasing. However, patients treated with a triple therapy consisting of oral anticoagulation, aspirin, and a P2Y12 inhibitor have been demonstrated to be at high bleeding risk. The best combination of these agents and the duration of the different therapies are still uncertain. Recently, data on the safety of combinations including nonvitamin K antagonists have been published and evidence for the feasibility of a dual therapy is increasing. This review aims to provide insights to the pathophysiology of thrombus formation in AF versus coronary artery disease, summarize available data on postprocedural treatment strategies, and report current guidelines for AF patients after percutaneous coronary intervention. Furthermore, the role of stent type selection and tools to evaluate as well as strategies to reduce the individual bleeding risk will be discussed.

22 Review Everolimus-Eluting Bioresorbable Scaffolds Versus Everolimus-Eluting Metallic Stents. 2017

Sorrentino, Sabato / Giustino, Gennaro / Mehran, Roxana / Kini, Anapoorna S / Sharma, Samin K / Faggioni, Michela / Farhan, Serdar / Vogel, Birgit / Indolfi, Ciro / Dangas, George D. ·Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy. · Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York. · Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Cardiothoracic Department, Division of Cardiology, University Hospital of Pisa, Pisa, Italy. · Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy; URT-CNR, Department of Medicine, Consiglio Nazionale delle Ricerche of IFC, Catanzaro, Italy. · Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: george.dangas@mountsinai.org. ·J Am Coll Cardiol · Pubmed #28412389.

ABSTRACT: BACKGROUND: Recent evidence suggests that bioresorbable vascular scaffolds (BVS) are associated with an excess of thrombotic complications compared with metallic everolimus-eluting stents (EES). OBJECTIVES: This study sought to investigate the comparative effectiveness of the Food and Drug Administration-approved BVS versus metallic EES in patients undergoing percutaneous coronary intervention at longest available follow-up. METHODS: The authors searched MEDLINE, Scopus, and web sources for randomized trials comparing BVS and EES. The primary efficacy and safety endpoints were target lesion failure and definite or probable stent thrombosis, respectively. RESULTS: Seven trials were included: in sum, 5,583 patients were randomized to receive either the study BVS (n = 3,261) or the EES (n = 2,322). Median time of follow-up was 2 years (range 2 to 3 years). Compared with metallic EES, risk of target lesion failure (9.6% vs. 7.2%; absolute risk difference: +2.4%; risk ratio: 1.32; 95% confidence interval: 1.10 to 1.59; number needed to harm: 41; p = 0.003; I CONCLUSIONS: Compared with metallic EES, the BVS appears to be associated with both lower efficacy and higher thrombotic risk over time. (Bioresorbable vascular scaffold compare to everolimus stents in long term follow up; CRD42017059993).

23 Review Risk of contrast-induced acute kidney injury in ST-elevation myocardial infarction patients undergoing multi-vessel intervention-meta-analysis of randomized trials and risk prediction modeling study using observational data. 2017

Chatterjee, Saurav / Kundu, Amartya / Mukherjee, Debabrata / Sardar, Partha / Mehran, Roxana / Bashir, Riyaz / Giri, Jay / Abbott, Jinnette D. ·Division of Cardiology, St. Luke's-Roosevelt Hospital Center of the Mount Sinai Health System, New York, New York. · Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts. · Division of Cardiology, Texas Tech University Health Sciences Center, El Paso, Texas. · Division of Cardiovascular Medicine, University of Utah, Salt Lake City, Utah. · Director of Interventional Research, Icahn School of Medicine, Mount Sinai Health System, New York, New York. · Division of Cardiology, Temple University School of Medicine, Philadelphia, Pennsylvania. · Penn Cardiovascular Outcomes, Quality & Evaluative Research Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. · Warren Alpert School of Medicine and Brown University, Rhode Island Hospital, Providence, Rhode Island. ·Catheter Cardiovasc Interv · Pubmed #28112470.

ABSTRACT: OBJECTIVES: Ascertaining risk of contrast induced acute kidney injury (CI-AKI) in ST-segment elevation myocardial infarction (STEMI) patients undergoing multi-vessel percutaneous coronary intervention (MV-PCI). BACKGROUND: Complete revascularization may improve outcomes in STEMI patients with multi-vessel disease. However, a practice of MV-PCI may be associated with a higher risk of CI-AKI. We aimed to evaluate the risk of CI-AKI in patients with STEMI and MV-PCI and examine the accuracy of a validated risk score. METHODS: We searched PubMed, Cochrane Library, EMBASE, EBSCO, Web of Science, and CINAHL databases from inception through August 31, 2016 for randomized studies comparing CI-AKI rates with MV-PCI and infarct-related artery (IRA) only PCI during index hospitalization. A random effects model was used to estimate the risk ratio (RR) and respective 95% confidence intervals (CI). We queried the Nationwide Inpatient Sample (NIS) to assess the ability of the Mehran risk score to accurately predict the incidence of CI-AKI in patients undergoing MV-PCI. RESULTS: Four randomized studies (N = 1,602) were included in the final analysis. The risk of CI-AKI was low and no difference was observed with MV-PCI (1.45%) compared with IRA-only (1.94%) (RR 0.73, 95% CI 0.34-1.57; P = 0.57). From 2009 to 2012, excluding shock, there were 11,454 MV-PCI for STEMI patients in the NIS. The Mehran risk score accurately discriminated 78% of the patients who developed CI-AKI in this cohort (c-statistic of 0.78, P = 0.002). CONCLUSIONS: MV-PCI in STEMI is not associated with a higher risk of CI-AKI and the Mehran risk score can identify patients at higher risk for this complication. © 2017 Wiley Periodicals, Inc.

24 Review 2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients With Coronary Artery Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines: An Update of the 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention, 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery, 2012 ACC/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease, 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction, 2014 AHA/ACC Guideline for the Management of Patients With Non-ST-Elevation Acute Coronary Syndromes, and 2014 ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery. 2016

Levine, Glenn N / Bates, Eric R / Bittl, John A / Brindis, Ralph G / Fihn, Stephan D / Fleisher, Lee A / Granger, Christopher B / Lange, Richard A / Mack, Michael J / Mauri, Laura / Mehran, Roxana / Mukherjee, Debabrata / Newby, L Kristin / O'Gara, Patrick T / Sabatine, Marc S / Smith, Peter K / Smith, Sidney C. ·Focused Update writing group members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. ACC/AHA Representative. Evidence Review Committee Chair. American Society of Anesthesiologists/Society of Cardiovascular Anesthesiologists Representative. American Association for Thoracic Surgery/Society of Thoracic Surgeons Representative. Society for Cardiovascular Angiography and Interventions Representative. ·Circulation · Pubmed #27026020.

ABSTRACT: -- No abstract --

25 Review Stable coronary artery disease: revascularisation and invasive strategies. 2015

Piccolo, Raffaele / Giustino, Gennaro / Mehran, Roxana / Windecker, Stephan. ·Department of Cardiology, Bern University Hospital, Bern, Switzerland. · The Zena and Michael A Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA. · The Zena and Michael A Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address: Roxana.Mehran@mountsinai.org. ·Lancet · Pubmed #26334162.

ABSTRACT: Stable coronary artery disease is the most common clinical manifestation of ischaemic heart disease and a leading cause of mortality worldwide. Myocardial revascularisation is a mainstay in the treatment of symptomatic patients or those with ischaemia-producing coronary lesions, and reduces ischaemia to a greater extent than medical treatment. Documentation of ischaemia and plaque burden is fundamental in the risk stratification of patients with stable coronary artery disease, and several invasive and non-invasive techniques are available (eg, fractional flow reserve or intravascular ultrasound) or being validated (eg, instantaneous wave-free ratio and optical coherence tomography). The use of new-generation drug-eluting stents and arterial conduits greatly improve clinical outcome in patients undergoing percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). PCI is feasible, safe, and effective in many patients with stable coronary artery disease who remain symptomatic despite medical treatment. In patients with multivessel and left main coronary artery disease, the decision between PCI or CABG is guided by the local Heart Team (team of different cardiovascular specialists, including non-invasive and invasive cardiologists, and cardiac surgeons), who carefully judge the possible benefits and risks inherent to PCI and CABG. In specific subsets, such as patients with diabetes and advanced, multivessel coronary artery disease, CABG remains the standard of care in view of improved protection against recurrent ischaemic adverse events.

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