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Coronary Artery Disease: HELP
Articles by Roxana Mehran
Based on 186 articles published since 2010
(Why 186 articles?)
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Between 2010 and 2020, R. Mehran wrote the following 186 articles about Coronary Artery Disease.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8
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 / Anonymous5500709 / Anonymous5510709 / Anonymous5520709. · ·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 Minding the Microcirculation: Is it Worth the Effort? 2019

Claessen, Bimmer E / Cao, Davide / Mehran, Roxana. ·The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York (B.E.C., D.C., R.M.). · Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy (D.C.). ·Circ Cardiovasc Interv · Pubmed #31525079.

ABSTRACT: -- No abstract --

7 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 --

8 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 --

9 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 --

10 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.

11 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 --

12 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 --

13 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 --

14 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 --

15 Editorial Evaluating the bite of the BARC. 2012

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

ABSTRACT: -- No abstract --

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

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

ABSTRACT: -- No abstract --

17 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 --

18 Review ST-segment elevation myocardial infarction. 2019

Vogel, Birgit / Claessen, Bimmer E / Arnold, Suzanne V / Chan, Danny / Cohen, David J / Giannitsis, Evangelos / Gibson, C Michael / Goto, Shinya / Katus, Hugo A / Kerneis, Mathieu / Kimura, Takeshi / Kunadian, Vijay / Pinto, Duane S / Shiomi, Hiroki / Spertus, John A / Steg, P Gabriel / Mehran, Roxana. ·The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA. · Department of Cardiovascular Medicine, Saint Luke's Mid America Heart Institute, Kansas City, MO, USA. · University of Missouri-Kansas City, Kansas City, MO, USA. · Institute of Cellular Medicine, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK. · Department of Medicine III, Institute for Cardiomyopathies Heidelberg (ICH), University of Heidelberg, Heidelberg, Germany. · Division of Cardiovascular Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. · Department of Medicine (Cardiology), Tokai University School of Medicine, Isehara, Kanagawa, Japan. · Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan. · Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK. · Division of Cardiology, Richard A. and Susan F. Smith Center for Cardiovascular Outcomes Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. · FACT, French Alliance for Cardiovascular Trials, Paris, France. · Université Paris-Diderot, Paris, France. · The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Roxana.Mehran@mountsinai.org. ·Nat Rev Dis Primers · Pubmed #31171787.

ABSTRACT: ST-segment elevation myocardial infarction (STEMI) is the most acute manifestation of coronary artery disease and is associated with great morbidity and mortality. A complete thrombotic occlusion developing from an atherosclerotic plaque in an epicardial coronary vessel is the cause of STEMI in the majority of cases. Early diagnosis and immediate reperfusion are the most effective ways to limit myocardial ischaemia and infarct size and thereby reduce the risk of post-STEMI complications and heart failure. Primary percutaneous coronary intervention (PCI) has become the preferred reperfusion strategy in patients with STEMI; if PCI cannot be performed within 120 minutes of STEMI diagnosis, fibrinolysis therapy should be administered to dissolve the occluding thrombus. The initiation of networks to provide around-the-clock cardiac catheterization availability and the generation of standard operating procedures within hospital systems have helped to reduce the time to reperfusion therapy. Together with new advances in antithrombotic therapy and preventive measures, these developments have resulted in a decrease in mortality from STEMI. However, a substantial amount of patients still experience recurrent cardiovascular events after STEMI. New insights have been gained regarding the pathophysiology of STEMI and feed into the development of new treatment strategies.

19 Review Residual angina in female patients after coronary revascularization. 2019

Vogel, Birgit / Goel, Ridhima / Kunadian, Vijay / Kalkman, Deborah N / Chieffo, Alaide / Appelman, Yolande / Mehran, Roxana. ·Icahn School of Medicine at Mount Sinai, New York, NY, USA. · Institute of Cellular Medicine, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom. · Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Cardiology, Amsterdam Universities Medical Center, location VU University Medical Center, Amsterdam, the Netherlands. · San Raffaele Hospital, Milan, Italy. · Department of Cardiology, Amsterdam Universities Medical Center, location VU University Medical Center, Amsterdam, the Netherlands. · Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address: Roxana.Mehran@mountsinai.org. ·Int J Cardiol · Pubmed #30745255.

ABSTRACT: Coronary revascularization, either percutaneous by stent implantation or surgical, has been established as the treatment of choice for patients with significant coronary stenosis. One of the main targets of coronary revascularization - especially in patients with stable disease - is to alleviate symptoms and thereby improve quality of life. Residual angina after successful coronary revascularization is not uncommon and indeed frustrating for the patient as much as for the treating physician. Several studies have shown worse outcomes in females with regard to post-revascularization morbidity and mortality in percutaneous as well as surgical coronary procedures. Although none of the studies has specifically looked at sex-related differences in residual angina after revascularization, some studies have found that female compared to male sex was a predictor of post-revascularization angina. This review article aims to summarize the results of these studies as well as to discuss the potential underlying mechanisms of these findings.

20 Review Sex Disparities in Cardiovascular Device Evaluations: Strategies for Recruitment and Retention of Female Patients in Clinical Device Trials. 2019

Ghare, M Imran / Chandrasekhar, Jaya / Mehran, Roxana / Ng, Vivian / Grines, Cindy / Lansky, Alexandra. ·Division of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut. · Icahn School of Medicine at Mount Sinai, New York, New York. · Division of Cardiology, Department of Internal Medicine, Columbia University Medical Center, New York, New York. · Department of Cardiology, Northwell Health North Shore University Hospital, Manhasset, New York. · Division of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut; BARTS Heart Center, St. Bartholomew's Hospital, and the William Harvey Research Institute, Queen Mary University of London, London, United Kingdom. Electronic address: alexandra.lansky@yale.edu. ·JACC Cardiovasc Interv · Pubmed #30732736.

ABSTRACT: Women have historically been underrepresented in clinical trials evaluating cardiovascular devices. Existing initiatives through government agencies have made some progress, but contemporary rates of female clinical trial participation leave much room for improvement. This position paper provides a narrative review and investigates reasons for the underrepresentation of women in cardiovascular trials. The observed differences in safety and/or effectiveness of devices in women warrant a campaign to increase their trial participation with the aim of better understanding and improving outcomes. The authors propose a multifaceted approach to increasing female enrollment through the development of a national public awareness and education campaign aimed to inform women, clinician-providers, and clinical research personnel of these differences. Finally, the authors visit some barriers relevant to women and recommend ways to facilitate their participation in clinical trials through multistakeholder engagement.

21 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.

22 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.

23 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.

24 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.

25 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.

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