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Coronary Artery Disease: HELP
Articles by Dr. Gregg Stone
Based on 253 articles published since 2008
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Between 2008 and 2019, Gregg Stone wrote the following 253 articles about Coronary Artery Disease.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11
1 Guideline Tissue characterisation using intravascular radiofrequency data analysis: recommendations for acquisition, analysis, interpretation and reporting. 2009

García-García, Héctor M / Mintz, Gary S / Lerman, Amir / Vince, D Geoffrey / Margolis, M Paulina / van Es, Gerrit-Anne / Morel, Marie-Angèle M / Nair, Anuja / Virmani, Renu / Burke, Allen P / Stone, Gregg W / Serruys, Patrick W. ·Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands. ·EuroIntervention · Pubmed #20449928.

ABSTRACT: This document suggests standards for the acquisition, measurement, and reporting of radiofrequency data analysis (virtual histology - VH) intravascular ultrasound (IVUS) studies. Readers should view this document as the authors' best attempt in an area of rapidly evolving investigation, an area where rigorous evidence is not yet available or widely accepted. Nevertheless, this document is based on known pathologic data as well as previously reported imaging data; where practical, this data is summarised in the current document, a document which will also include recommendations for future evolution of the technology.

2 Editorial Multivessel PCI on its 40th anniversary: finally a match for CABG? 2017

Stone, Gregg W. ·New York Presbyterian Hospital, Columbia University Medical Center and the Cardiovascular Research Foundation, New York, NY, USA. ·Eur Heart J · Pubmed #29020370.

ABSTRACT: -- No abstract --

3 Editorial High-Risk Coronary Atherosclerosis: Is It the Plaque Burden, the Calcium, the Lipid, or Something Else? 2017

Maehara, Akiko / Stone, Gregg W. ·From the Department of Medicine, Division of Cardiology, Columbia University Medical Center, The Cardiovascular Research Foundation; and Department of Medicine, Division of Cardiology, Cardiovascular Research Foundation, New York, NY. ·Circ Cardiovasc Imaging · Pubmed #28982648.

ABSTRACT: -- No abstract --

4 Editorial Myocardial Infarction After Percutaneous Coronary Intervention and Coronary Artery Bypass Graft Surgery: Time for a Unifying Common Definition. 2017

Moussa, Issam D / Stone, Gregg W. ·Division of Cardiovascular Diseases and Hypertension, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey. Electronic address: issam.moussa@rutgers.edu. · Division of Cardiology, New York Presbyterian Hospital and Columbia University Medical Center, New York, New York. ·JACC Cardiovasc Interv · Pubmed #28797426.

ABSTRACT: -- No abstract --

5 Editorial Left main revascularization: surgical and interventional perspectives. 2015

Sabik, Joseph F / Stone, Gregg W. ·Cleveland Clinic Foundation, Cleveland, Ohio. · Columbia University Medical Center and the Cardiovascular Research Foundation, New York, New York. Electronic address: gs2184@columbia.edu. ·J Am Coll Cardiol · Pubmed #25998666.

ABSTRACT: -- No abstract --

6 Editorial Fractional flow reserve for the evaluation of coronary stenoses: limitations and alternatives. 2015

Jeremias, Allen / Stone, Gregg W. ·Stony Brook University Medical Center, Stony Brook, New York; Cardiovascular Research Foundation, New York, New York. ·Catheter Cardiovasc Interv · Pubmed #25702910.

ABSTRACT: -- No abstract --

7 Editorial Revascularization decisions in coronary artery disease: hitting a moving target. 2014

Stone, Gregg W. ·Columbia University Medical Center and the Cardiovascular Research Foundation, New York, New York. Electronic address: gs2184@columbia.edu. ·JACC Cardiovasc Interv · Pubmed #24746651.

ABSTRACT: -- No abstract --

8 Editorial The myth of the mild vulnerable plaques. 2013

Stone, Gregg W / Narula, Jagat. ·Columbia University Medical Center and the Cardiovascular Research Foundation, New York, New York. · Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: jagat.narula@mountsinai.org. ·JACC Cardiovasc Imaging · Pubmed #24135329.

ABSTRACT: -- No abstract --

9 Editorial OCT versus IVUS: accuracy versus clinical utility. 2013

Maehara, Akiko / Mintz, Gary S / Stone, Gregg W. ·Columbia University Medical Center and New York-Presbyterian Hospital, New York, New York; The Cardiovascular Research Foundation, New York, New York. · The Cardiovascular Research Foundation, New York, New York. · Columbia University Medical Center and New York-Presbyterian Hospital, New York, New York; The Cardiovascular Research Foundation, New York, New York. Electronic address: gs2184@columbia.edu. ·JACC Cardiovasc Imaging · Pubmed #24135323.

ABSTRACT: -- No abstract --

10 Editorial In search of vulnerable plaque. 2012

Stone, Gregg W. · ·Circ Cardiovasc Imaging · Pubmed #22811414.

ABSTRACT: -- No abstract --

11 Editorial The reality of vulnerable plaque detection. 2011

Stone, Gregg W / Maehara, Akiko / Mintz, Gary S. · ·JACC Cardiovasc Imaging · Pubmed #21835383.

ABSTRACT: -- No abstract --

12 Editorial Everolimus-eluting stents: insights from the SPIRIT IV and COMPARE trials. 2010

Kedhi, Elvin / Stone, Gregg W. · ·Expert Rev Cardiovasc Ther · Pubmed #20828341.

ABSTRACT: -- No abstract --

13 Review Percutaneous coronary intervention or coronary artery bypass graft in left main coronary artery disease: a comprehensive meta-analysis of adjusted observational studies and randomized controlled trials. 2018

Bertaina, Maurizio / De Filippo, Ovidio / Iannaccone, Mario / Colombo, Antonio / Stone, Gregg / Serruys, Patrick / Mancone, Massimo / Omedè, Pierluigi / Conrotto, Federico / Pennone, Mauro / Kimura, Takeshi / Kawamoto, Hiroyoshi / Zoccai, Giuseppe Biondi / Sheiban, Imad / Templin, Christian / Benedetto, Umberto / Cavalcante, Rafael / D'Amico, Maurizio / Gaudino, Mario / Moretti, Claudio / Gaita, Fiorenzo / D'Ascenzo, Fabrizio. ·Division of Cardiology, Città Della Salute e della Scienza, Molinette Hospital, Turin. · Interventional Cardiology, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy. · Cardiovascular Research and Education Columbia University Medical Center, Presbyterian Hospital, New York, USA. · Department of Interventional Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands. · Department of Cardiovascular, Respiratory, Nephrology, Anesthesiology and Geriatric Sciences, University 'La Sapienza' of Rome, Rome, Italy. · Department of Cardiovascular Medicine, Kyoto University, Japan. · Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina. · Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli. · Cardiology Department, Pederzoli Hospital, Verona, Italy. · University Heart Center, Department of Cardiology, University Hospital Zurich, Zurich, Switzerland. · Bristol Heart Institute, University of Bristol, School of Clinical Sciences, Bristol, United Kingdom. · Department of Cardiothoracic Surgery, Weill Cornell Medical College, New York, New York, USA. ·J Cardiovasc Med (Hagerstown) · Pubmed #30095584.

ABSTRACT: BACKGROUND: Treatment of patients with ULMCA (unprotected left main coronary artery disease) with percutaneous coronary intervention (PCI) has been compared with coronary artery bypass graft (CABG), without conclusive results. METHODS: All randomized controlled trials (RCTs) and observational studies with multivariate analysis comparing PCI and CABG for ULMCA were included. Major cardiovascular events (MACEs, composite of all-cause death, MI, definite or probable ST, target vessel revascularization and stroke) were the primary end points, whereas its single components were the secondary ones, along with stent thrombosis, graft occlusion and in-hospital death and stroke. Subgroup analyses were performed according to Syntax score. RESULTS: Six RCTs (4717 patients) and 20 observational studies with multivariate adjustment (14 597 patients) were included. After 5 (3-5.5) years, MACE rate was higher for PCI [odds ratio (OR) 1.10, 95% confidence interval (CI) 1.07-1.14], without difference in death, whereas more relevant risk of MI was because of observational studies. Coronary stenting increased risk of revascularization (OR 1.52; 95% CI 1.34-1.72). At meta-regression, performance of PCI was improved by use of intra-coronary imaging and worsened by first generation stents, whereas two arterial grafts increased benefit of CABG. For patients with Syntax score less than 22, MACE rates did not differ, whereas for higher values, CABG reduced MACE because of lower risk of revascularization. Incidence of graft occlusion was 3.24% (2.25-4.23), whereas 2.13% (1.28-2.98: all CI 95%) of patients experienced stent thrombosis. CONCLUSION: Surgical revascularization reduces risk of revascularization for ULMCA patients, especially for those with Syntax score greater than 22, with a higher risk of in-hospital death. Intra-coronary imaging and use of arterial grafts improved performance of revascularization strategies.

14 Review Algorithmic Approach for Optical Coherence Tomography-Guided Stent Implantation During Percutaneous Coronary Intervention. 2018

Shlofmitz, Evan / Shlofmitz, Richard A / Galougahi, Keyvan Karimi / Rahim, Hussein M / Virmani, Renu / Hill, Jonathan M / Matsumura, Mitsuaki / Mintz, Gary S / Maehara, Akiko / Landmesser, Ulf / Stone, Gregg W / Ali, Ziad A. ·Center for Interventional Vascular Therapy, Division of Cardiology, NewYork-Presbyterian Hospital, Columbia University Medical Center, 161 Fort Washington Avenue, New York, NY 10032, USA; Department of Cardiology, St. Francis Hospital, 100 Port Washington Boulevard, Suite 105, Roslyn, NY 11576, USA; Clinical Trials Center, Cardiovascular Research Foundation, 1700 Broadway 9th Floor, New York, NY 10019, USA. · Department of Cardiology, St. Francis Hospital, 100 Port Washington Boulevard, Suite 105, Roslyn, NY 11576, USA. · Center for Interventional Vascular Therapy, Division of Cardiology, NewYork-Presbyterian Hospital, Columbia University Medical Center, 161 Fort Washington Avenue, New York, NY 10032, USA. · CVPath Institute, 19 Firstfield Road, Gaithersburg, MD 20878, USA. · London Bridge Hospital, 2nd Floor, St Olaf House, London SE1 2PR, UK; Department of Cardiology, King's College Hospital, Denmark Hill, London, SE5 9RS, UK. · Clinical Trials Center, Cardiovascular Research Foundation, 1700 Broadway 9th Floor, New York, NY 10019, USA. · Center for Interventional Vascular Therapy, Division of Cardiology, NewYork-Presbyterian Hospital, Columbia University Medical Center, 161 Fort Washington Avenue, New York, NY 10032, USA; Clinical Trials Center, Cardiovascular Research Foundation, 1700 Broadway 9th Floor, New York, NY 10019, USA. · Department of Cardiology, Charité - Universitätsmedizin Berlin, Hindenburgdamm 30, Berlin 12200, Germany. · Center for Interventional Vascular Therapy, Division of Cardiology, NewYork-Presbyterian Hospital, Columbia University Medical Center, 161 Fort Washington Avenue, New York, NY 10032, USA; Department of Cardiology, St. Francis Hospital, 100 Port Washington Boulevard, Suite 105, Roslyn, NY 11576, USA; Clinical Trials Center, Cardiovascular Research Foundation, 1700 Broadway 9th Floor, New York, NY 10019, USA. Electronic address: zaa2112@columbia.edu. ·Interv Cardiol Clin · Pubmed #29983145.

ABSTRACT: Intravascular imaging plays a key role in optimizing outcomes for percutaneous coronary intervention (PCI). Optical coherence tomography (OCT) utilizes a user-friendly interface and provides high-resolution images. OCT can be used as part of daily practice in all stages of a coronary intervention: baseline lesion assessment, stent selection, and stent optimization. Incorporating a standardized, algorithmic approach when using OCT allows for precision PCI.

15 Review Imaging-guided pre-dilatation, stenting, post-dilatation: a protocolized approach highlighting the importance of intravascular imaging for implantation of bioresorbable scaffolds. 2018

Ali, Ziad A / Karimi Galougahi, Keyvan / Shlofmitz, Richard / Maehara, Akiko / Mintz, Gary S / Abizaid, Alexandre / Chamié, Daniel / Hill, Jonathan / Serruys, Patrick W / Onuma, Yoshinobu / Stone, Gregg W. ·a Clinical Trials Center, Cardiovascular Research Foundation , New York , NY , USA. · b Department of Cardiology , NewYork-Presbyterian Hospital/Columbia University Medical Center , New York , NY , USA. · c Department of Cardiology , St Francis Hospital , Roslyn , NY , USA. · d Department of Cardiology , Instituto Dante Pazzanese of Cardiology , São Paulo , Brazil. · e Department of Cardiology , Cardiovascular Research Center , São Paulo , Brazil. · f Department of Cardiology , King's College , London , UK. · g Imperial College of Science, Technology and Medicine , London , UK. · h Thoraxcenter, Erasmus Medical Center , Rotterdam , The Netherlands. ·Expert Rev Cardiovasc Ther · Pubmed #29732926.

ABSTRACT: INTRODUCTION: The advent of the fully bioresorbable vascular scaffold (BVS) is the latest step in a series of advancements in the design of intracoronary stents over the past few decades. The novelty of this technology is in providing temporary vessel scaffolding and local antiproliferative therapy to prevent neointimal hyperplasia after percutaneous coronary intervention followed by gradual resorption of the scaffold to restore the native vessel anatomy and physiology - a process termed vascular reparative therapy. Areas covered: The first generation of BVS has not been able to fully match the high benchmark in safety and efficacy set by contemporary metallic drug-eluting stents. These shortcomings of BVS may be due to factors related to the device itself, the complexity of the underlying lesion, or the implantation technique. Expert commentary: Here, how intravascular imaging may be used to minimize these shortcomings is described and moreover, an imaging-guided step-by-step approach for BVS implantation that integrates the recently described pre-dilatation, stenting, post-dilatation (PSP) strategy is explained.

16 Review Mortality after coronary artery bypass grafting versus percutaneous coronary intervention with stenting for coronary artery disease: a pooled analysis of individual patient data. 2018

Head, Stuart J / Milojevic, Milan / Daemen, Joost / Ahn, Jung-Min / Boersma, Eric / Christiansen, Evald H / Domanski, Michael J / Farkouh, Michael E / Flather, Marcus / Fuster, Valentin / Hlatky, Mark A / Holm, Niels R / Hueb, Whady A / Kamalesh, Masoor / Kim, Young-Hak / Mäkikallio, Timo / Mohr, Friedrich W / Papageorgiou, Grigorios / Park, Seung-Jung / Rodriguez, Alfredo E / Sabik, Joseph F / Stables, Rodney H / Stone, Gregg W / Serruys, Patrick W / Kappetein, Arie Pieter. ·Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, Netherlands. Electronic address: s.head@erasmusmc.nl. · Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, Netherlands. · Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands. · Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea. · Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark. · Icahn School of Medicine at Mount Sinai, New York, NY, USA; Peter Munk Cardiac Centre and the Heart and Stroke Richard Lewar Centre, University of Toronto, Toronto, ON, Canada. · Norwich Medical School University of East Anglia and Norfolk and Norwich University Hospital, Norwich, UK. · Icahn School of Medicine at Mount Sinai, New York, NY, USA. · Stanford University School of Medicine, Stanford, CA, USA. · Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil. · Richard L Roudebush VA Medical Center, Indianapolis, IN, USA. · Department of Cardiology, Oulu University Hospital, Oulu, Finland. · Department of Cardiac Surgery, Herzzentrum Universität Leipzig, Leipzig, Germany. · Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, Netherlands; Department of Biostatistics, Erasmus University Medical Center, Rotterdam, Netherlands. · Cardiac Unit, Otamendi Hospital, Buenos Aires, Argentina. · Department Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA. · Institute of Cardiovascular Medicine and Science, Liverpool Heart and Chest Hospital, Liverpool, UK. · Columbia University Medical Center and the Center for Clinical Trials, Cardiovascular Research Foundation, New York, NY, USA. · Imperial College London, London, UK. ·Lancet · Pubmed #29478841.

ABSTRACT: BACKGROUND: Numerous randomised trials have compared coronary artery bypass grafting (CABG) with percutaneous coronary intervention (PCI) for patients with coronary artery disease. However, no studies have been powered to detect a difference in mortality between the revascularisation strategies. METHODS: We did a systematic review up to July 19, 2017, to identify randomised clinical trials comparing CABG with PCI using stents. Eligible studies included patients with multivessel or left main coronary artery disease who did not present with acute myocardial infarction, did PCI with stents (bare-metal or drug-eluting), and had more than 1 year of follow-up for all-cause mortality. In a collaborative, pooled analysis of individual patient data from the identified trials, we estimated all-cause mortality up to 5 years using Kaplan-Meier analyses and compared PCI with CABG using a random-effects Cox proportional-hazards model stratified by trial. Consistency of treatment effect was explored in subgroup analyses, with subgroups defined according to baseline clinical and anatomical characteristics. FINDINGS: We included 11 randomised trials involving 11 518 patients selected by heart teams who were assigned to PCI (n=5753) or to CABG (n=5765). 976 patients died over a mean follow-up of 3·8 years (SD 1·4). Mean Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) score was 26·0 (SD 9·5), with 1798 (22·1%) of 8138 patients having a SYNTAX score of 33 or higher. 5 year all-cause mortality was 11·2% after PCI and 9·2% after CABG (hazard ratio [HR] 1·20, 95% CI 1·06-1·37; p=0·0038). 5 year all-cause mortality was significantly different between the interventions in patients with multivessel disease (11·5% after PCI vs 8·9% after CABG; HR 1·28, 95% CI 1·09-1·49; p=0·0019), including in those with diabetes (15·5% vs 10·0%; 1·48, 1·19-1·84; p=0·0004), but not in those without diabetes (8·7% vs 8·0%; 1·08, 0·86-1·36; p=0·49). SYNTAX score had a significant effect on the difference between the interventions in multivessel disease. 5 year all-cause mortality was similar between the interventions in patients with left main disease (10·7% after PCI vs 10·5% after CABG; 1·07, 0·87-1·33; p=0·52), regardless of diabetes status and SYNTAX score. INTERPRETATION: CABG had a mortality benefit over PCI in patients with multivessel disease, particularly those with diabetes and higher coronary complexity. No benefit for CABG over PCI was seen in patients with left main disease. Longer follow-up is needed to better define mortality differences between the revascularisation strategies. FUNDING: None.

17 Review Intracoronary Optical Coherence Tomography 2018: Current Status and Future Directions. 2017

Ali, Ziad A / Karimi Galougahi, Keyvan / Maehara, Akiko / Shlofmitz, Richard A / Ben-Yehuda, Ori / Mintz, Gary S / Stone, Gregg W. ·Center for Interventional Vascular Therapy, Division of Cardiology, Presbyterian Hospital and Columbia University, New York, New York; Cardiovascular Research Foundation, New York, New York. Electronic address: zaa2112@columbia.edu. · Center for Interventional Vascular Therapy, Division of Cardiology, Presbyterian Hospital and Columbia University, New York, New York. · Center for Interventional Vascular Therapy, Division of Cardiology, Presbyterian Hospital and Columbia University, New York, New York; Cardiovascular Research Foundation, New York, New York. · Department of Cardiology, St. Francis Hospital, Roslyn, New York. · Cardiovascular Research Foundation, New York, New York. ·JACC Cardiovasc Interv · Pubmed #29268880.

ABSTRACT: The advent of intravascular imaging has been a significant advancement in visualization of coronary arteries, particularly with optical coherence tomography (OCT) that allows for high-resolution imaging of intraluminal and transmural coronary structures. Accumulating data support a clinical role for OCT in a multitude of clinical scenarios, including assessing the natural history of atherosclerosis and modulating effects of therapies, mechanisms of acute coronary syndromes, mechanistic insights into the effects of novel interventional devices, and optimization of percutaneous coronary intervention. In this state-of-the-art review, we provide an overview of the published data on the clinical utility of OCT, highlighting the areas that need further investigation and the current barriers for further adoption of OCT in interventional cardiology practice.

18 Review IVUS-Guided Versus OCT-Guided Coronary Stent Implantation: A Critical Appraisal. 2017

Maehara, Akiko / Matsumura, Mitsuaki / Ali, Ziad A / Mintz, Gary S / Stone, Gregg W. ·Center for Interventional Vascular Therapy, Division of Cardiology, New York-Presbyterian Hospital/Columbia University Medical Center, New York, New York; Clinical Trials Center, Cardiovascular Research Foundation, New York, New York. Electronic address: amaehara@crf.org. · Clinical Trials Center, Cardiovascular Research Foundation, New York, New York. · Center for Interventional Vascular Therapy, Division of Cardiology, New York-Presbyterian Hospital/Columbia University Medical Center, New York, New York; Clinical Trials Center, Cardiovascular Research Foundation, New York, New York. ·JACC Cardiovasc Imaging · Pubmed #29216976.

ABSTRACT: Procedural guidance with intravascular ultrasound (IVUS) imaging improves the clinical outcomes of patients undergoing percutaneous coronary intervention (PCI) by: 1) informing the necessity for lesion preparation; 2) directing appropriate stent sizing to maximize the final stent area and minimize geographic miss; 3) selecting the optimal stent length to cover residual disease adjacent to the lesion, thus minimizing geographic miss; 4) guiding optimal stent expansion; 5) identifying acute complications (edge dissection, stent malapposition, tissue protrusion); and 6) clarifying the mechanism of late stent failure (stent thrombosis, neointimal hyperplasia, stent underexpansion or fracture, or neoatherosclerosis). Optical coherence tomography (OCT) provides similar information to IVUS (with some important differences), also potentially improving acute and long-term patient outcomes compared to angiography-guided PCI. The purpose of this review is to describe the similarities and differences between IVUS and OCT technologies, and to highlight the evidence supporting their utility to improve PCI outcomes.

19 Review Imaging and Physiology to Guide Venous Graft Interventions Without Contrast Administration in Advanced Renal Failure. 2017

Parviz, Yasir / Fall, Khady / Stone, Gregg W / Maehara, Akiko / Ben-Yehuda, Ori / Mintz, Gary S / Ali, Ziad A. ·Center for Interventional Vascular Therapy, New York-Presbyterian Hospital and Columbia University, 161 Fort Washington Ave, New York, NY 10032 USA. zaa2112@columbia.edu. ·J Invasive Cardiol · Pubmed #29086735.

ABSTRACT: We describe step-by-step "zero-contrast" saphenous vein bypass graft intervention using a modified technique.

20 Review Impact of design of coronary stents and length of dual antiplatelet therapies on ischaemic and bleeding events: a network meta-analysis of 64 randomized controlled trials and 102 735 patients. 2017

D'Ascenzo, Fabrizio / Iannaccone, Mario / Saint-Hilary, Gaelle / Bertaina, Maurizio / Schulz-Schüpke, Stefanie / Wahn Lee, Cheol / Chieffo, Alaide / Helft, Gerard / Gili, Sebastiano / Barbero, Umberto / Biondi Zoccai, Giuseppe / Moretti, Claudio / Ugo, Fabrizio / D'Amico, Maurizio / Garbo, Roberto / Stone, Gregg / Rettegno, Sara / Omedè, Pierluigi / Conrotto, Federico / Templin, Christian / Colombo, Antonio / Park, Seung-Jung / Kastrati, Adnan / Hildick-Smith, David / Gasparini, Mauro / Gaita, Fiorenzo. ·Department of Cardiology, Città Della Salute e della Scienza Hospital, Corso Bramante 88/90, 10126 Turin, Italy. · Department of Cardiology, San Giovanni Bosco Hospital, Piazza del Donatore di Sangue 3, 10154 Turin, Italy. · Department of Mathematical Sciences "G. L. Lagrange", Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy. · Department of Cardiology, Deutsches Herzzentrum München, Technische Universität München Lazarettstrasse 36, Munich 80636, Germany. · Department of Cardiology, The Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea. · Interventional Cardiology Unit, San Raffaele Scientific Institute, Via Olgettina Milano, 60, 20132 Milan, Italy. · Department of Cardiology, Cardiology Institute, Pitié-Salpêtrière Hospital, UPMC, APHP, 47-83 Boulevard de l'Hôpital, 75013 Paris, France. · Department of Cardiology, University Heart Center, University Hospital Zurich, Rämistrasse 100, 8091 Zürich, Switzerland. · Department of Cardiology, La Sapienza, Piazzale Aldo Moro, 5, 00185 Rome, Italy. · Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso Della Repubblica 79, 04100 Latina, Italy. · Department of AngioCardioNeurology, IRCCS Neuromed, Via Atinense, 18, 86077 Pozzilli, Italy. · Department of Cardiology, Columbia University Medical Center, USA Cardiovascular Research Foundation, 161 Ft. Washington Ave. Herbert Irving Pavilion 6th Floor, New York, NY 10032 212.305.7060, USA. · Department of Cardiology, Sussex Cardiac Centre, Barry Building, Eastern Rd, Brighton BN2 5BE, UK. ·Eur Heart J · Pubmed #29020300.

ABSTRACT: Aims: The differential impact on ischaemic and bleeding events of the type of drug-eluting stent [durable polymer stents [DES] vs. biodegradable polymer stents vs. bioresorbable scaffolds (BRS)] and length of dual antiplatelet therapy (DAPT) remains to be defined. Methods and results: Randomized controlled trials comparing different types of DES and/or DAPT durations were selected. The primary endpoint was Major Adverse Cardiovascular Events (MACE) [a composite of death, myocardial infarction (MI), and target vessel revascularization]. Definite stent thrombosis (ST) and single components of MACE were secondary endpoints. The arms of interest were: BRS with 12 months of DAPT (12mDAPT), biodegradable polymer stent with 12mDAPT, durable polymer stent [everolimus-eluting (EES), zotarolimus-eluting (ZES)] with 12mDAPT, EES/ZES with <12 months of DAPT, and EES/ZES with >12 months of DAPT (DAPT > 12 m). Sixty-four studies with 150 arms and 102 735 patients were included. After a median follow-up of 20 months, MACE rates were similar in the different arms of interest. EES/ZES with DAPT > 12 m reported a lower incidence of MI than the other groups, while BRS showed a higher rate of ST when compared to EES/ZES, irrespective of DAPT length. A higher risk of major bleedings was observed for DAPT > 12 m as compared to shorter DAPT. Conclusion: Durable and biodegradable polymer stents along with BRS report a similar rate of MACE irrespective of DAPT length. Fewer MI are observed with EES/ZES with DAPT > 12 m, while a higher rate of ST is reported for BRS when compared to EES/ZES, independently from DAPT length. Stent type may partially affect the outcome together with DAPT length.

21 Review State of the art: the inception, advent and future of fully bioresorbable scaffolds. 2017

Katagiri, Yuki / Stone, Gregg W / Onuma, Yoshinobu / Serruys, Patrick W. ·Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands. ·EuroIntervention · Pubmed #28844034.

ABSTRACT: To overcome the limitations of metallic stents, the development of the bioresorbable vascular scaffold started about 30 years ago. Researchers anticipated a transformative revolution from "vascular reparative therapy" by BRS at the beginning of its development. To date, there are five commercially available bioresorbable scaffolds which have already gained CE mark. However, recent studies, including randomised trials and meta-analyses evaluating clinical results of BRS, have raised concerns about the safety and efficacy of the device in the first few years prior to its complete bioresorption, compared to contemporary metallic DES. As one of the efforts to address these concerns, the impact of implantation technique was investigated. In addition, there are several aspects to be improved such as mechanical integrity, strut configuration, and late structural discontinuity. Intensive researches into the underlying causes of the greater device thrombosis rates with BRS have stimulated improvement of implantation technique and the development of next-generation BRS. Just as we have witnessed the evolution from first- to second-generation metallic DES, we anticipate that future generations of BRS with thinner struts and enhanced mechanical properties will result in substantially improved intermediate-term outcomes and safety.

22 Review Clinical outcomes with percutaneous coronary revascularization vs coronary artery bypass grafting surgery in patients with unprotected left main coronary artery disease: A meta-analysis of 6 randomized trials and 4,686 patients. 2017

Palmerini, Tullio / Serruys, Patrick / Kappetein, Arie Pieter / Genereux, Philippe / Riva, Diego Della / Reggiani, Letizia Bacchi / Christiansen, Evald Høj / Holm, Niels R / Thuesen, Leif / Makikallio, Timo / Morice, Marie Claude / Ahn, Jung-Min / Park, Seung-Jung / Thiele, Holger / Boudriot, Enno / Sabatino, Mario / Romanello, Mattia / Biondi-Zoccai, Giuseppe / Cavalcante, Raphael / Sabik, Joseph F / Stone, Gregg W. ·Polo Cardio-Toraco-Vascolare, Policlinico S. Orsola, Bologna, Italy. · International Centre for Circulatory Health, NHLI, Imperial College London, London, United Kingdom. · Department of Cardiothoracic Surgery, Erasmus Medical Center, Rotterdam, the Netherlands. · Columbia University Medical Center and the Cardiovascular Research Foundation, New York, NY; Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada; Morristown Medical Center, Morristown, NJ. · Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark. · Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark. · Department of Cardiology, Oulu University Hospital, Oulu, Finland. · MC Moriec Ramsay Générale de Santé, ICPS, Massy, France. · The Heart Institute, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea. · University Heart Center Lübeck and the German Center for Cardiovascular Research (DZHK), Lübeck, Germany. · Department of Internal Medicine/Cardiology, University Heart Center, Leipzig, Germany. · Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy; Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy. · Department of Interventional Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands. · The Cleveland Clinic Foundation, Cleveland, OH. · Columbia University Medical Center and the Cardiovascular Research Foundation, New York, NY. Electronic address: gs2184@columbia.edu. ·Am Heart J · Pubmed #28760214.

ABSTRACT: Some but not all randomized controlled trials (RCT) have suggested that percutaneous coronary intervention (PCI) with drug-eluting stents may be an acceptable alternative to coronary artery bypass grafting (CABG) surgery for the treatment of unprotected left main coronary artery disease (ULMCAD). We therefore aimed to compare the risk of all-cause mortality between PCI and CABG in patients with ULMCAD in a pairwise meta-analysis of RCT. METHODS: Randomized controlled trials comparing PCI vs CABG for the treatment of ULMCAD were searched through MEDLINE, EMBASE, Cochrane databases, and proceedings of international meetings. RESULTS: Six trials including 4,686 randomized patients were identified. After a median follow-up of 39 months, there were no significant differences between PCI vs CABG in the risk of all-cause mortality (hazard ratio [HR] 0.99, 95% CI 0.76-1.30) or cardiac mortality. However, a significant interaction for cardiac mortality (P CONCLUSIONS: In patients undergoing revascularization for ULMCAD, PCI was associated with similar rates of mortality compared with CABG at a median follow-up of 39 months, but with an interaction effect suggesting relatively lower mortality with PCI in patients with low SYNTAX score and relatively lower mortality with CABG in patients with high SYNTAX score. Both procedures resulted in similar long-term composite rates of death, myocardial infarction, or stroke, with PCI offering an early safety advantage and CABG demonstrating greater durability.

23 Review 2-year outcomes with the Absorb bioresorbable scaffold for treatment of coronary artery disease: a systematic review and meta-analysis of seven randomised trials with an individual patient data substudy. 2017

Ali, Ziad A / Serruys, Patrick W / Kimura, Takeshi / Gao, Runlin / Ellis, Stephen G / Kereiakes, Dean J / Onuma, Yoshinobu / Simonton, Charles / Zhang, Zhen / Stone, Gregg W. ·New York Presbyterian Hospital, Columbia University Medical Center and the Cardiovascular Research Foundation, New York, NY, USA. · International Centre for Cardiovascular Health, Imperial College, London, London, UK. · Kyoto University Hospital, Kyoto, Japan. · Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China. · Cleveland Clinic, Cleveland, OH, USA. · The Christ Hospital, Heart and Vascular Center, Lindner Research Center, Cincinnati, OH, USA. · Thoraxcenter, Erasmus Medical Center, Rotterdam, Netherlands. · Abbott Vascular, Santa Clara, CA, USA. · New York Presbyterian Hospital, Columbia University Medical Center and the Cardiovascular Research Foundation, New York, NY, USA. Electronic address: gs2184@columbia.edu. ·Lancet · Pubmed #28732815.

ABSTRACT: BACKGROUND: Bioresorbable vascular scaffolds (BVS) offer the potential to improve long-term outcomes of percutaneous coronary intervention after their complete bioresorption. Randomised trials have shown non-inferiority between BVS and metallic drug-eluting stents at 1 year in composite safety and effectiveness outcomes, although some increases in rates of target vessel-related myocardial infarction and device thrombosis were identified. Outcomes of BVS following the first year after implantation are unknown. We sought to ascertain whether BVS are as safe and effective as drug-eluting stents within 2 years after implantation and between 1 and 2 years. METHODS: We did a systematic review and meta-analysis of randomised trials in which patients were randomly assigned to everolimus-eluting Absorb BVS or metallic everolimus-eluting stents (EES) and followed up for at least 2 years. We searched MEDLINE, the Cochrane database, TCTMD, ClinicalTrials.gov, Clinical Trial Results, CardioSource, and abstracts and presentations from major cardiovascular meetings up to April 1, 2017, to identify relevant studies. The primary efficacy outcome measure was the device-oriented composite endpoint (cardiac mortality, target vessel-related myocardial infarction, or ischaemia-driven target lesion revascularisation) and the primary safety outcome measure was definite or probable device thrombosis. Individual patient data from the four ABSORB trials were used for landmark and subgroup analysis and multivariable modelling. FINDINGS: We identified seven randomised trials in which 5583 patients were randomly assigned to Absorb BVS (n=3261) or metallic EES (n=2322) and followed up for 2 years. BVS had higher 2-year relative risks of the device-oriented composite endpoint than did EES (9·4% [304 of 3217] vs 7·4% [169 of 2299]; relative risk [RR] 1·29 [95% CI 1·08-1·56], p=0·0059). These differences were driven by increased rates of target vessel-related myocardial infarction (5·8% [187 of 3218] vs 3·2% [74 of 2299]; RR 1·68 [95% CI 1·29-2·19], p=0·0003) and ischaemia-driven target lesion revascularisation (5·3% [169 of 3217] vs 3·9% [90 of 2300]; 1·40 [1·09-1·80], p=0·0090) with BVS, with non-significant differences in cardiac mortality. The cumulative 2-year incidence of device thrombosis was higher with BVS than with EES (2·3% [73 of 3187] vs 0·7% [16 of 2281]; RR 3·35 [95% CI 1·96-5·72], p<0·0001). Landmark analysis between 1 and 2 years also showed higher rates of the device-oriented composite endpoint (3·3% [69 of 2100] vs 1·9% [23 of 1193]; RR 1·64 [95% CI 1·03-2·61], p=0·0376) and device thrombosis (0·5% [11 of 2085] vs none [0 of 1183], p<0·0001) in BVS-treated patients than in EES-treated patients. INTERPRETATION: BVS was associated with increased rates of composite device-oriented adverse events and device thrombosis cumulatively at 2 years and between 1 and 2 years of follow-up compared with EES. FUNDING: Abbott Vascular.

24 Review Derivation and validation of the predicting bleeding complications in patients undergoing stent implantation and subsequent dual antiplatelet therapy (PRECISE-DAPT) score: a pooled analysis of individual-patient datasets from clinical trials. 2017

Costa, Francesco / van Klaveren, David / James, Stefan / Heg, Dik / Räber, Lorenz / Feres, Fausto / Pilgrim, Thomas / Hong, Myeong-Ki / Kim, Hyo-Soo / Colombo, Antonio / Steg, Philippe Gabriel / Zanchin, Thomas / Palmerini, Tullio / Wallentin, Lars / Bhatt, Deepak L / Stone, Gregg W / Windecker, Stephan / Steyerberg, Ewout W / Valgimigli, Marco / Anonymous4670899. ·Swiss Cardiovascular Center Bern, Bern University Hospital, Bern, Switzerland; Erasmus University Medical Center, Rotterdam, Netherlands; Department of Clinical and Experimental Medicine, Policlinic "G Martino", University of Messina, Messina, Italy. · Erasmus University Medical Center, Rotterdam, Netherlands; Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA. · Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden. · Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland. · Swiss Cardiovascular Center Bern, Bern University Hospital, Bern, Switzerland. · Istituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil. · Severance Cardiovascular Hospital, Yonsei University College of Medicine and Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea. · Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea. · EMO-GVM Centro Cuore Columbus, Milan, Italy; Interventional Cardiology Department, San Raffaele Scientific Institute, Milan, Italy. · Department of Cardiology, Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, Paris, France. · Dipartimento Cardio-Toraco-Vascolare, University of Bologna, Bologna, Italy. · Brigham and Women's Hospital Heart & Vascular Center and Harvard Medical School, Boston, MA, USA. · Columbia University Medical Center/New York-Presbyterian Hospital and the Cardiovascular Research Foundation, New York, NY, USA. · Erasmus University Medical Center, Rotterdam, Netherlands. · Swiss Cardiovascular Center Bern, Bern University Hospital, Bern, Switzerland; Erasmus University Medical Center, Rotterdam, Netherlands. Electronic address: marco.valgimigli@insel.ch. ·Lancet · Pubmed #28290994.

ABSTRACT: BACKGROUND: Dual antiplatelet therapy (DAPT) with aspirin plus a P2Y METHODS: A total of 14 963 patients treated with DAPT after coronary stenting-largely consisting of aspirin and clopidogrel and without indication to oral anticoagulation-were pooled at a single-patient level from eight multicentre randomised clinical trials with independent adjudication of events. Using Cox proportional hazards regression, we identified predictors of out-of-hospital Thrombosis in Myocardial Infarction (TIMI) major or minor bleeding stratified by trial, and developed a numerical bleeding risk score. The predictive performance of the novel score was assessed in the derivation cohort and validated in patients treated with percutaneous coronary intervention from the PLATelet inhibition and patient Outcomes (PLATO) trial (n=8595) and BernPCI registry (n=6172). The novel score was assessed within patients randomised to different DAPT durations (n=10 081) to identify the effect on bleeding and ischaemia of a long (12-24 months) or short (3-6 months) treatment in relation to baseline bleeding risk. FINDINGS: The PRECISE-DAPT score (age, creatinine clearance, haemoglobin, white-blood-cell count, and previous spontaneous bleeding) showed a c-index for out-of-hospital TIMI major or minor bleeding of 0·73 (95% CI 0·61-0·85) in the derivation cohort, and 0·70 (0·65-0·74) in the PLATO trial validation cohort and 0·66 (0·61-0·71) in the BernPCI registry validation cohort. A longer DAPT duration significantly increased bleeding in patients at high risk (score ≥25), but not in those with lower risk profiles (p INTERPRETATION: The PRECISE-DAPT score is a simple five-item risk score, which provides a standardised tool for the prediction of out-of-hospital bleeding during DAPT. In the context of a comprehensive clinical evaluation process, this tool can support clinical decision making for treatment duration. FUNDING: None.

25 Review Three, six, or twelve months of dual antiplatelet therapy after DES implantation in patients with or without acute coronary syndromes: an individual patient data pairwise and network meta-analysis of six randomized trials and 11 473 patients. 2017

Palmerini, Tullio / Della Riva, Diego / Benedetto, Umberto / Bacchi Reggiani, Letizia / Feres, Fausto / Abizaid, Alexandre / Gilard, Martine / Morice, Marie-Claude / Valgimigli, Marco / Hong, Myeong-Ki / Kim, Byeong-Keuk / Jang, Yangsoo / Kim, Hyo-Soo / Park, Kyung Woo / Colombo, Antonio / Chieffo, Alaide / Sangiorgi, Diego / Biondi-Zoccai, Giuseppe / Généreux, Philippe / Angelini, Gianni D / Pufulete, Maria / White, Jonathon / Bhatt, Deepak L / Stone, Gregg W. ·Dipartimento Cardio-Toraco-Vascolare, University of Bologna, Italy. · Bristol Heart Institute, University of Bristol School of Clinical Sciences, Bristol, Bristol, UK. · Istituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil. · Department of Cardiology, Brest University, Brest, France. · Générale de Santé, Institut Cardiovasculaire Paris Sud, Massy, France. · Swiss Cardiovascular Center, Bern, Switzerland. · Severance Cardiovascular Hospital and Science Institute, Yonsei University College of Medicine, Seoul, Korea. · Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. · San Raffaele Scientific Institute, Milan, Italy. · Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, and Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy. · Columbia University Medical Center/New York-Presbyterian Hospital and the Cardiovascular Research Foundation, New York, NY. · Brigham and Women's Hospital Heart & Vascular Center and Harvard Medical School, Boston, MA. ·Eur Heart J · Pubmed #28110296.

ABSTRACT: Aim: We sought to determine whether the optimal dual antiplatelet therapy (DAPT) duration after drug-eluting stent (DES) placement varies according to clinical presentation. Methods and Results: We performed an individual patient data pairwise and network meta-analysis comparing short-term (≤6-months) versus long-term (1-year) DAPT as well as 3-month vs. 6-month vs 1-year DAPT. The primary study outcome was the 1-year composite risk of myocardial infarction (MI) or definite/probable stent thrombosis (ST). Six trials were included in which DAPT after DES consisted of aspirin and clopidogrel. Among 11 473 randomized patients 6714 (58.5%) had stable CAD and 4758 (41.5%) presented with acute coronary syndrome (ACS), the majority of whom (67.0%) had unstable angina. In ACS patients, ≤6-month DAPT was associated with non-significantly higher 1-year rates of MI or ST compared with 1-year DAPT (Hazard Ratio (HR) 1.48, 95% Confidence interval (CI) 0.98-2.22; P = 0.059), whereas in stable patients rates of MI and ST were similar between the two DAPT strategies (HR 0.93, 95%CI 0.65-1.35; P = 0.71; Pinteraction = 0.09). By network meta-analysis, 3-month DAPT, but not 6-month DAPT, was associated with higher rates of MI or ST in ACS, whereas no significant differences were apparent in stable patients. Short DAPT was associated with lower rates of major bleeding compared with 1-year DAPT, irrespective of clinical presentation. All-cause mortality was not significantly different with short vs. long DAPT in both patients with stable CAD and ACS. Conclusions: Optimal DAPT duration after DES differs according to clinical presentation. In the present meta-analysis, despite the fact that most enrolled ACS patients were relatively low risk, 3-month DAPT was associated with increased ischaemic risk, whereas 3-month DAPT appeared safe in stable CAD. Prolonged DAPT increases bleeding regardless of clinical presentation. Further study is required to identify the optimal duration of DAPT after DES in individual patients based on their relative ischaemic and bleeding risks.

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