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Coronary Artery Disease: HELP
Articles by Jonathon M. White
Based on 2 articles published since 2008

Between 2008 and 2019, Jonathon White wrote the following 2 articles about Coronary Artery Disease.
+ Citations + Abstracts
1 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.

2 Article Impact of Coronary Artery Disease Severity Assessed With the SYNTAX Score on Outcomes Following Transcatheter Aortic Valve Replacement. 2017

Paradis, Jean-Michel / White, Jonathon M / Généreux, Philippe / Urena, Marina / Doshi, Darshan / Nazif, Tamim / Hahn, Rebecca / George, Isaac / Khalique, Omar / Harjai, Kishore / Lasalle, Laura / Labbé, Benoit M / DeLarochellière, Robert / Doyle, Daniel / Dumont, Éric / Mohammadi, Siamak / Leon, Martin B / Rodés-Cabau, Josep / Kodali, Susheel. ·Quebec Heart and Lung Institute, Quebec, Canada. · Cardiovascular Research Foundation, New-York, NY. · Columbia University Medical Center, New-York, NY. · Hopital du Sacre-Coeur de Montreal, Montreal, Quebec Canada. · Gagnon Cardiovascular Institute Morristown Medical Center, Morristown, New Jersey. · Cardiovascular Research Foundation, New-York, NY sk2427@cumc.columbia.edu. ·J Am Heart Assoc · Pubmed #28219920.

ABSTRACT: BACKGROUND: The influence of coronary artery disease (CAD) on clinical and echocardiographic outcomes after transcatheter aortic valve replacement (TAVR) is still controversial. We sought to evaluate the impact of CAD severity as measured by the SYNTAX score (SS) on patients undergoing TAVR. METHODS AND RESULTS: A total of 377 patients who underwent TAVR in 2 high-volume centers in North America were included in our retrospective analysis. A blinded angiographic core laboratory calculated the SS on all available coronary angiograms with the use of quantitative coronary analysis. Patients were stratified into 4 groups: (1) no CAD (SS=0); (2) low SS (SS between 1 and 22); (3) intermediate SS (SS between 23 and 32); and (4) high SS (SS ≥33). Patients who had undergone percutaneous coronary intervention within 6 months prior to TAVR were separated into 2 categories based on their residual SS (<8 and ≥8). Patients with previous coronary artery bypass grafting (CABG) were divided into 2 groups: (1) low CABG SS and (2) high CABG SS. The primary end point was a composite of all-cause mortality, myocardial infarction, and stroke. At 30 days and 1 year, both the presence and the severity of CAD had no impact on the rate of the combined primary end point and on all-cause mortality, cardiovascular mortality, and myocardial infarction. Patients with less complete revascularization (residual SS ≥8 versus residual SS <8 and low CABG SS versus high CABG SS, had similar rates of the combined primary end point, all-cause mortality, cardiovascular mortality, MI, and stroke, at both 30 days and 1 year. CONCLUSIONS: In our core laboratory-validated study, neither the severity of CAD nor completeness of revascularization after percutaneous coronary intervention or CABG were associated with clinical outcomes after TAVR, at both 30 days and 1 year.