Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · May 2015
Randomized Controlled Trial Multicenter Study Comparative StudyRandomized Trial of Stents Versus Bypass Surgery for Left Main Coronary Artery Disease: 5-Year Outcomes of the PRECOMBAT Study.
In a previous randomized trial, we found that percutaneous coronary intervention (PCI) was not inferior to coronary artery bypass grafting (CABG) for the treatment of unprotected left main coronary artery stenosis at 1 year. ⋯ During 5 years of follow-up, our study did not show significant difference regarding the rate of MACCE between patients who underwent PCI with a sirolimus-eluting stent and those who underwent CABG. However, considering the limited power of our study, our results should be interpreted with caution. (Bypass Surgery Versus Angioplasty Using Sirolimus-Eluting Stent in Patients With Left Main Coronary Artery Disease [PRECOMBAT]; NCT00422968).
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J. Am. Coll. Cardiol. · May 2015
ReviewBleeding avoidance strategies during percutaneous coronary interventions.
Bleeding avoidance strategies for percutaneous coronary interventions continue to evolve with the availability of newer antiplatelet and anticoagulation therapies. Advances in interventional practices have altered the balance between ischemic and bleeding complications. ⋯ Vascular closure devices have long been used for early ambulation; however, more recent results demonstrating lower bleeding complications from observational registries are encouraging. This review synthesizes this information, taking into account changes in the landscape of interventional practice with respect to current bleeding avoidance strategies.
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J. Am. Coll. Cardiol. · May 2015
Randomized Controlled Trial Multicenter Study Comparative StudyBenefits and Risks of Extended Duration Dual Antiplatelet Therapy After PCI in Patients With and Without Acute Myocardial Infarction.
The benefits and risks of prolonged dual antiplatelet therapy may be different for patients with acute myocardial infarction (MI) compared with more stable presentations. ⋯ Compared with 12 months of therapy, 30 months of dual antiplatelet therapy reduced the risk of stent thrombosis and MI in patients with and without MI, and increased bleeding. (The Dual Antiplatelet Therapy Study [The DAPT Study]; NCT00977938).
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J. Am. Coll. Cardiol. · May 2015
Long-Term Effect of Goal-Directed Weight Management in an Atrial Fibrillation Cohort: A Long-Term Follow-Up Study (LEGACY).
Obesity and atrial fibrillation (AF) frequently coexist. Weight loss reduces the burden of AF, but whether this is sustained, has a dose effect, or is influenced by weight fluctuation is unknown. ⋯ Long-term sustained weight loss is associated with significant reduction of AF burden and maintenance of sinus rhythm. (Long-Term Effect of Goal directed weight management on Atrial Fibrillation Cohort: A 5 Year follow-up study [LEGACY Study]; ACTRN12614001123639).
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J. Am. Coll. Cardiol. · May 2015
Randomized Controlled Trial Multicenter Study Comparative StudyTranscatheter Versus Surgical Aortic Valve Replacement in Patients With Severe Aortic Valve Stenosis: 1-Year Results From the All-Comers NOTION Randomized Clinical Trial.
Transcatheter aortic valve replacement (TAVR) is an option in certain high-risk surgical patients with severe aortic valve stenosis. It is unknown whether TAVR can be safely introduced to lower-risk patients. ⋯ In the NOTION trial, no significant difference between TAVR and SAVR was found for the composite rate of death from any cause, stroke, or MI after 1 year. (Nordic Aortic Valve Intervention Trial [NOTION]; NCT01057173).