Journal of the American College of Cardiology
-
J. Am. Coll. Cardiol. · Dec 2014
Randomized Controlled Trial Multicenter StudyEffect of prasugrel pre-treatment strategy in patients undergoing percutaneous coronary intervention for NSTEMI: the ACCOAST-PCI study.
After percutaneous coronary intervention (PCI) for non-ST-segment elevation myocardial infarction (NSTEMI), treatment with a P2Y12 antagonist with aspirin is recommended for 1 year. ⋯ These findings support deferring treatment with prasugrel until a decision is made about revascularization in patients with NSTEMI undergoing angiography within 48 h of admission. (A Comparison of prasugrel at the time of percutaneous Coronary intervention Or as pre-treatment At the time of diagnosis in patients with non-ST-segment elevation myocardial infarction [ACCOAST]; NCT01015287).
-
J. Am. Coll. Cardiol. · Dec 2014
Randomized Controlled Trial Multicenter StudyIncidence, predictors, and prognostic impact of late bleeding complications after transcatheter aortic valve replacement.
The incidence and prognostic impact of late bleeding complications after transcatheter aortic valve replacement (TAVR) are unknown. ⋯ MLBCs after TAVR were frequent and associated with increased mortality. Better individualized and risk-adjusted antithrombotic therapy after TAVR is urgently needed in this high-risk population. (THE PARTNER TRIAL: Placement of AoRTic TraNscathetER Valve Trial; NCT00530894).
-
J. Am. Coll. Cardiol. · Dec 2014
Comparative StudyClinical phenotype and outcome of hypertrophic cardiomyopathy associated with thin-filament gene mutations.
Mild hypertrophy but increased arrhythmic risk characterizes the stereotypic phenotype proposed for hypertrophic cardiomyopathy (HCM) caused by thin-filament mutations. However, whether such clinical profile is different from more prevalent thick-filament-associated disease is unresolved. ⋯ In adult HCM patients, thin-filament mutations are associated with increased likelihood of advanced LV dysfunction and heart failure compared with thick-filament disease, whereas arrhythmic risk in both subsets is comparable. Triphasic LV filling is particularly common in thin-filament HCM, reflecting profound diastolic dysfunction.
-
J. Am. Coll. Cardiol. · Dec 2014
Right ventricular dysfunction, but not tricuspid regurgitation, is associated with outcome late after left heart valve procedure.
Significant tricuspid regurgitation (TR) late after left heart valve procedure is frequent and associated with increased morbidity. Surgical correction carries a significant mortality risk, whereas the impact of TR on survival in these patients is unclear. ⋯ RV dysfunction, but not significant TR, is independently associated with survival late after left heart valve procedure.