Cardiovascular Revascularization Medicine最新文献

{"title":"Outcomes of transcatheter aortic valve replacement in patients with history of chest wall irradiation: Propensity matched analysis of five years data from national inpatient sample (2016–2020)","authors":"Rohan Gajjar ,&nbsp;Gianfranco Bittar Carlini ,&nbsp;Taha Teaima ,&nbsp;Imran Aziz ,&nbsp;Ufuk Vardar ,&nbsp;Aneeza Jamshed ,&nbsp;Sadichhya Karki ,&nbsp;Gaurav Dhar ,&nbsp;Neeraj Jolly ,&nbsp;Aviral Vij","doi":"10.1016/j.carrev.2024.05.031","DOIUrl":"10.1016/j.carrev.2024.05.031","url":null,"abstract":"<div><h3>Introduction</h3><div><span><span>Chest radiotherapy has been utilized to treat intra-thoracic and mediastinal tumors. Chest wall irradiation (C-XRT) survivors frequently develop valvular disease, including </span>aortic stenosis, which eventually requires valve replacement. Previous trials have shown worse outcomes with surgical </span>aortic valve replacement<span>. However, transcatheter aortic valve replacement (TAVR) outcomes-related data in patients with C-XRT is limited.</span></div></div><div><h3>Methods</h3><div>The national inpatient sample (NIS) database was queried from 2016 to 2020 to identify adult hospitalizations with TAVR, which were dichotomized based on a history of C-XRT using ICD-10-CM codes. Propensity score matching<span> was performed to derive age, sex, hospital characteristics, and co-morbidities matched controls without a history of C-XRT. The outcomes studied were inpatient mortality and complications, mean length of stay (LOS), and total hospital charge (THC). Multivariate logistic and linear regression were used to analyze the outcomes.</span></div></div><div><h3>Results</h3><div>Of 296,670 patients who underwent TAVR between 2016 and 2020, 515 had a history of C-XRT. Upon propensity score matching in patients undergoing TAVR, Patients with a history of C-XRT showed significantly lower adjusted odds of in-hospital mortality (adjusted odd ratio [aOR] 0.04, 95 % CI [0.003–0.57], <em>p</em> = 0.017), lower mean LOS by 1.6 days (−1.88 to −1.26 days, <em>p</em><span><span> &lt; 0.001) and reduced mean THC (−$74,720, [−$88,784 to -$60,655], p &lt; 0.001). Additionally, patients with C-XRT had significantly lower adjusted odds of inpatient complications, mainly acute myocardial infarction, cerebrovascular events, </span>acute respiratory failure<span><span>, acute kidney injury<span>, need for vasopressors and cardiopulmonary resuscitation, whereas similar odds of complications, including a requirement of intubation<span><span>, mechanical ventilation, </span>hemodialysis, and </span></span></span>cardiogenic shock.</span></span></div></div><div><h3>Conclusion</h3><div>Our analysis showed reduced adjusted odds of in-hospital mortality, length of stay, total hospital charges, and inpatient complications in patients undergoing TAVR with a history of C-XRT. TAVR appears to be a safe and viable alternative in this population subgroup.</div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"69 ","pages":"Pages 12-16"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141134744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The recruitment of Andreas Gruentzig","authors":"Spencer B. King III","doi":"10.1016/j.carrev.2024.11.009","DOIUrl":"10.1016/j.carrev.2024.11.009","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"69 ","pages":"Pages 101-102"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: ORC in patients with COPD undergoing aortic repair for type A dissections","authors":"Elizabeth G. Dieter ,&nbsp;Raymond A. Dieter Jr. ,&nbsp;Robert S. Dieter","doi":"10.1016/j.carrev.2024.06.024","DOIUrl":"10.1016/j.carrev.2024.06.024","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"69 ","pages":"Page 24"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional wall motion abnormalities in transthoracic echocardiography in patients with significant coronary artery disease and coronary collateral circulation in adults","authors":"Michael D. Woods ,&nbsp;Jess Hatfield ,&nbsp;Kendall Hammonds ,&nbsp;Jose Exaire ,&nbsp;Timothy A. Mixon ,&nbsp;Vinh Nguyen ,&nbsp;Christopher Chiles ,&nbsp;Robert J. Widmer","doi":"10.1016/j.carrev.2024.05.023","DOIUrl":"10.1016/j.carrev.2024.05.023","url":null,"abstract":"<div><h3>Background</h3><div><span>Coronary collateral circulation<span> is a common finding in patients with chronic total occlusions (CTOs) resulting from chronic </span></span>coronary artery disease<span> (CAD). Regional wall motion abnormalities (RWMA) on transthoracic echocardiography (TTE) can be used for the diagnosis of CAD. However, little work has been done to investigate the impact of collateral vessels on the diagnostic accuracy of resting TTE for CAD.</span></div></div><div><h3>Methods</h3><div><span>A retrospective chart review was conducted of adults who received a resting TTE and cardiac catheterization<span> within 30 days over a 4-year period at the Temple Baylor Scott &amp; White echocardiography laboratory. Exclusion criteria included catheterization without </span></span>coronary angiography<span> and prior history of CAD, percutaneous coronary intervention (PCI), or coronary artery bypass graft<span> (CABG). We analyzed RWMA on TTE in patients with CAD and coronary collateral circulation on cardiac catheterization to assess for correlation.</span></span></div></div><div><h3>Results</h3><div>Of the 753 patients were included in this study, 453 had CAD, 272 had both CAD and RWMA, 111 had collateral circulation, and 73 had collateral circulation and RWMA. There was no significant difference in RWMA in patients with CAD with and without collateral circulation. There was no significant difference in the sensitivity (60.0 % vs 59.2 %) and specificity (78.4 % vs 73.9 %) after collateral-adjusted interpretation of RWMA and CAD (<em>p</em> = 0.3).</div></div><div><h3>Discussion</h3><div>Our results suggest the average coronary collateral system is of insufficient clinical significance to prevent the development of RWMA on resting TTE.</div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"69 ","pages":"Pages 35-41"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141132262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the axiom of balloon angioplasty, “the more you gain the more you lose,” still true in the era of DCB with paclitaxel?","authors":"Patrick W. Serruys ,&nbsp;Akihiro Tobe ,&nbsp;Kai Ninomiya ,&nbsp;Scot Garg ,&nbsp;Aloke V. Finn ,&nbsp;Bruno Scheller ,&nbsp;Bernardo Cortese ,&nbsp;Antonio Colombo ,&nbsp;Bernhard Reimers ,&nbsp;Sandeep Basavarajaiah ,&nbsp;Faisal Sharif ,&nbsp;Simone Fezzi ,&nbsp;Chao Gao ,&nbsp;Ling Tao ,&nbsp;Yoshinobu Onuma","doi":"10.1016/j.carrev.2024.04.001","DOIUrl":"10.1016/j.carrev.2024.04.001","url":null,"abstract":"<div><div>Balloon angioplasty achieves luminal enlargement by fracturing the atherosclerotic intima at its point of least resistance, thereby creating a dissection plane and space with dehiscence of the intima from the media. This barotraumatic dissection triggers an inflammatory and proliferative reaction, resulting in a restenosis process at medium-term. In the era of plain old balloon angioplasty, quantitative angiographic studies at follow-up demonstrated that - the greater the acute luminal gain was after balloon angioplasty, the greater the late luminal loss was at follow-up. The interventional cardiologists coined the following motto “the more you gain, the more you lose”. However, in the current era of drug coated balloon (DCB), it appears that this vexing conundrum could have been abrogated. A recently published DCB study in small de novo vessel has demonstrated that there was a slightly negative correlation between the volume of dissection assessed by optical coherence tomography and the angiographic late luminal loss (now gain) after Paclitaxel coated balloon treatment. In other words, the barotraumatic dissection does not necessarily herald a restenosis process in the era of DCB. This article revisits the mechanism of balloon angioplasty and explores how DCB with Paclitaxel may change the paradigm of balloon angioplasty as default treatment in CAD percutaneous treatment.</div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"69 ","pages":"Pages 70-78"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary microvascular dysfunction and inflammation: Insights from the Coronary Microvascular Disease Registry","authors":"Ilan Merdler ,&nbsp;Kalyan R. Chitturi ,&nbsp;Abhishek Chaturvedi ,&nbsp;Jason Li ,&nbsp;Matteo Cellamare ,&nbsp;Sevket Tolga Ozturk ,&nbsp;Vaishnavi Sawant ,&nbsp;Itsik Ben-Dor ,&nbsp;Ron Waksman ,&nbsp;Brian C. Case ,&nbsp;Hayder D. Hashim","doi":"10.1016/j.carrev.2024.05.020","DOIUrl":"10.1016/j.carrev.2024.05.020","url":null,"abstract":"<div><h3>Background</h3><div>Coronary microvascular dysfunction<span> (CMD) is associated with various inflammatory conditions that worsen endothelial dysfunction. This study aimed to investigate the relationship between CMD and inflammation using common inflammatory markers derived from complete blood count (CBC) analysis.</span></div></div><div><h3>Methods</h3><div><span>Information was gathered from the Coronary Microvascular Disease Registry to examine the neutrophil-to-lymphocyte ratio (NLR), eosinophil-to-monocyte ratio (EMR), and monocyte-to-high-density lipoprotein ratio (MHR) in a cohort of patients with angina who showed non-obstructive </span>coronary arteries and underwent invasive physiological assessments for CMD.</div></div><div><h3>Results</h3><div>Of the 171 patients studied, 126 were CMD-negative and 45 were CMD-positive, constituting two groups of interest. The average age of all patients was 61.7 ± 11.1 years, and 63.7 % were female. No significant differences were observed between the two groups in terms of baseline characteristics, cardiovascular risk factors, or potential anti-inflammatory medications. Furthermore, there were no statistically significant differences in NLR (2.54 ± 3.71 vs. 2.52 ± 2.28, <em>p</em> = 0.97), EMR (0.3 ± 0.21 vs. 0.34 ± 0.29, <em>p</em> = 0.31), or MHR (0.02 ± 0.01 vs. 0.01 ± 0.01, <em>p</em> = 0.54) between CMD-positive and CMD-negative patients.</div></div><div><h3>Conclusion</h3><div>Our findings did not show a noteworthy connection between CMD and inflammation, as suggested by various simple CBC-based biomarkers.</div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"69 ","pages":"Pages 30-34"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141030897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Classification of lesion complexity in the modern PCI era: Relic of the past or relevant today?","authors":"Evan K. Harmon ,&nbsp;Ankur Kalra ,&nbsp;Grant W. Reed","doi":"10.1016/j.carrev.2024.07.007","DOIUrl":"10.1016/j.carrev.2024.07.007","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"69 ","pages":"Pages 60-61"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141634995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The enigma of the ‘smoker's paradox’: Results from a single-center registry of patients with STEMI undergoing primary percutaneous coronary intervention","authors":"Umberto Paradossi ,&nbsp;Alberto Ranieri De Caterina ,&nbsp;Giancarlo Trimarchi ,&nbsp;Fausto Pizzino ,&nbsp;Luca Bastiani ,&nbsp;Filippo Dossi ,&nbsp;Mario Raccis ,&nbsp;Giacomo Bianchi ,&nbsp;Cataldo Palmieri ,&nbsp;Cesare de Gregorio ,&nbsp;Giuseppe Andò ,&nbsp;Sergio Berti","doi":"10.1016/j.carrev.2024.06.007","DOIUrl":"10.1016/j.carrev.2024.06.007","url":null,"abstract":"<div><h3>Background</h3><div>Smoker's paradox usually refers to the observation of a favorable outcome of smoking patients in acute myocardial infarction.</div></div><div><h3>Methods</h3><div>From April 2006 to December 2018 a population of 2456 patients with ST segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI) were prospectively enrolled in the MATRIX registry. Ischemic time, clinical, demographics, angiographic data, and 1-year follow-up were collected.</div></div><div><h3>Results</h3><div>Among 2546 patients admitted with STEMI, 1007 (41 %) were current smokers. Smokers were 10 years younger and had lower crude in-hospital and 1-year mortality (1.5 % vs 6 %, <em>p</em> &lt; 0.0001 and 5 % vs 11 %, p &lt; 0.0001), shorter ischemic time (203 [147–299] vs 220 [154–334] minutes, <em>p</em> = 0.002) and shorter decision time (60 [30–135] vs 70 [36–170] minutes, <em>p</em> = 0.0063). Smoking habit [OR:0.37(95 % CI:0.18–0.75)-<em>p</em> &lt; 0.01], younger age [OR 1.06 (95%CI:1.04–1.09)-<em>p</em> &lt; 0.001] and shorter ischemic time [OR:1.01(95%CI:1.01–1.02)-<em>p</em> &lt; 0.05] were associated to lower in-hospital mortality. Only smoking habit [HR:0.65(95 % CI: 0.44–0.9)–<em>p</em> = 0.03] and younger age [HR:1.08 (95%CI:1.06–1.09)–<em>p</em> &lt; 0.001] were also independently associated to lower all-cause death at 1-year follow-up. After propensity matching, age, cardiogenic shock and TIMI flow &lt;3 were associated with in-hospital mortality, while smoking habit was still associated with reduced mortality. Smoking was also associated with reduced mortality at 1-year follow-up (HR 0.54, 95 % CI [0.37–0.78]; <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Smoking patients show better outcome after PCI for STEMI at 1-year follow-up. Although “Smoking paradox” could be explained by younger age of patients, other factors may have a role in the explanation of the phenomenon.</div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"69 ","pages":"Pages 42-49"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141307137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients with metastatic cancer have worse short-term coronary artery bypass grafting outcomes: A population-based study of National Inpatient Sample from 2015 to 2020","authors":"Renxi Li ,&nbsp;Qianyun Luo ,&nbsp;Stephen J. Huddleston","doi":"10.1016/j.carrev.2024.05.029","DOIUrl":"10.1016/j.carrev.2024.05.029","url":null,"abstract":"<div><h3>Background</h3><div><span>Metastasis is a hallmark for cancer progression. While patients with metastatic cancer (MC) have higher risk profiles, outcomes of </span>coronary artery bypass grafting (CABG) in these patients have not been established, likely due to their smaller representation in the CABG patient population. This study aimed to examine the short-term outcomes of patients with MC who underwent CABG.</div></div><div><h3>Methods</h3><div>Patients who underwent CABG were identified in National Inpatient Sample from Q4 2015–2020. Exclusion criteria included age &lt;18 years, concomitant procedures, and non-metastatic malignancies. A 1:3 propensity-score matching was used to address differences in demographics, socioeconomic status, primary payer status, hospital characteristics, comorbidities, and transfer/admission status between MC and non-MCC patients. In-hospital post-CABG outcomes were evaluated.</div></div><div><h3>Results</h3><div>There were 379 (0.23 %) patients with MC who underwent CABG. All MC patients were matched to 1161 out of 164,351 non-MC patients who underwent CABG during the same period. Patients with MC had higher risks of mortality (4.76 % vs 2.58 %, <em>p</em><span> = 0.04), pacemaker implantation (2.91 % vs 1.12 %, </span><em>p</em><span> = 0.03), venous thromboembolism (1.85 % vs 0.43 %, </span><em>p</em> = 0.01), and hemorrhage/hematoma (61.11 % vs 55.04 %, <em>p</em> = 0.04). In addition, MC patients had a longer time from admission to operation (3.35 ± 4.19 vs 2.82 ± 3.54 days, <em>p</em> = 0.03) and longer hospital length of stay (11.86 ± 8.17 vs 10.65 ± 8.08 days, <em>p</em> = 0.01).</div></div><div><h3>Conclusion</h3><div><span>Patients with MC had higher short-term mortality and morbidities after CABG. These findings can help provide insights for clinicians in the management of patients with concurrent coronary artery disease and MC, particularly in terms of preoperative </span>risk stratification and therapeutic decision-making.</div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"69 ","pages":"Pages 62-67"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141138658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Decreasing pacemaker implantation rates with Evolut supra-annular transcatheter aortic valves","authors":"John G. Webb,&nbsp;Kevin Millar","doi":"10.1016/j.carrev.2024.07.010","DOIUrl":"10.1016/j.carrev.2024.07.010","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"69 ","pages":"Pages 10-11"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141696854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}