Publications by authors named "Alexey V Protopopov"
High-risk features in non-culprit lesions and clinical outcome after NSTEMI versus STEMI.
Eur Heart J Cardiovasc Imaging
November 2024
Article Synopsis
- The study investigates the impact of non-culprit (NC) lesions in patients with NSTEMI compared to those with STEMI, focusing on high-risk plaque features and their influence on clinical outcomes.
- Among 438 patients, both NSTEMI and STEMI groups showed similar prevalence of high-risk plaques, but NSTEMI patients had a higher rate of major adverse cardiovascular events (MACE) after two years.
- The findings suggest that the presence of high-risk plaques in NC lesions is critical for dictating future cardiovascular events, indicating the need for further research on effective revascularization strategies in NSTEMI patients.
Article Synopsis
- Recurrent events after myocardial infarction (MI) often arise from non-flow limiting lesions, which may differ between sexes, prompting this study to investigate these potential differences among MI patients.
- The study examined 420 patients, finding that female patients had longer NC lesions and smaller lumen areas and diameters, as well as thinner fibrous caps compared to male patients.
- Despite females exhibiting more high-risk plaque characteristics, both genders experienced similar rates of major cardiovascular events at two years, suggesting the need for further research on long-term outcomes related to these differences.
Article Synopsis
- - Study aimed to determine factors influencing early mortality after left atrial appendage occlusion (LAAO) to improve patient selection and cost-effectiveness for stroke prevention.
- - Analyzed data from 1,020 patients, finding a 2-year mortality rate of 16.4%, with 50% of deaths attributed to non-cardiovascular causes, and identified six key predictors of mortality including age and heart failure.
- - Concluded that as the number of risk factors in patients increased, the mortality rate rose significantly, underscoring the need for careful patient selection for LAAO procedures.
Article Synopsis
- Patients who undergo FFR-guided revascularization after a myocardial infarction still face high rates of repeat major cardiovascular events, often due to nonculprit lesions identified as high-risk by optical coherence tomography (OCT).
- The study, called PECTUS-obs, evaluates how OCT can help detect high-risk plaques in nonculprit lesions, which were defined by specific characteristics such as lipid content and plaque stability.
- Out of 438 enrolled patients, 34% had at least one high-risk plaque, and 15.4% of those with high-risk plaques experienced recurrent major adverse cardiovascular events within a two-year period.
Background: Left atrial appendage occlusion (LAAO) is recommended for patients with atrial fibrillation at increased stroke risk, where effective long-term oral anticoagulation (OAC) is not feasible. In order to assess long-term safety of LAAO with aspirin monotherapy or no therapy, we aimed to report on patients with the Watchman LAAO device (Boston Scientific) once postimplantation intensified antiplatelet or anticoagulation therapy is discontinued.
Methods: A total of 1025 patients scheduled for elective LAAO therapy prospectively consented for participation in the EWOLUTION registry; 1005 patients received a successful implant and were followed for 2 years.
Introduction: In patients with myocardial infarction, the decision to treat a nonculprit lesion is generally based on its physiological significance. However, deferral of revascularisation based on nonischaemic fractional flow reserve (FFR) values in these patients results in less favourable outcomes compared with patients with stable coronary artery disease, potentially caused by vulnerable nonculprit lesions. Intravascular optical coherence tomography (OCT) imaging allows for in vivo morphological assessment of plaque 'vulnerability' and might aid in the detection of FFR-negative lesions at high risk for recurrent events.
View Article and Find Full Text PDFIncidence, predictors and outcomes of device-related thrombus after left atrial appendage closure with the WATCHMAN device-Insights from the EWOLUTION real world registry.
Catheter Cardiovasc Interv
June 2021
Background: In this analysis of the EWOLUTION registry, we evaluated the incidence, relevance and predictors of device-related thrombus in a large multi-center real-world cohort undergoing LAAc with the WATCHMAN device.
Methods And Results: We analyzed the 835 patients who underwent percutaneous LAA closure with the WATCHMAN device in the EWOLUTION registry in whom at least one TEE follow up was performed. Patients were 74 ± 9 y/o and were at high risk for stroke and bleeding (CHA2DS2-VASC-Score 4.
Aims: Evidence regarding post-procedural antithrombotic regimen other than used in randomized trials assessing percutaneous left atrial appendage (LAA) closure is limited. The present work aimed to compare different antithrombotic strategies applied in the real-world EWOLUTION study.
Methods And Results: A total of 998 patients with successful WATCHMAN implantation were available for the present analysis.
Evaluating Real-World Clinical Outcomes in Atrial Fibrillation Patients Receiving the WATCHMAN Left Atrial Appendage Closure Technology: Final 2-Year Outcome Data of the EWOLUTION Trial Focusing on History of Stroke and Hemorrhage.
Circ Arrhythm Electrophysiol
April 2019
Background: Left atrial appendage occlusion with WATCHMAN has emerged as viable alternative to vitamin K antagonists in randomized controlled trials. Evaluating real-life clinical outcomes in atrial fibrillation patients receiving the WATCHMAN left atrial appendage closure technology was designed to collect prospective multicenter outcomes of thromboembolic events, bleeding, and mortality for patients implanted with a WATCHMAN in routine daily practice.
Methods: One thousand twenty patients with a WATCHMAN implant procedure were prospectively followed in 47 centers.
Aims: The study aimed to confirm the efficacy and safety of WATCHMAN LAA closure in atrial fibrillation patients unsuitable for oral anticoagulation.
Methods And Results: The EWOLUTION registry prospectively collects all clinical data on 1,005 European patients implanted with a WATCHMAN device. Following the procedure, 605 patients (60.
Efficacy and safety of left atrial appendage closure with WATCHMAN in patients with or without contraindication to oral anticoagulation: 1-Year follow-up outcome data of the EWOLUTION trial.
Heart Rhythm
September 2017
Background: Left atrial appendage (LAA) occlusion with WATCHMAN has emerged as viable alternative to vitamin K antagonists in randomized controlled trials.
Objective: EWOLUTION was designed to provide data in routine practice from a prospective multicenter registry.
Methods: A total of 1025 patients scheduled for a WATCHMAN implant were prospectively and sequentially enrolled at 47 centers.