One-year clinical outcome of elderly patients undergoing angioplasty for ST-elevation myocardial infarction complicated by cardiogenic shock: the importance of 3-vessel disease and final TIMI-3 flow grade.

Background: The influence of age on clinical results of primary percutaneous coronary intervention (PCI) in patients with ST-elevation myocardial infarctions (STEMI) complicated by cardiogenic shock (CS) is poorly investigated.

Methods: In this study, we evaluated the outcome of 216 consecutive all-comer patients with STEMI and CS undergoing PCI who were divided into 2 groups according to age: <75 years (n = 131) or ≥75 years (n = 81). The study endpoint was the incidence of death at 1-year follow-up.

Comparison between the new Gore septal and Amplatzer devices for transcatheter closure of patent foramen ovale. Short- and mid-term clinical and echocardiographic outcomes.

Background: The ideal device for percutaneous patent foramen ovale (PFO) occlusion should provide effective closure with long-term biocompatibility and it should have a low profile without interfering with adjacent cardiac structures. Long-term data regarding safety and efficacy of the GORE Septal Occluder (GSO) are lacking. The aim of this study was to investigate the short- and mid-term clinical and echocardiographic outcomes of this device.

Effect of multivessel coronary artery disease with or without a concomitant chronic total occlusion on 1-year survival in patients treated with rescue angioplasty.

Background: The effect of multivessel disease (MVD) with or without a concomitant chronic total occlusion (CTO) has never been investigated in patients treated with rescue percutaneous coronary intervention (PCI).

Objectives: This study evaluates whether there is an increased rate of death at 1-year follow-up in patients undergoing rescue PCI with angiographic pattern of MVD and a concurrent CTO in comparison with single-vessel disease (SVD) and MVD without CTO.

Methods: Among 551 consecutive patients undergoing rescue PCI, we compared the 1-year survival rates of 361 patients with SVD, 137 with MVD without a CTO, and 53 with MVD and a CTO.

Head-to-head comparison of sirolimus-eluting stent versus bare metal stent evaluation of the coronary endothelial dysfunction in the same patient presenting with multiple coronary artery lesions: the CREDENTIAL study.

Objectives: To assess the endothelial dysfunction (ED) after bare metal stents (BMS) and sirolimus eluting stents (SES) implantation in the same patient, overcoming the confounding role of individual variables.

Background: SES reduce restenosis rate compared to BMS but causes more ED. ED is a potentially unsafe phenomenon, since it is the first step in the cascade of atherosclerosis.

Five-year outcomes in patients with chronic total coronary occlusion treated with drug-eluting vs bare-metal stents: a case-control study.

Background: Limited data exist on long-term safety and effectiveness of drug-eluting stents (DESs) in true chronic total coronary occlusion (CTO) settings. We evaluated 5-year clinical outcomes of patients with CTO treated successfully with DES vs bare-metal stent (BMS).

Methods: We compared the 5-year clinical outcomes of 156 patients treated with DES implantation with outcomes of a historical cohort of 159 patients treated with BMS.

Gore Helex septal occluder for percutaneous closure of patent foramen ovale associated with atrial septal aneurysm: short- and mid-term clinical and echocardiographic outcomes.

Objectives: To evaluate the short- and mid-term clinical and echocardiographic outcome of HELEX Septal Occluder (HSO) implantation in patients with patent foramen ovale (PFO) and atrial septal aneurysm (ASA).

Background: Percutaneous closure of PFO and ASA with HSO device has not been systematically studied.

Methods: We studied 90 patients with PFO and ASA with documented paradoxical embolic events.

Early and mid-term clinical outcome of emergency PCI in patients with STEMI due to unprotected left main coronary artery disease.

Objectives: Evaluation of acute and mid-term outcomes of patients with ST-elevation myocardial infarction (STEMI) undergoing emergency PCI due to unprotected left main coronary artery (ULMCA) disease.

Background: STEMI patients due to ULMCA disease represent a rare, high risk group. Percutaneous coronary intervention (PCI) may be the preferred strategy of myocardial revascularization but there are few data about this topic.

Comparison of one-year outcome of patients aged <75 years versus ≥75 years undergoing "rescue" percutaneous coronary intervention.

The influence of age on the clinical results after rescue angioplasty (percutaneous coronary intervention [PCI]) has been poorly investigated. In the present study, we evaluated the outcome of 514 consecutive patients undergoing rescue PCI who were divided into 2 groups according to age: <75 years (n = 469) and ≥75 years (n = 45). The primary end point of the study was the incidence of death at 1 year of follow-up.

One-year clinical outcome of patients treated with or without abciximab in rescue coronary angioplasty.

Background: The clinical results of abciximab administration during rescue angioplasty (PCI) are poorly investigated.

Methods: We evaluated the outcome of 406 consecutive patients undergoing rescue PCI treated with (n=218) or without (n=188) abciximab and a clopidogrel loading dose of 300 mg. The end point was the incidence of major cardiac adverse events (MACE) defined as death, recurrent acute myocardial infarction (AMI) and target vessel revascularization at 30 days and 1 year.

Comparison of one-year cardiac events with drug-eluting versus bare metal stent implantation in rescue coronary angioplasty.

Rescue percutaneous coronary intervention (PCI) with bare metal stent (BMS) implantation is useful in patients with acute myocardial infarction (AMI) and failed thrombolysis. Drug-eluting stent (DESs) are more effective in reducing restenosis compared to BMS. No data are available comparing the clinical outcomes between the 2 types of stents nor has information ever been provided about the predictors of events in patients treated with rescue PCI in the current era.

Angiographic predictors of recurrent stent thrombosis (from the Outcome of PCI for stent-ThrombosIs MultIcentre STudy [OPTIMIST]).

Stent thrombosis is a catastrophic occurrence burdened by a high mortality rate and a tendency to recur. We sought to evaluate the angiographic risk factors for recurrent stent thrombosis (rST) in a subpopulation of 91 Outcome of PCI for stent-ThrombosIs Multicenter STudy (OPTIMIST) patients who underwent quantitative angiographic evaluation by an independent core laboratory. The Academic Research Consortium criteria were used for rST adjudication.

3-year clinical outcome of patients with chronic total occlusion treated with drug-eluting stents.

Objectives: The aim of this study was to evaluate whether percutaneous coronary intervention (PCI) with drug-eluting stent (DES) reduces major adverse cardiac events (MACE) in patients with chronic coronary total occlusions (CTO) compared with bare-metal stent (BMS) during 3-year follow-up.

Background: The long-term prognosis of patients with CTO treated with PCI and DES implantation is poorly investigated.

Methods: We compared the 3-year clinical outcome of 124 patients with CTO after successful PCI with DES implantation with that of 159 patients with CTO previously treated with BMS.

Long-term outcome of transcatheter patent foramen ovale closure in patients with paradoxical embolism.

Background: Optimal management of patients with PFO and paradoxical embolic events is still debated. Moreover, data from long-term studies on large patient populations are lacking. Aim of the study is to assess immediate and long-term clinical outcome of patients with PFO and paradoxical thrombo-embolic events submitted to transcatheter PFO closure.

Clinical outcome of patients with diabetes mellitus and chronic total occlusion treated with drug-eluting stents.

Objectives: The prognosis of patients with chronic total occlusion (CTO) and diabetes mellitus treated with percutaneous coronary intervention (PCI) and drug-eluting stent (DES) implantation is unknown.

Methods: We compared the 12-month outcomes of 52 diabetic patients with CTO after successful PCI who underwent DES implantation with that of 47 patients with diabetes and CTO previously treated with bare-metal stents (BMS). Death, myocardial infarction and repeat PCI or coronary artery bypass surgery were considered as a combined primary endpoint.

Angiographic and clinical outcome of invasively managed patients with thrombosed coronary bare metal or drug-eluting stents: the OPTIMIST study.

Aims: Stent thrombosis (ST) is a major complication of percutaneous coronary interventions (PCIs). An invasive management by re-PCI is the commonly adopted treatment for ST, but data on outcome are limited.

Methods And Results: We performed a 2-year multicentre registry enrolling consecutive patients with angiographically confirmed ST undergoing PCI.

Clinical outcome of patients with chronic total occlusion treated with drug-eluting stents.

Background: There is limited evidence on the medium-term prognosis of patients with chronic total occlusion successfully treated with drug-eluting stent (DES) implantation.

Methods: We compared the medium-term outcome of 111 patients with chronic total occlusion (CTO) successfully treated with implantation of sirolimus-or paclitaxel-eluting stents versus 112 patients treated with bare metal stents.

Results: During an overall follow-up period of 18 months, the composite endpoint of death, myocardial infarction or target lesion revascularization was significantly lower in the drug-eluting stent than in the bare metal stent group: 8.

An unusual congenital coronary anomaly: origin of the left circumflex coronary artery from a right coronary artery arising from the left sinus of valsalva.

A 54-year-old male was admitted to our department for stable angina. Coronary angiography and 16-slice computed tomography revealed an abnormal origin of the right coronary artery from the left sinus of Valsalva, coursing between the aorta and the pulmonary trunk and then giving origin to the left circumflex coronary artery. A severe stenosis was present in the middle segment of the right coronary artery, which was successfully treated by stent implantation.

Randomized trial of Sirolimus-Eluting Stent Versus Bare-Metal Stent in Acute Myocardial Infarction (SESAMI).

Objectives: To confirm whether sirolimus-eluting stents (SES) safely reduce the incidence of restenosis in patients with ST-segment elevation acute myocardial infarction compared with bare-metal stents (BMS).

Background: In the setting of primary angioplasty, stent restenosis occurs in up to 27% of patients. The introduction of drug-eluting stents has drastically reduced the incidence of restenosis in clinically stable patients.

[Anomalous origin of the right coronary artery from the left sinus of Valsalva: case report and literature review].

We describe the case of a patient in whom evaluation of effort angina revealed a tight stenosis of a right coronary artery anomalously arising from the left sinus of Valsalva, which was successfully treated by stent implantation. The abnormal origin of the right coronary artery from the left aortic sinus coursing between the aorta and the pulmonary trunk is a rare congenital anomaly. It may remain asymptomatic, but can also cause major cardiac events, even in the absence of coronary atherosclerosis.

The Outcome of PCI for stent-ThrombosIs MultIcentre Study (OPTIMIST): rationale and design of a multicenter registry.

Background: Stent thrombosis (ST) is a recognized complication limiting the clinical efficacy of percutaneous coronary interventions (PCI). Because of the increasing number of stent-based PCI, the absolute number of patients experiencing ST is expected to expand. Re-PCI is the commonly adopted treatment for patients with ST; however, the prognostic variables as well as the angiographic and clinical results have not been systematically assessed.

Outcome of diabetic and non-diabetic patients undergoing successful coronary angioplasty with bare stent of chronic total occlusion.

Background: The prognosis of patients with diabetes mellitus and chronic coronary total occlusion (CTO) treated with percutaneous coronary angioplasty (PTCA) is poorly investigated.

Methods: To compare the long-term outcome of patients with CTO, with and without diabetes mellitus and undergoing successful PTCA with bare stent implantation performed in a single centre, 170 consecutive patients (mean age 62 +/- 10 years) with CTO aged > 1 month were analysed. Death, myocardial infarction, repeat angioplasty and coronary artery by-pass were considered as hard events in 167 patients with available long-term follow-up (mean 25 +/- 15 months).

[Long-term clinical results of the treatment with bare metal stents of chronic total occlusions].

Background. Previous studies have shown that successful recanalization by stent implantation of a chronic total coronary occlusion (CTO) is associated with an improved clinical outcome. However, most of these studies have used first-generation stents and dated regimens of antithrombotic therapy.

Primary coronary angioplasty in ST-elevation myocardial infarction: prediction of the thirty-day mortality risk in an unselected population of patients.

Background: The 30-day mortality in catheter-based reperfusion therapy in patients with acute myocardial infarction varies widely in the literature and only some factors, such as cardiogenic shock, are clearly associated with the risk. This non-randomized, single center study investigates the potential factors influencing the 30-day mortality in 586 consecutive patients with ST-elevation myocardial infarction, treated with primary coronary angioplasty (PTCA).

Methods: In the whole series and in two subgroups (with and without cardiogenic shock) the clinical, angiographic and procedural variables were used to develop multivariate statistical models for the prediction of the endpoint.