Publications by authors named "Bimmer Claessen"
Deferral of routine percutaneous coronary intervention in patients undergoing transcatheter aortic valve implantation: rationale and design of the PRO-TAVI trial: the PRO-TAVI trial: rationale and design.
Am Heart J
December 2024
Background: Concomitant coronary artery disease (CAD) is highly prevalent in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI). The optimal treatment strategy for CAD is a topic of debate. An initial conservative strategy for CAD in patients undergoing TAVI may be favorable as multiple studies have failed to show an evident beneficial effect of percutaneous coronary intervention (PCI) on mortality after TAVI.
View Article and Find Full Text PDFBackground: Despite the excellent success and safety of intravascular lithotripsy (IVL) in heavily calcified lesions, evidence in acute coronary syndromes (ACS) remains limited.
Aims: This study aimed to evaluate the procedural and clinical outcomes of IVL in heavily calcified ACS.
Methods: Patients who underwent IVL between 2019 and 2024 from the ongoing prospective BENELUX registry were eligible for inclusion.
Article Synopsis
- * A total of 454 patients were included, with more men than women, and women showed higher rates of acute coronary syndrome and aorto-ostial lesions.
- * Results indicated that despite differences in clinical presentation, the safety and efficacy outcomes of IVL were comparable between men and women, demonstrating its effectiveness across genders.
Background: Intravascular lithotripsy (IVL) is increasingly used for treatment of coronary artery calcification. This study aimed to evaluate contemporary utilisation patterns, safety and efficacy of IVL in an unselected real-world patient cohort.
Methods: We included 454 patients undergoing IVL from May 2019 to February 2024 across seven centres in two European countries.
Article Synopsis
- The systematic review examined the effects of chronic total occlusion (CTO) in non-infarct-related arteries on clinical outcomes in patients with acute coronary syndrome (ACS) and the potential advantages of staged revascularization.
- Analysis of 30 studies revealed that patients receiving only culprit lesion PCI faced higher rates of all-cause mortality and major adverse cardiac events compared to those undergoing multivessel PCI, particularly in cases of ST elevation myocardial infarction.
- The findings suggest that while revascularizing non-IRA CTOs may improve outcomes, especially in specific conditions like cardiogenic shock, the best treatment strategies are still unclear and require further investigation.
Background: Percutaneous coronary intervention of calcified aorto-ostial lesions (AOL) pose unique challenges due to anatomical propensity for recoil, leading to poorer outcomes compared to non-AOL. Although intravascular lithotripsy (IVL) has shown excellent success and safety in heavily calcified plaques, evidence specific to AOL is limited. This study aims to evaluate the efficacy and safety of IVL in AOL versus non-AOL.
View Article and Find Full Text PDFLipoprotein(a) in interventional cardiology: identifying patients at highest risk of recurrent cardiovascular events through early recognition - a case based review.
Expert Rev Cardiovasc Ther
August 2024
Article Synopsis
- Lipoprotein(a) [Lp(a)] is associated with increased risk for atherosclerotic cardiovascular disease (ASCVD), but there are gaps in its measurement among cardiologists according to current guidelines.
- The review presents four clinical cases showing the link between elevated Lp(a) levels and coronary artery disease (CAD), supported by consensus statements from leading heart organizations.
- Emphasizing routine Lp(a) measurement can help identify high-risk patients, guiding more aggressive treatment and tailored care in catheterization settings, while ongoing clinical trials explore Lp(a)-lowering therapies.
Article Synopsis
- The 2023 European Society of Cardiology guidelines for acute coronary syndrome emphasize updated management strategies for better clinical outcomes.
- The review highlights specific practices in the Netherlands, such as pre-treatment protocols and antiplatelet agent strategies tailored to patient needs.
- It also covers the importance of risk scoring and the logistical aspects of scheduling coronary angiography to improve patient care efficiency.
Article Synopsis
- The study investigates the use of intravascular lithotripsy (IVL) in treating heavily calcified chronic total occlusions (CTOs), noting that calcification leads to worse patient outcomes.
- It analyzes data from 404 patients, finding that procedural success rates and safety outcomes were similar for both CTO and non-CTO patients.
- The conclusion emphasizes that IVL is effective and safe for managing heavily calcified lesions, supporting its use in clinical practice.
Predictors of outcomes after PCI with incomplete revascularization: Impact of CTO and LAD vessel.
Catheter Cardiovasc Interv
September 2024
Article Synopsis
- Incomplete revascularization (ICR) after percutaneous coronary intervention (PCI) can lead to higher risks of mortality and morbidity, and this study aimed to compare the effects of ICR in different arteries (LAD vs. RCA/LCX) and in patients with chronic total occlusion (CTO) versus those without.
- The research included 2,651 patients from the RIVER-PCI trial and found that about 66.5% had ICR involving the left anterior descending artery, and follow-up showed similar rates of hospitalization for ischemia regardless of the artery affected.
- However, patients with a CTO experienced increased hospitalizations for ischemia, heart failure, and myocardial infarction compared to those without CTO
Aims: The optimal vascular access site for percutaneous coronary interventions (PCIs) in patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS) remains uncertain. While observational data favour transradial access (TRA) due to lower complication rates and mortality, transfemoral access (TFA) PCI offers advantages such as shorter access and procedure times, along with quicker escalation to mechanical circulatory support (MCS). In this study, we aimed to investigate factors associated with a transfemoral approach and compare mortality rates between TRA and TFA in AMI-CS patients undergoing PCI.
View Article and Find Full Text PDFArticle Synopsis
- - The EXPLORE trial was a 10-year study comparing chronic total occlusion (CTO) percutaneous coronary intervention (PCI) to no-CTO PCI in patients who had a ST-segment-elevation myocardial infarction (STEMI).
- - The trial found that after a median follow-up of 10 years, there was no significant difference in major adverse cardiac events or overall mortality between the two groups, but the CTO PCI group experienced higher cardiovascular mortality.
- - Although the CTO PCI group had more effective relief from dyspnea (83% vs. 65%), the findings suggest that the benefits of symptom relief should be carefully considered against the increased risk of cardiovascular mortality.
Impact of a Chronic Total Coronary Occlusion on the Incidence of Appropriate Implantable Cardioverter-Defibrillator Shocks and Mortality: A Substudy of the Dutch Outcome in ICD Therapy (DO-IT)) Registry.
J Am Heart Assoc
April 2024
Background: Chronic total coronary occlusions (CTO) substantially increase the risk for sudden cardiac death. Among patients with chronic ischemic heart disease at risk for sudden cardiac death, an implantable cardioverter defibrillator (ICD) is the favored therapy for primary prevention of sudden cardiac death. This study sought to investigate the impact of CTOs on the risk for appropriate ICD shocks and mortality within a nationwide prospective cohort.
View Article and Find Full Text PDFNative coronary artery or bypass graft percutaneous coronary intervention in patients after previous coronary artery bypass surgery: A large nationwide analysis from the Netherlands Heart Registration.
Int J Cardiol
June 2024
Article Synopsis
- Patients with a history of coronary artery bypass surgery (CABG) often undergo percutaneous coronary intervention (PCI) for repeat revascularization, with a study examining factors influencing whether the intervention targets native vessels or bypass grafts.
- Data from over 154,000 PCI patients from 2017 to 2021 indicated that 8.3% had previous CABG, with most undergoing native vessel PCI; however, those presenting with acute coronary syndrome (ACS) were more likely to have graft interventions.
- One year after PCI, major adverse cardiac events (MACE) were higher in patients treated with grafts compared to those with only native vessels, though there was no notable difference in mortality or short-term outcomes between the two
Systematic review and meta-analysis of early aortic valve replacement versus conservative therapy in patients with asymptomatic aortic valve stenosis with preserved left ventricle systolic function.
Open Heart
January 2024
Background: A quarter of patients with severe aortic stenosis (AS) were asymptomatic, and only a third of them survived at the end of 4 years. Only a select subset of these patients was recommended for aortic valve replacement (AVR) by the current American College of Cardiology/American Heart Association guidelines. We intended to study the effect of early AVR (eAVR) in this subset of asymptomatic patients with preserved left ventricle function.
View Article and Find Full Text PDFArticle Synopsis
- Patients with non-obstructive lipid-rich plaques (LRPs) are at a high risk for future health issues, prompting the exploration of a new treatment strategy involving a paclitaxel-eluting drug-coated balloon (PE-DCB).
- This pilot study focuses on assessing the safety and effectiveness of PE-DCB treatment on non-culprit LRPs, aiming to reduce the lipid core burden over a 9-month follow-up period through advanced imaging techniques (IVUS and NIRS).
- Outcomes will be measured based on changes in lipid core burden, clinical events, and various cardiac parameters, with ongoing follow-up extending to one year to evaluate long-term safety and effectiveness.
One-year follow-up of patients treated with single antiplatelet therapy directly after percutaneous coronary intervention for non-ST-segment elevation acute coronary syndrome.
Eur Heart J Open
September 2023
Graphical AbstractClinical outcomes and treatment adherence during 12 months follow-up. *Second bleeding event in same patient. PCI, percutaneous coronary intervention; TVR, target vessel revascularization.
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- The LEGACY study examines whether stopping aspirin right after PCI for NSTE-ACS and using only P2Y-inhibitor therapy is safer and effective compared to continuing dual antiplatelet therapy (DAPT) for 12 months.
- The research involves 3,090 patients, comparing the incidence of bleeding events between those on aspirin and those who aren’t, while also ensuring no significant increase in serious health issues like heart attacks or strokes.
- This study is groundbreaking as it specifically investigates the effects of immediately omitting aspirin, making it a crucial step in understanding optimal post-PCI treatment options.