Publications by authors named "Florim Cuculi"
Article Synopsis
- The study investigates the significance of cardiac troponin (cTn) levels in predicting mortality in patients with Takotsubo syndrome (TTS), analyzing data from the International Takotsubo Registry.
- It identifies that a cTn increase greater than 28.8 times the upper reference limit signals clinically relevant myocardial injury, correlating with a higher risk of mortality over 5 years (adjusted HR 1.58).
- The findings enhance understanding of patient risk profiles in TTS, emphasizing the need for increased monitoring and follow-up for those with significant troponin elevations.
Article Synopsis
- The study investigated changes in demographics, risk factors, clinical presentations, and outcomes of takotsubo syndrome (TTS) patients from 2004 to 2021, using data from the InterTAK registry.
- Over the years, the proportion of male patients increased, and there was a rise in cases of midventricular TTS as well as significant growth in the incidence of physical triggers.
- There was also a notable increase in 60-day mortality rates, although no significant change in 1-year mortality when excluding early deaths was observed, indicating a complex evolution of TTS and its management in recent years.
Article Synopsis
- The study looked at two ways to close a hole in the heart called a patent foramen ovale (PFO) to prevent blood clots, using either fluoroscopy (FS) or both fluoroscopy and transesophageal echocardiography (TOE) for guidance.
- They analyzed 203 patients and found that using FS alone was faster, but both methods achieved similar success rates in closing the PFO at 6 months.
- No significant differences were found in complications or reoccurring heart issues between the two methods, suggesting FS-only guidance is just as effective as using both TOE and FS.
Background: In patients undergoing transcatheter aortic valve replacement (TAVR), elevated pre-procedural C-reactive protein (CRP) levels are frequently observed. Its impact on long-term results of TAVR is unclear. The aim of the study was to investigate the long-term (up to six years) clinical outcomes of TAVR patients with normal compared to elevated CRP levels before TAVR.
View Article and Find Full Text PDFBackground: In transcatheter aortic valve replacement (TAVR), transfemoral (TF) access offers several advantages over alternative access routes. Advances in sheaths and valve delivery technology have catalyzed the feasibility of TF-TAVR, even in challenging anatomies.
Aims: Report procedural characteristics and outcomes of a TAVR program aiming for a 100% TF access rate.
Article Synopsis
- This study explores the effectiveness of the NeVa™ mechanical thrombectomy device in treating acute myocardial infarction (AMI) patients with large thrombus burden (LTB).
- Among 15 patients, the procedure was successful in 93% of cases, with a majority achieving good blood flow post-treatment and no serious complications reported.
- The findings indicate that the NeVa™ device is a safe and efficient option for these patients, but further research is needed to confirm its benefits compared to other methods.
Article Synopsis
- The study aims to evaluate the effectiveness of drug-coated balloons (DCB) compared to drug-eluting stents (DES) in patients undergoing percutaneous coronary interventions (PCI) for chronic total occlusions (CTO), highlighting that DCB may reduce the need for repeat procedures.
- A total of 157 patients were analyzed, with 112 receiving DCB and 45 treated with DES; results showed that DCB patients had significantly lower rates of major adverse cardiac and cerebrovascular events (MACCE) at 12 months following the procedure.
- The research concludes that DCB use in CTO cases may be safer and improve outcomes by limiting stent length, which is linked to better PCI results.
Article Synopsis
- The study evaluates the performance of the SeQuent® crystalline sirolimus-coated balloon (SCB) in treating coronary artery disease and in-stent restenosis (ISR), suggesting it features a sustained release of the drug compared to traditional options like paclitaxel-coated balloons.
- Data from 126 patients were analyzed from the SIROOP registry over a two-year period, with outcomes measuring major adverse cardiovascular events (MACE), revascularization, and myocardial infarction; results showed a high procedural success rate and low MACE occurrence.
- The findings indicate promising results for the SCB in managing complex coronary lesions, but further research with randomized trials is necessary to confirm these outcomes.
Objectives: Percutaneous closure of a patent foramen ovale (PFO) for the prevention of recurrent paradoxical thromboembolic events has been shown to be safe and effective in randomized controlled trials. However, it remains uncertain if differences in the structure and design of the occluder devices impact the outcomes. The aim of this study was to compare results of percutaneous PFO closure using 2 widely used double-disc occluders.
View Article and Find Full Text PDFBackground: Chronic inflammatory disease (CID) accelerates atherosclerosis and the development of aortic stenosis. Data on long-term outcomes after transcatheter aortic valve implantation (TAVI) in those patients are missing. The aim of this study was to investigate the clinical long-term outcomes of patients with and without autoimmune-related CID undergoing TAVI for the treatment of severe aortic stenosis.
View Article and Find Full Text PDFArticle Synopsis
- Inflammation is key in coronary artery disease (CAD), and anti-inflammatory drugs like colchicine show promise in reducing related ischemic events.
- Colchicine, a long-used anti-inflammatory medication, may help limit atherosclerosis progression in CAD patients by targeting specific immune cell activities.
- Recent studies suggest low doses of colchicine can lower the risk of serious complications in CAD, including repeat surgeries, heart attacks, and strokes, prompting a review of its benefits and potential side effects.
Objectives: The Allegra-THV is a novel, self-expanding THV with supra-annular bovine leaflets. The valve is available in 3 different sizes and is delivered through an 18 French sheath. To determine the safety and efficacy of the Allegra transcatheter heart valve (THV; Biosensors) for the treatment of severe aortic valve stenosis under real-world conditions.
View Article and Find Full Text PDFBackground: Motion artifacts in planning computed tomography (CT) for transcatheter aortic valve implantation (TAVI) can potentially skew measurements required for procedural planning. Whether such artifacts may affect safety or efficacy has not been studied.
Methods: We conducted a retrospective analysis of 852 consecutive patients (mean age, 82 years; 47% women) undergoing TAVI-planning CT at a tertiary care center.
Background: Biodegradable polymer sirolimus-eluting stents improve early stent-related clinical outcomes compared to durable polymer everolimus-eluting stents in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention. The long-term advantages of biodegradable polymer sirolimus-eluting stents after complete degradation of its polymer coating in patients with STEMI remains however uncertain.
Methods: BIOSTEMI Extended Survival (BIOSTEMI ES) was an investigator-initiated, follow-up extension study of the BIOSTEMI prospective, multicentre, single-blind, randomised superiority trial that compared biodegradable polymer sirolimus-eluting stents with durable polymer everolimus-eluting stents in patients with STEMI undergoing primary percutaneous coronary intervention at ten hospitals in Switzerland.
Objectives: It is uncertain, if omitting post-dilatation and stent oversizing (stent optimization) is safe and may decrease the risk for distal thrombus embolization (DTE) in STEMI patients with large thrombus burden (LTB).
Background: In patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI) with stenting, (DTE) and flow deterioration are common and increase infarct size leading to worse outcomes.
Methods: From a prospective registry, 74 consecutive STEMI patients with LTB undergoing pPCI with stenting and intentionally deferred stent optimization were analyzed.
Article Synopsis
- Reducing venous drainage from the coronary sinus using the CSR System™ can alleviate symptoms and enhance quality of life for patients with refractory angina.
- This case series reports on three patients, confirming that cardiac resynchronization therapy (CRT) is workable for those with the CSR implant, including the successful extraction of a left ventricular lead.
- While CRT shows promise, caution is advised when considering lead extraction due to potential complications, suggesting that alternative approaches should be explored early in treatment.
Article Synopsis
- Researchers developed a machine learning model to predict in-hospital death risk in Takotsubo syndrome (TTS) patients using data from over 3,400 individuals.
- The model included 31 clinical variables and achieved strong performance results, with AUC values indicating high accuracy in identifying patients at risk of death.
- Clustering analysis revealed six distinct patient groups with varying in-hospital death rates, demonstrating the model's ability to stratify risk profiles effectively.
Background And Objectives: Recent data have established non-inferiority of drug-coated balloons (DCB) compared to drug-eluting stents (DES) for treatment of small-vessel coronary artery disease. Since coronary vessels in women might have anatomical and pathophysiological particularities, the safety of the DCB strategy among women compared to men needs to be assessed in more detail.
Methods: In BASKET-SMALL 2, patients with de novo lesions in coronary vessels < 3 mm and an indication for percutaneous coronary intervention were randomly allocated (1:1) to DCB vs.
Subclinical leaflet thrombosis, identified as hypoattenuated leaflet thickening (HALT) on cardiac computed tomography scan, has been observed after transcatheter aortic valve replacement (TAVR). However, data on HALT after the implant of the supra-annular ACURATE neo/neo2 prosthesis are limited. This study aimed to determine the prevalence and risk factors for the development of HALT after TAVR with the ACURATE neo/neo2.
View Article and Find Full Text PDFBackground: Growing interest in neuroprotection in transcatheter aortic valve replacement (TAVR) has catalyzed the development of cerebral protection systems (CPS).
Objectives: Report insights from consecutive real-world patients undergoing TAVR with the Sentinel-CPS.
Methods: Patients with severe aortic stenosis undergoing TAVR from April 2019 to May 2022 were enrolled in a prospective registry.
Background: A decade ago, the iopromide-paclitaxel coated balloon (iPCB) was added to the cardiologist's toolbox to initially treat in-stent restenosis followed by the treatment of de novo coronary lesions. In the meantime, DES technologies have been substantially improved to address in-stent restenosis and thrombosis, and shortened anti-platelet therapy. Recently, sirolimus-coated balloon catheters (SCB) have emerged to provide an alternative drug to combat restenosis.
View Article and Find Full Text PDFBackground: Calcified lesions often lead to difficulty achieving optimal stent expansion. OPN non-compliant (NC) is a twin layer balloon with high rated burst pressure that may modify calcium effectively.
Methods: Retrospective, multicenter registry in patients undergoing optical coherence tomography (OCT) guided intervention with OPN NC.