Publications by authors named "H Routledge"
Fractional Flow Reserve and Instantaneous Wave-Free Ratio as Predictors of the Placebo-Controlled Response to Percutaneous Coronary Intervention in Stable Coronary Artery Disease.
Circulation
October 2024
Article Synopsis
- The ORBITA-2 trial examined the effectiveness of percutaneous coronary intervention (PCI) in relieving stable angina in patients with coronary artery disease (CAD) compared to a placebo.
- Participants reported daily angina episodes and underwent tests to measure fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) before being randomized to receive either PCI or a placebo.
- Results indicated that lower FFR and iFR values were associated with significantly greater improvement in angina symptoms following PCI, suggesting these measurements can help predict the benefits of the intervention.
Background: Incomplete revascularization (ICR) has been associated with a worse prognosis after a percutaneous coronary intervention (PCI). In NSTEMI patients with multivessel disease (MVD) however, the benefit of a complete revascularization (CR) remains unclear.
Methods: Patients presenting with an NSTEMI and MVD were selected from the global e-ULTIMASTER registry and grouped according to completeness of revascularization at index hospitalization discharge.
Background: Placebo-controlled evidence from ORBITA-2 (Objective Randomised Blinded Investigation with Optimal Medical Therapy of Angioplasty in Stable Angina-2) found that percutaneous coronary intervention (PCI) in stable coronary artery disease with little or no antianginal medication relieved angina, but residual symptoms persisted in many patients. The reason for this was unclear.
Objectives: This ORBITA-2 secondary analysis investigates the relationship between presenting symptoms and disease severity (anatomic, noninvasive, and invasive ischemia) and the ability of symptoms to predict the placebo-controlled efficacy of PCI.
Introduction: Despite the growing awareness towards the importance of adequate representation of women in clinical trials among patients treated with percutaneous coronary intervention (PCI), available evidence continues to demonstrate a skewed distribution of study populations in favour of men.
Methods And Results: In this pre-specified analysis from the MASTER DAPT screening log and trial, we aimed to investigate the existence of a negative selection bias for women inclusion in a randomized clinical trial. A total of 2847 consecutive patients who underwent coronary revascularization across 65 participating sites, during a median of 14 days, were entered in the screening log, including 1749 (61.
Article Synopsis
- Cardiac surgery for coronary artery disease decreased significantly during the first COVID-19 pandemic wave, leading many patients to receive percutaneous coronary intervention (PCI) instead of the usual coronary artery bypass grafting (CABG).
- A study tracked 215 patients who underwent PCI, gathering 12-month outcomes like death, heart attacks, and other complications to evaluate the procedure's effectiveness.
- Results showed that after a year, PCI had acceptable outcomes with low rates of major adverse events, suggesting the need for further research comparing PCI to CABG in similar patient populations.