Lipid-Lowering Medication and Outcomes After Anatomical and Functional Imaging in Suspected Coronary Artery Disease.

Background: Anatomical and functional imaging identify different phenotypes of coronary artery disease (CAD) that may have implications for lipid-lowering medication (LLM).

Objectives: The aim of this study was to assess the associations between LLM and long-term outcomes after combined anatomical and functional imaging in patients with suspected obstructive CAD.

Methods: Consecutive patients (n = 1,973; 41% men; median age: 63 years) underwent coronary computed tomography angiography (CTA) because of suspected CAD.

Imaging of Myocardial αβ Integrin Expression for Evaluation of Myocardial Injury After Acute Myocardial Infarction.

[Ga]Ga-NODAGA-Arg-Gly-Asp (RGD) is a PET tracer targeting αβ integrin, which is upregulated during angiogenesis soon after acute myocardial infarction (AMI). We prospectively evaluated determinants of myocardial uptake of [Ga]Ga-NODAGA-RGD and its associations with left ventricular (LV) function in patients after AMI. Myocardial blood flow and [Ga]Ga-NODAGA-RGD uptake (60 min after injection) were evaluated by PET in 31 patients 7.

Short-term effects of sacubitril/valsartan therapy on myocardial oxygen consumption and energetic efficiency of cardiac work in heart failure with reduced ejection fraction: A randomized controlled study.

Aims: We sought to evaluate the mechanism of angiotensin receptor-neprilysin inhibitor (ARNI) sacubitril/valsartan therapy and compare it with a valsartan-only control group in patients with heart failure with reduced ejection fraction (HFrEF).

Methods And Results: The study was a phase IV, prospective, randomized, double-blind, parallel-group study in patients with New York Heart Association class II-III heart failure and left ventricular ejection fraction (LVEF) ≤35%. During a 6-week run-in period, all patients received valsartan therapy, which was up-titrated to the highest tolerated dose level (80 mg bid or 160 mg bid) and then randomized to either valsartan or sacubitril/valsartan.

The impact of diabetes on the relationship of coronary artery disease and outcome: a study using multimodality imaging.

Background: Patients with prediabetes or diabetes are at increased risk of developing cardiovascular disease and adverse outcomes. First-line coronary computed tomography angiography (CTA) followed by selective use of positron emission tomography (PET) myocardial perfusion imaging is a feasible strategy to diagnose and risk-stratify patients with suspected coronary artery disease (CAD). The aim of the present study was to study whether diabetes changes the relationship of CAD and long-term outcome.

Prognostic value of combined coronary CT angiography and myocardial perfusion imaging in women and men.

Aims: Combined anatomical and functional imaging enables detection of non-obstructive and obstructive coronary artery disease (CAD) as well as myocardial ischaemia. We evaluated sex differences in disease profile and outcomes after combined computed tomography angiography (CTA) and positron emission tomography (PET) perfusion imaging in patients with suspected obstructive CAD.

Methods And Results: We retrospectively evaluated 1948 patients (59% women) referred for coronary CTA due to suspected CAD during the years 2008-2016.

Time-resolved fluorescence based direct two-site apoA-I immunoassays and their clinical application in patients with suspected obstructive coronary artery disease.

Objective: High-density lipoprotein (HDL) is a heterogeneous group of subpopulations differing in protein/lipid composition and in their anti-atherogenic function. There is a lack of assays that can target the functionality of HDL particles related to atherosclerosis. The objective of this study was to construct two-site apolipoprotein A-I (apoA-I) assays and to evaluate their clinical performance in patients with suspected obstructive coronary artery disease (CAD).

Comparative study of neointimal coverage between titanium-nitric oxide-coated and everolimus-eluting stents in acute coronary syndromes.

Introduction And Objectives: To evaluate by optical coherence tomography neointimal healing response after implantation of cobalt-chromium-based titanium-nitride-oxide-coated (TiNO) stents and platinum-chromium-based biodegradable-polymer-coated everolimus-eluting stents (EES) in patients with acute coronary syndrome.

Methods: Patients were randomized (1:1) to receive either a TiNO-stent or EES. Optical coherence tomography images were obtained at 30-day (cohort A, n = 52) and 6-month (cohort B, n = 30) follow-up.

Cardiac perfusion by positron emission tomography.

Myocardial perfusion imaging (MPI) with positron emission tomography (PET) is an established tool for evaluation of obstructive coronary artery disease (CAD). The contemporary 3-dimensional scanner technology and the state-of-the-art MPI radionuclide tracers and pharmacological stress agents, as well as the cutting-edge image reconstruction techniques and data analysis software, have all enabled accurate, reliable and reproducible quantification of absolute myocardial blood flow (MBF), and henceforth calculation of myocardial flow reserve (MFR) in several clinical scenarios. In patients with suspected coronary artery disease, both absolute stress MBF and MFR can identify myocardial territories subtended by epicardial coronary arteries with haemodynamically significant stenosis, as defined by invasive coronary fractional flow reserve measurement.

Global and segmental absolute stress myocardial blood flow in prediction of cardiac events: [O] water positron emission tomography study.

Purpose: We evaluated the value of reduced global and segmental absolute stress myocardial blood flow (sMBF) quantified by [O] water positron emission tomography (PET) for predicting cardiac events in patients with suspected obstructive coronary artery disease (CAD).

Methods: Global and segmental sMBF during adenosine stress were retrospectively quantified in 530 symptomatic patients who underwent [O] water PET for evaluation of coronary stenosis detected by coronary computed tomography angiography.

Results: Cardiovascular death, myocardial infarction, or unstable angina occurred in 28 (5.

Titanium-Nitride-Oxide-Coated Versus Everolimus-Eluting Stents in Acute Coronary Syndrome: The Randomized TIDES-ACS Trial.

Objectives: This study sought to compare next-generation cobalt-chromium-based titanium-nitride-oxide (TiNO)-coated stents with a platinum-chromium-based biodegradable polymer everolimus-eluting stent (EES) in patients with acute coronary syndrome (ACS).

Background: Previous generation TiNO-coated stents showed acceptable performance in patients with ACS.

Methods: In a multicenter, randomized trial, we randomly assigned 1,491 ACS patients (2:1) to receive either a TiNO-coated stent (n = 989) or EES (n = 502).

Clinical frailty scale and outcome after coronary artery bypass grafting.

Objectives: The aim of this study was to assess the impact of frailty on the outcome after coronary artery bypass grafting (CABG) and whether it may improve the predictive ability of European System for Cardiac Operative Risk Evaluation (EuroSCORE II).

Methods: The Clinical Frailty Scale (CFS) was assessed preoperatively in patients undergoing isolated CABG from the multicentre E-CABG registry, and patients were stratified into 3 classes: scores 1-2, scores 3-4 and scores 5-7.

Results: Of the 6156 patients enrolled, 39.

Impact of preoperative thrombocytopenia on the outcome after coronary artery bypass grafting.

The impact of thrombocytopenia on postoperative bleeding and other major adverse events after cardiac surgery is unclear. This issue was investigated in a series of patients who underwent isolated coronary artery bypass grafting (CABG) from the prospective, multicenter E-CABG registry. Preoperative thrombocytopenia was defined as preoperative platelet count <150 × 10/L and it was considered moderate-severe when preoperative platelet count was <100 × 10/L.

Value of DAPT score to predict adverse outcome in patients with atrial fibrillation undergoing percutaneous coronary intervention: A post-hoc analysis from the AFCAS registry.

Background: The DAPT score identifies patients with expected benefit from extended dual antiplatelet therapy beyond 1year after percutaneous coronary intervention (PCI). In a post-hoc analysis from the AFCAS registry, we explored the value of DAPT score to predict outcome in patients with atrial fibrillation (AF) undergoing PCI.

Methods And Results: Outcome measures included major adverse cardiac/cerebrovascular events (MACCE) [all-cause death, myocardial infarction, repeat revascularization, stent thrombosis, or stroke/transient ischemic attack] and bleeding events.

Outcome of octogenarians with atrial fibrillation undergoing percutaneous coronary intervention: insights from the AFCAS registry.

Background: More evidence is needed on the optimal antithrombotic regimen in elderly patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI).

Hypothesis: Octogenarian patients (aged ≥80 years) with AF who underwent PCI have worse 12-month clinical outcome, compared with younger patients.

Methods: We performed a post-hoc analysis of data from the prospective, multicenter AFCAS registry, which enrolled consecutive patients with AF who underwent PCI and stenting.

Outcome of poor initial TIMI flow in patients presenting with acute coronary syndrome.

Objectives: We explored the predictors and outcome of poor, versus good, initial TIMI flow in patients with acute coronary syndrome (ACS).

Design: We performed post-hoc analysis of a randomized trial of patients presenting with ACS who received 2 comparative stents. Poor initial TIMI flow was defined as baseline TIMI flow grade 0/1 at the initial coronary angiography.

Incidence and predictors of atrial fibrillation after coronary artery bypass surgery: detection by event loop recorder monitoring from a contemporary multicentre cohort.

Background Atrial fibrillation (AF) is a frequent complication after cardiac surgery. We explored the incidence and predictors of post-operative AF at 30-day follow-up in an unselected multi-centre cohort of patients undergoing elective coronary artery bypass grafting (CABG) in contemporary practice. Methods and results We enrolled 740 consecutive patients scheduled for elective CABG with or without valve surgery.

Local Intracoronary Infusion of Glycoprotein IIb/IIIa Inhibitors via a Perfusion Catheter versus Intracoronary Guiding Catheter Injection during Primary Percutaneous Coronary Intervention: A Pilot Observational Study.

Background: Glycoprotein IIb IIIa inhibitors improved short- and long-term outcome when added to primary percutaneous coronary intervention (PPCI) in patients with ST-segment-elevation myocardial infarction (STEMI). We hypothesized that intracoronary eptifibatide infusion via a perfusion catheter improves angiographic and clinical outcome of patients with STEMI undergoing PPCI, versus conventional intracoronary bolus injection.

Methods: Prospectively, we enrolled 80 patients with acute STEMI and thrombolysis in myocardial infarction (TIMI) thrombus grade ≥ 2.

Neointimal Healing Evaluated by Optical Coherence Tomography after Drug-Eluting Absorbable Metal Scaffold Implantation in de novo Native Coronary Lesions: Rationale and Design of the Magmaris-OCT Study.

Objectives: We sought to explore neointimal healing assessed by optical coherence tomography (OCT) following implantation of the Magmaris sirolimus-eluting absorbable metal scaffold.

Methods: The Magmaris-OCT is a prospective, multicenter, single-arm observational clinical study, intended to enrol 60 consecutive patients with up to 2 de novo native coronary lesions, each located in different major epicardial vessels, with a reference vessel diameter of 2.5-3.

Percutaneous revascularization of coronary chronic total occlusion: Toward a reappraisal of the available evidence.

Chronic total occlusion (CTO) is a challenging subset of coronary artery disease that is commonly encountered in real-world practice; it is associated with worse long-term prognosis. Observational studies suggest that percutaneous coronary intervention (PCI) for CTO is associated with reduction in myocardial ischemia and improvement in quality of life and left ventricular function. Some observational studies suggested that CTO-PCI is associated with improvement of the 'hard' clinical endpoints; others did not.

Renal sympathetic denervation for treatment of patients with heart failure: summary of the available evidence.

Heart failure syndrome results from compensatory mechanisms that operate to restore - back to normal - the systemic perfusion pressure. Sympathetic overactivity plays a pivotal role in heart failure; norepinephrine contributes to maintenance of the systemic blood pressure and increasing preload. Cardiac norepinephrine spillover increases in patients with heart failure; norepinephrine exerts direct toxicity on cardiac myocytes resulting in a decrease of synthetic activity and/or viability.