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Left Anterior Descending Nonculprit Lesions and Clinical Outcomes in Patients With ST-Segment Elevation Myocardial Infarction.
JACC Cardiovasc Interv
October 2024
Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada. Electronic address:
Article Synopsis
- The COMPLETE trial showed that complete revascularization in STEMI patients with multivessel disease leads to better health outcomes than treating only the culprit lesion.
- This subanalysis focused on whether having a nonculprit lesion (NCL) in the proximal/mid left anterior descending artery (LAD) affects outcomes compared to NCLs in other locations.
- Results indicated that while the presence of a proximal/mid-LAD NCL did not significantly alter treatment benefits, complete revascularization consistently reduced major cardiovascular events across both groups.
Colchicine in Acute Myocardial Infarction.
N Engl J Med
November 2024
From the Population Health Research Institute, McMaster University (S.S.J., M.-A.E., S.F.L., R. Mian, J.T., S.R.M., P.J.D., J.E., T.S., D.C., S.T., S.Y.), and Hamilton Health Sciences (S.S.J., M.-A.E., S.F.L., R. Mian, S.R.M., P.J.D., J.E., T.S., D.C.), Hamilton, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke (M.-A.E.), the University of British Columbia and Centre for Cardiovascular Innovation, Vancouver Coastal Health, Vancouver (J.A.C.), the Department of Medicine, University of Saskatchewan, Saskatoon (W.T.), and London Health Sciences, University of Western Ontario, London (S.L.) - all in Canada; the University Clinic of Cardiology, Medical Faculty, University Ss. Cyril and Methodius, Skopje, North Macedonia (S.K., B.Z.); Sorbonne University, ACTION Study Group, Centre Hospitalier Universitaire Pitié-Salpêtrière Assistance Publique-Hopitaux de Paris, Paris (G.M.); the Dutch Network for Cardiovascular Research, Utrecht, Radboud University Medical Center, Nijmegen, and Northwest Clinics, Alkmaar - all in the Netherlands (J.H.C.); the University Clinical Center of Serbia and the Faculty of Medicine, University of Belgrade, Belgrade (G.S.); the Cardiology Department, University Hospital La Paz, Universidad Autónoma de Madrid, Madrid (R. Moreno); NIHR Sheffield Biomedical Research Centre, Sheffield Teaching Hospitals NHS Foundation Trust, and the Division of Clinical Medicine, University of Sheffield - both in Sheffield, United Kingdom (R.F.S.); the Caril and Edyth Lindner Center for Research and Education, Christ Hospital Health Network, Cincinnati (T.D.H.); the Cardiology Division, Heart Center, Luzerner Kantonsspital, and the Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland (M.B.); University Hospital Brno, Brno, Czech Republic (P.K.); the Department of Cardiology, Peninsula Health, Frankston, VIC, and Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, VIC - both in Australia (J.L.); the Division of Cardiology, Department of Medicine, NYU Grossman School of Medicine, and the Section of Cardiology, Department of Medicine, VA New York Harbor Healthcare System, New York (B.S.); and B.P. Koirala Institute of Health Sciences, Dharan, Nepal (S.K.S.).
Article Synopsis
- * A total of 7062 patients participated, and the results showed no significant difference in primary cardiovascular outcomes between the colchicine group (9.1%) and the placebo group (9.3%) over a 3-year follow-up period.
- * Colchicine did lower C-reactive protein levels, indicating some anti-inflammatory effect, but it also caused more diarrhea compared to placebo, though serious infections were similar in both groups.
Routine Spironolactone in Acute Myocardial Infarction.
N Engl J Med
November 2024
From the Population Health Research Institute, McMaster University (S.S.J., M.-A.E., S.F.L., R. Mian, J.T., S.R.M., P.J.D., J.E., M.K.N., J.D.S., D.C., S.T., S.Y.), and Hamilton Health Sciences (S.S.J., M.-A.E., S.F.L., R. Mian, S.R.M., P.J.D., J.E., M.K.N., J.D.S., D.C.), Hamilton, ON, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC (M.-A.E.), the University of British Columbia and Centre for Cardiovascular Innovation, Vancouver Coastal Health, Vancouver (J.A.C.), the Department of Medicine, University of Saskatchewan, Moose Jaw (W.T.), London Health Sciences Centre, University of Western Ontario, London (S.L.), Southlake Regional Health Centre, Newmarket, University of Toronto, Toronto (W.J.C.), Quebec Heart-Lung Institute, Laval University, Quebec, QC (O.F.B.), and St. Mary's Hospital, Kitchener, ON (A.P.) - all in Canada; the University of Michigan, Ann Arbor (B.P.); the Medical Faculty, University Clinic of Cardiology, University Ss. Cyril and Methodius, Skopje, North Macedonia (S.K., B.Z.); Sorbonne University, ACTION Study Group, Centre Hospitalier Universitaire Pitié-Salpêtrière Assistance Publique-Hôpitaux de Paris, Paris (G.M.); Dutch Network for Cardiovascular Research, Utrecht, Radboud University Medical Center, Nijmegen, and Northwest Clinics, Alkmaar - all in the Netherlands (J.H.C.); University Clinical Center of Serbia and the Faculty of Medicine, University of Belgrade (G.S.), and Institut za Kardiovaskularne Bolesti Dedinje-Belgrade (D.T.) - all in Belgrade; the Cardiology Department, University Hospital La Paz, Madrid (R. Moreno); NIHR Sheffield Biomedical Research Centre, Sheffield Teaching Hospitals NHS Foundation Trust, and the Division of Clinical Medicine, University of Sheffield, Sheffield - both in the United Kingdom (R.F.S.); the Caril and Edyth Lindner Center for Research and Education, Christ Hospital Health Network, Cincinnati (T.D.H.); the Cardiology Division, Heart Center, Luzerner Kantonsspital, and the Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland (M.B.); University Hospital Brno, Brno, Czech Republic (P.K.); the Department of Cardiology, Peninsula Health, Frankston, VIC, and Peninsula Clinical School, Central Clinical School. Monash University, Melbourne, VIC - both in Australia (R.B.); B.P. Koirala Institute of Health Sciences, Dharan, Nepal (S.K.S.); and Clinical Hospital Tetovo, Tetovo, North Macedonia (V.A.).
Background: Mineralocorticoid receptor antagonists have been shown to reduce mortality in patients after myocardial infarction with congestive heart failure. Whether routine use of spironolactone is beneficial after myocardial infarction is uncertain.
Methods: In this multicenter trial with a 2-by-2 factorial design, we randomly assigned patients with myocardial infarction who had undergone percutaneous coronary intervention to receive either spironolactone or placebo and either colchicine or placebo.
Stent thrombosis in the setting of ST-segment elevation acute myocardial infarction in the contemporary practice: results from the TOTAL randomized trial.
Coron Artery Dis
March 2025
Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Article Synopsis
- The study focuses on identifying risk factors for stent thrombosis (ST) in patients with STEMI who underwent primary PCI, using data from the TOTAL trial involving over 10,000 patients.
- Out of the participants, 1.54% experienced ST within a year, with factors like prior heart attacks, number of stents, and certain medications influencing risk.
- The findings suggest that while ST remains a common complication, different predictors exist for ST occurring at different times after the procedure, emphasizing the need for tailored preventive strategies.
Analysis of factors associated with use of real-world data in single technology appraisals of cancer drugs by the National Institute for Health and Care Excellence.
J Cancer Policy
December 2024
Department of Health Service Research and Policy, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK; Centre for Cancer Biomarkers (CCBIO), University of Bergen, Bergen, Norway.
Objectives: This study investigates factors associated with use of real-world data (RWD) in economic modelling for single technology appraisals (STAs) of cancer drugs by the National Institute for Health and Care Excellence (NICE) to improve systematic understanding of the use of RWD.
Methods: The data were extracted from STAs of cancer drugs, for which NICE issued guidance between January 2011 and December 2022 (n=267). Binary regression was used to test hypotheses concerning the greater or lesser use of RWD.
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