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Impella versus Non-Impella for Non-emergent High-Risk Percutaneous Coronary Intervention: Impella vs. Non-Impella for HR-PCI.
Am J Cardiol
January 2025
Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA. Electronic address:
Background: The benefit of mechanical circulatory support (MCS) with Impella (Abiomed, Inc, Danvers, MA) for patients undergoing non-emergent, high-risk percutaneous coronary intervention (HR-PCI) is unclear and currently the subject of a large randomized clinical trial (RCT), PROTECT IV. While contemporary registry data from PROTECT III demonstrated improvement of outcomes with Impella when compared with historical data (PROTECT II), there is lack of direct comparison to the HR-PCI cohort that did not receive Impella support.
Methods: We retrospectively identified patients from our institution meeting PROTECT III inclusion criteria (left ventricular ejection fraction [LVEF] <35% with unprotected left main or last remaining vessel or LVEF <30% undergoing multivessel PCI), and compared this group (NonIMP) to the published outcomes data from the PROTECT III registry (IMP).
Physiology-Versus Angiography-Guided Complete Coronary Revascularization in STEMI Patients with Multivessel Disease: A Network Meta-Analysis.
J Clin Med
January 2025
Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Rende, Italy.
: In patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease (MVD), complete revascularization (CR) is recommended over culprit-only PCI to reduce adverse cardiovascular outcomes. However, the optimal strategy for CR, whether angiography (Angio)-guided or physiology-guided, remains uncertain. : This network meta-analysis included 14 randomized controlled trials (RCTs) with 11,568 patients to compare the efficacy of angio-guided CR, physiology-guided CR, and culprit-only PCI in reducing major adverse cardiovascular events (MACE), all-cause mortality, recurrent myocardial infarction (MI), cardiovascular (CV) death, and unplanned revascularization.
View Article and Find Full Text PDF25-Year Comparison of Coronary Lesions Anatomy in Two Cohorts of French Canadians with Familial Hypercholesterolemia.
J Clin Med
January 2025
Department of Medicine, Université de Montréal and ECOGENE-21, Chicoutimi, QC G7H 7K9, Canada.
Over the past decades, new treatments and guidelines have been introduced for the screening and management of familial hypercholesterolemia (FH). However, the impact of these medical and scientific advances on the characteristics and burden of coronary lesions over time in FH remains poorly documented. The primary goal of this study is to determine the characteristics of coronary lesions in HeFH patients who underwent coronary angiography within two distinct timeframes: the last five years versus those who had the procedure at the same hospital 25 years earlier.
View Article and Find Full Text PDFLong-term outcomes of second-generation drug-eluting stents versus coronary artery bypass graft: a systematic review and meta-analysis of randomized trials and multivariable adjusted data.
Coron Artery Dis
January 2025
Division of Cardiology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil.
Long-term data are limited comparing percutaneous coronary intervention (PCI) with second-generation drug-eluting stents (S-DES) vs coronary artery bypass grafting (CABG) in patients with complex coronary artery disease (CAD). We aimed to conduct a systematic review and meta-analysis comparing these interventions in patients with left main or multivessel CAD. We systematically reviewed PubMed, Embase, and Cochrane for studies that compared PCI with S-DES and CABG in patients with left main or multivessel CAD with a minimum mean follow-up period of 3 years.
View Article and Find Full Text PDFElevated lipoprotein(a) is independently associated with the presence of significant coronary stenosis in de-novo patients with stable chest pain.
Am Heart J
January 2025
Department of Cardiology, Gødstrup Regional Hospital, Hospitalsparken 15, 7400 Herning, Denmark; Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark. Electronic address:
Background: The role of lipoprotein(a) (Lp(a)) in the risk-assessment of patients with de-novo stable chest pain is sparsely investigated. We assessed the association between Lp(a) concentration and the presence of coronary stenosis on coronary computed tomography (CT) angiography in a broad population of patients referred with stable chest pain.
Methods: Lp(a) measurements and coronary CT angiography were performed in 4,346 patients with stable chest pain and no previous history of coronary artery disease.
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