1,721,537 research outputs found
Angioplasty in chronic coronary syndromes after the ISCHEMIA trial: What's new? - The interventional cardiologist's point of view
No full text
Focus on relevant aspects of 2020 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation
No full text
Pathophysiology of aortic stenosis and approach to treatment with percutaneous valve implantation
No full textAortic stenosis (AS) is the most commonly acquired valvular heart disease in the Western world (2-7% of the population aged >65 years) and the mortality for untreated symptomatic severe AS is up to 50-60% at 2 years in high-risk patients. This review summarizes laboratory and recent clinical investigations concerning AS and current best treatment. Particular emphasis will be placed on pathophysiology and on the concept of afterload mismatch and preload reserve in which left ventricular function is proportionately matched to level of left ventricular pressure, mainly because such studies carry important implications for both treatment with transcatheter aortic valve implantation (TAVI) and prognosis. Surgical aortic valve replacement is currently the gold-standard treatment for patients with severe symptomatic AS. Without surgery, the prognosis is extremely poor, with a 3-year survival rate 75 years with severe AS are declined for surgery. TAVI was recently introduced as a new therapeutic option for patients with AS, so the current indications, the technical differences between 2 different transcatheter aortic valves and the clinical available data will be also examined in detail
Algorithm for diagnosis of infective endocarditis after transcatheter aortic valve replacement
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Drug eluting stents versus bare metal stents in percutaneous coronary interventions (A meta-analysis)
No full textThis meta-analysis combined the results of randomized
clinical trials to compare the efficacy of drug-eluting stents
with that of bare metal stents in percutaneous coronary
interventions to ascertain which revascularization strategy
is most safe and effective. The literature identified 13 published
studies, and 8 were included in the main metaanalysis,
thus allowing a meta-analysis on 3,860 patients
for the effect on all major adverse clinical events (MACEs)
combined and for target vessel revascularization. Metaanalyses
were performed for combined MACEs, patient
MACEs, and thrombosis. Regression meta-analyses were
performed to examine the effect of certain variables on the
efficacy of drug-eluting stents compared with bare metal
stents. Meta-analysis of all trials showed that drug-eluting
stents produced significant decreases in the need for percutaneous
revascularization (relative risk [RR] 0.30, 95%
confidence interval [CI] 0.22 to 0.40) and coronary artery
bypass grafting (RR 0.54, 95% CI 0.32 to 0.89). Drugeluting
stents significantly decreased all MACEs combined
(RR 0.40, 95% CI 0.33 to 0.49) but were not associated
with an increased risk of stent thrombosis or death. These
results were confirmed at analysis as stratified by type of
eluting stent, because the need for percutaneous revascularization
was significantly lower for sirolimus-eluting
stents (RR 0.23, 95% CI 0.15 to 0.35) and paclitaxel-eluting
stents (RR 0.39, 95% CIl 0.29 to 0.53).This meta-analysis combined the results of randomized
clinical trials to compare the efficacy of drug-eluting stents
with that of bare metal stents in percutaneous coronary
interventions to ascertain which revascularization strategy
is most safe and effective. The literature identified 13 published
studies, and 8 were included in the main metaanalysis,
thus allowing a meta-analysis on 3,860 patients
for the effect on all major adverse clinical events (MACEs)
combined and for target vessel revascularization. Metaanalyses
were performed for combined MACEs, patient
MACEs, and thrombosis. Regression meta-analyses were
performed to examine the effect of certain variables on the
efficacy of drug-eluting stents compared with bare metal
stents. Meta-analysis of all trials showed that drug-eluting
stents produced significant decreases in the need for percutaneous
revascularization (relative risk [RR] 0.30, 95%
confidence interval [CI] 0.22 to 0.40) and coronary artery
bypass grafting (RR 0.54, 95% CI 0.32 to 0.89). Drugeluting
stents significantly decreased all MACEs combined
(RR 0.40, 95% CI 0.33 to 0.49) but were not associated
with an increased risk of stent thrombosis or death. These
results were confirmed at analysis as stratified by type of
eluting stent, because the need for percutaneous revascularization
was significantly lower for sirolimus-eluting
stents (RR 0.23, 95% CI 0.15 to 0.35) and paclitaxel-eluting
stents (RR 0.39, 95% CIl 0.29 to 0.53)
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