Thrombus Aspiration in ST- Elevation myocardial infarction in Scandinavia (TASTE trial)
|
|
- Gilbert Poole
- 5 years ago
- Views:
Transcription
1 UCR Uppsala Clinical Research Center Thrombus Aspiration in ST- Elevation myocardial infarction in Scandinavia (TASTE trial) Main results at 30 days Ole Fröbert, MD, PhD - on behalf of the TASTE investigators Departement of Cardiology Örebro University Hospital Sweden
2 Background Intracoronary thrombus aspiration may reduce distal embolization and improve reperfusion No previous randomized trial on thrombus aspiration has been powered for hard endpoints Current ESC recommendation: class IIa with a level of evidence B
3 TAPAS / Swedish registry data PCI alone (N=16 417) TA+PCI (N=3 666) HR (95% CI): 1.21 ( ) Vlaar, P.J. et al. The Lancet 2008; 371: Fröbert, O. et al. Int J Cardiol. 2010; 145:572-3
4 Methods (1) All 29 Swedish, 1 Icelandic and 1 Danish PCI center Inclusion criteria STEMI and ability to provide oral consent <24 h symptoms correspondence between ECG and angio findings Exclusion criteria need for emergency CABG age <18 years previous randomization in TASTE 1:1 randomization to manual thrombus aspiration and PCI vs. PCI alone
5 Methods (2) Endorsed aspiration catheters Eliminate (Terumo), Export (Medtronic) and Pronto (Vascular Solutions) Anticoagulation and platelet inhibition according to current guideline recommendations Primary endpoint time to all-cause death at 30 days Secondary endpoints time to rehospitalization with reinfarction at 30 days time to stent thrombosis at 30 days
6 Methods (3) TASTE introduces the Registry-based Randomized Clinical Trial (RRCT) concept Online health quality registries (SCAAR and SWEDEHEART) serve as on-line platforms for: randomization case record forms follow-up
7 TASTE trial enrollment flow chart Enrolled in Denmark N=247 All patients with STEMI in Sweden and Iceland undergoing primary or rescue PCI. N= * ) Erroneous enrollments N=15 N=3621 assigned to thrombus aspiration N=3399 underwent thrombus aspiration N=222 underwent conventional PCI Enrolled in TASTE N=7259 Randomized in TASTE N=7244 N=3623 assigned to conventional PCI N=3445 underwent conventional PCI N=178 underwent thrombus aspiration N=1162 underwent thrombus aspiration Not enrolled N=4697 No patients (0) were lost to follow-up of the primary endpoint! N=3535 underwent conventional PCI N=3621 were followed up N=3623 were followed up N=1162 were followed up N=3535 were followed up
8 TASTE and previous studies TASTE
9 Baseline clinical characteristics Randomized in TASTE Not randomized in TASTE PCI Only Thrombus Aspiration PCI Only Thrombus Aspiration N Age - yr. (mean (± SD)) 65.9 (11.7) 66.5 (11.5) 69.4 (12.5) 66.8 (13.5) Male sex - no. (%) 2703 (74.6) 2721 (75.1) 2360 (66.8) 829 (71.3) Diabetes mellitus - no. (%) 453 (12.5) 448 (12.4) 635 (18.0) 162 (13.9) Current smoker - no. (%) 1173 (32.4) 1083 (29.9) 878 (24.8) 317 (27.3) Previous myocardial infarction - no. (%) 439 (12.1) 402 (11.1) 644 (18.2) 191 (16.4) Previous PCI - no. (%) 362 (10.0) 337 (9.3) 438 (12.4) 138 (11.9) Previous CABG - no. (%) 74 (2.0) 70 (1.9) 167 (4.7) 65 (5.6) Symptom to PCI time, min (median (IQR)) 182 ( ) 185 ( ) 210 ( ) 180 ( ) Diagnostic ECG to PCI time, min (median (IQR)) 66 (47-93) 67 (48-94) 72 (50-108) 65 (47-95) Killip class 2 no. (%) 183 (5.1) 198 (5.5) 533 (15.1) 195 (16.8)
10 Baseline procedural characteristics Randomized in TASTE Not randomized in TASTE PCI Only Thrombus Aspiration PCI Only Thrombus Aspiration Radial artery aproach 2415 (66.7) 2394 (66.1) 1949 (55.1) 629 (54.1) ACC/AHA lesion class - no (%) A 420 (11.6) 389 (10.7) 384 (10.9) 88 (7.6) B (37.6) 1317 (36.4) 1315 (37.2) 400 (34.4) B (38.4) 1430 (39.5) 1305 (36.9) 472 (40.6) C 796 (22.0) 778 (21.5) 789 (22.3) 258 (22.2) TIMI flow grade 0 or 1 before PCI - no. (%) 2811 (77.6) 2821 (77.9) NA NA Thrombus score G3 to G5 - % NA NA
11 Post randomization characteristics (1) Randomized in TASTE Not randomized in TASTE PCI Only Thrombus Aspiration P Value PCI Only Thrombus Aspiration Thrombus aspiration - no. (%) 178 (4.9) 3399 (93.9) < (0) 1162 (100) Thrombus aspiration device - no. (%) Terumo Eliminate NA 1748 (48.3) NA NA Medtronic Export NA 1291 (35.7) NA NA Vascular Solutions Pronto NA 380 (10.5) NA NA Procedure-related medication - no. (%) Acetylsalicylic acid 3542 (97.8) 3546 (97.9) (95.3) 1096 (94.3) Clopidogrel/ticlopidine 2395 (66.1) 2384 (65.8) (62.8) 760 (65.4) Ticagrelor 1015 (28.0) 1050 (29.0) (27.1) 351 (30.2) Prasugrel 538 (14.8) 562 (15.5) (11.7) 103 (8.9) Heparin 3074 (84.8) 3063 (84.6) (83.3) 935 (80.5) Bivalirudin 2835 (78.3) 2874 (79.4) (67.1) 764 (65.7) Glucoprotein Glycoprotein IIb/IIIa Iib/IIIa inhibitor inhibitor 630 (17.4) 558 (15.4) (14.6) 322 (27.7)
12 Post randomization characteristics (2) Randomized in TASTE Not randomized in TASTE PCI Only Thrombus Aspiration P Value PCI Only Thrombus Aspiration Direct stenting no. (%) 843 (23.3) 1388 (38.3) < (19.1) 406 (34.9) Stent no. per procedure. Mean (± SD) 1.39 (0.81) 1.35 (0.77) (0.87) 1.24 (0.87) Total stent length (mm). Mean (± SD) 28.5 (16.4) 27.7 (15.9) (16.4) 27.7 (16.6) Stent diameter (mm). Mean (± SD) 3.1 (0.5) 3.1 (0.5) (0.5) 3.2 (0.5) Drug-eluting stent implantation - no. (%) 1742 (48.1) 1703 (47.0) (42.7) 440 (37.9) Treated vessel - no. (%) 0.96 RCA 1560 (43.1) 1543 (42.6) 1324 (37.5) 478 (41.1) LM 38 (1.0) 40 (1.1) 139 (3.9) 45 (3.9) LAD 1611 (44.5) 1612 (44.5) 1690 (47.8) 540 (46.5) LCx 618 (17.1) 598 (16.5) 675 (19.1) 171 (14.7) By-pass graft 33 (0.9) 31 (0.9) 59 (1.7) 42 (3.6) Procedural success (%) 3510 (96.9) 3522 (97.3) (91.0) 1083 (93.2) Procedural x-ray time, sec (median (IQR)) 540 ( ) 625 ( ) < ( ) 682 ( )
13 All-cause mortality at 30 days HR 0.94 ( ), P=0.63 Per protocol analysis based on actual treatment: HR 0.88 ( ), P=0.38
14 Reinfarction at 30 days HR 0.61 ( ), P=0.09 Per protocol analysis based on actual treatment: HR 0.67 ( ), P=0.19
15 Additional results Randomized in TASTE Not randomized in TASTE PCI Only Thrombus Aspiration Point Estimate (95% confidence interval) P Value PCI Only Thrombus Aspiration 30 days All cause death or myocardial infarction - no. (%) 140 (3.9) 121 (3.3) HR 0.86 ( ) (11.6) 134 (11.8) Stent thrombosis - no. (%) 19 (0.5) 9 (0.2) HR 0.47 ( ) (0.5) 5 (0.4) Target vessel revascularization - no. (%) 76 (2.2) 63 (1.8) HR 0.83 ( ) (2.3) 30 (2.6) Target lesion revascularization - no. (%) 57 (1.6) 43 (1.2) HR 0.75 ( ) (1.8) 25 (2.2) Index hospitalization Stroke or neurological complication - no. (%) 18 (0.5) 19 (0.5) OR 1.06 ( ) (0.9) 12 (1.0) Perforation or tamponade - no.(%) 14 (0.4) 13 (0.4) OR 0.93 ( ) (0.4) 7 (0.6) Heart failure - no.(%) 234 (6.5) 245 (6.8) OR 1.05 ( ) (10.0) 125 (10.8) Left ventricular function - no. (%) 0.33 Moderately reduced, LVEF 30-39% 495 (13.7) 526 (14.5) 523 (14.8) 190 (16.4) Severely reduced, LVEF <30% 157 (4.3) 137 (3.8) 255 (7.2) 102 (8.8)
16
17 TASTE vs. TAPAS
18 TASTE vs. TAPAS
19 Conclusions This large, prospective, registry-based randomized clinical trial showed: no reduction of mortality at 30 days no significant reduction of hospitalization for MI or of stent thrombosis at 30 days no reduction of other important clinical endpoints during hospitalization Our findings leave little role for manual thrombus aspiration as a routine adjunct to PCI in STEMI
20 Steering committee Stefan K. James, MD, PhD (chair) Bo Lagerqvist, MD, PhD Göran K. Olivecrona, MD, PhD Michael Mæng, MD, PhD (DENMARK) Thórarinn Gudnason, MD, PhD (ICELAND) Ole Fröbert, MD, PhD (PI) Participating centers Borås Hospital, Sweden. Capio, S:t Görans Hospital, Sweden. Danderyd University Hospital, Sweden. Eskilstuna Hospital, Sweden. Falun Hospital, Sweden. Gävle Hospital, Sweden. Halmstad Hospital, Sweden. Helsingborg Hospital, Sweden. Jönköping Hospital, Sweden. Linköping University Hospital, Sweden. Lund University Hospital, Sweden. Malmö Hospital, Sweden. Kalmar Hospital, Sweden. Karlskrona Hospital, Sweden. Karlstad Hospital, Sweden. Karolinska Institutet, Södersjukhuset, Sweden. Karolinska Solna and Huddinge Hospitals, Sweden. Karolinska University Hospital, Sweden. Kristianstad Hospital, Sweden. Sahlgrenska University Hospital, Gothenburg, Sweden. Skövde Hospital, Sweden. Sunderby Hospital, Sweden. Sundsvall Hospital, Sweden. Trollhättan Hospital, Sweden. Umeå University Hospital, Sweden. Uppsala Clinical research center, Sweden. Västerås Hospital, Sweden. Örebro University Hospital, Sweden. Landspitali University Hospital, Reykjavik, Iceland. Aarhus University Hospital, Denmark.
Outcomes 1 Year after Thrombus Aspiration for Myocardial Infarction
The new england journal of medicine original article Outcomes 1 Year after Thrombus Aspiration for Myocardial Infarction Bo Lagerqvist, M.D., Ph.D., Ole Fröbert, M.D., Ph.D., Göran K. Olivecrona, M.D.,
More informationImpact of thrombus aspiration during ST-Elevation Myocardial Infarction: a six month composite endpoint and risk of stroke analyses of the TASTE trial
Olivecrona et al. BMC Cardiovascular Disorders (2016) 16:62 DOI 10.1186/s12872-016-0238-y RESEARCH ARTICLE Impact of thrombus aspiration during ST-Elevation Myocardial Infarction: a six month composite
More informationIncidence, temporal trends and prognostic impact of heart failure complicating acute myocardial infarction in the SWEDEHEART registry:
Incidence, temporal trends and prognostic impact of heart failure complicating acute myocardial infarction in the SWEDEHEART registry: A study of 199 851 patients from 1996-2008 admitted with an index
More informationTrial Update- TOTAL. Jonathan Byrne
Trial Update- TOTAL Jonathan Byrne No conflicts of interest Background- rationale for thrombectomy Major Limitation of primary PCI: distal embolisation and reduced flow Stonel JACC 2002;39:591-7 Henriques
More informationSTEMI 2014 YAHYA KIWAN. Consultant Cardiologist Head Of Cardiology Belhoul Specialty Hospital
STEMI 2014 YAHYA KIWAN Consultant Cardiologist Head Of Cardiology Belhoul Specialty Hospital Aspiration Thrombectomy Manual aspiration thrombectomy is reasonable for patients undergoing primary PCI. I
More informationRegisterbaserade randomiserade kliniska pro vningar Innovativa exempel fra n dagens pa ga ende hja rt- forskning i Sverige
Registerbaserade randomiserade kliniska pro vningar Innovativa exempel fra n dagens pa ga ende hja rt- forskning i Sverige SWEDE HEART Stefan James, Professor Kardiologi Vetenskaplig ledeare UCR, Uppsala
More informationABSTRACT. n engl j med 369;17 nejm.org october 24,
The new england journal of medicine established in 1812 october 24, 2013 vol. 369 no. 17 Thrombus Aspiration during ST-Segment Elevation Myocardial Infarction Ole Fröbert, M.D., Ph.D., Bo Lagerqvist, M.D.,
More informationProtocol. This trial protocol has been provided by the authors to give readers additional information about their work.
Protocol This trial protocol has been provided by the authors to give readers additional information about their work. Protocol for: Erlinge D, Omerovic E, Fröbert O, et al. Bivalirudin versus heparin
More informationWhat is new in the Treatment of STEMI? Malcolm R. Bell, MBBS Mayo Clinic Rochester, MN
What is new in the Treatment of STEMI? Malcolm R. Bell, MBBS Mayo Clinic Rochester, MN October 2011 Part 2 Summary of newer antithrombotic and antiplatelet agents in STEMI Role of thrombectomy in PPCI
More informationNational registries for quality improvement and research
Swedish experiences: National registries for quality improvement and research Stefan James Professor of Cardiology Uppsala Clinical Research Centre Uppsala University Uppsala, Sweden Evidence based health
More informationUpdated and Guideline Based Treatment of Patients with STEMI
Updated and Guideline Based Treatment of Patients with STEMI Eli I. Lev, MD Director, Cardiac Catheterization Laboratory Hasharon Hospital, Rabin Medical Center Associate Professor of Cardiology Tel-Aviv
More informationAbstract. Background The long-term safety and efficacy of drug-eluting coronary stents have been questioned.
The new england journal of medicine established in 1812 may 7, 29 vol. 36 no. 19 Long-Term Safety and Efficacy of Drug-Eluting versus Bare-Metal Stents in Sweden Stefan K. James, M.D., Ph.D., Ulf Stenestrand,
More informationAsian AMI Registry Session The 17 th Joint Meeting of Coronary Revascularization (JCR 2017) Busan, Korea Dec 8 th 2017
Asian AMI Registry Session The 17 th Joint Meeting of Coronary Revascularization (JCR 2017) Busan, Korea Dec 8 th 2017 Trends of acute myocardial infarction in Korea from the experience of Korea Acute
More informationEffect of upstream clopidogrel treatment in patients with ST-segment elevation myocardial infarction undergoing primary PCI
Effect of upstream clopidogrel treatment in patients with ST-segment elevation myocardial infarction undergoing primary PCI Dr Sasha Koul, MD Dept of Cardiology, Lund University Hospital, Lund, Sweden
More informationBivalirudin versus Heparin Monotherapy in Myocardial Infarction
The new england journal of medicine Original Article versus Monotherapy in Myocardial Infarction D. Erlinge, E. Omerovic, O. Fröbert, R. Linder, M. Danielewicz, M. Hamid, E. Swahn, L. Henareh, H. Wagner,
More informationSTEMI update. Vijay Krishnamoorthy M.D. Interventional Cardiology
STEMI update Vijay Krishnamoorthy M.D. Interventional Cardiology OVERVIEW Current Standard of Care in Management of STEMI Update in management of STEMI Pre-Cath Lab In the ED/Office/EMS. Cath Lab Post
More informationPrimary PCI State of the Art. A/Prof Michael Nguyen Fremantle Hospital/Fiona Stanley Hospital Perth Australia JCR Meeting Busan 2014
Primary PCI State of the Art A/Prof Michael Nguyen Fremantle Hospital/Fiona Stanley Hospital Perth Australia JCR Meeting Busan 2014 Content Evidence of Primary PCI vs Thrombolysis When, Why, How Transfer
More informationSTEMI Primary Percutaneous Coronary Intervention
STEMI Primary Percutaneous Coronary Intervention Abdul Razek Maaty, MD Professor of Medicine Outline Primary PCI Aspiration, manual thrombectomy and distal protection devices Choice of stent Pharmacothaerpy,
More informationBivalirudin versus Heparin Monotherapy in Myocardial Infarction
Original Article versus Monotherapy in Myocardial Infarction D. Erlinge, E. Omerovic, O. Fröbert, R. Linder, M. Danielewicz, M. Hamid, E. Swahn, L. Henareh, H. Wagner, P. Hårdhammar, I. Sjögren, J. Stewart,
More informationLessons learned From The National PCI Registry
Lessons learned From The National PCI Registry w a v e On Behalf of The Publication Committee of the National PCI Registry Objectives & Anticipated Achievements To determine the epidemiology of patients
More informationORIGINAL ARTICLE Bivalirudin versus Heparin Monotherapy in Myocardial Infarction David Erlinge, M.D., Ph.D., Elmir Omerovic, M.D., Ph.D.
ORIGINAL ARTICLE Bivalirudin versus Heparin Monotherapy in Myocardial Infarction David Erlinge, M.D., Ph.D., Elmir Omerovic, M.D., Ph.D., Ole Fröbert, M.D., Ph.D., Rikard Linder, M.D., Ph.D., Mikael Danielewicz,
More informationSCAAR: Lower late and very late stent thrombosis rates with new generation drug eluting stents compared to bare metal stents
SCAAR: Lower late and very late stent thrombosis rates with new generation drug eluting stents compared to bare metal stents Christoph Varenhorst, Giovanna Sarno, Göran Olivecrona, Per Tornvall, Johan
More informationRevived indications for thrombus aspiration during primary PCI: Unanswered questions after TAPAS
Revived indications for thrombus aspiration during primary PCI: Unanswered questions after TAPAS Gregg W. Stone MD Columbia University Medical Center Cardiovascular Research Foundation Disclosures Gregg
More informationLong-Term Outcomes with Drug-Eluting Stents versus Bare-Metal Stents in Sweden
original article Long-Term Outcomes with Drug-Eluting s versus Bare-Metal s in Sweden Bo Lagerqvist, M.D., Ph.D., Stefan K. James, M.D., Ph.D., Ulf Stenestrand, M.D., Ph.D., Johan Lindbäck, M.Sc., Tage
More informationBivalirudin Clinical Trials Update Evidence and Future Perspectives
Bivalirudin Clinical Trials Update Evidence and Future Perspectives Andreas Baumbach Consultant Cardiologist/ hon. Reader in Cardiology Bristol Heart Institute University Hospitals Bristol MY CONFLICTS
More informationSWEDEHEART. Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies
SWEDEHEART Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies Tomas Jernberg TAVI Chairman, SWEDEHEART Karolinska University
More informationWhat is the Optimal Triple Anti-platelet Therapy Duration in Patients with Acute Myocardial Infarction Undergoing Drug-eluting Stents Implantation?
What is the Optimal Triple Anti-platelet Therapy Duration in Patients with Acute Myocardial Infarction Undergoing Drug-eluting Stents Implantation? Keun-Ho Park, Myung Ho Jeong, Min Goo Lee, Jum Suk Ko,
More informationNCVD-PCI Registry. Percutaneous Coronary Intervention (PCI) Registry, MALAYSIA c/o National Heart Association of Malaysia
NCVD-PCI Registry National Cardiovascular Disease Database (NCVD) National Cardiovascular Disease Database (NCVD) Percutaneous Coronary Intervention (PCI) Registry, MALAYSIA c/o National Heart Association
More informationMid-term results from real-world REPARA registry. Felipe Hernandez, on behalf of the REPARA investigators
Mid-term results from real-world REPARA registry Felipe Hernandez, on behalf of the REPARA investigators Potential conflicts of interest Speaker's name: Felipe Hernandez I have the following potential
More informationOptimal antithrombotic therapy:
Optimal antithrombotic therapy: upstream and during primary PCI. Steen D Kristensen, MD, DMSc, FESC Professor and Consultant Interventional Cardiologist Aarhus University, Denmark UNIVERSITY OF AARHUS
More informationLearning Objectives. Epidemiology of Acute Coronary Syndrome
Cardiovascular Update: Antiplatelet therapy in acute coronary syndromes PHILLIP WEEKS, PHARM.D., BCPS-AQ CARDIOLOGY Learning Objectives Interpret guidelines as they relate to constructing an antiplatelet
More informationWhat oral antiplatelet therapy would you choose? a) ASA alone b) ASA + Clopidogrel c) ASA + Prasugrel d) ASA + Ticagrelor
76 year old female Prior Hypertension, Hyperlipidemia, Smoking On Hydrochlorothiazide, Atorvastatin New onset chest discomfort; 2 episodes in past 24 hours Heart rate 122/min; BP 170/92 mm Hg, Killip Class
More informationThe Case for Multivessel Revascularization in Shock
The Case for Multivessel Revascularization in Shock Emmanouil S. Brilakis, MD, PhD Minneapolis Heart Institute 9.37 9.49 am Disclosures Consulting/speaker honoraria: Abbott Vascular, American Heart Association
More informationResolute in Bifurcation Lesions: Data from the RESOLUTE Clinical Program
Resolute in Bifurcation Lesions: Data from the RESOLUTE Clinical Program Prof. Ran Kornowski, MD, FESC, FACC Director - Division of Interventional Cardiology Rabin Medical Center and Tel Aviv University,
More informationSYSTEMATIC MANUAL THROMBUS ASPIRATION: PRO
SYSTEMATIC MANUAL THROMBUS ASPIRATION: PRO FRANCESCO BURZOTTA INSTITUTE OF CARDIOLOGY CATHOLIC UNIVERSITY OF THE SACRED HEART ROME, ITALY CONTROVERSIES IN PRIMARY PERCUTANEOUS CORONARY INTERVENTION ESC
More informationRandomized Comparison of Prasugrel and Bivalirudin versus Clopidogrel and Heparin in Patients with ST-Segment Elevation Myocardial Infarction
Randomized Comparison of Prasugrel and Bivalirudin versus Clopidogrel and Heparin in Patients with ST-Segment Elevation Myocardial Infarction The Bavarian Reperfusion Alternatives Evaluation (BRAVE) 4
More informationThrombus aspiration during percutaneous coronary intervention
Impact of Thrombus Aspiration on Mortality, Stent Thrombosis, and Stroke in Patients With ST-Segment Elevation Myocardial Infarction: A Report From the Swedish Coronary Angiography and Angioplasty Registry
More informationNational registries for quality improvement and research
Swedish experiences: National registries for quality improvement and research Stefan James Professor of Cardiology Uppsala Clinical Research Centre Uppsala University Uppsala, Sweden Evidence based health
More informationWhen Aspiration Thrombectomy Does Not Work? A A R O N W O N G N A T I O N A L H E A R T C E N T R E S I N G A P O R E
When Aspiration Thrombectomy Does Not Work? A A R O N W O N G N A T I O N A L H E A R T C E N T R E S I N G A P O R E Thrombus in STEMI Over 70% of STEMI patients has angiographic evidence of thrombus
More informationSupplementary Table S1: Proportion of missing values presents in the original dataset
Supplementary Table S1: Proportion of missing values presents in the original dataset Variable Included (%) Missing (%) Age 89067 (100.0) 0 (0.0) Gender 89067 (100.0) 0 (0.0) Smoking status 80706 (90.6)
More informationBeta-blockers in Patients with Mid-range Left Ventricular Ejection Fraction after AMI Improved Clinical Outcomes
Beta-blockers in Patients with Mid-range Left Ventricular Ejection Fraction after AMI Improved Clinical Outcomes Seung-Jae Joo and other KAMIR-NIH investigators Department of Cardiology, Jeju National
More informationTarget vessel only revascularization versus complet revascularization in non culprit lesions in acute myocardial infarction treated by primary PCI
Target vessel only revascularization versus complet revascularization in non culprit lesions in acute myocardial infarction treated by primary PCI Gamal Abdelhady, Emad Mahmoud Department of interventional
More informationPCI Update Qesaria 2009
PCI Update Qesaria 2009 Amit Segev Interventional Cardiology Chaim Outline Primary PCI Non-ST elevation ACS Multi-vessel disease Hemodynamic assessment of borderline lesions - FFR Stable AP Non-coronary
More informationThrombus Aspiration before PCI: Routine Mandatory. Professor Clinical Cardiology Academic Medical Center University of Amsterdam
Seoul, 27 April TCT AP 2010 Thrombus Aspiration before PCI: Routine Mandatory Robbert J de Winter MD PhD FESC Professor Clinical Cardiology Academic Medical Center University of Amsterdam AMC Amsterdam
More informationDECLARATION OF CONFLICT OF INTEREST. Lecture fees: AstraZeneca, Ely Lilly, Merck.
DECLARATION OF CONFLICT OF INTEREST Lecture fees: AstraZeneca, Ely Lilly, Merck. Risk of stopping dual therapy. S D Kristensen, FESC Aarhus Denmark Acute coronary syndrome: coronary thrombus Platelets
More informationVerwendung von routinemässig erhobenen Daten für pragmatische randomisierte Studien: Erste Erfahrungen in der Schweiz
Verwendung von routinemässig erhobenen Daten für pragmatische randomisierte Studien: Erste Erfahrungen in der Schweiz Landesmuseum, Zürich, 21. November 2017 Prof. Dr. med. Heiner C. Bucher MPH Institut
More informationEXCEL vs. NOBLE: How to Treat Left Main Disease in 2017 AATS International Cardiovascular Symposium December 8-9, 2017
EXCEL vs. NOBLE: How to Treat Left Main Disease in 2017 AATS International Cardiovascular Symposium December 8-9, 2017 Igor F. Palacios, MD Director of Interventional Cardiology Professor of Medicine Massachusetts
More informationThrombectomy. how? For whom?
Thrombectomy how? For whom? Marco Zimarino, MD, PhD Institute of Cardiology - University G. d Annunzio, Chieti (Italy) Why Manual Thrombectomy? Pros 1 Extraction of thrombotic material, acute reduction
More informationThe MAIN-COMPARE Study
Long-Term Outcomes of Coronary Stent Implantation versus Bypass Surgery for the Treatment of Unprotected Left Main Coronary Artery Disease Revascularization for Unprotected Left MAIN Coronary Artery Stenosis:
More informationPharmaco-Invasive Approach for STEMI
Pharmaco-Invasive Approach for STEMI Michael C. Kontos, MD Medical Director, Coronary Intensive Care Unit Director, Chest Pain Evaluation Center Associate Professor Departments of Internal Medicine (Cardiology),
More informationEXAMINATION trial. Manel Sabaté Hospital Clínic, Barcelona (On behalf of the Examination Investigators)
Manel Sabaté Hospital Clínic, Barcelona (On behalf of the Examination Investigators) Disclosures Investigator Initiated Trial: NCT00828087. Unrestricted grant from Abbott to the Spanish Heart Foundation.
More informationSafety of Single- Versus Multi-vessel Angioplasty for Patients with AMI and Multi-vessel CAD
Safety of Single- Versus Multi-vessel Angioplasty for Patients with AMI and Multi-vessel CAD Mun K. Hong, MD Associate Professor of Medicine Director, Cardiovascular Intervention and Research Weill Cornell
More informationACUTE CORONARY SYNDROME PCI IN THE ELDERLY
ACUTE CORONARY SYNDROME PCI IN THE ELDERLY G.KARABELA MD.PhD ATHENS NAVAL HOSPITAL INTERVENTIONAL CARDIOLOGY DEPARTMENT NO CONFLICT OF INTEREST TO DECLAIRE Risk stratification in Αcute Coronary Syndrome.
More informationGuideline for STEMI. Reperfusion at a PCI-Capable Hospital
MANSOURA. 2015 Guideline for STEMI Reperfusion at a PCI-Capable Hospital Mahmoud Yossof MANSOURA 2015 Reperfusion Therapy for Patients with STEMI *Patients with cardiogenic shock or severe heart failure
More informationORIGINAL INVESTIGATION. Fibrinolytic Therapy in Patients 75 Years and Older With ST-Segment Elevation Myocardial Infarction
ORIGINAL INVESTIGATION in Patients 75 Years and Older With ST-Segment Elevation Myocardial Infarction One-Year Follow-up of a Large Prospective Cohort Ulf Stenestrand, MD; Lars Wallentin, MD, PhD; for
More information1. Whether the risks of stent thrombosis (ST) and major adverse cardiovascular and cerebrovascular events (MACCE) differ from BMS and DES
1 Comparison of Ischemic and Bleeding Events After Drug- Eluting Stents or Bare Metal Stents in Subjects Receiving Dual Antiplatelet Therapy: Results from the Randomized Dual Antiplatelet Therapy (DAPT)
More informationFrom STEMIs to Stents: Updates in PCI practice
From STEMIs to Stents: Updates in PCI practice Arnold Seto, MD, MPA Assistant Clinical Professor, UC-Irvine and Long Beach VA Director of Interventional Cardiology Research Hospitalizations in the U.S.
More informationPROMUS Element Experience In AMC
Promus Element Luncheon Symposium: PROMUS Element Experience In AMC Jung-Min Ahn, MD. University of Ulsan College of Medicine, Heart Institute, Asan Medical Center, Seoul, Korea PROMUS Element Clinical
More informationClinical Seminar. Which Diabetic Patient is a Candidate for Percutaneous Coronary Intervention - European Perspective
Clinical Seminar Which Diabetic Patient is a Candidate for Percutaneous Coronary Intervention - European Perspective Stephan Windecker Department of Cardiology Swiss Cardiovascular Center and Clinical
More informationSCAN-B Pilot study in Helsingborg
SCAN-B Pilot study in Helsingborg Martin Malmberg Department of Oncology Christian Brueffer SCAN-B Lao Saal SCAN-B Anna Ehinger Department of Clinical Pathology Lund Dorthe Grabau Johan Vallon Christersson
More informationThe SORT OUT VI Trial
A Prospective, Randomized, "All-Comers" Trial of Biodegradable Polymer-Coated Biolimus-Eluting Stents vs. Biocompatible Polymer-Coated Zotarolimus-Eluting Stents The SORT OUT VI Trial Bent Raungaard, Lisette
More informationNovel Anticoagulation Therapy in Acute Coronary Syndrome
Novel Anticoagulation Therapy in Acute Coronary Syndrome Soon Jun Hong Korea University Anam Hospital 1 Thrombus Formation Cascade Coagulation Cascade Platelet Cascade TXA2 Aspirin R Inhibitor Fondaparinux
More informationSafety-outcomes of bioresorbable Everolimus eluting scaffold in (German-Austrian-ABSORB RegIsteR)
Safety-outcomes of bioresorbable Everolimus eluting scaffold in 2168 patients with CAD: 30 days follow-up from the GABI-R (German-Austrian-ABSORB RegIsteR) C. Hamm, University of Giessen, Germany on behalf
More informationΑ-Δ. ΜΑΤΡΟΓΙΑΝΝΗ ΚΑΡΔΙΟΛΟΓΟ AIMOΔΤΝΑΜΙΚΟ ΕΡΓΑΣΗΡΙΟ Γ.Ν.Θ. Γ. ΠΑΠΑΝΙΚΟΛΑΟΤ ΘΕΑΛΟΝΙΚΗ
Α-Δ. ΜΑΤΡΟΓΙΑΝΝΗ ΚΑΡΔΙΟΛΟΓΟ AIMOΔΤΝΑΜΙΚΟ ΕΡΓΑΣΗΡΙΟ Γ.Ν.Θ. Γ. ΠΑΠΑΝΙΚΟΛΑΟΤ ΘΕΑΛΟΝΙΚΗ Angiographic no reflow TIMI grade 0 No antegrade flow beyond the point of obstruction I Contrast material is able
More informationLM stenting - Cypher
LM stenting - Cypher Left main stenting with BMS Since 1995 Issues in BMS era AMC Restenosis and TLR (%) 3 27 TLR P=.282 Restenosis P=.71 28 2 1 15 12 Ostium 5 4 Shaft Bifurcation Left main stenting with
More informationStephan Windecker Department of Cardiology Swiss Cardiovascular Center and Clinical Trials Unit Bern Bern University Hospital, Switzerland
Advances in Antiplatelet Therapy in PCI and ACS Stephan Windecker Department of Cardiology Swiss Cardiovascular Center and Clinical Trials Unit Bern Bern University Hospital, Switzerland Targets for Platelet
More informationA Randomized Trial Evaluating Clinically Significant Bleeding with Low-Dose Rivaroxaban vs Aspirin, in Addition to P2Y12 inhibition, in ACS
A Randomized Trial Evaluating Clinically Significant Bleeding with Low-Dose Rivaroxaban vs Aspirin, in Addition to P2Y12 inhibition, in ACS Magnus Ohman MB, on behalf of the GEMINI-ACS-1 Investigators
More information3/23/2017. Angelika Cyganska, PharmD Austin T. Wilson, MS, PharmD Candidate Europace Oct;14(10): Epub 2012 Aug 24.
Angelika Cyganska, PharmD Austin T. Wilson, MS, PharmD Candidate 2017 Explain the efficacy and safety of triple therapy, in regards to thromboembolic and bleeding risk Summarize the guideline recommendations
More informationAngelika Cyganska, PharmD Austin T. Wilson, MS, PharmD Candidate 2017
Angelika Cyganska, PharmD Austin T. Wilson, MS, PharmD Candidate 2017 Explain the efficacy and safety of triple therapy, in regards to thromboembolic and bleeding risk Summarize the guideline recommendations
More informationPercutaneous Coronary Interventions Without On-site Cardiac Surgery
Percutaneous Coronary Interventions Without On-site Cardiac Surgery Hassan Al Zammar, MD,FESC Consultant & Interventional Cardiologist Head of Cardiology Department European Gaza Hospital Palestine European
More informationOptimal antiplatelet and anticoagulant therapy for patients treated in STEMI network
Torino 6 Joint meeting with Mayo Clinic Great Innovation in Cardiology 14-15 Ottobre 2010 Optimal antiplatelet and anticoagulant therapy for patients treated in STEMI network Diego Ardissino Ischemic vs
More informationKorea University Guro Hospital, Seoul, Korea * Chonnam National University Hospital, Gwangju, Korea
Left Main Disease versus Non Left Main Disease in Acute Myocardial Infarction Patients in Real world Clinical Practice : Lessons from Korea Acute Myocardial Infarction Registry (KAMIR) Seung-Woon Rha*,
More informationDECLARATION OF CONFLICT OF INTEREST
DECLARATION OF CONFLICT OF INTEREST How to manage antiplatelet treatment in patients with diabetes in acute coronary syndrome Lars Wallentin Professor of Cardiology, Chief Researcher Cardiovascular Science
More informationTherapeutic Advances in Cardiology
Page 5 to 11 Volume 1 Issue 1 2016 Review Article Therapeutic Advances in Cardiology Thromboaspiration during Primary PCI. When, Where and How? ISSN: 2575-5161 Athanassios Antonopoulos 1,2 * and Evangelia
More informationORIGINAL ARTICLE. Rescue PCI Versus a Conservative Approach for Failed Fibrinolysis in Patients with STEMI
Heart Mirror Journal From Affiliated Egyptian Universities and Cardiology Centers Vol. 6, No. 3, 2012 ISSN 1687-6652 ORIGINAL ARTICLE for Failed Fibrinolysis in Patients with STEMI Mohamed Salem, MD, PhD;
More informationFine-tuning treatment for patients with ST-elevation myocardial infarction
Editorial Fine-tuning treatment for patients with ST-elevation myocardial infarction Feng Qian, Edward L. Hannan University at Albany-State University of New York, Albany, NY, USA Correspondence to: Feng
More informationA Large Prospective Randomized Trial of DES vs BMS in Patients with STEMI
HORIZONS-AMI: A Large Prospective Randomized Trial of DES vs BMS in Patients with STEMI Gregg W. Stone MD Columbia University Medical Center Cardiovascular Research Foundation Disclosures Gregg W. Stone
More informationInstantaneous Wave-free Ratio versus Fractional Flow Reserve to Guide PCI
Original Article Instantaneous Wave-free Ratio versus Fractional Flow Reserve to Guide PCI M. Götberg, E.H. Christiansen, I.J. Gudmundsdottir, L. Sandhall, M. Danielewicz, L. Jakobsen, S.-E. Olsson, P.
More informationAdjunctive Antithrombotic for PCI. SCAI Fellows Course December 9, 2013
Adjunctive Antithrombotic for PCI SCAI Fellows Course December 9, 2013 Theodore A Bass, MD FSCAI President SCAI Professor of Medicine, University of Florida Medical Director UF Shands CV Center,Jacksonville
More informationUnprotected LM intervention
Unprotected LM intervention Guideline for COMBAT Seung-Jung Park, MD, PhD Professor of Internal Medicine, Seoul, Korea Current Recommendation for unprotected LMCA Stenosis Class IIb C in ESC guideline
More informationRevascularization after Drug-Eluting Stent Implantation or Coronary Artery Bypass Surgery for Multivessel Coronary Disease
Impact of Angiographic Complete Revascularization after Drug-Eluting Stent Implantation or Coronary Artery Bypass Surgery for Multivessel Coronary Disease Young-Hak Kim, Duk-Woo Park, Jong-Young Lee, Won-Jang
More informationSupplementary Online Content
Supplementary Online Content Valle JA, Tamez H, Abbott JD, et al. Contemporary use and trends in unprotected left main coronary artery percutaneous coronary intervention in the United States: an analysis
More informationHow to approach non-infarct related artery disease in patients with STEMI in a limited resource setting
How to approach non-infarct related artery disease in patients with STEMI in a limited resource setting Ahmed A A Suliman, MBBS, FACP, FESC Associate Professor, University of Khartoum Interventional Cardiologist,
More informationTicagrelor compared with clopidogrel in patients with acute coronary syndromes the PLATO trial
compared with clopidogrel in patients with acute coronary syndromes the PLATO trial August 30, 2009 at 08.00 CET PLATO background In NSTE-ACS and STEMI, current guidelines recommend 12 months aspirin and
More informationISAR-LEFT MAIN: A Randomized Clinical Trial on Drug-Eluting Stents for Unprotected Left Main Lesions
Julinda Mehilli, MD Deutsches Herzzentrum Technische Universität Munich Germany ISAR-LEFT MAIN: A Randomized Clinical Trial on Drug-Eluting Stents for Unprotected Left Main Lesions Background Left main
More informationCangrelor: Is it the new CHAMPION for PCI? Robert Barcelona, PharmD, BCPS Clinical Pharmacy Specialist, Cardiac Intensive Care Unit November 13, 2015
Cangrelor: Is it the new CHAMPION for PCI? Robert Barcelona, PharmD, BCPS Clinical Pharmacy Specialist, Cardiac Intensive Care Unit November 13, 2015 Objectives Review the pharmacology and pharmacokinetic
More informationTicagrelor compared with clopidogrel in patients with acute coronary syndromes the PLATelet Inhibition and patient Outcomes trial
compared with clopidogrel in patients with acute coronary syndromes the PLATelet Inhibition and patient Outcomes trial Outcomes in patients with and planned PCI Ph.Gabriel Steg*, Stefan James, Robert A
More informationFACTOR Xa AND PAR-1 BLOCKER : ATLAS-2, APPRAISE-2 & TRACER TRIALS
New Horizons In Atherothrombosis Treatment 2012 순환기춘계학술대회 FACTOR Xa AND PAR-1 BLOCKER : ATLAS-2, APPRAISE-2 & TRACER TRIALS Division of Cardiology, Jeonbuk National University Medical School Jei Keon Chae,
More informationjournal of medicine The new england Instantaneous Wave-free Ratio versus Fractional Flow Reserve to Guide PCI abstract
The new england journal of medicine established in 1812 May 11, 2017 vol. 376 no. 19 Instantaneous Wave-free Ratio versus Fractional Flow Reserve to Guide PCI M. Götberg, E.H. Christiansen, I.J. Gudmundsdottir,
More informationChronic Total Occlusions in Sweden A Report from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR)
A Report from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR) Truls Råmunddal 1 *., Loes Hoebers 2., Jose P. S. Henriques 2, Christian Dworeck 1, Oskar Angerås 1, Jacob Odenstedt 1, Dan
More informationImpact of Thromboaspiration during Primary PCI on infarcted segmental myocardial function: a Tissue Doppler imaging evaluation. EXPIRA Trial substudy.
Impact of Thromboaspiration during Primary PCI on infarcted segmental myocardial function: a Tissue Doppler imaging evaluation. EXPIRA Trial substudy. GENNARO SARDELLA, MD, FACC,FESC; MASSIMO MANCONE,
More information1. Diabetes mellitus (DM) is associated with worse clinical and angiographic outcomes even in acute myocardial Infarction (AMI) patients.
Midterm Clinical Outcomes of Insulin Requiring Diabetes Mellitus versus Non-insulin Dependent Diabetes Mellitus in Acute Myocardial Infarction Patients in Drug Eluting Stent Era : Insight from Korea Acute
More informationTICAGRELOR VERSUS CLOPIDOGREL AFTER THROMBOLYTIC THERAPY IN PATIENTS WITH ST- ELEVATION MYOCARDIAL INFARCTION: A RANDOMIZED CLINICAL TRIAL
TICAGRELOR VERSUS CLOPIDOGREL AFTER THROMBOLYTIC THERAPY IN PATIENTS WITH ST- ELEVATION MYOCARDIAL INFARCTION: A RANDOMIZED CLINICAL TRIAL Otavio Berwanger, MD, PhD - On behalf of the TREAT Trial Steering
More informationThree-Year Clinical Outcomes with Everolimus-Eluting Bioresorbable Scaffolds: Results from the Randomized ABSORB III Trial Stephen G.
Three-Year Clinical Outcomes with Everolimus-Eluting Bioresorbable Scaffolds: Results from the Randomized ABSORB III Trial Stephen G. Ellis MD Dean J. Kereiakes MD and Gregg W. Stone MD for the ABSORB
More informationAre Asian Patients Different? - Updates Of Biomatrix Experience In Regional Settings: BEACON II (3 Yr F up) &
Are Asian Patients Different? - Updates Of Biomatrix Experience In Regional Settings: BEACON II (3 Yr F up) & Biomatrix TM Single Center Experience (Indonesia)(Final 5 Yr F up) T. Santoso University of
More informationControversies in Cardiac Pharmacology
Controversies in Cardiac Pharmacology Thomas D. Conley, MD FACC FSCAI Disclosures I have no relevant relationships with commercial interests to disclose. 1 Doc, do I really need to take all these medicines?
More information(ClinicalTrials.gov ID: NCT ) Title: The Italian Elderly ACS Study Author: Stefano Savonitto. Date: 29 August 2011 Meeting: ESC congress, Paris
Early aggressive versus initially conservative strategy in elderly patients with non-st- elevation acute coronary syndrome: the Italian randomised trial (ClinicalTrials.gov ID: NCT00510185) Stefano Savonitto,
More informationDepartment of Medicine III, Martin Luther-University Halle, Germany b. Unità Operativa di Cardiologia, Ospedale Maggiore, Bologna, Italy c
Comparison of CHADS 2 -Score with CHA 2 DS 2 VASc-Score in a prospective multicenter registry on patients with atrial fibrillation undergoing coronary artery stenting -First results from the AFCAS-trial-
More informationMinimalist immediate mechanical intervention in acute ST-segment elevation myocardial infarction: is it time to redefine targets?
Editorial Minimalist immediate mechanical intervention in acute ST-segment elevation myocardial infarction: is it time to redefine targets? Philip Francis Dingli, Javier Escaned Department of Interventional
More informationMeet the Guidelines Le principali novità che modificheranno la nostra pratica clinica: STEMI
Meet the Guidelines 2017. Le principali novità che modificheranno la nostra pratica clinica: STEMI Guido Parodi Cardiologia Interventistica AOU Sassari Scuola di Specializzazione in Malattie dell Apparato
More information