Author
Mikael Danielewicz
Bio: Mikael Danielewicz is an academic researcher. The author has contributed to research in topics: Myocardial infarction & Percutaneous coronary intervention. The author has an hindex of 6, co-authored 9 publications receiving 1542 citations.
Papers
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TL;DR: Routine thrombus aspiration before PCI as compared with PCI alone did not reduce 30-day mortality among patients with STEMI, and results were consistent across all major prespecified subgroups, including subgroups defined according toThrombus burden and coronary flow before PCI.
Abstract: BackgroundThe clinical effect of routine intracoronary thrombus aspiration before primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI ...
926 citations
TL;DR: Among patients with stable angina or an acute coronary syndrome, an iFR‐ guided revascularization strategy was noninferior to an FFR‐guided revascularized strategy with respect to the rate of major adverse cardiac events at 12 months.
Abstract: BackgroundThe instantaneous wave-free ratio (iFR) is an index used to assess the severity of coronary-artery stenosis. The index has been tested against fractional flow reserve (FFR) in small trials, and the two measures have been found to have similar diagnostic accuracy. However, studies of clinical outcomes associated with the use of iFR are lacking. We aimed to evaluate whether iFR is noninferior to FFR with respect to the rate of subsequent major adverse cardiac events. MethodsWe conducted a multicenter, randomized, controlled, open-label clinical trial using the Swedish Coronary Angiography and Angioplasty Registry for enrollment. A total of 2037 participants with stable angina or an acute coronary syndrome who had an indication for physiologically guided assessment of coronary-artery stenosis were randomly assigned to undergo revascularization guided by either iFR or FFR. The primary end point was the rate of a composite of death from any cause, nonfatal myocardial infarction, or unplanned revascul...
652 citations
TL;DR: The rate of the composite of death from any cause, myocardial infarction, or major bleeding was not lower among those who received bivalirudin than among thosewho received heparin monotherapy, and the results were consistent between patients with STEMI and those with NSTEMI and across other major subgroups.
Abstract: BACKGROUND The comparative efficacy of various anticoagulation strategies has not been clearly established in patients with acute myocardial infarction who are undergoing percutaneous coronary inte ...
201 citations
Complutense University of Madrid1, Imperial College London2, University College London3, Universidad Francisco de Vitoria4, King Abdulaziz Medical City5, Uppsala University6, Royal North Shore Hospital7, Lund University8, Cardiovascular Institute of the South9, St. Michael's Hospital10, Örebro University11, Linnaeus University12, Aarhus University Hospital13, Inje University14, Conquest Hospital15, Reykjavík University16, Linköping University17, Karolinska Institutet18, Stony Brook University19, John Radcliffe Hospital20, Ain Shams University21, Charité22, Seoul National University Hospital23, University of Helsinki24, Flinders University25, Keimyung University26, Catholic University of the Sacred Heart27, Sahlgrenska University Hospital28, Emory University29, Cedars-Sinai Medical Center30, Monash University31, Veterans Health Administration32, Istanbul University33, Royal Devon and Exeter Hospital34, University of Ulsan35, Washington University in St. Louis36, Aichi Medical University37, Tokyo Medical University38, Anglia Ruskin University39, French Institute of Health and Medical Research40, VU University Medical Center41, Duke University42, Hammersmith Hospital43
TL;DR: Overall, deferral of revascularization is equally safe with both iFR and FFR, with a low MACE rate of about 4%.
Abstract: Objectives: The aim of this study was to investigate the clinical outcomes of patients deferred from coronary revascularization on the basis of instantaneous wave-free ratio (iFR) or fractional flow reserve (FFR) measurements in stable angina pectoris (SAP) and acute coronary syndromes (ACS). Background: Assessment of coronary stenosis severity with pressure guidewires is recommended to determine the need for myocardial revascularization. Methods: The safety of deferral of coronary revascularization in the pooled per-protocol population (n = 4,486) of the DEFINE-FLAIR (Functional Lesion Assessment of Intermediate Stenosis to Guide Revascularisation) and iFR-SWEDEHEART (Instantaneous Wave-Free Ratio Versus Fractional Flow Reserve in Patients With Stable Angina Pectoris or Acute Coronary Syndrome) randomized clinical trials was investigated. Patients were stratified according to revascularization decision making on the basis of iFR or FFR and to clinical presentation (SAP or ACS). The primary endpoint was major adverse cardiac events (MACE), defined as the composite of all-cause death, nonfatal myocardial infarction, or unplanned revascularization at 1 year. Results: Coronary revascularization was deferred in 2,130 patients. Deferral was performed in 1,117 patients (50%) in the iFR group and 1,013 patients (45%) in the FFR group (p < 0.01). At 1 year, the MACE rate in the deferred population was similar between the iFR and FFR groups (4.12% vs. 4.05%; fully adjusted hazard ratio: 1.13; 95% confidence interval: 0.72 to 1.79; p = 0.60). A clinical presentation with ACS was associated with a higher MACE rate compared with SAP in deferred patients (5.91% vs. 3.64% in ACS and SAP, respectively; fully adjusted hazard ratio: 0.61 in favor of SAP; 95% confidence interval: 0.38 to 0.99; p = 0.04). Conclusions: Overall, deferral of revascularization is equally safe with both iFR and FFR, with a low MACE rate of about 4%. Lesions were more frequently deferred when iFR was used to assess physiological significance. In deferred patients presenting with ACS, the event rate was significantly increased compared with SAP at 1 year.
98 citations
TL;DR: No previous studies have evaluated the performance of the Synergy stent in a large real‐life population, so this is the first study of its kind to evaluate its performance in a real-life population.
Abstract: Background
No previous studies have evaluated the performance of the Synergy stent in a large real-life population
Objectives
To describe the initial real-life experience with a novel everolimus eluting platinum chromium stent with abluminal biodegradable polymer (SYNERGY) in unselected patients from a nationwide registry
Methods
All implanted Synergy stents were compared with other new generation drug eluting stents (n-DES) with >1,000 implantations in Sweden between March 2013 and October 2015 Restenosis, definite stent thrombosis (ST), myocardial infarction (MI) and death rates were assessed using propensity score and Cox regression analyses
Results
A total of 7,886 of Synergy stents and 64,429 other n-DES (BioMatrix, N = 1,953; Orsiro, N = 4,946; Promus Element Plus, N= 2,543; Promus Premier, N= 20,414; Xience Xpedition, N= 7,971, Resolute/Resolute Integrity, N = 19,021; Ultimaster, N = 1,156; Resolute Onyx, N = 6,425) were implanted in 42,357 procedures
Restenosis and stent thrombosis occurred in 642 and 314 cases, respectively, in the overall population at 1 year The cumulative rate of restenosis (11% vs 10%, adjusted HR: 124 95% CI: 088–175; P = 021) and ST (04% vs 05%, adjusted HR: 097; 95% CI: 063–150; P = 017) up to 1 year was low in both the Synergy group and the other n-DES group Death occurred in 52% versus 45% (adjusted HR: 114; 95% CI: 096–136; P = 011) and MI in 32% versus 35%, (adjusted HR: 111; 95% CI: 093–133; P = 024) up to 1 year
Conclusions
In a large real-life population the Synergy stent appears to be safe and effective with a low rate of restenosis and ST comparable with other n-DES © 2017 Wiley Periodicals, Inc
36 citations
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TL;DR: 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation are published.
Abstract: 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC)
6,599 citations
TL;DR: Authors/Task Force Members: Franz-Josef Neumann* (ESC Chairperson) (Germany), Miguel Sousa-Uva* (EACTS Chair person) (Portugal), Anders Ahlsson (Sweden), Fernando Alfonso (Spain), Adrian P. Banning (UK), Umberto Benedetto (UK).
4,342 citations
TL;DR: Neumann et al. as discussed by the authors proposed a task force to evaluate the EACTS Review Co-ordinator's work on gender equality in the context of women's reproductive health.
Abstract: Authors/Task Force Members: Franz-Josef Neumann* (ESC Chairperson) (Germany), Miguel Sousa-Uva* (EACTS Chairperson) (Portugal), Anders Ahlsson (Sweden), Fernando Alfonso (Spain), Adrian P. Banning (UK), Umberto Benedetto (UK), Robert A. Byrne (Germany), Jean-Philippe Collet (France), Volkmar Falk (Germany), Stuart J. Head (The Netherlands), Peter Jüni (Canada), Adnan Kastrati (Germany), Akos Koller (Hungary), Steen D. Kristensen (Denmark), Josef Niebauer (Austria), Dimitrios J. Richter (Greece), Petar M. Seferovi c (Serbia), Dirk Sibbing (Germany), Giulio G. Stefanini (Italy), Stephan Windecker (Switzerland), Rashmi Yadav (UK), Michael O. Zembala (Poland) Document Reviewers: William Wijns (ESC Review Co-ordinator) (Ireland), David Glineur (EACTS Review Co-ordinator) (Canada), Victor Aboyans (France), Stephan Achenbach (Germany), Stefan Agewall (Norway), Felicita Andreotti (Italy), Emanuele Barbato (Italy), Andreas Baumbach (UK), James Brophy (Canada), Héctor Bueno (Spain), Patrick A. Calvert (UK), Davide Capodanno (Italy), Piroze M. Davierwala
3,879 citations
TL;DR: A correction has been published: European Heart Journal, ehaa895, https://doi.org/10.1093/eurheartj/ehaa-895.
Abstract: A correction has been published: European Heart Journal, ehaa895, https://doi.org/10.1093/eurheartj/ehaa895
2,361 citations