Journal ArticleDOI
A Prospective Natural-History Study of Coronary Atherosclerosis
Gregg W. Stone,Akiko Maehara,Alexandra J. Lansky,Bernard De Bruyne,Ecaterina Cristea,Gary S. Mintz,Roxana Mehran,John A. McPherson,Naim Farhat,Steven P. Marso,Helen Parise,Barry Templin,Roseann White,Zhen Zhang,Patrick W. Serruys +14 more
TLDR
In patients who presented with an acute coronary syndrome and underwent percutaneous coronary intervention, major adverse cardiovascular events occurring during follow-up were equally attributable to recurrence at the site of culprit lesions and to nonculprit lesions.Abstract:
A b s t r ac t Background Atherosclerotic plaques that lead to acute coronary syndromes often occur at sites of angiographically mild coronary-artery stenosis. Lesion-related risk factors for such events are poorly understood. Methods In a prospective study, 697 patients with acute coronary syndromes underwent three-vessel coronary angiography and gray-scale and radiofrequency intravascular ultrasonographic imaging after percutaneous coronary intervention. Subsequent major adverse cardiovascular events (death from cardiac causes, cardiac arrest, myocardial infarction, or rehospitalization due to unstable or progressive angina) were adjudicated to be related to either originally treated (culprit) lesions or untreated (nonculprit) lesions. The median follow-up period was 3.4 years. Results The 3-year cumulative rate of major adverse cardiovascular events was 20.4%. Events were adjudicated to be related to culprit lesions in 12.9% of patients and to nonculprit lesions in 11.6%. Most nonculprit lesions responsible for follow-up events were angiographically mild at baseline (mean [±SD] diameter stenosis, 32.3±20.6%). However, on multivariate analysis, nonculprit lesions associated with recurrent events were more likely than those not associated with recurrent events to be characterized by a plaque burden of 70% or greater (hazard ratio, 5.03; 95% confidence interval [CI], 2.51 to 10.11; P<0.001) or a minimal luminal area of 4.0 mm 2 or less (hazard ratio, 3.21; 95% CI, 1.61 to 6.42; P = 0.001) or to be classified on the basis of radiofrequency intravascular ultrasonography as thin-cap fibroatheromas (hazard ratio, 3.35; 95% CI, 1.77 to 6.36; P<0.001). Conclusions In patients who presented with an acute coronary syndrome and underwent percutaneous coronary intervention, major adverse cardiovascular events occurring during follow-up were equally attributable to recurrence at the site of culprit lesions and to nonculprit lesions. Although nonculprit lesions that were responsible for unanticipated events were frequently angiographically mild, most were thin-cap fibroatheromas or were characterized by a large plaque burden, a small luminal area, or some combination of these characteristics, as determined by gray-scale and radiofrequency intravascular ultrasonography. (Funded by Abbott Vascular and Volcano; ClinicalTrials.gov number, NCT00180466.)read more
Citations
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2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC)
Marco Roffi,Carlo Patrono,Jean-Philippe Collet,Christian Mueller,Marco Valgimigli,Felicita Andreotti,Jeroen J. Bax,Michael A. Borger,Carlos Brotons,Derek P. Chew,Baris Gencer,Gerd Hasenfuss,Keld Kjeldsen,Patrizio Lancellotti,Ulf Landmesser,Julinda Mehilli,Debabrata Mukherjee,Robert F. Storey,Stephan Windecker +18 more
TL;DR: The current guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation are based on the findings of the ESC Task Force on 12 March 2015.
Journal ArticleDOI
2018 ESC/EACTS Guidelines on myocardial revascularization.
Miguel Sousa-Uva,Franz-Josef Neumann,Anders Ahlsson,Fernando Alfonso,Adrian P. Banning,Umberto Benedetto,Robert A. Byrne,Jean-Philippe Collet,Falk,Stuart J. Head,Peter Jüni,Adnan Kastrati,Akos Koller,Steen Dalby Kristensen,Josef Niebauer,Dimitrios J. Richter,Petar M. Seferovic,Dirk Sibbing,Giulio G. Stefanini,Stephan Windecker,Rashmi Yadav,Michael O. Zembala +21 more
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).
Journal ArticleDOI
2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology.
Gilles Montalescot,Udo Sechtem,Stephan Achenbach,Felicita Andreotti,Chris Arden,Andrzej Budaj,Raffaele Bugiardini,Filippo Crea,Thomas Cuisset,Carlo Di Mario,J. Rafael Ferreira,Bernard J. Gersh,Anselm K. Gitt,Jean-Sébastien Hulot,Nikolaus Marx,Lionel H. Opie,Matthias Pfisterer,Eva Prescott,Frank Ruschitzka,Manel Sabaté,Roxy Senior,David P. Taggart,Ernst E. van der Wall,Christiaan J. Vrints,José Luis Zamorano,Helmut Baumgartner,Jeroen J. Bax,Héctor Bueno,Veronica Dean,Christi Deaton,Çetin Erol,Robert Fagard,Roberto Ferrari,David Hasdai,Arno W. Hoes,Paulus Kirchhof,Juhani Knuuti,Philippe Kolh,Patrizio Lancellotti,Aleš Linhart,Petros Nihoyannopoulos,Massimo F Piepoli,Piotr Ponikowski,Per Anton Sirnes,Juan Tamargo,Michal Tendera,Adam Torbicki,William Wijns,Stephan Windecker,Marco Valgimigli,Marc J. Claeys,Norbert Donner-Banzhoff,Herbert Frank,Christian Funck-Brentano,Oliver Gaemperli,José Ramón González-Juanatey,Michalis Hamilos,Steen Husted,Stefan James,Kari Kervinen,Steen Dalby Kristensen,Aldo P. Maggioni,Axel R. Pries,Francesco Romeo,Lars Rydén,Maarten L. Simoons,Ph. Gabriel Steg,Adam Timmis,Aylin Yildirir +68 more
TL;DR: The If Inhibitor Ivabradine in Patients With Coronary Artery Disease and Left Ventricular Dysfunction is evaluated as well as patients with Diabetes mellitus for Optimal management of Multivessel disease.
Journal ArticleDOI
2014 ESC/EACTS Guidelines on myocardial revascularization: The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI).
Stephan Windecker,Philippe Kolh,Fernando Alfonso,Jean-Philippe Collet,Jochen Cremer,Volkmar Falk,Gerasimos Filippatos,Christian W. Hamm,Stuart J. Head,Peter Jüni,A. Pieter Kappetein,Adnan Kastrati,Juhani Knuuti,Ulf Landmesser,Günther Laufer,Franz-Josef Neumann,Dimitrios J. Richter,Patrick Schauerte,Miguel Sousa Uva,Giulio G. Stefanini,David P. Taggart,Lucia Torracca,Marco Valgimigli,William Wijns,Adam Witkowski +24 more
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.
Journal ArticleDOI
ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation
Christian W. Hamm,Jean-Pierre Bassand,Stefan Agewall,Jeroen J. Bax,Eric Boersma,Héctor Bueno,Pio Caso,Dariusz Dudek,Stephan Gielen,Kurt Huber,Magnus Ohman,Mark C. Petrie,Frank Sonntag,Miguel Sousa Uva,Robert F. Storey,William Wijns,Doron Zahger +16 more
TL;DR: This paper presents a Randomized Assessment of Acute Coronary Syndrome Treatment of Intracoronary Stenting With Antithrombotic Regimen and Harmonizing Outcomes with RevasculariZatiON and Stents in Acute Myocardial Infarction.
References
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Heart Disease and Stroke Statistics—2010 Update A Report From the American Heart Association
Donald M. Lloyd-Jones,Robert J. Adams,Todd M. Brown,Mercedes R. Carnethon,Shifan Dai,Giovanni de Simone,T. Bruce Ferguson,Earl S. Ford,Karen L. Furie,Cathleen Gillespie,Alan S. Go,Kurt J. Greenlund,Nancy Haase,Susan M. Hailpern,P. Michael Ho,Virginia J. Howard,Brett M. Kissela,Steven J. Kittner,Daniel T. Lackland,Lynda D. Lisabeth,Ariane Marelli,Mary M. McDermott,James B. Meigs,Dariush Mozaffarian,Michael E. Mussolino,Graham Nichol,Véronique L. Roger,Wayne D. Rosamond,Ralph L. Sacco,Paul D. Sorlie,Randall S. Stafford,Thomas Thom,Sylvia Wasserthiel-Smoller,Nathan D. Wong,Judith Wylie-Rosett +34 more
TL;DR: The Statistical Update brings together the most up-to-date statistics on heart disease, stroke, other vascular diseases, and their risk factors and presents them in its Heart Disease and Stroke Statistical Update each year.
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ACC/AHA guidelines for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction: Executive summary and recommendations: A report of the American College of Cardiology/American Heart Association task force on practice guidelines (committee on the management of patients with unstable angina)
Eugene Braunwald,Elliott M. Antman,John W. Beasley,Robert M. Califf,Melvin D. Cheitlin,Judith S. Hochman,Robert H. Jones,Dean J. Kereiakes,Joel Kupersmith,Thomas N. Levin,Carl J. Pepine,John W. Schaeffer,Earl E. Smith,David E Steward,Pierre Theroux,Raymond J. Gibbons,Joseph S. Alpert,David P. Faxon,Valentin Fuster,Gabriel Gregoratos,Loren F. Hiratzka,Alice K. Jacobs,Sidney C. Smith +22 more
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Christopher P. Cannon,Eugene Braunwald,Carolyn H. McCabe,Daniel J. Rader,Jean L. Rouleau,Rene Belder,Steven V. Joyal,Karen A. Hill,Marc A. Pfeffer,Allan M. Skene +9 more
TL;DR: Among patients who have recently had an acute coronary syndrome, an intensive lipid-lowering statin regimen provides greater protection against death or major cardiovascular events than does a standard regimen.
Journal ArticleDOI
Lessons From Sudden Coronary Death A Comprehensive Morphological Classification Scheme for Atherosclerotic Lesions
TL;DR: This review will reconsider the current paradigm for understanding the critical, final steps in the progression of atherosclerotic lesions, and devise a simpler classification scheme that is consistent with the AHA categories but is easier to use, able to deal with a wide array of morphological variations, and not overly burdened by mechanistic implications.
Journal ArticleDOI
From vulnerable plaque to vulnerable patient: a call for new definitions and risk assessment strategies: Part II.
Morteza Naghavi,Peter Libby,Erling Falk,S. Ward Casscells,S. Ward Casscells,Silvio H. Litovsky,Silvio H. Litovsky,John A. Rumberger,Juan J. Badimon,Christodoulos Stefanadis,Pedro R. Moreno,Gerard Pasterkamp,Zahi A. Fayad,Peter Stone,Sergio Waxman,Paolo Raggi,Mohammad Madjid,Mohammad Madjid,Alireza Zarrabi,Alireza Zarrabi,Allen P. Burke,Chun Yuan,Peter J. Fitzgerald,David S. Siscovick,Chris L. de Korte,Masanori Aikawa,K.E. Juhani Airaksinen,Gerd Assmann,Christoph R. Becker,James H. Chesebro,Andrew Farb,Zorina S. Galis,Christopher L. Jackson,Ik-Kyung Jang,Wolfgang Koenig,Robert A. Lodder,Keith L. March,Jasenka Demirovic,Mohamad Navab,Silvia G. Priori,Mark D. Rekhter,Raymond D. Bahr,Scott M. Grundy,Roxana Mehran,Antonio Colombo,Eric Boerwinkle,Christie M. Ballantyne,William Insull,Robert S. Schwartz,Robert A. Vogel,Patrick W. Serruys,Göran K. Hansson,David P. Faxon,Sanjay Kaul,Helmut Drexler,Philip Greenland,James E. Muller,Renu Virmani,Renu Virmani,Paul M. Ridker,Douglas P. Zipes,Prediman K. Shah,James T. Willerson,James T. Willerson +63 more
TL;DR: The term "vulnerable patient" may be more appropriate and is proposed now for the identification of subjects with high likelihood of developing cardiac events in the near future and a quantitative method for cumulative risk assessment of vulnerable patients needs to be developed.
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