Intravascular Imaging-Guided PCI Reaches a Turning Point With Survival, MI Benefits
For the first time, intravascular imaging-guided coronary stenting was associated with better survival and reduced myocardial infarction (MI) in a meta-analysis powered to detect these benefits against angiography, researchers reported. Randomized to optical coherence tomography (OCT) or intravascular ultrasound (IVUS) guidance, patients who underwent percutaneous coronary intervention (PCI) with contemporary stents showed a decrease in […]
Erectile Dysfunction Drugs Plus Nitrates Still a Losing Combination, Study Shows
As expected, men taking nitrates for stable coronary artery disease (CAD) fared poorly if they added certain erectile dysfunction (ED) drugs to their medicine cabinet, a Swedish population-based study found. Compared with nitrate users not on phosphodiesterase-5 (PDE5) inhibitor treatment for ED, those who had both types of drugs in their medication history tended to […]
Coronary Heart Disease by Age 45 Linked With Subsequent Dementia
Younger onset age of coronary heart disease was tied to higher risks of incident all-cause dementia, Alzheimer’s disease, and vascular dementia, a large prospective cohort study in Great Britain showed. Each 10-year decrease in coronary heart disease onset age was associated with a 25% increased risk of all-cause dementia, a 29% increased risk of Alzheimer’s […]
Yes, It Matters Who Manages Sedation During Interventional Radiology Procedures
SAN FRANCISCO — Following interventional radiology procedures such as coronary angioplasty, patients were more likely to be discharged home, rather than to a nursing or long-term care facility, when sedation was provided by trained anesthesia specialists, a researcher said. Odds of an “adverse discharge” were lower by 32% (OR 0.68, 95% CI 0.57-0.81) when anesthesia […]
Link Between Psoriasis, Heart Disease Tracks to Coronary Microvascular Dysfunction
Almost a third of patients with severe psoriasis had echocardiographic evidence of asymptomatic coronary microvascular dysfunction (CMD), a prospective study showed. Doppler echocardiography showed that 31.5% of 448 patients with psoriasis had CMD. Every 1-point increase in the Psoriasis Area and Severity Index (PASI) score and 1-year increase in psoriasis duration correlated with a 5% […]
Multimodal Evaluations May Flag Cardiac Allograft Problems Earlier
Coronary anatomy and physiology both predicted early cardiac allograft vasculopathy (CAV) progression, according to a study that strengthens the case for advanced multimodal testing to improve early detection of a major contributor to allograft failure. Among heart transplant recipients at two Canadian centers, early progression of percent intimal volume (PIV) on intravascular ultrasound (IVUS) between […]
Ultrasound Guidance No Advantage for PCI Access
BOSTON — Routine ultrasound guidance for accessing the femoral vein for percutaneous coronary procedures didn’t cut down on bleeding and vascular complications, the UNIVERSAL trial showed. The primary combined endpoint of major bleeding and major vascular complications at 30 days showed no advantage to the imaging technique added to fluoroscopy, reported Sanjit S. Jolly, MD, […]
Chronic Total Occlusion PCI Is Getting Safer — At Least Until the Pandemic
ATLANTA — Percutaneous coronary intervention for chronic total occlusion (CTO PCI) has improved in success rates, but the pandemic might have impacted complication rates, a registry study showed. Technical and procedural success rates steadily improved over time from 2016 to 2021, rising from 81.6% to 88.1% and 80.0% to 87.0%, respectively (both P<0.0001). And the […]
Heart Failure Patients Still Undertested for CAD
People with new-onset heart failure (HF) continued to lack adequate testing for coronary artery disease (CAD), a common and treatable cause of HF, and nationwide variations in testing rates suggested room for quality improvement across physicians and geographic regions. From a large pool of patients with incident HF in 2004-2019, just 34.8% underwent CAD testing […]
One Month of DAPT Reasonable in Patients at High Bleeding Risk
Dual antiplatelet therapy (DAPT) for 1 month after percutaneous coronary intervention (PCI) lowered bleeding rates and was non-inferior for ischemic events compared with 3-month DAPT in patients at high bleeding risk, according to results of the MASTER DAPT trial. Among the 4,579 patients in the intention-to-treat (ITT) population, major or clinically relevant non-major bleeding occurred […]