Personalized or Standard Duration of Dual Antiplatelet Therapy after Percutaneous Coronary Intervention: PARTHENOPE Randomized Trial.

Background: Dual antiplatelet therapy (DAPT) is recommended for patients undergoing percutaneous coronary intervention (PCI), although its optimal duration remains uncertain.

Objectives: We performed a randomized trial comparing a personalized duration of DAPT, based on a risk score, for 3-, 6-, or 24-months with a standard duration of DAPT for 12 months after PCI.

Methods: We randomly assigned 2,107 patients undergoing PCI to receive either a personalized or a standard DAPT.

Early Hemodynamic Performance of the SAPIEN 3 Ultra Resilia and Evolut Valves: A Propensity-Matched Analysis.

Background: Limited data are available on early hemodynamic outcomes comparing the balloon-expandable SAPIEN 3 Ultra Resilia (S3UR) the self-expandable Evolut THVs. This study aimed to compare the hemodynamic performance of the S3UR with contemporary Evolut platforms (Evolut PRO, PRO+, Fx) in a propensity matched study.

Methods: A total of 307 patients receiving an S3UR valve were matched with 488 patients receiving Evolut valves (mean age 80.

An evaluation of the SavvyWire as a support wire for TAVR procedures.

Transcatheter aortic valve replacement (TAVR) represents a minimally invasive alternative for the treatment of severe symptomatic aortic stenosis and is increasingly adopted in younger and lower-risk patients. A support guidewire placed in the left ventricle is required in all TAVR procedures, and rapid ventricular pacing is frequently used to ensure valve implant stability. Also, recent studies showed a correlation between post-TAVR hemodynamic gradients and clinical outcomes, underscoring the importance of accurate invasive measurements.

Pharmacodynamic effects of cangrelor in patients with acute or chronic coronary syndrome undergoing percutaneous coronary intervention: the POMPEII Registry.

Background: Cangrelor is approved for oral P2Y inhibitor-naïve patients undergoing percutaneous coronary intervention (PCI). Pharmacodynamic (PD) investigations in various clinical settings, with various assays, have shown contrasting data in terms of the extent of platelet inhibition and rates of high residual platelet reactivity (HRPR).

Aims: We aimed to assess the PD effects of cangrelor in all patients receiving it during PCI.

Procedural and Antithrombotic Therapy Optimization in Patients with Atrial Fibrillation Undergoing Percutaneous Coronary Intervention: A Narrative Review.

In the past decades, percutaneous coronary intervention (PCI) has become the most common modality for myocardial revascularization in patients with coronary artery disease (CAD). Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor is essential in all patients undergoing PCI to prevent thrombotic complications. A large proportion of patients undergoing PCI also have concomitant atrial fibrillation (AF), thus requiring an oral anticoagulant (OAC) to prevent ischemic stroke or systemic embolism.

Long-term Antithrombotic Therapy in Patients With Chronic Coronary Syndrome: An Updated Review of Current Evidence.

Purpose: Despite improvements in the secondary prevention of atherothrombosis in patients with coronary artery disease during the past decade, it is estimated that approximately 19 million people annually die from cardiovascular diseases worldwide. Atherothrombosis remains the core pathobiology of acute complications including myocardial infarction (MI), and therefore, antithrombotic therapy plays a pivotal role in the strategies for major adverse cardiovascular event (MACE) prevention. Unlike early antithrombotic management after acute coronary syndrome, less evidence is available on long-term antithrombotic therapy in patients with chronic coronary syndrome (CCS).

Optimal Oversizing With the New-Generation Evolut (PRO/PRO+/FX) Self-Expanding Valves: A Multicenter Study.

Background: Paravalvular leaks (PVLs) after transcatheter aortic valve replacement have a significant prognostic impact, and valve oversizing, particularly with self-expanding valves, may prevent postprocedural PVL occurrence. Recent iterations of the Evolut valve system are intended to reduce PVL, but the effects of oversizing with such valves on PVL are largely unknown. We aimed to assess, in a real-world contemporary setting, the impact of Evolut valve oversizing on PVL after transcatheter aortic valve replacement.

Vascular Complications in Patients Undergoing Transcatheter Aortic Valve Replacement With Contemporary Devices.

Background: Vascular complications (VCs) remain a major concern after transcatheter aortic valve replacement (TAVR). However, their occurrence in patients treated with newer generation devices has been scarcely studied. Therefore, the aim of this study was to determine the incidence, management, predictors, and clinical impact of VCs in patients undergoing TAVR with contemporary devices.

Transcarotid Versus Surgical Aortic Valve Replacement for the Treatment of Severe Aortic Stenosis.

Background: Current guidelines recommend surgical aortic valve replacement (SAVR) for patients with severe aortic stenosis and unfavorable iliofemoral access. Transcarotid transcatheter aortic valve replacement (TC-TAVR) has emerged as an alternative access in suboptimal transfemoral candidates, but no data exist comparing TC-TAVR and SAVR. The main objective of this study was to compare the clinical outcomes in a propensity-matched population of TC-TAVR and SAVR patients with severe aortic stenosis.

Acute Heart Failure and Non-Ischemic Cardiomyopathies: A Comprehensive Review and Critical Appraisal.

Acute heart failure (AHF) is a complex clinical syndrome characterized by the rapid or gradual onset of symptoms and/or signs of heart failure (HF), leading to an unplanned hospital admission or an emergency department visit. AHF is the leading cause of hospitalization in patients over 65 years, thus significantly impacting public health care. However, its prognosis remains poor with high rates of mortality and rehospitalization.

Early safety after TAVR according to VARC-3 criteria: incidence, predictors, and clinical impact.

Introduction And Objectives: The Valve Academic Research Consortium (VARC)-3 definition of the early safety (ES) composite endpoint after transcatheter aortic valve replacement (TAVR) lacks clinical validation. The aim of this study was to determine the incidence, predictors, and clinical impact of ES after TAVR as defined by VARC-3 criteria.

Methods: We performed a multicenter study including 10 078 patients with severe aortic stenosis undergoing transarterial TAVR.

Transcatheter Aortic Valve Replacement in Aortic Stenosis Patients With New York Heart Association Functional Class III or IV.

Background: Patients with symptomatic aortic stenosis are a vulnerable population with associated cardiac damage and a significant comorbidity burden. In this study we aimed to determine the rate, factors associated with, and prognostic value of poor functional status (New York Heart Association [NYHA] class III-IV) in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR).

Methods: This multicenter study included 6363 transarterial TAVR patients, classified according to baseline functional status (NYHA class I or II vs III or IV).

Clinical Outcomes in Atrial Fibrillation Patients Undergoing Transcatheter Aortic Valve Replacement With Contemporary Devices.

Background: Atrial fibrillation (AF) has been identified as a marker of advanced cardiac damage in patients with aortic stenosis. However, the factors associated with poorer outcomes among AF patients in contemporary transcatheter aortic valve replacement (TAVR) practice, particularly regarding mortality and heart failure (HF)-related hospitalizations, remain largely unknown.

Methods: In this multicenter study, we assessed consecutive patients with a history of AF and evaluated the clinical outcomes of those who underwent TAVR with newer generation devices using either balloon- or self-expandable valves.

Validation of the Valve Academic Research Consortium High Bleeding Risk Definition in Patients Undergoing TAVR.

Background: The Valve Academic Research Consortium for High Bleeding Risk (VARC-HBR) has recently introduced a consensus document that outlines risk factors to identify high bleeding risk in patients undergoing transcatheter aortic valve replacement. The objective of the present study was to evaluate the prevalence and predictive value of the VARC-HBR definition in a contemporary, large-scale transcatheter aortic valve replacement population.

Methods: Multicenter study including 10 449 patients undergoing transcatheter aortic valve replacement.

Changes and prognostic impact of noninvasive myocardial work indices in patients undergoing transcatheter aortic valve implantation.

Purpose: The prognostic significance of noninvasive myocardial work (MW) indices in patients undergoing transcatheter aortic valve implantation (TAVI) has not been adequately examined.

Methods: We retrospectively selected 88 consecutive patients (mean age 79.9 ± 6.

Safety and Efficacy of Combined Coronary and Peripheral Percutaneous Revascularization: A Proof-of-Concept Study.

. Lower extremity peripheral artery disease (LEPAD) frequently coexists with coronary artery disease (CAD) in patients with multisite vascular disease (MVD). While percutaneous revascularization is well-established for both LEPAD and CAD, limited evidence exists for patients eligible for both procedures.

Ticagrelor 60 vs. 90 mg in elderly ACS patients undergoing PCI: a randomized, crossover trial.

Aims: Although dual antiplatelet therapy with aspirin and a potent P2Y12 receptor inhibitor is currently recommended in patients with acute coronary syndrome (ACS), its use in elderly patients remains challenging. The aim of this trial is to evaluate the pharmacodynamic and pharmacokinetic profile of ticagrelor 60 vs. 90 mg twice daily among elderly patients (≥75 years) with ACS undergoing percutaneous coronary intervention (PCI).