Timing, indications and transition patterns associated with cangrelor use in patients undergoing PCI.

Optimal antiplatelet therapy is crucial in percutaneous coronary intervention (PCI) to balance thrombotic and bleeding risk. Cangrelor, a rapid-acting intravenous P2Y12 inhibitor, is particularly effective in high-risk PCI scenarios, including acute coronary syndrome (ACS) or patients unable to take oral medications. The SMILE study evaluated real-world timing, indications, and outcomes of cangrelor use, along with transition to oral P2Y12 inhibitors, in high-risk patients undergoing PCI.

Predictors of postprocedural troponin increase in patients undergoing elective percutaneous coronary intervention.

Background: Elevation in serum troponin following elective percutaneous coronary intervention (PCI) is indicative of post-PCI troponin increase (pTI) and is associated with higher mortality rates. In this analysis, we sought to identify clinical and angiographic risk factors for pTI.

Methods: Consecutive patients undergoing elective PCI with drug-eluting stent implantation at Mount Sinai Hospital, New York, USA, between 2012 and 2022 were retrospectively analysed.

Geographic variation in endovascular revascularization for chronic limb-threatening ischemia care among Medicare beneficiaries (2016-2023).

Objective: Chronic limb-threatening ischemia (CLTI), the most severe manifestation of peripheral artery disease, is associated with high risk of major amputation and mortality. Although timely revascularization is a cornerstone of CLTI management, disparities in access to care and outcomes persist across U.S.

Drug Eluting Stents as a Management for Patients with Below the Knee Peripheral Artery Disease: A Systematic Review and Meta-Analysis.

PurposeThe purpose of this study was to compare the effectiveness and safety of drug eluting stents with percutaneous transluminal angioplasty and bare-metal stents in below the knee peripheral artery disease. : The systematic review was registered in Research Registry. A literature search was performed across four databases: PubMed, Medline/Embase, Cochrane Review, and Web of Science for eligible comparative studies.

Impact of lesion location and SYNTAX score breakdown on patients undergoing percutaneous left main revascularization.

Background: Left main coronary artery disease (LMCAD) complexity is assessed using the SYNTAX score. High scores may reflect complex LM lesions or multivessel disease. Evidence on the prognosis of these distinct populations is scarce.

Temporal and Geographic Trends in the Treatment of Peripheral Arterial Disease Stratified by Race Among Medicare Beneficiaries.

Importance: Racial disparities in the management of peripheral arterial disease (PAD) are well established. Analysis of the temporal trends and geographic variation in racial differences in the use of revascularization and major amputation may identify areas for targeted intervention.

Objective: To investigate differences in the treatment of PAD between Black and White patients over time and by US state.

Residual cholesterol and inflammatory risk in statin-treated patients undergoing percutaneous coronary intervention†.

Background And Aims: Elevated LDL-cholesterol levels and inflammation, as assessed by high-sensitivity C-reactive protein, correlate with cardiovascular risk. However, data on the relative impact of residual LDL-cholesterol and inflammatory risk among statin-treated patients undergoing percutaneous coronary intervention (PCI) is lacking. Hence, this study aimed to investigate the impact of residual cholesterol/inflammatory risk in patients on statin therapy undergoing PCI.

Impact of Peripheral Arterial Disease on Clinical Outcomes of Patients Undergoing Complex vs Noncomplex Percutaneous Coronary Intervention.

Peripheral arterial disease (PAD) often predicts poor outcomes in patients undergoing percutaneous coronary intervention (PCI). Here we examine the impact of PAD in patients receiving complex PCI (CPCI) and noncomplex PCI. Patients undergoing PCI at the Mount Sinai Hospital between 2012 and 2022 were stratified by the presence of CPCI and PAD.

Prognostic impact of neutrophil-to-lymphocyte ratio in patients with and without diabetes mellitus undergoing percutaneous coronary intervention.

Background: The neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation associated with adverse cardiovascular outcomes. However, limited evidence exists regarding its prognostic role in patients with diabetes mellitus (DM) undergoing percutaneous coronary intervention (PCI), which we sought to explore in this analysis.

Methods: We retrospectively evaluated all patients undergoing PCI at a large tertiary centre between 2012 and 2022.

Prognostic impact of residual inflammatory and triglyceride risk in statin-treated patients with well-controlled LDL cholesterol and atherosclerotic cardiovascular disease.

Aims: Identifying alternative contributors to the residual risk of atherosclerotic cardiovascular disease (ASCVD) beyond LDL cholesterol (LDL-C) levels is crucial. We investigated the relative impact of triglycerides (TGs) and high-sensitivity C-reactive protein (hs-CRP) on outcomes in statin-treated patients with well-controlled LDL-C undergoing percutaneous coronary intervention (PCI) for established ASCVD.

Methods And Results: We included 9446 statin-treated patients with LDL-C < 70 mg/dL undergoing PCI between 2012 and 2022, stratified into four groups: (i) no residual risk (TG <150 mg/dL + hs-CRP <2 mg/L); (ii) residual TG risk (TG ≥150 mg/dL + hs-CRP <2 mg/L); (iii) residual inflammatory risk (TG <150 mg/dL + hs-CRP ≥2 mg/L); and (iv) residual TG and inflammatory risk (TG ≥150 mg/dL + hs-CRP ≥2 mg/L).

Concomitant Mechanical Aspiration and Appendage Closure for Recalcitrant Left Atrial Appendage Thrombi.

Importance: It is well appreciated that a small yet high-risk subset of patients with atrial fibrillation (AF) develops persistent left atrial appendage (LAA) thrombus despite optimal oral anticoagulation (OAC). In patients with either a heightened risk of bleeding precluding enhanced doses of OAC to dissolve the thrombus, or thromboembolism despite optimal OAC, there are limited nonsurgical options.

Objectives: To introduce a novel management strategy for resistant LAA thrombus: percutaneous mechanical thrombus aspiration with cerebral protection, followed by LAA closure (LAAC).

Potent P2Y12 Inhibitors vs Clopidogrel in Cancer Patients Undergoing Percutaneous Coronary Intervention.

Background: Patients with cancer undergoing percutaneous coronary intervention (PCI) experience a higher risk of both ischemic and bleeding events. The aim of this study was to assess ischemic and bleeding risks after PCI in cancer patients treated with potent P2Y12 inhibitors (P2Y12i; prasugrel and ticagrelor) compared with clopidogrel.

Methods: Consecutive patients with cancer undergoing PCI at a tertiary center between 2012 and 2022 and discharged on P2Y12i were included in this study.

Clinical outcomes after complex and high-risk percutaneous coronary intervention according to baseline chronic kidney disease.

Background: Chronic kidney disease (CKD) is associated with unfavorable outcomes in patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI). However, its prognostic role in patients undergoing complex high-risk PCI (CHIP) remains unexplored, prompting our investigation.

Methods: Consecutive CHIP patients treated at a tertiary care center from 2012 to 2022 were included in the current analysis.

Predictive Ability of the Academic Research Consortium High Bleeding Risk Criteria in Patients Undergoing Percutaneous Coronary Intervention According to Body Mass Index.

Background: Whether the high bleeding risk (HBR) criteria of the Academic Research Consortium (ARC) have a consistent predictive ability across different categories of body mass index (BMI) remains unclear.

Methods: Consecutive patients undergoing percutaneous coronary intervention (PCI) between 2012 and 2019 at Mount Sinai Hospital (New York, USA) were stratified into five BMI categories (18.5-24.

Validation of a High Bleeding Risk Definition in Cancer Patients undergoing Percutaneous Coronary Intervention.

Aim: Due to the absence of validated bleeding risk tools in cancer patients undergoing percutaneous coronary intervention (PCI), we aimed to validate an adapted version of the Academic Research Consortium (ARC) High Bleeding Risk (HBR) criteria.

Methods: Consecutive patients with active or remission cancer undergoing PCI between 2012 and 2022 at Mount Sinai Hospital (New York, USA) were included. Patients were considered at HBR if they met at least one of the major ARC-HBR criteria, other than cancer, or two minor criteria.

The Role of Intravascular Ultrasound in Limb Salvage: A Systematic Review and Meta-Analysis.

Purpose: The purpose of this study was to review the current literature of intravascular ultrasound (IVUS) use in real world cohorts inclusive of chronic limb threatening ischemia (CLTI) patients and compare the outcomes to patients imaged by angiography alone.

Methods: The systematic review was registered in Research Registry. A literature search was performed across 4 databases: PubMed, Medline/Embase, Cochrane Review, and Web of Science for eligible comparative studies.

An Aggressively Recurrent Squamous Cell Carcinoma of the Foot.

Squamous cell carcinoma is a malignant tumor that is most commonly found on the head and neck. The current global incidence of squamous cell carcinoma at any site is estimated to be more than 1 million cases per year, with a reported 3-year mortality rate of 30%. Recurrence of squamous cell carcinoma at any site is estimated to be 15% to 50% and has been associated with greater rates of infiltration, perineural invasion, and mortality.

Significance of diabetes mellitus status in patients undergoing percutaneous left main coronary artery intervention.

Background: Diabetes mellitus (DM) is a modifiable risk factor for patients with coronary artery disease (CAD). Treatment with insulin correlates with advanced disease and has been associated with excess cardiovascular risk, but evidence on outcomes of patients with insulin-treated DM (ITDM) undergoing left main percutaneous coronary intervention (LMPCI) remains scarce.

Aims: The aim of the presented study is to evluate the risk attributable to DM and ITDM in patients undergoing LMPCI.

Change in left ventricular function and outcomes following high-risk percutaneous coronary intervention with Impella-guided hemodynamic support.

Introduction: High-risk percutaneous coronary interventions (HRPCI) are a potential treatment option for patients with reduced left ventricular ejection fraction (LVEF) and coronary artery disease. The extent to which such intervention is coupled with improvement in LVEF and associated with favorable outcomes is unknown.

Methods: We aimed to characterize the incidence and correlates of LVEF improvement after Impella-guided HRPCI, and compare clinical outcomes in patients with versus without LVEF improvement.

Stellarex Drug-Coated Balloon for the Treatment of Peripheral Artery Disease: Five-Year Results from the ILLUMENATE Pivotal Randomized Controlled Trial.

This study aimed to report the 5-year outcomes from the ILLUMENATE Pivotal randomized controlled trial of the lower dose (2 µg/mm) Stellarex drug-coated balloon (DCB) (Philips, formerly Spectranetics Corp, Colorado Springs, Colorado) compared with percutaneous transluminal angioplasty (PTA) for the treatment of symptomatic peripheral arterial disease. Long-term safety and effectiveness data for DCBs remains limited. The ILLUMENATE Pivotal was a prospective, randomized, multi-center, single-blinded study.

Inflammatory risk and clinical outcomes according to polyvascular atherosclerotic disease status in patients undergoing PCI.

Background: Individuals suffering from polyvascular atherosclerotic disease (PolyVD) face a higher likelihood of adverse cardiovascular events. Additionally, inflammation, assessed by high-sensitivity C-reactive protein (hsCRP), affects residual risk following percutaneous coronary intervention (PCI). We aimed to explore the interplay between PolyVD and hsCRP in terms of clinical outcomes after PCI.

Impact of Polyvascular Disease in Patients Undergoing Unprotected Left Main Percutaneous Coronary Intervention.

Percutaneous coronary intervention (PCI) has demonstrated its safety and efficacy in treating left main (LM) coronary artery disease (CAD) in select patients. Polyvascular disease (PolyVD) is associated with adverse events in all-comers with CAD. However, there is little data examining the interplay between PolyVD and LM-PCI, which we sought to investigate in a retrospective single-center study.