Prior studies suggest patients are often misinformed about the anticipated benefits of PCI for stable coronary disease. However, there is little data on patient-provider discussions that may explain discrepancies in patient understanding about the limited benefits of PCI in this setting. Rothberg and colleagues performed a cross-sectional analysis of 59 conversations between providers and patients […]
Tag: PCI
Precision Medicine to Reduce Bleeding with PCI
Periprocedural bleeding remains one of the most common adverse events after percutaneous coronary intervention (PCI) and is associated with increased mortality. Although strategies to minimize PCI bleeding have been identified, these strategies are infrequently applied to patients at highest bleeding risk. Using a pre-post study design, Spertus et al. evaluated the impact of assessing individual patient bleeding risk from validated models and providing this bleeding risk estimate in personalized informed […]
Second-generation stents fail to BEST CABG
The technology of drug eluting stents for percutaneous coronary intervention (PCI) has improved over time with resultant improvements in patient outcomes. Although prior studies have demonstrated the benefit of surgical coronary artery bypass grafting (CABG) over transcatheter PCI among patients with multivessel coronary artery disease (CAD), these studies did not incorporate newer generation drug-eluting stents. […]
Risks and Benefits of Percutaneous Coronary Interventions in Stable Coronary Disease: A Qualitative Analysis of Cardiologists’ Bedside Discussions
Although the benefits of PCI for stable CAD are limited to symptom reduction, prior studies have shown that patients often believe PCI for stable coronary artery disease (CAD) will mitigate the future risks of myocardial infarction or death. This study examined discussions between cardiologists and patients regarding angiograms and PCI in stable CAD to identify […]
Dual Antiplatelet Therapy Beyond 1-year after Percutaneous Coronary Interventions for Stable Coronary Artery Disease Results in Harm
The benefit of extended dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) is uncertain. The ARTIC-Interruption Trial examined discontinuation of DAPT at 1-year after PCI vs continuation for an additional 6-18 months. The study randomized patients 1-year after PCI to continuation (N=635) or interruption (N=624) groups, and examined the primary composite endpoint of death, […]
No benefit to thrombus aspiration in STEMI
Thrombus aspiration in acute ST-segment elevation myocardial infarction (STEMI) is clinically appealing and often used prior to PCI. However, the majority of trials evaluating thrombus aspiration have failed to demonstrate significant mortality benefit. The Thrombus Aspiration in ST-Elevation Myocardial Infarction in Scandinavia (TASTE) trial is a multi-center study that randomized a total of 7244 presenting […]
Patient Understanding of Elective PCI Benefit Varies by Hospital
Elective percutaneous coronary intervention (PCI) does not prevent mortality or myocardial infarction, but is an important therapy for the relief of ischemic symptoms. However, a majority of patients believe that PCI for stable coronary artery disease (CAD) will prolong their lives and prevent heart attacks. In this study, investigators surveyed 991 patients undergoing elective PCI […]
No Benefit from Extended Dual Anti-Platelet Therapy?
The PARIS (patterns of non-adherence to anti-platelet regimens in stented patients) registry is a prospective observational study of patients from the US and Europe who were discharged on dual anti-platelet therapy (DAPT) following coronary stenting. Among 5018 patients from this registry, the rates of physician recommended discontinuation, brief interruption (i.e. for surgery), or disruption (ie […]
Stent type and interrupted anti-platelet therapy does not correlate with adverse events after non-cardiac surgeries
Guidelines recommend delaying elective surgery in patients with drug eluting stent (DES) for one year after stent implantation to allow completion of 1 year of dual anti-platelet therapy (DAPT) without interruption. This recommendation is based on expert consensus and results in several clinical questions, including whether it is preferable to use a bare metal stent […]
Bivalirudin in contemporary STEMI treatment
The novel direct thrombin inhibitor bivalirudin is now widely used as an adjunctive therapy in patients undergoing primary PCI for ST elevation myocardial infarction (STEMI). This stems from trial data demonstrating bivalirudin results in lower bleeding rates and better long term survival as compared with the combination of heparin and a GP IIb/IIIa inhibitor. However, […]