Left Main Coronary Artery Percutaneous Coronary Intervention in High-Risk Patients: Hopes for Improvement and Limitations of Randomized Trials

2014 ◽  
Vol 30 (11) ◽  
pp. 1256-1258
Author(s):  
Shahar Lavi ◽  
Andrew Yadegari
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
High Risk ◽  
Randomized Trials ◽  
Left Main Coronary Artery ◽  
Coronary Intervention ◽  
Left Main ◽  
High Risk Patients ◽  
Percutaneous Coronary ◽  
Risk Patients

scholarly journals TCT-293 High Syntax score and left main percutaneous coronary intervention in high risk patients. Results at a 10 year follow-up

2016 ◽  
Vol 68 (18) ◽  
pp. B120-B121
Author(s):  
Ignacio Sanchez-Perez ◽  
Jesus Piqueras-Flores ◽  
Alfonso Jurado ◽  
María Thiscal López Lluva ◽  
Natalia Pinilla-Echeverri ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
High Risk ◽  
Coronary Intervention ◽  
Syntax Score ◽  
Left Main ◽  
High Risk Patients ◽  
Percutaneous Coronary ◽  
Risk Patients

scholarly journals TCT-811 High Syntax score and left main percutaneous coronary intervention in high risk patients. Results at 10-year follow-up

2017 ◽  
Vol 70 (18) ◽  
pp. B330
Author(s):  
Ignacio Sanchez-Perez ◽  
Jesus Piqueras-Flores ◽  
Alfonso Jurado-Román ◽  
María Thiscal López Lluva ◽  
Natalia Pinilla-Echeverri ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
High Risk ◽  
Coronary Intervention ◽  
Syntax Score ◽  
Left Main ◽  
High Risk Patients ◽  
Percutaneous Coronary ◽  
Risk Patients

Unprotected Left Main Coronary Artery Percutaneous Coronary Intervention-Our Experiences at a Tertiary Hospital

2014 ◽  
Vol 6 (2) ◽  
pp. 107-111
Author(s):  
S Munwar ◽  
AHMW Islam ◽  
S Talukder ◽  
AQM Reza ◽  
T Ahmed ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Left Main Coronary Artery ◽  
Coronary Intervention ◽  
Drug Eluting Stent ◽  
Bare Metal ◽  
Coronary Artery Diseases ◽  
Left Main ◽  
Percutaneous Coronary ◽  
Drug Eluting

Background: Aim of the study was to evaluate the primary procedural success of percutaneous coronary intervention of unprotected left main coronary artery stenosis using either Bare-metal stents or drug eluting stent. Methods: Total 33 patients were enrolled in this very preliminary non-randomized prospective cohort study. Among them, Male: 25 and Female: 8. Total 35 stents were deployed. Mean age were for Male: 59 yrs, for Female: 62 yrs. Associated coronary artery diseases risk factors were dyslipidemia, High Blood pressure, Diabetes Mellitus, Positive family history for coronary artery diseases and smoking. Results: Among the study group; 26 (78%) were Dyslipidemic, 24(70%) were hypertensive; 17 (51.5%) patients were Diabetic, 11(33%) were smoker and 7(21%) patients had family history of Ischaemic heart disease. Female patients were more obese (BMI M 26: F 27) and developed coronary artery diseases in advance age. Common stented territory were left main: 20 (60%), Left main to left anterior descending artery 7 (22%) and Left main to left circumflex artery 6 (18%). Average length and diameter of stent was 3.5 and 18 mm respectively. Stent used: Bare Metal Stent 5 (15%), Drug Eluting Stent: 28 (85%). Among the different Drug Eluting Stents, Everolimus eluting stents were 11 (39.3%), Sirolimus eluting 10(35.7%), Paclitaxel eluting 3 (10.7%), Biolimus eluting 3 (10.7%) and Zotarolimus eluting1 (3.6%). In the present study, overall survival outcome was 94% (31 patient), mortality of cardiac cause 3% (1 patient) and 1 patient (3%) died of hepatocellular carcinoma. Conclusion: Our study has shown that percutaneous coronary intervention of the unprotected left main is a safe and effective alternative to Coronary Artery Bypass Graft (CABG). DOI: http://dx.doi.org/10.3329/cardio.v6i2.18349 Cardiovasc. j. 2014; 6(2): 107-111

TWILIGHT: A Randomized Trial of Ticagrelor Monotherapy Versus Ticagrelor Plus Aspirin Beginning at 3 Months in High-risk Patients Undergoing Percutaneous Coronary Intervention

2020 ◽  
Vol 14 ◽  
Author(s):  
Johny Nicolas ◽  
Usman Baber ◽  
Roxana Mehran
Keyword(s):  
Percutaneous Coronary Intervention ◽  
High Risk ◽  
Antiplatelet Therapy ◽  
Dual Antiplatelet Therapy ◽  
Coronary Intervention ◽  
Bleeding Events ◽  
High Risk Patients ◽  
Risk Of Death ◽  
Percutaneous Coronary ◽  
Risk Patients

A P2Y12 inhibitor-based monotherapy after a short period of dual antiplatelet therapy is emerging as a plausible strategy to decrease bleeding events in high-risk patients receiving dual antiplatelet therapy after percutaneous coronary intervention. Ticagrelor With Aspirin or Alone in High-Risk Patients After Coronary Intervention (TWILIGHT), a randomized double-blind trial, tested this approach by dropping aspirin at 3 months and continuing with ticagrelor monotherapy for an additional 12 months. The study enrolled 9,006 patients, of whom 7,119 who tolerated 3 months of dual antiplatelet therapy were randomized after 3 months into two arms: ticagrelor plus placebo and ticagrelor plus aspirin. The primary endpoint of interest, Bleeding Academic Research Consortium type 2, 3, or 5 bleeding, occurred less frequently in the experimental arm (HR 0.56; 95% CI [0.45–0.68]; p<0.001), whereas the secondary endpoint of ischemic events was similar between the two arms (HR 0.99; 95% CI [0.78–1.25]). Transition from dual antiplatelet therapy consisting of ticagrelor plus aspirin to ticagrelor-based monotherapy in high-risk patients at 3 months after percutaneous coronary intervention resulted in a lower risk of bleeding events without an increase in risk of death, MI, or stroke.

Sign in / Sign up

Export Citation Format

Share Document