20 results on '"Pavel, Cervinka"'
Search Results
2. Undetected ventricular fibrillation in a single-chamber implantable cardioverter-defibrillator: When the far-field channel sees more than the intraventricular channel
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Milena Kubickova, MD, Pavel Cervinka, MD, PhD, FESC, FSCAI, Andreas Kucher, MSc, PhD, Zdenek Nastoupil, and Roland X. Stroobandt, MD, PhD, FHRS
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Implantable cardioverter-defibrillator ,Ventricular tachycardia ,Ventricular fibrillation ,Left ventricular sensing ,Dissimilar ventricular rhythms ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2016
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3. THE IMPACT OF CARDIOGENIC SHOCK AND OUT-OF-HOSPITAL CARDIAC ARREST ON THE OUTCOME OF ACUTE MYOCARDIAL INFARCTION. NATIONAL LEVEL ANALYSIS
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Zuzana Motovska, Jirí Jarkovský, Ota Hlinomaz, Petr Kala, Jan Mrozek, Pavol Tomasov, and Pavel Cervinka
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Cardiology and Cardiovascular Medicine - Published
- 2023
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4. Ischemic Events Occur Early in Patients Undergoing Percutaneous Coronary Intervention and Are Reduced With Cangrelor: Findings From CHAMPION PHOENIX
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Matthew A. Cavender, Robert A. Harrington, Gregg W. Stone, Ph. Gabriel Steg, C. Michael Gibson, Christian W. Hamm, Matthew J. Price, Renato D. Lopes, Sergio Leonardi, Efthymios N. Deliargyris, Jayne Prats, Kenneth W. Mahaffey, Harvey D. White, Deepak L. Bhatt, Kurt Huber, Valter C. Lima, Julia B. Jorgova-Makedonska, Petr Widimský, Bondo Kobulia, Peter W. Radke, Ezio Bramucci, Adam Witkowski, Evgeny Shlyakhto, Frans Van de Werf, David P. Faxon, E. Magnus Ohman, Freek W.A. Verheugt, W. Douglas Weaver, Jan G.P. Tijssen, Matthew Wilson, Stacey Mangum, Chiara Melloni, Matthew J. Brennan, Pierluigi Tricoci, Robert Harrison, Pedro Barros, Luciana Armaganijan, Monique Anderson, Akshay Bagai, Philippe Généreux, Sorin J. Brener, Laura LaSalle, Werner Benzer, Georg Delle-Karth, Franz Leisch, Jamil Abdalla Saad, Alexandre Abizaid, Carlos Augusto Formiga Areas, Expedito E. Ribeiro, Fabio Rossi Dos Santos, Rogerio Tadeu Tumelero, Roberto Vieira Botelho, Borislav Atzev, Boicho Boichev, Georgi Grigorov, Nikolay Penkov, Ivo Petrov, Boris Zehirov, Pavel Cervinka, Zdenek Coufal, Petr Hajek, David Horak, Petr Kala, Petr Kmonicek, Viktor Kocka, Jan Mrozek, Stanislav Simek, Jan Sitar, Josef Stasek, Frantisek Tousek, Gulnara Chapidze, Nodar Emukhvari, George Khabeishvili, Merab Mamatsashvili, Tamaz Shaburishvili, Steffen Behrens, Harald Darius, Martin Dissmann, Stephan Fichtlscherer, Wolfgang Franz, Tobias Geisler, Sabine Genth-Zotz, Britta Goldmann, Hubertus Heuer, Stefan Hoffmann, Andreas Mugge, Tudor Poerner, Peter Radke, Gert Richardt, Christoph Stellbrink, Nikos Werner, Stefano De Servi, Gennaro Galasso, Alberto Menozzi, Giuseppe Musumeci, Andrea Picchi, Patrizia Presbitero, Gerard Devlin, Alexander Sasse, Douglas Scott, Ralph Stewart, Szyszka Andrzej, Witold Dubaniewicz, Zbigniew Gasior, Jaroslaw Kasprzak, Andrzej Kleinrok, Zdzislawa Kornacewicz-Jach, Andrzej Rynkiewicz, Cezary Sosnowski, Radoslaw Targonski, Jaroslaw Trebacz, Elzbieta Zinka, Olga Barbarash, Yakov Dovgalevsky, Ivan Gordeev, Svetlana Kalinina, Elena Kosmachova, Valentin Markov, Prokhor Pavlov, Sergey Shalaev, Zaur Shogenov, Irina Sukmanova, Elena Vasilieva, Alexey Yakovlev, Sarana Boonbaichaiyapruck, Noppadol Chamnarnphol, Pinij Kaewsuwanna, Srun Kuanprasert, Dilok Piyayotai, Maged Amine, Dominick Angiolillo, Imran Arif, James Blankenship, Emmanouil Brilakis, Michael Chan, Joseph Cinderella, Brent Davis, Chandanreddy Devireddy, Mark Dorogy, John Douglas, Norman Ferrier, Daniel Fisher, Robert Foster, William French, John Galla, Lawrence Gimple, Harinder Gogia, Prospero Gogo, Raghava Gollapudi, Luis Gruberg, James Hermiller, Richard Heuser, Robert Iwaoka, Zubair Jafar, Carey Kimmelstiel, Scott Kinlay, James Leggett, Pierre Leimgruber, Dustin Letts, Michael Lipsitt, Reginald Low, Joaquin Martinez-Arraras, Marc Mayhew, Brent McLaurin, Paul McWhirter, Ayoub Mirza, Brian Negus, Thomas Nygaard, William O’Riordan, Richard Paulus, John Petersen, Hector Picon, Mark Picone, Ernesto Rivera, David Rizik, Arsenio Rodriguez, Jorge Saucedo, J. Christopher Scott, Virender Sethi, Adhir Shroff, Craig Siegel, Douglas Spriggs, Daniel Steinberg, Michael Stillabower, Thomas Stuckey, Jose Suarez, Jeffrey Tauth, Dogan Temizer, Mladen Vidovich, Michele Voeltz, Jonathan Waltman, Michael Wilensky, ACS - Heart failure & arrhythmias, and Cardiology
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percutaneous coronary intervention ,P2Y12 receptor antagonist ,Original Articles ,Adenosine Monophosphate ,Clopidogrel ,Coronary Interventions ,Treatment Outcome ,myocardial infarction ,Purinergic P2Y Receptor Antagonists ,ComputingMethodologies_DOCUMENTANDTEXTPROCESSING ,Humans ,Cardiology and Cardiovascular Medicine ,Platelet Aggregation Inhibitors ,coronary artery disease ,thrombosis - Abstract
Supplemental Digital Content is available in the text., Background: Thrombotic events are reduced with cangrelor, an intravenous P2Y12 inhibitor. We sought to characterize the timing, number, and type of early events (within 2 hours of randomization) in CHAMPION PHOENIX (A Clinical Trial Comparing Cangrelor to Clopidogrel Standard of Care Therapy in Subjects Who Require Percutaneous Coronary Intervention). Methods: CHAMPION PHOENIX was a double-blind, placebo-controlled trial that randomized patients undergoing percutaneous coronary intervention to cangrelor or clopidogrel. For this analysis, we evaluated the efficacy of cangrelor in the first 2 hours postrandomization with regards to the primary end point (death, myocardial infarction, ischemia-driven revascularization, or stent thrombosis). Sensitivity analyses were performed evaluating a secondary, post hoc end point (death, Society of Coronary Angiography and Intervention myocardial infarction, ischemia-driven revascularization, or Academic Research Consortium definite stent thrombosis). Results: The majority of events (63%) that occurred in the trial occurred within 2 hours of randomization. The most common early event was myocardial infarction; next were stent thrombosis, ischemia driven revascularization, and death. In the first 2 hours after randomization, cangrelor significantly decreased the primary composite end point compared with clopidogrel (4.1% versus 5.4%; hazard ratio, 0.76 [95% CI, 0.64–0.90], P=0.002). Similar findings were seen for the composite end point of death, Society of Coronary Angiography and Intervention myocardial infarction, ischemia-driven revascularization, or Academic Research Consortium stent thrombosis at 2 hours (0.9% versus 1.6%; hazard ratio, 0.57 [95% CI, 0.40–0.80], P=0.001). Between 2 and 48 hours, there was no difference in the primary composite end point (0.6% versus 0.5%; odds ratio, 1.17 [95% CI, 0.71–1.93]; P=0.53). Early (≤2 hours of randomization) GUSTO (Global Use of Strategies to Open Occluded Coronary Arteries) moderate or severe bleeding events were infrequent, and there was no significant difference with cangrelor compared with clopidogrel (0.2% [n=10] versus 0.1% [n=4]; adjusted odds ratio, 1.41 [95% CI, 0.37–5.40]; P=0.62). Conclusions: The reductions in ischemic events and overall efficacy seen with cangrelor in CHAMPION PHOENIX occurred early and during the period of time in which patients were being actively treated with cangrelor. These findings provide evidence that supports the importance of potent platelet inhibition during percutaneous coronary intervention. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01156571.
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- 2021
5. Cangrelor With and Without Glycoprotein IIb/IIIa Inhibitors in Patients Undergoing Percutaneous Coronary Intervention
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Muthiah Vaduganathan, Robert A. Harrington, Gregg W. Stone, Efthymios N. Deliargyris, Ph. Gabriel Steg, C. Michael Gibson, Christian W. Hamm, Matthew J. Price, Alberto Menozzi, Jayne Prats, Steven Elkin, Kenneth W. Mahaffey, Harvey D. White, Deepak L. Bhatt, Fernando Cura, Miguel Ballarino, Anibal Agustín Damonte, Diego Grinfeld, Carlos Alejandro Álvarez, Alberto Fernandez, Ahmad Farshid, Brendan Gunalingam, Craig Jeurgens, Harry Lowe, Hisham Hallani, Greg Nelson, Gishel New, Ronald Dick, Jeffrey Lefkovits, Stephen Duffy, Nick Bett, Raibhan Yadav, Paul Garrahy, Ron Lehman, Philip Aylward, John Horowitz, Matthew Worthley, David Cross, Jaime Rankin, Peter Thompson, Phil Roberts-Thomson, Rohan Jayasinghe, Con Aroney, Kurt Huber, Franz Leisch, Johann Altenberger, Georg Gaul, Thomas Neunteufl, Franz Weidinger, Herwig Schuchlenz, Heinrich Weber, Werner Benzer, Paulo Rossi, Breno Almeida, Antonio Godinho, Fabio Vilas-Boas, Luciano Vacanti, Renato Serpa, José Antonio Jatene, Gilmar Reis, Jamil Saad, Marcos Marino, Roberto Botelho, Constantino Costantini, Ricardo Wang, Dalton Precoma, Miguel Rati, Luis Bodanese, Euler Manenti, João Paulo Zouvi, Rogerio Tumelero, Arthur Herdy, Eulogio Martinez Filho, Antônio Carvalho, Roberto Franken, Lawrence Title, Charles Lazzam, Francois Reeves, Tamaz Shaburishvili, Gulnara Chapidze, Merab Mamatsashvili, Irakli Khintibidze, Hubertus Heuer, Hans-Georg Olbrich, Sabine Genth-Zotz, Sven Moebius-Winkler, Michael Buerke, Stefan Hoffmann, Peter Radke, Helge Moellmann, Hugo Katus, Hans-Friedrich Voehringer, Christian Hengstenberg, Volker Klauss, Johannes Brachmann, Aftab Khan, Sampath Kumar, Padinhare Mohanan, Praveen Chandra, Maddury Rao, S.S. Ramesh, Keyur Parikh, Arun Srinivas, Nakul Sinha, V.S. Prakash, Shirish Hiremath, Anil Mishra, Sanjeeb Roy, Kamal Sethi, Ashwani Mehta, Tejas Patel, Suman Bhandari, Milind Gadkari, Stefano De Servi, Giuseppe Musumeci, Bernardo Cortese, Giancarlo Marenzi, Raffaele De Caterina, Ralph Stewart, Gerard Devlin, Scott Harding, John Elliott, Gerard Wilkins, Douglas Scott, Slawomir Dobrzycki, Waldemar Dorniak, Dariusz Dudek, Zbigniew Gasior, Jaroslaw Hiczkiewicz, Zdzislawa Kornacewicz-Jach, Leszek Kubik, Krzysztof Kuc, Jerzy Kuzniar, Walentyna Mazurek, Jakub Ostrowski, Michal Tendera, Andrzej Wisniewski, Elzbieta Zinka, Krzysztof Zmudka, Jana Pawła, Maciej Kosmider, null Seweryna, Andres Iñiguez, Rafael Melgares, Francisco Goicolea, Jose Hernandez, Javier Zueco, Igor Kraiz, Mykola Vatutin, Anatoliy Polyakov, Yury Sokolov, Kenneth House, Charles Campbell, Timothy Trageser, Kenneth Baran, Neal Kleiman, Roberto Medina, Roger Hill, M. Zubair Jafar, David Drenning, Herbert Ladley, Ahed Nahhas, Alan Niederman, Amit Goyal, William Abernethy, Naseem Jaffrani, Richard Zelman, Brian Negus, Jose Marquez, Ehtisham Mahmud, William French, John Paulowski, Charles Pollack, Mark Mines, Robert Federici, Marc Schweiger, Kalim Habet, Ofsman Quintana, Thomas Nygaard, Steve Orlow, Douglas Spriggs, Ivan Chavez, Mark Warner, Richard Paulus, David Cochran, Cary Hirsch, Ajay Virmani, Peter Soukas, Nalin Srivastava, L. Norman Ferrier, Annapoorna Kini, Mark Greenberg, Howard Herrmann, Valerian Fernandes, Barry Bertolet, Ron Waksman, Joseph Henderson, Harinder Gogia, Maged Amine, Kourosh Mastali, Thomas Stuckey, Peter Hui, Luigi Pacifico, Todd Caulfield, Wilson Ginete, William Ballard, Robert Iwaoka, Joseph Stella, Vijay Misra, Costa Andreou, Michele Voeltz, Wayne Batchelor, Cezar Staniloae, Sanford Gips, Jeffrey Kramer, Paul Mahoney, John Wang, Prospero Gogo, David Rizik, Rex Winters, Garry MacKenzie, Stephen Jenkins, Paul Teirstein, Pierre Leimgruber, J. Christopher Scott, Seth Krauss, Steven Rohrbeck, Robert Martin, Gustavo Grieco, Louis Cannon, Don Westerhausen, F. David Fortuin, Steven Schulman, Joel Cohn, Brent McLaurin, Jorge Saucedo, Robert Wozniak, Jack Hall, Kevin Marzo, Merrill Krolick, Lawrence Gimple, Eric Hockstad, Arsenio Rodriguez, John Kao, Adhir Shroff, Michael Attubato, Ramon Quesada, Ernesto Rivera, Dean Kereiakes, Russell Raymond, Thomas Amidon, David Lee, Spencer King, John Douglas, Abnash Jain, J. Patrick Kleaveland, Mitchell Driesman, Krishna Kumar, Glen Kowalchuk, Behzad Taghizadeh, Lawrence Barr, Keith Benzuly, Tarek Helmy, Duane Pinto, Joseph Aragon, Reginald Low, Phillip Horwitz, Thomas LeGalley, Dominick Angiolillo, Rajesh Sachdeva, Kenneth Kent, Luis Gruberg, Richard Bach, Thomas Pow, Charles O'Shaughnessy, Shing Wong, Saeed R. Shaikh, Arthur Reitman, Mark Lawrence, Alejandro Garcia Escudero, Carlos Poy, Miguel Miceli, Antonio Pocovi, Hugo Londero, Jorge Baccaro, Leonid Polonetsky, Aliaksey Karotkin, Leanid Shubau, Eduardo Maffini, Bruno Machado, José Airton, Valter Lima, Jose Jatene, Marco Perin, Paulo Caramori, Iran Castro, Ivan Manukov, Mladen Grigorov, Plamen Milkov, Julia Jorgova, Svetoslav Georgiev, Nizar Rifai, Alexander Doganov, Ivo Petrov, William Hui, Jean-Francois Tanguay, Marek Richter, Frantisek Tousek, Zdenek Klimsa, Michal Padour, Jan Mrozek, Marian Branny, Zdenek Coufal, Stanislav Simek, Vladimir Rozsival, Leos Pleva, Josef Stasek, Petr Kala, Ladislav Groch, Viktor Kocka, Rajesh Jain, Darshan Banker, Lanka Krishna, Hasit Joshi, Jaspal Arneja, Virgilijus Grinius, Sigute Norkiene, Birute Petrauskiene, Rolf Michels, Melvin Tjon, Hans de Swart, Robbert de Winter, Harvey White, Malcolm Abernethey, Alexander Osiev, Kirill Linev, Svetlana Kalinina, Svetlana Baum, Elena Kosmachova, Zaur Shogenov, Valentin Markov, Svetlana Boldueva, Olga Barbarash, Victor Kostenko, Elena Vasilieva, Aleksey Gruzdev, Victor Lusov, Pavel Dovgalevsky, Oleg Azarin, Sergey Chernov, Olga Smolenskaya, Alexey Duda, Viliam Fridrich, Marian Hranai, Martin Studenčan, Peter Kurray, John Bennett, Pieter Blomerus, Laurence Disler, Johannes Engelbrecht, Eric Klug, Robert Routier, Tjaart Venter, Nico Van Der Merwe, Anthony Becker, Kwang-Soo Cha, Seung-Hwan Lee, Sang-Jin Han, Tae Jin Youn, Seung-Ho Hur, Hong Seog Seo, Hun-Sik Park, Chong-Yun Rhim, Wook-Bum Pyun, Hyunmin Choe, Myung-Ho Jeong, Jong-Seon Park, Eak-Kyun Shin, Felipe Hernández, Jaume Figueras, Rosana Hernández, José Ramón López-Minguez, José Ramón González Juanatey, Ramón López Palop, Guillermo Galeote, Noppadol Chamnarnphol, Wacin Buddhari, Nakarin Sansanayudh, Srun Kuanprasert, William Penny, Charles Lui, Garfield Grimmett, Venkatraman Srinivasan, Kevin Ariani, Waqor Khan, James Blankenship, Steven Eisenberg, Jerry Greenberg, Jeffrey Breall, Harish Chandna, Paul Tolerico, Georges Nseir, Adam Greenbaum, Pierre Istfan, Joel Sklar, Robert Smith, Nicholaos Xenopoulos, Mahesh Mulumudi, James Hoback, Gregory Eaton, John Griffin, Ramin Ebrahimi, Robert Lundstrom, Dogan Temizer, Kenneth Tam, Jose Suarez, Amish Raval, Jay Kaufman, Emmanouil Brilakis, Michael Stillabower, Kathleen Quealy, Boris Nunez, Bruce Samuels, Agustin Argenal, Vankeepuram Srinivas, Andrew Rosenthal, Pradyumna Tummala, Paul Myers, Nelson LaMarche, Michael Chan, Daniel Simon, Richard Kettelkamp, Gary Schaer, Edward Kosinski, Maurice Buchbinder, Mukesh Sharma, Mark Goodwin, J. Tift Mann, David Holmes, Sunil Rao, Michael Azrin, Roger Gammon, Kreton Mavromatis, Abdel Ahmed, Marcel Zughaib, R. Jeffrey Westcott, Ash Jain, Georg Delle-Karth, Jamil Abdalla Saad, Alexandre Abizaid, Carlos Augusto Formiga Areas, Expedito E. Ribeiro, Fabio Rossi Dos Santos, Rogerio Tadeu Tumelero, Roberto Vieira Botelho, Borislav Atzev, Boicho Boichev, Georgi Grigorov, Nikolay Penkov, Boris Zehirov, Pavel Cervinka, Petr Hajek, David Horak, Petr Kmonicek, Jan Sitar, Nodar Emukhvari, George Khabeishvili, Steffen Behrens, Harald Darius, Martin Dissmann, Stephan Fichtlscherer, Wolfgang Franz, Tobias Geisler, Britta Goldmann, Andreas Mugge, Tudor Poerner, Gert Richardt, Christoph Stellbrink, Nikos Werner, Ezio Bramucci, Gennaro Galasso, Andrea Picchi, Patrizia Presbitero, Alexander Sasse, Szyszka Andrzej, Witold Dubaniewicz, Jaroslaw Kasprzak, Andrzej Kleinrok, Andrzej Rynkiewicz, Cezary Sosnowski, Radoslaw Targonski, Jaroslaw Trebacz, Adam Witkowski, Yakov Dovgalevsky, Ivan Gordeev, Prokhor Pavlov, Sergey Shalaev, Irina Sukmanova, Alexey Yakovlev, Sarana Boonbaichaiyapruck, Pinij Kaewsuwanna, Dilok Piyayotai, Imran Arif, Joseph Cinderella, Brent Davis, Chandanreddy Devireddy, Mark Dorogy, Norman Ferrier, Daniel Fisher, Robert Foster, John Galla, Raghava Gollapudi, James Hermiller, Richard Heuser, Zubair Jafar, Carey Kimmelstiel, Scott Kinlay, James Leggett, Dustin Letts, Michael Lipsitt, Joaquin Martinez-Arraras, Marc Mayhew, Paul McWhirter, Ayoub Mirza, William O'Riordan, John Petersen, Hector Picon, Mark Picone, Matthew Price, Virender Sethi, Craig Siegel, Daniel Steinberg, Jeffrey Tauth, Mladen Vidovich, Jonathan Waltman, and Michael Wilensky
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Male ,medicine.medical_specialty ,Ticlopidine ,medicine.medical_treatment ,Myocardial Ischemia ,Hemorrhage ,Platelet Glycoprotein GPIIb-IIIa Complex ,030204 cardiovascular system & hematology ,Cohort Studies ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Cangrelor ,P2Y12 ,Double-Blind Method ,Internal medicine ,medicine ,Humans ,Prospective Studies ,030212 general & internal medicine ,Angioplasty, Balloon, Coronary ,Infusions, Intravenous ,Aged ,Aspirin ,business.industry ,Percutaneous coronary intervention ,Middle Aged ,Clopidogrel ,Adenosine Monophosphate ,Surgery ,Treatment Outcome ,chemistry ,Glycoprotein IIb/IIIa inhibitors ,Conventional PCI ,Eptifibatide ,Cardiology ,Platelet aggregation inhibitor ,Drug Therapy, Combination ,Female ,Cardiology and Cardiovascular Medicine ,business ,Platelet Aggregation Inhibitors ,medicine.drug - Abstract
Background Cangrelor, an intravenous, reversible P2Y12 antagonist, is approved for use in patients undergoing percutaneous coronary intervention (PCI). Objectives This study sought to evaluate the efficacy and safety of cangrelor compared with clopidogrel in subgroups that did and did not receive glycoprotein IIb/IIIa inhibitors (GPIs). Methods This pooled, patient-level analysis of the 3 CHAMPION (Cangrelor versus Standard Therapy to Achieve Optimal Management of Platelet Inhibition) trials analyzed all randomized patients who underwent PCI and received the study drug (n = 24,902). Only bailout/rescue GPI use was permitted, except in CHAMPION PCI, in which routine or bailout/rescue GPI use was at the site investigator’s discretion. The primary efficacy endpoint was the composite of all-cause mortality, myocardial infarction, ischemia-driven revascularization, or stent thrombosis at 48 h after randomization. Results Overall, 3,173 patients (12.7%) received a GPI, most commonly eptifibatide (69.4%). Despite variation in indications for GPIs, baseline characteristics were well balanced between the cangrelor and clopidogrel arms in subsets receiving and not receiving GPIs. Rates of the primary composite endpoint were lower with cangrelor compared with clopidogrel in patients who did (4.9% vs. 6.5%; odds ratio [OR]: 0.74; 95% confidence interval [CI]: 0.55 to 1.01) or did not receive a GPI (3.6% vs. 4.4%; OR: 0.82; 95% CI: 0.72 to 0.94; Pint = 0.55). Cangrelor did not increase the primary safety endpoint, GUSTO-defined severe/life-threatening bleeding, in patients who did (0.4% vs. 0.5%; OR: 0.71; 95% CI: 0.25 to 1.99) or did not receive GPIs (0.2% vs. 0.1%; OR: 1.56; 95% CI: 0.80 to 3.04; Pint = 0.21). GPI use was associated with increased risk of bleeding in both treatment arms. Conclusions Cangrelor’s efficacy in reducing ischemic complications in patients undergoing PCI was maintained irrespective of GPI administration. GPI use was associated with substantially higher bleeding rates, regardless of the randomization to cangrelor or clopidogrel. (A Clinical Trial to Demonstrate the Efficacy of Cangrelor [PCI]: NCT00305162 ; Cangrelor Versus Standard Therapy to Achieve Optimal Management of Platelet Inhibition [PLATFORM]: NCT00385138 ; A Clinical Trial Comparing Cangrelor to Clopidogrel Standard Therapy in Subjects Who Require Percutaneous Coronary Intervention [PCI] [CHAMPION PHOENIX] [CHAMPION]: NCT01156571 )
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- 2017
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6. Characterization of Plaque Prolapse After Drug-Eluting Stent Implantation in Diabetic Patients
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Pavel Cervinka, Julie Jiang, Marco A. Costa, Rosana Hernández-Antolín, Fernando Alfonso, Cecilia Corros, Pilar Jiménez-Quevedo, Kino Morikawa-Futamatsu, Manel Sabaté, Dominick J. Angiolillo, Hideki Futamatsu, Theodore A. Bass, and Carlos Macaya
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Ultrasound ,Follow up studies ,Diabetic angiopathy ,medicine.disease ,Drug-eluting stent ,Diabetes mellitus ,Intravascular ultrasound ,Circulatory system ,medicine ,Stent implantation ,Radiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
Characterization of Plaque Prolapse After Drug-Eluting Stent Implantation in Diabetic Patients: A Three-Dimensional Volumetric Intravascular Ultrasound Outcome StudyHideki Futamatsu, Manel Sabate, ...
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- 2006
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7. [The user´s reporting from the national registry of catheter aortic valve implantations (Czech TAVI Registry): the possibilities of the analytical reports based on the database system TrialDB2]
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Milan, Bláha, Petr, Kala, Daniel, Klimeš, Ivo, Bernat, Marian, Branny, Pavel, Cervinka, Jan, Horák, Viktor, Kočka, Martin, Mates, Petr, Němec, Ladislav, Pešl, Roman, Stípal, Josef, Sťásek, and Michael, Zelízko
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Transcatheter Aortic Valve Replacement ,Benchmarking ,User-Computer Interface ,Databases, Factual ,Humans ,Aortic Valve Stenosis ,Czech Republic - Abstract
Assessment of the treatment procedures and their results is increasingly important in current medicine. The emphasis is put on an effective use of the health technologies (HTA). Unlike randomised studies, which involve strictly selected groups of patients who meet inclusion and exclusion criterias, the multicentre clinical registries provide a real-life picture of the treatment safety and effectiveness. Well prepared registries involve both research database and a friendly user interface enabling collection of parametric and easily analyzable data. Although there are some technological aspects aiming to ensure a maximum quality of entered data, cooperation with the users and data managers is essential. Such a registry, otherwise meaningful, must provide answers to previously defined medical hypotheses. Regular feedback to users (so called benchmarking or reporting) is considered to be of key importance. The Czech TAVI Registry (CTR) is a good example of reaching all of the above defined criterias. This registry contains data of approximately 95 % of all transcatheter aortic valve implantations (TAVI) performed in the Czech Republic. It is based on a general system aimed at the design of clinical trials, namely the TrialDB2 (a database system for clinical registries developed by the Institute of Biostatistics and Analyses at the Masaryk University (IBA MU). CTR has been run as an English-language version under the auspices of the Czech Society of Cardiology and represents one of the top-quality registries maintained by IBA MU. This paper presents the currently available database systems and some reports from this particular registry.
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- 2014
8. [Optical coherence tomography, delayed stent implantation and primary percutaneous coronary intervention in patients with myocardial infarction and ST segment elevation]
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Pavel, Cervinka
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Male ,Coronary Thrombosis ,Myocardial Infarction ,Arrhythmias, Cardiac ,Pilot Projects ,Middle Aged ,Radiography ,Percutaneous Coronary Intervention ,Treatment Outcome ,Cardiac Conduction System Disease ,Heart Conduction System ,Humans ,Female ,Stents ,Tomography, Optical Coherence ,Aged ,Brugada Syndrome ,Thrombectomy - Abstract
Primary percutaneous coronary intervention (PCI) is an effective treatment for myocardial infarction with ST-segment elevation. However, the stent may slow (slow-flow) or even interrupt the flow (no-reflow) in the infarct-related artery with an increase in short-term and long-term mortality. Due to these limitations there is an effort to search for alternative methods or certain modifications of existing PCI. Present article introduces a modified PCI and results of trombo-aspiration technique by optical coherence tomography (OCT). The article presents the results of our clinical study and brief case report. Our pilot project involved 100 patients with STEMI in 2011-2012. 20 patients (20%) were initially treated only with trombo-aspiration without stent implantation, based on OCT. Control angiography and OCT done 9 months after event have revealed insignificant stenosis in all patients. It is plausible that universal medical procedure with stenting is not suitable for all patients with STEMI and especially patients with large thrombus may benefit from the alternative procedure performed by manually trombo-aspiration technique with intensive anticoagulant/antiaggregant therapy. Nevertheless, only randomized trials with sufficiently follow-up may confirm this hypothesis.
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- 2014
9. Coronary bifurcation stenting using dedicated bifurcation stents
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Jurgen Ligthart, Manel Sabaté, Marco A. Costa, David P. Foley, P. Serrano, Patrick W. Serruys, Pavel Cervinka, and Cardiology
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medicine.medical_specialty ,Percutaneous ,business.industry ,medicine.medical_treatment ,Coronary stenting ,Stent ,General Medicine ,Coronary disease ,equipment and supplies ,Surgery ,surgical procedures, operative ,Angioplasty ,medicine ,Radiology, Nuclear Medicine and imaging ,Intracoronary ultrasound ,cardiovascular diseases ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Coronary bifurcation ,Bifurcation - Abstract
We report three cases of successful implantation of three different stents specially designed for bifurcation lesions, guided by intracoronary ultrasound. The BARD and AVE are true bifurcated stents for side-branch access and the NIR-Side Royal is a single modified NIR stent with an aperture to allow provisional bifurcation stenting. These designs introduce a new era in percutaneous management of coronary bifurcation lesions. Cathet. Cardiovasc. Intervent. 49:105-111, 2000.
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- 2000
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10. Late Coronary Occlusion After Intracoronary Brachytherapy
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Peter C. Levendag, P. Serrano, Pavel Cervinka, Marco A. Costa, Patrick W. Serruys, Manel Sabaté, Wim J. van der Giessen, V.L.M.A. Coen, I. Patrick Kay, and Jurgen Ligthart
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medicine.medical_specialty ,medicine.diagnostic_test ,Interventional cardiology ,business.industry ,medicine.medical_treatment ,Stent ,Balloon ,medicine.disease ,Thrombosis ,Restenosis ,Coronary occlusion ,Physiology (medical) ,Internal medicine ,Angioplasty ,Angiography ,medicine ,Cardiology ,Radiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background —Intracoronary brachytherapy appears to be a promising technology to prevent restenosis. Presently, limited data are available regarding the late safety of this therapeutic modality. The aim of the study was to determine the incidence of late (>1 month) thrombosis after PTCA and radiotherapy. Methods and Results —From April 1997 to March 1999, we successfully treated 108 patients with PTCA followed by intracoronary β-radiation. Ninety-one patients have completed at least 2 months of clinical follow-up. Of these patients, 6.6% (6 patients) presented with sudden thrombotic events confirmed by angiography 2 to 15 months after intervention (2 balloon angioplasty and 4 stent). Some factors (overlapping stents, unhealed dissection) may have triggered the thrombosis process, but the timing of the event is extremely unusual. Therefore, the effect of radiation on delaying the healing process and maintaining a thrombogenic coronary surface is proposed as the most plausible mechanism to explain such late events. Conclusions —Late and sudden thrombosis after PTCA followed by intracoronary radiotherapy is a new phenomenon in interventional cardiology.
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- 1999
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11. Long-term health outcome and mortality evaluation after invasive coronary treatment using drug eluting stents with or without the IVUS guidance. Randomized control trial. HOME DES IVUS
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Jozef, Jakabcin, Radim, Spacek, Marian, Bystron, Martin, Kvasnák, Jiri, Jager, Josef, Veselka, Petr, Kala, and Pavel, Cervinka
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Male ,Chi-Square Distribution ,Time Factors ,Myocardial Infarction ,Drug-Eluting Stents ,Thrombosis ,Coronary Artery Disease ,Middle Aged ,Prosthesis Design ,Risk Assessment ,Outcome and Process Assessment, Health Care ,Treatment Outcome ,Humans ,Drug Therapy, Combination ,Female ,Prospective Studies ,Angioplasty, Balloon, Coronary ,Platelet Aggregation Inhibitors ,Ultrasonography, Interventional ,Aged - Abstract
To assess the role of the intravascular ultrasound (IVUS) during implantation of drug-eluting stents (DES) on long-term outcome in patients with complex coronary artery disease and high clinical risk profile with special attention to the development of late stent thrombosis (LST).Two hundred and ten patients were randomly assigned to receive DES either with (N = 105) or without (N = 105) the IVUS guidance. Dual antiplatelet treatment was administered for 6 months in all patients. At 18-month follow-up, the rates of major adverse cardiac events (MACEs) (death, myocardial infarction, and reintervention) were assessed in both groups with special attention to possible LST. Stent thrombosis was classified according to Academic Research Consortium (ARC).At the 18-month follow-up, there was no significant difference between both groups regarding MACE (11% vs. 12%; P = NS). Stent thrombosis has occurred in four patients (3.8%) in the group with and in 6 patients (5.7%; P = NS) in the group without the IVUS guidance.In our randomized trial we failed to demonstrate the superiority of the IVUS guidance during DES implantation over standard high-pressure postdilatation. However we confirmed worrisome results concerning DES thrombosis after discontinuation of dual antiplatelet-treatment with documented stent thrombosis related events in almost 5% of patients with 50% of mortality in this high-risk clinical scenario.
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- 2009
12. Treatment of bifurcation lesions using dedicated bifurcation stents versus classic bare-metal stents. Randomized, controlled trial with 12-month angiographic follow up
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Pavel, Cervinka, Marian, Bystron, Radim, Spacek, Martin, Kvasnak, Sunil, Adhikari, and Jozef, Jakabcin
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Adult ,Male ,Ticlopidine ,Heparin ,Anticoagulants ,Coronary Artery Disease ,Middle Aged ,Coronary Angiography ,Clopidogrel ,Coronary Restenosis ,Fluoroscopy ,Humans ,Female ,Stents ,Prospective Studies ,Platelet Aggregation Inhibitors ,Aged - Abstract
The aim of this study was to compare the use of classic bare- metal stents with dedicated bifurcation bare-metal stents in patients who were not eligible for drug-eluting stents (DES) implantation.Sixty patients with bifurcation stenosis were randomly assigned to received either a dedicated bifurcation or a bare-metal stent (n = 30) or classic bare-metal stent (n = 30) with stenting of the parent vessel and angioplasty/or provisional stenting of the side branch. Fifty-nine patients underwent 12-month clinical and angiographic follow up unless this was performed earlier due to symptoms. Dual antiplatelet treatment was administered for 1 month. Acute success as well as the long-term clinical and angiographic outcome have been assessed in both groups.Baseline demographic, angiographic and procedure-related characteristics were well balanced in both groups. The use of dedicated stents was associated either with reduced procedure or fluoroscopy time (34 +/- 9 minutes vs. 46 +/- 20 minutes; p = 0.004 and 9 +/- 6 minutes vs. 15 +/- 9 minutes; p = 0.003, respectively) and lesser contrast volume (168 +/- 86 milliliters vs. 199 +/- 103 ml; p = 0.02). At the 12-month follow up, no statistically significant difference was found between both groups regarding major adverse cardiovascular events (MACE) (13.7 vs. 13.3%; p = 0.9).In our study we failed to demonstrate the superiority of a dedicated stent versus classic a bare-metal stent for the treatment of bifurcation lesions regarding MACE in patients who were not eligible for DES implantation. However, the use of dedicated stents may be preferable due to reduced procedure and fluoroscopy time and lesser contrast volume.
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- 2008
13. Outcomes associated with drug-eluting and bare-metal stents: a collaborative network meta-analysis
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Paul Vermeersch, Anna Sonia Petronio, Adnan Kastrati, Stephan Windecker, Albert Schömig, Bernhard Meier, Maarten J. Suttorp, Pavel Cervinka, Peter Jüni, Sven Trelle, Seung-Jung Park, Maurizio Menichelli, Simon Wandel, José Suárez de Lezo, Marcel Zwahlen, Alain J Nordmann, Maurits T. Dirksen, Marie Claude Morice, Peter Diem, Martin B. Leon, Matthias Pfisterer, Christoph Stettler, Jean-Jacques Goy, Gregg W. Stone, Manel Sabaté, Sabin Allemann, Christian Spaulding, Stephan Reichenbach, and Henning Kelbæk
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Target lesion ,Male ,medicine.medical_specialty ,Paclitaxel ,medicine.medical_treatment ,Myocardial Infarction ,Coronary Disease ,law.invention ,Coronary artery disease ,Randomized controlled trial ,law ,medicine ,Humans ,Zotarolimus ,cardiovascular diseases ,Myocardial infarction ,Randomized Controlled Trials as Topic ,Sirolimus ,business.industry ,Hazard ratio ,Stent ,General Medicine ,equipment and supplies ,medicine.disease ,Surgery ,Anti-Bacterial Agents ,surgical procedures, operative ,Drug-eluting stent ,Female ,Stents ,business ,medicine.drug ,Follow-Up Studies - Abstract
Summary Background Whether the two drug-eluting stents approved by the US Food and Drug Administration—a sirolimus-eluting stent and a paclitaxel-eluting stent—are associated with increased risks of death, myocardial infarction, or stent thrombosis compared with bare-metal stents is uncertain. Our aim was to compare the safety and effectiveness of these stents. Methods We searched relevant sources from inception to March, 2007, and contacted investigators and manufacturers to identify randomised controlled trials in patients with coronary artery disease that compared drug-eluting with bare-metal stents, or that compared sirolimus-eluting stents head-to-head with paclitaxel-eluting stents. Safety outcomes included mortality, myocardial infarction, and definite stent thrombosis; the effectiveness outcome was target lesion revascularisation. We included 38 trials (18 023 patients) with a follow-up of up to 4 years. Trialists and manufacturers provided additional data on clinical outcomes for 29 trials. We did a network meta-analysis with a mixed-treatment comparison method to combine direct within-trial comparisons between stents with indirect evidence from other trials while maintaining randomisation. Findings Mortality was similar in the three groups: hazard ratios (HR) were 1·00 (95% credibility interval 0·82–1·25) for sirolimus-eluting versus bare-metal stents, 1·03 (0·84–1·22) for paclitaxel-eluting versus bare-metal stents, and 0·96 (0·83–1·24) for sirolimus-eluting versus paclitaxel-eluting stents. Sirolimus-eluting stents were associated with the lowest risk of myocardial infarction (HR 0·81, 95% credibility interval 0·66–0·97, p=0·030 vs bare-metal stents; 0·83, 0·71–1·00, p=0·045 vs paclitaxel-eluting stents). There were no significant differences in the risk of definite stent thrombosis (0 days to 4 years). However, the risk of late definite stent thrombosis (>30 days) was increased with paclitaxel-eluting stents (HR 2·11, 95% credibility interval 1·19–4·23, p=0·017 vs bare-metal stents; 1·85, 1·02–3·85, p=0·041 vs sirolimus-eluting stents). The reduction in target lesion revascularisation seen with drug-eluting stents compared with bare-metal stents was more pronounced with sirolimus-eluting stents than with paclitaxel-eluting stents (0·70, 0·56–0·84; p=0·0021). Interpretation The risks of mortality associated with drug-eluting and bare-metal stents are similar. Sirolimus-eluting stents seem to be clinically better than bare-metal and paclitaxel-eluting stents.
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- 2007
14. Impact of ethanol dosing on the long-term outcome of alcohol septal ablation for obstructive hypertrophic cardiomyopathy: a single-center prospective, and randomized study
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Josef, Veselka, Radka, Duchonová, Jana, Páleníckova, David, Zemánek, Marie, Tiserová, Katerina, Linhartová, and Pavel, Cervinka
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Adult ,Male ,Cardiac Catheterization ,Treatment Outcome ,Ethanol ,Humans ,Cardiovascular Agents ,Female ,Prospective Studies ,Cardiomyopathy, Hypertrophic ,Injections, Intralesional ,Middle Aged ,Aged - Abstract
The impact of ethanol dose on the long-term outcome of alcohol septal ablation (ASA) for obstructive hypertrophic cardiomyopathy was investigated.Fifty-four patients (age 24-82 years; 65% women) undergoing ASA were randomized into 2 groups according to the dose of injected ethanol: Group A 1-2 ml, Group B2 ml. Clinical and echocardiographic data were obtained at baseline and during follow-up. The volume of ethanol injected was 1.50+/-0.4 and 2.60+/-0.6 ml (p0.001) with a subsequent peak of creatine kinase-MB of 2.25+/-1.00 and 2.62+/-1.57 microkat/L (p=0.02) in Groups A and B, respectively. The median follow-up was 39 (range 6-72) months after ASA, during which 1 patient died and 1 repeat procedure was necessary in both groups of patients. Both groups had a significant and similar improvement in outflow pressure gradient, dyspnea (New York Heart Association functional class) and angina pectoris (Canadian Cardiovascular Society class) (p0.001). There was a significant decrease in the left ventricular ejection fraction (LVEF) in Group B (81+/-7 vs 75+/-7%; p=0.002), but not in Group A (80+/-7 vs 79+/-7%; p=0.67). Thinning of the basal septum was more pronounced in Group B than in Group A (9.3+/-5.7 vs 6.6+/-3.4 mm; p=0.04).A lower dose of ethanol injected into the target septal branch reduces both the size of necrosis and subsequent thinning of the basal septum, and preserves LVEF during long-term follow-up. Moreover, the low dose (1-2 ml) is as safe and as hemodynamically efficacious as higher doses.
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- 2006
15. Characterization of plaque prolapse after drug-eluting stent implantation in diabetic patients: a three-dimensional volumetric intravascular ultrasound outcome study
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Hideki, Futamatsu, Manel, Sabaté, Dominick J, Angiolillo, Pilar, Jimenez-Quevedo, Cecilia, Corros, Kino, Morikawa-Futamatsu, Fernando, Alfonso, Julie, Jiang, Pavel, Cervinka, Rosana, Hernandez-Antolin, Carlos, Macaya, Theodore A, Bass, and Marco A, Costa
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Male ,Sirolimus ,Paclitaxel ,Coronary Stenosis ,Coronary Disease ,Equipment Design ,Middle Aged ,Risk Assessment ,Drug Delivery Systems ,Imaging, Three-Dimensional ,Treatment Outcome ,Metals ,Chronic Disease ,Prolapse ,Humans ,Multicenter Studies as Topic ,Female ,Stents ,Diabetic Angiopathies ,Ultrasonography, Interventional ,Aged ,Follow-Up Studies ,Randomized Controlled Trials as Topic - Abstract
The aim of this research was to evaluate the plaque prolapse (PP) phenomenon after bare-metal (BMS) and drug-eluting stent (DES) implantation in patients with diabetes mellitus using 3-dimensional volumetric intravascular ultrasound (IVUS).Plaque prolapse has been observed in up to 22% of patients treated with BMS. Diabetic patients have a larger atherothrombotic burden and may be more prone to have PP. However, the incidence of PP and its clinical impact after DES implantation is unknown.Three-dimensional IVUS was performed after intervention and at 9-month follow-up in 168 patients with diabetes (205 lesions) treated with bare BX Velocity stents ((BX Velocity/Sonic, Cordis, JohnsonJohnson) (BMS, n = 65), sirolimus-eluting stents (Cypher, Cordis) (SES, n = 69), and paclitaxel-eluting stents (Taxus, Boston Scientific, Natick, Massachusetts) (PES, n = 71). Intravascular ultrasound data at the sites of PP were compared with stented segments without PP in each lesion. Outcomes were evaluated at 9- and 12-month follow-up.There were 42 sites of PP (BMS = 11, SES = 11, PES = 20, p = NS) in 34 stented segments of 205 (16.6%) lesions. Plaque prolapse was more frequent in the right coronary artery and in chronic total occlusion lesions. Post-procedure PP volume was 1.95 mm3 in BMS, 2.96 mm3 in SES, and 4.53 mm3 in PES. At follow-up, tissue volume increased at PP sites in both BMS and PES, but not after SES. Neointimal proliferation was similar between PP and non-PP sites. Stent thrombosis and restenosis rates were similar between PP and non-PP lesions.The incidence of PP after implantation of new generation tubular stents in patients with diabetes remains high. Drug-eluting stent implantation was not associated with increased risk of PP. Plaque prolapse was not associated with stent thrombosis or increased neointimal proliferation.
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- 2006
16. Alcohol septal ablation for hypertrophic obstructive cardiomyopathy: Lower alcohol dose reduces size of infarction and has comparable hemodynamic and clinical outcome
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Josef, Veselka, Sárka, Procházková, Radka, Duchonová, Ingrid, Bolomová-Homolová, Jana, Pálenícková, David, Tesar, Pavel, Cervinka, and Tomás, Honek
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Male ,Chi-Square Distribution ,Time Factors ,Ethanol ,Hemodynamics ,Cardiomyopathy, Hypertrophic ,Injections, Intralesional ,Middle Aged ,Coronary Angiography ,Treatment Outcome ,Echocardiography ,Catheter Ablation ,Heart Septum ,Humans ,Female - Abstract
Patients with highly symptomatic hypertrophic obstructive cardiomyopathy (HOCM) are considered to be good candidates for percutaneous transluminal septal myocardial ablation (PTSMA). However, there is ongoing discussion regarding the optimal dose of alcohol injected into target septal artery and the impact of infarct sizes on the clinical and hemodynamic outcome. Thirty-four patients with symptomatic HOCM receiving maximum medical therapy were consecutively enrolled. Patients were randomized in a 1:1 ratio into one of the two arms according to dose of injected alcohol during echocardiography-guided PTSMA procedure. Clinical, electrocardiographic, and echocardiographic evaluation were performed 6 months after the procedure in all the patients. Both groups of patients matched in all clinical and echocardiographic data. The dose of alcohol injected was 1.6 +/- 0.4 and 3.4 +/- 0.9 (P0.001) with subsequent peak of CK-MB 1.9 and 3.2 microkat/L (P0.05) in group A and B, respectively. There was a correlation between amount of injected alcohol and the peak of CK-MB (r = 0.58; P0.01), whereas no significant relationship (r = 0.16; P = NS) was documented between the peak of CK-MB and left ventricular outflow gradient at follow-up. At 6-month follow-up, both groups of patients were not significantly different with regard to symptoms or electrocardiographic and echocardiographic findings. In conclusion, this study suggests that the low dose (1- 2 ml) of alcohol injected into target septal branch reduces size of necrosis. Moreover, the low dose is probably as safe and efficacious as usually used doses (2-4 ml).
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- 2004
17. The 'edge effect' after implantation of beta-emitting (55Co) stents with high initial activity
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Pavel, Cervinka, Josef, St'ásek, Marco Aurelio, Costa, Jan, Stursa, Miloslav, Fiser, Petr, Vodnanský, Michaela, Kocisová, Josef, Veselka, Miloslav, Pleskot, and Jaroslav, Malý
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Coronary Restenosis ,Male ,Humans ,Coronary Disease ,Female ,Stents ,Angioplasty, Balloon, Coronary ,Cobalt Radioisotopes ,Middle Aged ,Ultrasonography, Interventional ,Aged ,Beta Particles - Abstract
The aim of this study was to evaluate the incidence and the cause of "edge restenosis" after implantation of high activity 41.1 microCi +/- 1.2 microCi = 1520 kBq +/- 44 kBq, beta-emitting (55Co) stents. Proton bombarding in cyclotron has brought the radioactivity. Intravascular ultrasound (IVUS) investigation has been completed in 10 patients. The angiographies performed at 6 month revealed restenosis50% in 5 cases (50%). The analysis of edges (5 mm distally and proximally to the last stent struts) showed no significant changes in TVV (187.3 +/- 62.60 mm3 and 176.9 +/- 53.5 mm3) but PMV increase significantly (i.e. neointimal proliferation) from 61.9 +/- 31.2 mm3 to 82.2 +/- 43.4 mm3 (p0.04) and was the major contributor (from 66%) to lumen volume loss (125.4 +/- 40.7 mm3 and 94.7 +/- 22.2 mm3, p0.02). In conclusion, neither statistically significant positive nor negative remodelling at the "stent edges", were present. Statistically significant increase in plaque +/- media volume (i.e. neointimal hyperplasia) and reduction in lumen volume were found. The cause of "edge restenosis" was especially (from 66%) due to increase in plaque +/- media volume (i.e. neointimal hyperplasia). Probably, main reason for "edge effect"/neointimal hyperplasia was in this trial sharp fall-off in radiation at the edges of the stents.
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- 2004
18. Treatment of coronary bifurcation lesions by stent implantation only in parent vessel and angioplasty in sidebranch: immediate and long-term outcome
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Pavel, Cervinka, Joseph, Stasek, Miloslav, Pleskot, and Jaroslav, Malý
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Male ,Cardiac Catheterization ,Time Factors ,Coronary Stenosis ,Middle Aged ,Coronary Angiography ,Risk Assessment ,Severity of Illness Index ,Cohort Studies ,Treatment Outcome ,Recurrence ,Humans ,Female ,Stents ,Angioplasty, Balloon, Coronary ,Aged ,Follow-Up Studies - Abstract
The aim of this study was to evaluate the immediate and long-term outcome of intracoronary stent implantation for the treatment of bifurcation lesions. We treated 30 patients with bifurcation stenosis with the Bx Velocity stent implanted only in the parent vessel and with balloon angioplasty of the sidebranch. Angiographic success was 86.7% (n = 26 patients) in both branches and 100% in the main branch. Clinical success was achieved in 29 patients (96.7%). One patient (3.3%) suffered from a small non-Q wave myocardial infarction. All 30 patients underwent control coronary angiography at 6 months unless performed earlier due to symptoms. After the 6-month follow-up, a total of 27 patients (90%) were asymptomatic; angiographic restenosis (50%) was found in four cases (13.3%). There was no sidebranch restenosis. During the follow-up, one patient (3.3%) had unstable angina and angiography revealed severe diffuse restenosis within the whole stent; this patient was referred for coronary artery bypass surgery. Two patients had mild angina (Canadian Cardiovascular Society Class II) and 1 patient had silent ischemia during exercise stress test. These patients underwent repeat coronary angioplasty. The rate of major adverse cardiac events was 16.6% and target vessel revascularization rate was 13.3%. We concluded that stent implantation only in the parent vessel with angioplasty of the sidebranch in bifurcation lesions is safe and has a high clinical success rate and low rate of target lesion revascularization.
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- 2002
19. The incidence and outcomes of acute coronary syndromes in a central European country: Results of the CZECH-2 registry
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Petr, Tousek, Frantisek, Tousek, David, Horak, Pavel, Cervinka, Richard, Rokyta, Ladislav, Pesl, Jiri, Jarkovsky, Petr, Widimsky, and Petr, Widimský
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Male ,medicine.medical_specialty ,Acute coronary syndrome ,Registry ,medicine.medical_treatment ,Population ,Myocardial Infarction ,Total population ,Health Services Accessibility ,Percutaneous Coronary Intervention ,Risk Factors ,Internal medicine ,medicine ,Humans ,In patient ,Myocardial infarction ,Angina, Unstable ,Hospital Mortality ,Registries ,cardiovascular diseases ,education ,Aged ,Czech Republic ,Outcome ,Aged, 80 and over ,education.field_of_study ,business.industry ,Incidence (epidemiology) ,Incidence ,Percutaneous coronary intervention ,Middle Aged ,medicine.disease ,Hospitals ,3. Good health ,Treatment Outcome ,Conventional PCI ,Cardiology ,Female ,business ,Cardiology and Cardiovascular Medicine - Abstract
BackgroundThe incidence and treatment strategies of acute coronary syndrome (ACS) vary by region. Additionally, the clinical spectrum of ACS is changing and outcomes are improving.AimWe assessed the incidence, treatment strategies, and outcomes of ACS for a well-defined population within a well-established network of percutaneous coronary intervention (PCI) centers and non-PCI centers.MethodsThe CZECH-2 registry included 1221 consecutive patients (mean age: 68±13years; 63.4% males) admitted for suspected ACS to 32 hospitals (including 4 PCI centers) within four Czech counties (total population: 2,370,841 inhabitants) during a 2-month period.ResultsThe estimated incidence of confirmed ACS was 2149cases/million/year. In 374 (31%) patients, ACS was ruled out during the hospital stay. Coronary angiography (CAG) was performed in 60% of the patients overall and PCI was performed in 59% of the confirmed ACS patients. Killip classifications II–IV on admission were more common in patients with final diagnosis of non ST-elevation myocardial infarction (NSTEMI) than ST-elevation myocardial infarction (STEMI) (37.1% vs. 22.8%; p
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20. Drug eluting and bare metal stents in people with and without diabetes: Collaborative network meta-analysis
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Pavel Cervinka, Paul Vermeersch, Andrejs Erglis, Marie Claude Morice, Seung-Jung Park, Simon Wandel, Martin J. Schalij, Jean-Jacques Goy, Sabin Allemann, Manel Sabaté, Maarten J. Suttorp, Peter Diem, Matthias Pfisterer, Adnan Kastrati, Paolo Ortolani, Tania Chechi, Christoph Stettler, Christian Spaulding, Peter Jüni, Martin B. Leon, Stephan Windecker, Marco De Carlo, Maurits T. Dirksen, Henning Kelbæk, José Suárez de Lezo, Albert Schömig, Bernhard Meier, Maurizio Menichelli, and Gregg W. Stone
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medicine.medical_specialty ,Paclitaxel ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Coronary Restenosis ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Blood vessel prosthesis ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,cardiovascular diseases ,General Environmental Science ,Randomized Controlled Trials as Topic ,Sirolimus ,business.industry ,Research ,Hazard ratio ,General Engineering ,Drug-Eluting Stents ,General Medicine ,equipment and supplies ,3. Good health ,Surgery ,Blood Vessel Prosthesis ,Prosthesis Failure ,Clinical trial ,surgical procedures, operative ,chemistry ,Drug-eluting stent ,Meta-analysis ,General Earth and Planetary Sciences ,Platelet aggregation inhibitor ,Stents ,business ,Diabetic Angiopathies ,Platelet Aggregation Inhibitors ,medicine.drug - Abstract
Objective To compare the effectiveness and safety of three types of stents (sirolimus eluting, paclitaxel eluting, and bare metal) in people with and without diabetes mellitus. Design Collaborative network meta-analysis. Data sources Electronic databases (Medline, Embase, the Cochrane Central Register of Controlled Trials), relevant websites, reference lists, conference abstracts, reviews, book chapters, and proceedings of advisory panels for the US Food and Drug Administration. Manufacturers and trialists provided additional data. Review methods Network meta-analysis with a mixed treatment comparison method to combine direct within trial comparisons between stents with indirect evidence from other trials while maintaining randomisation. Overall mortality was the primary safety end point, target lesion revascularisation the effectiveness end point. Results 35 trials in 3852 people with diabetes and 10 947 people without diabetes contributed to the analyses. Inconsistency of the network was substantial for overall mortality in people with diabetes and seemed to be related to the duration of dual antiplatelet therapy (P value for interaction 0.02). Restricting the analysis to trials with a duration of dual antiplatelet therapy of six months or more, inconsistency was reduced considerably and hazard ratios for overall mortality were near one for all comparisons in people with diabetes: sirolimus eluting stents compared with bare metal stents 0.88 (95% credibility interval 0.55 to 1.30), paclitaxel eluting stents compared with bare metal stents 0.91 (0.60 to 1.38), and sirolimus eluting stents compared with paclitaxel eluting stents 0.95 (0.63 to 1.43). In people without diabetes, hazard ratios were unaffected by the restriction. Both drug eluting stents were associated with a decrease in revascularisation rates compared with bare metal stents in people both with and without diabetes. Conclusion In trials that specified a duration of dual antiplatelet therapy of six months or more after stent implantation, drug eluting stents seemed safe and effective in people both with and without diabetes.
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