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1. Impact of Pre-Procedural Blood Pressure on Long-Term Outcomes Following Percutaneous Coronary Intervention

Author

Reid, Chris, Andrianopoulos, Nick, Brennan, Angela, Dinh, Diem, Ajani, Andrew, Duffy, Stephen, Clark, David, Freeman, Melanie, Hiew, Chin, Oqueli, Ernesto, Duffy, S.J., Shaw, J.A., Walton, A., Dart, A., Broughton, A., Federman, J., Keighley, C., Hengel, C., Peter, K.H., Stub, D., Chan, W., Warren, J., O’Brien, J., Selkrig, L., Huntington, R., Clark, D.J., Farouque, O., Horrigan, M., Johns, J., Oliver, L., Brennan, J., Chan, R., Proimos, G., Dortimer, T., Chan, B., Nadurata, V., Huq, R., Fernando, D., Al-Fiadh, A., Yudi, M., Sugumar, H., Ramchand, J., Han, H., Picardo, S., Brown, L., Oqueli, E., Sharma, A., Zhu, B., Ryan, N., Harrison, T., New, G., Roberts, L., Freeman, M., Rowe, M., Cheong, Y., Goods, C., Teh, A., Parfrey, S., Ramzy, J., Koshy, A., Venkataraman, P., Flannery, D., Hiew, C., Sebastian, M., Yip, T., Mok, Michael, Jaworski, C., Hutchinson, A., Cimenkaya, C., Ngu, P., Khialani, B., Salehi, H., Turner, M., Dyson, J., McDonald, B., Van Den Nouwelant, D., Halliburton, K., Reid, C., Andrianopoulos, N., Brennan, A.L., Dinh, D., Yan, B.P., Ajani, A.E., Warren, R., Eccleston, D., Lefkovits, J., Iyer, R., Gurvitch, R., Wilson, W., Brooks, M., Biswas, S., Yeoh, J., Warren, Josephine, Nanayakkara, Shane, Yudi, Matias, Ajani, Andrew E., Reid, Christopher M., Selkrig, Laura, Shaw, James, Kaye, David, Kingwell, Bronwyn A., Dart, Anthony M., and Duffy, Stephen J.

Published
2019
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2. Trends and Impact of Door-to-Balloon Time on Clinical Outcomes in Patients Aged

Author

Duffy, SJ, Shaw, JA, Walton, A, Dart, A, Broughton, A, Federman, J, Keighley, C, Hengel, C, Peter, KH, Stub, D, Chan, W, O'Brien, J, Selkrig, L, Rankin, K, Vandernet, R, Huntington, R, Pally, S, Clark, DJ, Farouque, O, Horrigan, M, Johns, J, Oliver, L, Brennan, J, Chan, R, Proimos, G, Dortimer, T, Chan, B, Nadurata, V, Huq, R, Fernando, D, Al-Fiadh, A, Yudi, M, Sugumar, H, Ramchand, J, Han, H, Picardo, S, Brown, L, Oqueli, E, Sharma, A, Zhu, B, Ryan, N, Harrison, T, New, G, Roberts, L, Freeman, M, Rowe, M, Cheong, Y, Goods, C, Teh, A, Parfrey, S, Ramzy, J, Koshy, A, Venkataraman, P, Flannery, D, Hiew, C, Sebastian, M, Yip, T, Mok, M, Jaworski, C, Hutchinson, A, Cimenkaya, C, Ngu, P, Khialani, B, Salehi, H, Turner, M, Dyson, J, McDonald, B, Van Den Nouwelant, D, Halliburton, K, Krum, H, Reid, C, Andrianopoulos, N, Brennan, AL, Chand, V, Dinh, D, Yan, BP, Ajani, AE, Warren, R, Eccleston, D, Lefkovits, J, Iyer, R, Gurvitch, R, Wilson, W, Brooks, M, Biswas, S, Yeoh, J, Yudi, Matias B., Hamilton, Garry, Farouque, Omar, Andrianopoulos, Nick, Duffy, Stephen J., Lefkovits, Jeffrey, Brennan, Angela, Fernando, Dharsh, Hiew, Chin, Freeman, Melanie, Reid, Christopher M., Dakis, Robynne, Ajani, Andrew E., and Clark, David J.

Published
2017
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3. Evolution of Australian Percutaneous Coronary Intervention (from the Melbourne Interventional Group [MIG] Registry)

Author

Reid, Chris, Ajani, Andrew E., Duffy, Stephen, Clark, David, Freeman, Melanie, Hiew, Chin, Andrianopoulos, Nick, Oqueli, Ernesto, Brennan, Angela, Duffy, S.J., Shaw, J.A., Walton, A., Dart, A., Broughton, A., Federman, J., Keighley, C., Hengel, C., Peter, K.H., Stub, D., Chan, W., Nanayakkara, S., O'Brien, J., Selkrig, L., Rankin, K., Huntington, R., Pally, S., Clark, D.J., Farouque, O., Horrigan, M., Johns, J., Oliver, L., Brennan, J., Chan, R., Proimos, G., Dortimer, T., Chan, B., Huq, R., Fernando, D., Yudi, M., Charter, K., Brown, L., AlFiadh, A., Ramchand, J., Picardo, S., Oqueli, E., Sharma, A., Ryan, N., Harrison, T., Barry, C., Freeman, M., Roberts, L., Teh, A., Rowe, M., Cheong, Y., Goods, C., Baradi, A., Jackson, D., Sajeev, J., Hiew, C., Sebastian, M., Yip, T., Mok, M., Jaworski, C., Hutchison, A., Turner, M., Khialani, B., Dyson, J., McDonald, B., Duff, L., Reid, C., Andrianopoulos, N., Brennan, A.L., Chand, V., Dinh, D., Yan, B.P., Ajani, A.E., Warren, R., Eccleston, D., Lefkovits, J., Iyer, R., Gurvitch, R., Wilson, W., Brooks, M., Biswas, S., Yeoh, J., Yeoh, Julian, Yudi, Matias B., Yan, Bryan P., Clark, David J., Duffy, Stephen J., New, Gishel, Eccleston, David, Sebastian, Martin, Reid, Christopher M., and Wilson, William

Published
2017
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6. The assessment of intermediate coronary lesions using intracoronary imaging.

Author

Brown A.J., Prosser H., O'Brien J., Thakur U., Soon K., Proimos G., Nogic J., Brown A.J., Prosser H., O'Brien J., Thakur U., Soon K., Proimos G., and Nogic J.

Abstract

Intermediate coronary artery stenosis, defined as visual angiographic stenosis severity of between 30-70%, is present in up to one quarter of patients undergoing coronary angiography. Patients with this particular lesion subset represent a distinct clinical challenge, with operators often uncertain on the need for revascularization. Although international guidelines appropriately recommend physiological pressure-based assessment of these lesions utilizing either fractional flow reserve (FFR) or quantitative flow ratio (QFR), there are specific clinical scenarios and lesion subsets where the use of such indices may not be reliable. Intravascular imaging, mainly utilizing intravascular ultrasound (IVUS) and optical coherence tomography (OCT) represents an alternate and at times complementary diagnostic modality for the evaluation of intermediate coronary stenoses. Studies have attempted to validate these specific imaging measures with physiological markers of lesion-specific ischaemia with varied results. Intravascular imaging however also provides additional benefits that include portrayal of plaque morphology, guidance on stent implantation and sizing and may portend improved clinical outcomes. Looking forward, research in computational fluid dynamics now seeks to integrate both lesion-based physiology and anatomical assessment using intravascular imaging. This review will discuss the rationale and indications for the use of intravascular imaging assessment of intermediate lesions, while highlighting the current limitations and benefits to this approach.Copyright © Cardiovascular Diagnosis and Therapy. All rights reserved.

Published
2020

7. TCT CONNECT-386 Diabetes Mellitus Is Associated With Increased Risk of Early Stent-Related Complications in Patients Undergoing Drug-Eluting Stent Implantation: Insight From the Victorian Cardiac Outcomes Registry (VCOR).

Author

Nicholls S., Nogic J., Nerlekar N., Soon K., Proimos G., Brown A., Freeman M., Roberts L., Dinh D., Brennan A., Cooke J., Nicholls S., Nogic J., Nerlekar N., Soon K., Proimos G., Brown A., Freeman M., Roberts L., Dinh D., Brennan A., and Cooke J.

Abstract

Background: The presence of diabetes mellitus (DM) is a known predictor of restenosis and late stent thrombosis (ST) in patients undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DESs). However, there remains a paucity of real-world, all-comer data on whether DM is associated with early ST in patients receiving third-generation DESs. These data are particularly important considering the push toward abbreviated dual-antiplatelet therapy. We sought to compare outcomes of patients with and without DM from the Victorian Cardiac Outcomes Registry. Method(s): All consecutive patients undergoing PCI with DESs were included from January 2014 through December 2018. The primary outcome was ST at 30 days with secondary outcomes of major adverse cardiac events (MACEs) and mortality. Long-term survival analysis was obtained through linkage with the National Death Index. Multivariable logistic regression was performed with ST as the outcome and independent predictors added to the model on the basis of a univariable association (p < 0.2). Model fit was assessed by the Akaike information criterion to develop a parsimonious regression model. Result(s): A total of 43,209 patients underwent PCI during the study period with 9,730 (22.5%) having DM. At 30 days, DM was independently associated with higher rates of ST (0.72% vs. 0.52%; odds ratio: 1.41; 95% confidence interval: 1.05 to 1.87; p = 0.02), MACEs (4.1% vs. 3.5%, p = 0.004), and mortality (1.9% vs. 1.5%, p = 0.01). Increased risk was not simply due to treatment, with those on insulin and hypoglycemic agents equally affected in terms of MACEs (4.7% vs. 3.9%, p = 0.069) and mortality (1.9% vs. 1.8%, p = 0.746). National Death Index linkage showed patients with DM had an increased risk of death over a 6-year follow-up period (odds ratio: 1.69; 95% confidence interval: 1.55 to 1.83; p <= 0.001). Conclusion(s): In this large real-world registry, DM was an independent predictor of ST, MACEs, and mortality

Published
2020

8. Impact of Pre-Procedural Blood Pressure on Long-Term Outcomes Following Percutaneous Coronary Intervention

Author

Warren, J, Nanayakkara, S, Andrianopoulos, N, Brennan, A, Dinh, D, Yudi, M, Clark, D, Ajani, AE, Reid, CM, Selkrig, L, Shaw, J, Hiew, C, Freeman, M, Kaye, D, Kingwell, BA, Dart, AM, Duffy, SJ, Reid, C, Duffy, S, Oqueli, E, Shaw, JA, Walton, A, Broughton, A, Federman, J, Keighley, C, Hengel, C, Peter, KH, Stub, D, Chan, W, O'Brien, J, Huntington, R, Farouque, O, Horrigan, M, Johns, J, Oliver, L, Brennan, J, Chan, R, Proimos, G, Dortimer, T, Chan, B, Nadurata, V, Huq, R, Fernando, D, Al-Fiadh, A, Sugumar, H, Ramchand, J, Han, H, Picardo, S, Brown, L, Sharma, A, Zhu, B, Ryan, N, Harrison, T, New, G, Roberts, L, Rowe, M, Cheong, Y, Goods, C, Teh, A, Parfrey, S, Ramzy, J, Koshy, A, Venkataraman, P, Flannery, D, Hiew, Chin, Sebastian, M, Yip, T, Mok, Michael, Jaworski, C, Hutchinson, A, Cimenkaya, C, Ngu, P, Khialani, B, Salehi, H, Turner, M, Dyson, J, McDonald, B, Van Den Nouwelant, D, Halliburton, K, Yan, BP, Warren, R, Eccleston, D, Lefkovits, J, Iyer, R, Gurvitch, R, Wilson, W, Brooks, M, Biswas, S, Yeoh, J, Warren, J, Nanayakkara, S, Andrianopoulos, N, Brennan, A, Dinh, D, Yudi, M, Clark, D, Ajani, AE, Reid, CM, Selkrig, L, Shaw, J, Hiew, C, Freeman, M, Kaye, D, Kingwell, BA, Dart, AM, Duffy, SJ, Reid, C, Duffy, S, Oqueli, E, Shaw, JA, Walton, A, Broughton, A, Federman, J, Keighley, C, Hengel, C, Peter, KH, Stub, D, Chan, W, O'Brien, J, Huntington, R, Farouque, O, Horrigan, M, Johns, J, Oliver, L, Brennan, J, Chan, R, Proimos, G, Dortimer, T, Chan, B, Nadurata, V, Huq, R, Fernando, D, Al-Fiadh, A, Sugumar, H, Ramchand, J, Han, H, Picardo, S, Brown, L, Sharma, A, Zhu, B, Ryan, N, Harrison, T, New, G, Roberts, L, Rowe, M, Cheong, Y, Goods, C, Teh, A, Parfrey, S, Ramzy, J, Koshy, A, Venkataraman, P, Flannery, D, Hiew, Chin, Sebastian, M, Yip, T, Mok, Michael, Jaworski, C, Hutchinson, A, Cimenkaya, C, Ngu, P, Khialani, B, Salehi, H, Turner, M, Dyson, J, McDonald, B, Van Den Nouwelant, D, Halliburton, K, Yan, BP, Warren, R, Eccleston, D, Lefkovits, J, Iyer, R, Gurvitch, R, Wilson, W, Brooks, M, Biswas, S, and Yeoh, J

Published
2019

10. Impact of Pre-Procedural Blood Pressure on Long-Term Outcomes Following Percutaneous Coronary Intervention

Author

Warren, Josephine, primary, Nanayakkara, Shane, additional, Andrianopoulos, Nick, additional, Brennan, Angela, additional, Dinh, Diem, additional, Yudi, Matias, additional, Clark, David, additional, Ajani, Andrew E., additional, Reid, Christopher M., additional, Selkrig, Laura, additional, Shaw, James, additional, Hiew, Chin, additional, Freeman, Melanie, additional, Kaye, David, additional, Kingwell, Bronwyn A., additional, Dart, Anthony M., additional, Duffy, Stephen J., additional, Reid, Chris, additional, Ajani, Andrew, additional, Duffy, Stephen, additional, Oqueli, Ernesto, additional, Duffy, S.J., additional, Shaw, J.A., additional, Walton, A., additional, Dart, A., additional, Broughton, A., additional, Federman, J., additional, Keighley, C., additional, Hengel, C., additional, Peter, K.H., additional, Stub, D., additional, Chan, W., additional, Warren, J., additional, O’Brien, J., additional, Selkrig, L., additional, Huntington, R., additional, Clark, D.J., additional, Farouque, O., additional, Horrigan, M., additional, Johns, J., additional, Oliver, L., additional, Brennan, J., additional, Chan, R., additional, Proimos, G., additional, Dortimer, T., additional, Chan, B., additional, Nadurata, V., additional, Huq, R., additional, Fernando, D., additional, Al-Fiadh, A., additional, Yudi, M., additional, Sugumar, H., additional, Ramchand, J., additional, Han, H., additional, Picardo, S., additional, Brown, L., additional, Oqueli, E., additional, Sharma, A., additional, Zhu, B., additional, Ryan, N., additional, Harrison, T., additional, New, G., additional, Roberts, L., additional, Freeman, M., additional, Rowe, M., additional, Cheong, Y., additional, Goods, C., additional, Teh, A., additional, Parfrey, S., additional, Ramzy, J., additional, Koshy, A., additional, Venkataraman, P., additional, Flannery, D., additional, Hiew, C., additional, Sebastian, M., additional, Yip, T., additional, Mok, Michael, additional, Jaworski, C., additional, Hutchinson, A., additional, Cimenkaya, C., additional, Ngu, P., additional, Khialani, B., additional, Salehi, H., additional, Turner, M., additional, Dyson, J., additional, McDonald, B., additional, Van Den Nouwelant, D., additional, Halliburton, K., additional, Reid, C., additional, Andrianopoulos, N., additional, Brennan, A.L., additional, Dinh, D., additional, Yan, B.P., additional, Ajani, A.E., additional, Warren, R., additional, Eccleston, D., additional, Lefkovits, J., additional, Iyer, R., additional, Gurvitch, R., additional, Wilson, W., additional, Brooks, M., additional, Biswas, S., additional, and Yeoh, J., additional

Published
2019
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11. The Journey of Drug-Eluting Stents: A Multi-Centre Australian Registry Review

Author

Yeoh, J., primary, Andrianopoulos, N., additional, Yudi, M., additional, Horrigan, M., additional, Horrigan, S., additional, Ajani, A., additional, O’Brien, J., additional, Brennan, A., additional, Proimos, G., additional, Picardo, S., additional, Freeman, M., additional, Oqueli, E., additional, Sebastian, M., additional, Reid, C., additional, Farouque, O., additional, and Clark, D., additional

Published
2018
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12. Trends and Impact of Door-to-Balloon Time on Clinical Outcomes in Patients Aged <75, 75 to 84, and ≥85 Years With ST-Elevation Myocardial Infarction

Author

Yudi, Matias B., primary, Hamilton, Garry, additional, Farouque, Omar, additional, Andrianopoulos, Nick, additional, Duffy, Stephen J., additional, Lefkovits, Jeffrey, additional, Brennan, Angela, additional, Fernando, Dharsh, additional, Hiew, Chin, additional, Freeman, Melanie, additional, Reid, Christopher M., additional, Dakis, Robynne, additional, Ajani, Andrew E., additional, Clark, David J., additional, Duffy, SJ, additional, Shaw, JA, additional, Walton, A, additional, Dart, A, additional, Broughton, A, additional, Federman, J, additional, Keighley, C, additional, Hengel, C, additional, Peter, KH, additional, Stub, D, additional, Chan, W, additional, O'Brien, J, additional, Selkrig, L, additional, Rankin, K, additional, Vandernet, R, additional, Huntington, R, additional, Pally, S, additional, Clark, DJ, additional, Farouque, O, additional, Horrigan, M, additional, Johns, J, additional, Oliver, L, additional, Brennan, J, additional, Chan, R, additional, Proimos, G, additional, Dortimer, T, additional, Chan, B, additional, Nadurata, V, additional, Huq, R, additional, Fernando, D, additional, Al-Fiadh, A, additional, Yudi, M, additional, Sugumar, H, additional, Ramchand, J, additional, Han, H, additional, Picardo, S, additional, Brown, L, additional, Oqueli, E, additional, Sharma, A, additional, Zhu, B, additional, Ryan, N, additional, Harrison, T, additional, New, G, additional, Roberts, L, additional, Freeman, M, additional, Rowe, M, additional, Cheong, Y, additional, Goods, C, additional, Teh, A, additional, Parfrey, S, additional, Ramzy, J, additional, Koshy, A, additional, Venkataraman, P, additional, Flannery, D, additional, Hiew, C, additional, Sebastian, M, additional, Yip, T, additional, Mok, M, additional, Jaworski, C, additional, Hutchinson, A, additional, Cimenkaya, C, additional, Ngu, P, additional, Khialani, B, additional, Salehi, H, additional, Turner, M, additional, Dyson, J, additional, McDonald, B, additional, Van Den Nouwelant, D, additional, Halliburton, K, additional, Krum, H, additional, Reid, C, additional, Andrianopoulos, N, additional, Brennan, AL, additional, Chand, V, additional, Dinh, D, additional, Yan, BP, additional, Ajani, AE, additional, Warren, R, additional, Eccleston, D, additional, Lefkovits, J, additional, Iyer, R, additional, Gurvitch, R, additional, Wilson, W, additional, Brooks, M, additional, Biswas, S, additional, and Yeoh, J, additional

Published
2017
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13. Evolution of Australian Percutaneous Coronary Intervention (from the Melbourne Interventional Group [MIG] Registry)

Author

Yeoh, Julian, primary, Yudi, Matias B., additional, Andrianopoulos, Nick, additional, Yan, Bryan P., additional, Clark, David J., additional, Duffy, Stephen J., additional, Brennan, Angela, additional, New, Gishel, additional, Freeman, Melanie, additional, Eccleston, David, additional, Sebastian, Martin, additional, Reid, Christopher M., additional, Wilson, William, additional, Ajani, Andrew E., additional, Reid, Chris, additional, Duffy, Stephen, additional, Clark, David, additional, Hiew, Chin, additional, Oqueli, Ernesto, additional, Duffy, S.J., additional, Shaw, J.A., additional, Walton, A., additional, Dart, A., additional, Broughton, A., additional, Federman, J., additional, Keighley, C., additional, Hengel, C., additional, Peter, K.H., additional, Stub, D., additional, Chan, W., additional, Nanayakkara, S., additional, O'Brien, J., additional, Selkrig, L., additional, Rankin, K., additional, Huntington, R., additional, Pally, S., additional, Clark, D.J., additional, Farouque, O., additional, Horrigan, M., additional, Johns, J., additional, Oliver, L., additional, Brennan, J., additional, Chan, R., additional, Proimos, G., additional, Dortimer, T., additional, Chan, B., additional, Huq, R., additional, Fernando, D., additional, Yudi, M., additional, Charter, K., additional, Brown, L., additional, AlFiadh, A., additional, Ramchand, J., additional, Picardo, S., additional, Oqueli, E., additional, Sharma, A., additional, Ryan, N., additional, Harrison, T., additional, Barry, C., additional, Freeman, M., additional, Roberts, L., additional, Teh, A., additional, Rowe, M., additional, Cheong, Y., additional, Goods, C., additional, Baradi, A., additional, Jackson, D., additional, Sajeev, J., additional, Hiew, C., additional, Sebastian, M., additional, Yip, T., additional, Mok, M., additional, Jaworski, C., additional, Hutchison, A., additional, Turner, M., additional, Khialani, B., additional, Dyson, J., additional, McDonald, B., additional, Duff, L., additional, Reid, C., additional, Andrianopoulos, N., additional, Brennan, A.L., additional, Chand, V., additional, Dinh, D., additional, Yan, B.P., additional, Ajani, A.E., additional, Warren, R., additional, Eccleston, D., additional, Lefkovits, J., additional, Iyer, R., additional, Gurvitch, R., additional, Wilson, W., additional, Brooks, M., additional, Biswas, S., additional, and Yeoh, J., additional

Published
2017
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14. Long-Term Outcomes After Percutaneous Coronary Intervention (PCI) to an Unprotected Left Main Coronary Artery (LMCA) in Cardiogenic Shock: Observations From the Melbourne Interventional Group (MIG) Registry

Author

Yeoh, J., primary, Andrianopoulos, N., additional, Reid, C., additional, Brennan, A., additional, Yudi, M., additional, Proimos, G., additional, Chan, R., additional, Noaman, S., additional, Oqueli, E., additional, Picardo, S., additional, Ajani, A., additional, Chan, W., additional, Farouque, O., additional, and Clark, D., additional

Published
2017
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15. Long-Term Outcomes After Percutaneous Coronary Intervention (PCI) to an Unprotected Left Main Coronary Artery (LMCA): 10 Year Observations From the Melbourne Interventional Group (MIG) Registry

Author

Yeoh, J., primary, Andrianopoulos, N., additional, Reid, C., additional, Brennan, A., additional, Yudi, M., additional, Proimos, G., additional, Chan, R., additional, Noaman, S., additional, Oqueli, E., additional, Picardo, S., additional, Ajani, A., additional, Chan, W., additional, Farouque, O., additional, and Clark, D., additional

Published
2017
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18. Contemporary outcomes in women undergoing percutaneous coronary intervention for acute coronary syndromes

Author

Al-Fiadh, A., Andrianopoulos, N., Farouque, O., Yan, B., Duffy, S., Charter, K., Tongyoo, S., New, G., Yip, T., Brennan, A., Proimos, G., Reid, Christopher, Ajani, A., Clark, D., Al-Fiadh, A., Andrianopoulos, N., Farouque, O., Yan, B., Duffy, S., Charter, K., Tongyoo, S., New, G., Yip, T., Brennan, A., Proimos, G., Reid, Christopher, Ajani, A., and Clark, D.

Abstract

Background: Uncertainty remains as to whether females benefit as much as males from percutaneous coronary intervention (PCI) in the setting of an acute coronary syndrome (ACS). Methods: We compared 802 women with 2151 men presenting with ACS, undergoing PCI from April 2004 to October 2006 from the Melbourne Interventional Group registry. Clinical characteristics, in-hospital, 30-day and 1-year outcomes were compared. Results: Women were older (69.6 ± 11.6 vs. 62.17 ± 12.3 years, p < 0.001), and had more diabetes (27.1% vs. 19.6%, p < 0.001) and hypertension (70.3% vs. 53.9%, p < 0.001) than men. Women were less likely to present with ST-elevation myocardial infarction (30.5% vs. 37.9%, p < 0.001). Bleeding (3.6% vs. 0.8%, p < 0.001) was higher among women. Thirty-day mortality (4.7 vs. 2.4%, p < 0.001) and MACE (10.1 vs. 6.4%, p < 0.001) were higher in women. Gender was an independent predictor of overall MACE at 30 days (OR 1.45, 95% CI 1.04–2.02, p = 0.03) but not death. At 12 months, there were no significant differences in mortality (6.4% vs. 4.8%, p = 0.09), myocardial infarction (5.5% vs. 5.0%, p = 0.64), target vessel revascularization (7.9% vs. 7.0%, p = 0.42) and MACE (16.3% vs. 14%, p = 0.13) between women and men. Conclusions: There is an early hazard amongst women undergoing PCI for ACS, but not at 12 months. These data suggest that gender should not affect the decision to offer PCI but further gender specific studies are warranted.

Published
2011

19. Outcomes after percutaneous coronary intervention of ostial lesions in the era of drug-eluting stents

Author

Freeman, M., Clark, D., Andrianopoulos, N., Duffy, S., Lim, H., Brennan, A., Charter, K., Shaw, J., Horrigan, M., Ajani, A., Sebastian, M., Reid, Christopher, Farouque, H., Walton, A., Farrington, C., Gunaratne, R., Broughton, A., Federman, J., Keighley, C., Dart, A., Johns, J., Farouque, O., Oliver, L., Brennan, J., Chan, R., Proimos, G., Dortimer, T., Chan, B., Tonkin, A., Brown, L., Champbell, N., Sahar, A., New, G., Roberts, L., Liew, H., Rowe, M., Cheong, N., Goods, C., Lew, R., Szto, G., Templin, R., Black, A., Yip, T., Ponnuthrai, L., Rahmen, M., Dyson, J., Duplessis, T., Krum, H., Reid, C., Meehan, A., Loane, P., Curran, L., Groen, F., O'Shea, V., Warren, R., Eccleston, D., Lefkovits, J., Yan, B., Roy, P., Shetty, S., Gurvitch, R., Lim, Y., Freeman, M., Clark, D., Andrianopoulos, N., Duffy, S., Lim, H., Brennan, A., Charter, K., Shaw, J., Horrigan, M., Ajani, A., Sebastian, M., Reid, Christopher, Farouque, H., Walton, A., Farrington, C., Gunaratne, R., Broughton, A., Federman, J., Keighley, C., Dart, A., Johns, J., Farouque, O., Oliver, L., Brennan, J., Chan, R., Proimos, G., Dortimer, T., Chan, B., Tonkin, A., Brown, L., Champbell, N., Sahar, A., New, G., Roberts, L., Liew, H., Rowe, M., Cheong, N., Goods, C., Lew, R., Szto, G., Templin, R., Black, A., Yip, T., Ponnuthrai, L., Rahmen, M., Dyson, J., Duplessis, T., Krum, H., Reid, C., Meehan, A., Loane, P., Curran, L., Groen, F., O'Shea, V., Warren, R., Eccleston, D., Lefkovits, J., Yan, B., Roy, P., Shetty, S., Gurvitch, R., and Lim, Y.

Abstract

Background: Ostial lesions are a difficult subset associated with suboptimal outcomes after percutaneous coronary intervention (PCI). The aim of this study was to analyze outcomes of ostial lesions in contemporary Australian interventional practice. Methods: The study population comprised 1,713 consecutive patients who underwent PCI for proximal lesions of the left anterior descending, left circumflex, and right coronary arteries, who were prospectively enrolled in the Melbourne Interventional Group Registry (February 2004-December 2006). We compared the in-hospital, 30-day, and 1-year outcomes of the 109 patients undergoing PCI for ostial, with the 1,604 patients with proximal nonostial lesions. Left main and bifurcation lesions were excluded. Results: Patients in the ostial group were older (mean age 68.8 ± 11 vs. 64.9 ± 12 years; P = 0.001), and there was a greater proportion of women (38.5% vs. 28.0%; P = 0.021). Other clinical characteristics were similar. The nonostial group were more likely receive a stent (94.6% vs. 87.2%; P = 0.005) but drug-eluting stents (DES) were deployed more often in the ostial group (47.9% vs. 66.1%; P < 0.0001). There was lower procedural success, with no significant difference in in-hospital death, bleeding or emergency PCI, but unplanned in-hospital coronary artery bypass grafting was more frequent in the ostial group (4.8% vs. 1.0%; P = 0.007). There was no difference in 30-day major adverse cardiac events. However, 12-month death (8.8% vs. 4%, log rank P = 0.032) and MACE (24.2% vs. 13.8%, log rank P = 0.005) were higher in the ostial group than the nonostial group with trends to increased incidence of myocardial infarction (6.6% vs. 4.7%, P = NS), and target vessel revascularization (13.2% vs. 7.9%, P = NS). Conclusion: In contemporary, Australian interventional practice, PCI for ostial lesions is associated with a high incidence of adverse outcome at one year despite the introduction of DES. © 2009 Wiley-Liss, Inc.

Published
2009

20. Trends in PCI Over the Last Decade at Box Hill Hospital (BHH)

Author

Tong, D., primary, Roberts, L., additional, Beale, J., additional, Jangwal, H., additional, Baradi, A., additional, Jackson, D., additional, Naidu, P., additional, Rowe, M., additional, Cheong, Y., additional, Proimos, G., additional, Fernando, D., additional, Goods, C., additional, and New, G., additional

Published
2013
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21. Is Remote Telemetry Monitoring of Non-Cardiology Patients Worthwhile?

Author

Munnur, K., primary, Roberts, L., additional, Shields, C., additional, Jangwel, H., additional, Tong, D., additional, Kerr, G., additional, Pandelli, V., additional, Cooke, J., additional, Cheong, Y., additional, Chou, B., additional, Hamer, A., additional, Goods, C., additional, Gordon, G., additional, Low, R., additional, Proimos, G., additional, Rowe, M., additional, Stevenson, I., additional, and New, G., additional

Published
2012
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22. A Decade of PCI Experience with Off-site Surgical Back-up at Box Hill Hospital: What Have We Learnt?

Author

Shields, C., primary, Roberts, L., additional, Munnar, K., additional, Jangwal, H., additional, Tong, D., additional, Beale, J., additional, Phan, M., additional, Burton, A., additional, Collins, B., additional, Scully, C., additional, Rowe, M., additional, Cheong, Y., additional, Proimos, G., additional, Fernando, D., additional, Goods, C., additional, and New, G., additional

Published
2012
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23. A Decade of Primary PCI: Has Field Triage Improved Door to Balloon Time (D2BT) and Outcomes?

Author

Munnur, K., primary, Roberts, L., additional, Shields, C., additional, Jangwel, H., additional, Tong, D., additional, Beale, J., additional, Phan, M., additional, Burton, A., additional, Collins, B., additional, Scully, C., additional, Rowe, M., additional, Proimos, G., additional, Cheong, Y., additional, Fernando, D., additional, Goods, C., additional, and New, G., additional

Published
2012
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27. What is the Optimal Strategy and Timing of PCI after Thrombolysis?

Author

Lim, C.C.S., primary, Teh, A., additional, Roberts, L., additional, Proimos, G., additional, Cheong, Y.M., additional, Andrianopoulos, N., additional, Reid, C., additional, Clark, D., additional, Sebastian, M., additional, Lefkovits, J., additional, Duffy, S., additional, and New, G., additional

Published
2007
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28. A Trial of Early Inhibition of Platelet Aggregation in Patients with Acute Coronary Syndrome (ACS) Undergoing Percutaneous Intervention (PCI): High Dose Tirofiban Bolus and Infusion Compared to Standard Dose Abciximab

Author

Lim, C.C.S., primary, Chou, B., additional, Roberts, L., additional, Pandeli, V., additional, Teh, A., additional, Cheong, Y.M., additional, Goods, C., additional, Rowe, M., additional, McPherson, L., additional, Collins, B., additional, New, G., additional, and Proimos, G., additional

Published
2007
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30. Routine Protamine Administration for Bleeding in Transcatheter Aortic Valve Implantation: The ACE-PROTAVI Randomized Clinical Trial.

Author

Vriesendorp PA, Nanayakkara S, Heuts S, Ball J, Chandrasekar J, Dick R, Haji K, Htun NM, McGaw D, Noaman S, Palmer S, Cairo S, Shulman M, Lin E, Hastings S, Waldron B, Proimos G, Soon KH, Yudi MB, Zimmet A, Stub D, and Walton AS

Subjects
Humans, Female, Male, Double-Blind Method, Aged, 80 and over, Aged, Hemorrhage chemically induced, Hemorrhage epidemiology, Transcatheter Aortic Valve Replacement methods, Protamines therapeutic use, Protamines administration & dosage, Heparin Antagonists therapeutic use, Heparin Antagonists administration & dosage, Postoperative Hemorrhage epidemiology, Postoperative Hemorrhage prevention & control, Aortic Valve Stenosis surgery
Abstract

Importance: Vascular complications after transfemoral transcatheter aortic valve implantation (TAVI) remain an important cause of procedure-related morbidity. Routine reversal of anticoagulation with protamine at the conclusion of transfemoral TAVI could reduce complications, but data remain scarce., Objective: To evaluate the efficacy and safety of routine protamine administration after transfemoral TAVI., Design, Setting, and Participants: The ACE-PROTAVI trial was an investigator-initiated, double-blind, placebo-controlled randomized clinical trial performed at 3 Australian hospitals between December 2021 and June 2023 with a 1-year follow-up period. All patients accepted for transfemoral TAVI by a multidisciplinary heart team were eligible for enrollment., Interventions: Eligible patients were randomized 1:1 between routine protamine administration and placebo., Main Outcomes and Measures: The coprimary outcomes were the rate of hemostasis success and time to hemostasis (TTH), presented as categorical variables and compared with a χ2 test or as continuous variables as mean (SD) or median (IQR), depending on distribution. The major secondary outcome was a composite of all-cause death, major and minor bleeding complications, and major and minor vascular complications after 30 days, reported in odds ratios (ORs) with 95% CIs and P values., Results: The study population consisted of 410 patients: 199 patients in the protamine group and 211 in the placebo group. The median (IQR) patient age in the protamine group was 82 (77-85) years, and 68 of 199 patients receiving protamine (34.2%) were female. The median (IQR) patient age in the placebo group was 80 (75-85) years, and 89 of 211 patients receiving the placebo (42.2%) were female. Patients receiving up-front protamine administration had a higher rate of hemostasis success (188 of 192 patients [97.9%]) than patients in the placebo group (186 of 203 patients [91.6%]; absolute risk difference, 6.3%; 95% CI, 2.0%-10.6%; P = .006); in addition, patients receiving up-front protamine had a shorter median (IQR) TTH (181 [120-420] seconds vs 279 [122-600] seconds; P = .002). Routine protamine administration resulted in a reduced risk of the composite outcome in the protamine group (10 of 192 [5.2%]) vs the placebo group (26 of 203 [12.8%]; OR, 0.37; 95% CI, 0.1-0.8; P = .01). This difference was predominantly driven by the difference in the prevalence of minor vascular complications. There were no adverse events associated with protamine use., Conclusions and Relevance: In the ACE-PROTAVI randomized clinical trial, routine administration of protamine increased the rate of hemostasis success and decreased TTH. The beneficial effect of protamine was reflected in a reduction in minor vascular complications, procedural time, and postprocedural hospital stay duration in patients receiving routine protamine compared with patients receiving placebo., Trial Registration: anzctr.org.au Identifier: ACTRN12621001261808.

Published
2024
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31. The assessment of intermediate coronary lesions using intracoronary imaging.

Author

Nogic J, Prosser H, O'Brien J, Thakur U, Soon K, Proimos G, and Brown AJ

Abstract

Intermediate coronary artery stenosis, defined as visual angiographic stenosis severity of between 30-70%, is present in up to one quarter of patients undergoing coronary angiography. Patients with this particular lesion subset represent a distinct clinical challenge, with operators often uncertain on the need for revascularization. Although international guidelines appropriately recommend physiological pressure-based assessment of these lesions utilizing either fractional flow reserve (FFR) or quantitative flow ratio (QFR), there are specific clinical scenarios and lesion subsets where the use of such indices may not be reliable. Intravascular imaging, mainly utilizing intravascular ultrasound (IVUS) and optical coherence tomography (OCT) represents an alternate and at times complementary diagnostic modality for the evaluation of intermediate coronary stenoses. Studies have attempted to validate these specific imaging measures with physiological markers of lesion-specific ischaemia with varied results. Intravascular imaging however also provides additional benefits that include portrayal of plaque morphology, guidance on stent implantation and sizing and may portend improved clinical outcomes. Looking forward, research in computational fluid dynamics now seeks to integrate both lesion-based physiology and anatomical assessment using intravascular imaging. This review will discuss the rationale and indications for the use of intravascular imaging assessment of intermediate lesions, while highlighting the current limitations and benefits to this approach., Competing Interests: Conflicts of Interest: The authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/cdt-20-226). The series “Intracoronary Imaging” was commissioned by the editorial office without any funding or sponsorship. ATB reports other from Abbott Vascular, other from Boston Scientific, outside the submitted work. The authors have no other conflicts of interest to declare., (2020 Cardiovascular Diagnosis and Therapy. All rights reserved.)

Published
2020
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32. Contemporary outcomes in women undergoing percutaneous coronary intervention for acute coronary syndromes.

Author

Al-Fiadh AH, Andrianopoulos N, Farouque O, Yan BP, Duffy SJ, Charter K, Tongyoo S, New G, Yip T, Brennan A, Proimos G, Reid CM, Ajani AE, and Clark DJ

Subjects
Acute Coronary Syndrome diagnosis, Acute Coronary Syndrome mortality, Aged, Electrocardiography, Female, Follow-Up Studies, Hospital Mortality trends, Humans, Male, Middle Aged, Retrospective Studies, Survival Rate trends, Treatment Outcome, Victoria epidemiology, Acute Coronary Syndrome therapy, Angioplasty, Balloon, Coronary methods
Abstract

Background: Uncertainty remains as to whether females benefit as much as males from percutaneous coronary intervention (PCI) in the setting of an acute coronary syndrome (ACS)., Methods: We compared 802 women with 2151 men presenting with ACS, undergoing PCI from April 2004 to October 2006 from the Melbourne Interventional Group registry. Clinical characteristics, in-hospital, 30-day and 1-year outcomes were compared., Results: Women were older (69.6 ± 11.6 vs. 62.17 ± 12.3 years, p<0.001), and had more diabetes (27.1% vs. 19.6%, p<0.001) and hypertension (70.3% vs. 53.9%, p<0.001) than men. Women were less likely to present with ST-elevation myocardial infarction (30.5% vs. 37.9%, p<0.001). Bleeding (3.6% vs. 0.8%, p<0.001) was higher among women. Thirty-day mortality (4.7 vs. 2.4%, p<0.001) and MACE (10.1 vs. 6.4%, p<0.001) were higher in women. Gender was an independent predictor of overall MACE at 30 days (OR 1.45, 95% CI 1.04-2.02, p=0.03) but not death. At 12 months, there were no significant differences in mortality (6.4% vs. 4.8%, p=0.09), myocardial infarction (5.5% vs. 5.0%, p=0.64), target vessel revascularization (7.9% vs. 7.0%, p=0.42) and MACE (16.3% vs. 14%, p=0.13) between women and men., Conclusions: There is an early hazard amongst women undergoing PCI for ACS, but not at 12 months. These data suggest that gender should not affect the decision to offer PCI but further gender specific studies are warranted., (Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.)

Published
2011
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33. Treatment of unprotected left main disease with drug-eluting stents in patients at high risk for coronary artery bypass grafting.

Author

Barlis P, Horrigan M, Elis S, Chan R, Wong M, Farouque O, Proimos G, Ajani AE, and Clark DJ

Subjects
Adult, Aged, Aged, 80 and over, Angioplasty, Balloon, Coronary adverse effects, Cardiovascular Diseases etiology, Cardiovascular Diseases mortality, Coronary Angiography, Coronary Stenosis diagnostic imaging, Coronary Stenosis mortality, Coronary Stenosis surgery, Feasibility Studies, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prospective Studies, Prosthesis Design, Research Design, Risk Assessment, Severity of Illness Index, Shock, Cardiogenic etiology, Shock, Cardiogenic mortality, Time Factors, Treatment Outcome, Angioplasty, Balloon, Coronary instrumentation, Cardiovascular Agents administration & dosage, Coronary Artery Bypass adverse effects, Coronary Stenosis therapy, Patient Selection, Stents
Abstract

Background: Percutaneous coronary intervention (PCI) for high-grade stenosis of the left main coronary artery with bare-metal stents has been limited by restenosis, and most patients are managed with coronary artery bypass grafting (CABG). Recently, drug-eluting stents (DES) have reduced instent restenosis after PCI, but their role in the treatment of left main disease remains unclear., Aims: The aim of this study was to determine the outcomes after utilizing DES to treat left main disease., Methods: Twenty consecutive symptomatic patients with >50% angiographic stenosis of the left main coronary artery with no prior history of CABG ["unprotected left main" (ULM)] underwent PCI with DES. Patients were divided into two groups based on the presence (Group A, n=5) or absence (Group B, n=15) of preprocedural cardiogenic shock. At follow up (median, 14 months), cumulative major adverse cardiac events (MACE-death, myocardial infarction, or target vessel revascularization) were determined., Results: Sixteen (80%) of 20 patients were at high risk for CABG because of comorbidity, advanced age, or cardiogenic shock. Procedural success was 100% (20/20). Three of five patients in Group A (60%) died in hospital and the two surviving patients experienced no MACE at follow up. In Group B (n=15), there was no in-hospital MACE, but one patient died suddenly 8 weeks postprocedure [cumulative MACE of 7% (1/15)]., Conclusions: Our study demonstrates the feasibility of ULM treatment with DES with acceptable medium-term outcomes. While CABG remains the best form of revascularization for the majority of patients with ULM, DES should be considered in those who are at high risk.

Published
2007
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34. What is the best contemporary treatment for in-stent restenosis?

Author

Barlis P, Horrigan MC, Chan RK, Ajani AE, Proimos G, Schumer W, van Gaal WJ, Rowe M, Eccleston D, Yan BB, Mun Cheong Y, Oliver LE, and Clark DJ

Subjects
Aged, Coronary Angiography, Coronary Restenosis diagnostic imaging, Endosonography, Female, Follow-Up Studies, Humans, Immunosuppressive Agents therapeutic use, Male, Retrospective Studies, Sirolimus therapeutic use, Treatment Outcome, Blood Vessel Prosthesis Implantation instrumentation, Brachytherapy methods, Coated Materials, Biocompatible, Coronary Restenosis therapy, Decision Making, Stents
Abstract

In-stent restenosis (ISR) remains a challenging problem in percutaneous coronary intervention and the optimal treatment strategy remains unclear. The aim of this study was to compare the 18 month clinical outcomes in patients receiving sirolimus-eluting stents (SES) with vascular brachytherapy (VBT) for the treatment of ISR. Twenty-five consecutive patients treated with VBT were compared with 29 patients who had SES deployment for ISR. Major adverse cardiac events (MACE) were defined as a combination of death from cardiac causes, nonfatal myocardial infarction, or repeat TVR. At 18 month follow-up, the MACE rate was significantly lower in the SES compared with the VBT group (14% vs 40%, P=.03). One patient in the VBT group developed late stent thrombosis (at 10 months) and died; there was no stent thrombosis in the SES group. This observational study, taken with other recent reports, offers further credence to the use of SES for ISR. The results of randomized comparisons with VBT are awaited with interest.

Published
2005
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35. Platelet aggregation inhibition with glycoprotein IIb--IIIa inhibitors.

Author

Proimos G

Subjects
Abciximab, Adenosine Diphosphate pharmacology, Amino Acid Chloromethyl Ketones pharmacology, Antibodies, Monoclonal administration & dosage, Antibodies, Monoclonal chemistry, Antibodies, Monoclonal pharmacology, Antibodies, Monoclonal therapeutic use, Anticoagulants pharmacology, Anticoagulants therapeutic use, Clinical Trials as Topic, Coronary Disease drug therapy, Dose-Response Relationship, Drug, Drug Interactions, Eptifibatide, Heparin pharmacology, Humans, Immunoglobulin Fab Fragments administration & dosage, Immunoglobulin Fab Fragments chemistry, Immunoglobulin Fab Fragments pharmacology, Immunoglobulin Fab Fragments therapeutic use, Oligopeptides chemistry, Oligopeptides pharmacology, Peptides administration & dosage, Peptides chemistry, Peptides pharmacology, Peptides therapeutic use, Platelet Aggregation Inhibitors administration & dosage, Platelet Aggregation Inhibitors therapeutic use, Platelet Function Tests, Platelet Glycoprotein GPIIb-IIIa Complex chemistry, Platelet Glycoprotein GPIIb-IIIa Complex physiology, Proteins pharmacology, Receptors, Thrombin, Thrombin pharmacology, Tirofiban, Tyrosine administration & dosage, Tyrosine analogs & derivatives, Tyrosine chemistry, Tyrosine pharmacology, Tyrosine therapeutic use, Platelet Aggregation drug effects, Platelet Aggregation Inhibitors pharmacology, Platelet Glycoprotein GPIIb-IIIa Complex antagonists & inhibitors
Abstract

Inhibitors of the platelet receptor glycoprotein (GP) IIb--IIIa are a novel and potent class of antithrombotic drugs for the management of patients with non-ST-segment elevation acute coronary syndromes (ACS) and those undergoing percutaneous coronary intervention (PCI). Pharmacodynamic studies with three currently approved agents in this class (abciximab [ReoPro, Centocor, Inc., Malvern, Pennsylvania, and Eli Lilly & Company, Indianapolis, Indiana]; eptifibatide [INTEGRILIN, COR Therapeutics, Inc., South San Francisco, California, and Key Pharmaceuticals, Inc., Kenilworth, New Jersey]; and tirofiban HCI [Aggrastat, Merck & Co., Inc., Whitehouse Station, New Jersey]) all sought to identify dosing regimens that would establish and maintain >80 % inhibition of ex vivo platelet aggregation throughout the duration of intravenous infusion. Direct comparison of these prior studies is difficult, however, because the assays used different anticoagulants (sodium citrate [abciximab, tirofiban HCI] or D-phenylalanyl-L-prolyl-L-arginine chloromethyl ketone [PPACK] [eptifibatide]) and different concentrations of the platelet agonist adenosine diphosphate (ADP) (5 micromol [tirofiban HCI] or 20 micromol [abciximab, eptifibatide]). More recent work has attempted to overcome these limitations by using similar assay conditions for all GP IIb--IIIa inhibitors. These studies have indicated that the concentrations of all three agents required to provide the targeted effect for platelet inhibition are considerably higher in the presence of an anticoagulant that does not chelate calcium ions (e.g., heparin or PPACK) than in the presence of calcium-chelating anticoagulant (i.e., sodium citrate). Of the three currently approved GP IIb--IIIa inhibitors, eptifibatide is the only agent whose approved dosing is based on an ex vivo platelet aggregation assay that uses such an anticoagulant. Additionally, Kereiakes et al. have recently reported that the high levels of platelet inhibition (>80 %), using PPACK as an anticoagulant and ADP (20 micromol) as an agonist, are more consistently achieved with the approved dosing regimen of eptifibatide. The antiplatelet effect of abciximab showed more interpatient variability, whereas the median inhibition of ex vivo platelet aggregation with the approved dosing regimen for tirofiban HCl was <80 % at almost all time points during drug infusion.

Published
2001
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