Publications by authors named "Cindy Grines"

385 Publications

Adequate preparation of complex left main lesions prior to stenting appears to level the playing field.

Catheter Cardiovasc Interv 2021 Jul;98(1):33-34

Northside Hospital Cardiovascular Institute, Atlanta, Georgia, USA.

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http://dx.doi.org/10.1002/ccd.29839DOI Listing
July 2021

Ending Gender Inequality in Cardiovascular Clinical Trial Leadership: JACC Review Topic of the Week.

J Am Coll Cardiol 2021 Jun;77(23):2960-2972

Michael E. DeBakey Veterans Affairs Medical Center and Winters Center for Heart Failure Research, Cardiovascular Institute, Cardiology, Baylor College of Medicine, Houston, Texas, USA.

Women are under-represented as leaders of cardiovascular randomized controlled trials, representing 1 in 10 lead authors of cardiovascular trials published in high-impact journals. Although the proportion of cardiovascular specialists who are women has increased in recent years, the proportion of cardiovascular clinical trialists who are women has not. This gap, underpinned by systemic sexism, has not been adequately addressed. The benefits of diverse randomized controlled trial leadership extend to patients and professionals. In this position statement, we present strategies adopted by some organizations to end gender inequality in research leadership. We offer an actionable roadmap for early-career researchers, scientists, academic institutions, professional societies, trial sponsors, and journals to follow, with the goal of harnessing the strength of women and under-represented groups as research leaders and facilitating a just culture in the cardiovascular clinical trial enterprise.
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http://dx.doi.org/10.1016/j.jacc.2021.04.038DOI Listing
June 2021

Acute myocardial infarction related cardiogenic shock: How important is vascular access site?

Catheter Cardiovasc Interv 2021 Jun;97(7):1367-1368

Northside Hospital Cardiovascular Institute, Atlanta, Georgia, USA.

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http://dx.doi.org/10.1002/ccd.29775DOI Listing
June 2021

Outcomes of bailout percutaneous ventricular assist device versus prophylactic strategy in patients undergoing nonemergent percutaneous coronary intervention.

Catheter Cardiovasc Interv 2021 May 29. Epub 2021 May 29.

Division of Cardiovascular Medicine, University of California San Diego, La Jolla, California, USA.

Objectives: To compare in-hospital outcomes of bailout support to prophylactic support with percutaneous ventricular assist devices (pVAD) for high-risk nonemergent percutaneous coronary intervention (HRPCI).

Background: Prophylactic support with pVAD for a HRPCI is used in patients felt to be at risk for hemodynamic collapse during PCI. An alternative strategy of bailout pVAD support in the event of hemodynamic collapse is also entertained.

Methods: We compared the outcomes of patients entered in the cVAD database who underwent Impella Protected PCI (ProPCI group) with patients from the cVAD and USpella databases receiving bailout Impella support for hemodynamic collapse during HRPCI (Bailout group).

Results: A total of 1,028 patients supported with Impella pVAD were entered into the cVAD database as of July 2019 and were included in this analysis. Of those 971 were in the ProPCI group and 57 in the Bailout group. Patients in the Bailout group were more often female (50.9%vs. 27.2%, p = .0002) with higher median baseline left ventricular ejection fraction (LVEF) (40%vs. 30%, p < .0001) and with lower prevalence of both heart failure (42.1%vs. 56.9%, p = .0385) and left main disease (40.0%vs. 56.1%, p = .0250) compared to the ProPCI group. Unadjusted and adjusted in-hospital mortality was significantly higher in the Bailout group (49.1%vs. 4.3%, and 57.8%vs. 4.4%, p < .0001 for both).

Conclusions: In our study population, the bailout group was associated with significant increased mortality compared to ProPCI group. Female gender was more frequently observed in patients requiring bailout pVAD. Further investigation is warranted in order to generalize the findings of our study.
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http://dx.doi.org/10.1002/ccd.29758DOI Listing
May 2021

SCAI COVID 19 Updated Consumer Survey Shows Continued Concern of Patients, Especially among Underserved Populations.

Authors:
Cindy L Grines

Catheter Cardiovasc Interv 2021 May 27. Epub 2021 May 27.

SCAI 2020-21 President Chief Scientific Officer, Northside Cardiovascular Institute, Atlanta, Georgia.

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http://dx.doi.org/10.1002/ccd.29788DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8239767PMC
May 2021

President's Message: Amplifying SCAI's DEI Efforts.

Authors:
Cindy L Grines

Catheter Cardiovasc Interv 2021 May 25. Epub 2021 May 25.

Northside Hospital Cardiovascular Institute, Atlanta, GA.

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http://dx.doi.org/10.1002/ccd.29787DOI Listing
May 2021

The DISCO study-Does Interventionalists' Sex impact Coronary Outcomes?

Catheter Cardiovasc Interv 2021 May 17. Epub 2021 May 17.

Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan, USA.

Objectives: To examine the association of operator sex with appropriateness and outcomes of percutaneous coronary intervention (PCI).

Background: Recent studies suggest that physician sex may impact outcomes for specific patient cohorts. There are no data evaluating the impact of operator sex on PCI outcomes.

Methods: We studied the impact of operator sex on PCI outcome and appropriateness among all patients undergoing PCI between January 2010 and December 2017 at 48 non-federal hospitals in Michigan. We used logistic regression models to adjust for baseline risk among patients treated by male versus female operators in the primary analysis.

Results: During this time, 18 female interventionalists and 385 male interventionalists had performed at least one PCI. Female interventionalists performed 6362 (2.7%) of 239,420 cases. There were no differences in the odds of mortality (1.48% vs. 1.56%, adjusted OR [aOR] 1.138, 95% CI: 0.891-1.452), acute kidney injury (3.42% vs. 3.28%, aOR 1.027, 95% CI: 0.819-1.288), transfusion (2.59% vs. 2.85%, aOR 1.168, 95% CI: 0.980-1.390) or major bleeding (0.95% vs. 1.07%, aOR 1.083, 95% CI: 0.825-1.420) between patients treated by female versus male interventionalist. While the absolute differences were small, PCIs performed by female interventional cardiologists were more frequently rated as appropriate (86.64% vs. 84.45%, p-value <0.0001). Female interventional cardiologists more frequently prescribed guideline-directed medical therapy.

Conclusions: We found no significant differences in risk-adjusted in-hospital outcomes between PCIs performed by female versus male interventional cardiologists in Michigan. Female interventional cardiologists more frequently performed PCI rated as appropriate and had a higher likelihood of prescribing guideline-directed medical therapy.
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http://dx.doi.org/10.1002/ccd.29774DOI Listing
May 2021

Racial and ethnic disparities in coronary, vascular, structural, and congenital heart disease.

Catheter Cardiovasc Interv 2021 Apr 28. Epub 2021 Apr 28.

Cardiology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.

Cardiovascular disease (CVD) remains the leading cause of death in the United States. However, percutaneous interventional cardiovascular therapies are often underutilized in Blacks, Hispanics, and women and may contribute to excess morbidity and mortality in these vulnerable populations. The Society for Cardiovascular Angiography and Interventions (SCAI) is committed to reducing racial, ethnic, and sex-based treatment disparities in interventional cardiology patients. Accordingly, each of the SCAI Clinical Interest Councils (coronary, peripheral, structural, and congenital heart disease [CHD]) participated in the development of this whitepaper addressing disparities in diagnosis, treatment, and outcomes in underserved populations. The councils were charged with summarizing the available data on prevalence, treatment, and outcomes and elucidating potential reasons for any disparities. Given the huge changes in racial and ethnic composition by age in the United States (Figure 1), it was difficult to determine disparities in rates of diagnosis and we expected to find some racial differences in prevalence of disease. For example, since the average age of patients undergoing transcatheter aortic valve replacement (TAVR) is 80 years, one may expect 80% of TAVR patients to be non-Hispanic White. Conversely, only 50% of congenital heart interventions would be expected to be performed in non-Hispanic Whites. Finally, we identified opportunities for SCAI to advance clinical care and equity for our patients, regardless of sex, ethnicity, or race.
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http://dx.doi.org/10.1002/ccd.29745DOI Listing
April 2021

Initial Findings From the North American COVID-19 Myocardial Infarction Registry.

J Am Coll Cardiol 2021 04;77(16):1994-2003

Frederick Health Hospital, Frederick, Maryland, USA; Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Background: The coronavirus disease 2019 (COVID-19) pandemic has impacted many aspects of ST-segment elevation myocardial infarction (STEMI) care, including timely access to primary percutaneous coronary intervention (PPCI).

Objectives: The goal of the NACMI (North American COVID-19 and STEMI) registry is to describe demographic characteristics, management strategies, and outcomes of COVID-19 patients with STEMI.

Methods: A prospective, ongoing observational registry was created under the guidance of 3 cardiology societies. STEMI patients with confirmed COVID+ (group 1) or suspected (person under investigation [PUI]) (group 2) COVID-19 infection were included. A group of age- and sex-matched STEMI patients (matched to COVID+ patients in a 2:1 ratio) treated in the pre-COVID era (2015 to 2019) serves as the control group for comparison of treatment strategies and outcomes (group 3). The primary outcome was a composite of in-hospital death, stroke, recurrent myocardial infarction, or repeat unplanned revascularization.

Results: As of December 6, 2020, 1,185 patients were included in the NACMI registry (230 COVID+ patients, 495 PUIs, and 460 control patients). COVID+ patients were more likely to have minority ethnicity (Hispanic 23%, Black 24%) and had a higher prevalence of diabetes mellitus (46%) (all p < 0.001 relative to PUIs). COVID+ patients were more likely to present with cardiogenic shock (18%) but were less likely to receive invasive angiography (78%) (all p < 0.001 relative to control patients). Among COVID+ patients who received angiography, 71% received PPCI and 20% received medical therapy (both p < 0.001 relative to control patients). The primary outcome occurred in 36% of COVID+ patients, 13% of PUIs, and 5% of control patients (p < 0.001 relative to control patients).

Conclusions: COVID+ patients with STEMI represent a high-risk group of patients with unique demographic and clinical characteristics. PPCI is feasible and remains the predominant reperfusion strategy, supporting current recommendations.
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http://dx.doi.org/10.1016/j.jacc.2021.02.055DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8054772PMC
April 2021

Radiation-Induced Vascular Disease-A State-of-the-Art Review.

Front Cardiovasc Med 2021 30;8:652761. Epub 2021 Mar 30.

Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.

Since the 1990s, there has been a steady increase in the number of cancer survivors to an estimated 17 million in 2019 in the US alone. Radiation therapy today is applied to a variety of malignancies and over 50% of cancer patients. The effects of ionizing radiation on cardiac structure and function, so-called radiation-induced heart disease (RIHD), have been extensively studied. We review the available published data on the mechanisms and manifestations of RIHD, with a focus on vascular disease, as well as proposed strategies for its prevention, screening, diagnosis, and management.
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http://dx.doi.org/10.3389/fcvm.2021.652761DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8042773PMC
March 2021

Racial, Ethnic, and Sex Disparities in Patients With STEMI and Cardiogenic Shock.

JACC Cardiovasc Interv 2021 Mar;14(6):653-660

Department of Cardiology, Henry Ford Hospital, Detroit, Michigan, USA.

Objectives: The aim of this study was to evaluate the combined impact of race, ethnicity, and sex on in-hospital outcomes using data from the National Inpatient Sample.

Background: Cardiogenic shock (CS) is a major cause of mortality following ST-segment elevation myocardial infarction (STEMI). Early revascularization reduces mortality in such patients. Mechanical circulatory support (MCS) devices are increasingly used to hemodynamically support patients during revascularization. Little is known about racial, ethnic, and sex disparities in patients with STEMI and CS.

Methods: The National Inpatient Sample was queried from January 2006 to September 2015 for hospitalizations with STEMI and CS. The associations between sex, race, ethnicity, and outcomes were examined using complex-samples multivariate logistic or generalized linear model regressions.

Results: Of 159,339 patients with STEMI and CS, 57,839 (36.3%) were women. In-hospital mortality was higher for all women (range 40% to 45.4%) compared with men (range 30.4% to 34.7%). Women (adjusted odds ratio [aOR]: 1.11; 95% confidence interval [CI]: 1.06 to 1.16; p < 0.001) as well as Black (aOR: 1.18; 95% CI: 1.04 to 1.34; p = 0.011) and Hispanic (aOR: 1.19; 95% CI: 1.06 to 1.33; p = 0.003) men had higher odds of in-hospital mortality compared with White men, with Hispanic women having the highest odds of in-hospital mortality (aOR: 1.46; 95% CI: 1.26 to 1.70; p < 0.001). Women were older (age: 69.8 years vs. 63.2 years), had more comorbidities, and underwent fewer invasive cardiac procedures, including revascularization, right heart catheterization, and MCS.

Conclusions: There are significant racial, ethnic, and sex differences in procedural utilization and clinical outcomes in patients with STEMI and CS. Women are less likely to undergo invasive cardiac procedures, including revascularization and MCS. Women as well as Black and Hispanic patients have a higher likelihood of death compared with White men.
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http://dx.doi.org/10.1016/j.jcin.2021.01.003DOI Listing
March 2021

The cloak of calcium: Coronary angiography is not to be trusted.

Catheter Cardiovasc Interv 2021 Mar;97(4):632-633

Northside Hospital Cardiovascular Institute, Atlanta, Georgia.

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http://dx.doi.org/10.1002/ccd.29565DOI Listing
March 2021

Transcatheter Versus Surgical Aortic Valve Replacement in the United States (From the Nationwide Readmission Database).

Am J Cardiol 2021 06 3;148:110-115. Epub 2021 Mar 3.

Westchester Medical Center and New York Medical College, Department of Internal Medicine, Valhalla, New York.

Clinical outcomes of transcatheter aortic valve implantation (TAVI) have significantly improved with the accumulation of operator and institution experience as well as the wide use of newer generation devices. There is limited data on TAVI outcomes compared with surgical aortic valve replacement (SAVR) in contemporary practice in the United States. We queried the 2018 Nationwide Readmission Database of the United States. International Classification Diagnosis code 10 was used to extract TAVI and SAVR admissions. A propensity-matched cohort was created to compare TAVI and SAVR outcomes. A weighted 48,349 TAVI and 24,896 SAVR for aortic stenosis were included and 4.9% of TAVI were performed with an embolic protection device. In propensity-matched cohort (12,708 TAVI and 12,708 SAVR), TAVI conferred lower in-hospital mortality (1.7% vs 3.8%), acute kidney injury (11.3% vs 22.9%), and transfusion rate (5.9% vs. 20.6%) whereas new pacemaker rate was higher in TAVI compared with SAVR (10.5% vs. 7.0%) (all p values < 0.001). Stroke rate was similar between TAVI and SAVR (1.5% vs. 1.5%) (p value = 0.79). The routine discharge was more frequent (66.9% vs 25.8%) and length of stay was shorter (4.8 vs. 9.8 days) in TAVI than SAVR. Hospitalization cost was higher in SAVR than TAVI (51,962 vs 57,754 U.S. dollars) (all p values < 0.001). In-hospital mortality was also lower in TAVI compared with isolated SAVR. TAVI was performed more frequently than SAVR in 2018 in the United States with lower in-hospital mortality of TAVI compared with both SAVR and isolated SAVR.
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http://dx.doi.org/10.1016/j.amjcard.2021.02.031DOI Listing
June 2021

Meta-Analysis of Gender Disparities in In-hospital Care and Outcomes in Patients with ST-Segment Elevation Myocardial Infarction.

Am J Cardiol 2021 05 25;147:23-32. Epub 2021 Feb 25.

Yale Cardiovascular Research Group, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut. Electronic address:

Gender disparities in ST-segment elevation myocardial infarction (STEMI) outcomes continue to be reported worldwide; however, the magnitude of this gap remains unknown. To evaluate gender-based discrepancies in clinical outcomes and identify the primary driving factors a global meta-analysis was performed. Studies were selected if they included all comers with STEMI, reported gender specific patient characteristics, treatments, and outcomes, according to the registered PROSPERO protocol: CRD42020161469. A total of 56 studies (705,098 patients, 31% females) were included. Females were older, had more comorbidities and received less antiplatelet therapy and primary percutaneous coronary intervention (PCI). Females experienced significantly longer delays to first medical contact (mean difference 42.5 min) and door-to-balloon time (mean difference 4.9 min). In-hospital, females had increased rates of mortality (odds ratio [OR] 1.91, 95% confidence interval [CI] 1.84 to 1.99, p <0.00001), repeat myocardial infarction (MI) (OR 1.25, 95% CI 1.00 to 1.56, p=0.05), stroke (OR 1.67, 95% CI 1.27 to 2.20, p <0.001), and major bleeding (OR 1.82, 95% CI 1.56 to 2.12, p <0.00001) compared with males. Older age at presentation was the primary driver of excess mortality in females, although other factors including lower rates of primary PCI and aspirin usage, and longer door-to-balloon times contributed. In contrast, excess rates of repeat MI and stroke in females appeared to be driven, at least in part, by lower use of primary PCI and P2Y12 inhibitors, respectively. In conclusion, despite improvements in STEMI care, women continue to have in-hospital rates of mortality, repeat MI, stroke, and major bleeding up to 2-fold higher than men. Gender disparities in in-hospital outcomes can largely be explained by age differences at presentation but comorbidities, delays to care and suboptimal treatment experienced by women may contribute to the gender gap.
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http://dx.doi.org/10.1016/j.amjcard.2021.02.015DOI Listing
May 2021

Hospital variation of 30-day readmission rate following transcatheter aortic valve implantation.

Heart 2021 Feb 24. Epub 2021 Feb 24.

Division of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, New York, USA.

Objectives: Thirty-day readmission rate is one of the hospital quality metrics. Outcomes of transcatheter aortic valve implantation (TAVI) have improved significantly, but it remains unclear whether hospital-level variance in 30-day readmission rate exists in the contemporary TAVI era.

Methods: From the 2017 US Nationwide Readmission Database, endovascular TAVI were identified. The unadjusted 30-day readmission rate and 30-day risk-standardised readmission rate (RSRR) were calculated and we then conducted model testing to determine the relative contribution of hospital characteristics, patient-level covariates and economic status to the variation in readmission rates observed between the hospitals.

Results: A total of 44 899 TAVI from 338 hospitals were identified. The range of unadjusted 30-day readmission rate and 30-day RSRR was 2.0%-33.3% and 9.4%-15.3%, respectively. Median 30-day RSRR was 11.8% and there was a significant hospital-level variation (median OR 1.22, 95% CI 1.16 to 1.32, p<0.01) and this was similar in both readmissions caused due to major cardiac and non-cardiac conditions. Patient, hospital and economic factors accounted for 9.6%, 1.9% and 3.8% of the variability in hospital readmission rate, respectively.

Conclusions: There was significant hospital-level variation in 30-day RSRR following TAVI. Further measures are required to mitigate this variance in the readmission rate.
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http://dx.doi.org/10.1136/heartjnl-2020-318583DOI Listing
February 2021

Prognosis after AMI-related cardiogenic shock: myocardial blush score is one piece of the puzzle.

EuroIntervention 2021 Feb 5;16(15):e1209-e1210. Epub 2021 Feb 5.

Northside Hospital Cardiovascular Institute, Atlanta, GA, USA.

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http://dx.doi.org/10.4244/EIJV16I15A217DOI Listing
February 2021

Between a rock and a hard place: Orbital atherectomy for under-expanded stents.

Catheter Cardiovasc Interv 2021 01;97(1):8-9

Northside Hospital Cardiovascular Institute, Atlanta, Georgia, USA.

Stent under-expansion (rather than intimal hyperplasia) may be the cause of in-stent restenosis. Later expansion of coronary stents that were not fully deployed initially, can be difficult. Atherectomy is one method of facilitating late stent expansion, but too few patients have been treated to determine the risk benefit ratio.
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http://dx.doi.org/10.1002/ccd.29452DOI Listing
January 2021

The importance of your membership and involvement.

Authors:
Cindy L Grines

Catheter Cardiovasc Interv 2021 Feb 24;97(3):374-375. Epub 2020 Dec 24.

Northside Hospital Cardiovascular Institute, Atlanta, GA.

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http://dx.doi.org/10.1002/ccd.29440DOI Listing
February 2021

SCAI consumer survey comparing fear of COVID-19 versus heart attack or stroke (first publish date: September 4, 2020).

Authors:
Cindy L Grines

Catheter Cardiovasc Interv 2021 02 1;97(2):193-194. Epub 2020 Dec 1.

SCAI 2020-21 President Chief Scientific Officer, Northside Hospital Cardiovascular Institute, Atlanta, Georgia, USA.

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http://dx.doi.org/10.1002/ccd.29419DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7753652PMC
February 2021

SCAI digital education bridging the gap (October 31, 2020).

Authors:
Cindy L Grines

Catheter Cardiovasc Interv 2021 01 30;97(1). Epub 2020 Nov 30.

SCAI 2020-21 President Chief Scientific Officer, Northside Hospital Cardiovascular Institute, Atlanta, Georgia, USA.

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http://dx.doi.org/10.1002/ccd.29420DOI Listing
January 2021

It's not shocking that the SCAI shock classification works.

Catheter Cardiovasc Interv 2020 11;96(6):1143-1144

Northside Hospital Cardiovascular Institute, Atlanta, Georgia.

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http://dx.doi.org/10.1002/ccd.29364DOI Listing
November 2020

Redo aortic valve intervention after transcatheter aortic valve replacement: Analysis of the nationwide readmission database.

Int J Cardiol 2021 02 22;325:115-120. Epub 2020 Oct 22.

University of Iowa Hospitals and Clinics, IA, Iowa, United States.

Background: Outcomes of redo aortic valve intervention (AVI) following transcatheter aortic valve replacement (TAVR) have not been well described. We thought to investigate the incidence, predictors, and outcomes of redo AVI after TAVR.

Methods: The Nationwide Readmission Database (from 2012 to 2017) was queried to identify admissions for TAVR. Redo AVI was defined as readmissions that required either TAVR or balloon aortic valvuloplasty (BAV) or surgical aortic valve replacement (SAVR). A multivariable regression model was used to identify independent predictors of redo AVI. In-hospital outcomes of redo TAVR or BAV and redo SAVR were compared in the unadjusted model.

Results: A total of weighted 148,200 (unweighted redo AVI 297, no redo AVI 73,804) index TAVRs were identified. A weighted 593 (435 TAVR or BAV and 158 SAVR) redo AVI was included with an incidence of 1.0 per 100 person-year during a median of 105 (interquartile range 41-195) days follow-up. Predictors of redo AVI were female, heart failure, obesity, atrial fibrillation, transapical approach, oral anticoagulant use, and acute kidney injury. In-hospital mortality of redo AVI was 7.6% (5.3% for redo TAVR or BAV vs. 13.8% for redo SAVR, unadjusted p = 0.10). Stroke, myocardial infarction, bleeding requiring transfusion, new pacemaker, and acute kidney injury rates were 4.7%, 2.6%, 9.3%, 10.0%, and 31.2%, respectively in redo AVI. Length of stay and hospital cost was 4.8 days and 55,826 U.S. dollars, respectively.

Conclusions: The incidence of redo AVI was low following TAVR but was associated with high mortality and morbidities.
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http://dx.doi.org/10.1016/j.ijcard.2020.10.038DOI Listing
February 2021

Another nail in the coffin for the use of risk-adjusted mortality after percutaneous coronary intervention as a quality indicator.

Catheter Cardiovasc Interv 2020 10;96(4):741-742

Northside Hospital Cardiovascular Institute, Atlanta, Georgia.

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http://dx.doi.org/10.1002/ccd.29289DOI Listing
October 2020

Coronary Revascularization Before Transcatheter Aortic Valve Replacement: It Is Safe, But Is It Necessary?

JACC Cardiovasc Interv 2020 11 14;13(22):2614-2616. Epub 2020 Oct 14.

Northside Hospital Cardiovascular Institute, Atlanta, Georgia.

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http://dx.doi.org/10.1016/j.jcin.2020.08.018DOI Listing
November 2020

Trends of utilization and outcomes after transcatheter and surgical aortic valve replacement on chronic dialysis.

J Card Surg 2020 Dec 28;35(12):3294-3301. Epub 2020 Sep 28.

Division of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, New York, USA.

Background And Aim: Trends of utilization and outcomes of transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) for patients on chronic dialysis (CD) are not well described. We aimed to assess the trends in utilization and outcomes of TAVR and SAVR on CD.

Methods: Nationwide Readmission Databases from 2013 to 2017 was analyzed. International Classification of Diseases Clinical Modification 9 and 10 codes were used to identify diagnoses and procedures. A multivariable regression model was used to compare the outcomes expressed as adjusted odds ratio (aOR) and 95% confidence interval (CI).

Results: A total of 5731 TAVR and 6491 SAVR were performed in patients with CD, respectively. The volume of TAVR increased by approximately four-folds and SAVR increased by approximately 33%. However, amongst patients with CD, the percentage of TAVR increased, whereas that of SAVR decreased (p < .001 for all). In 2016 and 2017, TAVR volume surpassed that of SAVR on CD. In-hospital mortality remained similar in TAVR (aOR: 0.92; 95% CI: 0.79-1.07; p-trend = .23) whereas it increased significantly in SAVR (aOR: 1.14: 95% CI: 1.05-1.25, p-trend = .002). In 2017, in-hospital mortality and 30-day readmission were significantly higher in TAVR among CD than non-CD patients.

Conclusion: Despite increased use of TAVR among CD, there still is an opportunity for improvement in outcome of aortic valve replacement for those on CD.
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http://dx.doi.org/10.1111/jocs.15022DOI Listing
December 2020

Women and Cardiology: The Value of Diversity.

Heart Lung Circ 2021 Jan 27;30(1):3-5. Epub 2020 Aug 27.

Monash Cardiovascular Research Centre, Monash University, Melbourne, Vic, Australia; Monash Heart, Monash Medical Centre, Melbourne, Vic, Australia.

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http://dx.doi.org/10.1016/j.hlc.2020.06.027DOI Listing
January 2021

Hot topics in interventional cardiology: Proceedings from the society for cardiovascular angiography and interventions 2020 think tank.

Catheter Cardiovasc Interv 2020 11 25;96(6):1258-1265. Epub 2020 Aug 25.

University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.

The society for cardiovascular angiography and interventions (SCAI) think tank is a collaborative venture that brings together interventional cardiologists, administrative partners, and select members of the cardiovascular industry community for high-level field-wide discussions. The 2020 think tank was organized into four parallel sessions reflective of the field of interventional cardiology: (a) coronary intervention, (b) endovascular medicine, (c) structural heart disease, and (d) congenital heart disease (CHD). Each session was moderated by a senior content expert and co-moderated by a member of SCAI's emerging leader mentorship program. This document presents the proceedings to the wider cardiovascular community in order to enhance participation in this discussion, create additional dialogue from a broader base, and thereby aid SCAI and the industry community in developing specific action items to move these areas forward.
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http://dx.doi.org/10.1002/ccd.29197DOI Listing
November 2020

"Back to the Future" for STEMI?: The COVID-19 Experience.

JACC Case Rep 2020 Aug 19;2(10):1651-1653. Epub 2020 Aug 19.

Carl and Edyth Lindner Center for Research and Education, Christ Hospital Health Network, Cincinnati, Ohio.

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http://dx.doi.org/10.1016/j.jaccas.2020.07.011DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7438036PMC
August 2020

Diabetics: To stent, or not to stent… Is that the question, or is it "which stent?"

Catheter Cardiovasc Interv 2020 08;96(2):266-267

Northside Cardiovascular Institute, Atlanta, Georgia.

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http://dx.doi.org/10.1002/ccd.29169DOI Listing
August 2020