Considerations for Percutaneous Coronary Intervention (PCI)

Slides:



Advertisements
Similar presentations
2013 ACCF/AHA/SCAI Update of the Clinical Competence Statement on Coronary Artery Interventional Procedures A Report of the American College of Cardiology.
Advertisements

Disclosure Statement of Financial Interest
Rate of Obstructive Coronary Disease in Elective Diagnostic Cath Manesh R. Patel, MD Assistant Professor of Medicine Director Cath Lab Research – Duke.
Cardiology Morning Report: Revascularization in Stable Ischemic Heart Disease Bobby Mathew, MD LSU Internal Medicine, HO-II.
Screening: Doctors Paid for Heart Tests Order More NICHOLAS BAKALAR NY Times - November 14, 2011
COURAGE: Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation Purpose To compare the efficacy of optimal medical therapy (OMT)
Factors influencing treatment decisions for coronary artery disease after cardiac catheterization American Heart Association November 18, 2013 Dallas,
Published in Circulation 2005 Percutaneous Coronary Intervention Versus Conservative Therapy in Nonacute Coronary Artery Disease: A Meta-Analysis Demosthenes.
New ESC/EACTS guidelines on myocardial revascularisation Indications for coronary artery bypass grafting (CABG) vs. percutaneous coronary intervention.
© Copyright 2009 by the American Association for Clinical Chemistry Plasma Myeloperoxidase Predicts Incident Cardiovascular Risks in Stable Patients Undergoing.
REVASCULARIZATION Vs MEDICAL THERAPY IN STABLE CAD
BARI 2D Trial BARI 2D Trial Presented at the American Diabetes Association (ADA) Annual Scientific Sessions 2009 in New Orleans The Bypass Angioplasty.
Ten-Year Follow-up Survival of the Medicine, Angioplasty, or Surgery Study (MASS-II): a Randomized Controlled Clinical Trial of Therapeutic Strategies.
Silent Ischemia STABLE CAD
Through its Quality efforts, the is… Supporting the appropriate use of new, transformational technologies and therapies Moving from a volume-to-value.
Journal Club Jeffrey P Schaefer, MD April 16, 2007.
Cost-Effectiveness of Fractional Flow Reserve-Guided Percutaneous Coronary Intervention in Patients with Stable Coronary Disease: Results from the FAME.
Bangalore S, et al. β-Blocker use and clinical outcomes in stable outpatients with and without coronary artery disease. JAMA. 2012;308(13): ?
? What more will it take to turn the tide of treatment for angina patients from a PCI-first to an optimal medical therapy– first approach? 1.
Disclosures for Manesh R. Patel, MD  Research Grants:  NHLB, AHRQ, AstraZeneca, Pleuristem, Johnson and Johnson, Maquet / Datascope  Advisory Board/Consulting:
Date of download: 5/28/2016 Copyright © The American College of Cardiology. All rights reserved. From: Trends in Vascular Complications After Diagnostic.
Date of download: 5/29/2016 Copyright © The American College of Cardiology. All rights reserved. From: AACVPR/ACC/AHA 2007 Performance Measures on Cardiac.
Patient Beliefs Regarding Benefits of Percutaneous Coronary Intervention in Chronic Stable Angina My Summer Research Project of 2014 Carla Lauture, of.
Samuel Thomas Rayburn, III MD Cardiovascular Surgeon Jack Stephens Heart Institute April 25, 2015.
Date of download: 6/25/2016 Copyright © The American College of Cardiology. All rights reserved. From: Medical Therapy With Versus Without Revascularization.
Date of download: 7/5/2016 From: Validation of the Appropriate Use Criteria for Coronary Angiography: A Cohort Study Ann Intern Med. 2015;162(8):
Date of download: 7/8/2016 Copyright © The American College of Cardiology. All rights reserved. From: Fractional Flow Reserve Versus Angiography for Guiding.
From: Contemporary Mortality Risk Prediction for Percutaneous Coronary Intervention: Results From 588,398 Procedures in the National Cardiovascular Data.
Survival Benefits in Higher Risk Patients Coronary Revascularization has Revolutionized the Therapy of Ischemic Heart Disease Acute coronary syndromes.
PCI Appropriateness: Evidence and Tools Direct US
William E. Boden, MD, FACC, FAHA
On-Site Surgical Back-up is ‘Critically’ Important for PCI!
European and US Guidelines
Trends in Coronary Procedures per 1000 Medicare Beneficiaries
Optimizing Therapy for Osteoarthritis
Cardiogenic Shock.
Complex Revascularization: Geographic Variations in Practice
Preventing SCD With a WCD: Reviewing the Results of the VEST Trial
Barriers to Oral Anticoagulant Use for Stroke Prevention in AF
Dual Goals for the Management of Stable Ischemic Heart Disease (SIHD)
It’s Elementary.
How and When to Decide on Revascularization in Stable Ischemic Heart Disease.
Recurrent Angina: New Tools for an Old Problem
Goals. The Truth About Statins: High vs Moderate Dose for Secondary Prevention of CAD.
Are We Closer to Personalized Medicine in MS?
Section 5: Intervention and drug therapy
AF and PCI in Practice.
Compare-Acute Trial design: STEMI patients undergoing primary PCI were randomized to fractional flow reserve (FFR)-guided complete revascularization (n.
European Society of Cardiology 2003
A Hard Look at Cardiogenic Shock: IABP-SHOCK II Revisited
Figure 1 PCI strategies in patients with STEMI and multivessel disease
Nat. Rev. Cardiol. doi: /nrcardio
Physiology Myocardial Oxygen Supply and Demanda,b.
Updates in Cardiovascular Medicine
Effect of PCI on 1-year risk of all-cause mortality and major cardiovascular outcomes. CABG, coronary artery bypass grafting; CI, confidence interval (bars);
Guide to Atopic Dermatitis
Category: PCI Research
Figure 1 Periprocedural myonecrosis and myocardial infarction after left main coronary artery revascularization with ... Figure 1 Periprocedural myonecrosis.
ACC/SCAI – i2 Summit Late Breaking Clinical Trials March 29, 2008
Goals. The Truth About Statins: High vs Moderate Dose for Secondary Prevention of CAD.
The Challenge of AF and PCI: Practical Strategies to Improve Outcomes
Factor Xa Inhibitors in Coronary Artery Disease
Clinical case report platform
Glenn N. Levine et al. JACC 2011;58:e44-e122
Figure 1 Design of trials included in individual patient data meta-analysis. Unless provided in the caption above, the following copyright applies to the.
Effect of PCI on 3 to 5-year risk of all-cause mortality and major cardiovascular outcomes. CABG, coronary artery bypass grafting; CI, confidence interval.
Transatlantic editorial: A comparison between European and North American guidelines on myocardial revascularization  Philippe Kolh, MD, PhD, Paul Kurlansky,
Rethinking Risk Stratification for Nonischemic HF:
FFR guided deferral of PCI in patients with ACS and stable coronary artery disease (SCAD). FFR guided deferral of PCI in patients with ACS and stable coronary.
Can the Dual vs Triple Therapy Controversy in Patients With AF Undergoing PCI Be Put to Rest?
Presentation transcript:

Considerations for Percutaneous Coronary Intervention (PCI)

Clinical Stratification

Let’s Agree on Basic Principles

COURAGE Trial Optimal Medical Therapy (OMT) With or Without PCI for CAD

COURAGE Trial Outcomes

FAME 2 Fractional Flow Reserve-Guided PCI vs Medical Therapy (MT) in Stable CAD

High-Quality Cardiovascular Procedures

Growth in Imaging Basis for the AUC for Cardiac Catheterization

Development of Clinical Practice Guidelines, Performance Measures, and Appropriate Use Documents

AUC for Coronary Revascularization

AUC Developed Using the Modified Rand/Delphi Method

Framework for Decision Making

Framework for Decision Making Five Core Variables

Coronary Revascularization and Outcomes Based on AUC

Abbreviations

References

References (cont)

References (cont)