0000000000644801

AUTHOR

James Spratt

0000-0001-8719-4538

showing 7 related works from this author

Vorapaxar in the secondary prevention of atherothrombotic events

2012

BACKGROUND: Thrombin potently activates platelets through the protease-activated receptor PAR-1. Vorapaxar is a novel antiplatelet agent that selectively inhibits the cellular actions of thrombin through antagonism of PAR-1. METHODS: We randomly assigned 26,449 patients who had a history of myocardial infarction, ischemic stroke, or peripheral arterial disease to receive vorapaxar (2.5 mg daily) or matching placebo and followed them for a median of 30 months. The primary efficacy end point was the composite of death from cardiovascular causes, myocardial infarction, or stroke. After 2 years, the data and safety monitoring board recommended discontinuation of the study treatment in patients …

MalePyridines[SDV]Life Sciences [q-bio]Myocardial InfarctionMedizinKaplan-Meier Estimate030204 cardiovascular system & hematologyBrain IschemiaLactones0302 clinical medicineMESH: Peripheral Arterial DiseaseSecondary PreventionMESH: Double-Blind Method030212 general & internal medicineMyocardial infarctionStrokeVorapaxarMESH: AgedAspirinMESH: Middle AgedMESH: RiskCardiovascular diseases [NCEBP 14]MESH: Secondary PreventionHazard ratioMESH: Brain IschemiaGeneral MedicineMiddle AgedClopidogrel3. Good healthStrokeMESH: Receptor PAR-1MESH: Myocardial Infarctionvorapaxar secondary prevention atherothrombotic eventsCardiovascular DiseasesMESH: Platelet Aggregation InhibitorsAnesthesiaRetreatmentPlatelet aggregation inhibitorFemaleIntracranial HemorrhagesMESH: HemorrhageMESH: Intracranial HemorrhagesMESH: Lactonescirculatory and respiratory physiologymedicine.drugRiskISQUEMIA CEREBRALHemorrhagePlaceboMESH: StrokePeripheral Arterial Disease03 medical and health sciencesDouble-Blind Method[INFO.INFO-IM]Computer Science [cs]/Medical ImagingmedicineHumansReceptor PAR-1MESH: RetreatmentMESH: Kaplan-Meier EstimateAgedMESH: Humansbusiness.industryMESH: PyridinesMESH: Cardiovascular Diseasesmedicine.diseaseSettore MED/11 - Malattie Dell'Apparato CardiovascolareMESH: MalebusinessMESH: FemalePlatelet Aggregation Inhibitors
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Utility of Intravascular Ultrasound in Percutaneous Revascularization of Chronic Total Occlusions

2016

Intravascular ultrasound has been used for >20 years to guide percutaneous coronary intervention in different subsets of coronary lesions. During the last decade, the interest in percutaneous coronary intervention for chronic total occlusion (CTO) has increased dramatically, leading to high success rates. Failure of guidewire crossing is the most common reason for failed CTO attempts. Certain angiographic features, such as blunt proximal CTO cap, tortuosity, heavy calcification, and lack of visibility of path in the distal vessel, increase procedural difficulty. A better understanding of the behavior of the guidewire within the CTO segment may represent a key issue to achieve successful …

medicine.medical_specialtyPercutaneousmedicine.diagnostic_testbusiness.industrymedicine.medical_treatmentPercutaneous coronary intervention030204 cardiovascular system & hematologyRevascularizationTotal occlusionSettore MED/11 - Malattie Dell'Apparato Cardiovascolare03 medical and health sciences0302 clinical medicineBluntInternal medicineCTO = chronic total occlusion DES = drug-eluting stents IVUS = intravascular ultrasound MACE = major adverse cardiac event(s) PCI = percutaneous coronary interventionIntravascular ultrasoundConventional PCImedicineCardiology030212 general & internal medicineRadiologyCardiology and Cardiovascular MedicinebusinessMace
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A randomized multicentre trial to compare revascularization with optimal medical therapy for the treatment of chronic total coronary occlusions

2018

Aims: The clinical value of percutaneous coronary intervention (PCI) for chronic coronary total occlusions (CTOs) is not established by randomized trials. This study should compare the benefit of PCI vs. optimal medical therapy (OMT) on the health status in patients with at least one CTO.Method and results: Three hundred and ninety-six patients were enrolled in a prospective randomized, multicentre, open-label, and controlled clinical trial to compare the treatment by PCI with OMT with a 2:1 randomization ratio. The primary endpoint was the change in health status assessed by the Seattle angina questionnaire (SAQ) between baseline and 12 months follow-up. Fifty-two percent of patients have …

Malemedicine.medical_specialtyRandomizationmedicine.medical_treatmentAdrenergic beta-AntagonistsAngiotensin-Converting Enzyme Inhibitors030204 cardiovascular system & hematologyAngina Pectorislaw.inventionAngina03 medical and health sciences0302 clinical medicinePercutaneous Coronary InterventionRandomized controlled triallawInternal medicinemedicineClinical endpointHumansPercutaneous transluminal interventioncardiovascular diseases030212 general & internal medicineMyocardial infarctionOptimal medical therapyAgedNitratesbusiness.industryAngina PectoriPercutaneous coronary interventionAngiotensin-Converting Enzyme InhibitorMiddle Agedmedicine.diseaseClinical trialCoronary OcclusionChronic coronary occlusion; EQ-5D; Optimal medical therapy; Percutaneous transluminal intervention; Seattle angina questionnaire; Cardiology and Cardiovascular MedicineConventional PCIChronic DiseaseChronic coronary occlusionQuality of LifeSeattle angina questionnaireFemaleHydroxymethylglutaryl-CoA Reductase InhibitorsCardiology and Cardiovascular MedicinebusinessPlatelet Aggregation Inhibitors
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Derivation and Validation of a Chronic Total Coronary Occlusion Intervention Procedural Success Score From the 20,000-Patient EuroCTO Registry : the …

2019

Objectives: The aim was to establish a contemporary scoring system to predict the outcome of chronic total occlusion coronary angioplasty. Background: Interventional treatment of chronic total coronary occlusions (CTOs) is a developing subspecialty. Predictors of technical success or failure have been derived from datasets of modest size. A robust scoring tool could facilitate case selection and inform decision making. Methods: The study analyzed data from the EuroCTO registry. This prospective database was set up in 2008 and includes >20,000 cases submitted by CTO expert operators (>50 cases/year). Derivation (n = 14,882) and validation (n = 5,745) datasets were created to develop a …

Aged 80 and overMaleDatabases FactualRisk Factorpercutaneous coronary interventionscoring systemReproducibility of Resultschronic total occlusion; coronary artery disease; percutaneous coronary intervention; scoring system; Aged; Aged 80 and over; Chronic Disease; Coronary Occlusion; Databases Factual; Europe; Female; Humans; Male; Middle Aged; Percutaneous Coronary Intervention; Predictive Value of Tests; Registries; Reproducibility of Results; Risk Assessment; Risk Factors; Treatment Failure; Decision Support TechniquesMiddle AgedRisk AssessmentDecision Support TechniquesEuropePercutaneous Coronary InterventionCoronary OcclusionPredictive Value of TestsRisk FactorsChronic DiseaseHumansFemaleRegistriesTreatment Failurechronic total occlusioncoronary artery diseaseAged
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Definitions and Clinical Trial Design Principles for Coronary Artery Chronic Total Occlusion Therapies: CTO-ARC Consensus Recommendations.

2021

Over the past 2 decades, chronic total occlusion (CTO) percutaneous coronary intervention has developed into its own subspecialty of interventional cardiology. Dedicated terminology, techniques, devices, courses, and training programs have enabled progressive advancements. However, only a few randomized trials have been performed to evaluate the safety and efficacy of CTO percutaneous coronary intervention. Moreover, several published observational studies have shown conflicting data. Part of the paucity of clinical data stems from the fact that prior studies have been suboptimally designed and performed. The absence of standardized end points and the discrepancy in definitions also prevent…

Malemedicine.medical_specialtyClinical trial protocols as topicmedicine.medical_treatmentPsychological intervention030204 cardiovascular system & hematologySubspecialtylaw.invention03 medical and health sciences0302 clinical medicineRandomized controlled triallawPhysiology (medical)MedicineHumansMedical physics030212 general & internal medicineCoronary VesselClinical Trials as TopicInterventional cardiologybusiness.industryClinical study designPercutaneous coronary interventionCoronary VesselsCoronary OcclusionCoronary occlusionEndpoint determination:Myocardial revascularizationObservational studyFemaleCardiology and Cardiovascular MedicinebusinessCirculation
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Derivation and Validation of a Chronic Total Coronary Occlusion Intervention Procedural Success Score From the 20,000-Patient EuroCTO Registry

2019

Abstract Objectives The aim was to establish a contemporary scoring system to predict the outcome of chronic total occlusion coronary angioplasty. Background Interventional treatment of chronic total coronary occlusions (CTOs) is a developing subspecialty. Predictors of technical success or failure have been derived from datasets of modest size. A robust scoring tool could facilitate case selection and inform decision making. Methods The study analyzed data from the EuroCTO registry. This prospective database was set up in 2008 and includes >20,000 cases submitted by CTO expert operators (>50 cases/year). Derivation (n = 14,882) and validation (n = 5,745) datasets were created to develop a …

medicine.medical_specialtyFramingham Risk Scorebusiness.industrymedicine.medical_treatmentPercutaneous coronary intervention030204 cardiovascular system & hematologymedicine.diseaseCoronary artery disease03 medical and health sciencesDissection0302 clinical medicineCoronary occlusionAngioplastyOcclusionmedicine030212 general & internal medicineRadiologyDerivationCardiology and Cardiovascular MedicinebusinessJACC: Cardiovascular Interventions
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Global Chronic Total Occlusion Crossing Algorithm: JACC State-of-the-Art Review

2021

© 2021 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation. This is an open access article under the CC-BY-NC-ND license.

Coronary Occlusionpercutaneous coronary interventionHumanstreatment algorithmglobalCoronary Angiographychronic total occlusionAlgorithms
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