Results of DKCRUSH-VI trial reported at TCT 2014

First-of-its-kind study compares outcomes of fractional flow reserve-guided and angiography-guided provisional side branch stenting

2014-09-16

(Press-News.org) WASHINGTON, DC – September 14, 2014 – A new study found that fractional flow reserve (FFR)-guided provisional side branch (SB) stenting of true coronary bifurcation lesions yields similar outcomes to the current standard of care. The DKCRUSH-VI clinical trial is the first study to compare FFR-guided and angiography-guided stenting.

Findings were reported today at the 26th annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium. Sponsored by the Cardiovascular Research Foundation (CRF), TCT is the world's premier educational meeting specializing in interventional cardiovascular medicine.

Angiography alone is most commonly used to guide the decision whether and how to treat SBs of a coronary bifurcation lesion. Previous studies have demonstrated that this approach is effective for the majority of these lesions. However, there is little data regarding outcomes after FFR-guided provisional bifurcation stenting. FFR integrates both lesion severity and the area of the myocardium supplied by the specific coronary artery, and has become the gold standard for assessing the functional significance of a coronary lesion.

The DKCRUSH-VI trial examined a total of 320 patients at eight centers with true coronary bifurcation lesions (Medina 1,1,1, or 0,1,1) undergoing stenting with a provisional SB approach. Patients were randomly assigned 1:1 to an angiography-guided and FFR-guided method. The primary endpoint was the one-year composite rate of major adverse cardiac events (MACE) including cardiac death, myocardial infarction (MI) and ischemia-driven target vessel revascularization (TVR).

Comparing the angiography and FFR groups, treatment of the SB (balloon or stenting) was performed in 63.1 percent vs. 56.3 percent of cases, respectively (p=0.07). Stenting of the side branch was attempted in 38.1 percent vs. 25.9 percent, respectively (p=0.01). Among attempted cases, stenting was successful in 83.6 percent and 77.3 percent respectively (p=0.01). While fewer SB stents were used in the FFR group, the one-year composite MACE rate was 18.1 percent in both groups (p=1.0).

"Given the nearly identical one-year MACE rates with both approaches, either the angiography-guided or FFR-guided technique may be recommended for provisional side branch stenting of true bifurcation lesions," said lead investigator Shao-Liang Chen, MD. Dr. Chen is Director of Cardiology and Cath Lab at Nanjing First Hospital and Professor of Internal Medicine and Cardiology at Nanjing Medical University in China.

"The FFR technique may result in somewhat fewer stents being implanted and a slightly lower long-term restenosis rate, but may be technically challenging and require the upfront cost of a pressure wire in all patients."

INFORMATION: The DKCRUSH-VI trial was funded by the Jiangsu Provincial Special Program of Medical Science. Dr. Chen reported no disclosures.

The results of the DKCRUSH-VI trial will be presented on Sunday, September 14 at 11:24 AM EDT in the Main Arena (Level 3, Ballroom) of the Walter E. Washington Convention Center.

About CRF and TCT The Cardiovascular Research Foundation (CRF) is an independent, academically focused nonprofit organization dedicated to improving the survival and quality of life for people with heart disease through high quality research and education. Since its inception in 1991, CRF has played a major role in realizing dramatic improvements in the lives of countless numbers of patients by establishing the safe use of new technologies and therapies in interventional cardiovascular medicine.

Transcatheter Cardiovascular Therapeutics (TCT) is the annual scientific symposium of CRF and the world's premier educational meeting specializing in interventional cardiovascular medicine. For more than 25 years, TCT has featured major medical research breakthroughs and gathered leading researchers and clinicians from around the world to present and discuss the latest evidence-based research in the field.

For more information, visit http://www.crf.org and http://www.tctconference.com.

ELSE PRESS RELEASES FROM THIS DATE:

Results of RIBS IV trial reported at TCT 2014

2014-09-16

WASHINGTON, DC – September 14, 2014 – A new clinical trial comparing the use of everolimus-eluting stents (EES) and drug-eluting balloons (DEB) in treating in-stent restenosis (ISR) from drug-eluting stents found that EES provided superior late angiographic results and better late clinical outcomes. Findings were reported today at the 26th annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium. Sponsored by the Cardiovascular Research Foundation (CRF), TCT is the world's premier educational meeting specializing in interventional cardiovascular medicine. ...

UTMB professor implements lifesaving protocol for school children with severe allergies

2014-09-16

As the number of children with food allergies in the U.S. increases, so does the risk of children having a severe, potentially life-threatening allergic reaction called anaphylaxis on school campuses. School nurses often have treatment plans in place for students with diagnosed allergies, but many children have their first allergic reactions at school, where a specific medication, such as EpiPen epinephrine injectors, may not be available and a response protocol may not be in place. Students with identified food allergies are generally well known to school nurses. School ...

Healthy humans make nice homes for viruses

2014-09-16

The same viruses that make us sick can take up residence in and on the human body without provoking a sneeze, cough or other troublesome symptom, according to new research at Washington University School of Medicine in St. Louis. On average, healthy individuals carry about five types of viruses on their bodies, the researchers report online in BioMed Central Biology. The study is the first comprehensive analysis to describe the diversity of viruses in healthy people. The research was conducted as part of the Human Microbiome Project, a major initiative funded by the ...

Benefit of endocrine therapy in elderly women with low risk hormone receptor positive breast cancer?

2014-09-16

Treatment with endocrine therapy and radiation therapy as part of breast conservation is the current standard of care for women with hormone-receptor positive (HR+) invasive breast cancer. A new study by researchers at Fox Chase Cancer Center, however, shows that combination may not be necessary for all patient populations with the disease. The results, which Fox Chase researchers presented at the American Society for Radiation Oncology's 56th Annual Meeting on Sunday, September 14, suggest that low-risk patients over 65 years old with small tumors may achieve comparable ...

Study identifies when and how much various prostate cancer treatments will impact urinary and sexual functioning

2014-09-16

Men with prostate cancer may one day be able to predict when and how much various treatments will impact their urinary and sexual functioning, thanks in part to new findings that researchers at Fox Chase Cancer Center presented at the American Society for Radiation Oncology's 56th Annual Meeting on Tuesday, September 16. Looking over data gathered from more than 17,000 surveys completed by men diagnosed with prostate cancer, Fox Chase researchers tracked when patients' urinary and sexual symptoms changed following each type of treatment, and by how much. "The ultimate ...

World Health Organization policy improves use of medicines

2014-09-16

In this issue of PLOS Medicine, Kathleen Holloway from WHO and David Henry (University of Toronto, Canada) evaluated data on reported adherence to WHO essential medicines practices and measures of quality use of medicines from 56 low and middle income countries for 2002-2008. They compared the countries' government-reported implementation of 36 essential medicines policies with independent survey results for 10 validated indicators of quality use of medicines (QUM). They claim that the results provide the strongest evidence to date that WHO essential medicines policies ...

Access to female-controlled contraception needed in intimate partner violence

2014-09-16

Access to female-controlled contraceptive methods must be improved in order to help women and girls to counteract any risks to their reproductive health caused by intimate partner violence and reproductive coercion,* according to US experts writing in this week's PLOS Medicine. Jay Silverman and Anita Raj from the University of California in San Diego explain that intimate partner violence is a major contributor to poor reproductive outcomes, such as unintended pregnancy, among women and girls around the world. The authors argue that to improve reproductive health, ...

Meteorite that doomed dinosaurs remade forests

2014-09-16

The meteorite impact that spelled doom for the dinosaurs 66 million years ago decimated the evergreens among the flowering plants to a much greater extent than their deciduous peers, according to a study led by UA researchers. The results are published in the journal PLOS Biology. Applying biomechanical formulas to a treasure trove of thousands of fossilized leaves of angiosperms — flowering plants excluding conifers — the team was able to reconstruct the ecology of a diverse plant community thriving during a 2.2 million-year period spanning the cataclysmic impact event, ...

A novel therapy for sepsis?

2014-09-16

This release is available in Japanese. A University of Tokyo research group has discovered that pentatraxin 3 (PTX3), a protein that helps the innate immune system target invaders such as bacteria and viruses, can reduce mortality of mice suffering from sepsis. This discovery may lead to a therapy for sepsis, a major cause of death in developed countries that is fatal in one in four cases. Professor Takao Hamakubo's group at the Department of Quantitative Biology and Medicine, Research Center for Advanced Science and Technology (RCAST), have shown that PTX3 forms ...

Meteorite that doomed the dinosaurs helped the forests bloom

2014-09-16

66 million years ago, a 10-km diameter chunk of rock hit the Yukatan peninsula near the site of the small town of Chicxulub with the force of 100 teratons of TNT. It left a crater more than 150 km across, and the resulting megatsunami, wildfires, global earthquakes and volcanism are widely accepted to have wiped out the dinosaurs and made way for the rise of the mammals. But what happened to the plants on which the dinosaurs fed? A new study led by researchers from the University of Arizona reveals that the meteorite impact that spelled doom for the dinosaurs also decimated ...

Results of DKCRUSH-VI trial reported at TCT 2014

ELSE PRESS RELEASES FROM THIS DATE:

LAST 30 PRESS RELEASES: