Saurav Chatterjee

• MD
• Fellow at Saint Luke's Hospital (NY, USA)

Purpose of Review This review aims to explain the current advancements in the treatment modalities for small vessel coronary artery disease (SVCAD) and de novo lesions post-percutaneous coronary intervention (PCI), focusing on drug-coated stents (DES) and drug-coated balloons (DCB). Its goal is to address the lack of standards in the management of...

The inferior vena cava (IVC) and superior vena cava are the main conduits of the systemic venous circulation into the right atrium. Developmental or procedural interruptions of vena cava might predispose to stasis and deep vein thrombosis (DVT) distal to the anomaly and may impact the subsequent rate of pulmonary embolism (PE). This study aimed to...

Coronary atherosclerosis, a progressive disease, has long been the focus of clinical investigations aimed at understanding its natural evolution and response to medical therapies. While traditional imaging modalities, such as intravascular ultrasound (IVUS) and coronary computed tomography angiography (CTA), have shed light on plaque characteristic...

Introduction: The efficacy and safety of direct oral anticoagulants (DOACs) as treatment alternatives for patients with thrombotic antiphospholipid syndrome (APS) remain controversial. Methods: We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) that compared the efficacy and safety of DOACs with vitamin-K anta...

Importance The optimal treatment of intermediate-high–risk pulmonary embolism (PE) remains unknown. Objective To assess the effect of conventional catheter-directed thrombolysis (cCDT) plus anticoagulation vs anticoagulation monotherapy in improving echocardiographic measures of right ventricle (RV) to left ventricle (LV) ratio in acute intermedia...

Background The efficacy and safety of direct oral anticoagulants (DOACs) for patients with thrombotic antiphospholipid syndrome (APS) remain controversial. Objectives We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) that compared DOACs with vitamin-K antagonists (VKAs). Methods We searched PubMed, EMBASE,...

Purpose of Review The ISCHEMIA trial demonstrated no difference in myocardial infarction or death in patients with stable coronary disease and moderate or large ischemia territory treated either with invasive revascularization or optimal medical therapy. Whether the findings of the randomized control trial relates to real-world outcomes is uncertai...

Objectives The study sought to assess the proportion of patients in modern U.S. interventional practice that fulfilled criteria for enrollment in the ISCHEMIA (International Study of Comparative Health Effectiveness With Medical and Invasive Approaches) trial. Background The ISCHEMIA trial, which enrolled patients with stable ischemic heart diseas...

Contemporary trends of mechanical complications like papillary muscle rupture (PMR), ventricular septal defect/rupture (VSR), and free wall rupture (FWR) in ST-elevation m'yocardial infarction (STEMI), especially in the era of primary percutaneous coronary interventions (PPCI) has not been definitively investigated. We utilized the National Inpatie...

Background Superior vena cava (SVC) syndrome is caused by the obstruction of the SVC and can result in significant morbidity and mortality. In contemporary practice, endovascular therapy (ET) has become the standard of care for a majority of these patients. This study is a systematic review and meta-analysis of the available literature to assess te...

Introduction: The optimal choice of oral P2Y12 receptor inhibitors has the potential to significantly influence outcomes. We seek to compare the safety and efficacy of the three most commonly used oral P2Y12 receptor inhibitors (clopidogrel, prasugrel, and ticagrelor) in acute coronary syndromes (ACS) via a comprehensive systematic review and netw...

Thrombotic cardiovascular disease (myocardial infarction [MI], stroke, and venous thromboembolism [VTE]) remains a major cause of death and disability. Sulodexide is an oral glycosaminoglycan containing heparan sulfate and dermatan sulfate. We conducted a systematic review and meta-analysis to determine the cardiovascular efficacy, and safety of su...

Coronavirus disease 2019 (COVID-19), currently a worldwide pandemic, is a viral illness caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The suspected contribution of thrombotic events to morbidity and mortality in COVID-19 patients has prompted a search for novel potential options for preventing COVID-19-associated throm...

Objectives: We sought to investigate the prognostic value of serum lactate on survival in patients postcardiac arrest. Background: Patients who experience cardiac arrest, in- or out-of-hospital, may have a poor outcome. Initial electrocardiograms may suggest ischemia as an underlying cause and urgent referral for catheterization occurs. It remai...

Pulmonary embolism (PE) represents the third leading cause of cardiovascular mortality. The technological landscape for management of acute intermediate- and high-risk PE is rapidly evolving. Two interventional devices using pharmacomechanical means to recanalize the pulmonary arteries have recently been cleared by the US Food and Drug Administrati...

Background: Recent trials have shown benefits with percutaneous coronary intervention (PCI) on nonculprit coronary vessels in select ST-elevation myocardial infarction (STEMI) patients with multivessel coronary artery disease (CAD). However, readmission rates and causes in this high-risk group are unknown. Objective of this study is to explore pat...

Background: There are conflicting data regarding the relative effectiveness of renal sympathetic denervation (RSD) in patients with hypertension. Objectives: The purpose of this study was to evaluate the blood pressure (BP) response after RSD in sham-controlled randomized trials. Methods: Databases were searched through June 30, 2018. Randomiz...

Purpose of Review Coronary artery bypass grafting is a preferred strategy for complete coronary revascularization in patients who have multi-vessel coronary artery disease, left ventricular dysfunction, and/or diabetes. Both arterial (internal thoracic artery/radial artery) and venous grafts are utilized to bypass the obstruction in native vessels....

Background: The objective of this study was to evaluate the evidence-base supporting the American Heart Association and American College of Cardiology guidelines on peripheral vascular interventions. Methods and results: American Heart Association/American College of Cardiology guideline documents available as of May 2018 were abstracted for bot...

Background: The optimal timing of revascularization in unstable angina (UA) or non-ST-segment elevation myocardial infarction (NSTEMI) remains uncertain. We compared routine early revascularization (REV) versus selective late revascularization (SLR) strategies and divergence in the approach of cardiologists in the United States and Europe. Methods...

Left ventricular assist devices (LVADs) have emerged as an attractive option in patients with advance heart failure. Nationwide readmission database 2013 to 2014 was utilized to identify LVAD recipients using ICD-9 procedure code 37.66. The primary outcome was 90-day readmission. Readmission causes were identified using ICD-9 codes in primary diagn...

Purpose of review: This review describes the dynamic relationship between diabetes mellitus (DM) and coronary artery disease (CAD) with respect to different revascularization strategies and how angiographic tools such as the Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) score can supplement clinical decision-making. Recent findings:...

Purpose of review: In-stent restenosis (ISR) is a complex disease process that became apparent shortly after the introduction of stents into clinical practice. This review seeks to define in-stent restenosis (ISR) as well as to summarize the major treatment options that have been developed and studied over the past two decades. Recent findings:...

With advancing medical knowledge and the advent of newer technologies, the coronary sinus (CS)—a structure that was once thought to be nothing more than an obscure source of passive venous drainage—is now recognized as an important gateway for an array of clinical interventions. Although vascular cardiology has historically focused on coronary arte...

With recent advances in the field of cardiovascular medicine, cardiac catheterization has become one of the most common invasive procedures performed in the United States. Although catheterization is generally considered to be a safe procedure, the large volume of interventions performed carry with them the risk of infrequent but potentially signif...

Pulmonary embolism (PE) affects 23 per 100,000 people annually,1 causing morbidity including prolonged hospital stay, recurrence, postthrombotic syndrome, and even mortality. Annual US mortality rates associated with PE are 4 to 5 times greater than those associated with breast cancer or human immunodeficiency virus.1,2 The incidence of PE rises wi...

Background Routine invasive (RI) (early revascularization) versus selective invasive (SI) (revascularization in case of recurrent or inducible ischemia) strategies are employed to manage the patients with unstable angina (UA) and non-ST segment elevation myocardial infarction (NSTEMI). However, data regarding the superior strategy are conflicting....

Background Percutaneous ventricular assist devices (PVAD) are used for hemodynamic support in patients with cardiogenic shock. This data is the first of its kind to look for etiologies, trends and predictors of 90-day readmissions after the use of PVAD. Methods Data were extracted from Nationwide Readmissions Database for the year 2013 and 2014. P...

Background Patients undergoing percutaneous mechanical circulatory support (pMCS)‐assisted percutaneous coronary intervention (PCI) represent a high‐risk group vulnerable to complications and readmissions. Hypothesis Thirty‐day readmissions after pMCS‐assisted PCI are common among patients with comorbidities and account for a significant amount of...

The effectiveness of inferior vena cava filter (IVCF) insertion in reducing venous thromboembolism (VTE)-associated morbidity and mortality is uncertain.¹ Nevertheless, IVCF placement rates in the United States have been rapidly increasing and are 25-fold higher than in Europe.¹ Prompted by the report by Nicholson et al² in this journal of high pre...

Objectives: This meta-analysis evaluated the effectiveness of hybrid coronary revascularization (HCR) compared to coronary artery bypass grafting (CABG) for the treatment of multivessel coronary artery disease (MVCAD). Background: HCR involves a combination of surgical and percutaneous techniques, which in selected patients may present an altern...

Background: Data conflict regarding the relative effectiveness of carotid artery stenting (CAS) and carotid artery endarterectomy (CEA) for the prevention of stroke due to carotid artery stenosis. Objectives: The authors performed an updated meta-analysis evaluating the efficacy and safety of CAS versus CEA, given recently published clinical tri...

Objectives: We performed a meta-analysis to evaluate the efficacy and safety of transcatheter aortic valve replacement (TAVR) in comparison to surgical aortic valve replacement (SAVR) in intermediate-risk patients. Background: TAVR is an established treatment option in high-risk patients with severe aortic valve stenosis (AS). There are fewer da...

Catheter-directed thrombolysis (CDT) is being increasingly used for the treatment of proximal lower extremity (LE) deep venous thrombosis (DVT). However, sex differences in utilization and safety outcomes of CDT in these patients are unknown. The Nationwide Inpatient Sample (NIS) database was used to identify all patients with a principal discharge...

Patients with unprotected left main coronary artery (ULMCA) disease are increasingly treated with percutaneous coronary intervention (PCI) using new generation drug-eluting stents (DES), however the benefits of DES compared with coronary artery bypass grafting (CABG) in ULMCA remain controversial. This meta-analysis evaluated the effects of PCI wit...

Pulmonary embolism (PE) is a major cause of morbidity and mortality world-wide, and the use of thrombolytic therapy has been associated with favourable clinical outcomes in certain patient subsets. These potential benefits are counterbalanced by the risk of bleeding complications, the most devastating of which is intracranial haemorrhage (ICH). We...

Background: Radiotherapy (RT) is frequently associated with late cardiovascular (CV) complications. The mean cardiac dose from irradiation of a left-sided breast cancer is much higher than that for a right-sided breast cancer. However, data is limited on the long-term risks of RT on CV mortality. Hypothesis: RT for breast cancer is associated wi...

Methods: Electronic databases were searched to identify all randomized trials comparing IVUS-guided vs angiography-guided DES implantation. We evaluated major adverse cardiac events (MACE), all-cause and cardiovascular death, myocardial infarction, target lesion revascularization (TLR), target vessel revascularization (TVR), and stent thrombosis o...

Cardiovascular death is the leading cause of mortality for patients with type 2 diabetes mellitus. The etiology of cardiovascular disease in diabetes may be divided into hyperglycemia per se and factors operating through components of metabolic syndrome (MetS). Hyperglycemia causes direct injury to vascular endothelium and possibly on cardiac myocy...

Objective: To study the cumulative evidence for vorapaxar use in patients with atherosclerotic cardiovascular disease. Methods: A systematic review of randomized control trials in MEDLINE, EMBASE, EBSCO, CINAHL, Web of Science and Cochrane databases comparing vorapaxar with placebo was performed. Pre-specified efficacy endpoints were all-cause m...

A 41-year-old man with acute-on-chronic decompensated heart failure presented for evaluation for heart transplantation. He had non-ischaemic cardiomyopathy and had undergone a heterotopic heart transplantation (HHT) 24 years earlier. His severe pulmonary hypertension necessitated a heterotopic transplant, with the native heart maintaining the right...

Background: Remote ischemic preconditioning (RIPC) has been associated with reduced risk of myocardial injury in patients undergoing cardiovascular surgery, but uncertainty about clinical outcomes remains, particularly in the light of 2 recent large randomized clinical trials (RCTs) which were neutral. We performed a meta-analysis to evaluate the...

Objectives: Appraisal of evidence for recommendations for multivessel coronary intervention in ST-elevation myocardial infarction (STEMI). Background: Multi-vessel disease (MVD) is common in patients with ST-segment elevation myocardial infarction (STEMI). Published observational data has suggested that multi-vessel percutaneous coronary interve...

Novel oral anticoagulants (NOACs) such as dabigatran, rivaroxaban, apixaban and edoxaban have gained a lot of popularity as alternatives to warfarin for anticoagulation in various clinical settings. However, there is conflicting opinion regarding the absolute benefit of NOAC use in elderly patients. Low body mass, altered body composition of fat an...

Background: Whether compression stockings are effective in the prevention of post thrombotic syndrome in patients with deep vein thrombosis remains unknown. Since the recently published SOX trial, no meta-analysis has been done to re-evaluate the available literature on whether compression stockings are beneficial in these patients. We aimed to de...

Meta analysis

meta analysis

meta analysis

Objectives: This study sought to systematically assess the relationship between the magnitude of coronary artery calcium (CAC) and presence of myocardial ischemia. Background: The likelihood of myocardial ischemia rises with increasing CAC score. However, the likelihood of ischemia according to different CAC abnormality cutoffs has not been syst...

Mitral regurgitation (MR) is one of the common complications in myocardial infarction (MI) patients. Almost half of the post MI patients have MR (ischemic MR)17 which is moderate to severe (grade II-IV). Whether there is a mortality benefit of performing mitral valve repair (MVR) along with coronary artery bypass grafting (CABG) in patients with po...

We aim to evaluate the potential benefit and risk of addition of vorapaxar to standard medical therapy in patients who underwent coronary revascularization with either percutaneous coronary revascularization or coronary artery bypass graft surgery. We searched PubMed, EMBASE, the Cochrane Central Register of Controlled trials, and the clinical tria...