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Coronary Revascularization

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https://www.readbyqxmd.com/read/28538000/revascularization-for-patients-with-diabetes-mellitus-and-stable-ischemic-heart-disease-an-update
#1
G B John Mancini, Michael Farkouh, Subodh Verma
PURPOSE OF REVIEW: To provide an update on the management of patients with diabetes mellitus and requiring coronary revascularization. RECENT FINDINGS: Evidence continues to show that patients with diabetes mellitus and ischemic heart disease represent a very high-risk group of patients. Choice of stent appears important for minimizing target lesion and target vessel adverse events with everolimus eluting stents having the best performance, particularly in patients being treated with insulin...
May 19, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28537939/current-perspectives-on-revascularization-in-multivessel-st-elevation-myocardial-infarction
#2
Guy Witberg, Ran Kornowski
Up to 50% of patients presenting with ST elevation myocardial infarction (STEMI) are found to have multivessel coronary artery disease. These patients have a worse prognosis compared with the overall STEMI population. Two revascularization strategies are possible for these patients: treating the infarct-related artery percutaneous coronary intervention (IRA-PCI) only or achieving Complete revascularization (CR), either through an immediate multivessel PCI during the index angiography or during a second-staged procedure...
May 19, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28532984/prognostic-impact-of-residual-syntax-score-in-patients-with-st-elevation-myocardial-infarction-and-multivessel-disease-analysis-of-an-8-year-all-comers-registry
#3
Carlos Galvão Braga, Ana Belén Cid-Alvarez, Alfredo Redondo Diéguez, Belén Alvarez Alvarez, Diego López Otero, Raymundo Ocaranza Sánchez, Xoan Sanmartin Pena, Violeta González Salvado, Ramiro Trillo-Nouche, José R González-Juanatey
BACKGROUND: The residual SYNTAX score (rSS) was designed and validated to quantify the burden of residual coronary artery disease after percutaneous coronary intervention (PCI). The aim of this study was to assess the prognostic impact of rSS in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease undergoing primary-PCI. METHODS: This retrospective cohort study included 1499 consecutive patients with STEMI who underwent primary-PCI between January 2008 and December 2015...
April 20, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28532780/meta-analysis-comparing-coronary-artery-bypass-grafting-to-drug-eluting-stents-and-to-medical-therapy-alone-for-left-main-coronary-artery-disease
#4
Rahman Shah, Mohamed S Morsy, Darryl S Weiman, George W Vetrovec
Historically, coronary artery bypass graft (CABG) surgery has been the standard revascularization method for unprotected left main coronary artery (LMCA) disease. Over the last decade, several randomized controlled trials (RCTs) have shown favorable results for percutaneous coronary intervention (PCI) with drug-eluting stent (DES) compared with CABG; however, no RCT has been conducted directly comparing DESs with medical therapy alone (MTA). Furthermore, the 2 most recently reported larger RCTs, using new-generation DESs reached somewhat conflicting conclusions comparing the 2 revascularization strategies...
April 12, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28531282/near-infrared-spectroscopy-derived-lipid-core-burden-index-predicts-adverse-cardiovascular-outcome-in-patients-with-coronary-artery-disease-during-long-term-follow-up
#5
Anne-Sophie Schuurman, Maxime Vroegindewey, Isabella Kardys, Rohit M Oemrawsingh, Jin M Cheng, Sanneke de Boer, Hector M Garcia-Garcia, Robert-Jan van Geuns, Evelyn S Regar, Joost Daemen, Nicolas M van Mieghem, Patrick W Serruys, Eric Boersma, K Martijn Akkerhuis
Aims: Near-infrared spectroscopy (NIRS) is able to quantify cholesterol within coronary arteries by the lipid core burden index (LCBI). We studied the prognostic value of NIRS-derived LCBI in patients with coronary artery disease (CAD) for adverse cardiac outcome during long-term follow-up. Methods and results: During 2009-2013, NIRS was performed in a non-culprit artery of 275 patients undergoing coronary angiography for acute coronary syndrome (ACS) or stable angina...
May 20, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28530518/antiplatelet-therapy-and-clinical-outcomes-following-myocardial-infarction-among-patients-in-a-u-s-employer-based-insurance-database
#6
Mehul D Patel, David Wu, Monica Reed Chase, Panagiotis Mavros, Kim Heithoff, Mary E Hanson, Ross J Simpson
BACKGROUND: Estimates of residual cardiovascular risks among patients who have experienced a recent acute myocardial infarction (MI) are predominantly derived from secondary prevention trial populations, patient registries, and population-based cohorts. OBJECTIVE: To generate real-world evidence of antiplatelet treatment and recurrent events following MI in patients on antiplatelet treatment among commercial, employer-based insured patients in a large administrative database...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28530070/-the-coronary-sinus-reducer-a-devicebased-therapy-for-refractory-angina
#7
REVIEW
Maayan Konigstein, Shmuel Banai
Alongside the remarkable progress in therapeutic strategies destined to patients with coronary artery disease (CAD), a growing number of patients who suffer from severe and diffuse CAD not amenable for revascularization, continue to experience severe debilitating angina despite optimal medical therapy. The Coronary Sinus (CS) Reducer has emerged as a novel therapeutic strategy for patients with refractory angina pectoris. The Reducer is a stainless steel, balloon-expandable, hourglass shaped device implanted percutaneously through the right internal jugular vein in the coronary sinus...
November 2016: Harefuah
https://www.readbyqxmd.com/read/28529547/basal-hyperinsulinemia-beyond-a-threshold-predicts-major-adverse-cardiac-events-at-1-year-after-coronary-angiogram-in-type-2-diabetes-mellitus-a-retrospective-cohort-study
#8
Mukund Srinivasan, Padmanabh Kamath, Narayan Bhat, Narasimha Pai, Rajesh Bhat, Tejas Shah, Poornima Manjrekar, Chakrapani Mahabala
BACKGROUND: There is a substantial reduction in cardiovascular related morbidity and mortality in the general population attributed to improved treatment of cardiac risk factors and disease, the same magnitude of benefit has not been observed in those with diabetes mellitus. The aim of the present study was to evaluate factors associated with the cardiac outcome at 1 year after coronary angiogram in patients with type 2 diabetes mellitus and to compare the outcomes with nondiabetics. METHODS: A retrospective cohort study was carried out in subjects who underwent coronary angiogram for an evaluation of CAD, with follow-up data available for period of 12 months...
2017: Diabetology & Metabolic Syndrome
https://www.readbyqxmd.com/read/28529094/outcomes-of-patients-with-myocardial-infarction-who-underwent-orbital-atherectomy-for-severely-calcified-lesions
#9
Michael S Lee, Evan Shlofmitz, Gentian Lluri, Jeremy Kong, Natalya Neverova, Richard Shlofmitz
OBJECTIVES: This study analyzed the outcomes of patients who presented with non-ST-elevation myocardial infarction (NSTEMI) and subsequently underwent orbital atherectomy for severe coronary artery calcification (CAC). BACKGROUND: Patients who present with NSTEMI have increased risk for death and recurrent MI after percutaneous coronary intervention (PCI). Patients with severe CAC have worse outcomes after PCI.Orbital atherectomy modifies calcified plaque, facilitating stent delivery and optimizing stent expansion...
May 7, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28529093/revascularization-methods-in-spontaneous-coronary-artery-dissection-a-focused-review
#10
REVIEW
Regina Lee, Itsik Ben-Dor
Spontaneous coronary artery dissection (SCAD) is becoming widely recognized as an important cause of myocardial infarction, particularly in younger women. Tendency toward conservative management has been primarily based on observational data. Intervention is recommended when coronary blood flow is compromised and high risk features such as left main involvement, ongoing ischemia, or hemodynamic or electrical instability are present. Unlike the atherosclerotic process where the superiority of stenting compared with plain old balloon angioplasty has been established in the acute setting, randomized studies for revascularization strategies for spontaneous coronary dissection are currently lacking...
May 12, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28525605/reply-to-does-gender-determine-the-strategy-of-coronary-revascularization
#11
Paul Kurlansky
No abstract text is available yet for this article.
May 19, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28525575/does-gender-determine-the-strategy-of-coronary-revascularization
#12
Chikara Ueki
No abstract text is available yet for this article.
May 18, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28521919/intravascular-ultrasound-analysis-of-intraplaque-versus-subintimal-tracking-in-percutaneous-intervention-for-coronary-chronic-total-occlusions-and-association-with-procedural-outcomes
#13
Lei Song, Akiko Maehara, Matthew T Finn, Sanjog Kalra, Jeffrey W Moses, Manish A Parikh, Ajay J Kirtane, Michael B Collins, Tamim M Nazif, Khady N Fall, Raja Hatem, Ming Liao, Tiffany Kim, Philip Green, Ziad A Ali, Candido Batres, Martin B Leon, Gary S Mintz, Dimitri Karmpaliotis
OBJECTIVES: Using intravascular ultrasound (IVUS), the authors compared outcomes by observed wire position (intraplaque vs. subintimal) achieved during successful chronic total occlusion (CTO) lesion treatment. BACKGROUND: Recent successes in CTO percutaneous coronary intervention (PCI) have used both intraluminal and subintimal wire tracking to improve procedural success. IVUS may be used to determine the course of wire tracking after crossing a CTO. METHODS: From March 2014 to March 2016, data were collected into a single-center database from 219 patients undergoing CTO PCI with concomitant IVUS imaging...
May 22, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28521888/clinical-significance-of-lipid-rich-plaque%C3%A2-detected-by-optical-coherence%C3%A2-tomography-a%C3%A2-4-year-follow-up-study
#14
Lei Xing, Takumi Higuma, Zhao Wang, Aaron D Aguirre, Kyoichi Mizuno, Masamichi Takano, Harold L Dauerman, Seung-Jung Park, Yangsoo Jang, Chong-Jin Kim, Soo-Joong Kim, So-Yeon Choi, Tomonori Itoh, Shiro Uemura, Harry Lowe, Darren L Walters, Peter Barlis, Stephen Lee, Amir Lerman, Catalin Toma, Jack Wei Chieh Tan, Erika Yamamoto, Krzysztof Bryniarski, Jiannan Dai, Thomas Zanchin, Shaosong Zhang, Bo Yu, Hang Lee, James Fujimoto, Valentin Fuster, Ik-Kyung Jang
BACKGROUND: Lipid-rich plaque (LRP) is thought to be a precursor to cardiac events. However, its clinical significance in coronary arteries has never been systematically investigated. OBJECTIVES: This study investigated the prevalence and clinical significance of LRP in the nonculprit region of the target vessel in patients undergoing percutaneous coronary intervention (PCI). METHODS: The study included 1,474 patients from 20 sites across 6 countries undergoing PCI, who had optical coherence tomography (OCT) imaging of the target vessel...
May 23, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28520861/influence-of-practice-patterns-on-outcome-among-countries-enrolled-in-the-syntax-trial-5-year-results-between-percutaneous-coronary-intervention-and-coronary-artery-bypass-grafting%C3%A2
#15
Milan Milojevic, Stuart J Head, Michael J Mack, Friedrich W Mohr, Marie-Claude Morice, Keith D Dawkins, David R Holmes, Patrick W Serruys, Arie Pieter Kappetein
OBJECTIVES: To examine differences among participating countries in baseline characteristics, clinical practice, medication strategies and outcomes of patients randomized to coronary artery bypass grafting and percutaneous coronary intervention in the SYNTAX trial. METHODS: In SYNTAX, centres in 18 different countries enrolled 1800 patients, of which 8 countries enrolled ≥80 patients, what was projected to be a large enough sample size to be included in the analysis...
May 16, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28515854/determinants-of-percutaneous-coronary-intervention-success-in-repeat-chronic-total-occlusion-procedures-following-an-initial-failed-attempt
#16
Cecilia Cuevas, Nicola Ryan, Alicia Quirós, Juan Gustavo Del Angel, Nieves Gonzalo, Pablo Salinas, Pilar Jiménez-Quevedo, Luis Nombela-Franco, Ivan Nuñez-Gil, Antonio Fernandez-Ortiz, Carlos Macaya, Javier Escaned
AIM: To investigate the rates and determinants of success of repeat percutaneous coronary intervention (PCI) following an initial failed attempt at recanalising the chronic total occlusions (CTO) percutaneously. METHODS: In 445 consecutive first attempt CTO-PCI procedures in our institution, procedural failure occurred in 149 (33.5%). Sixty-four re-PCI procedures were performed in 58 patients (39%) all had a single CTO. Procedural and outcome data in the re-PCI population was entered into the institutional database...
April 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28515826/successful-restoration-of-complete-heart-block-to-normal-sinus-rhythm-by-primary-angioplasty-of-dual-left-anterior-descending-artery
#17
Santosh Kumar Sinha, Vikas Mishra, Mukesh Jitendra Jha, Mahmadula Razi, Nasar Abdali, Anupam Mahrotra, Mohammad Asif, Lokendra Rekwal, Vikas Chaturvedi, Shravan Singh, Vinay Krishna
Dual left anterior descending (LAD) artery is a rare coronary anomaly. We present a patient with a rare case of dual LAD, smaller one arising from the left main coronary stem and larger one from right coronary artery who presented with acute anterior wall myocardial infarction with complete heart block (CHB). Temporary pacemaker was implanted and coronary angiogram revealed critical occlusion of proximal LAD which was subsequently revascularized by primary angioplasty using drug-eluting stent (Xience prime, 2...
April 2017: Cardiology Research
https://www.readbyqxmd.com/read/28515822/primary-percutaneous-coronary-intervention-angioplasty-of-occluded-twin-circumflex-coronary-artery-in-a-patient-of-acute-inferior-wall-myocardial-infarction-a-rare-anomaly
#18
Santosh Kumar Sinha, Vikas Mishra, Nasar Abdali, Mukesh Jitendra Jha, Mahmadula Razi, Shravan Singh, Lokendra Rekwal, Vikas Chaturvedi, Chandra Mohan Varma, Ramesh Thakur
Anomalies of the coronary arteries are reported in 1-2% of patients among diagnostic angiogram. Dual origin of a circumflex from both sinuses is extremely rare among them. We report a case of a patient who underwent primary percutaneous coronary intervention for acute inferior wall myocardial infarction where left coronary injection demonstrated normal obtuse marginal and right coronary injection demonstrated normal right coronary artery (RCA). On further probing, an anomalous left circumflex (LCx) artery was seen arising from RCA ostium which was subsequently cannulated and revascularized by deployment of 2...
April 2017: Cardiology Research
https://www.readbyqxmd.com/read/28515747/revascularization-in-ischemic-heart-failure-with-reduced-left-ventricular-ejection-fraction-the-impact-of-complete-revascularization
#19
Łukasz Pyka, Michał Hawranek, Mariusz Gąsior
Heart failure is a growing problem worldwide, with coronary artery disease being the underlying cause of over two-thirds of cases. Revascularization in this group of patients may potentially inhibit the progressive damage to the myocardium and lead to improved outcomes, but data in this area are scarce. This article emphasizes the role of qualification for revascularization and selection of method (percutaneous coronary intervention vs. coronary artery bypass grafting) and subsequently focuses on the issue of completeness of revascularization in this group of patients...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28514624/evacetrapib-and-cardiovascular-outcomes-in-high-risk-vascular-disease
#20
RANDOMIZED CONTROLLED TRIAL
A Michael Lincoff, Stephen J Nicholls, Jeffrey S Riesmeyer, Philip J Barter, H Bryan Brewer, Keith A A Fox, C Michael Gibson, Christopher Granger, Venu Menon, Gilles Montalescot, Daniel Rader, Alan R Tall, Ellen McErlean, Kathy Wolski, Giacomo Ruotolo, Burkhard Vangerow, Govinda Weerakkody, Shaun G Goodman, Diego Conde, Darren K McGuire, Jose C Nicolau, Jose L Leiva-Pons, Yves Pesant, Weimin Li, David Kandath, Simon Kouz, Naeem Tahirkheli, Denise Mason, Steven E Nissen
BACKGROUND: The cholesteryl ester transfer protein inhibitor evacetrapib substantially raises the high-density lipoprotein (HDL) cholesterol level, reduces the low-density lipoprotein (LDL) cholesterol level, and enhances cellular cholesterol efflux capacity. We sought to determine the effect of evacetrapib on major adverse cardiovascular outcomes in patients with high-risk vascular disease. METHODS: In a multicenter, randomized, double-blind, placebo-controlled phase 3 trial, we enrolled 12,092 patients who had at least one of the following conditions: an acute coronary syndrome within the previous 30 to 365 days, cerebrovascular atherosclerotic disease, peripheral vascular arterial disease, or diabetes mellitus with coronary artery disease...
May 18, 2017: New England Journal of Medicine
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