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Coronary Revascularization

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https://www.readbyqxmd.com/read/28821166/perioperative-acute-myocardial-infarction-associated-with-non-cardiac-surgery
#1
Nathaniel R Smilowitz, Navdeep Gupta, Yu Guo, Jeffrey S Berger, Sripal Bangalore
Aims: Acute myocardial infarction (AMI) is a significant cardiovascular complication following non-cardiac surgery. We sought to evaluate national trends in perioperative AMI, its management, and outcomes. Methods and results: Patients who underwent non-cardiac surgery from 2005 to 2013 were identified using the United States National Inpatient Sample. Perioperative AMI was evaluated over time. Propensity score matching was used to compile a cohort of AMI patients managed invasively (defined as cardiac catheterization or coronary revascularization) vs...
August 14, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28818353/does-calcium-burden-impact-culprit-lesion-morphology-and-clinical-results-an-adapt-des-ivus-substudy
#2
Peiren Shan, Gary S Mintz, Bernhard Witzenbichler, D Christopher Metzger, Michael J Rinaldi, Peter L Duffy, Giora Weisz, Thomas D Stuckey, Bruce R Brodie, Philippe Généreux, Aaron Crowley, Ajay J Kirtane, Gregg W Stone, Akiko Maehara
BACKGROUND: Increasing coronary lesion calcification is thought to be associated with adverse percutaneous coronary intervention (PCI) and clinical outcomes. We investigated the effects of calcium burden on culprit lesion morphology and clinical events after intravascular ultrasound (IVUS)-guided PCI in the ADAPT-DES study. METHODS: ADAPT-DES was a prospective, multicenter registry of 8582 consecutive patients undergoing successful PCI using DES. A pre-specified virtual histology (VH)-IVUS substudy of 638 culprit lesions (638 patients) had both pre- and post-PCI VH-IVUS...
August 12, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28818317/reconsidering-the-gatekeeper-paradigm-for-percutaneous-coronary-intervention-in-stable-coronary-disease-management
#3
EDITORIAL
Joshua Schulman-Marcus, William S Weintraub, William E Boden
Major randomized clinical trials over the last decade support the role of optimal medical therapy for the initial management approach for patients with stable coronary artery disease (CAD), whereas percutaneous coronary intervention (PCI) ought to be reserved for patients with persistent symptoms despite optimal medical therapy. Likewise, several studies have continued to demonstrate the superiority of coronary artery bypass grafting surgery over PCI in many patients with extensive multivessel CAD, especially those with diabetes...
July 24, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28818167/long-term-outcomes-of-paclitaxel-eluting-versus-sirolimus-eluting-stent-for-percutaneous-coronary-intervention-ameta-analysis
#4
Jie Kong, Peng Liu, Xueqiang Fan, Jianyan Wen, Jianbin Zhang, Yanan Zhen, Jinyong Li, Yiyao Cui, Xia Zheng, Zhidong Ye
The relative long-term efficacy and safety of sirolimus-eluting stents (SES) compared with paclitaxel-eluting stents (PES) in multiple comparative studies remains controversial. This report evaluates 29 randomized trials with 18,379 patients in whom long-term (more than 1 year) outcomes were evaluated. The primary outcomes were target lesion revascularization (TLR) and the secondary end points were death, cardiac death, myocardial infarction (MI), major adverse cardiac events (MACEs), target vessel revascularization (TVR) and stent thrombosis (ST)...
July 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28814233/statins-in-acute-coronary-syndromes
#5
Manolis Vavuranakis, Maria Kariori, Gerasimos Siasos, Konstantinos Kalogeras, Dimitris Tousoulis
BACKGROUND: Patients with acute coronary syndrome (ACS) frequently experience recurrent adverse events from the cardiovascular system comparing to either healthy individuals or individuals with stable coronary artery disease. This is attributed to the inflammatory cascade that is activated during ACS resulting in increased risk for rupture of vulnerable plaques. OBJECTIVE: Therefore, it is of great importance to avoid recurrent events with treatment aiming at secondary prevention which includes the management of lipid profile besides alteration in the lifestyle and habits...
August 15, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28813218/five-year-outcomes-after-on-pump-and-off-pump-coronary-artery-bypass
#6
A Laurie Shroyer, Brack Hattler, Todd H Wagner, Joseph F Collins, Janet H Baltz, Jacquelyn A Quin, G Hossein Almassi, Elizabeth Kozora, Faisal Bakaeen, Joseph C Cleveland, Muath Bishawi, Frederick L Grover
Background Coronary-artery bypass grafting (CABG) surgery may be performed either with cardiopulmonary bypass (on pump) or without cardiopulmonary bypass (off pump). We report the 5-year clinical outcomes in patients who had been included in the Veterans Affairs trial of on-pump versus off-pump CABG. Methods From February 2002 through June 2007, we randomly assigned 2203 patients at 18 medical centers to undergo either on-pump or off-pump CABG, with 1-year assessments completed by May 2008. The two primary 5-year outcomes were death from any cause and a composite outcome of major adverse cardiovascular events, defined as death from any cause, repeat revascularization (CABG or percutaneous coronary intervention), or nonfatal myocardial infarction...
August 17, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28811677/the-relationship-between-vegfa-and-tgfb1-polymorphisms-and-target-lesion-revascularization-after-elective-percutaneous-coronary-intervention
#7
Tadeusz Osadnik, Andrzej Lekston, Kamil Bujak, Joanna Katarzyna Strzelczyk, Lech Poloński, Mariusz Gąsior
BACKGROUND AND AIM: The specific association between genetic variation and in-stent restenosis is still only partly understood. The aim of this study is to analyze the relationship between functional polymorphisms in the genes encoding vascular endothelial growth factor A (VEGF-A; rs699947) and transforming growth factor beta 1 (TGF-β1; rs1800470) and target lesion revascularization (TLR) risk. METHODS: A total of 676 patients (805 lesions) with stable coronary artery disease (SCAD) who received elective percutaneous coronary intervention (PCI) with at least one bare-metal stent implantation were included...
2017: Disease Markers
https://www.readbyqxmd.com/read/28810900/polymer-free-dual-drug-eluting-stents-evaluated-in-a-porcine-model
#8
Bin Zhang, Bo Zheng, Xingang Wang, Qiuping Shi, Jia Jia, Yong Huo, Chunshui Pan, Jingyan Han, Ming Chen
BACKGROUND: Although drug-eluting stents have dramatically reduced the rates of restenosis and target lesion revascularization, they are associated with stent thrombosis (ST), a catastrophic event likely due to delayed endothelialization and chronic inflammation caused by the polymer and the metal scaffolds. To increase the safety and efficacy of stents, polymer-free dual drug-eluting stents (DDES) have been developed. METHODS: A total 160 stents (Bare-metal stents (BMS), polymer-free probucol stents (PrES), sirolimus-eluting stents (SES) and DDES) were randomly implanted in the coronary arteries of 80 pigs...
August 15, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28810251/a-prospective-randomized-open-label-blinded-endpoint-study-exploring-platelet-response-to-half-dose-prasugrel-and-ticagrelor-in-patients-with-the-acute-coronary-syndrome-hope-tailor-study
#9
Cai De Jin, Moo Hyun Kim, Junghee Bang, Victor Serebruany
BACKGROUND: The optimal dosing of novel oral P2Y12 receptor platelet inhibitors such as prasugrel or ticagrelor is unclear and especially challenging in East Asians. We hypothesize that half-dose prasugrel and ticagrelor may be sufficient for long-term maintenance management in Korean patients with the acute coronary syndrome (ACS) compared with conventional dosages. DESIGN: HOPE-TAILOR (Half Dose of Prasugrel and Ticagrelor in Platelet Response after Acute Coronary Syndromes) is a prospective, randomized, open-label, blinded, endpoint (PROBE) single-center, clinical trial...
August 16, 2017: Cardiology
https://www.readbyqxmd.com/read/28807577/a-comparison-of-inflammatory-responses-between-robotically-enhanced-coronary-artery-bypass-grafting-and-conventional-coronary-artery-bypass-grafting-implications-for-hybrid-revascularization
#10
Galina Leyvi, Kumar Vivek, Sankalp Sehgal, Adrienne Warrick, Kea Alexa Moncada, Nancy Shilian, Jonathan D Leff, Robert E Michler, Joseph J DeRose
OBJECTIVE: The inflammatory response elicited by robotically enhanced coronary artery bypass grafting (r-CABG) has not been well described. When r-CABG is performed as part of hybrid coronary revascularization, the inflammatory milieu and the timing of percutaneous coronary intervention may affect the stent patency negatively in the short and long term. The goal of this study was to describe the extent and time course of cytokine release after r-CABG compared with conventional CABG (c-CABG) and to elucidate the optimal timing for r-CABG in the setting of hybrid coronary revascularization for a future study...
April 26, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28807510/angina-after-percutaneous-coronary-intervention-the-need-for-precision-medicine
#11
Giampaolo Niccoli, Rocco Antonio Montone, Gaetano Antonio Lanza, Filippo Crea
Persistence or recurrence of angina after successful percutaneous coronary intervention (PCI) represent an important clinical issue involving from one fifth to one third of patients undergoing myocardial revascularization at one-year follow-up. A systematic approach to this syndrome is strongly needed. Precision medicine is particularly important in addressing angina after successful PCI because of the multiple underlying causes. Restenosis or coronary atherosclerosis progression explain symptom recurrence after successful PCI in some patients, while functional causes, including vasomotor abnormalities of epicardial coronary arteries and/or coronary microvascular dysfunction, explain symptoms in the remaining patients...
August 11, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28807382/association-between-statin-therapy-and-amputation-free-survival-in-patients-with-critical-limb-ischemia-in-the-critisch-registry
#12
Konstantinos Stavroulakis, Matthias Borowski, Giovanni Torsello, Theodosios Bisdas
OBJECTIVE: Secondary prevention in patients with critical limb ischemia (CLI) is crucial for the reduction of cardiovascular morbidity and mortality. Nonetheless, current recommendations are extrapolated from other high-risk populations because of the lack of CLI-dedicated trials. The aim of this explorative study was to evaluate the association of statin therapy with the outcomes of CLI patients. METHODS: The First-Line Treatments in Patients With Critical Limb Ischemia (CRITISCH) registry is a prospective multicenter registry analyzing the effectiveness of all available treatment strategies in 1200 CLI patients...
August 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28805967/prognostic-value-of-exercise-capacity-among-men-undergoing-pharmacologic-treatment-for-erectile-dysfunction-the-fit-project
#13
Robert V Same, Mahmoud Al Rifai, David I Feldman, Kevin L Billups, Clinton A Brawner, Zeina A Dardari, Jonathan K Ehrman, Steven J Keteyian, Mouaz H Al-Mallah, Michael J Blaha
BACKGROUND: Vascular erectile dysfunction (ED) has been identified as a potentially useful risk factor for predicting future cardiovascular events, particularly in younger men. Because these men typically score more favorably on traditional cardiovascular disease risk assessment tools, there exists a gap in knowledge for how to most appropriately identify those men who would benefit from more aggressive treatments. To date, no studies have examined the impact of fitness on cardiovascular outcomes in men with ED...
August 14, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28805102/favourable-long-term-outcome-after-coronary-artery-bypass-grafting-in-a-nationwide-cohort
#14
Hera Johannesdottir, Linda O Arnadottir, Jonas A Adalsteinsson, Tomas A Axelsson, Martin I Sigurdsson, Solveig Helgadottir, Dadi Helgason, Helga R Gardarsdottir, Steinthor A Marteinsson, Arnar Geirsson, Gudmundur Thorgeirsson, Tomas Gudbjartsson
OBJECTIVES: In a nationwide cohort, we analyzed long-term outcome following coronary artery bypass grafting, using the combined strategy of left internal mammary artery to the left anterior descending artery and saphenous vein as secondary graft to other coronary targets. METHODS: 1,507 consecutive patients that underwent myocardial revascularization during 2001-2012 in Iceland. Mean follow-up was 6.8 years. Major adverse cardiac and cerebrovascular events were depicted using the Kaplan-Meier method...
August 13, 2017: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/28804231/preliminary-report-on-the-safety-and-efficacy-of-staged-versus-complete-revascularization-in-patients-with-multivessel-disease-at-the-time-of-primary-percutaneous-coronary-intervention
#15
Marwan Saad, Ahmed Rashed, Wael El-Kilany, Mohamed El-Haddad, Islam Y Elgendy
This study aims to determine the safety and efficacy of complete versus staged-percutaneous coronary intervention (PCI) of nonculprit lesions at the time of primary PCI in patients with multivessel disease. Recent trials had suggested that revascularization of nonculprit lesions at the time of primary PCI is associated with better outcomes, however; the optimum timing and overall safety of this approach is not well known. An observational prospective study was conducted, including 50 patients who presented with ST-segment elevation myocardial infarction and found to have at least an additional nonculprit significant (> 70%) type A or B lesion...
September 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28802533/bifurcation-culprit-lesions-in-st-segment-elevation-myocardial-infarction-procedural-success-and-5-year-outcome-compared-with-nonbifurcation-lesions
#16
Pablo Salinas, Hernán Mejía-Rentería, Raúl Herrera-Nogueira, Pilar Jiménez-Quevedo, Luis Nombela-Franco, Iván Javier Núñez-Gil, Nieves Gonzalo, María Del Trigo, María José Pérez-Vizcayno, Alicia Quirós, Javier Escaned, Carlos Macaya, Antonio Fernández-Ortiz
INTRODUCTION AND OBJECTIVES: We assessed short- and long-term outcomes of primary angioplasty in ST-segment elevation myocardial infarction by comparing bifurcation culprit lesions (BCL) with non-BCL. METHODS: Observational study with a propensity score matched control group. Among 2746 consecutive ST-segment elevation myocardial infarction patients, we found 274 (10%) patients with BCL. The primary outcome was a composite endpoint including all-cause death, myocardial infarction, coronary artery bypass grafting or target vessel revascularization, assessed at 30-days and 5-years...
August 9, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28802512/cangrelor-versus-clopidogrel-on-a-background-of-unfractionated-heparin-from-champion-phoenix
#17
Muthiah Vaduganathan, Robert A Harrington, Gregg W Stone, Ph Gabriel Steg, C Michael Gibson, Christian W Hamm, Matthew J Price, Efthymios N Deliargyris, Jayne Prats, Kenneth W Mahaffey, Harvey D White, Deepak L Bhatt
Cangrelor is approved for use during percutaneous coronary intervention (PCI) and is administered with different parenteral anticoagulants. We examined the efficacy and safety of cangrelor in the subgroup of patients who received unfractionated heparin (UFH) during PCI in the modified intention-to-treat population of the randomized CHAMPION PHOENIX trial (cangrelor vs clopidogrel; n = 10,939). The primary efficacy end point was the composite of death, myocardial infarction, ischemia-driven revascularization, or stent thrombosis (ST) at 48 hours...
July 18, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28801799/double-versus-single-source-left-sided-coronary-revascularization-using-bilateral-internal-thoracic-artery-graft-alone
#18
Giuseppe Gatti, Gianluca Castaldi, Marco Morosin, Irena Tavcar, Manuel Belgrano, Bernardo Benussi, Gianfranco Sinagra, Aniello Pappalardo
Left-sided coronary revascularization with bilateral internal thoracic artery (BITA) graft is performed usually either with an in situ (double source) or Y-graft configuration (single source). Two hundred fifty-three (mean age, 67.1 ± 9.5 years) patients underwent isolated left-sided coronary revascularization with BITA graft alone at the present authors' institution (2000-2015). Skeletonized BITA grafts were used either in an in situ (n = 199) or Y-graft configuration (n = 54). Forty pairs were identified with the propensity score-matching...
August 11, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28801539/cangrelor-in-older-patients-undergoing-percutaneous-coronary-intervention-findings-from-champion-phoenix
#19
Matthew A Cavender, Deepak L Bhatt, Gregg W Stone, Ph Gabriel Steg, C Michael Gibson, Christian W Hamm, Matthew J Price, Jayne Prats, Steven Elkin, Efthymios N Deliargyris, Kenneth W Mahaffey, Harvey D White, Robert A Harrington
BACKGROUND: Older patients treated with percutaneous coronary intervention are at increased risk of periprocedural events. METHODS AND RESULTS: CHAMPION (cangrelor versus standard therapy to achieve optimal management of platelet inhibition) PHOENIX randomized 11 145 patients to cangrelor or clopidogrel. We sought to determine the outcomes in the prespecified subgroup of patients ≥75 years old (n=2010; 18%). Cangrelor resulted in directionally consistent effects on the primary end point (death, myocardial infarction, ischemia-driven revascularization, or stent thrombosis) in patients ≥75 years old (odds ratio [OR], 0...
August 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28800856/-impact-of-mitral-annuloplasty-combined-with-surgical-revascularization-in-ischemic-mitral-regurgitation
#20
M Tribak, M Konaté, B Ould Hbib, P Konan, L Mahfoudi, A El Hassani, A Daouda, F Lachhab, N Bendagha, A Soufiani, J Fila, S Maghraoui, A Bensouda, L Marmade, S Moughil
INTRODUCTION: Ischemic Mitral Regurgitation (IMR) is a serious complication of coronary artery disease and is associated with a poor prognosis. The optimal surgical treatment of IMR involves controversies in its indications and modalities. OBJECTIVES: To determine whether mitral annuloplasty associated with surgical revascularization improved short and mid terms outcomes compared with revascularization alone in patients with IMR. METHODS: Between January 2007 and January 2011, 81 patients operated on Department of Cardiovascular Surgery "B" were included in this study divided into 3 groups...
August 8, 2017: Annales de Cardiologie et D'angéiologie
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