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https://www.readbyqxmd.com/read/27923461/impact-of-patient-and-lesion-complexity-on-long-term-outcomes-following-coronary-revascularization-with-new-generation-drug-eluting-stents
#1
Konstantinos C Koskinas, Masanori Taniwaki, Fabio Rigamonti, Dik Heg, Marco Roffi, David Tüller, Olivier Muller, Andre Vuillomenet, Stephane Cook, Daniel Weilenmann, Christopher Kaiser, Peiman Jamshidi, Peter Jüni, Stephan Windecker, Thomas Pilgrim
Long-term clinical outcomes of new-generation drug-eluting stents in complex anatomic and clinical settings are not well defined. This study assessed the impact of patient and lesion complexity on 2-year outcomes after coronary revascularization with ultrathin strut biodegradable-polymer (BP) sirolimus-eluting stents (SES) versus durable-polymer (DP) everolimus-eluting stents (EES). In a prespecified analysis of the BIOSCIENCE randomized trial (NCT01443104), complex patients (911 of 2,119; 43%) were defined by the presence of acute ST-elevation myocardial infarction (MI); left ventricular ejection fraction ≤30%; renal dysfunction; insulin-treated diabetes; treatment of ostial lesion, bypass graft, unprotected left main lesion; or 3-vessel intervention...
November 16, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27920452/five-year-outcome-of-consecutive-unprotected-left-main-percutaneous-coronary-interventions
#2
Z Piroth, T Ferenci, G Fontos, T Szonyi, J Nemeth, S Szoke, A K Chaurasia, P Andreka
No abstract text is available yet for this article.
2016: Acta Cardiologica
https://www.readbyqxmd.com/read/27899408/percutaneous-coronary-intervention-using-drug-eluting-stents-versus-coronary-artery-bypass-grafting-for-unprotected-left-main-coronary-artery-stenosis-a-meta-analysis-of-randomized-trials
#3
Nitesh Nerlekar, Francis J Ha, Kunal P Verma, Martin R Bennett, James D Cameron, Ian T Meredith, Adam J Brown
BACKGROUND: Current guidelines suggest that coronary artery bypass grafting (CABG) should be the preferred revascularization method for unprotected left main coronary artery stenosis. In light of evidence from recent randomized trials, we assessed whether percutaneous coronary intervention (PCI) using drug-eluting stents is as safe and effective as CABG for the treatment of unprotected left main coronary artery disease. METHODS AND RESULTS: Digital databases and manual searches were performed for randomized trials comparing PCI and CABG for unprotected left main coronary artery stenosis...
December 2016: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27887688/long-term-outcomes-after-stent-implantation-for-left-main-coronary-artery-from-the-multicenter-assessing-optimal-percutaneous-coronary-intervention-for-left-main-coronary-artery-stenting-registry
#4
Masanobu Ohya, Kazushige Kadota, Mamoru Toyofuku, Takeshi Morimoto, Hirooki Higami, Yasushi Fuku, Kyohei Yamaji, Hiromi Muranishi, Yuhei Yamaji, Koji Nishida, Daisuke Furukawa, Tomohisa Tada, Euihong Ko, Kenji Ando, Hiroki Sakamoto, Takashi Tamura, Kazuya Kawai, Takeshi Kimura
We assessed long-term outcomes after left main coronary artery (LMCA) stenting based on lesion types and stenting strategies. In the Assessing Optimal percutaneous coronary Intervention for Left Main Coronary Artery stenting registry, we evaluated 1,607 consecutive patients undergoing stent implantation for unprotected LMCA lesions (bifurcation lesions: n = 1318 and nonbifurcation lesions: n = 289). Among the bifurcation lesions, 1,281 lesions were treated with stenting across the bifurcation (bifurcation 1-stent strategy: n = 999 or bifurcation 2-stent strategy: n = 282)...
October 31, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27884354/computing-methods-for-composite-clinical%C3%A2-endpoints-in-unprotected-left-main-coronary-artery-revascularization-a-post-hoc-analysis-of-the-delta-registry
#5
Davide Capodanno, Giuseppe Gargiulo, Sergio Buccheri, Alaide Chieffo, Emanuele Meliga, Azeem Latib, Seung-Jung Park, Yoshinobu Onuma, Piera Capranzano, Marco Valgimigli, Inga Narbute, Raj R Makkar, Igor F Palacios, Young-Hak Kim, Pawel E Buszman, Tarun Chakravarty, Imad Sheiban, Roxana Mehran, Christoph Naber, Ronan Margey, Arvind Agnihotri, Sebastiano Marra, Martin B Leon, Jeffrey W Moses, Jean Fajadet, Thierry Lefèvre, Marie-Claude Morice, Andrejs Erglis, Ottavio Alfieri, Patrick W Serruys, Antonio Colombo, Corrado Tamburino
OBJECTIVES: The study sought to investigate the impact of different computing methods for composite endpoints other than time-to-event (TTE) statistics in a large, multicenter registry of unprotected left main coronary artery (ULMCA) disease. BACKGROUND: TTE statistics for composite outcome measures used in ULMCA studies consider only the first event, and all the contributory outcomes are handled as if of equal importance. METHODS: The TTE, Andersen-Gill, win ratio (WR), competing risk, and weighted composite endpoint (WCE) computing methods were applied to ULMCA patients revascularized by percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) at 14 international centers...
November 28, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27829638/comparison-of-percutaneous-coronary-intervention-versus-coronary-artery-bypass-graft-in-aged-patients-with-unprotected-left-main-artery-lesions
#6
Zhonghai Wei, Jun Xie, Kun Wang, Lina Kang, Qing Dai, Jian Bai, Biao Xu
There is still much debate about revascularization strategies in aged patients with unprotected left main coronary artery (UPLM) lesions. This study compared the outcomes of percutaneous coronary intervention (PCI) versus coronary artery bypass graft (CABG) in this population.A total of 126 patients older than 60 years of age with LM lesions who underwent revascularization in our hospital from January 2012 to December 2013 were followed up for an average of 15.2 months. The cumulative incidence of major adverse cardiac and cerebral events (MACCE) was estimated by Kaplan-Meier plots...
November 9, 2016: International Heart Journal
https://www.readbyqxmd.com/read/27818146/spanish-cardiac-catheterization-and-coronary-intervention-registry-25th-official-report-of-the-spanish-society-of-cardiology-working-group-on-cardiac-catheterization-and-interventional-cardiology-1990-2015
#7
Pilar Jiménez-Quevedo, Ana Serrador, Armando Pérez de Prado, Manuel Pan
INTRODUCTION AND OBJECTIVES: The Working Group on Cardiac Catheterization and Interventional Cardiology presents its annual report on the data from the registry of the activity in 2015. METHODS: All Spanish hospitals with catheterization laboratories were invited to voluntarily contribute their activity data. The information was collected online and analyzed mostly by an independent company. RESULTS: In 2015, 106 centers participated in the national register; 73 of these centers are public...
November 3, 2016: Revista Española de Cardiología
https://www.readbyqxmd.com/read/27810964/comparison-between-1-and-2-stent-strategies-in-unprotected-distal-left-main-disease-the-milan-and-new-tokyo-registry
#8
Kensuke Takagi, Toru Naganuma, Alaide Chieffo, Yusuke Fujino, Azeem Latib, Satoko Tahara, Hisaaki Ishiguro, Matteo Montorfano, Mauro Carlino, Hiroyoshi Kawamoto, Naoyuki Kurita, Koji Hozawa, Shotaro Nakamura, Sunao Nakamura, Antonio Colombo
BACKGROUND: There are only little data available on the comparison of clinical outcomes between a 1-stent strategy (1-SS) and a 2-stent strategy (2-SS) for percutaneous coronary intervention in unprotected distal left main disease. METHODS AND RESULTS: Between April 2005 and August 2011, we recruited 937 consecutive unprotected distal left main patients treated with drug-eluting stents (1-SS, 608 patients; 2-SS, 329 patients). Major adverse cardiovascular events were defined as all-cause death, myocardial infarction, or target lesion revascularization (TLR) during the median follow-up period of 1592 days...
November 2016: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27810312/percutaneous-coronary-angioplasty-versus-coronary-artery-bypass-grafting-in-treatment-of-unprotected-left-main-stenosis-noble-a-prospective-randomised-open-label-non-inferiority-trial
#9
Timo Mäkikallio, Niels R Holm, Mitchell Lindsay, Mark S Spence, Andrejs Erglis, Ian B A Menown, Thor Trovik, Markku Eskola, Hannu Romppanen, Thomas Kellerth, Jan Ravkilde, Lisette O Jensen, Gintaras Kalinauskas, Rikard B A Linder, Markku Pentikainen, Anders Hervold, Adrian Banning, Azfar Zaman, Jamen Cotton, Erlend Eriksen, Sulev Margus, Henrik T Sørensen, Per H Nielsen, Matti Niemelä, Kari Kervinen, Jens F Lassen, Michael Maeng, Keith Oldroyd, Geoff Berg, Simon J Walsh, Colm G Hanratty, Indulis Kumsars, Peteris Stradins, Terje K Steigen, Ole Fröbert, Alastair N J Graham, Petter C Endresen, Matthias Corbascio, Olli Kajander, Uday Trivedi, Juha Hartikainen, Vesa Anttila, David Hildick-Smith, Leif Thuesen, Evald H Christiansen
BACKGROUND: Coronary artery bypass grafting (CABG) is the standard treatment for revascularisation in patients with left main coronary artery disease, but use of percutaneous coronary intervention (PCI) for this indication is increasing. We aimed to compare PCI and CABG for treatment of left main coronary artery disease. METHODS: In this prospective, randomised, open-label, non-inferiority trial, patients with left main coronary artery disease were enrolled in 36 centres in northern Europe and randomised 1:1 to treatment with PCI or CABG...
October 31, 2016: Lancet
https://www.readbyqxmd.com/read/27784884/second-vs-first-generation-drug-eluting-stents-in-complex-lesions-subsets-3-years-follow-up-of-eraci-iv-study
#10
Alfredo E Rodriguez, Omar Santaera, Miguel Larribau, Ricardo Sarmiento, Carlos Haiek, Juan F Del Pozo, Hernan Pavlovsky, Alfredo M Rodriguez-Granillo
BACKGROUND: Although percutaneous coronary intervention (PCI) with first-generation drug-eluting stents (DES-1) did not show a benefit in terms of death rate and myocardial infarction (MI) compared to bypass surgery (coronary artery bypass graft [CABG]), DES platforms have seen a remarkable improvement in the last few years, and a significant increase in their safety and efficacy was observed in randomized controlled trials and observational studies in comparison with DES-1 in patients with coronary artery disease (CAD)...
February 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/27777528/staged-high-risk-percutaneous-coronary-intervention-with-impella-support-after-on-pump-transcatheter-aortic-valve-replacement
#11
Sameer Arora, Amol A Bahekar
The management of concomitant obstructive coronary artery disease and severe aortic stenosis in poor surgical candidates is an evolving topic. Although the typical current practice is to perform percutaneous revascularization before transcatheter aortic valve replacement (TAVR), some data have emerged regarding revascularization after performing TAVR. We present the case of a 90-year-old man with multivessel coronary artery disease who was at prohibitive risk for surgical aortic valve replacement. We first performed TAVR with use of hemodynamic support, then Impella-assisted multivessel percutaneous coronary intervention on the patient's unprotected left main coronary artery...
October 2016: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/27765302/impact-of-operator-experience-and%C3%A2-volume-on-outcomes-after-left%C3%A2-main%C3%A2-coronary-artery-percutaneous%C3%A2-coronary-intervention
#12
Bo Xu, Björn Redfors, Yuejin Yang, Shubin Qiao, Yongjian Wu, Jilin Chen, Haibo Liu, Jue Chen, Liang Xu, Yanyan Zhao, Changdong Guan, Runlin Gao, Philippe Généreux
OBJECTIVES: The aim of this study was to assess the impact of operator experience on prognosis after left main coronary artery (LM) percutaneous coronary intervention (PCI). BACKGROUND: LM PCI can be technically challenging and potentially risky considering the amount of supplied myocardium. METHODS: Consecutive patients who underwent unprotected LM PCI at a single institution were included and compared according to whether the primary operator was an experienced, high-volume LM operator (defined as an operator who performed at least 15 LM PCIs per year for at least 3 consecutive years) or not...
October 24, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27756119/two-year-clinical-outcomes-in-stable-angina-and-acute-coronary-syndrome-after-percutaneous-coronary-intervention-of-left-main-coronary-artery-disease
#13
Dae Young Hyun, Myung Ho Jeong, Doo Sun Sim, Yun Ah Jeong, Kyung Hoon Cho, Min Chul Kim, Hyun Kuk Kim, Hae Chang Jeong, Keun Ho Park, Young Joon Hong, Jun Han Kim, Youngkeun Ahn, Jung Chaee Kang
Background/Aims: This study appraised the long term clinical outcomes of patients treated with percutaneous coronary intervention (PCI) for unprotected left main coronary artery (ULMCA) disease. There are limited data regarding long-term clinical outcomes after PCI for ULMCA disease. Methods: From 2001 to 2011, a total of 448 patients who underwent PCI for ULMCA disease and had 2-year clinical follow-up, were analyzed. The study patients were divided into two groups: group I (stable angina pectoris [SAP], n = 60, 48 men, 62 ± 10 years) and group II (acute coronary syndrome [ACS], n = 388, 291 men, 64 ± 10 years)...
October 18, 2016: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/27746958/stenting-or-bypass-surgery-for-unprotected-left-main-coronary-artery-disease-still-a-long-rally-to-go
#14
COMMENT
Tzu-Hsien Tsai, Cheng-I Cheng
No abstract text is available yet for this article.
September 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27720383/impact-of-a-combination-of-full-coverage-stenting-and-proximal-optimization-technique-on-long-term-outcome-for-unprotected-distal-left-main-disease
#15
Kensuke Takagi, Yusuke Fujino, Toru Naganuma, Yusuke Watanabe, Hiroto Yabushita, Satoru Mitomo, Hiroyoshi Kawamoto, Satoko Tahara, Tsuyoshi Kobayashi, Takayuki Warisawa, Kenichi Karube, Takahiro Matsumoto, Tomohiko Sato, Hisaaki Ishiguro, Naoyuki Kurita, Shotaro Nakamura, Koji Hozawa, Sunao Nakamura
BACKGROUND: There is no consensual opinion regarding the percutaneous coronary intervention (PCI) procedure for unprotected distal left main (UDLM) lesion. METHODS: Between April 2005 and August 2011, 586 consecutive patients with UDLM stenosis treated with drug-eluting stents were recruited for this study to clarify the impact of combination of full-coverage stenting and proximal optimization technique (POT) for UDLM lesion. An optimal strategy of full-coverage stenting and POT was performed in 353 patients and the other 233 patients were not optimally treated...
September 4, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/27710802/long-term-survival-among-patients-with-coronary-angioplasty-with-drug-eluting-stent-for-the-treatment-of-unprotected-left-main-stenosis-compared-to-coronary-artery-bypass-grafting
#16
Timo H Mäkikallio, Juhani Junttila, Antti Kiviniemi, Sudhir Kurl, Kari Ylitalo, Jarkko Magga, Vesa Jokinen, Olli-Pekka Piira, Kari Kervinen, Matti Niemelä, Jari A Laukkanen
No abstract text is available yet for this article.
September 28, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27709324/comparison-of-mid-term-clinical-outcomes-between-on-label-and-off-label-use-of-rotational-atherectomy
#17
Takayuki Mori, Kenichi Sakakura, Hiroshi Wada, Yousuke Taniguchi, Kei Yamamoto, Yusuke Adachi, Hiroshi Funayama, Shin-Ichi Momomura, Hideo Fujita
While rotational atherectomy (RA) is used for complex lesions in percutaneous coronary intervention, there are several contraindications such as unprotected left main stenosis or left ventricular dysfunction. We previously reported that the incidence of in-hospital complications was significantly greater in off-label as compared to on-label use RA. However, the mid-term clinical outcomes between off-label and on-label RA have not been investigated. The purpose of this study was to compare the mid-term clinical outcomes between off-label (n = 156) and on-label RA (n = 94)...
October 5, 2016: Heart and Vessels
https://www.readbyqxmd.com/read/27651035/clinical-outcomes-of-percutaneous-coronary-intervention-in-patients-turned-down-for-surgical-revascularization
#18
Devraj Sukul, Milan Seth, Simon R Dixon, Mark Zainea, Nicklaus K Slocum, Elizabeth J Pielsticker, Hitinder S Gurm
OBJECTIVES: We examined clinical outcomes following percutaneous coronary intervention (PCI) in patients turned down for surgical revascularization across a broad population. BACKGROUND: Prior studies suggest that surgical ineligibility is associated with increased mortality in patients with unprotected left main or multivessel coronary artery disease undergoing PCI. METHODS: This study included consecutive patients who underwent PCI in a multicenter registry in Michigan from January 2010 to December 2014...
September 21, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27609687/left-main-coronary-artery-disease-secular-trends-in-patient-characteristics-treatments-%C3%A2-and%C3%A2-outcomes
#19
REVIEW
Pil Hyung Lee, Jung-Min Ahn, Mineok Chang, Seunghee Baek, Sung-Han Yoon, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Duk-Woo Park, Seung-Jung Park
Left main coronary artery (LMCA) disease is the highest-risk lesion subset of ischemic heart disease, and has traditionally been an indication for coronary artery bypass grafting (CABG). Recent evidence suggests comparable clinical outcomes between percutaneous coronary intervention (PCI) and CABG for LMCA disease, with similar rates of mortality and serious composite outcomes, a higher rate of stroke with CABG, and a higher rate of repeat revascularization with PCI. These results have been translated to the current guideline recommendation that PCI is a reasonable alternative to CABG in patients with low to intermediate anatomic complexity...
September 13, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27585503/outcomes-after-percutaneous-coronary-intervention-or-bypass-surgery-in-patients-with-unprotected-left-main-disease
#20
Rafael Cavalcante, Yohei Sotomi, Cheol W Lee, Jung-Min Ahn, Vasim Farooq, Hiroki Tateishi, Erhan Tenekecioglu, Yaping Zeng, Pannipa Suwannasom, Carlos Collet, Felipe N Albuquerque, Yoshinobu Onuma, Seung-Jung Park, Patrick W Serruys
BACKGROUND: Currently available randomized data on the comparison between percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) for the treatment of unprotected left main coronary disease (LMD) lacks statistical power due to low numbers of patients enrolled. OBJECTIVES: This study assessed long-term outcomes of PCI and CABG for the treatment of LMD in specific subgroups according to disease anatomic complexity. METHODS: We conducted a pooled analysis of individual patient-level data of the LMD patients included in the PRECOMBAT (Bypass Surgery Versus Angioplasty Using Sirolimus-Eluting Stent in Patients With Left Main Coronary Artery Disease) and SYNTAX (Synergy Between PCI With TAXUS and Cardiac Surgery) trials...
September 6, 2016: Journal of the American College of Cardiology
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