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https://www.readbyqxmd.com/read/29662510/long-term-outcomes-of-drug-eluting-stent-versus-coronary-artery-bypass-grafting-for-left-main-coronary-artery-disease-a-meta-analysis
#1
Kong-Yong Cui, Shu-Zheng Lyu, Xian-Tao Song, Fei Yuan, Feng Xu, Min Zhang, Ming-Duo Zhang, Wei Wang, Dong-Feng Zhang, Jing Dai, Jin-Fan Tian, Yun-Lu Wang
Background: It is still controversial whether percutaneous coronary intervention with drug-eluting stent (DES) is safe and effective compared to coronary artery bypass graft surgery (CABG) for unprotected left main coronary artery (ULMCA) disease at long-term follow up (≥ 3 years). Methods: Eligible studies were selected by searching PubMed, EMBASE, and Cochrane Library up to December 6, 2016. The primary endpoint was a composite of death, myocardial infarction (MI) or stroke during the longest follow-up...
February 2018: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29599504/left-main-coronary-artery-disease-pathophysiology-diagnosis-and-treatment
#2
REVIEW
Carlos Collet, Davide Capodanno, Yoshinobu Onuma, Adrian Banning, Gregg W Stone, David P Taggart, Joseph Sabik, Patrick W Serruys
The advent of coronary angiography in the 1960s allowed for the risk stratification of patients with stable angina. Patients with unprotected left main coronary artery disease have an increased risk of death related to the large amount of myocardium supplied by this vessel. Although coronary angiography remains the preferred imaging modality for the evaluation of left main coronary artery stenosis, this technique has important limitations. Angiograms of the left main coronary artery segment can be difficult to interpret, and almost one-third of patients can be misclassified when fractional flow reserve is used as the reference...
March 29, 2018: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/29588736/unprotected-left-main-coronary-artery-disease-management-in-the-post-noble-and-excel-era
#3
Nyal Borges, Samir R Kapadia, Stephen G Ellis
The optimal management of unprotected left main coronary artery (ULMCA) disease is currently a debated topic. Percutaneous coronary intervention (PCI) has seen an increased adoption for the management of ULMCA disease after numerous small-scale randomised trials and cohort studies showed equipoise with coronary artery bypass grafting (CABG) for low complexity lesions. The recently published NOBLE and EXCEL trials are two of the largest international randomised clinical trials comparing PCI and CABG in patients with ULMCA disease...
September 2017: Interventional Cardiology
https://www.readbyqxmd.com/read/29563384/coronary-artery-bypass-surgery-versus-percutaneous-coronary-intervention-for-left-main-coronary-artery-disease-with-chronic-kidney-disease
#4
Ting-Chao Lin, Tse-Min Lu, Feng-Chyn Huang, Pai-Feng Hsu, Chun-Che Shih, Shing-Jong Lin, Chiao-Po Hsu
Percutaneous coronary intervention (PCI) has emerged as an alternative treatment to coronary artery bypass grafting (CABG) in patients with unprotected left main coronary artery disease (ULMCAD). However, the optimal treatment for ULMCAD concomitant with chronic kidney disease (CKD) was rarely addressed. Herein, we compare the long-term outcomes of these patients treated with CABG or PCI.From January 2004 to December 2010, 185 patients with ULMCAD and CKD undergoing PCI (n = 84) or CABG (n = 101) were matched for the selection criteria...
March 20, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29521440/patient-selection-and-percutaneous-technique-of-unprotected-left-main-revascularization
#5
L Testa, A Latib, M Bollati, F Bedogni
Increasing evidence suggests that percutaneous coronary intervention with newer generation drug-eluting stents may be an acceptable alternative, or even preferred in selected cases to the surgical approach, in patients with left main disease. This review will discuss the anatomic factors, the clinical variables, and the procedural strategies to consider, including physiology assessment and imaging guidance, in order to optimize outcomes.
March 9, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29502793/a-meta-analysis-comparing-percutaneous-coronary-intervention-with-drug-eluting-stents-versus-coronary-artery-bypass-grafting-in-unprotected-left-main-disease
#6
Vamsi Kodumuri, Senthil Balasubramanian, Aviral Vij, Sisir Siddamsetti, Ankur Sethi, Rommy Khalafallah, Sandeep Khosla
Coronary artery bypass grafting (CABG) is the preferred revascularization strategy for unprotected left main disease (UPLMD). Multiple small-scale trials and registry data showed that percutaneous coronary intervention (PCI) with drug-eluting stents (DES) is a noninferior strategy with a Class IIa American College of Cardiology/American Heart Association recommendation in patients with high surgical risk and favorable anatomy. However, 2 recent large-scale randomized trials showed conflicting evidence. We conducted a meta-analysis of the existing data to compare outcomes of PCI with DES versus CABG for UPLMD...
January 31, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29443766/meta-analysis-study-comparing-percutaneous-coronary-intervention-drug-eluting-stent-versus-coronary-artery-bypass-surgery-of-unprotected-left-main-coronary-artery-disease-clinical-outcomes-during-short-term-versus-long-term-1-year-follow-up
#7
Waleed E Ali, Satyanarayana R Vaidya, Sylvester U Ejeh, Kingsley U Okoroafor
BACKGROUND: Results on the safety and long-term efficacy of drug-eluting stent placement in unprotected left main coronary artery disease (ULMCAD) compared with those of coronary artery bypass surgery (CABG) remain inconsistent across randomized clinical trials and recent meta-analysis studies. We aimed to compare the clinical outcomes and safety over short- and long-term follow-ups by conducting a meta-analysis of large pooled data from randomized controlled trials and up-to-date observational studies...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29443740/clinical-outcomes-of-left-main-coronary-artery-disease-patients-undergoing-three-different-revascularization-approaches
#8
Chieh-Shou Su, Yu-Wei Chen, Ching-Hui Shen, Tsun-Jui Liu, Yen Chang, Wen-Lieng Lee
Significant unprotected left main (LM) coronary artery disease is frequently associated with severe multivessel disease and increased mortality and morbidity compared with non-LM coronary artery disease. This study compared the clinical outcomes of patients with LM disease who received percutaneous coronary intervention (PCI) with stenting, conventional coronary-artery bypass grafting (C-CABG), and robot-assisted CABG (R-CABG).This retrospective study analyzed 472 consecutive LM disease patients who underwent three different revascularization approaches at a tertiary medical center between January 2005 and November 2013...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29357762/outcome-and-selection-of-revascularization-strategy-in-left-main-coronary-artery-stenosis
#9
Thomas Gripenberg, Fadi Jokhaji, Nikolaos Östlund-Papadogeorgos, Christina Ekenbäck, Rikard Linder, Bassem Samad, Jonas Persson
OBJECTIVES: To investigate clinical outcome in unselected real-life patients with unprotected left main coronary artery (ULMCA) stenosis and determine factors associated with selection of revascularization strategy. DESIGN: Consecutive patients with ULMCA stenosis at our institution in 2009-2013 (n = 308) were retrospectively analyzed with propensity score adjusted Cox proportional hazards models for outcome. Baseline characteristics in relation to selection of revascularization strategy were analyzed with multivariate logistic regression...
April 2018: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/29338862/new-generation-stents-compared-with-coronary-bypass-surgery-for-unprotected-left-main-disease-a-word-of-caution
#10
Umberto Benedetto, David P Taggart, Miguel Sousa-Uva, Giuseppe Biondi-Zoccai, Antonino Di Franco, Lucas B Ohmes, Mohamed Rahouma, Mohamed Kamel, Massimo Caputo, Leonard N Girardi, Gianni D Angelini, Mario Gaudino
BACKGROUND: With the advent of bare metal stents and drug-eluting stents, percutaneous coronary intervention has emerged as an alternative to coronary artery bypass grafting surgery for unprotected left main disease. However, whether the evolution of stents technology has translated into better results after percutaneous coronary intervention remains unclear. We aimed to compare coronary artery bypass grafting with stents of different generations for left main disease by performing a Bayesian network meta-analysis of available randomized controlled trials...
May 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29317974/global-risk-score-and-clinical-syntax-score-as-predictors-of-clinical-outcomes-of-patients-undergoing-unprotected-left-main-percutaneous-catheter-intervention
#11
Lucky Cuenza, Marianne P Collado, James Ho Khe Sui
Background: Risk stratification is an important component of left main percutaneous catheter intervention (PCI) which has emerged as a feasible alternative to cardiac surgery. We sought to compare the clinical SYNTAX score and the global risk score in predicting outcomes of patients undergoing unprotected left main PCI in our institution. Methods: Clinical, angiographic and procedural characteristics of 92 patients who underwent unprotected left main PCI (mean age 62 ± 12...
December 2017: Cardiology Research
https://www.readbyqxmd.com/read/29306472/equal-sex-based-outcomes-in-unprotected-left-main-pci-no-advantage-for-men
#12
EDITORIAL
Jaya Chandrasekhar, Roxana Mehran
No abstract text is available yet for this article.
February 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29306470/sex-differences-in-left-main-coronary-artery-stenting-different-characteristics-but-similar-outcomes-for-women-compared-with-men
#13
Eun-Seok Shin, Cheol Whan Lee, Jung-Min Ahn, Pil Hyung Lee, Mineok Chang, Min-Ju Kim, Sung-Han Yoon, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Seong-Wook Park, Seung-Jung Park
BACKGROUND: The clinical outcomes for women compared with men undergoing left main PCI were sparse. We compared the characteristics and long-term outcomes in women versus men after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) for unprotected left main CAD. METHODS: We identified 2328 patients (545 women; 1783 men) with unprotected left main CAD who received PCI with DES between January 2007 and December 2013 in the Interventional Cardiology Research In-cooperation Society-left MAIN revascularization (IRIS-MAIN) registry...
February 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29275602/-long-term-outcomes-of-implanting-drug-eluting-stents-for-unprotected-left-main-coronary-artery-disease-patients-with-left-ventricular-systolic-dysfunction
#14
Y Pan, Q Qiu, W H Ren, X P Yu, Q Li, X J Ren
Objective: To analyze the clinical characteristics and prognosis of implanting drug-eluting stents (DES) for unprotected left main (ULM) coronary artery disease patients with left ventricular systolic dysfunction (LVSD). Methods: A total of 511 ULM coronary artery disease patients who underwent DES implantation from January 2005 to January 2012 in Department of Cardiology, Beijing Anzhen Hospital were included in the study. Based on left ventricular ejection fraction (LVEF), the patients were divided into three groups: LVEF≤40% ( n =104), 41%≤LVEF≤49% ( n =137), and LVEF≥50% ( n =270)...
December 12, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29259788/all-cause-mortality-and-major-cardiovascular-outcomes-comparing-percutaneous-coronary-angioplasty-versus-coronary-artery-bypass-grafting-in-the-treatment-of-unprotected-left-main-stenosis-a-meta-analysis-of-short-term-and-long-term-randomised-trials
#15
Jari A Laukkanen, Setor K Kunutsor, Matti Niemelä, Kari Kervinen, Leif Thuesen, Timo H Mäkikallio
Objective: We compared percutaneous coronary intervention (PCI) with coronary artery bypass grafting (CABG) for the treatment of left main coronary artery (LMCA) disease by conducting a systematic review and meta-analysis of randomised controlled trials (RCTs). Methods: RCTs of PCI versus CABG in patients with LMCA stenosis were identified from MEDLINE, the Cochrane Library and search of bibliographies to November 2016. Study-specific HRs with 95% CIs were aggregated for all-cause mortality, major adverse cardiac and cerebrovascular events (MACCE), and other cardiovascular events at time points of 30 days, 1 year and 3 years and beyond...
2017: Open Heart
https://www.readbyqxmd.com/read/29217002/the-delta-2-registry-a-multicenter-registry-evaluating-percutaneous-coronary-intervention-with-new-generation-drug-eluting-stents-in-patients-with-obstructive-left-main-coronary-artery-disease
#16
Alaide Chieffo, Akihito Tanaka, Gennaro Giustino, Ieva Briede, Fadi J Sawaya, Joost Daemen, Hiroyoshi Kawamoto, Emanuele Meliga, Fabrizio D'Ascenzo, Enrico Cerrato, Giulio G Stefanini, Davide Capodanno, Andrea Mangiameli, Christian Templin, Andrejs Erglis, Marie Claude Morice, Roxana Mehran, Nicolas M Van Mieghem, Sunao Nakamura, Mauro De Benedictis, Marco Pavani, Ferdinando Varbella, Marco Pisaniello, Samin K Sharma, Corrado Tamburino, Didier Tchetche, Antonio Colombo
OBJECTIVES: The aim of this study was to evaluate clinical outcomes of unprotected left main coronary artery percutaneous coronary intervention (PCI) with new-generation drug-eluting stents in a "real world" population. BACKGROUND: PCI of the unprotected left main coronary artery is currently recommended as an alternative to coronary artery bypass grafting (CABG) in selected patients. METHODS: All consecutive patients with unprotected left main coronary artery stenosis treated by PCI with second-generation drug-eluting stents were analyzed in this international, all-comers, multicenter registry...
December 11, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29211222/cabg-surgery-remains-the-best-option-for-patients-with-left-main-coronary-disease-in-comparison-with-pci-des-meta-analysis-of-randomized-controlled-trials
#17
COMPARATIVE STUDY
Michel Pompeu Barros Oliveira Sá, Artur Freire Soares, Rodrigo Gusmão Albuquerque Miranda, Mayara Lopes Araújo, Alexandre Motta Menezes, Frederico Pires Vasconcelos Silva, Ricardo Carvalho Lima
OBJECTIVE: To compare the safety and efficacy of coronary artery bypass grafting (CABG) with percutaneous coronary intervention (PCI) using drug-eluting stents (DES) in patients with unprotected left main coronary artery (ULMCA) disease. METHODS: MEDLINE, EMBASE, CENTRAL/CCTR, SciELO, LILACS, Google Scholar and reference lists of relevant articles were searched for clinical studies that reported outcomes at 1-year follow-up after PCI with DES and CABG for the treatment of ULMCA stenosis...
September 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29169984/left-main-restenosis-in-the-des-era-a-call-for-action
#18
REVIEW
Gaetano di Palma, Bernardo Cortese
Percutaneous treatment of the unprotected left main trunk (ULM), defined as a vessel without patent bypass graft either to the left circumflex (LCX) or left anterior descending (LAD) artery, has gained a precise role thanks to recent scientific evidence. Although new generation drug-eluting stents have already proven to be safer, there is still a consistent risk of restenosis and late adverse events. The optimal management of a ULM restenosis is still debated. Here we aim at presenting a review of the available data in literature and show our choice for treating it...
November 10, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29148142/outcomes-of-primary-percutaneous-coronary-intervention-in-acute-myocardial-infarction-due-to-unprotected-left-main-thrombosis-the-asia-pacific-left-main-st-elevation-registry-aster
#19
Jonathan Yap, Gagan D Singh, Jung-Sun Kim, Krishan Soni, Kelvin Chua, Alvin Neo, Choong Hou Koh, Ehrin J Armstrong, Stephen W Waldo, Kendrick A Shunk, Reginald I Low, Myeong-Ki Hong, Yangsoo Jang, Khung Keong Yeo
INTRODUCTION: Prior studies of ULM STEMI have been confined to small cohorts. Recent registry data with larger patient cohorts have shown contrasting results. We aim to study the outcomes of patients with unprotected left main (ULM) ST-elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI). METHODS: The Asia-pacific left main ST-Elevation Registry (ASTER) is a multicenter retrospective registry involving 4 sites in Singapore, South Korea, and the United States...
November 16, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29130573/planned-angiographic-control-versus-clinical-follow-up-for-patients-with-unprotected-left-main-stem-stenosis-treated-with-second-generation-drug-eluting-stents-a-propensity-score-with-matching-analysis-from-the-fails-failure-in-left-main-with-second-generation
#20
Fabrizio D'Ascenzo, Mario Iannaccone, Marco Pavani, Hyroishi Kawamoto, Javier Escaned, Ferdinando Varbella, Giacomo Boccuzzi, David Hiddick-Smith, Antonio Colombo, Fiorenzo Gaita
BACKGROUND: The value of angiographic follow-up in unprotected left main (ULM) stenting remains undefined. METHODS: The FAILS-2 registry included consecutive patients presenting with a critical lesion of an ULM treated with second generation drug eluting stents in 6 centers from June 2007 to January 2015. Patients were stratified into two groups: those discharged with planned angiographic follow-up and those with clinical follow-up. MACE (Major Adverse Clinical Events, a composite end point of death, myocardial infarction, TLR, and ST) was the primary end point, while each component was a secondary endpoint Sensitivity analysis was performed for patients treated with a provisional or a two-stent strategy...
November 11, 2017: Catheterization and Cardiovascular Interventions
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