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https://www.readbyqxmd.com/read/29027735/temporal-trends-in-percutaneous-coronary-interventions-thru-the-drug-eluting-stent-era-insights-from-18-641-procedures-performed-over-12-year-period
#1
Uri Landes, Tamir Bental, Amos Levi, Abid Assali, Hana Vaknin-Assa, Eli I Lev, Eldad Rechavia, Gabriel Greenberg, Katia Orvin, Ran Kornowski
BACKGROUND: The last decade, regarded as the DES era in PCI, has witnessed significant advances in the management of coronary disease. We aimed to assess temporal trends in the practice and outcome of percutaneous coronary intervention (PCI) during the drug eluting stent (DES) era. METHODS: We analyzed 18,641 consecutive PCI's performed between January 2004 and December 2016, distinguished by procedural date (Q1 : 2004-2006, n = 4,865; Q2 : 2007-2009, n = 4,977; Q3 : 2010-2012, n = 4,230; Q4 : 2013-2016, n = 4,569)...
October 13, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28992999/provisional-versus-elective-two-stent-strategy-for-unprotected-true-left-main-bifurcation-lesions-insights-from-a-fails-2-sub-study
#2
Hiroyoshi Kawamoto, Alaide Chieffo, Fabrizio D'Ascenzo, Richard J Jabbour, Toru Naganuma, Enrico Cerrato, Fabrizio Ugo, Marco Pavani, Ferdinando Varbella, Giacomo Boccuzzi, Mauro Pennone, Roberto Garbo, Federico Conrotto, Giuseppe Biondi-Zoccai, Maurizio D'Amico, Claudio Moretti, Javier Escaned, Fiorenzo Gaita, Sunao Nakamura, Antonio Colombo
BACKGROUND: This study sought to investigate the optimal percutaneous coronary intervention (PCI) strategy for true unprotected left main coronary artery (ULMCA) bifurcations. METHODS: The FAILS-2 was a retrospective multi-center study including patients with ULMCA disease treated with second-generation drug-eluting stents. Of these, we compared clinical outcomes of a provisional strategy (PS; n=216) versus an elective two-stent strategy (E2S; n=161) for true ULMCA bifurcations...
October 4, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28980283/low-diastolic-blood-pressure-is-associated-with-a-high-atherosclerotic-burden-in-patients-with-obstructive-coronary-artery-disease
#3
Vichai Senthong, Upa Kukongviriyapan, Nongnuch Settasatian, Chatri Settasatian, Nantarat Komanasin
BACKGROUND: The optimal blood pressure (BP) treatment target is still being debated, specifically diastolic BP in patients with obstructive coronary artery disease (CAD); a diastolic BP which is too low could compromise myocardial perfusion and is associated with adverse outcomes. METHODS: This study examined the relationship between diastolic BP (DBP) levels and the severity and atherosclerotic burden of CAD in 231 consecutive stable patients with evidence of obstructive CAD as detected by elective coronary angiography...
October 5, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28974664/percutaneous-stenting-for-unprotected-left-main-chronic-total-occlusion
#4
Nagaraja Moorthy, Rangaraj Ramalingam, K Subramanyam, Shivanand S Patil, Manjunath C Nanjappa
PCI of a left main coronary artery chronic total occlusion followed by PCI of the right coronary artery was performed in a patient refusing CABG surgery.
October 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28895284/usefulness-of-the-syntax-score-ii-to-validate-2-year-outcomes-in-patients-with-complex-coronary-artery-disease-undergoing-percutaneous-coronary-intervention-a-large-single-center-study
#5
Ying Song, Zhan Gao, Xiaofang Tang, Yuanliang Ma, Ping Jiang, Jingjing Xu, Yi Yao, Xueyan Zhao, Shubin Qiao, Yuejin Yang, Runlin Gao, Bo Xu, Jinqing Yuan
OBJECTIVE: This study aimed to assess the prognostic ability of synergy between percutaneous coronary intervention with Taxus and cardiac surgery score II (SS-II) in a large cohort of patients with complex coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) in clinical practice. BACKGROUND: Few studies have explored the usefulness of SS-II in nonrandomized clinical patients with complex CAD undergoing temporary PCI. METHODS: We prospectively enrolled 4398 consecutive patients undergoing three-vessel and/or unprotected left main PCI in a single center from January 2013 to December 2013...
September 12, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28886851/meta-analysis-of-comparison-of-5-year-outcomes-of-percutaneous-coronary-intervention-versus-coronary-artery-bypass-grafting-in-patients-with-unprotected-left-main-coronary-artery-in-the-era-of-drug-eluting-stents
#6
Mahin R Khan, Waleed T Kayani, Waqas Ahmad, Ravi S Hira, Salim S Virani, Ihab Hamzeh, Hani Jneid, Nasser Lakkis, Mahboob Alam
Patients with unprotected left main coronary artery (ULMCA) disease are increasingly being treated with percutaneous coronary intervention (PCI) using drug-eluting stents (DES), but long-term outcomes comparing PCI with coronary artery bypass grafting (CABG) remain limited. We performed aggregate data meta-analyses of clinical outcomes (all-cause death, nonfatal myocardial infarction, stroke, repeat revascularization, cardiac death, and major adverse cardiac and cerebrovascular events) in studies comparing 5-year outcomes of PCI with DES versus CABG in patients with ULMCA disease...
November 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28877676/long-term-outcomes-of-coronary-artery-bypass-grafting-versus-stent-pci-for-unprotected-left-main-disease-a-meta-analysis
#7
Salvatore De Rosa, Alberto Polimeni, Jolanda Sabatino, Ciro Indolfi
BACKGROUND: Coronary artery bypass graft (CABG) surgery has traditionally represented the standard of care for left main coronary artery (LMCA) disease. However, percutaneous coronary intervention with stent implantation (PCI) has more recently emerged as a valuable alternative. The long-time awaited results of the largest randomized trials on the long-term impact of PCI versus CABG in LMCA disease, the newly published NOBLE and EXCEL studies, revealed contrasting results. Thus, aim of the present meta-analysis was to review the most robust evidence from randomized comparisons of CABG versus PCI for revascularization of LMCA...
September 6, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28838096/revsacularization-for-unprotected-left-main-coronary-artery-disease-has-stenting-caught-up-with-bypass-surgery
#8
R Andrew Archbold
No abstract text is available yet for this article.
July 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/28797009/left-main-coronary-stenosis-surgery-still-reigns
#9
Marc Ruel, Hidetake Kawajiri, David Glineur, Juan Grau, Mario Gaudino, Subodh Verma
PURPOSE OF REVIEW: Coronary artery bypass grafting (CABG) has been regarded as the mainstream treatment for unprotected left main coronary artery (ULMCA) stenosis. However, the results of the Evaluation of XIENCE versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization (EXCEL) trial, in which percutaneous coronary intervention (PCI) was deemed noninferior to CABG, have raised a question whether the guidelines should be changed. This article provides a critical appraisal of recent randomized control trials (RCTs) on ULMCA stenosis...
September 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28792156/successful-treatment-of-unprotected-left-main-coronary-bifurcation-lesion-using-minimum-contrast-volume-with-intravascular-ultrasound-guidance
#10
Oh Hyun Lee, Chul Min Ahn, Jung Sun Kim, Byeong Keuk Kim, Young Guk Ko, Donghoon Choi, Yangsoo Jang, Myeong Ki Hong
Contrast-induced nephropathy (CIN) is a serious complication in patients undergoing percutaneous coronary intervention (PCI), and is associated with higher morbidity and mortality. The limiting volume of contrast medium is safest and most reliable strategy for CIN prevention. Intravascular ultrasound (IVUS) serves as an attractive alternative imaging tool to angiography in many steps during PCI, thereby reducing the use of contrast agents. Here, we reported a case of successfully treated unprotected left main bifurcation lesion with heavily calcified and diffuse lesion under the IVUS-guided PCI using low volumes of contrast dye of total 12 cc in an elderly patient...
September 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/28763313/generalizability-of-excel-and-noble-results-to-a-large-registry-population-with-unprotected-left-main-coronary-artery-disease
#11
Pil Hyung Lee, Se Hun Kang, Seungbong Han, Jung-Min Ahn, Jae Seok Bae, Cheol Hyun Lee, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Duk-Woo Park, Seung-Jung Park
OBJECTIVE: The aim of this study was to determine how trial-based findings of EXCEL and NOBLE might be interpreted and generalizable in 'real-world' settings with comparison of data from the large-scaled, all-comer Interventional Research Incorporation Society-Left MAIN Revascularization (IRIS-MAIN) registry. PATIENTS AND METHODS: We compared baseline clinical and procedural characteristics and also determined how the relative treatment effect of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) was different in EXCEL and NOBLE, compared with those of the multicenter, IRIS-MAIN registry (n=2481)...
July 31, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28760214/clinical-outcomes-with-percutaneous-coronary-revascularization-vs-coronary-artery-bypass-grafting-surgery-in-patients-with-unprotected-left-main-coronary-artery-disease-a-meta-analysis-of-6-randomized-trials-and-4-686-patients
#12
REVIEW
Tullio Palmerini, Patrick Serruys, Arie Pieter Kappetein, Philippe Genereux, Diego Della Riva, Letizia Bacchi Reggiani, Evald Christiansen, Niels R Holm, Leif Thuesen, Timo Makikallio, Marie Claude Morice, Jung-Min Ahn, Seung-Jung Park, Holger Thiele, Enno Boudriot, Mario Sabatino, Mattia Romanello, Giuseppe Biondi-Zoccai, Raphael Cavalcante, Joseph F Sabik, Gregg W Stone
Some but not all randomized controlled trials (RCT) have suggested that percutaneous coronary intervention (PCI) with drug-eluting stents may be an acceptable alternative to coronary artery bypass grafting (CABG) surgery for the treatment of unprotected left main coronary artery disease (ULMCAD). We therefore aimed to compare the risk of all-cause mortality between PCI and CABG in patients with ULMCAD in a pairwise meta-analysis of RCT. METHODS: Randomized controlled trials comparing PCI vs CABG for the treatment of ULMCAD were searched through MEDLINE, EMBASE, Cochrane databases, and proceedings of international meetings...
August 2017: American Heart Journal
https://www.readbyqxmd.com/read/28738482/-viewpoint-on-treatment-strategy-choice-for-patientswith-unprotected-left-main-coronary-artery-lesion
#13
Y L Han
No abstract text is available yet for this article.
July 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/28707446/percutaneous-coronary-intervention-after-a-surgeon-says-no-way
#14
EDITORIAL
Samuel M Butman
The rate of surgical turndowns (1.5-2.5%) in this report that went on to PCI is relatively consistent across centers. Unprotected left main intervention in patients turned down for surgery has high hospital mortality. With certain caveats, the HEART Team approach to these unique patients may be the answer.
July 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28707445/angiographic-and-clinical-outcome-after-crush-of-everolimus-eluting-stent-for-distal-unprotected-left-main-disease
#15
Angela Migliorini, Renato Valenti, Ruben Vergara, Maria Grazia De Gregorio, Eleonora Gabrielli, Elena De Vito, Maria Raffaella Aicale, Nazario Carrabba, David Antoniucci
Obiectives: Angiographic and clinical outcomes after crushing of everolimus-eluting stent (EES) for distal unprotected left main disease (ULMD). BACKGROUND: Few data exist about crushing of EES for distal ULMD. METHODS: From the Florence ULMD Percutaneous Coronary Interevention Registry consecutive patients with distal ULMD treated with EES were included in the analysis. Patients treated with provisional stenting were compared with patients treated with crush stenting...
July 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28701487/differential-event-rates-and-independent-predictors-of-long-term-major-cardiovascular-events-and-death-in-5795-patients-with-unprotected-left-main-coronary-artery-disease-treated-with-stents-bypass-surgery-or-medication-insights-from-a-large-international-multicenter
#16
Se Hun Kang, Jung-Min Ahn, Cheol Hyun Lee, Pil Hyung Lee, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Duk-Woo Park, Seung-Jung Park
BACKGROUND: Identifying predictive factors for major cardiovascular events and death in patients with unprotected left main coronary artery disease is of great clinical value for risk stratification and possible guidance for tailored preventive strategies. METHODS AND RESULTS: The Interventional Research Incorporation Society-Left MAIN Revascularization registry included 5795 patients with unprotected left main coronary artery disease (percutaneous coronary intervention, n=2850; coronary-artery bypass grafting, n=2337; medication alone, n=608)...
July 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28692459/comparative-determinants-of-5-year-cardiovascular-event-rates-in-patients-with-unprotected-left-main-coronary-artery-disease
#17
Cheol Hyun Lee, Jung-Min Ahn, Pil Hyung Lee, Minkyu Han, Se Hun Kang, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Duk-Woo Park, Seung-Jung Park
BACKGROUND: Diabetes mellitus (DM), low ejection fraction (EF), and the extent of coronary artery disease (CAD) have all been identified as predictors of cardiovascular events in multivessel disease, but their comparative contributions to future risk remain unclear in patients with unprotected left main coronary artery (ULMCA) disease. Through this study we aimed to categorize the risk for cardiovascular events in patients with ULMCA disease using simple clinical descriptors. PATIENTS AND METHODS: Our study included a total of 5975 patients with ULMCA disease from the Interventional Research Incorporation Society-Left MAIN Revascularization registry who were treated with percutaneous coronary intervention (n=2850), coronary artery bypass grafting (n=2337), or medical therapy alone (n=608)...
August 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28684430/percutaneous-coronary-intervention-has-similar-5-year-survival-rates-to-coronary-artery-bypass-grafting-surgery-for-patients-with-unprotected-left-main-artery-disease
#18
Carlos Collet, Patrick W Serruys
No abstract text is available yet for this article.
August 2017: Evidence-based Medicine
https://www.readbyqxmd.com/read/28663763/long-term-outcomes-of-pci-vs-cabg-for-ostial-midshaft-lesions-in-unprotected-left-main-coronary-artery
#19
Cheng-Long Guo, Xian-Peng Yu, Bang-Guo Yang, Meng-Meng Li, Ji-Qiang He, Quan Li, Cheng-Xiong Gu, Shu-Zheng Lyu, Jian-Zeng Dong
BACKGROUND: There are limited data on long-term (> 5 years) outcomes of drug-eluting stent (DES) implantation compared with coronary artery bypass grafting (CABG) for ostial/midshaft left main coronary artery (LMCA) lesions. METHODS: Of the 259 consecutive patients in Beijing Anzhen Hospital with ostial/midshaft LMCA lesions, 149 were treated with percutaneous coronary intervention (PCI) with DES and 110 were with CABG. The endpoints of the study were death, repeat revascularization, myocardial infarction (MI), stroke, the composite of cardiac death, and major adverse cardiac and cerebrovascular events (MACCE, the composite of cardiac death, MI, stroke or repeat revascularization)...
April 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28658308/unprotected-left-main-revascularization-percutaneous-coronary-intervention-versus-coronary-artery-bypass-an-updated-systematic-review-and-meta-analysis-of-randomised-controlled-trials
#20
REVIEW
Luca Testa, Azeem Latib, Mario Bollati, Rocco Antonio Montone, Antonio Colombo, Filippo Crea, Francesco Bedogni
BACKGROUND: The optimal treatment of unprotected left main (UPLM) with either PCI or CABG remains uncertain. AIM: The purpose of this study was to determine the comparative safety and efficacy of PCI versus CABG in patients with UPLM disease. METHODS: Search of BioMedCentral, CENTRAL, mRCT, PubMed, major cardiological congresses proceedings and references cross-check (updated November 2016). Outcomes were the rate of MACE [all cause death, MI, stroke], the rates of the individual components of MACE and the rate of target vessel revascularisation (TVR)...
2017: PloS One
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