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Multivessel coronary disease

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https://www.readbyqxmd.com/read/29471949/impact-of-routine-invasive-physiology-at-time-of-angiography-in-patients-with-multivessel-coronary-artery-disease-on-reclassification-of-revascularization-strategy-results-from-the-define-real-study
#1
Eric Van Belle, Robert Gil, Volker Klauss, Mohammed Balghith, Martijn Meuwissen, Jérôme Clerc, Bernhard Witzenbichler, Miha Cercek, Marios Vlachojannis, Irene Lang, Philippe Commeau, Flavien Vincent, Luca Testa, Wojciech Wasek, Nicolas Debry, Stephan Kische, Gabriele Gabrielli, Gennaro Sardella
OBJECTIVES: This study sought to prospectively assess the impact of routine invasive physiology at the time of angiography on reclassification of therapeutic management of multivessel disease (MVD) patients, and to assess how implementation of instantaneous wave-free ratio (iFR) alters the process. BACKGROUND: Routine invasive physiology in intermediate coronary lesions at the time of diagnostic angiography, primarily in patients with single-vessel disease and using fractional flow reserve (FFR), reclassifies coronary revascularization management in 26% to 44% of patients...
February 26, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29471935/multivessel-percutaneous-coronary-intervention-in-patients-with-st-segment-elevation-myocardial-infarction-with-cardiogenic-shock
#2
Joo Myung Lee, Tae-Min Rhee, Joo-Yong Hahn, Hyun Kuk Kim, Jonghanne Park, Doyeon Hwang, Ki Hong Choi, Jihoon Kim, Taek Kyu Park, Jeong Hoon Yang, Young Bin Song, Jin-Ho Choi, Seung-Hyuk Choi, Bon-Kwon Koo, Young Jo Kim, Shung Chull Chae, Myeong Chan Cho, Chong Jin Kim, Hyeon-Cheol Gwon, Ju Han Kim, Hyo-Soo Kim, Myung Ho Jeong
BACKGROUND: Recent trials demonstrated a benefit of multivessel percutaneous coronary intervention (PCI) for noninfarct-related artery (non-IRA) stenosis over IRA-only PCI in patients with ST-segment elevation myocardial infarction (STEMI) multivessel disease. However, evidence is limited in patients with cardiogenic shock. OBJECTIVES: This study investigated the prognostic impact of multivessel PCI in patients with STEMI multivessel disease presenting with cardiogenic shock, using the nationwide, multicenter, prospective KAMIR-NIH (Korea Acute Myocardial Infarction-National Institutes of Health) registry...
February 27, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29471931/coronary-artery-bypass-surgery-improves-outcomes-in-patients-with-diabetes-and-left-ventricular-dysfunction
#3
Jeevan Nagendran, Sabin J Bozso, Colleen M Norris, Finlay A McAlister, Jehangir J Appoo, Michael C Moon, Darren H Freed, Jayan Nagendran
BACKGROUND: The role of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) in patients with diabetes mellitus (DM) and multivessel coronary artery disease (CAD) has been established by large trials; however, these trials largely excluded patients with left ventricular dysfunction (LVD). OBJECTIVES: The aim of this study was to determine whether treatment with PCI or CABG leads to improved outcomes in patients with DM, CAD, and LVD...
February 27, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29468730/comparison-of-three-treatment-strategies-for-patients-with-triple-vessel-coronary-disease-and-left-ventricular-dysfunction
#4
Lin Jiang, Lianjun Xu, Lei Song, Zhan Gao, Jian Tian, Kai Sun, Hongwei Yu, Bo Xu, Lei Song, Jinqing Yuan
INTRODUCTION: Current guidelines recommend coronary artery bypass grafting (CABG) for patients with multivessel coronary disease and left ventricular (LV) dysfunction. However, some patients undergo percutaneous coronary intervention (PCI) or solely medical therapy (MT) in actual practice. The comparison of long-term outcomes of these three treatment strategies in real world is unclear. METHODS: A total of 699 consecutive patients in a single centre from 2004 to 2011 who had TVD and LV ejection fraction ≤40%, no prior PCI or CABG and had completed a median 6...
February 21, 2018: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29462051/long-term-outcome-of-patients-undergoing-minimally-invasive-direct-coronary-artery-bypass-surgery-a-single-center-experience
#5
Shakil Farid, Jason M Ali, Victoria Stohlner, Ruhina Alam, Peter Schofield, Samer Nashef, Ravi De Silva
OBJECTIVE: The primary objective was to investigate the long-term survival of patients who underwent single-vessel coronary revascularization with minimally invasive direct coronary artery bypass surgery with or without hybrid revascularization. The secondary outcome measures were repeat revascularization either by coronary artery bypass grafting or by percutaneous coronary intervention and the incidence of myocardial infarction or recurrent angina. METHODS: This is a retrospective study of prospectively collected data of patients who underwent minimally invasive direct coronary artery bypass procedure in our center between January 2001 and December 2015...
February 15, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29458248/revascularization-strategies-in-stemi-with-multivessel-disease-when-and-how
#6
Gianpiero D'Amico, Marco Basile, Giuseppe Tarantini, Alfredo Marchese
Acute ST-segment elevation myocardial infarction (STEMI) typically arises from total occlusion of an epicardial coronary artery, most often due to atherosclerotic plaque rupture/erosion and subsequent thrombus formation. Granted this, important angiographic information for patients presenting with STEMI is not only about the status of infarct-related artery (IRA) but also about the atherosclerotic disease burden and disease severity of non-IRA vessels. Previous studies have reported that multivessel (MV) coronary artery disease (CAD) is found in approximately 50% of patients with STEMI undergoing primary percutaneous coronary intervention (PCI) [1,2]...
February 19, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29452484/comparison-of-patients-with-multivessel-disease-treated-at-centers-with-and-without-on-site-cardiac-surgery
#7
Eilon Ram, Ilan Goldenberg, Yigal Kassif, Amit Segev, Jakob Lavee, Nir Shlomo, Ehud Raanani
BACKGROUND: The regional needs and consolidation of cardiac surgery services (CSS) result in an increased number of stand-alone interventional cardiology units. We aimed to explore the impact of a heart team on the decision making and outcomes of patients with multivessel coronary artery disease referred for coronary revascularization in stand-alone interventional cardiology units. METHODS: This prospective study included 1063 consecutive patients with multivessel disease enrolled between January and April 2013 from all 22 hospitals in Israel that perform coronary angiography and percutaneous coronary intervention (PCI), with or without on-site CSS...
March 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29449325/quantitative-flow-ratio-identifies-nonculprit-coronary-lesions-requiring-revascularization-in-patients-with-st-segment-elevation-myocardial-infarction-and-multivessel-disease
#8
Giosafat Spitaleri, Matteo Tebaldi, Simone Biscaglia, Jelmer Westra, Salvatore Brugaletta, Andrea Erriquez, Giulia Passarini, Alessandro Brieda, Antonio Maria Leone, Andrea Picchi, Alfonso Ielasi, Domenico Di Girolamo, Carlo Trani, Roberto Ferrari, Johan H C Reiber, Marco Valgimigli, Manel Sabatè, Gianluca Campo
BACKGROUND: The nonculprit lesion (NCL) management in ST-segment-elevation myocardial infarction patients with multivessel disease is debated. We sought to assess whether quantitative flow ratio (QFR), a noninvasive tool to identify potentially flow-limiting lesions, may be reliable in this scenario. METHODS AND RESULTS: The present proof-of-concept study is based on a 3-step process: (1) identification of the QFR reproducibility in NCLs assessment (cohort A, n=31); (2) prospective validation of QFR diagnostic accuracy in respect to fractional flow reserve (cohort B, n=45); and (3) investigation of long-term clinical outcomes of NCLs stratified according to QFR (cohort C, n=110)...
February 2018: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29449274/clinical-relevance-of-functionally-insignificant-moderate-coronary-artery-stenosis-assessed-by-3-vessel-fractional-flow-reserve-measurement
#9
Jonghanne Park, Joo Myung Lee, Bon-Kwon Koo, Eun-Seok Shin, Chang-Wook Nam, Joon-Hyung Doh, Doyeon Hwang, Jinlong Zhang, Xinyang Hu, JianAn Wang, Fei Ye, Shaoliang Chen, Junqing Yang, Jiyan Chen, Nobuhiro Tanaka, Hiroyoshi Yokoi, Hitoshi Matsuo, Hiroaki Takashima, Yasutsugu Shiono, Takashi Akasaka
BACKGROUND: Understanding of the risk conferred by functionally insignificant lesions in multiple coronary vessels is limited. We investigated the prognostic implications of coronary artery disease (CAD) based on 3-vessel fractional flow reserve (FFR). METHODS AND RESULTS: A total of 1,136 patients underwent FFR measurement in the 3 major epicardial arteries. We defined vessels with "Moderate CAD" as vessels with FFR, 0.81 to 0.87. Patients were classified into Group 1: No apparent CAD (FFR>0...
February 15, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29449272/differential-clinical-outcomes-between-angiographic-complete-versus-incomplete-coronary-revascularization-according-to-the-presence-of-chronic-kidney-disease-in-the-drug-eluting-stent-era
#10
Jihoon Kim, Joo Myung Lee, Ki Hong Choi, Tae-Min Rhee, Doyeon Hwang, Jonghanne Park, Chul Ahn, Taek Kyu Park, Jeong Hoon Yang, Young Bin Song, Jin-Ho Choi, Joo-Yong Hahn, Seung-Hyuk Choi, Hyeon-Cheol Gwon
BACKGROUND: There are limited data regarding the prognostic impact of angiographic complete revascularization (CR) in patients with chronic kidney disease (CKD). We sought to investigate the differential prognostic impact of angiographic CR over incomplete revascularization (IR), according to the presence of CKD in the drug-eluting stent era. METHODS AND RESULTS: Between 2003 and 2011 at Samsung Medical Center, consecutive patients with multivessel disease were stratified by the presence of CKD (estimated glomerular filtration rate <60 mL/min per 1...
February 15, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29443740/clinical-outcomes-of-left-main-coronary-artery-disease-patients-undergoing-three-different-revascularization-approaches
#11
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/29434090/determinants-and-long-term-outcomes-of-percutaneous-coronary-interventions-vs-surgery-for-multivessel-disease-according-to-clinical-presentation
#12
Sung-Jin Hong, Byeong-Keuk Kim, Sanghoon Shin, Yongsung Suh, Seunghwan Kim, Chul-Min Ahn, Jung-Sun Kim, Young-Guk Ko, Donghoon Choi, Myeong-Ki Hong, Yangsoo Jang
BACKGROUND: The long-term outcome of percutaneous coronary intervention (PCI) vs. coronary artery bypass graft (CABG), particularly for patients with non-ST-elevation acute coronary syndrome (NSTE-ACS), remains controversial.Methods and Results:We retrospectively analyzed 2,827 patients (stable coronary artery disease [SCAD], n=1,601; NSTE-ACS, n=1,226) who underwent either PCI (n=1,732) or CABG (n=1,095). The 8-year composite of cardiac death and myocardial infarction (MI) was compared between PCI and CABG before and after propensity matching...
February 9, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29432130/combined-assessment-of-stress-myocardial-perfusion-cardiovascular-magnetic-resonance-and-flow-measurement-in-the-coronary-sinus-improves-prediction-of-functionally-significant-coronary-stenosis-determined-by-fractional-flow-reserve-in-multivessel-disease
#13
Shiro Nakamori, Hajime Sakuma, Kaoru Dohi, Masaki Ishida, Takashi Tanigawa, Akimasa Yamada, Shinichi Takase, Hiroshi Nakajima, Toshiki Sawai, Jun Masuda, Motonori Nagata, Yasutaka Ichikawa, Kakuya Kitagawa, Eitaro Fujii, Norikazu Yamada, Masaaki Ito
BACKGROUND: Recent studies using stress-rest perfusion cardiovascular magnetic resonance (CMR) demonstrated a close correlation between myocardial ischemia and reduced fractional flow reserve (FFR). However, its diagnostic concordance may be reduced in patients with multivessel disease. We sought to evaluate the concordance of adenosine stress-rest perfusion CMR for predicting reduced FFR, and to determine the additive value of measuring global coronary flow reserve (CFR) in the coronary sinus in multivessel disease...
January 26, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29408926/mid-to-long-term-mortality-following-surgical-versus-percutaneous-coronary-revascularization-stratified-according-to-stent-subtype-an-analysis-of-6-682-patients-with-multivessel-disease
#14
Shahzad G Raja, Charles Ilsley, Fabio De Robertis, Rebecca Lane, Tito Kabir, Toufan Bahrami, Andre Simon, Aron Popov, Miles C Dalby, Mark Mason, Richard Grocott-Mason, Robert D Smith, M Bilal Iqbal
BACKGROUND: Studies comparing coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) have largely been performed in the bare-metal stent (BMS) and first-generation drug eluting stent (F-DES) era. Second-generation DES (S-DES) have shown improved outcomes when compared to F-DES, but data comparing CABG with PCI using S-DES is limited. We compared mortality following CABG versus PCI for patients with multivessel disease and analyzed different stent types. METHODS: A total of 6,682 patients underwent multivessel revascularization at Harefield Hospital, UK...
2018: PloS One
https://www.readbyqxmd.com/read/29407133/incomplete-revascularization-and-long-term-survival-after-coronary-artery-bypass-surgery
#15
Umberto Benedetto, Mario Gaudino, Antonino Di Franco, Massimo Caputo, Lucas B Ohmes, Juan Grau, David Glineur, Leonard N Girardi, Gianni D Angelini
BACKGROUND: We sought to investigate the impact of incomplete revascularization (IR) on long-term survival after isolated coronary artery bypass grafting (CABG). The possible interaction between IR and off-pump surgery was also explored. METHODS: A total of 13,701 patients with multivessel disease undergoing CABG were included in the analysis. All patients received left internal thoracic artery (LITA) to the left anterior descending artery (LAD) territory. IR was defined as at least one diseased arterial territory (right coronary artery [RCA] and/or circumflex [CX] artery) incompletely revascularized...
March 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29406853/ticagrelor-for-secondary-prevention-of-atherothrombotic-events-in-patients-with-multivessel-coronary-disease
#16
Sameer Bansilal, Marc P Bonaca, Jan H Cornel, Robert F Storey, Deepak L Bhatt, Ph Gabriel Steg, Kyungah Im, Sabina A Murphy, Dominick J Angiolillo, Robert G Kiss, Alexander N Parkhomenko, Jose Lopez-Sendon, Daniel Isaza, Assen Goudev, Frederic Kontny, Peter Held, Eva C Jensen, Eugene Braunwald, Marc S Sabatine, A J Oude Ophuis
BACKGROUND: Patients with prior myocardial infarction (MI) and multivessel coronary disease (MVD) are at high risk for recurrent coronary events. OBJECTIVES: The authors investigated the efficacy and safety of ticagrelor versus placebo in patients with MVD in the PEGASUS-TIMI 54 (Prevention of Cardiovascular Events in Patients With Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin-Thrombolysis In Myocardial Infarction 54) trial. METHODS: Patients with a history of MI 1 to 3 years before inclusion in the PEGASUS-TIMI 54 trial were stratified in a pre-specified analysis based on the presence of MVD...
February 6, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29400656/outcome-after-revascularisation-of-acute-myocardial-infarction-with-cardiogenic-shock-on-extracorporeal-life-support
#17
Pavel Overtchouk, Julien Pascal, Guillaume Lebreton, Jean-Sebastien Hulot, Charles-Edouard Luyt, Alain Combes, Mathieu Kerneis, Johanne Silvain, Olvier Barthelemy, Pascal Leprince, Nicolas Brechot, Gilles Montalescot, Jean-Philippe Collet
AIMS: To identify independent correlates of survival in patients undergoing PCI for refractory cardiogenic shock due to myocardial infarction (RCS-MI) with need for extracorporeal life support (ECLS). METHOD AND RESULTS: This observational single-tertiary-centre study enrolled 106 consecutive patients (52.7±10.4 years) with ECLS placed before or after the PCI. Half of the patients had triple vessel disease and PCI was attempted whenever possible (74.5%). The 30-day mortality rate was 63...
February 6, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29399567/safety-and-efficacy-of-the-endeavor-resolute%C3%A2-stent-in-patients-with-multivessel-disease-the-heart-honam-endeavor-resolute-prospective-multicenter-trial
#18
Doo Sun Sim, Myung Ho Jeong, Young Joon Hong, Ju Han Kim, Youngkeun Ahn, Keun Ho Park, Sun Ho Hwang, Dong Goo Kang, Seung Uk Lee, Joon Woo Kim, Jong Pil Park, Jay Young Rhew, Sang Rok Lee, Jei Keon Chae, Kyeong Ho Yun, Seok Kyu Oh, Won You Kang, Su Hyun Kim, Jang Hyun Cho
The Endeavor Resolute® (ER) is a zotarolimus-eluting stent (ZES) with a biocompatible BioLinx polymer. This study prospectively compared the clinical outcomes of 2 versions of ZES, ER and Endeavor Sprint® (ES), in patients with multivessel disease. A total of 488 patients who underwent multivessel percutaneous coronary intervention (PCI) were divided into 2 groups the ER group (n=288) and the ES group (n=200). The primary endpoint was a composite of major adverse cardiac events (MACE) consisting of death, myocardial infarction, and target vessel revascularization after 12 months...
January 2018: Chonnam Medical Journal
https://www.readbyqxmd.com/read/29397881/incidence-predictors-and-impact-on-six-month-mortality-of-three-different-definitions-of-contrast-induced-acute-kidney-injury-after-coronary-angiography
#19
Benoit Guillon, Fiona Ecarnot, Charles Marcucci, Didier Ducloux, Marion Chatot, Marc Badoz, Benjamin Bonnet, Romain Chopard, Pierre Frey, Nicolas Meneveau, François Schiele
We assessed incidence, predictors, and impact on 6-month mortality of contrast-induced acute kidney injury (CI-AKI) after coronary angiography with or without percutaneous coronary intervention in patients with acute coronary syndrome (ACS), according to 3 different CI-AKI definitions. Serum creatinine (sCr) was assessed at baseline and 48 to 72 hours after procedure to classify patients into 3 CI-AKI groups: Group 1: increase in sCR ≥25% over baseline but absolute increase <0.5 mg/dl; Group 2: absolute increase ≥0...
January 9, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29396239/long-term-outcomes-of-new-generation-drug-eluting-stents-versus-coronary-artery-bypass-grafting-for-multivessel-and-or-left-main-coronary-artery-disease-a-bayesian-network-meta-analysis-of-randomized-controlled-trials
#20
George S Mina, Hussam Watti, Demiana Soliman, Anand Shewale, Jessica Atkins, Pratap Reddy, Paari Dominic
BACKGROUND: Most data guiding revascularization of multivessel disease (MVD) and/or left main disease (LMD) favor coronary artery bypass grafting (CABG) over percutaneous coronary intervention (PCI). However, those data are based on trials comparing CABG to bare metal stents (BMS) or old generation drug eluting stents (OG-DES). Hence, it is essential to outcomes of CABG to those of new generation drug eluting stents (NG-DES). METHODS: We searched PUBMED and Cochrane database for trials evaluating revascularization of MVD and/or LMD with CABG and/or PCI...
January 5, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
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