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Multivessel coronary disease

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https://www.readbyqxmd.com/read/28723830/early-versus-delayed-coronary-artery-bypass-graft-surgery-for-patients-with-non-st-elevation-myocardial-infarction
#1
Le Dung Ha, Gbolahan Ogunbayo, Ayman Elbadawi, Odunayo Olorunfemi, Adrian Messerli
BACKGROUND: Although coronary artery bypass graft surgery (CABG) has been proven to have mortality and morbidity benefits in patients with non-ST elevation myocardial infarction and multivessel disease, the appropriate timing of this procedure remains unclear. Therefore, we proposed a propensity score-matched analysis comparing the clinical outcomes between patients who underwent CABG within the first 48 h of admission (early CABG) and patients who underwent CABG after 48 h of admission (delayed CABG)...
July 18, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28717115/coronary-artery-disease-and-type-2-diabetes-mellitus
#2
Ryo Naito, Katsumi Miyauchi
Type 2 diabetes mellitus (T2DM) is a major risk factor of coronary artery diseases (CAD). Clinical outcomes in CAD with T2DM are poor despite improvement in medications and intervention devices. Coronary artery bypass grafting (CABG) is superior to percutaneous coronary intervention (PCI) in treating diabetic patients with multivessel coronary artery diseases (MVD). However, selecting a revascularization strategy should depend not only on the lesion complexity but also on the patient's background and comorbidities...
July 14, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28706929/diabetes-mellitus-and-multivessel-coronary-artery-disease-an-ongoing-battle-for-an-ideal-treatment-strategy
#3
EDITORIAL
Laura S Kerkmeijer, Serdar Farhan, Roxana Mehran, George D Dangas
No abstract text is available yet for this article.
June 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28703046/multivessel-versus-culprit-lesion-only-percutaneous-coronary-intervention-in-cardiogenic-shock-complicating-acute-myocardial-infarction-a-systematic-review-and-meta-analysis
#4
Suzanne de Waha, Alexander Jobs, Ingo Eitel, Janine Pöss, Thomas Stiermaier, Roza Meyer-Saraei, Georg Fuernau, Uwe Zeymer, Steffen Desch, Holger Thiele
BACKGROUND: Early revascularisation of the culprit lesion is the therapeutic cornerstone in cardiogenic shock complicating acute myocardial infarction. The optimal management of additional non-culprit lesions is unclear. This systematic review and meta-analysis aims to summarise current evidence on the comparison of immediate multivessel percutaneous coronary intervention (MV-PCI) or culprit lesion only PCI with possible staged revascularisation (C-PCI) in patients with cardiogenic shock complicating acute myocardial infarction...
July 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28701632/clinical-features-and-gaps-in-the-management-of-probable-familial-hypercholesterolemia-and-cardiovascular-disease
#5
Barak Zafrir, Ayman Jubran, Gil Lavie, David A Halon, Moshe Y Flugelman, Chen Shapira
BACKGROUND: Familial hypercholesterolemia (FH) is associated with premature atherosclerotic cardiovascular disease (ASCVD). The introduction of potent therapeutic agents underlies the importance of improving clinical diagnosis and treatment gaps in FH.Methods and Results:A regional database of 1,690 adult patients with high-probability FH based on age-dependent peak-low-density lipoprotein cholesterol (LDL-C) cut-offs and exclusion of secondary causes of severe hypercholesterolemia, was examined to explore the clinical manifestations and current needs in the management of ASCVD, which was present in 248 patients (15%), of whom 83% had coronary artery disease (CAD); 19%, stroke; and 13%, peripheral artery disease...
July 12, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28695977/quality-of-life-in-patients-with-coronary-artery-disease-treated-with-coronary-artery-bypass-grafting-and-hybrid-coronary-revascularization
#6
Karolina Gierszewska, Izabela Jaworska, Michał Skrzypek, Mariusz Gąsior, Robert Pudlo
BACKGROUND: Patients with stable coronary artery disease (CAD) have a worse quality of life (QoL) in comparison to patients without stable CAD. Standardized questionnaires are used in evaluation of QoL. Hybrid coronary revascularization (HCR) is a recently-introduced, minimally invasive option for patients requiring revascularization for coronary lesions. The aim of this study was to assess health-related quality of life (HRQoL) in patients with multivessel CAD (MVCAD), according to the mode of revascularization: coronary artery bypass grafting or HCR, using the generic SF-36 v...
July 11, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28695560/minimally-invasive-extracorporeal-circulation-excellent-outcome-and-life-expectancy-after-coronary-artery-bypass-grafting-surgery
#7
Bernhard Winkler, Paul Philipp Heinisch, Grzegorz Zuk, Katarzyna Zuk, Brigitta Gahl, Hans-Jörg Jenni, Alexander Kadner, Christoph Huber, Thierry Carrel
OBJECTIVE: Coronary artery bypass grafting (CABG) remains the gold standard for complex revascularisation in multivessel disease. The concept of the minimally invasive extracorporeal circulation circuit (MiECC) was introduced to minimise pathophysiological side effects of conventional extracorporeal circulation. This study presents early and long-term outcomes after CABG with use of MiECC in a single-centre consecutive patient cohort. METHODS: From 1 January 2005 to 31 December 2010, 2130 patients underwent isolated CABG with MiECC at our centre...
July 11, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28692459/comparative-determinants-of-5-year-cardiovascular-event-rates-in-patients-with-unprotected-left-main-coronary-artery-disease
#8
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/28682149/glycosylated-haemoglobin-and-coronary-atherosclerosis-in-non-diabetic-patients-is-it-a-prognostic-factor
#9
Reza Ajudani, Mohammad Saeid Rezaee-Zavareh, Hamidreza Karimi-Sari, Mahdi Safiabadi, Fardin Dolatimehr, Mohammadreza Okhovatian, Mahdi Ramezani-Binabaj, Bahram Pishgoo
BACKGROUND: Some studies aimed to evaluate the relationship between HbA1c and coronary artery disease (CAD). However, it is well known that long-term glycometabolic disorders put the heart at risk for CAD. Considering the inconsistencies between previous studies, this study aimed to investigate the relationship between HbA1c and coronary artery atherosclerosis. METHODS: A cross-sectional study was conducted on 411 non-diabetic patients who underwent their first coronary angiography between November 2013 and December 2014 in Baqiyatallah Hospital...
July 6, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28679027/clinical-scintigraphic-and-angiographic-predictors-of-oxygen-pulse-abnormality-in-patients-undergoing-cardiopulmonary-exercise-testing
#10
Andrea De Lorenzo, Carlito Lessa da Silva, Fernando Cesar Castro Souza, Salvador Serra, Pablo Marino, Ronaldo Sl Lima
BACKGROUND: The oxygen (O2 ) pulse curve obtained at cardiopulmonary exercise testing provides information on cardiorespiratory fitness and the presence of cardiovascular disease. O2 pulse abnormalities have been attributed to myocardial ischemia, among other conditions, but the predictors of abnormal O2 pulse curves are not completely known. HYPOTHESIS: Perfusion abnormalities detected by myocardial perfusion scintigraphy (MPS) may be associated with abnormal O2 pulse curves...
July 5, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28660892/reperfusion-strategies-in-acute-myocardial-infarction-and-multivessel-disease
#11
REVIEW
Birgit Vogel, Shamir R Mehta, Roxana Mehran
Approximately 50% of patients with ST-segment elevation myocardial infarction (STEMI) have multivessel disease. The optimal reperfusion strategy in these patients is still uncertain. Whether percutaneous coronary intervention (PCI) of only the culprit vessel or a strategy of complete revascularization, either in a simultaneous or staged multivessel PCI approach, should be performed remains unclear. Although a large number of observational studies have mostly shown worse clinical outcomes associated with a multivessel PCI approach, increasing evidence from randomized controlled trials suggests that multivessel PCI is safe, while reducing the need for revascularization in selected patients, compared with culprit vessel-only PCI...
June 29, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28660768/comparison-of-peri-and-post-procedural-complications-in-patients-undergoing-revascularisation-of-coronary-artery-multivessel-disease-by-coronary-artery-bypass-grafting-or-protected-percutaneous-coronary-intervention-with-the-impella-2-5-device
#12
Tobias Becher, Stefan Baumann, Frederik Eder, Simon Perschka, Dirk Loßnitzer, Christian Fastner, Michael Behnes, Christina Doesch, Martin Borggrefe, Ibrahim Akin
BACKGROUND: While coronary artery bypass grafting remains the standard treatment of complex multivessel coronary artery disease, the advent of peripheral ventricular assist devices has enhanced the safety of percutaneous coronary intervention. We therefore evaluated the safety in terms of inhospital outcome comparing protected high-risk percutaneous coronary intervention with the Impella 2.5 device and coronary artery bypass grafting in patients with complex multivessel coronary artery disease...
June 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28657113/high-burden-of-coronary-atherosclerosis-in-patients-with-cirrhosis
#13
Konstantin Kazankov, Kim Munk, Kristian Altern Øvrehus, Jesper Møller Jensen, Cecilie Brøckner Siggaard, Henning Grønbaek, Bjarne Linde Nørgaard, Hendrik Vilstrup
BACKGROUND: Population studies report increased cardiovascular mortality in patients with cirrhosis. Coronary artery disease may be a trait of end-stage liver disease, but whether it is frequent or extensive in cirrhosis in general is unknown. Thus, we aimed to assess the prevalence and extent of coronary artery disease in unselected cirrhosis patients. MATERIALS AND METHODS: Using coronary computed tomography angiography, we investigated 52 patients from all Child-Pugh classes and etiologies of cirrhosis without known cardiac disease for presence and severity of coronary artery disease in a cross-sectional design...
June 28, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28647440/optimal-percutaneous-coronary-intervention-in-patients-with-st-elevation-myocardial-infarction-and-multivessel-disease-an-updated-large-scale-systematic-review-and-meta-analysis
#14
An Vu Nguyen, Le Van Thanh, Mohamed Gomaa Kamel, Sara Attia Mahmoud Abdelrahman, Mohamed El-Mekawy, Mohamed Ashraf Mokhtar, Aya Ashraf Ali, Nam Nguyen Nho Hoang, Nguyen Lam Vuong, Fatma Abd-Elshahed Abd-Elhay, Omer Abdelbagi Omer, Ahmed Abdou Mohamed, Kenji Hirayama, Nguyen Tien Huy
BACKGROUND: Our study aimed to compare three different percutaneous coronary intervention (PCI) approaches: culprit-only (COR) and complete (CR) revascularization - categorizing into immediate (ICR) or staged (SCR). METHODS: We searched 13 databases for randomized controlled trials. Articles were included if they compared at least two strategies. To have more studies in each analysis, an adjusted analysis was performed using person-years to incorporate follow-up durations and obtain pooled rate ratios (RR), with their corresponding 95% confidence interval...
June 11, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28645959/formal-consensus-to-identify-clinically-important-changes-in-management-resulting-from-the-use-of-cardiovascular-magnetic-resonance-cmr-in-patients-who-activate-the-primary-percutaneous-coronary-intervention-ppci-pathway
#15
Maria Pufulete, Rachel C Brierley, Chiara Bucciarelli-Ducci, John P Greenwood, Stephen Dorman, Richard A Anderson, Jessica Harris, Elisa McAlindon, Chris A Rogers, Barnaby C Reeves
OBJECTIVE: To define important changes in management arising from the use of cardiovascular magnetic resonance (CMR) in patients who activate the primary percutaneous coronary intervention (PPCI) pathway. DESIGN: Formal consensus study using literature review and cardiologist expert opinion to formulate consensus statements and setting up a consensus panel to review the statements (by completing a web-based survey, attending a face-to-face meeting to discuss survey results and modify the survey to reflect group discussion and completing the modified survey to determine which statements were in consensus)...
June 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28632690/noninvasive-nuclear-spect-myocardial-blood-flow-quantitation-to-guide-management-for-coronary-artery-disease
#16
Lung-Ching Chen, Bor-Hsin Jong, Sheng-Che Lin, Chi-Tai Ku, Ing-Jou Chen, Yen-Kung Chen, Bailing Hsu
Recently, myocardial blood flow quantitation with dynamic SPECT has been validated to enhance the detection of multivessel coronary artery disease (CAD) and conclude equivocal SPECT myocardial perfusion study. This advance opened an important clinical application to utilize the tool in guiding CAD management for area where myocardial perfusion tracers for PET are unavailable or unaffordable. We present a clinical patient with ongoing recursive angina who underwent multiple nuclear stress tests for a sequence of CAD evaluation in 26 months and demonstrated that SPECT myocardial blood flow quantitation properly guided CAD management to warrant patient outcome...
June 19, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28629780/is-bilateral-internal-thoracic-artery-grafting-a-safe-option-for-chronic-dialysis-patients
#17
Giuseppe Gatti, Andrea Perrotti, Antonio Fiore, Eric Bergoend, Sidney Chocron, Jean-Paul Couetil, Gianfranco Sinagra, Aniello Pappalardo
BACKGROUND: The use of bilateral internal thoracic artery (BITA) grafting has been proposed for dialysis patients with multivessel coronary artery disease, primarily because of hypothetical long-term survival benefits. AIMS: To investigate the outcome of BITA grafting in dialysis patients. METHODS: This was a retrospective analysis of the use of BITA grafting in 105 consecutive patients with end-stage renal failure on chronic dialysis in three European centres with extensive experience in BITA...
June 16, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28617684/non-infarct-related-artery-revascularization-in-st-segment-elevation-myocardial-infarction-patients-with-multivessel-disease
#18
Asim N Cheema, Shamir R Mehta, Subodh Verma, Akshay Bagai
PURPOSE OF REVIEW: Multivessel disease (MVD) is common in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) and is associated with significant risk of future cardiovascular (CV) events including short and longer-term mortality. In this review, we examine the pathophysiologic construct contributing to adverse prognosis of MVD in STEMI, relevant available evidence that currently guides the management of the noninfarct-related artery (IRA) stenosis and define the remaining knowledge gaps for future studies...
June 15, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28611782/long-term-percutaneous-coronary-intervention-outcomes-of-patients-with-chronic-kidney-disease-in-the-era-of-second-generation-drug-eluting-stents
#19
Wojciech Wańha, Damian Kawecki, Tomasz Roleder, Aleksandra Pluta, Kamil Marcinkiewicz, Beata Morawiec, Janusz Dola, Sylwia Gładysz, Tomasz Pawłowski, Grzegorz Smolka, Andrzej Ochała, Ewa Nowalany-Kozielska, Wojciech Wojakowski
BACKGROUND: The following registry (Katowice-Zabrze retrospective registry) aimed to assess the influence of a chronic kidney disease (CKD) on long-term clinical outcomes in patients undergoing percutaneous coronary intervention (PCI) using either first-generation (DES-I) or second-generation (DES-II) drug-eluting stents. METHODS: The study group consisted of 1,908 consecutive patients, of whom 331 (17.3%) had CKD. CKD was defined as an estimated glomerular filtration rate of <60 mL/min/m(2)...
February 2017: Cardiorenal Medicine
https://www.readbyqxmd.com/read/28602369/heart-failure-complicating-acute-mtyocardial-infarction
#20
REVIEW
Wilbert S Aronow
Factors predisposing the older person with acute myocardial infarction (MI) to develop heart failure (HF) include an increased prevalence of MI, multivessel coronary artery disease, decreased left ventricular (LV) contractile reserve, impairment of LV diastolic relaxation, increased hypertension, LV hypertrophy, diabetes mellitus, valvular heart disease, and renal insufficiency. HF associated with acute MI should be treated with a loop diuretic. The use of nitrates, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, aldosterone antagonists, beta-blockers, digoxin, and positive inotropic drugs; treatment of arrhythmias and mechanical complications; and indications for use of implantable cardioverter-defibrillators and cardiac resynchronization is discussed...
July 2017: Heart Failure Clinics
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