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multi vessel stage pci

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https://www.readbyqxmd.com/read/29560788/major-adverse-cardiovascular-events-while-awaiting-staged-non-culprit-percutaneous-coronary-intervention-after-st-segment-elevation-myocardial-infarction
#1
Keir McCutcheon, Andreas S Triantafyllis, Thomas Marynissen, Tom Adriaenssens, Johan Bennett, Christophe Dubois, Peter R Sinnaeve, Walter Desmet
BACKGROUND: The optimal therapeutic strategy for ST-segment elevation myocardial infarction (STEMI) patients found to have multi-vessel disease (MVD) is controversial but recent data support complete revascularisation (CR). Whether CR should be completed during the index admission or during a second staged admission remains unclear. Our main objective was to measure rates of major adverse cardiovascular events (MACEs) during the waiting period in STEMI patients selected for staged revascularisation (SR), in order to determine the safety of delaying CR...
March 21, 2018: Acta Cardiologica
https://www.readbyqxmd.com/read/29393604/how-the-functional-assessment-of-culprit-and-non-culprit-lesions-may-improve-stratification-and-treatment-of-stemi-patients
#2
Gianluca Campo, Francesco Gallo, Giulia Bugani, Rita Pavasini, Massimo Fineschi
Reperfusion therapy of the infarct-related artery (IRA) with primary percutaneous coronary intervention (pPCI) is the cornerstone for the treatment of patients with ST-elevation myocardial infarction (STEMI). However, up to 30% of STEMI patients present a multi-vessel coronary artery disease. Several methods are now available for the assessment of functional severity of a coronary stenosis both for IRA and non culprit coronary lesions. The functional assessment of the IRA has mainly a prognostic implication in terms of major adverse cardiovascular events (MACEs), recovery of left ventricular function and evaluation myocardial viability...
February 1, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29316058/patients-preferences-for-coronary-bypass-grafting-or-staged-percutaneous-coronary-intervention-in-multi-vessel-coronary-artery-disease
#3
Marc-Alexander Ohlow, Ahmed Farah, Thomas Kuntze, Bernward Lauer
BACKGROUND: The decision for coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) in patients with multi-vessel coronary artery disease (mCAD) is currently made by a heart-team approach. Patients' preference is less well investigated. METHODS: All consecutive patients with prior CABG and at least 2 PCI procedures were interviewed whether they would elect bypass surgery or staged PCI in case of a hypothetical scenario in which they had mCAD and CABG or PCI will equally improve symptoms and survival...
January 9, 2018: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/29297472/effect-of-hybrid-treatment-on-rehabilitation-and-clinical-condition-of-patients-with-multivessel-coronary-artery-disease
#4
Joanna Foik, Anna Brzęk, Marek J Gierlotka, Michał O Zembala, Mariusz Gąsior, Marian Zembala
INTRODUCTION    Rehabilitation after coronary revascularization procedures is an intrinsic part of treatment during the in‑hospital period. OBJECTIVES    We aimed to compare the course and effects of rehabilitation in patients receiving hybrid treatment (minimally invasive direct coronary artery bypass / percutaneous coronary intervention) or classic treatment (coronary artery bypass grafting / off‑pump coronary artery bypass) during hospitalization. PATIENTS AND METHODS    The study included 200 patients participating in a prospective randomized clinical trial (POLMIDES) that assessed the effect of hybrid treatment on in‑hospital outcomes and long‑term results in patients with multivessel coronary artery disease...
February 28, 2018: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/29151496/cost-effectiveness-analysis-of-cardiovascular-disease-treatment-in-japan
#5
REVIEW
Satoshi Kodera, Arihiro Kiyosue, Jiro Ando, Hiroshi Akazawa, Hiroyuki Morita, Masafumi Watanabe, Issei Komuro
The quality-adjusted life year (QALY) and incremental cost-effectiveness ratio (ICER) are important concepts in cost-effectiveness analysis, which is becoming increasingly important in Japan. QALY is used to estimate quality of life (QOL) and life years, and can be used to compare the efficacies of cancer and cardiovascular treatments. ICER is defined as the difference in cost between treatments divided by the difference in their effects, with a smaller ICER indicating better cost-effectiveness. Here, we present a review of cost-effectiveness analyses in Japan as well other countries...
December 12, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28762902/-outcomes-of-various-revascularisation-strategies-in-the-elderly-stemi-patients-with-multi-vessel-coronary-pathology
#6
R S Tarasov, A M Kochergina, V I Ganyukov, V V Kashtalap, N A Kochergin, O L Barbarash
AIM: to assess safety and efficacy of single stage complete revascularization by multivessel stenting as primary percutaneous coronary intervention (pPCI) in elderly and middle aged patients with acute ST-elevation myocardial infarction (STEMI). MATERIAL AND METHODS: We included in this analysis data on 327 of 1690 STEMI patients who had undergone pPCI from 2009 to 2013. Age of 103 patients was more or equal 65 and of 224 less or equal 64 years. Multivessel stenting (MS) during pPCI was carried out in 26 and 65, while strategy of staged revascularization (SR) was implemented in 77 and 129 individuals among older and younger patients, respectively...
April 2017: Kardiologiia
https://www.readbyqxmd.com/read/28400078/comparison-of-coronary-artery-bypass-grafting-and-drug-eluting-stents-in-patients-with-chronic-kidney-disease-and-multivessel-disease-a-meta-analysis
#7
Yushu Wang, Sui Zhu, Peijuan Gao, Qing Zhang
BACKGROUND: The optimal revascularization strategy of coronary artery bypass grafting (CABG) versus percutaneous coronary intervention with drug-eluting stent (PCI-DES) in patients with chronic kidney disease (CKD) and multivessel disease (MVD) remains unclear. METHODS: Pubmed, EMBASE and Cochrane Library electronic databases were searched from inception until June 2016. Studies that evaluate the comparative benefits of DES versus CABG in CKD patients with multi-vessel disease were considered for inclusion...
April 8, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28135709/acute-kidney-injury-and-in-hospital-mortality-after-coronary-artery-bypass-graft-versus-percutaneous-coronary-intervention-a-nationwide-study
#8
Wen Shen, Rodrigo Aguilar, Alex R Montero, Stephen J Fernandez, Allen J Taylor, Christopher S Wilcox, Michael S Lipkowitz, Jason G Umans
BACKGROUND: Post-procedural acute kidney injury (AKI) is associated with significantly increased short- and long-term mortalities, and renal loss. Few studies have compared the incidence of post-procedural AKI and in-hospital mortality between 2 major modalities of revascularization - coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) - and results have been inconsistent. METHODS: We generated a propensity score-matched cohort that includes a total of 286,670 hospitalizations with multi-vessel coronary disease undergoing CABG or PCI (2004-2012) from the National Inpatient Sample database...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28107455/staged-versus-one-time-complete-revascularization-with-percutaneous-coronary-intervention-in-stemi-patients-with-multivessel-disease-a-systematic-review-and-meta-analysis
#9
REVIEW
Zhenwei Li, Yijiang Zhou, Qingqing Xu, Xiaomin Chen
INTRODUCTION: In patients with acute ST-elevation myocardial infarction (STEMI), the preferred intervention is percutaneous coronary intervention (PCI).Whether staged PCI (S-PCI) or one-time complete PCI (MV-PCI) is more beneficial and safer in terms of treating the non-culprit vessel during the primary PCI procedure is unclear. We performed a meta-analysis of all randomized and non-randomized controlled trials comparing S-PCI with MV-PCI in patients with acute STEMI and MVD. METHODS: Studies of STEMI with multivessel disease receiving primary PCI were searched in PUBMED, EMBASE and The Cochrane Register of Controlled Trials from January 2004 to December 2014...
2017: PloS One
https://www.readbyqxmd.com/read/27357434/timing-of-staged-percutaneous-coronary-intervention-for-a-non-culprit-lesion-in-patients-with-anterior-wall-st-segment-elevation-myocardial-infarction-with-multiple-vessel-disease
#10
COMPARATIVE STUDY
Wei-Chieh Lee, Bo-Jui Wu, Chih-Yuan Fang, Chien-Jen Chen, Cheng-Hsu Yang, Hon-Kan Yip, Chi-Ling Hang, Chiung-Jen Wu, Hsiu-Yu Fang
The optimal timing of a staged percutaneous coronary intervention (PCI) for non-culprit lesions in patients with STsegment elevation myocardial infarction (STEMI) patients with multi-vessel disease (MVD) remains controversial. We focused on patients with anterior wall STEMI with MVD and determined the clinical effects for timing of staged PCI.From November 2005 to December 2014, 258 patients were diagnosed with anterior wall STEMI with MVD in our hospital. Among them, 37 patients received staged PCI within 3 weeks, 50 patients received staged PCI during 3 weeks to one year, and 167 patients received only primary PCI for culprit lesions...
July 27, 2016: International Heart Journal
https://www.readbyqxmd.com/read/27179310/platelet-reactivity-in-patients-receiving-a-maintenance-dose-of-p2y12-adp-receptor-antagonists-undergoing-elective-percutaneous-coronary-intervention
#11
Laurent Bonello, Marc Laine, Franck Thuny, Franck Paganelli, Gilles Lemesle, Antoine Roch, François Kerbaul, Françoise Dignat-George, Julie Berbis, Corinne Frere
BACKGROUND: P2Y12-ADP receptor blockade during percutaneous coronary intervention (PCI) is critical to prevent thrombotic events. In patients under chronic P2Y12 blockers, the use of additional loading dose (LD) before an elective PCI is debated. We aimed to investigate the rate of high on-treatment platelet reactivity (HTPR) in patients undergoing elective PCI during chronic clopidogrel or ticagrelor therapy. METHODS AND RESULTS: We performed a sub-group analysis of a randomized trial comparing ticagrelor and clopidogrel in acute coronary syndrome (ACS) patients undergoing PCI...
August 1, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/26831901/time-related-changes-in-neointimal-tissue-coverage-of-a-novel-sirolimus-eluting-stent-serial-observations-with-optical-coherence-tomography
#12
Gioel Gabrio Secco, Alessio Mattesini, Rossella Fattori, Rosario Parisi, Fausto Castriota, Matteo Vercellino, Gianni Dall'Ara, Lucia Uguccioni, Lucia Marinucci, Giuseppe De Luca, Paolo Nicola Marino, Gianfranco Pistis, Carlo Di Mario
BACKGROUND: DES has reduced rates of restenosis compared with BMS but it has been associated with delayed healing and increase of stent thrombosis. The aim of our study was to evaluate the vascular time-related changes following implantation of a new SES coated with an amorphous silicon carbide that allows faster re-endothelisation (Orsiro-Biotronik). METHODS: This prospective registry enrolled STEMI-patients with multi-vessel disease, thus candidates for a two-step procedure...
January 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/26796390/single-staged-compared-with-multi-staged-pci-in-multivessel-nstemi-patients-the-smile-trial
#13
COMMENT
Gennaro Sardella, Luigi Lucisano, Roberto Garbo, Mauro Pennacchi, Erika Cavallo, Rocco Edoardo Stio, Simone Calcagno, Fabrizio Ugo, Giacomo Boccuzzi, Francesco Fedele, Massimo Mancone
BACKGROUND: A lack of clarity exists about the role of complete coronary revascularization in patients presenting with non-ST-segment elevation myocardial infarction. OBJECTIVES: The aim of our study was to compare long-term outcomes in terms of major adverse cardiovascular and cerebrovascular events of 2 different complete coronary revascularization strategies in patients with non-ST-segment elevation myocardial infarction and multivessel coronary artery disease: 1-stage percutaneous coronary intervention (1S-PCI) during the index procedure versus multistage percutaneous coronary intervention (MS-PCI) complete coronary revascularization during the index hospitalization...
January 26, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/26526421/completeness-of-revascularization-and-its-impact-on-the-outcomes-of-a-staged-approach-of-percutaneous-coronary-intervention-followed-by-minimally-invasive-valve-surgery-for-patients-with-concomitant-coronary-artery-and-valvular-heart-disease
#14
COMPARATIVE STUDY
Andrés M Pineda, Ramesh Chandra, Saqib A Gowani, Orlando Santana, Christos G Mihos, Ajay J Kirtane, Gregg W Stone, Paul Kurlansky, Craig R Smith, Nirat Beohar
BACKGROUND: A staged approach of percutaneous coronary intervention (PCI) followed by minimally invasive valve surgery (MIVS) is an alternative to the conventional combined coronary artery bypass and valve surgery for patients with concomitant coronary artery and valve disease. Limited data exist on degree of the completeness of revascularization achieved with this approach and its impact on outcomes. METHODS: A total of 138 patients, who underwent a staged approach between January 2009 and June 2013, were retrospectively evaluated...
September 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/26508415/description-of-a-heart-team-approach-to-coronary-revascularization-and-its-beneficial-long-term-effect-on-clinical-events-after-pci
#15
Tassilo Bonzel, Volker Schächinger, Hilmar Dörge
OBJECTIVE AND BACKGROUND: We present a first description of a Heart Team (HT)-guided approach to coronary revascularization and its long-term effect on clinical events after percutaneous coronary intervention (PCI). The HT approach is a structured process to decide for coronary bypass grafting (CABG), PCI or conservative therapy in ad hoc situations as well as in HT conferences. As a hypothesis, during the long-term course after a PCI performed according to HT rules, a low number of late revascularizations, especially CABGs, are expected (F-PCI study)...
May 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/26089845/culprit-vessel-only-versus-one-week-staged-percutaneous-coronary-intervention-for-multivessel-disease-in-patients-presenting-with-st-segment-elevation-myocardial-infarction
#16
Li-Xiang Ma, Zhen-Hua Lu, Le Wang, Xin Du, Chang-Sheng Ma
OBJECTIVE: To explore the impact of a "one-week" staged multivessel percutaneous coronary intervention (PCI) versus culprit-only PCI on deaths and major adverse cardiac events (MACE). METHODS: We retrospectively analyzed 447 patients with multivessel disease who experienced a ST-segment elevation myocardial infarction (STEMI) within 12 h before undergoing PCI between July 26, 2008 and September 25, 2011. After completion of PCI in the infarct artery, 201 patients still in the hospital agreed to undergo PCI in non-infarct arteries with more than 70% stenosis for a "one-week" staged multivessel PCI...
May 2015: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/25757964/-evaluation-of-different-revascularization-strategies-for-patients-with-acute-myocardial-infarction-with-lesions-of-multiple-coronary-arteries-after-primary-percutaneous-coronary-intervention-and-its-economic-evaluation
#17
RANDOMIZED CONTROLLED TRIAL
Jing Zhang, Qingsheng Wang, Hongmei Yang, Lixiang Ma, Xianghua Fu, Weijing Hou, Jianshuang Feng, Xiaoyuan Liu
OBJECTIVE: To investigate the effect and medical cost of different revascularization strategies for acute myocardial infarction (AMI) patients with multi-vessel disease (MVD). METHODS: A prospective randomized controlled trial (RCT) was conducted. From January 2009 to June 2012, patients with AMI and MVD undergoing primary percutaneous coronary intervention (PCI) were enrolled. They were randomly assigned to group A [staged PCI for non-infarction related artery (non-IRA) within 7-10 days after AMI] and group B (subsequent PCI for non-IRA recommended only for those with evidence of ischemia)...
March 2015: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/25454258/multi-vessel-versus-culprit-vessel-and-staged-percutaneous-coronary-intervention-in-stemi-patients-with-multivessel-disease-a-meta-analysis-of-randomized-controlled-trials
#18
Khagendra Dahal, Jharendra Rijal, Raju Panta, Juyong Lee, Michael Azrin, Robert Lootens
INTRODUCTION: Percutaneous coronary intervention (PCI) is preferred in patients with acute ST-elevation myocardial infarction (STEMI). In patients with acute STEMI with multivessel disease (MVD), the guidelines recommend culprit vessel PCI (CV-PCI) in the absence of hemodynamic instability. We performed a meta-analysis of all randomized controlled trials (RCTs) comparing multi-vessel PCI (MV-PCI) with CV-PCI or staged PCI (S-PCI) in patients with acute STEMI and MVD. METHODS: PubMed, EMBASE and CENTRAL were searched for publications since inception to December 2013...
November 2014: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/24580774/meta-analysis-of-the-effect-of-percutaneous-coronary-intervention-on-chronic-total-coronary-occlusions
#19
Ruogu Li, Shuansuo Yang, Lei Tang, Yiqing Yang, Hui Chen, Shaofeng Guan, Wenzheng Han, Hua Liu, Jinjie Dai, Qian Gan, Weiyi Fang, Xinkai Qu
BACKGROUND AND PURPOSE: Coronary chronic total occlusion (CTO) is the last stage of coronary artery atherosclerosis. Percutaneous coronary intervention (PCI) is a therapeutic procedure used to recanalize vessels with total occlusion. However, successful recanalization of CTO is still not optimal, and the key influence factors are still uncertainty. Therefore, a scientific evaluation on the effective of PCI for CTO treatment is necessary. METHODS: Relevant studies of PCI treatment for CTO were examined...
2014: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/23065469/how-should-we-treat-multi-vessel-disease-in-stemi-patients
#20
Victar Hsieh, Shamir R Mehta
Primary angioplasty of the culprit coronary artery lesion is the preferred reperfusion strategy for ST-elevation myocardial infarction (STEMI) when timely access to a catheterization laboratory is available. The presence of multi-vessel disease (MVD) in patients undergoing primary PCI is common, occurring in about 40 %-50 % of patients. The presence of MVD in patients who have undergone successful primary PCI substantially increases the risks of mortality and major adverse cardiac events, such as reinfarction or need for urgent revascularization...
February 2013: Current Treatment Options in Cardiovascular Medicine
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