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cardiac revascularization

Hassan Aghajani, Paniz Nezami, Akbar Shafiee, Arash Jalali, Alireza Nezami, Younes Nozari, Hamidreza Pourhosseini, Seyed Ebrahim Kassaian, Mojtaba Salarifar, Alimohammad Hajzeinali, Alireza Amirzadegan, Mohammad Alidoosti, Ebrahim Nematipour
BACKGROUND: We aimed to recognize the predictors of long-term major adverse cardiac events (MACE) in the elderly candidates for elective percutaneous coronary intervention (PCI) at our center. METHODS: In this retrospective cohort study, we reviewed the data of the elderly (age ≥65 years) candidates for elective PCI who met our study criteria, at Tehran heart center between 2004 and 2013. Demographic, anthropometric, clinical, angiographic, procedural and follow-up data of the enrolled patients were retrieved from the angiography/PCI databank of our center...
August 1, 2018: Archives of Iranian Medicine
Ping Zhu, Xin Zhou, Chenliang Zhang, Huakang Li, Zhihui Zhang, Zhiyuan Song
BACKGROUND: The Orsiro biodegradable polymer sirolimus-eluting stent (O-SES) is a new-generation biodegradable polymer drug-eluting stent with the thinnest strut thickness to date developed to improve the percutaneous treatment of patients with coronary artery disease. We perform a meta-analysis of randomized clinical trials (RCTs) comparing the efficacy and safety of an ultra-thin, Orsiro biodegradable polymer sirolimus-eluting stent (O-SES) compared with durable polymer drug-eluting stents (DP-DESs)...
August 15, 2018: BMC Cardiovascular Disorders
Lin Li, Qi Wei Liu, Zhe Li, Li Wang, Jian Hong Wang, Lei Song, Bin Li
OBJECTIVE: It remains controversial whether patients with fractional flow reserve (FFR) values of 0.75-0.80 (gray-zone) should be treated with percutaneous coronary intervention (PCI). This study aimed to evaluate the prediction of high-sensitivity C-reactive protein (hs-CRP) levels to guide treatment selection in gray-zone patients. METHODS: This prospective interventional trial was conducted between January 2015 and March 2016. A total of 785 patients with stable angina and single-vessel stenosis with moderate coronary lesions were admitted to hospital in this period...
August 15, 2018: Anatolian Journal of Cardiology
Lu Liu, Jing Liu, Qun Gao, Yang Wu, Jinjin Lu, Jie Wan, Yan Li, Xiaoyun Cui, Kun Zhou, Wenhao Jia, Yanchao Huang, Wenbai Qu, Qian Lin
Objective: To examine the effects and safety of oral compound Chinese medicine (CCM) plus routine western medicine (RWM) in in-stent restenosis (ISR). Methods: Various electronic databases (CBM, CNKI, VIP, Wanfang, PubMed, EMBASE, and Cochrane Library) were searched until April 2017. The quality of the included studies was evaluated, and meta-analyses were performed using RevMan5.3 and STATA 12.0 software. Moreover, funnel plot and Egger's publication bias plots were analysed to identify publication bias and adverse reactions were reported...
2018: Evidence-based Complementary and Alternative Medicine: ECAM
Antonio Maria Leone, Pio Cialdella, Francesca Lassandro Pepe, Eloisa Basile, Giuseppe Zimbardo, Manfredi Arioti, Giovanna Ciriello, Domenico D'Amario, Antonino Buffon, Francesco Burzotta, Italo Porto, Cristina Aurigemma, Giampaolo Niccoli, Antonio G Rebuzzi, Carlo Trani, Filippo Crea
BACKGROUND: Fractional Flow Reserve (FFR) in Stable Ischemic Heart Disease (SIHD) is universally accepted, while in Acute Coronary Syndromes (ACS) is less established. Aims of this retrospective study were: to compare in patients undergoing FFR assessment the prognostic impact of ACS vs SIHD, to evaluate the clinical relevance of the modality of utilization and timing of FFR assessment and to assess the different outcomes associated with an FFR> or ≤0.80. METHODS: Major cardiac adverse events were assessed at a follow up of 16...
August 9, 2018: International Journal of Cardiology
Jessica O'Brien, Christopher M Reid, Nick Andrianopoulos, Andrew E Ajani, David J Clark, Henry Krum, Philippa Loane, Melanie Freeman, Martin Sebastian, Angela L Brennan, James Shaw, Anthony M Dart, Stephen J Duffy
Data from previous studies of patients with heart failure and coronary artery disease suggest that those with higher resting heart rates (HRs) have worse cardiovascular outcomes. We sought to evaluate whether HR immediately before percutaneous coronary intervention (PCI) is an independent predictor for 30-day outcome. We analyzed the outcome of 3,720 patients who had HR recorded before PCI from the Melbourne Interventional Group registry. HR and outcomes were analyzed by quintiles, and secondarily by dichotomizing into <70 or ≥70 beats/min...
July 4, 2018: American Journal of Cardiology
Xiao-Fang Tang, Yuan-Liang Ma, Ying Song, Jing-Jing Xu, Yi Yao, Chen He, Huan-Huan Wang, Ping Jiang, Lin Jiang, Ru Liu, Zhan Gao, Xue-Yan Zhao, Shu-Bin Qiao, Yue-Jin Yang, Run-Lin Gao, Bo Xu, Jin-Qing Yuan
BACKGROUND: To improve outcomes in patients with diabetes mellitus (DM) undergoing percutaneous coronary intervention remain an unmet clinical need. The study aimed to evaluate the efficacy and safety of G2-DESs and BP-DESs in patients with and without DM in a single center in China. METHODS: A total of 7666 consecutive patients who exclusively had G2-DES or BP-DES implantation throughout 2013 in our center were studied. The primary efficacy endpoint was any target lesion revascularization (TLR), whereas the primary safety endpoint was a composite of death or myocardial infarction (MI) at 2-year follow-up...
August 14, 2018: Cardiovascular Diabetology
Marija Polovina, Gerhard Hindricks, Aldo Maggioni, Massimo Piepoli, Panos Vardas, Milika Ašanin, Dijana Ðikic, Nemanja Ðuricic, Ivan Milinkovic, Petar M Seferovic
Aims: Evidence suggests an excess risk of non-thromboembolic major adverse cardiac events (MACE) associated with atrial fibrillation (AF), particularly in individuals free of overt coronary artery disease (CAD). Metabolic syndrome (MetS) increases cardiovascular risk in the general population, but less is known how it influences outcomes in AF patients. We aimed to assess whether MetS affects the risk of MACE in AF patients without overt CAD. Methods and results: This prospective, observational study enrolled 843 AF patients (mean-age, 62...
August 7, 2018: European Heart Journal
Mohamed Khalfallah, Ayman Elsheikh, Mohamed Abdalaal
BACKGROUND: The proper time for the use of percutaneous coronary intervention (PCI) following the successful fibrinolysis for ST-segment elevation myocardial infarction (STEMI) for maximum efficiency and minimum side effects has not been determined yet. The present study was designed to compare the outcome of myocardial infarction patients who received fibrinolytic therapy with successful results and underwent PCI very early (within 3-12 h) (group 1) versus early (within 12-24 h) (group 2)...
August 8, 2018: Global Heart
Fabio Ramponi, Michael Seco, James B Edelman, Andrew G Sherrah, Paul G Bannon, R John L Brereton, Michael K Wilson, Michael P Vallely
Coronary surgery performed on an arrested heart, using one internal mammary artery and a saphenous vein carries two main potential drawbacks: the known failure rate of vein grafts and the relatively high rate of neurologic injury. To address these concerns, we describe a technique that achieves complete revascularization without manipulating the ascending aorta (anaortic, off-pump) and utilizing total arterial grafts. All patients undergo thorough preoperative investigation, including bilateral carotid, vertebral and subclavian artery Duplex ultrasounds...
July 2018: Annals of Cardiothoracic Surgery
Duk-Woo Park, Jung-Min Ahn, Seung-Jung Park, David P Taggart
Although coronary-artery bypass grafting (CABG) is the standard choice of revascularization for significant left main coronary artery (LMCA) disease, percutaneous coronary intervention (PCI) for LMCA disease has been widely expanded with adoption of drug-eluting stents (DES). Several small- and moderate-sized trials of CABG and first-generation DES showed that PCI might be a good alternative for selected patients with LMCA disease. However, these early trials were relatively underpowered and comparative results of contemporary DES and CABG were clearly required...
July 2018: Annals of Cardiothoracic Surgery
Derrick Y Tam, Saswata Deb, Bao Nguyen, Dennis T Ko, Reena Karkhanis, Fuad Moussa, Jaclyn Fremes, Eric A Cohen, Sam Radhakrishnan, Stephen E Fremes
Background: Studies have demonstrated that female sex is an adverse risk factor in CABG. The primary aim of this study was to determine whether the radial artery (RA) was associated with reduced angiographic occlusion compared to the saphenous vein graft (SVG) stratified by sex in the multi-centered Radial Artery Patency Study (NCT00187356). Methods: Between 1996-2001, 529 patients less than 80 years, with graftable triple-vessel disease underwent isolated CABG across 11 centers with late angiographic and clinical follow-up...
July 2018: Annals of Cardiothoracic Surgery
Ki Hong Choi, Joo Myung Lee, Il Park, Jihoon Kim, Tae-Min Rhee, Doyeon Hwang, Jonghanne Park, Taek Kyu Park, Jeong Hoon Yang, Young Bin Song, Joo-Yong Hahn, Dong Seop Jeong, Yang Hyun Cho, Wook Sung Kim, Kiick Sung, Mi Ja Jang, Ji Dong Sung, Jin-Ho Choi, Seung-Hyuk Choi, Bon-Kwon Koo, Young Tak Lee, Eun Kyoung Kim, Sung A Chang, Sung-Ji Park, Jin-Oh Choi, Sang-Chol Lee, Seung Woo Park, Young Seok Cho, Joon Young Choi, Hyeon-Cheol Gwon, Jae K Oh
BACKGROUND: There have been limited and conflicting results regarding the prognostic impact of revascularization treatment on the long-term clinical outcomes of silent ischemia. The current study aimed to determine whether revascularization treatment compared with medical treatment (MT) alone reduces long-term risk of cardiac death of asymptomatic patients with objective evidence of inducible myocardial ischemia. METHODS: A total of 1473 consecutive asymptomatic patients with evidence of inducible myocardial ischemia were selected from a prospective institutional registry...
August 3, 2018: International Journal of Cardiology
Javier Escaned, Nicola Ryan, Hernán Mejía-Rentería, Christopher M Cook, Hakim-Moulay Dehbi, Eduardo Alegria-Barrero, Ali Alghamdi, Rasha Al-Lamee, John Altman, Alphonse Ambrosia, Sérgio B Baptista, Maria Bertilsson, Ravinay Bhindi, Mats Birgander, Waldemar Bojara, Salvatore Brugaletta, Christopher Buller, Fredrik Calais, Pedro Canas Silva, Jörg Carlsson, Evald H Christiansen, Mikael Danielewicz, Carlo Di Mario, Joon-Hyung Doh, Andrejs Erglis, David Erlinge, Robert T Gerber, Olaf Going, Ingibjörg Gudmundsdottir, Tobias Härle, Dario Hauer, Farrel Hellig, Ciro Indolfi, Lars Jakobsen, Luc Janssens, Jens Jensen, Allen Jeremias, Amra Kåregren, Ann-Charlotte Karlsson, Rajesh K Kharbanda, Ahmed Khashaba, Yuetsu Kikuta, Florian Krackhardt, Bon-Kwon Koo, Sasha Koul, Mika Laine, Sam J Lehman, Pontus Lindroos, Iqbal S Malik, Michael Maeng, Hitoshi Matsuo, Martijn Meuwissen, Chang-Wook Nam, Giampaolo Niccoli, Sukhjinder S Nijjer, Hans Olsson, Sven-Erik Olsson, Elmir Omerovic, Georgios Panayi, Ricardo Petraco, Jan J Piek, Flavo Ribichini, Habib Samady, Bruce Samuels, Lennart Sandhall, James Sapontis, Sayan Sen, Arnold H Seto, Murat Sezer, Andrew S P Sharp, Eun-Seok Shin, Jasvindar Singh, Hiroaki Takashima, Suneel Talwar, Nobuhiro Tanaka, Kare Tang, Eric Van Belle, Niels van Royen, Christoph Varenhorst, Hugo Vinhas, Christiaan J Vrints, Darren Walters, Hiroyoshi Yokoi, Ole Fröbert, Manesh R Patel, Patrick Serruys, Justin E Davies, Matthias Götberg
OBJECTIVES: The aim of this study was to investigate the clinical outcomes of patients deferred from coronary revascularization on the basis of instantaneous wave-free ratio (iFR) or fractional flow reserve (FFR) measurements in stable angina pectoris (SAP) and acute coronary syndromes (ACS). BACKGROUND: Assessment of coronary stenosis severity with pressure guidewires is recommended to determine the need for myocardial revascularization. METHODS: The safety of deferral of coronary revascularization in the pooled per-protocol population (n = 4,486) of the DEFINE-FLAIR (Functional Lesion Assessment of Intermediate Stenosis to Guide Revascularisation) and iFR-SWEDEHEART (Instantaneous Wave-Free Ratio Versus Fractional Flow Reserve in Patients With Stable Angina Pectoris or Acute Coronary Syndrome) randomized clinical trials was investigated...
August 13, 2018: JACC. Cardiovascular Interventions
Joo Myung Lee, Ki Hong Choi, Doyeon Hwang, Jonghanne Park, Ji-Hyun Jung, Hyung Yoon Kim, Hae Won Jung, Yun-Kyeong Cho, Hyuck-Jun Yoon, Young Bin Song, Joo-Yong Hahn, Joon-Hyung Doh, Chang-Wook Nam, Eun-Seok Shin, Seung-Ho Hur, Bon-Kwon Koo
OBJECTIVES: This study investigated the prognostic implication of coronary flow reserve (CFR) in patients who underwent fractional flow reserve (FFR) measurement. BACKGROUND: Limited data are available regarding the long-term prognosis associated with thermodilution CFR in patients with coronary artery disease. METHODS: A total of 519 patients (737 vessels) who did not undergo revascularization were classified according to FFR and CFR values...
August 13, 2018: JACC. Cardiovascular Interventions
Gianni Dall'Ara, Simone Grotti, Elisa Conficoni, Armando Zammarchi, Ottorino Catapano, Filippo Ottani, Fabio Tarantino, Marcello Galvani
The recommended treatment for ST-segment elevation myocardial infarction (STEMI) is primary percutaneous coronary intervention (pPCI). However, in a non-negligible proportion of patients, pPCI is ineffective and the cardiologist must face the decision of how to achieve optimal myocardial reperfusion. Although the possibility of a rescue fibrinolytic strategy has not been evaluated yet in this clinical setting, it is a viable alternative to emergency cardiac surgery. We here report the case of a 60-year-old STEMI patient presenting with a coronary anatomy unsuitable for percutaneous mechanical revascularization, characterized by marked dilation and tortuosity of the proximal and middle epicardial segments...
September 2018: Giornale Italiano di Cardiologia
Christine Attenhofer Jost, Philippe Müller, Osmund Bertel, Barbara Naegeli, Christoph Scharf, Peter Wenaweser, Franz Wolfgang Amann
The Old-Age Heart Abstract. Knowledge of cardiovascular changes in old age and their therapeutic options is important. Old age can lead to hypertrophy of the left ventricle, diastolic dysfunction, heart valve changes and pulmonary hypertension. Patients often develop arterial hypertension. Valvular changes are common in people over 100 years of age (aortic stenosis and mitral insufficiency). The risk of coronary heart disease is 35 % for men and 24 % for women. In old age, sinus node dysfunction and atrial fibrillation are common...
August 2018: Praxis
Tetsuro Tsujimoto, Hiroshi Kajio
BACKGROUND: Pulse pressure may be potentially useful for selecting effective cardiac treatment strategies. This study aimed to assess the association between the cardiac treatment strategies and risk of major adverse cardiovascular events (MACE) in patients with type 2 diabetes and coronary artery disease (CAD), based on low or high levels of pulse pressure. METHODS: We analyzed data from the Bypass Angioplasty Revascularization Investigation 2 Diabetes trial and calculated hazard ratios (HRs) for MACE with 95% confidence intervals (95%CIs) using the Cox proportional hazard model...
August 2, 2018: International Journal of Cardiology
Daniel A Jones, Peter Whittaker, Krishnaraj S Rathod, Amy J Richards, Mervyn Andiapen, Sotiris Antoniou, Anthony Mathur, Amrita Ahluwalia
OBJECTIVES: In the follow-up of patients in a trial of intracoronary sodium nitrite given during primary percutaneous coronary intervention (PCI) after acute myocardial infarction (AMI), we found a reduction in the incidence of major adverse cardiac events (MACEs). Specifically, MACE rates were 5.2% versus 25.0% with placebo at 3 years ( P = .013). Such MACE reductions should also be associated with economic benefit. Thus, we assessed the cost utility of sodium nitrite therapy versus standard primary PCI only...
August 6, 2018: Journal of Cardiovascular Pharmacology and Therapeutics
Sikandar Z Khan, Mariel Rivero, Gregory S Cherr, Linda M Harris, Maciej L Dryjski, Nader D Nader, Hasan H Dosluoglu
OBJECTIVE: The incidence of cardiovascular and limb-specific adverse outcomes is higher in PAD patients with diabetes. Metformin is associated with improved cardiovascular morbidity and mortality. However, the effect of metformin on limb-specific outcomes is unclear. The objective of this study was to assess the effect of metformin on outcomes following intervention for PAD. METHODS: Patients who underwent revascularization for chronic limb ischemia (Rutherford 3-6) between 06/2001-12/2014 were retrospectively identified...
August 3, 2018: Annals of Vascular Surgery
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