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cardiac revascularization

Gurpreet S Wander, Mohammed Yunus Khan Hukkeri, Sachin Yalagudri, Bharti Mahajan, Archana Toppo Panda
Cardiovascular (CV) diseases are a major cause of premature death and disability. Non-communicable diseases (NCD) are responsible for 52% of mortality amongst Indians, of these CV diseases are responsible for 66% of NCD mortality in India. We not only need widespread primary preventive strategy but also need effective secondary prevention protocols to reduce this. Secondary prevention in patients who already had myocardial infarction (MI) or revascularization is of utmost importance to reduce mortality, cardiac events and improve quality of life...
March 2018: Journal of the Association of Physicians of India
Raul Moreno, Victor Legrand, Maurizio Ferrario, Philip MacCarthy, Simon Redwood, Nikos Werner, Werner Jung, Imre Ungi, Azfar Zaman, Gert Richardt, James Crowley, Peter Schwimmbeck, Thomas Christen, Dominic J Allocco, Ian T Meredith
OBJECTIVES: The goal of this analysis was to evaluate the final 5-year safety and effectiveness of the PROMUS Element platinum-chromium everolimus-eluting stent in unselected patients treated in routine clinical practice. BACKGROUND: The prospective, open-label PROMUS Element™ European Post-Approval Surveillance Study (PE-PROVE) enrolled 1,010 "real-world" patients who received the PROMUS Element stent. Adverse event rates were low at 1-year, and the incidence of stent thrombosis was 0...
October 20, 2018: Catheterization and Cardiovascular Interventions
Caitlin W Hicks, Besma Nejim, Hanaa D Aridi, James H Black, Mahmoud B Malas
OBJECTIVE: Significant national variation exists in defining the degree of stenosis that requires intervention in patients with asymptomatic carotid artery stenosis (ACAS). We aimed to evaluate the risk of perioperative- and 2-year stroke and death in ACAS patients undergoing carotid endarterectomy (CEA) and carotid artery stenting (CAS) for severe versus very severe stenosis in a contemporary population. METHODS: All patients undergoing CEA or transfemoral CAS for ACAS in the Vascular Quality Initiative (2005-2017) were included...
October 16, 2018: Annals of Vascular Surgery
Anne-Sophie Schuurman, Maxime M Vroegindewey, Isabella Kardys, Rohit M Oemrawsingh, Hector M Garcia-Garcia, Robert-Jan van Geuns, Evelyn Regar, Nicolas M Van Mieghem, Jurgen Ligthart, Patrick W Serruys, Eric Boersma, K Martijn Akkerhuis
BACKGROUND: It has been shown that intravascular ultrasound (IVUS) and radiofrequency (RF-)IVUS can detect high-risk coronary plaque characteristics. OBJECTIVES: The authors studied the long-term prognostic value of (RF-)IVUS-derived plaque characteristics in patients with coronary artery disease (CAD) undergoing coronary angiography. METHODS: From 2008 to 2011, (RF-)IVUS was performed in 1 nonstenotic segment of a nonculprit coronary artery in 581 patients undergoing coronary angiography for acute coronary syndrome (ACS) or stable angina...
October 23, 2018: Journal of the American College of Cardiology
Krishnaraj S Rathod, Sudheer Koganti, Ajay K Jain, Zoe Astroulakis, Pitt Lim, Roby Rakhit, Sundeep Singh Kalra, Miles C Dalby, Constantinos O'Mahony, Iqbal S Malik, Charles J Knight, Anthony Mathur, Simon Redwood, Alexander Sirker, Philip A MacCarthy, Elliot J Smith, Andrew Wragg, Daniel A Jones
BACKGROUND: A large proportion of patients presenting with non-ST-segment elevation myocardial infarction (NSTEMI) present with multivessel disease (MVD). There is uncertainty in the role of complete coronary revascularization in this group of patients. OBJECTIVES: The aim of this study was to investigate the outcomes of complete revascularization compared with culprit vessel-only intervention in a large contemporary cohort of patients undergoing percutaneous coronary intervention (PCI) for NSTEMI...
October 23, 2018: Journal of the American College of Cardiology
Joo Myung Lee, Doyeon Hwang, Ki Hong Choi, Tae-Min Rhee, Jonghanne Park, Hyung Yoon Kim, Hae Won Jung, Ji-Won Hwang, Hyun-Jong Lee, Ho-Jun Jang, Su Hong Kim, Young Bin Song, Yun-Kyeong Cho, Chang-Wook Nam, Joo-Yong Hahn, Eun-Seok Shin, Yoshiaki Kawase, Akiko Matsuo, Nobuhiro Tanaka, Joon-Hyung Doh, Bon-Kwon Koo, Hitoshi Matsuo
OBJECTIVES: The study sought to investigate the prognostic implications of relative increase of fractional flow reserve (FFR) with PCI in combination with post-percutaneous coronary intervention (PCI) FFR. BACKGROUND: FFR, measured after PCI has been shown to possess prognostic implications. The relative increase of FFR with PCI can be determined by the interaction of baseline disease pattern, adequacy of PCI, and residual disease burden in a target vessel. However, the role of relative increase of FFR with PCI has not yet been evaluated...
October 22, 2018: JACC. Cardiovascular Interventions
Yoshiyuki Okuya, Yuichi Saito, Yoshiaki Sakai, Iwao Ishibashi, Yoshio Kobayashi
Clinical impact of tissue protrusion (TP) after coronary stenting is still controversial, especially in patients with ST-segment elevation myocardial infarction (STEMI). A total of 104 STEMI patients without previous MI who underwent primary percutaneous coronary intervention (PCI) under intravascular ultrasound (IVUS)-guidance were included. Post-stenting grayscale IVUS analysis was performed, and the patients were classified according to the presence or absence of post-stenting TP on IVUS. Coronary angiography and single-photon emission computed tomography myocardial perfusion imaging (SPECT MPI) with 99m Tc tetrofosmin were analyzed...
October 16, 2018: International Journal of Cardiovascular Imaging
Ahmad Hassan, Ronen Jaffe, Ronen Rubinshtein, Basheer Karkabi, David A Halon, Moshe Y Flugelman, Barak Zafrir
BACKGROUND: Contemporary data on clinical profiles and long-term outcomes of young adults with coronary artery disease (CAD) are limited. OBJECTIVES: To determine the risk profile, presentation, and outcomes of young adults undergoing coronary angiography. METHODS: A retrospective analysis (2000-2017) of patients aged ≤ 35 years undergoing angiography for evaluation and/or treatment of CAD was conducted. RESULTS: Coronary angiography was performed in 108 patients (88% males): 67 acute coronary syndrome (ACS) and 41 non-ACS chest pain syndromes...
October 2018: Israel Medical Association Journal: IMAJ
W Sun, L Sun, F Yang, X Zhao, R Cai, W Yuan
OBJECTIVE: Cardiovascular magnetic resonance imaging (CMR) has been established as a modality to detect myocardial viability. The aim of this study was to evaluate myocardial viability by observing transmural extent of infraction and microvascular perfusion level. METHODS: We performed CMR in 30 myocardial infarction (MI) patients within 7-10 days. At the 6‑month follow-up, CMR was used to evaluate the impact of abnormal reperfusion and observe the transmural extent of infraction on recovery of function...
October 15, 2018: Herz
Takashi Kubo, Masahiro Takahata, Kosei Terada, Kazuya Mori, Yu Arita, Yasushi Ino, Yoshiki Matsuo, Hironori Kitabata, Yasutsugu Shiono, Kunihiro Shimamura, Takeyoshi Kameyama, Hiroki Emori, Yosuke Katayama, Takashi Tanimoto, Takashi Akasaka
BACKGROUND: A fractional flow reserve (FFR) between 0.75 and 0.80 constitutes a "gray zone" for clinical decision-making in coronary artery disease. We compared long-term outcomes of percutaneous coronary intervention (PCI) using drug-eluting stents vs. medical therapy for coronary stenosis with gray zone FFR. Methods and Results: We retrospectively investigated the clinical outcomes of 263 patients with gray zone FFR: 78 patients in the PCI group and 185 patients in the medical therapy group...
October 13, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Filipa Cordeiro, Pedro Silva Mateus, Sílvia Leão, Miguel Moz, Joana Trigo, Catarina Ferreira, Sofia Silva Carvalho, Alberto Ferreira, José Ilídio Moreira
INTRODUCTION: We sought to assess the prognostic impact of left atrial (LA) size on long-term outcomes of ST-segment elevation myocardial infarction (STEMI). METHODS: We studied 200 consecutive patients admitted to a single center between January 2010 and December 2014 with non-fatal STEMI treated with primary percutaneous coronary intervention (pPCI) who underwent a comprehensive echocardiographic examination at discharge. LA volume was estimated by the area-length method...
October 11, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Carlos Branco, Gonçalo F Coutinho, Filipe Soares, Pedro E Antunes, Manuel J Antunes
BACKGROUND: Complete revascularization is the gold standard of coronary artery bypass grafting (CABG). However, the rationale for revascularization of all diseased vessels is questionable. We aimed at evaluating the impact of multiple versus single grafts in each diseased coronary territory in the long-term survival and incidence of major adverse cardiac and cerebrovascular events (MACCE). METHODS: From January/00 to November/15, 5.694 consecutive patients were submitted to isolated CABG, of whom 4...
January 2018: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
Alfonso Ielasi, Gianluca Campo, Bernardo Cortese, Massimo Leoncini, Attilio Varricchio, Salvatore Brugaletta, Enrico Favaretto, Massimo Fineschi, Davide Piraino, Paolo Calabria, Francesco Granata, Francesco Pisano, Marco Mussardo, Azeem Latib, Maurizio Tespili
BACKGROUND: data from clinical experiences with Absorb bioresorbable scaffold (BRS) in STEMI raised concerns among clinicians about the device safety because a noteworthy scaffold thrombosis (ScT) rate was reported at early and long-term follow-up. Nevertheless, pre-specified technical suggestions of how to perform an optimal BRS procedure in STEMI were lacking. In this study we sought to assess the 1-year results following a pre-specified BRS implantation strategy in ST-elevation myocardial infarction (STEMI) patients undergoing primary PCI (pPCI)...
October 4, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Carlos Collet, Yoshinobu Onuma, Daniele Andreini, Jeroen Sonck, Giulio Pompilio, Saima Mushtaq, Mark La Meir, Yosuke Miyazaki, Johan de Mey, Oliver Gaemperli, Ahmed Ouda, Juan Pablo Maureira, Damien Mandry, Edoardo Camenzind, Laurent Macron, Torsten Doenst, Ulf Teichgräber, Holger Sigusch, Taku Asano, Yuki Katagiri, Marie-Angele Morel, Wietze Lindeboom, Gianluca Pontone, Thomas F Lüscher, Antonio L Bartorelli, Patrick W Serruys
Aims: Coronary computed tomography angiography (CTA) has emerged as a non-invasive diagnostic method for patients with suspected coronary artery disease, but its usefulness in patients with complex coronary artery disease remains to be investigated. The present study sought to determine the agreement between separate heart teams on treatment decision-making based on either coronary CTA or conventional angiography. Methods and results: Separate heart teams composed of an interventional cardiologist, a cardiac surgeon, and a radiologist were randomized to assess the coronary artery disease with either coronary CTA or conventional angiography in patients with de novo left main or three-vessel coronary artery disease...
October 11, 2018: European Heart Journal
Wojciech Wańha, Maksymilian Mielczarek, Grzegorz Smolka, Tomasz Roleder, Miłosz Jaguszewski, Dariusz Ciećwierz, Brunon Tomasiewicz, Piotr Kubler, Jarosław Gorol, Michał Chmielecki, Stanisław Bartuś, Eliano Pio Navarese, Michał Kasprzak, Adam Sukiennik, Jacek Kubica, Andrzej Lekston, Michał Hawranek, Krzysztof Reczuch, Marcin Gruchała, Andrzej Ochała, Wojciech Wojakowski
BACKGROUND: There is a paucity of data on left main (LM) percutaneous coronary intervention (PCI) therapy with dedicated DES platforms. The LM-STENTYS is a multicenter registry aimed at evaluating clinical outcome after PCI of LM performed with a self-apposing Stentys DES implantation. METHODS: The registry consists of 175 consecutive patients treated with Stentys DES implanted to LM. The primary endpoint was the composite of major adverse cardiac and cerebral events (MACCE) defined as cardiac death, myocardial infarction (MI), target lesion revascularization (TLR), and stroke assessed after 1 year...
October 11, 2018: Catheterization and Cardiovascular Interventions
Choongki Kim, Sung-Jin Hong, Chul-Min Ahn, Jung-Sun Kim, Byeong-Keuk Kim, Young-Guk Ko, Donghoon Choi, Yangsoo Jang, Myeong-Ki Hong
Patient preference plays an important role in daily practice; however, its implication has not been well investigated regarding treatment strategy for complex coronary artery disease. We prospectively evaluated a trend of patient-centered decision-making of revascularization strategy in patients with multivessel or unprotected left main coronary artery disease. A standardized protocol that favors coronary artery bypass graft surgery (CABG) as the primary treatment of choice, rather than percutaneous coronary intervention, was adopted...
September 13, 2018: American Journal of Cardiology
David E Kandzari, J Aaron Grantham, Dimitrios Karmpaliotis, William Lombardi, Jeffrey W Moses, William Nicholson, Stephen Cook, Ashish Pershad, Jeffrey J Popma
BACKGROUND: Limited study has detailed the procedural outcomes and utilization of contemporary coronary guidewires and microcatheters designed for chronic total occlusion (CTO) percutaneous revascularization and with application of modern techniques. PATIENTS AND METHODS: A prospective, multicenter, single-arm trial was carried out to evaluate procedural and in-hospital outcomes among 163 patients undergoing attempted CTO revascularization with specialized guidewires and microcatheters...
October 10, 2018: Coronary Artery Disease
Toshiki Takano, Komei Tanaka, Kazuyuki Ozaki, Akinori Sato, Kenichi Iijima, Takao Yanagawa, Daisuke Izumi, Takuya Ozawa, Koichi Fuse, Masahito Sato, Naohito Tanabe, Tohru Minamino
BACKGROUND: The implantable cardioverter defibrillator (ICD) is a standard prevention therapy for patients at high risk for sudden cardiac death (SCD) due to life-threatening ventricular arrhythmia (VA), that is, ventricular fibrillation and ventricular tachycardia. However, clinical predictors of recurrent VA in secondary prevention ICD recipients with coronary artery disease (CAD) remain unknown. Methods and Results: We followed up 96 consecutive patients with CAD undergoing ICD implantation for secondary prevention of SCD...
October 11, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Eduardo Tavares Gomes, Regina Célia de Oliveira, Simone Maria Muniz da Silva Bezerra
OBJECTIVE: to investigate the patients' experience in the cardiac surgery preoperative period under the Heideggerian perspective. METHOD: exploratory qualitative research. Twelve patients were interviewed, from March to April, 2016, while they waited for myocardial revascularization surgery or valve replacement surgery. RESULTS: the analysis of the speeches allowed finding two dimensions of the being-there-patient-waiting-for-cardiac surgery, two meanings of the beingness: being-there-in-a-reduced-world and being-there-in-a-unknown-world...
September 2018: Revista Brasileira de Enfermagem
István Ferenc Édes, Zoltán Ruzsa, Árpád Lux, László Gellér, Levente Molnár, Fanni Nowotta, Márta Csilla Kerülő, Dávid Becker, Béla Merkely
Introduction: Acute, total occlusion of the unprotected left main stem (uLMo) in acute coronary syndrome (ACS) patients is a catastrophic event often accompanied by sudden cardiac death (SCD) and/or cardiogenic shock (CS) with high mortality rates and limited methods of successful treatment. Emergent, surgical and percutaneous revascularization has been reported before, yet comprehensive data remains scarce. Aim: To examine emergency percutaneous coronary intervention (PCI) outcomes in ACS cases presenting with uLMo...
2018: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
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