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Coronary artery topics

Bryan G Schwartz, Robert A Kloner, Morteza Naghavi
Inability to predict short-term cardiovascular (CV) events and take immediate preemptive actions has long been the Achilles heel of cardiology. However, certain triggers of these events have come to light. Although these triggers are nonspecific and are part of normal life, studying their temporal relationship with the onset of CV events provides an opportunity to alert high-risk atherosclerotic patients who may be most vulnerable to such triggers, the "vulnerable patient". Herein, we review the literature and shed light on the epidemiology and underlying pathophysiology of different triggers...
September 13, 2018: American Journal of Cardiology
Tom J O'Donohoe, Ryan G Schrale
The transradial approach has become the gold-standard for coronary angiography. It is better tolerated by patients, associated with less bleeding, earlier post-procedure mobilization, and reduced mortality in patients with myocardial infarction. Given the hand's dual arterial supply and extensive collateral circulation, the risk of serious functional injury after radial catheterization is essentially reduced to zero. However, even a small amount of bleeding in the volar compartment can lead to compartment syndrome (CS) and permanent neurovascular injury...
December 2017: Journal of Cardiology Cases
Mario F L Gaudino, David P Taggart, Stephen E Fremes
PURPOSE OF REVIEW: We herein summarize the current evidence on the clinical outcome associated with the use of single and multiple arterial grafts for coronary bypass surgery and the role and importance of the Randomized comparison of the clinical Outcome of single versus Multiple Arterial grafts (ROMA) trial. RECENT FINDINGS: Observational evidence suggests that the use of multiple arterial grafts is associated with better clinical outcomes compared to the use of a single arterial graft...
November 2018: Current Opinion in Cardiology
Ladislav Batalik, Filip Dosbaba, Martin Hartman, Katerina Batalikova, Jindrich Spinar
BACKGROUND: Cardiovascular diseases remain the most common causes of death in the world. Instructions for secondary prevention recommend multifaceted approach in cardiovascular diseases risk management. Center-based physical exercise training is considered as an important integral part of cardiac rehabilitation (CR). Despite all recognized benefits CR brings, active interest of patients remains low in many countries, including the Czech Republic. That is why there is a need to focus on more effective patients' participation in CR with respect to their preferences and needs...
September 2018: Medicine (Baltimore)
Lin Li, Wenyi Zhang, Yun Yang, Liyuan Zhao, Xinyao Zhou, Jian Zhang
BACKGROUND: It is more common to need dual antiplatelet therapy (DAPT) for patients who had recently inserted coronary artery stent. However, the postoperative bleeding risk of patients in DAPT could significantly increase. The dental management of patients with antithrombotic therapy has always been a controversial problem. Focusing on this issue, this review discussed the available evidence to provide optimal strategy for patients taking dual antiplatelet agents in the dental setting...
August 25, 2018: Clinical Oral Investigations
Cristiano Spadaccio, Umberto Benedetto
The optimal treatment of ischemic coronary artery disease (CAD) is still controversial. A number of randomized controlled trials (RCT) and several meta-analyses have been performed and are inspiring the current guidelines. However, a univocal consensus on the optimal therapeutic strategy for multivessel disease has still not been reached yet. We reviewed the current evidence on this topic, focusing on both RCT and meta-analyses. From both short and long-term studies, it emerges that in patients with multivessel disease, coronary artery bypass grafting (CABG) is associated with better survival, lower rates of major cardiovascular events (specifically myocardial infarction or stroke) and repeat revascularization as compared with percutaneous coronary intervention (PCI) with drug-eluting stents...
July 2018: Annals of Cardiothoracic Surgery
Rory Kelleher, Damian Gimpel, David J McCormack, Adam El-Gamel
A best evidence topic was constructed according to a structured protocol. The question addressed was whether the configuration of bilateral internal thoracic arteries (BITAs) influences survival, patency or repeat revascularization in patients undergoing coronary artery bypass grafting. Five hundred and seventy-one papers were found using the reported searches, of which 8 represented the best evidence to answer the clinical question. One systematic review, 4 randomized trials and 3 observational studies were selected...
July 20, 2018: Interactive Cardiovascular and Thoracic Surgery
Oliver Lindner, Johann Bauersachs, Frank M Bengel, Wolfgang Burchert, Jürgen Vom Dahl, Rolf Dörr, Marcus Hacker, Malte Kelm, Tienush Rassaf, Christoph Rischpler, Wolfgang Schäfer, Michael A Schäfers, Sigmund Silber, Rainer Zimmermann
The joint position paper of the working community "Cardiovascular Nuclear Medicine" of the German Society of Nuclear Medicine (DGN) and the working group "Nuclear Cardiology Diagnostics" of the German Cardiac Society (DKG) updates the former 2009 paper. It is the purpose of this paper to provide an overview about the application fields, the state-of-the-art and the current value of nuclear cardiology imaging. The topics covered are chronic coronary artery disease, including viability imaging, furthermore cardiomyopathies, infective endocarditis, cardiac sarcoidosis and amyloidosis...
August 2018: Nuklearmedizin. Nuclear Medicine
Lisa Gross, Dirk Sibbing, Christian Schulz, Florian Gärtner, Joachim Pircher, Steffen Massberg, Tobias Petzold
A core research area in the Department of Cardiology at Ludwig-Maximilians-University (LMU) Munich focuses on antiplatelet therapy, its translational aspects, and its underlying mechanism with respect to platelet physiology. We are conducting a broad range of investigator-initiated clinical trials (phase II-IV) and preclinical studies on the topic of antithrombotic therapy for percutaneous coronary intervention patients, platelet activation, and reactivity as well as on novel inhibitors of platelet adhesion...
July 11, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Ahmadreza Karimianpour, Anbukarasi Maran
PURPOSE OF REVIEW: Coronary artery no-reflow phenomenon is an incidental outcome of percutaneous coronary intervention in patients presenting with acute myocardial infarction. Despite advances in pharmacologic and non-pharmacologic therapies, coronary no-reflow phenomenon occurs more commonly than desired. It often results in poor clinical outcomes and remains as a relevant consideration in the cardiac catheterization laboratory. In this systematic review, we have sought to discuss the topic in detail, and to relay the most recent discoveries and data on management of this condition...
July 5, 2018: Current Atherosclerosis Reports
Sara Roversi, Leonardo M Fabbri
The interaction between the lung and the heart is a vast, complex, and fascinating topic and, from a clinical point of view, disorders of the one often influence and promote disorders of the other. This is especially true for chronic diseases, with chronic obstructive pulmonary disease (COPD) and ischemic heart disease (IHD) representing a classic example. Epidemiologic data indicate that cardiovascular diseases are frequent in patients with COPD, and vice versa. Accordingly, rates of IHD in COPD vary from 4% up to 60%, while, on the other hand, COPD has been reported in up to 30% of patients with coronary artery disease...
March 2018: Giornale Italiano di Cardiologia
Francesco Burzotta, Jens Flensted Lassen, Adrian P Banning, Thierry Lefèvre, David Hildick-Smith, Alaide Chieffo, Olivier Darremont, Manuel Pan, Yiannis S Chatzizisis, Remo Albiero, Yves Louvard, Goran Stankovic
The 2017 European Bifurcation Club (EBC) meeting was held in Porto (Portugal) and allowed a multidisciplinary international faculty to review and discuss the latest data collected in the field of coronary bifurcation interventions. In particular, the topic of percutaneous coronary intervention (PCI) on left main coronary artery (LM) disease was highlighted as a contemporary priority. Herein, we summarise the key LM anatomy features, the diagnostic modalities and available data that are relevant for a patient's procedural management...
May 20, 2018: EuroIntervention
Christian Tesche, Taylor M Duguay, U Joseph Schoepf, Marly van Assen, Carlo N De Cecco, Moritz H Albrecht, Akos Varga-Szemes, Richard R Bayer, Ullrich Ebersberger, John W Nance, Christian Thilo
Computed tomographic (CT) coronary artery calcium scoring (CAC) has been validated as a well-established screening method for cardiovascular risk stratification and treatment management that is used in addition to traditional risk factors. The purpose of this review is to present an update on current and future applications of CAC. Areas covered: The topic of CAC is summarized from its introduction to current application with focus on the validation and clinical integration including cardiovascular risk prediction and outcome, cost-effectiveness, impact on downstream medical testing, and the technical advances in scanner and software technology that are shaping the future of CAC...
June 2018: Expert Review of Cardiovascular Therapy
Maciej Peksa, Sleiman Sebastian Aboul-Hassan, Jakub Marczak, Romuald Cichon
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether administration of dual-antiplatelet therapy (DAPT) following off-pump coronary artery bypass grafting (OPCAB) would improve postoperative clinical outcomes or minimize the incidence of postoperative graft failure. In total, 101 papers were found using the reported search, 14 of which represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated...
October 1, 2018: Interactive Cardiovascular and Thoracic Surgery
Dimos Karangelis, Amine Mazine, Apostolos Roubelakis, George Stavridis
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether the anterolateral or the inferior wall served as a better location for the 2nd arterial graft in a 3-system coronary artery bypass grafting procedure. In total, more than 1800 papers were found, of which 6 represented the best evidence to answer the clinical question. All papers demonstrated equivalent early postoperative mortality and morbidity. The 3 largest studies comparing bilateral internal thoracic arteries showed no difference in perioperative mortality and morbidity regardless of whether the 2nd internal thoracic artery was used to graft the left or right system...
October 1, 2018: Interactive Cardiovascular and Thoracic Surgery
Toshio Kobayashi, Akira Andoh
The human intestinal microbiota has a close relationship with health control and causes of diseases, and a vast number of scientific papers on this topic have been published recently. Some progress has been made in identifying the causes or species of related microbiota, and successful results of data mining are reviewed here. Humans who are targets of a disease have their own individual characteristics, including various types of noise because of their individual life style and history. The quantitatively dominant bacterial species are not always deeply connected with a target disease...
March 2018: Journal of Clinical Biochemistry and Nutrition
Nyal Borges, Samir R Kapadia, Stephen G Ellis
The optimal management of unprotected left main coronary artery (ULMCA) disease is currently a debated topic. Percutaneous coronary intervention (PCI) has seen an increased adoption for the management of ULMCA disease after numerous small-scale randomised trials and cohort studies showed equipoise with coronary artery bypass grafting (CABG) for low complexity lesions. The recently published NOBLE and EXCEL trials are two of the largest international randomised clinical trials comparing PCI and CABG in patients with ULMCA disease...
September 2017: Interventional Cardiology
Daniel S Florisson, Joshua A DeBono, Reece A Davies, Andrew E Newcomb
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was 'In patients undergoing off-pump coronary artery bypass grafting, for single or multivessel disease, does minimally invasive direct coronary artery bypass (MIDCAB) or off-pump coronary artery bypass (OPCAB) provide the superior outcome including a reduction in morbidity and mortality?'. A total of 187 papers were found using the reported search, of which 12 represented the best evidence to answer the clinical question...
September 1, 2018: Interactive Cardiovascular and Thoracic Surgery
Roberto M Ferreira, Paolo B Villela, Juliano C G Almeida, Pedro Paulo N Sampaio, Felipe N Albuquerque, Fernanda M C Pinheiro, William França Filho, José Ary B E Salles, João Mansur Filho
Kounis syndrome (KS) consists of an association between hypersensitivity reactions triggered by various environmental and pharmacological factors and acute coronary syndromes. Blood supply may be compromised by either vasospasm (type I), native plaque destabilization (type II) or stent thrombosis (type III). Although the prognosis is generally favorable, treatment should include aggressive anti-thrombotic and anti-allergic therapies. A case compatible with type III KS, manifested as a macular rash followed by two episodes of stent thrombosis after primary angioplasty (PCI) of the right coronary artery is presented, and complemented by a review on the topic...
March 13, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Lawrence G Rudski, Luna Gargani, William F Armstrong, Patrizio Lancellotti, Steven J Lester, Ekkehard Grünig, Michele D'Alto, Meriam Åström Aneq, Francesco Ferrara, Rajeev Saggar, Rajan Saggar, Robert Naeije, Eugenio Picano, Nelson B Schiller, Eduardo Bossone
The cardiopulmonary vascular system represents a key determinant of prognosis in several cardiorespiratory diseases. Although right heart catheterization is considered the gold standard for assessing pulmonary hemodynamics, a comprehensive noninvasive evaluation including left and right ventricular reserve and function and cardiopulmonary interactions remains highly attractive. Stress echocardiography is crucial in the evaluation of many cardiac conditions, typically coronary artery disease but also heart failure and valvular heart disease...
May 2018: Journal of the American Society of Echocardiography
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