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https://www.readbyqxmd.com/read/29353319/management-strategies-for-noncardiac-surgery-following-a-coronary-artery-event
#1
REVIEW
Thomas F Whayne, Sibu P Saha
PURPOSE OF REVIEW: Coronary artery event includes acute coronary syndrome (ACS), percutaneous coronary intervention (PCI), and coronary artery bypass graft (CABG) surgery. Following such an event, risk of noncardiac surgery is increased. Of major concern is what can make this surgery safer? RECENT FINDINGS: High functional capacity improves cardiovascular (CV) risk; at least 4.0 metabolic equivalents (METs) on stress test are favorable. Risk scores can suggest need for further evaluation...
January 20, 2018: Current Cardiology Reports
https://www.readbyqxmd.com/read/29350305/percutaneous-mechanical-circulatory-support-devices-for-high-risk-percutaneous-coronary-intervention
#2
REVIEW
Subrata Kar
PURPOSE OF REVIEW: Percutaneous mechanical circulatory support devices (PMCSD) consist of the intra-aortic balloon pump (IABP), Impella (Abiomed Inc., Danvers, Massachusetts), Tandem Heart (Cardiac Assist, Inc., Pittsburgh, Pennsylvania), or extracorporeal membranous oxygenation (ECMO). They augment cardiac output, cardiac index, and cardiac power which allow the operator to mitigate hemodynamic perturbations during high-risk percutaneous coronary intervention (HR-PCI). This review discusses PMCSD and their contemporary literature...
January 19, 2018: Current Cardiology Reports
https://www.readbyqxmd.com/read/29349686/two-year-results-after-coronary-stenting-of-small-vessels-in-japanese-population-using-2-25-mm-diameter-sirolimus-eluting-stent-with-bioresorbable-polymer-primary-and-long-term-outcomes-of-century-jsv-study
#3
Shigeru Saito, Kenji Ando, Yoshiaki Ito, Tetsuya Tobaru, Junji Yajima, Takeshi Kimura, Kazushige Kadota
Percutaneous coronary intervention (PCI) in coronary artery disease (CAD) with very small vessels remains challenging. The aim of this study is to evaluate the safety and effectiveness of the 2.25-mm diameter Ultimaster sirolimus-eluting stent in the treatment of Japanese patients with CAD due to lesions in very small vessels. The CENTURY JSV study is a prospective, multicentre, single-arm study. Seventy patients with lesions deemed suitable for implantation of a 2.25-mm diameter stent were enrolled at seven hospitals in Japan...
January 18, 2018: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/29346126/complete-revascularization-for-patients-with-st-segment-elevation-myocardial-infarction-and-multivessel-coronary-artery-disease-a-meta-analysis-of-randomized-trials
#4
Gani Bajraktari, Haki Jashari, Pranvera Ibrahimi, Fernando Alfonso, Fisnik Jashari, Gjin Ndrepepa, Shpend Elezi, Michael Y Henein
INTRODUCTION: Despite the recent findings in randomized clinical trials (RCTs) with limited sample sizes and the updates in clinical guidelines, the current available data for the complete revascularization (CR) in hemodynamically stable patients with ST-segment elevation myocardial infarction (STEMI) at the time of primary percutaneous coronary intervention (PCI) are still contradictory. AIM: The aim of this meta-analysis of the existing RCTs was to assess the efficacy of the CR versus revascularization of infarct-related artery (IRA) only during primary PCI in patients with STEMI and multivessel disease (MVD)...
January 17, 2018: Coronary Artery Disease
https://www.readbyqxmd.com/read/29345588/the-role-of-percutaneous-coronary-intervention-in-the-treatment-of-chronic-total-occlusions-rationale-and-review-of-the-literature
#5
Harsh Agrawal, Richard Lange, Ruben Montanez, Soma Wali, Khan Omar Mohammad, Subrata Kar, Mohamed Teleb, Debabrata Mukherjee
BACKGROUND: Chronic total occlusion (CTO) of a coronary artery is defined as an occluded segment with no antegrade flow and a known or estimated duration of at least 12 weeks. OBJECTIVE: We considered the current literature describing the indications and clinical outcomes for de-novo CTO- percutaneous coronary intervention (PCI), and discuss the role of CTO-PCI and future directions for this procedure. METHOD: Databases (PubMed, the Cochrane Library, Embase, EBSCO, Web of Science, and CINAHL were searched and relevant studies of CTO-PCI were selected for review...
January 16, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29344756/the-current-state-of-left-main-percutaneous-coronary-intervention
#6
REVIEW
Harshith R Avula, Andrew N Rassi
PURPOSE OF REVIEW: While coronary artery bypass grafting (CABG) remains the standard of care, advances in stenting technology and procedural technique are changing the role of percutaneous coronary intervention (PCI) in the treatment of severe left main coronary artery (LMCA) disease. We review contemporary evidence comparing PCI and CABG for the treatment of severe LMCA disease, discuss optimal techniques during left main PCI, and provide guidance on studied revascularization strategies within specific patient subgroups...
January 17, 2018: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29340571/comparison-of-physician-visual-assessment-with-quantitative-coronary-angiography-in-assessment-of-stenosis-severity-in-china
#7
Haibo Zhang, Lin Mu, Shuang Hu, Brahmajee K Nallamothu, Alexandra J Lansky, Bo Xu, Georgios Bouras, David J Cohen, John A Spertus, Frederick A Masoudi, Jeptha P Curtis, Runlin Gao, Junbo Ge, Yuejin Yang, Jing Li, Xi Li, Xin Zheng, Yetong Li, Harlan M Krumholz, Lixin Jiang
Importance: Although physician visual assessment (PVA) of stenosis severity is a standard clinical practice to support decisions for coronary revascularization, there are concerns about its accuracy. Objective: To compare PVA with quantitative coronary angiography (QCA) as a means of assessing stenosis severity among patients undergoing percutaneous coronary intervention (PCI) in China. Design, Setting, and Participants: A cross-sectional study (2012-2013) of a random subset of 1295 patients from the China Patient-centered Evaluative Assessment of Cardiac Events (PEACE) Prospective PCI Study was carried out...
January 16, 2018: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29338896/novel-bioabsorbable-polymer-and-polymer-free-metallic-drug-eluting-stents
#8
REVIEW
Jason Nogic, Liam M McCormick, Rohin Francis, Nitesh Nerlekar, Catherine Jaworski, Nick E J West, Adam J Brown
The introduction of drug-eluting stents (DES) significantly reduced angiographic restenosis and the clinical need for revascularization following percutaneous coronary intervention. However, concerns remain regarding the long-term safety and efficacy of DES. The use of durable polymers for drug elution that have limited biocompatibility is thought to contribute toward DES failure, by promoting an adverse local inflammatory response and vascular toxicity. Biodegradable polymer and polymer-free metallic stents represent two novel technological solutions to this challenging clinical problem...
January 12, 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29338862/new-generation-stents-compared-with-coronary-bypass-surgery-for-unprotected-left-main-disease-a-word-of-caution
#9
Umberto Benedetto, David P Taggart, Miguel Sousa-Uva, Giuseppe Biondi-Zoccai, Antonino Di Franco, Lucas B Ohmes, Mohamed Rahouma, Mohamed Kamel, Massimo Caputo, Leonard N Girardi, Gianni D Angelini, Mario Gaudino
BACKGROUND: With the advent of bare metal stents and drug-eluting stents, percutaneous coronary intervention has emerged as an alternative to coronary artery bypass grafting surgery for unprotected left main disease. However, whether the evolution of stents technology has translated into better results after percutaneous coronary intervention remains unclear. We aimed to compare coronary artery bypass grafting with stents of different generations for left main disease by performing a Bayesian network meta-analysis of available randomized controlled trials...
January 12, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29338462/rethinking-revascularization-in-patients-with-stable-angina
#10
Ralf E Harskamp, Duk-Woo Park
Traditional and current perception for benefit of percutaneous coronary intervention (PCI) is that patients with stable angina will obtain symptom relief as well as improved exercise capacity after percutaneous revascularization. This common clinical perception is put to test in the ORBITA trial, the first blinded, randomized placebo-controlled clinical study ever conducted. The findings of this study will send shockwaves throughout the cardiology community.
January 17, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29334329/predictive-value-of-metabolic-syndrome-definitions-in-patients-with-myocardial-infarction-with-st-segment-elevation-are-they-all-the-same
#11
Milan Branko Lovic, Lidija Savic, Dragan Matic, Dragan Djordjevic, Ivana Nedeljkovic, Ivan Tasic
OBJECTIVES: We sought to determine the predictive power of metabolic syndrome (MS) definitions on the prognosis in patients with myocardial infarction with ST-segment elevation (STEMI). METHODS: We prospectively included 507 patients with STEMI who were admitted for primary percutaneous coronary intervention and could be identified for MS using the AHA-NHLBI, NCEP-ATP III and IDF definitions. After applying these criteria, we divided the group in patients with MS and without MS; we compared baseline characteristics, clinical findings and outcomes among these patients...
January 15, 2018: Acta Cardiologica
https://www.readbyqxmd.com/read/29332914/long-term-clinical-outcomes-after-treatment-with-excimer-laser-coronary-atherectomy-for-in-stent-restenosis-of-drug-eluting-stent
#12
Eiji Ichimoto, Tadayuki Kadohira, Takashi Nakayama, Joseph De Gregorio
Excimer laser coronary atherectomy (ELCA) has been used for the treatment of complex percutaneous coronary intervention (PCI) such as in-stent restenosis (ISR). However, little information was provided about the clinical outcomes after treatment with ELCA for ISR of drug-eluting stents (DES). This study aimed to investigate the long-term clinical outcomes after PCI with ELCA for ISR of DES.A total of 81 consecutive patients with 87 lesions who underwent PCI for ISR of DES were included. Patients were classified into a PCI with ELCA group (23 patients with 24 lesions) and a PCI without ELCA group (58 patients with 63 lesions)...
January 15, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29326152/decision-analytic-markov-model-weighting-expected-benefits-and-current-limitations-of-first-generation-bioresorbable-vascular-scaffolds-implications-for-manufacturers-and-next-device-iterations
#13
Davide Capodanno, Sergio Buccheri, Sara Romano, Piera Capranzano, Bruno Francaviglia, Corrado Tamburino
BACKGROUND: Relative benefits of bioresorbable vascular scaffolds (BVS) compared with everolimus-eluting stents (EES) are expected to accrue after complete bioresorption. METHODS AND RESULTS: We built a decision analytic Markov model comparing BVS and EES for a contemporary percutaneous coronary intervention population. Procedure-related morbidity and outcome data from the available literature were used to derive model probabilities. The net benefit of BVS and EES was estimated in terms of quality-adjusted life expectancy...
January 2018: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29325366/-outcome-of-patients-with-coronary-artery-disease-and-left-ventricular-ejection-fraction-less-than-50-undergoing-percutaneous-coronary-intervention
#14
L Jiang, Y Song, J J Xu, X F Tang, H H Wang, P Jiang, L J Gao, L Song, Z Gao, J Chen, R L Gao, S B Qiao, Y J Yang, B Xu, J Q Yuan
Objective: To investigate the in-hospital and long-term outcomes of patients with left ventricular ejection fraction (LVEF) <50% undergoing percutaneous coronary intervention (PCI) . Methods: From January to December 2013, 10 445 consecutive patients who underwent PCI in Fuwai Hospital and the LVEF value was available were prospectively included. The patients were divided into LVEF≥50% group (9 896 cases) and LVEF<50% group (549 cases) . The in-hospital and 2-year clinical outcomes were compared between the 2 groups...
December 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/29325365/-efficacy-comparison-of-3-strategies-for-real-world-stable-coronary-artery-disease-patients-with-three-vessel-disease
#15
R Liu, L Jiang, L J Xu, J Tian, X Y Zhao, Y Zhang, J J Xu, Y Song, H H Wang, Z Gao, L Song, J Q Yuan
Objective: To compare the effectiveness of percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG) or medical therapy (MT) alone for real-world stable coronary artery disease (SCAD) patients with three-vessel disease (TVD) in mainland China. Methods: A total of 8 943 consecutive cases with TVD hospitalized in our center from April 2004 to February 2011 were screened for this study. In this cohort, 3 435 cases diagnosed as SCAD were analyzed. PCI, CABG, MT alone were performed in 1 313 (38...
December 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/29317974/global-risk-score-and-clinical-syntax-score-as-predictors-of-clinical-outcomes-of-patients-undergoing-unprotected-left-main-percutaneous-catheter-intervention
#16
Lucky Cuenza, Marianne P Collado, James Ho Khe Sui
Background: Risk stratification is an important component of left main percutaneous catheter intervention (PCI) which has emerged as a feasible alternative to cardiac surgery. We sought to compare the clinical SYNTAX score and the global risk score in predicting outcomes of patients undergoing unprotected left main PCI in our institution. Methods: Clinical, angiographic and procedural characteristics of 92 patients who underwent unprotected left main PCI (mean age 62 ± 12...
December 2017: Cardiology Research
https://www.readbyqxmd.com/read/29316212/renal-artery-stenting-for-atherosclerotic-renal-artery-stenosis-identified-in-patients-with-coronary-artery-disease-does-captopril-renal-scintigraphy-predict-outcomes
#17
Spyros Stratigis, Kostas Stylianou, Periklis P Kyriazis, Eleftheria-Kleio Dermitzaki, Dimitra Lygerou, Paraskevi Syngelaki, Stavros Stratakis, Sophia Koukouraki, Fragiskos Parthenakis, Dimitrios Tsetis, Eugene Daphnis
The authors evaluated the effectiveness of percutaneous renal revascularization (PRR) with stenting for the treatment of atherosclerotic renal artery stenosis (ARAS) in patients with coronary artery disease and the usefulness of captopril renal scintigraphy for predicting clinical outcomes after PRR. Sixty-four consecutive patients, referred for evaluation of suspected ARAS, after coronary angiography, underwent baseline captopril renal scintigraphy followed by renal angiography. Forty-four patients (68.7%) were diagnosed with a significant ARAS≥ 60% and were treated with PRR plus medical therapy...
January 6, 2018: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/29314289/long-term-outcomes-post-chronic-total-occlusion-intervention-implications-of-completeness-of-revascularization
#18
Pravin K Goel, Roopali Khanna, C M Pandey, Fauzia Ashfaq
BACKGROUND: Long term clinical outcomes post chronic total occlusion (CTO) intervention may depend not only on CTO success/failure alone but also on Completeness of revascularization. OBJECTIVES: To determine long term outcomes post CTO intervention and relate them to both success versus failure and Complete Revascularization (CR) versus Incomplete Revascularization (IR). METHODS: Consecutive patients taken up for CTO intervention with at-least one CTO vessel between Jan 2006 to Dec 2015 were included...
January 4, 2018: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29313713/ischemic-and-bleeding-outcomes-after-coronary-artery-bypass-grafting-among-patients-initially-treated-with-a-p2y12-receptor-antagonist-for-acute-coronary-syndromes-insights-on-timing-of-discontinuation-of-ticagrelor-and-clopidogrel-prior-to-surgery
#19
Juan J Russo, Tyler E James, Marc Ruel, Jean-Yves Dupuis, Kuljit Singh, Daniel Goubran, Nikita Malhotra, Fraser Rubens, Aun-Yeong Chong, Benjamin Hibbert, Paul Boland, Diem Tt Tran, Jean-Francois Tanguay, Marie Lordkipanidzé, Louis Perrault, George A Wells, Michael Bourke, Vincent Chan, Derek Yf So
BACKGROUND: Clinical outcomes in acute coronary syndrome patients treated with P2Y12 inhibitors who require urgent coronary artery bypass grafting (CABG) have not been well studied. METHODS: We examined clinical outcomes in acute coronary syndrome patients in relation to the timing of CABG following P2Y12 inhibitor discontinuation (<72 h, 72 h to five days, >5 days). The primary ischemic outcome was a composite of death, reinfarction, need for revascularization, or stroke...
January 1, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29311287/comparison-of-a-simple-angiographic-approach-with-a-synergy-between-percutaneous-coronary-intervention-with-taxus-and-cardiac-surgery-score-based-approach-for-left-main-coronary-artery-stenting-a-pooled-analysis-of-serial-precombat-premier-of-randomized-comparison
#20
Pil Hyung Lee, Jong-Young Lee, Cheol Whan Lee, Seon-Ok Kim, Jung-Min Ahn, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Seong-Wook Park, Seung-Jung Park
BACKGROUND: The applicability of Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery scores to left main coronary artery disease (CAD) has been questioned. A simplified alternative is needed for guiding decision making. METHODS AND RESULTS: We evaluated the prognostic value of a simplified angiographic classification in comparison with a Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery score-based approach for patients with left main CAD undergoing drug-eluting stent implantation...
January 2018: Circulation. Cardiovascular Interventions
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