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Cristina Aurigemma, Francesco Burzotta, Giulio Russo, Leonardo Previ, Carlo Trani
The Completeness of Revascularization in patients with multivessel coronary artery disease (CAD) remains an unanswered question. Despite 20 years of investigation there are still major doubts in this topic, reaching as far as to the lack of a standardized definition. The employment of different definition and the multiplicity of confounding variables that in general favor patients who receive a complete revascularization (CR) are the reason of difficult comparisons between studies. The complexity of coronary anatomy diseases and the clinical features play important role in the revascularization strategy...
March 15, 2018: Minerva Cardioangiologica
Sigita Glaveckaite, Egle Uzdavinyte-Gateliene, Zaneta Petrulioniene, Darius Palionis, Nomeda Valeviciene, Gintaras Kalinauskas, Pranas Serpytis, Aleksandras Laucevicius
OBJECTIVES: We aimed to evaluate (i) the effectiveness of combined surgery (coronary artery bypass grafting with restrictive mitral valve annuloplasty) and (ii) the late gadolinium enhancement cardiovascular magnetic resonance-based predictors of ischaemic mitral regurgitation (IMR) recurrence. METHODS: The prospective analysis included 40 patients with multivessel coronary artery disease, IMR >II° and left ventricular (LV) dysfunction undergoing combined surgery...
March 9, 2018: Interactive Cardiovascular and Thoracic Surgery
David R Dobies, Kimberly R Barber
Evidence-based medicine (EBM) provides clinicians with beneficial information. Nonetheless, study findings are often arbitrary, speculative or provisional. The current state of misleading evidence exists in all applications, including those for guideline recommendations. We conductedan appraisal of the American College of Cardiologyand European Society of Cardiology Guidelines for revascularisation of complex coronary anatomy to determine the veracity of the evidence that recommendations were based on. Study-specific critical appraisals were conducted by the authors on the 5-year Synergy between percutaneous coronary intervention with Taxus and cardiac surgery (SYNTAX) and future revascularisation evaluation in patients with diabetes mellitus: optimal management of multivessel disease (FREEDOM) Trials...
2018: Open Heart
Benjamin D Horne, Joseph B Muhlestein, Durgesh Bhandary, Greta L Hoetzer, Naeem D Khan, Tami L Bair, Donald L Lappé
Objective: Post-myocardial infarction (MI) care is crucial to preventing recurrent major adverse cardiovascular events (MACE), but can be complicated to personalise. A tool is needed that effectively stratifies risk of cardiovascular (CV) events 1-3 years after MI but is also clinically usable. Methods: Patients surviving ≥1 year after an index MI with ≥1 risk factor for recurrent MI (ie, age ≥65 years, prior MI, multivessel coronary disease, diabetes, glomerular filtration rate <60 mL/min/1...
2018: Open Heart
Rocco A Montone, Giampaolo Niccoli
Patients with left main or multivessel coronary artery disease (CAD) and depressed left ventricular function undergoing coronary artery by-pass grafting (CABG) have a markedly worse prognosis compared with general population, making surgical treatment of CAD unattractive especially when features such as poor distal targets, severe comorbidities, reoperation, advanced age, or impaired renal function are present. At the same time, evidence for improved clinical outcome in this high-risk subset of patients using mini-invasive surgical techniques (i...
March 8, 2018: Minerva Cardioangiologica
Jialin He, Pingan Chen, Yishan Luo, Lushan Chen, Shaonan Li, Yichao Pan, Shenshen Fu
BACKGROUND: Carotid artery plaque is associated with coronary artery disease (CAD). Besides the presence of plaque, plaque characteristics is also related to the severity of CAD. So the characteristic difference of carotid plaque may affect this assessment role. However, it is unclear whether the maximum carotid plaque area can reflect the extents and severity of CAD. METHODS: We enrolled 388 consecutive CAD patients and 45 controls, and 204 patients were studied after excluding 184 patients without carotid plaque or coronary angiogram...
March 8, 2018: International Angiology: a Journal of the International Union of Angiology
Alberto Repossini, Lorenzo Di Bacco, Fabrizio Rosati, Maurizio Tespili, Antonio Saino, Alfonso Ielasi, Claudio Muneretto
AIMS: Hybrid revascularization (HCR) has been recently proposed as an alternative strategy in multivessel coronary disease, particularly in patients with high SYNTAX scores and risk scores. The objective of this study is to evaluate the outcomes of HCR versus percutaneous coronary intervention (PCI) drug-eluting stenting in left main treatment. METHODS: A series of 198 consecutive patients with left main stenosis have been treated. HCR, was performed in 77 patients (G1) whereas 121 patients (G2) received PCI on left main...
March 6, 2018: Journal of Cardiovascular Medicine
Kyu Yeon Hur, Ji Eun Jun, Young Ju Choi, Yong Ho Lee, Dae Jung Kim, Seok Won Park, Byung Wook Huh, Eun Jig Lee, Sun Ha Jee, Kap Bum Huh, Sung Hee Choi
BACKGROUND: The clinical utility of ankle-brachial index (ABI) is not clear in subjects with less severe or calcified vessel. Therefore, we investigated the usefulness of color Doppler ultrasonography for diagnosing peripheral artery disease (PAD) in type 2 diabetes mellitus (T2DM) subjects. METHODS: We analyzed 324 T2DM patients who concurrently underwent ABI and carotid intima-media thickness (CIMT) measurements and color Doppler ultrasonography from 2003 to 2006...
February 2018: Diabetes & Metabolism Journal
I-Chang Hsieh, Ming-Jer Hsieh, Chun-Chi Chen, Chao-Yung Wang, Shang-Hung Chang, Cheng-Hung Lee, Dong-Yi Chen, Chia-Hung Yang, Ming-Lung Tsai
BACKGROUND: Data regarding the long-term outcomes of a large patient population with multivessel coronary artery disease (MV-CAD) after complete revascularization (CR) and incomplete revascularization (IR) with drug-eluting stent (DES) implantation are controversial. The objective of this study was to evaluate differences between the clinical outcomes of CR and IR in such patients.Methods and Results:A total of 1,502 patients with MV-CAD who received DES between April 2005 and August 2016 were enrolled in this study after propensity score matching...
March 2, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
José Ferreira Santos
No abstract text is available yet for this article.
February 26, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
César Correia, Carlos Galvão Braga, Juliana Martins, Carina Arantes, Glória Abreu, Catarina Quina, Alberto Salgado, Miguel Álvares Pereira, João Costa, Jorge Marques
INTRODUCTION: There have been no prospective randomized trials that enable the best strategy and timing to be determined for revascularization in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and multivessel coronary artery disease (CAD). OBJECTIVES: To compare short- and long-term adverse events following multivessel vs. culprit-only revascularization in patients with NSTE-ACS and multivessel CAD. METHODS: This was a retrospective observational study that included all patients diagnosed with NSTE-ACS and multivessel CAD who underwent percutaneous coronary intervention (PCI) between January 2010 and June 2013 (n=232)...
February 24, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Deepak L Bhatt
No abstract text is available yet for this article.
February 22, 2018: Lancet
Stuart J Head, Milan Milojevic, Joost Daemen, Jung-Min Ahn, Eric Boersma, Evald H Christiansen, Michael J Domanski, Michael E Farkouh, Marcus Flather, Valentin Fuster, Mark A Hlatky, Niels R Holm, Whady A Hueb, Masoor Kamalesh, Young-Hak Kim, Timo Mäkikallio, Friedrich W Mohr, Grigorios Papageorgiou, Seung-Jung Park, Alfredo E Rodriguez, Joseph F Sabik, Rodney H Stables, Gregg W Stone, Patrick W Serruys, Arie Pieter Kappetein
BACKGROUND: Numerous randomised trials have compared coronary artery bypass grafting (CABG) with percutaneous coronary intervention (PCI) for patients with coronary artery disease. However, no studies have been powered to detect a difference in mortality between the revascularisation strategies. METHODS: We did a systematic review up to July 19, 2017, to identify randomised clinical trials comparing CABG with PCI using stents. Eligible studies included patients with multivessel or left main coronary artery disease who did not present with acute myocardial infarction, did PCI with stents (bare-metal or drug-eluting), and had more than 1 year of follow-up for all-cause mortality...
February 22, 2018: Lancet
Eric Van Belle, Robert Gil, Volker Klauss, Mohammed Balghith, Martijn Meuwissen, Jérôme Clerc, Bernhard Witzenbichler, Miha Cercek, Marios Vlachojannis, Irene Lang, Philippe Commeau, Flavien Vincent, Luca Testa, Wojciech Wasek, Nicolas Debry, Stephan Kische, Gabriele Gabrielli, Gennaro Sardella
OBJECTIVES: This study sought to prospectively assess the impact of routine invasive physiology at the time of angiography on reclassification of therapeutic management of multivessel disease (MVD) patients, and to assess how implementation of instantaneous wave-free ratio (iFR) alters the process. BACKGROUND: Routine invasive physiology in intermediate coronary lesions at the time of diagnostic angiography, primarily in patients with single-vessel disease and using fractional flow reserve (FFR), reclassifies coronary revascularization management in 26% to 44% of patients...
February 26, 2018: JACC. Cardiovascular Interventions
Joo Myung Lee, Tae-Min Rhee, Joo-Yong Hahn, Hyun Kuk Kim, Jonghanne Park, Doyeon Hwang, Ki Hong Choi, Jihoon Kim, Taek Kyu Park, Jeong Hoon Yang, Young Bin Song, Jin-Ho Choi, Seung-Hyuk Choi, Bon-Kwon Koo, Young Jo Kim, Shung Chull Chae, Myeong Chan Cho, Chong Jin Kim, Hyeon-Cheol Gwon, Ju Han Kim, Hyo-Soo Kim, Myung Ho Jeong
BACKGROUND: Recent trials demonstrated a benefit of multivessel percutaneous coronary intervention (PCI) for noninfarct-related artery (non-IRA) stenosis over IRA-only PCI in patients with ST-segment elevation myocardial infarction (STEMI) multivessel disease. However, evidence is limited in patients with cardiogenic shock. OBJECTIVES: This study investigated the prognostic impact of multivessel PCI in patients with STEMI multivessel disease presenting with cardiogenic shock, using the nationwide, multicenter, prospective KAMIR-NIH (Korea Acute Myocardial Infarction-National Institutes of Health) registry...
February 27, 2018: Journal of the American College of Cardiology
Jeevan Nagendran, Sabin J Bozso, Colleen M Norris, Finlay A McAlister, Jehangir J Appoo, Michael C Moon, Darren H Freed, Jayan Nagendran
BACKGROUND: The role of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) in patients with diabetes mellitus (DM) and multivessel coronary artery disease (CAD) has been established by large trials; however, these trials largely excluded patients with left ventricular dysfunction (LVD). OBJECTIVES: The aim of this study was to determine whether treatment with PCI or CABG leads to improved outcomes in patients with DM, CAD, and LVD...
February 27, 2018: Journal of the American College of Cardiology
Lin Jiang, Lianjun Xu, Lei Song, Zhan Gao, Jian Tian, Kai Sun, Hongwei Yu, Bo Xu, Lei Song, Jinqing Yuan
INTRODUCTION: Current guidelines recommend coronary artery bypass grafting (CABG) for patients with multivessel coronary disease and left ventricular (LV) dysfunction. However, some patients undergo percutaneous coronary intervention (PCI) or solely medical therapy (MT) in actual practice. The comparison of long-term outcomes of these three treatment strategies in real world is unclear. METHODS: A total of 699 consecutive patients in a single centre from 2004 to 2011 who had TVD and LV ejection fraction ≤40%, no prior PCI or CABG and had completed a median 6...
February 21, 2018: Journal of Interventional Cardiology
Y A Prilutskaya, L I Dvoretsky
OBJECTIVE: to compare strategies of invasive treatment of patients with non-ST elevation acute coronary syndrome (NSTEACS) hospitalized in 2014 and 2015. MATERIALS AND METHODS: We have analyzed treatment strategy used in patients with NSTEACS hospitalized in cardio-reanimation department of a city hospital during one month in two successive years (January 2014 and November 2015). We have compared indications to, and timing of coronary angiography, numbers of performed percutaneous coronary interventions (PCI) and coronary artery bypass grafting surgeries...
January 2018: Kardiologiia
Shakil Farid, Jason M Ali, Victoria Stohlner, Ruhina Alam, Peter Schofield, Samer Nashef, Ravi De Silva
OBJECTIVE: The primary objective was to investigate the long-term survival of patients who underwent single-vessel coronary revascularization with minimally invasive direct coronary artery bypass surgery with or without hybrid revascularization. The secondary outcome measures were repeat revascularization either by coronary artery bypass grafting or by percutaneous coronary intervention and the incidence of myocardial infarction or recurrent angina. METHODS: This is a retrospective study of prospectively collected data of patients who underwent minimally invasive direct coronary artery bypass procedure in our center between January 2001 and December 2015...
January 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Gianpiero D'Amico, Marco Basile, Giuseppe Tarantini, Alfredo Marchese
Acute ST-segment elevation myocardial infarction (STEMI) typically arises from total occlusion of an epicardial coronary artery, most often due to atherosclerotic plaque rupture/erosion and subsequent thrombus formation. Granted this, important angiographic information for patients presenting with STEMI is not only about the status of infarct-related artery (IRA) but also about the atherosclerotic disease burden and disease severity of non-IRA vessels. Previous studies have reported that multivessel (MV) coronary artery disease (CAD) is found in approximately 50% of patients with STEMI undergoing primary percutaneous coronary intervention (PCI) [1,2]...
February 19, 2018: Minerva Cardioangiologica
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