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Coronary artery bypass and angioplasty

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https://www.readbyqxmd.com/read/29205995/volume-and-health-outcomes-evidence-from-systematic-reviews-and-from-evaluation-of-italian-hospital-data
#1
Laura Amato, Danilo Fusco, Anna Acampora, Katia Bontempi, Alessandro Cesare Rosa, Paola Colais, Fabio Cruciani, Mariangela D'Ovidio, Francesca Mataloni, Silvia Minozzi, Zuzana Mitrova, Luigi Pinnarelli, Rosella Saulle, Salvatore Soldati, Chiara Sorge, Simona Vecchi, Martina Ventura, Marina Davoli
BACKGROUND Improving quality and effectiveness of healthcare is one of the priorities of health policies. Hospital or physician volume represents a measurable variable with an impact on effectiveness of healthcare. An Italian law calls for the definition of «qualitative, structural, technological, and quantitative standards of hospital care». There is a need for an evaluation of the available scientific evidence in order to identify qualitative, structural, technological, and quantitative standards of hospital care, including the volume of care above or below which the public and private hospitals may be accredited (or not) to provide specific healthcare interventions...
September 2017: Epidemiologia e Prevenzione
https://www.readbyqxmd.com/read/29148628/clinical-significance-of-st-depression-at-exercise-stress-testing-in-competitive-athletes-usefulness-of-coronary-ct-during-screening
#2
Fabio Sperandii, Emanuele Guerra, Eliana Tranchita, Carlo Minganti, Chiara Lanzillo, Antonia Nigro, Federico Quaranta, Attilio Parisi, Mauro DI Roma, Luciano Maresca, Federica Fagnani, Leonardo Calò
BACKGROUND: Congenital coronary anomalies (CCAs) and coronary artery disease (CAD) arouse intense scientific and clinical interest in sports medicine and sports cardiology medical communities because of their potential to trigger sudden cardiac death (SCD) in athletes. Exercise stress testing represent the first instrumental assessment to evaluate electrocardiographic changes during effort. Coronary computed tomography angiography (CCTA) is an advanced accurate noninvasive imaging modality for excluding CAD and abnormalities of origin and course of coronary vessels...
November 17, 2017: Journal of Sports Medicine and Physical Fitness
https://www.readbyqxmd.com/read/29132880/rivaroxaban-with-or-without-aspirin-in-patients-with-stable-peripheral-or-carotid-artery-disease-an-international-randomised-double-blind-placebo-controlled-trial
#3
Sonia S Anand, Jackie Bosch, John W Eikelboom, Stuart J Connolly, Rafael Diaz, Peter Widimsky, Victor Aboyans, Marco Alings, Ajay K Kakkar, Katalin Keltai, Aldo P Maggioni, Basil S Lewis, Stefan Störk, Jun Zhu, Patricio Lopez-Jaramillo, Martin O'Donnell, Patrick J Commerford, Dragos Vinereanu, Nana Pogosova, Lars Ryden, Keith A A Fox, Deepak L Bhatt, Frank Misselwitz, John D Varigos, Thomas Vanassche, Alvaro A Avezum, Edmond Chen, Kelley Branch, Darryl P Leong, Shrikant I Bangdiwala, Robert G Hart, Salim Yusuf
BACKGROUND: Patients with peripheral artery disease have an increased risk of cardiovascular morbidity and mortality. Antiplatelet agents are widely used to reduce these complications. METHODS: This was a multicentre, double-blind, randomised placebo-controlled trial for which patients were recruited at 602 hospitals, clinics, or community practices from 33 countries across six continents. Eligible patients had a history of peripheral artery disease of the lower extremities (previous peripheral bypass surgery or angioplasty, limb or foot amputation, intermittent claudication with objective evidence of peripheral artery disease), of the carotid arteries (previous carotid artery revascularisation or asymptomatic carotid artery stenosis of at least 50%), or coronary artery disease with an ankle-brachial index of less than 0·90...
November 10, 2017: Lancet
https://www.readbyqxmd.com/read/29102209/minimally-invasive-coronary-artery-bypass-grafting-with-bilateral-internal-thoracic-arteries-will-this-be-the-future
#4
Pradeep Nambiar, Sanjay Kumar, Chander Mohan Mittal, Kailash Saksena
OBJECTIVE: The aim was to show that total arterial revascularization via a left minithoracotomy using bilateral internal thoracic arteries was not only feasible but also a safe and reproducible procedure with excellent midterm outcomes. METHODS: From August 2011 to August 2016, 819 patients underwent off-pump minimally invasive multivessel coronary artery bypass grafting using bilateral internal thoracic arteries harvested through a 2-inch left minithoracotomy incision, and complete revascularization of the myocardium was performed using the left internal thoracic artery-right internal thoracic artery Y composite conduit...
September 28, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29079252/effect-of-an-intensified-multifactorial-intervention-on-cardiovascular-outcomes-and-mortality-in-type-2-diabetes-j-doit3-an-open-label-randomised-controlled-trial
#5
Kohjiro Ueki, Takayoshi Sasako, Yukiko Okazaki, Masayuki Kato, Sumie Okahata, Hisayuki Katsuyama, Mikiko Haraguchi, Ai Morita, Ken Ohashi, Kazuo Hara, Atsushi Morise, Kazuo Izumi, Naoki Ishizuka, Yasuo Ohashi, Mitsuhiko Noda, Takashi Kadowaki
BACKGROUND: Limited evidence suggests that multifactorial interventions for control of glucose, blood pressure, and lipids reduce macrovascular complications and mortality in patients with type 2 diabetes. However, safe and effective treatment targets for these risk factors have not been determined for such interventions. METHODS: In this multicentre, open-label, randomised, parallel-group trial, undertaken at 81 clinical sites in Japan, we randomly assigned (1:1) patients with type 2 diabetes aged 45-69 years with hypertension, dyslipidaemia, or both, and an HbA1c of 6·9% (52·0 mmol/mol) or higher, to receive conventional therapy for glucose, blood pressure, and lipid control (targets: HbA1c <6·9% [52·0 mmol/mol], blood pressure <130/80 mm Hg, LDL cholesterol <120 mg/dL [or 100 mg/dL in patients with a history of coronary artery disease]) or intensive therapy (HbA1c <6·2% [44·3 mmol/mol], blood pressure <120/75 mm Hg, LDL cholesterol <80 mg/dL [or 70 mg/dL in patients with a history of coronary artery disease])...
October 24, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/29051213/changes-in-statin-adherence-following-an-acute-myocardial-infarction-among-older-adults-patient-predictors-and-the-association-with-follow-up-with-primary-care-providers-and-or-cardiologists
#6
Ryan P Hickson, Jennifer G Robinson, Izabela E Annis, Ley A Killeya-Jones, Maarit Jaana Korhonen, Ashley L Cole, Gang Fang
BACKGROUND: Hospitalizations for acute myocardial infarctions (AMIs) are associated with changes in statin adherence. It is unclear to what extent adherence changes, which patients are likely to change, and how post-discharge follow-up is associated with statin adherence change. METHODS AND RESULTS: This retrospective study used Medicare data for all fee-for-service beneficiaries 66 years and older with an AMI hospitalization in 2008-2010 and statin use before their index AMI...
October 19, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28992207/propensity-score-based-methods-in-comparative-effectiveness-research-on-coronary-artery-disease
#7
Alexandra G Ellis, Thomas A Trikalinos, Benjamin S Wessler, John B Wong, Issa J Dahabreh
This review examines the conduct and reporting of observational studies using propensity score-based methods to compare coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), or medical therapy for patients with coronary artery disease. A systematic selection process identified 48 studies: 20 CABG vs. PCI; 21 bare-metal stents vs. drug-eluting stents; 5 CABG vs. medical therapy; 1 PCI vs. medical therapy; and 1 drug-eluting stents vs. balloon angioplasty. Of 32 studies reporting information on variable selection, 7 relied exclusively on statistical criteria for the association of covariates with treatment and 5 used such criteria to determine whether product or non-linear terms should be included in the propensity score model...
July 13, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/28947228/outcomes-after-first-time-lower-extremity-revascularization-for-chronic-limb-threatening-ischemia-between-patients-with-and-without-diabetes
#8
Jeremy D Darling, Thomas C F Bodewes, Sarah E Deery, Raul J Guzman, Mark C Wyers, Allen D Hamdan, Hence J Verhagen, Marc L Schermerhorn
OBJECTIVE: The effect of diabetes type and insulin dependence on short- and long-term outcomes after lower extremity revascularization for chronic limb-threatening ischemia (CLTI) warrants additional study and more targeted focus. We sought to address this paucity of information by evaluating outcomes in insulin-dependent and noninsulin-dependent patients after any first-time revascularization. METHODS: We reviewed all limbs undergoing first-time infrainguinal bypass grafting (BPG) or percutaneous transluminal angioplasty with or without stenting (PTA/S) for CLTI at our institution from 2005 to 2014...
September 22, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28919628/coronary-artery-bypass-graft-with-endarterectomy-and-stent-removal-in-patient-with-multivessel-in-stent-restenosis
#9
S S Husain, C M Ahmed, A B Adhikary, S A Sunny, M N Hasan
In the age of stent deployment after balloon angioplasty. In stent restenosis (ISR) has become a major concern. Various coronary interventional measures and coronary artery bypass graft (CABG) has employed to manage the ISR. Although CABG seems to offer advantages over other coronary intervention methods in patients with multi vessel ISR; lack of appropriate graftable vessels often make the surgery difficult and end up with incomplete revascularization. Coronary endarterectomy with stent removal mitigated some of the limitations of CABG but initial results of this surgical measure were not favorable...
July 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28890308/left-ventricular-mass-geometry-and-function-in-diabetic-patients-affected-by-coronary-artery-disease
#10
Maria Maiello, Annapaola Zito, Santa Carbonara, Marco Matteo Ciccone, Pasquale Palmiero
INTRODUCTION: Coronary artery disease (CAD) is quite common among diabetic patients, our study goal is to detect the prevalence of left ventricular (LV) adverse changes in geometry, mass and diastolic function on diabetic, but not hypertensive patients, with coronary artery disease(CAD) and LV ejection fraction(LVEF)>45%, actually unknown, because of current guidelines that do not include echocardiographic assessment for follow up of diabetic patients. PATIENTS AND METHODS: 665 consecutive diabetic patients (443 females, mean age 66±9years), performed a complete echocardiographic assessment according to current ASE echo-guidelines: diastolic dysfunction (DD), eccentric hypertrophy (EH), concentric hypertrophy (CH) and concentric remodeling (CR) of LV were reported...
October 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28888272/gender-differences-in-coronary-angiography-subsequent-interventions-and-outcomes-among-patients-with-acute-coronary-syndromes
#11
MULTICENTER STUDY
Gudny Stella Gudnadottir, Karl Andersen, Inga Sigurros Thrainsdottir, Stefan Karl James, Bo Lagerqvist, Thorarinn Gudnason
BACKGROUND: The objective was to investigate whether gender disparities are found in referrals of patients with acute coronary syndromes to percutaneous coronary interventions (PCIs) or coronary artery bypass grafting (CABG) and, furthermore, to study gender differences in complications and mortality. METHODS: All consecutive coronary angiographies (CAs) and PCIs performed in Sweden and Iceland are prospectively registered in the Swedish Coronary Angiography and Angioplasty Registry...
September 2017: American Heart Journal
https://www.readbyqxmd.com/read/28876423/thrombosed-aneurysm-of-saphenous-vein-coronary-artery-bypass-grafting
#12
Rodolfo Mendes Queiroz, Rogério Nastri, Marcus Antônio Ferez, Mauro José Brandão da Costa, Claudio Benedini Laguna, Marcus Vinicius Nascimento Valentin
We describe the case of a male patient, aged 76 years, referred for cardiac investigation due to retrosternal chest pain and dyspnea. He had a history of acute myocardial infarction and angioplasties in the last 30 years, including a saphenous vein coronary artery bypass grafting (SVCABG). Echocardiogram showed hypoechoic oval formation near the right ventricle, suggesting a pericardial cyst. Computed angiotomography revealed a predominantly fusiform and thrombosed aneurysmal dilation of the SVCABG to the right coronary artery...
June 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28854963/takayasu-s-arteritis-a-case-with-relapse-after-urgent-coronary-revascularization
#13
Klaus Empen, Astrid Hummel, Daniel Beug, Stephan B Felix, Mathias C Busch, Piotr M Kaczmarek
BACKGROUND: Vasculitides are commonly unrecognized causes of coronary stenosis and myocardial ischemia. We report on a 24-year old patient with Takayasu's arteritis who underwent urgent percutaneous coronary intervention, suffered from symptomatic restenosis of the left main coronary artery during standard immunosuppressive therapy. CASE PRESENTATION: A 24-year old woman was referred for coronary angiography because of typical progressive angina pectoris. On bicycle ergometry, there were both reproducible symptoms and deep ST segment depressions on precordial leads...
July 25, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28836672/whole-grain-cereals-for-the-primary-or-secondary-prevention-of-cardiovascular-disease
#14
REVIEW
Sarah Am Kelly, Louise Hartley, Emma Loveman, Jill L Colquitt, Helen M Jones, Lena Al-Khudairy, Christine Clar, Roberta Germanò, Hannah R Lunn, Gary Frost, Karen Rees
BACKGROUND: There is evidence from observational studies that whole grains can have a beneficial effect on risk for cardiovascular disease (CVD). Earlier versions of this review found mainly short-term intervention studies. There are now longer-term randomised controlled trials (RCTs) available. This is an update and expansion of the original review conducted in 2007. OBJECTIVES: The aim of this systematic review was to assess the effect of whole grain foods or diets on total mortality, cardiovascular events, and cardiovascular risk factors (blood lipids, blood pressure) in healthy people or people who have established cardiovascular disease or related risk factors, using all eligible RCTs...
August 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28802735/incidence-of-cardiovascular-events-and-vascular-interventions-in-patients-with-type-2-diabetes
#15
Suzanne E Engelen, Yolanda van der Graaf, Manon C Stam-Slob, Diederick E Grobbee, Maarten J Cramer, L Jaap Kappelle, Gert J de Borst, Frank L J Visseren, Jan Westerink
OBJECTIVE: Diabetes mellitus is associated with an increased risk for cardiovascular morbidity and mortality. The vascular burden in terms of incidence of cardiovascular events (CVE) and vascular interventions is however poorly quantified. In this study we evaluated the incidence rates of CVE and vascular interventions in patients with type 2 diabetes (T2DM) with and without cardiovascular disease (CVD) in comparison to patients without type 2 diabetes. RESEARCH DESIGN AND METHODS: In a cohort of 9...
December 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28802533/bifurcation-culprit-lesions-in-st-segment-elevation-myocardial-infarction-procedural-success-and-5-year-outcome-compared-with-nonbifurcation-lesions
#16
Pablo Salinas, Hernán Mejía-Rentería, Raúl Herrera-Nogueira, Pilar Jiménez-Quevedo, Luis Nombela-Franco, Iván Javier Núñez-Gil, Nieves Gonzalo, María Del Trigo, María José Pérez-Vizcayno, Alicia Quirós, Javier Escaned, Carlos Macaya, Antonio Fernández-Ortiz
INTRODUCTION AND OBJECTIVES: We assessed short- and long-term outcomes of primary angioplasty in ST-segment elevation myocardial infarction by comparing bifurcation culprit lesions (BCL) with non-BCL. METHODS: Observational study with a propensity score matched control group. Among 2746 consecutive ST-segment elevation myocardial infarction patients, we found 274 (10%) patients with BCL. The primary outcome was a composite endpoint including all-cause death, myocardial infarction, coronary artery bypass grafting or target vessel revascularization, assessed at 30-days and 5-years...
August 9, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28759844/circulating-soluble-receptor-for-advanced-glycation-end-product-cross-sectional-associations-with-cardiac-markers-and-subclinical-vascular-disease-in-older-men-with-and-without-diabetes
#17
S Goya Wannamethee, Paul Welsh, Olia Papacosta, Elizabeth A Ellins, Julian P J Halcox, Peter H Whincup, Naveed Sattar
BACKGROUND AND AIMS: The soluble receptor for advanced glycation end products (sRAGE) has been implicated in diabetic vascular complications. We have examined the association between sRAGE and cardiac markers [NT-proBNP and cardiac troponin T (cTnT)] and subclinical vascular markers in older men with and without diabetes. METHODS: We performed a cross-sectional study of 1159 men aged 71-92 years with no history of cardiovascular disease (myocardial infarction, stroke, heart failure, coronary artery bypass graft operation or angioplasty)...
September 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28759107/low-glycaemic-index-diets-for-the-prevention-of-cardiovascular-disease
#18
REVIEW
Christine Clar, Lena Al-Khudairy, Emma Loveman, Sarah Am Kelly, Louise Hartley, Nadine Flowers, Roberta Germanò, Gary Frost, Karen Rees
BACKGROUND: The glycaemic index (GI) is a physiological measure of the ability of a carbohydrate to affect blood glucose. Interest is growing in this area for the clinical management of people at risk of, or with, established cardiovascular disease. There is a need to review the current evidence from randomised controlled trials (RCTs) in this area. This is an update of the original review published in 2008. OBJECTIVES: To assess the effect of the dietary GI on total mortality, cardiovascular events, and cardiovascular risk factors (blood lipids, blood pressure) in healthy people or people who have established cardiovascular disease or related risk factors, using all eligible randomised controlled trials...
July 31, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28728654/comparison-of-stenting-versus-bypass-surgery-according-to-the-completeness-of-revascularization-in-severe-coronary-artery-disease-patient-level-pooled-analysis-of-the-syntax-precombat-and-best-trials
#19
Jung-Min Ahn, Duk-Woo Park, Cheol Whan Lee, Mineok Chang, Rafael Cavalcante, Yohei Sotomi, Yoshinobu Onuma, Erhan Tenekecioglu, Minkyu Han, Pil Hyung Lee, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Seong-Wook Park, Patrick W Serruys, Seung-Jung Park
OBJECTIVES: The aim of this study was to compare long-term survival between patients with severe coronary artery disease undergoing coronary artery bypass grafting (CABG) and those undergoing percutaneous coronary intervention (PCI) achieving complete revascularization (CR) or incomplete revascularization. BACKGROUND: The importance of CR in decision making regarding revascularization strategy in patients with severe coronary artery disease is unknown. METHODS: Data were pooled from the SYNTAX (Synergy Between PCI With Taxus and Cardiac Surgery), PRECOMBAT (Premier of Randomized Comparison of Bypass Surgery Versus Angioplasty Using Sirolimus-Eluting Stent in Patients With Left Main Coronary Artery Disease), and BEST (Randomized Comparison of Coronary Artery Bypass Surgery and Everolimus-Eluting Stent Implantation in the Treatment of Patients With Multivessel Coronary Artery Disease) trials...
July 24, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28673897/an-aggregate-biomarker-risk-score-predicts-high-risk-of-near-term-myocardial-infarction-and-death-findings-from-bari-2d-bypass-angioplasty-revascularization-investigation-2-diabetes
#20
Nima Ghasemzadeh, Maria M Brooks, Helen Vlachos, Regina Hardison, Sergey Sikora, Laurence Sperling, Arshed A Quyyumi, Stephen E Epstein
BACKGROUND: In a previous study, we found that a biomarker risk score (BRS) comprised of C-reactive protein, fibrin-degradation products, and heat shock protein-70 predicts risk of myocardial infarction and death in coronary artery disease patients. We sought to: (1) validate the BRS in the independent BARI 2D (Bypass Angioplasty Revascularization Investigation 2 Diabetes) cohort, (2) investigate whether 1 year of intensive medical therapy is associated with improved BRS, and (3) elucidate whether an altered BRS parallels altered risk...
July 3, 2017: Journal of the American Heart Association
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