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Multivessel angioplasty

Sebastian J Reinstadler, Thomas Stiermaier, Charlotte Eitel, Mohammed Saad, Bernhard Metzler, Suzanne de Waha, Georg Fuernau, Steffen Desch, Holger Thiele, Ingo Eitel
BACKGROUND: Antecedent hypertension is associated with poor outcome in patients with ST-elevation myocardial infarction (STEMI). Whether differences in myocardial salvage, infarct size and microvascular injury contribute to the adverse outcome is unknown. We investigated the association between antecedent hypertension and cardiovascular magnetic resonance (CMR) parameters of myocardial salvage and damage in a multicenter CMR substudy of the AIDA-STEMI trial (Abciximab Intracoronary versus intravenously Drug Application in ST-elevation myocardial infarction)...
November 11, 2016: Journal of Cardiovascular Magnetic Resonance
Pilar Jiménez-Quevedo, Ana Serrador, Armando Pérez de Prado, Manuel Pan
INTRODUCTION AND OBJECTIVES: The Working Group on Cardiac Catheterization and Interventional Cardiology presents its annual report on the data from the registry of the activity in 2015. METHODS: All Spanish hospitals with catheterization laboratories were invited to voluntarily contribute their activity data. The information was collected online and analyzed mostly by an independent company. RESULTS: In 2015, 106 centers participated in the national register; 73 of these centers are public...
November 3, 2016: Revista Española de Cardiología
Kuljit Singh, Benjamin Hibbert, Balwinder Singh, Kristin Carson, Manuja Premaratne, Michel Le May, Aun-Yeong Chong, Margaret Arstall, Derek So
AIMS: Admission hyperglycaemia (AH) has been associated with worse outcomes in acute myocardial infarction (AMI). In the current review, we evaluated the impact of primary angioplasty (pPCI) on mortality in AMI patients with AH. Our second aim was to evaluate if AH is a marker of baseline risk or an independent predictor of mortality. METHODS AND RESULTS: A comprehensive search of four major databases was performed. We included original research studies reporting data on mortality in AMI patients with AH (mean plasma glucose >156 mg/dL/8...
October 2015: European Heart Journal. Cardiovascular Pharmacotherapy
Kenneth Mangion, David Carrick, Barry W Hennigan, Alexander R Payne, John McClure, Maureen Mason, Rajiv Das, Rebecca Wilson, Richard J Edwards, Mark C Petrie, Margaret McEntegart, Hany Eteiba, Keith G Oldroyd, Colin Berry
OBJECTIVE: We hypothesised that, compared with culprit-only primary percutaneous coronary intervention (PCI), additional preventive PCI in selected patients with ST-elevation myocardial infarction with multivessel disease would not be associated with iatrogenic myocardial infarction, and would be associated with reductions in left ventricular (LV) volumes in the longer term. METHODS: In the preventive angioplasty in myocardial infarction trial (PRAMI; ISRCTN73028481), cardiac magnetic resonance (CMR) was prespecified in two centres and performed (median, IQR) 3 (1, 5) and 209 (189, 957) days after primary PCI...
August 8, 2016: Heart: Official Journal of the British Cardiac Society
Yohei Sotomi, Rafael Cavalcante, David van Klaveren, Jung-Min Ahn, Cheol Whan Lee, Robbert J de Winter, Joanna J Wykrzykowska, Yoshinobu Onuma, Ewout W Steyerberg, Seung-Jung Park, Patrick W Serruys
OBJECTIVES: The study sought to validate the SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) score II mortality prediction model after percutaneous coronary intervention (PCI) or coronary artery bypass grafting in a large pooled population of patients with multivessel coronary disease (MVD) and/or unprotected left main disease (UPLMD) enrolled in the PRECOMBAT (Bypass Surgery Versus Angioplasty Using Sirolimus-Eluting Stent in Patients With Left Main Coronary Artery Disease) and BEST (Artery Bypass Surgery and Everolimus-Eluting Stent Implantation in the Treatment of Patients with Multivessel Coronary Artery Disease) randomized controlled trials...
August 8, 2016: JACC. Cardiovascular Interventions
Leonardo Danduch, Vicens Marti, Joan Garcia-Picart, Antoni Serra
We present a 55-year-old man with multivessel coronary artery disease previously treated with stenting of the left main, left anterior descending, right coronary, circumflex, and first diagonal branch. He was diagnosed with in-stent restenosis of a diagonal branch, but treatment was complicated by radial artery coronary embolism, which is a rare complication of radial intervention.
August 2016: Journal of Invasive Cardiology
Adam J Buntaine, Binita Shah, Jeffrey D Lorin, Steven P Sedlis
Patients with diabetes mellitus (DM) have more severe CAD and higher mortality in acute coronary syndrome (ACS) than patients without DM. The optimal mode of revascularization-coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI)-remains controversial in this setting. For patients with DM and ST-segment elevation myocardial infarction, prompt revascularization of the culprit artery via PCI is generally preferable. In non-ST-elevation ACS, the decision on mode of revascularization is more challenging...
August 2016: Current Cardiology Reports
Chaim Locker, Hartzell V Schaff, Richard C Daly, Joseph A Dearani, Malcolm R Bell, Robert L Frye, Kevin L Greason, John M Stulak, Lyle D Joyce, Alberto Pochettino, Zhuo Li, Ryan J Lennon, Amir Lerman
OBJECTIVE: To compare long-term survival with multiple arterial coronary artery bypass grafting (CABG) (MultArt) versus percutaneous coronary intervention (PCI) in patients with multivessel disease (MVD). METHODS: We reviewed 12,615 patients with MVD with isolated primary CABG or PCI from 1993 to 2009. Patients with CABG (n = 6667) were grouped according to the number of arterial grafts into left internal thoracic artery (LITA)/saphenous vein (SV) (n = 5712) or MultArt (n = 955); patients with PCI (n = 5948) were grouped into balloon angioplasty (BA) (n = 1020), drug-eluting stent (DES) (n = 1686), and bare metal stent (BMS) (n = 3242)...
August 2016: Journal of Thoracic and Cardiovascular Surgery
Woo-Young Chung, Jae-Bin Seo, Dong-Hyun Choi, Young-Seok Cho, Joo Myung Lee, Jung-Won Suh, Tae-Jin Youn, In-Ho Chae, Dong-Ju Choi
BACKGROUND/AIMS: The best revascularization strategy for patients with both acute ST-elevation myocardial infarction (STEMI) and multivessel coronary disease (MVD) is still debatable. We aimed to compare the outcomes of multivessel revascularization (MVR) with those of culprit-only revascularization (COR). METHODS: A cohort of 215 consecutive patients who had received primary angioplasty for STEMI and MVD were divided into two groups according to whether angioplasty had been also performed for a stenotic nonculprit artery...
May 2016: Korean Journal of Internal Medicine
Whady Hueb, Bernard J Gersh, Leandro Menezes Alves da Costa, Fernando Teiichi Costa Oikawa, Rodrigo Morel Vieira de Melo, Paulo Cury Rezende, Cibele Larrosa Garzillo, Eduardo Gomes Lima, Cesar Higa Nomura, Alexandre Volney Villa, Alexandre Ciappina Hueb, Celia Maria Cassaro Strunz, Desiderio Favarato, Myrthes Emy Takiuti, Cicero Piva de Albuquerque, Expedito Eustáquio Ribeiro da Silva, Jose Antonio Franchini Ramires, Roberto Kalil Filho
BACKGROUND: The lack of a correlation between myocardial necrosis biomarkers and electrocardiographic abnormalities after revascularization procedures has resulted in a change in the myocardial infarction (MI) definition. METHODS: Patients with stable multivessel disease who underwent percutaneous or surgical revascularization were included. Electrocardiograms and concentrations of high-sensitive cardiac troponin I (cTnI) and creatine kinase (CK)-MB were assessed before and after procedures...
June 2016: Annals of Thoracic Surgery
Javier Mariani, Alejandro Macchia, Maximiliano De Abreu, Gabriel Gonzalez Villa Monte, Carlos Tajer
BACKGROUND: Multivessel disease is common in acute coronary syndrome patients. However, if multivessel percutaneous coronary intervention is superior to culprit-vessel angioplasty has not been systematically addressed. METHODS: A metaanalysis was conducted including studies that compared multivessel angioplasty with culprit-vessel angioplasty among non-ST elevation ACS patients. Since all studies were observational adjusted estimates of effects were used. Pooled estimates of effects were computed using the generic inverse of variance with a random effects model...
2016: PloS One
Kristina Hambraeus, Karin Jensevik, Bo Lagerqvist, Bertil Lindahl, Roland Carlsson, Ramin Farzaneh-Far, Thomas Kellerth, Elmir Omerovic, Gregg Stone, Christoph Varenhorst, Stefan James
OBJECTIVES: The aim of this study was to describe current practice regarding completeness of revascularization in patients with multivessel disease undergoing percutaneous coronary intervention (PCI) and to investigate the association of incomplete revascularization (IR) with death, repeat revascularization, and myocardial infarction (MI) in a large nationwide registry. BACKGROUND: The benefits of multivessel PCI are controversial. METHODS: Between 2006 and 2010 we identified 23,342 patients with multivessel disease in the SCAAR (Swedish Coronary Angiography and Angioplasty Registry) and merged data with official Swedish health data registries...
February 8, 2016: JACC. Cardiovascular Interventions
Eduardo Gomes Lima, Whady Hueb, Bernard J Gersh, Paulo Cury Rezende, Cibele Larrosa Garzillo, Desiderio Favarato, Alexandre Ciappina Hueb, Rosa Maria Rahmi Garcia, José Antonio Franchini Ramires, Roberto Kalil Filho
BACKGROUND: Coronary artery disease (CAD) among patients with diabetes and chronic kidney disease (CKD) is not well studied, and the best treatment for this condition is not established. Our aim was to compare three therapeutic strategies for CAD in diabetic patients stratified by renal function. METHODS: Patients with multivessel CAD that underwent coronary artery bypass graft (CABG), angioplasty (percutaneous coronary intervention [PCI]), or medical therapy alone (MT) were included...
May 2016: Annals of Thoracic Surgery
Marcello Dominici, Alessio Arrivi, Marco Bazzucchi, Marcella De Paolis, Caterina Milici, Carlo Bock, Attilio Placanica, Ludovico Lazzari, Roberto Diletti, Enrico Boschetti
BACKGROUND: The purpose of this registry is to report the immediate and long-term safety and efficacy of the Biotronik Orsiro stent in an unselected population during everyday practice. METHODS: Between May 2012 and June 2013, 246 consecutive coronary angioplasty procedures were performed using at least one Orsiro drug-eluting stent, in 225 patients and 303 lesions. RESULTS: Diabetes was present in 34.7% of patients. Procedures were non-elective percutaneous coronary intervention (PCI) in 17...
February 2016: Minerva Cardioangiologica
Sudhakar George, Patrick A Calvert
PURPOSE OF REVIEW: The purpose of this review is to highlight important and interesting advances in the field of ischaemic heart disease that have occurred over the last 18 months. It is focused on research that is likely to lead to changes in clinical practice. RECENT FINDINGS: There is new evidence on appropriate pharmacotherapy during angioplasty in both stable and unstable patients. The use of pressure wire assessment has been shown to improve patient outcome...
November 2015: Current Opinion in Cardiology
Yoshifumi Nakajima, Tomonori Itoh, Yoshihiro Morino
A 54-year-old woman treated with cobalt-chromium everolimus eluting stents (CoCr-EES) for her left distal circumflex and diagonal branch lesions suffered from repeated in-stent restenosis in both lesions. Neointimal proliferation occurred rapidly and almost simultaneously in the two lesions. The cause was established to be metal allergy, as determined by patch tests which were strongly positive for bare metal stents and weakly positive for CoCr-EES. Following the third successive angioplasty, we initiated treatment with prednisolone (30 mg daily) and the anti-allergic and anti-proliferative drug tranilast (300 mg daily)...
March 2016: Catheterization and Cardiovascular Interventions
Dan Eik Høfsten, Henning Kelbæk, Steffen Helqvist, Lene Kløvgaard, Lene Holmvang, Peter Clemmensen, Christian Torp-Pedersen, Hans-Henrik Tilsted, Hans Erik Bøtker, Lisette Okkels Jensen, Lars Køber, Thomas Engstrøm
BACKGROUND: In patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction, ischemic postconditioning has been shown to reduce infarct size, but the effect on clinical outcome has not been tested in a large randomized trial. In addition, deferring stent implantation in the infarct-related lesion 1 to 3 days after acute opening of the infarct-related artery could have protective effects, by reducing the risk of injury caused by distal embolization and microvascular obstruction...
May 2015: American Heart Journal
Sebastian Carrizo, Rafael Peinado Peinado, Angel Sanchez-Recalde, Juan Ruiz-Garcia, Santiago Jimenez-Valero, Guillermo Galeote, Sergio Garcia-Blas, Gabriel Trucco, Luis Calvo Orbe, Esteban Lopez-De-Sa, Raul Moreno, Jose Luis Lopez-Sendon
INTRODUCTION: Sudden death (SD) is in most cases due to cardiac causes, mainly secondary to ischemic heart disease. However, the angiographic characteristics in SD survivors in the context of an acute coronary syndrome (ACS) remain controversial. The aim of this study was to evaluate the clinical and angiographic characteristics of patients who suffered cardiac arrest during an ACS. METHODS: We evaluated 46 patients with SD related to ACS, who were divided into two groups according to their presentation: an ST-elevation myocardial infarction (SD-STEMI) group and a non ST-elevation myocardial infarction (SD-NSTEMI) group...
March 2015: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
Ari Pollack, Bibhu D Mohanty, Rishi Handa, Patrick M Looser, Valentin Fuster, Spencer B King, Samin K Sharma
Current practice guidelines advocate culprit vessel intervention alone in patients with ST-segment elevation myocardial infarction (STEMI) found to have multivessel coronary disease during primary percutaneous coronary intervention (PCI). The debate on the timing of noninfarct artery intervention has recently been reinvigorated by the PRAMI (Preventive Angioplasty in Acute Myocardial Infarction) trial, in which patients undergoing preventive PCI of significant nonculprit lesions at the time primary PCI for STEMI had reduced rates of cardiac death, nonfatal myocardial infarction, and refractory angina...
January 2015: JACC. Cardiovascular Interventions
Basem Elbarouni, Warren J Cantor, John Ducas, Bjug Borgundvaag, Vladimír Džavík, Michael Heffernan, Christopher E Buller, Anatoly Langer, Shaun G Goodman, Andrew T Yan
BACKGROUND: A strategy of early transfer for coronary angiography and intervention is superior to a standard approach of delayed coronary angiography after fibrinolysis for ST-elevation myocardial infarction (STEMI). STEMI patients with lesions in noninfarct-related arteries have a worse prognosis compared with patients with single vessel disease. This study aimed to assess whether the benefits of an early invasive strategy differ in patients with single vessel and multivessel disease...
December 2014: Canadian Journal of Cardiology
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