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syntax score primary pci

Arie Pieter Kappetein, Patrick W Serruys, Joseph F Sabik, Martin B Leon, David P Taggart, Marie-Claude Morice, Bernard J Gersh, Stuart J Pocock, David J Cohen, Lars Wallentin, Ori Ben-Yehuda, Gerrit-Anne van Es, Charles A Simonton, Gregg W Stone
AIMS: Coronary artery bypass graft (CABG) surgery is the standard of care for revascularisation of patients with left main coronary artery disease (LMCAD). Recent studies have suggested that percutaneous coronary intervention (PCI) with drug-eluting stents (DES) may provide comparable outcomes in selected patients with LMCAD without extensive CAD. We therefore designed a trial to investigate whether PCI with XIENCE cobalt-chromium everolimus-eluting stents (CoCr-EES) would result in non-inferior or superior clinical outcomes to CABG in selected patients with LMCAD...
September 18, 2016: EuroIntervention
Takuya Nakahashi, Kenji Sakata, Akihiro Nomura, Yohei Yakuta, Tadatsugu Gamou, Hidenobu Terai, Yuki Horita, Masatoshi Ikeda, Masanobu Namura, Masayuki Takamura, Masa-Aki Kawashiri, Masakazu Yamagishi, Kenshi Hayashi
Although Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery (SYNTAX) score based on angiographic scoring system was developed in patients with previous coronary artery bypass grafting (CABG), few data exist regarding its prognostic utility in patients undergoing percutaneous coronary intervention (PCI). We examined 272 patients with previous CABG (217 men; mean age, 70.4 ± 9.7 years) undergoing PCI. Severity of the coronary anatomy was evaluated using CABG-SYNTAX score. The primary end point of this study was cardiovascular death...
October 1, 2016: American Journal of Cardiology
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
Anna Franzone, Masanori Taniwaki, Fabio Rigamonti, Dik Heg, Raffaele Piccolo, Marco Roffi, David Tüller, Olivier Muller, Andre Vuilliomenet, Stéphane Cook, Daniel Weilenmann, Christoph Kaiser, Peiman Jamshidi, Peter Jüni, Stephan Windecker, Thomas Pilgrim
AIMS: We sought to assess the performance of drug-eluting stents combining an ultrathin cobalt-chromium platform with a biodegradable polymer across categories of increasing SYNTAX score (SS). METHODS AND RESULTS: Patients included in the BIOSCIENCE trial and randomly allocated to treatment with biodegradable polymer sirolimus-eluting stents (BP-SES) or durable polymer everolimus-eluting stents (DP-EES) were categorised according to SS tertiles (low <8, medium 8-15, high >15)...
2016: EuroIntervention
Jin Kyung Hwang, Jeong Hoon Yang, Ji-Won Hwang, Woo Jin Jang, Young Bin Song, Joo-Yong Hahn, Jin-Ho Choi, Sang Hoon Lee, Hyeon-Cheol Gwon, Seung-Hyuk Choi
There are limited data regarding the efficacy of β-blockers for secondary prevention in patients with coronary chronic total occlusion (CTO). Therefore, we investigated the association of β-blocker therapy with long-term clinical outcomes in CTO patients. From March 2003 to February 2012, a total of 2024 CTO patients treated with either medical therapy alone or revascularization were enrolled in the study. We assessed 1596 patients with stable ischemic heart disease and divided them into the β-blocker group (n = 932) and the no-β-blocker group (n = 664)...
July 2016: Medicine (Baltimore)
John D Puskas, Michael E Halkos, Joseph J DeRose, Emilia Bagiella, Marissa A Miller, Jessica Overbey, Johannes Bonatti, V S Srinivas, Mark Vesely, Francis Sutter, Janine Lynch, Katherine Kirkwood, Timothy A Shapiro, Konstantinos D Boudoulas, Juan Crestanello, Thomas Gehrig, Peter Smith, Michael Ragosta, Steven J Hoff, David Zhao, Annetine C Gelijns, Wilson Y Szeto, Giora Weisz, Michael Argenziano, Thomas Vassiliades, Henry Liberman, William Matthai, Deborah D Ascheim
BACKGROUND: Hybrid coronary revascularization (HCR) combines minimally invasive surgical coronary artery bypass grafting of the left anterior descending artery with percutaneous coronary intervention (PCI) of non-left anterior descending vessels. HCR is increasingly used to treat multivessel coronary artery disease that includes stenoses in the proximal left anterior descending artery and at least 1 other vessel, but its effectiveness has not been rigorously evaluated. OBJECTIVES: This National Institutes of Health-funded, multicenter, observational study was conducted to explore the characteristics and outcomes of patients undergoing clinically indicated HCR and multivessel PCI for hybrid-eligible coronary artery disease, to inform the design of a confirmatory comparative effectiveness trial...
July 26, 2016: Journal of the American College of Cardiology
Grant W Reed, Ahmad Masri, Brian P Griffin, Samir R Kapadia, Stephen G Ellis, Milind Y Desai
BACKGROUND: The incidence and predictors of long-term mortality after percutaneous coronary intervention (PCI) for radiation-associated coronary artery disease are unknown. METHODS AND RESULTS: In this observational study of 314 patients (age, 65.2±11.4 years; 233 [74%] women) treated with PCI, 157 patients with previous external beam radiation therapy (XRT) were matched 1:1 with 157 comparison patients with atherosclerotic coronary artery disease without previous XRT, based on age, sex, lesion artery, and PCI type...
June 2016: Circulation. Cardiovascular Interventions
Javier Escaned, Adrian Banning, Vasim Farooq, Mauro Echavarria-Pinto, Yoshinobu Onuma, Nicola Ryan, Rafael Cavalcante, Carlos M Campos, Bojan M Stanetic, Yuki Ishibashi, Pannipa Suwannasom, Arie-Pieter Kappetein, David Taggart, Marie-Angèle Morel, Gerrit-Anne van Es, Patrick W Serruys
AIMS: The applicability of the results of the SYNTAX trial comparing percutaneous coronary intervention (PCI) using first-generation drug-eluting stents (DES) with coronary artery bypass graft (CABG) surgery for the treatment of patients with complex coronary artery disease (CAD) has been challenged by recent major technical and procedural developments in coronary revascularisation. Functional assessment of coronary lesions has contributed to marked improvements in both safety and efficacy of DES implantation...
June 12, 2016: EuroIntervention
Zhe Zheng, Bo Xu, Heng Zhang, Changdong Guan, Ying Xian, Yanyan Zhao, Hongyang Fan, Yuejin Yang, Wei Wang, Runlin Gao, Shengshou Hu
OBJECTIVES: This study sought to investigate long-term clinical outcomes following coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) in patients with unprotected left main disease (ULMD). BACKGROUND: PCI has been increasingly used as an alternative mode of revascularization for ULMD. However, there are limited data comparing clinical outcomes between CABG surgery and PCI. METHODS: Between 2004 and 2010, 4,046 consecutive patients with ULMD were treated with either CABG surgery (n = 2,604) or PCI (n = 1,442) with drug-eluting stents...
June 13, 2016: JACC. Cardiovascular Interventions
Gang Wang, Chen Wang, Yuhui Zhang, Peng Wang, Chenguang Ran, Lei Zhao, Lixian Han
OBJECTIVE: This study aimed to investigate the predictive effect of SYNTAX score II (SS-II) for the 1-year outcome in patients with ST-segment elevation myocardial infarction undergoing a primary percutaneous coronary intervention and whether SS-II improves the ability of anatomical and Logistic Clinical SYNTAX score and Global Registry of Acute Coronary Events to predict major adverse cardiac events (MACE). BACKGROUND: SS-II can predict 1-year outcomes in patients with complex coronary artery disease...
September 2016: Coronary Artery Disease
Onur Kadir Uysal, Caner Turkoglu, Mustafa Duran, Mehmet Gungor Kaya, Durmus Yildiray Sahin, Mustafa Gur, Murat Cayli
BACKGROUND: CHADS2 and CHA2DS2-VASc scores are widely used in clinical practice and include similar risk factors for the development of coronary artery disease (CAD). It is known that the factors comprising the newly defined CHA2DS2-VASc-HSF score promote atherosclerosis and are associated with severity of CAD. AIM: To investigate the association of the CHA2DS2-VASc-HSF score with the severity of CAD as assessed by SYNTAX score (SxS) in patients with ST segment elevation myocardial infarction (STEMI)...
2016: Kardiologia Polska
R S Tarasov, V I Ganyukov, O L Barbarash, L S Barbarash
Based on the findings of a single-centre study of 327 patients presenting with ST segment elevation myocardial infarction (STEMI) subjected to primary percutaneous coronary intervention (PCI) we examined the prognostic role of severity of atherosclerotic multivascular lesion (ML) of the coronary bed. The patients were subdivided into three groups depending on the quantitative index assessing severity of coronary atherosclerosis in points with the help of the SYNTAX scale. Group One was composed of 207 patients with the SYNTAX score≤22 points (moderate lesion), Group Two comprised 89 patients with severe coronary atherosclerosis and the SYNTAX equalling 23-32 points, whereas 31 patients were included into Group Three with extremely severe lesion and the SYNTAX score>32 points...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Mohamed Loutfi, Sherif Ayad, Mohamed Sobhy
UNLABELLED: Primary percutaneous coronary intervention (P-PCI) has become the preferred reperfusion strategy in ST-elevation myocardial infarction (STEMI) when performed by an experienced team in a timely manner. However, no consensus exists regarding the management of multivessel coronary disease detected at the time of P-PCI. AIM: The aim of this study was to evaluate the use of the residual SYNTAX score (rSS) following a complete vs. culprit-only revascularization strategy in patients with STEMI and multivessel disease (MVD) to quantify the extent and complexity of residual coronary stenoses and their impact on adverse ischemic outcomes...
2016: Clinical Medicine Insights. Cardiology
R S Tarasov, A M Kochergina, V I Ganyukov, O L Barbarash
AIM: To investigate the impact of the degree of coronary atherosclerosis evaluated by the SYNTAX scale on the early and late results of endovascular revascularization in elderly and middle-aged patients with ST-segment elevation myocardial infarction (STEMI). SUBJECTS AND METHODS: The investigation enrolled 327 consecutively admitted patients with STEMI and multivessel coronary bed disease, who had received revascularization within the first 12 hours after disease onset via primary percutaneous coronary interventions (PCI)...
2016: Terapevticheskiĭ Arkhiv
Carlos Haiek, Carlos Fernández-Pereira, Omar Santaera, Juan Mieres, Ignacio Rifourcat, Juan Lloberas, Miguel Larribau, Antonio Pocoví, Alfredo M Rodriguez-Granillo, Ricardo A Sarmiento, David Antoniucci, Alfredo E Rodriguez
OBJECTIVE: To compare second generation drug eluting stents (2DES) with first generation (1DES) for the treatment of patients (pts) with multiple coronary vessel disease (MVD). BACKGROUND: Although 2DES improved safety and efficacy compared to 1DES, MVD remains a challenge for percutaneous coronary interventions. METHODS: ERACI IV was a prospective, observational, and controlled study in pts with MVD including left main and treated with 2DES (Firebird 2, Microport)...
March 7, 2016: Catheterization and Cardiovascular Interventions
Tolga Onuk, Bariş Güngör, Göktürk İpek, Mehmet B Karataş, Yiğit Çanga, Şükrü Akyüz, Recep Haci, Fatma Özpamuk Karadeniz, Aylin Sungur, Hülya Kaşikçioğlu, Neşe Çam
BACKGROUND: The prognostic value of baseline SYNTAX (SS) and clinical SYNTAX (cSS) scores has been shown in different populations with coronary artery disease. However, their prognostic value has not been compared in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease. METHODS: Patients who had undergone a primary percutaneous coronary intervention (PCI) for STEMI and had at least one critical lesion other than the culprit artery were recruited retrospectively...
June 2016: Coronary Artery Disease
Ji-Won Hwang, Jeong Hoon Yang, Seung-Hyuk Choi, Jin Kyung Hwang, Woo Jin Jang, Joo-Yong Hahn, Young Bin Song, Jin-Ho Choi, Sang Hoon Lee, Hyeon-Cheol Gwon
OBJECTIVES: To compare clinical outcomes of percutaneous coronary intervention (PCI) with those of optimal medical therapy (OMT) alone in patients with chronic total occlusion (CTO) of a single coronary artery. BACKGROUND: Limited data are available on the efficacy of OMT for the treatment of single-vessel CTO. METHODS: Between March 2003 and February 2012, we enrolled 2024 CTO patients in a retrospective, observational registry and analyzed 435 patients with CTO of a single coronary artery...
May 1, 2016: International Journal of Cardiology
Razi Khan, Malek Al-Hawwas, Raja Hatem, Lorenzo Azzalini, Annik Fortier, E Marc Joliecoeur, Jean-Francois Tanguay, Philippe Lavoie-L'Allier, Hung Q Ly
OBJECTIVES: This study sought to assess the impact of residual coronary artery disease (CAD), using the residual SYNTAX score (rSS), on in-hospital outcomes after primary percutaneous intervention (PPCI). The study also aimed to determine independent predictors for high rSS. Residual CAD has been associated with worsened prognosis in patients undergoing PCI for non-ST acute coronary syndromes. The rSS is a systematic angiographic score that measures the extent and complexity of residual CAD after PCI...
February 1, 2016: Catheterization and Cardiovascular Interventions
Konstantinos C Koskinas, George C M Siontis, Raffaele Piccolo, Anna Franzone, Alan Haynes, Julie Rat-Wirtzler, Sigmund Silber, Patrick W Serruys, Thomas Pilgrim, Lorenz Räber, Dik Heg, Peter Jüni, Stephan Windecker
BACKGROUND: Diabetes mellitus and angiographic coronary artery disease complexity are intertwined and unfavorably affect prognosis after percutaneous coronary interventions, but their relative impact on long-term outcomes after percutaneous coronary intervention with drug-eluting stents remains controversial. This study determined drug-eluting stents outcomes in relation to diabetic status and coronary artery disease complexity as assessed by the Synergy Between PCI With Taxus and Cardiac Surgery (SYNTAX) score...
February 2016: Circulation. Cardiovascular Interventions
Gang Wang, Qi Hua, Jing Li, Weiwei Zhu, Hongyu Luo, Yuhui Zhang, Chen Wang
BACKGROUND: SYNTAX score II (SS-II) has been demonstrated to predict long-term outcomes in unprotected left main or multiple vessels in patients with coronary artery disease. However, its prognostic value for patients with ST-segment elevation myocardial infarction (STEMI) remains unknown. The poor myocardial perfusion (myocardial blush grade [MBG] 0/1) after primary percutaneous coronary intervention (pPCI) has a negative prognostic value in patients with STEMI. We aimed to assess SS-II and its possible relationships with MBG 0/1 in patients with STEMI treated with pPCI...
2016: Cardiology Journal
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