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Multivessel coronary artery disease

Amin Daoulah, Mohamed N Alama, Osama E Elkhateeb, Mushabab Al-Murayeh, Salem Al-Kaabi, Salem M Al-Faifi, Hind M Alosaimi, Amir Lotfi, Khalid S Asiri, Ahmed M Elimam, Ayman S Abougalambo, Waheed Murad, Mamdouh M Haddara, Ciaran M Dixon, Alawi A Alsheikh-Ali
OBJECTIVES: The aim of this study was to assess the association of widowhood with the severity and extent of coronary artery disease (CAD), and whether it is modified by sex or socioeconomic status. PATIENTS AND METHODS: A total of 1068 patients undergoing coronary angiography at five centers in Saudi Arabia and the United Arab Emirates were included in the study. CAD was defined as more than 70% lumen stenosis in a major epicardial vessel or more than 50% in the left main coronary artery...
October 4, 2016: Coronary Artery Disease
Hwa Seon Shin, Mi Jung Park, Kyung Nyeo Jeon, Jae Min Cho, Kyung Soo Bae, Dae Seob Choi, Jae Boem Na, Ho Cheol Choi, Hye Young Choi, Ji Eun Kim, Soo Bueum Cho, Sung Eun Park
BACKGROUND: Until now, there has been no study on the relationship between the calcification of the lower extremity arteries and significant coronary arterial disease (CAD). OBJECTIVES: To evaluate whether lower extremity calcium scores (LECS) are associated with CAD and whether this can predict multivessel-CAD in patients with peripheral arterial disease (PAD). PATIENTS AND METHODS: We retrospectively enrolled 103 PAD patients without cardiac symptoms or known CAD...
April 2016: Iranian Journal of Radiology: a Quarterly Journal Published By the Iranian Radiological Society
Janet A Smereck, Argyro Papafilippaki, Sawali Sudarshan
Bench press exercise, which involves repetitive lifting of weights to full arm extension while lying supine on a narrow bench, has been associated with complications ranging in acuity from simple pectoral muscle strain, to aortic and coronary artery dissection. A 39-year-old man, physically fit and previously asymptomatic, presented with acute chest pain following bench press exercise. Diagnostic evaluation led to the discovery of critical multivessel coronary occlusive disease, and subsequently, highly elevated levels of lipoprotein (a)...
2016: Open Access Emergency Medicine: OAEM
Noa P Yee, Andrea M Siu, James Davis, John Kao
Recovery of left ventricular (LV) function after revascularization has been described for coronary artery bypass grafting (CABG); however, LV recovery after percutaneous coronary intervention (PCI), and how it compares to CABG has not been well described in the literature. The aim of this single center retrospective study was to evaluate LV recovery in patients with severely reduced LV function undergoing PCI compared to those undergoing CABG. Patients with LV ejection fraction (LVEF) < 40% and multivessel coronary artery disease (CAD) undergoing revascularization with either CABG (n=16) or PCI (n=176), and with 12 months of follow up data were included in the study...
September 2016: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
Cristiano Spadaccio, Francesco Nappi, Antonio Nenna, Gwyn Beattie, Massimo Chello, Fraser W H Sutherland
The optimal degree of revascularization for patients with chronic multivessel coronary artery disease remains an unsolved issue. Intuitively, complete revascularization decreases cardiovascular events and improves outcomes compared to incomplete procedures, but in recent years the concept of incomplete revascularization moved from a sub-optimal or a defective treatment towards the most appropriate revascularization technique in some categories of patients. A reasonable level of incomplete anatomic revascularization has been shown to be safe and achievable with both percutaneous (PCI) and surgical procedures (CABG), despite with different long-term outcomes...
September 18, 2016: International Journal of Cardiology
A Dionne, M Bakloul, C Manlhiot, B W McCrindle, M Hosking, C Houde, D Pepelassis, N Dahdah
Coronary artery (CA) aneurysms are serious complications of Kawasaki disease (KD) responsible for ischemic events. Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are reported with limited data on indications and comparative efficacy. Retrospective multicenter comparison of CA intervention following KD is performed in this study. Twenty two cases were available from 5 centers, of whom 11 underwent CABG, 10 PCI and 1 systemic thrombolysis. Age at intervention (8.3 ± 3.9 vs 11...
September 23, 2016: Pediatric Cardiology
Rafael Cavalcante, Yohei Sotomi, Yaping Zeng, Cheol Whan Lee, Jung-Min Ahn, Carlos Collet, Erhan Tenekecioglu, Pannipa Suwannasom, Yoshinobu Onuma, Seung-Jung Park, Patrick W Serruys
OBJECTIVE: In patients with multivessel disease and proximal left anterior descending artery (LAD) involvement, the best revascularisation strategy is still unclear. We assess outcomes after coronary artery bypass graft surgery (CABG) and percutaneous coronary intervention (PCI) with drug-eluting stents in a pooled analysis of individual patient-level data of the SYNTAX and BEST randomised trials. DESIGN: Proximal LAD involvement was defined by any lesion ≥ 50% diameter stenosis in the arterial segment starting from the left-main bifurcation up to (and including) the origin of the first major septal branch...
September 20, 2016: Heart: Official Journal of the British Cardiac Society
Devraj Sukul, Milan Seth, Simon R Dixon, Mark Zainea, Nicklaus K Slocum, Elizabeth J Pielsticker, Hitinder S Gurm
OBJECTIVES: We examined clinical outcomes following percutaneous coronary intervention (PCI) in patients turned down for surgical revascularization across a broad population. BACKGROUND: Prior studies suggest that surgical ineligibility is associated with increased mortality in patients with unprotected left main or multivessel coronary artery disease undergoing PCI. METHODS: This study included consecutive patients who underwent PCI in a multicenter registry in Michigan from January 2010 to December 2014...
September 21, 2016: Catheterization and Cardiovascular Interventions
Rahman Shah, Chalak Berzingi, Mubashir Mumtaz, John B Jasper, Rohan Goswami, Mohamed S Morsy, Kodangudi B Ramanathan, Sunil V Rao
Several recent randomized controlled trials (RCTs) demonstrated better outcomes with multivessel complete revascularization (CR) than with infarct-related artery-only revascularization (IRA-OR) in patients with ST-segment elevation myocardial infarction. It is unclear whether CR should be performed during the index procedure (IP) at the time of primary percutaneous coronary intervention (PCI) or as a staged procedure (SP). Therefore, we performed a pairwise meta-analysis using a random-effects model and network meta-analysis using mixed-treatment comparison models to compare the efficacies of 3 revascularization strategies (IRA-OR, CR-IP, and CR-SP)...
August 23, 2016: American Journal of Cardiology
Fernando Gondim, Ana Caribé, Karine Ferreira Vasconcelos, Alexandre Dantas Segundo, Francisco Bandeira
BACKGROUND: Vitamin D deficiency has been associated with cardiovascular risk factors, including type 2 diabetes mellitus (T2DM). Evidence shows that patients with low serum 25-hydroxyvitamin D (25OHD) concentrations have a higher risk of developing coronary artery disease. OBJECTIVE: The objective of this study was to assess vitamin D as a predictor of the severity in diabetics with acute coronary syndrome (ACS). METHODS: A total of 166 patients were diagnosed with ACS...
2016: Clinical Medicine Insights. Endocrinology and Diabetes
SriKrishna Modugula Reddy, Ramesh Babu Byrapaneni, ChandraMohan Rangappa, Uday Kumar Gouni, Chakravarthy Vakati, Satish Suryavanshi, Prabhakar Reddy Kola
Coronary artery bypass grafting surgery may be needed in children and young adults for significant premature coronary artery occlusive disease. We report a case series of seven patients who underwent surgical revascularization in their second and third decade of life for significant multivessel coronary artery occlusive disease due to unusual causes.
September 13, 2016: Interactive Cardiovascular and Thoracic Surgery
Giuseppe Tarantini, Gianpiero D'Amico, Sorin J Brener, Paola Tellaroli, Marco Basile, Alessandro Schiavo, Marco Mojoli, Chiara Fraccaro, Alfredo Marchese, Giuseppe Musumeci, Gregg W Stone
OBJECTIVES: The authors conducted a systematic pairwise and network meta-analysis to assess optimal treatment strategies in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease (MV-CAD) undergoing primary percutaneous coronary intervention (PCI). BACKGROUND: Patients with STEMI and MV-CAD have a worse prognosis than those with single-vessel CAD. The optimal revascularization strategy for these patients is uncertain...
September 12, 2016: JACC. Cardiovascular Interventions
Ahmed Al-Mamary, Filippo Zilio, Massimo Napodano
Optimal management of multivessel coronary artery disease can be complex. We report a 67-year-old male patient who was admitted to the Padua University Hospital, Padua, Italy, in 2014 with a non-ST-elevation myocardial infarction. Coronary angiography showed diffuse multiple sub-occlusive lesions of the proximal and distal left coronary vessels involving a long segment of the vessel. On intravascular ultrasonography (IVUS), the left main artery was moderately diseased with critically stenotic and calcified branch ostia...
August 2016: Sultan Qaboos University Medical Journal
Tobias Härle, Uwe Zeymer, Matthias Hochadel, Ralf Zahn, Sebastian Kerber, Bernhard Zrenner, Volker Schächinger, Bernward Lauer, Thorsten Runde, Albrecht Elsässer
BACKGROUND: There is growing evidence for beneficial prognostic and economic effects of FFR-guided treatment of stable coronary artery disease. We sought to evaluate the real-world use of FFR measurements in patients undergoing elective coronary angiography. METHODS AND RESULTS: We analyzed the data of the prospective ALKK coronary angiography and PCI registry including data of 38 hospitals from January 2010 to December 2013. A total of 100,977 patients undergoing coronary angiography were included...
September 6, 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Mineok Chang, Jung-Min Ahn, Nayoung Kim, Pil Hyung Lee, Jae-Hyung Roh, Sung-Han Yoon, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Duk-Woo Park, Seung-Jung Park
BACKGROUND: The clinical impact of completeness of revascularization on adverse cardiovascular events remains unclear among patients with multivessel coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI). METHODS: This analysis included consecutive patients with multivessel CAD, who underwent PCI with drug-eluting stents (DES) during the period from January 1, 2003, through to December 31, 2013. We compared the outcomes in patients, who achieved complete (CR) versus incomplete revascularization (IR) at the time of PCI...
September 2016: American Heart Journal
Dmitry Pevni, Benjamin Medalion, Rephael Mohr, Yanai Ben-Gal, Adam Laub, Avner Nevo, Amir Kramer, Yosef Paz, Nachum Nesher
BACKGROUND: Bilateral internal thoracic artery (BITA) grafting in patients with diabetes mellitus is controversial because of a higher risk for sternal infection. The purpose of this study is to compare the outcome of BITA grafting to that of single ITA (SITA) grafting in patients with diabetes. METHODS: Between 1996 and 2010, 964 diabetic patients with multivessel disease who underwent primary coronary artery bypass graft surgery with BITA were compared with 564 patients who underwent coronary artery bypass graft surgery with SITA and saphenous vein grafts...
September 1, 2016: Annals of Thoracic Surgery
Giuseppe Gatti, Luca Maschietto, Marco Morosin, Marco Russo, Bernardo Benussi, Gabriella Forti, Lorella Dreas, Gianfranco Sinagra, Aniello Pappalardo
BACKGROUND: Concerns about increased risk of postoperative complications, primarily deep sternal wound infection (DSWI), prevent liberal use of bilateral internal thoracic artery (BITA) grafting in women. Consequently, outcomes after routine BITA grafting remain largely unexplored in female gender. METHODS: Of 786 consecutive women with multivessel coronary disease who underwent isolated coronary bypass surgery at the authors' institution from 1999 throughout 2014, 477 (60...
August 14, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Eric R Bates, Jacqueline E Tamis-Holland, John A Bittl, Patrick T O'Gara, Glenn N Levine
Recent randomized controlled trials have suggested that patients with ST-segment elevation myocardial infarction and multivessel coronary artery disease may benefit more from multivessel percutaneous coronary intervention (PCI) compared with culprit vessel-only primary PCI. The American College of Cardiology, American Heart Association, and Society for Cardiovascular Angiography and Interventions recently published an updated recommendation on this topic. The purpose of this State-of-the-Art Review is to accurately document existing published reports, describe their limitations, and establish a base for future studies...
September 6, 2016: Journal of the American College of Cardiology
G B John Mancini, Michael E Farkouh, Maria M Brooks, Bernard R Chaitman, William E Boden, Helen Vlachos, Pamela M Hartigan, Flora S Siami, Mandeep S Sidhu, Vera Bittner, Robert Frye, Valentin Fuster
BACKGROUND: There are scant outcomes data in patients with type 2 diabetes and stable coronary artery disease (CAD) stratified by detailed angiographic burden of CAD or left ventricular ejection fraction (LVEF). OBJECTIVES: This study determined the effect of optimal medical therapy (OMT), with or without percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG), on long-term outcomes with respect to LVEF and number of diseased vessels, including proximal left anterior descending artery involvement...
September 6, 2016: Journal of the American College of Cardiology
Jacek Piątek, Anna Kędziora, Janusz Konstanty-Kalandyk, Grzegorz Kiełbasa, Marta Olszewska, Karol Wierzbicki, Irena Milaniak, Bryan HyoChan Song, Bogusław Kapelak, Tomasz Darocha
BACKGROUND: Coronary artery disease (CAD) is a major cause of death and disability in developed countries. Despite the fact that prevalence accrues with age, an increasing number of young patients suffering from CAD is being observed worldwide. The aim of this study is to describe the population of young adults suffering from CAD and requiring coronary artery bypass grafting (CABG), and to assess early outcomes after the procedure. METHODS: A retrospective cohort study analyzed 190 consecutive patients aged ≤50 years old that underwent CABG between 2010 and 2014...
2016: Heart Surgery Forum
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