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Multivessel coronary artery disease

Mingzhu Xu, Lihua Yan, Jialiang Xu, Xiangjun Yang, Tingbo Jiang
Patients with acute myocardial infarction (AMI) complicated by heart failure with preserved ejection fraction (HFpEF) are likely to have more adverse cardiovascular events and higher mortality. The purpose of this study was to examine the predictors and outcomes in AMI patients complicated by HFpEF.We examined the demographics, clinical data, and clinical outcomes in 405 consecutive subjects who firstly presented with AMI after undergoing emergency percutaneous coronary intervention from January 2013 to June 2016...
June 2018: Medicine (Baltimore)
Giuseppe Gatti, Gianluca Castaldi, Laura Morra, Gabriella Forti, Bernardo Benussi, Gianfranco Sinagra, Aniello Pappalardo
BACKGROUND: Bilateral internal thoracic artery (BITA) grafting is underused in women. METHODS: Outcomes of 798 consecutive women with multivessel coronary disease who underwent isolated coronary surgery (1999-2016) using BITA (n=530, 66.4%) or single internal thoracic artery (SITA) grafting (n=268, 33.6%) were reviewed retrospectively. Differences between BITA and SITA cohort were adjusted by propensity score matching. For both series, late survival was estimated with the Kaplan-Meier method...
September 1, 2018: International Journal of Cardiology
Mohammed Saad, Thomas Stiermaier, Georg Fuernau, Janine Pöss, Steffen Desch, Holger Thiele, Ingo Eitel
BACKGROUND: Mechanisms underlying increased mortality in patients with chronic total occlusion (CTO) of a non-infarct-related artery (non-IRA) are unknown. Cardiac magnetic resonance (CMR) is uniquely suited to provide important mechanistic and pathophysiological information on myocardial damage and reperfusion injury. Aim of this study was to investigate the association of a CTO in a non-IRA with myocardial damage assessed by CMR in patients with ST-elevation myocardial infarction (STEMI)...
August 15, 2018: International Journal of Cardiology
Sana Chams, Skye El Sayegh, Mulham Hamdon, Sarwan Kumar, Zain Kulairi
BACKGROUND: Takotsubo cardiomyopathy or stress cardiomyopathy is characterized by transient left ventricular apical ballooning in the absence of coronary occlusion. The underlying pathophysiological mechanism is still unclear but possible causes have been proposed mainly catecholamine cardiotoxicity, followed by metabolic disturbance, coronary microvascular impairment, and multivessel epicardial coronary artery vasospasm. Takotsubo cardiomyopathy accounts for 1-2% of patients presenting with acute coronary syndrome with the majority of patients diagnosed with Takotsubo cardiomyopathy being women > 55 years of age...
June 10, 2018: Journal of Medical Case Reports
Hyoung Woo Chang, Ho Young Hwang, Jeong-Wook Seo, Ki-Bong Kim
OBJECTIVES: The "lower versus upper leg saphenous vein (SV) composite graft based on the left internal thoracic artery (ITA) for coronary artery bypass grafting" trial was designed to compare the histologic, immunohistochemical, and angiographic findings of lower versus upper leg SV composite grafts. METHODS: Twenty-six patients with multivessel coronary artery disease were prospectively randomized to undergo revascularization using a lower leg (n = 13) or upper leg (n = 13) SV composite graft based on the in situ left ITA...
April 11, 2018: Journal of Thoracic and Cardiovascular Surgery
Daan Cottens, Joren Maeremans, Keir McCutcheon, Scott Lamers, Lien Roux, Jolien Duponselle, Johan Bennett, Jo Dens
AIMS: The prognostic value of postprocedural high-sensitivity troponin T (hs-TnT) after percutaneous coronary intervention (PCI) of chronic total occlusions (CTO) is currently unclear. We aimed to assess the prognostic value of elevated hs-TnT after elective CTO-PCI. METHODS: The current study included 409 patients undergoing elective CTO-PCI between September 2011 and August 2016 at two centres who had postprocedural hs-TnT measurements available. Clinical, angiographic and procedural characteristics were correlated with any or at least five times the 99th percentile hs-TnT elevation, as well as a 1-year combined endpoint of major adverse cardiac and cerebrovascular events (MACCE) and mortality...
July 2018: Journal of Cardiovascular Medicine
Lei Xu, Gang Zhao, Jingfeng Wang, Cheng Shen, Xiao Li, Fei Lu, Hongfa Jiang, George Liu, Kai Hu, Yanhua Tang, Aijun Sun, Junbo Ge
The aim of this study is to investigate the impact of aldehyde dehydrogenase 2 (ALDH2) genotype and alcohol consumption on coronary artery lesions in Chinese patients with stable coronary artery disease (CAD). A total of 753 Chinese patients (73.6% male) diagnosed with stable CAD by coronary angiography were included in the sample. The frequency of the mutated type ALDH2* 2 (including ALDH2* 1/* 2 and ALDH2* 2/* 2) was 44.1% in CAD patients. The mutated ALDH2 carriers were more susceptible to multivessel lesions...
June 6, 2018: International Heart Journal
Jun Ho Lee, Dong Seop Jeong, Kiick Sung, Wook Sung Kim, Pyo Won Park, Hyuck Kim, K C Carriere, Young Tak Lee
BACKGROUND:  Whether percutaneous coronary intervention (PCI) is superior to coronary artery bypass grafting (CABG) for the right coronary territory is unknown. The aim of this study was to compare the outcomes and patency in the right coronary territory after CABG or PCI. METHODS:  We studied 2,467 multivessel coronary artery disease patients from January 2001 to December 2011; 1,672 were off-pump CABG patients and 795 were PCI. The graft patency and the presence of major adverse cardiac and cerebrovascular events (MACCEs) including death, myocardial infarction, target vessel revascularization, and stroke were analyzed...
May 29, 2018: Thoracic and Cardiovascular Surgeon
Mattia Peyracchia, Giulia De Lio, Chiara Montrucchio, Pierluigi Omedè, Gabriella d'Ettore, Andrea Calcagno, Vincenzo Vullo, Enrico Cerrato, Mauro Pennacchi, Gennaro Sardella, Pravin Manga, Walter GrossoMarra, Francesco Vullo, Francesco Fedele, Giuseppe Biondi-Zoccai, Claudio Moretti, Ahmed Vachiat, Stefano Bonora, Mauro Rinaldi, Massimo Mancone, Fabrizio D'Ascenzo
BACKGROUND AND AIMS: The risk of recurrence of myocardial infarction (MI) in HIV patients presenting with acute coronary syndrome (ACS) is well known, but there is limited evidence about potential differences in coronary plaques compared to non-HIV patients. METHODS: In this multicenter case-control study, HIV patients presenting with ACS, with intravascular-ultrasound (IVUS) data, enrolled between February 2015 and June 2017, and undergoing highly active antiretroviral therapy (HAART), were retrospectively compared to non-HIV patients presenting with ACS, before and after propensity score with matching, randomly selected from included centers...
May 5, 2018: Atherosclerosis
Carlos Collet, Yosuke Miyazaki, Nicola Ryan, Taku Asano, Erhan Tenekecioglu, Jeroen Sonck, Daniele Andreini, Manel Sabate, Salvatore Brugaletta, Rodney H Stables, Antonio Bartorelli, Robbert J de Winter, Yuki Katagiri, Ply Chichareon, Giovanni Luigi De Maria, Pannipa Suwannasom, Rafael Cavalcante, Hans Jonker, Marie-Angèle Morel, Bernard Cosyns, Arie P Kappetein, David T Taggart, Vasim Farooq, Javier Escaned, Adrian Banning, Yoshinobu Onuma, Patrick W Serruys
BACKGROUND: The functional SYNTAX score (FSS) has been shown to improve the discrimination for major adverse cardiac events compared with the anatomic SYNTAX score (SS) while reducing interobserver variability. However, evidence supporting the noninvasive FSS in patients with multivessel coronary artery disease (CAD) is scarce. OBJECTIVES: The purpose of this study was to assess the feasibility of and validate the noninvasive FSS derived from coronary computed tomography angiography (CTA) with fractional flow reserve (FFRCT ) in patients with 3-vessel CAD...
April 17, 2018: Journal of the American College of Cardiology
Zhixin Jiang, Haipeng Tang, Jianzhou Shi, Yanli Zhou, Cheng Wang, Dianfu Li, Qijun Shan, Weihua Zhou
OBJECTIVES: Myocardial stunning provides additional nonperfusion markers of coronary artery disease (CAD), especially for severe multivessel CAD. The purpose of this study is to assess the influence of myocardial stunning to the changes of left ventricular mechanical dyssynchrony (LVMD) parameters between stress and rest gated single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI). PATIENTS AND METHODS: A total of 113 consecutive patients (88 males and 25 females) who had undergone both stress and rest Tc-sestamibi gated SPECT MPI were retrospectively enrolled...
May 23, 2018: Nuclear Medicine Communications
Giulio Guagliumi, Kunihiro Shimamura, Vasile Sirbu, Roberto Garbo, Giacomo Boccuzzi, Angelina Vassileva, Orazio Valsecchi, Luigi Fiocca, Paolo Canova, Francesco Colombo, Gabriel Tensol Rodriguez Pereira, Daisuke Nakamura, Guilherme F Attizzani, Alberto Cereda, Keisuke Satogami, Leonardo De Luca, Francesco Saia, Davide Capodanno
Aims: Delayed healing and endothelial dysfunction may occur with drug-eluting stents (DES), promoting accelerated infiltration of lipids in the neointima and development of neoatherosclerosis (NA). Pathology data suggest durable polymer (DP) of DES to play a major role in this process. Whether biodegradable polymer (BP) may address these issues is uncertain. We compared in vivo vessel healing and NA of current generation BP- or DP-DES using serial optical coherence tomography (OCT) assessments...
May 19, 2018: European Heart Journal
Moshrik Abd Alamir, Michael Goyfman, Adib Chaus, Firas Dabbous, Leslie Tamura, Veit Sandfort, Alan Brown, Mathew Budoff
Background: The extent of coronary artery calcium (CAC) improves cardiovascular disease (CVD) risk prediction. The association between common dyslipidemias (combined hyperlipidemia, simple hypercholesterolemia, metabolic Syndrome (MetS), isolated low high-density lipoprotein cholesterol, and isolated hypertriglyceridemia) compared with normolipidemia and the risk of multivessel CAC is underinvestigated. Objectives: To determine whether there is an association between common dyslipidemias compared with normolipidemia, and the extent of coronary artery involvement among MESA participants who were free of clinical cardiovascular disease at baseline...
2018: Journal of Lipids
Dhanuka Perera, Tom Crake, Victor Lee
BACKGROUND: In ST-elevation myocardial infarction (STEMI) patients with multivessel (MV) disease, after primary percutaneous coronary intervention (PCI), emerging evidence suggests that significant disease in non-infarct-related coronary arteries (IRAs) should be routinely stented. Whether this procedure should be guided by angiography alone or ischemia testing is unclear. METHODS: All STEMI patients treated with primary PCI between January 1, 2005, and December 31, 2012, at a tertiary cardiology center were reviewed retrospectively...
June 2018: Critical Pathways in Cardiology
Michał Hawranek, Michal O Zembala, Mariusz Gasior, Tomasz Hrapkowicz, Łukasz Pyka, Daniel Cieśla, Marian Zembala
Aims: To compare coronary artery bypass grafting (CABG) with percutaneous coronary interventions (PCI) in patients with heart failure with reduced ejection fraction (HFrEF) and multivessel coronary artery disease. Methods: 1213 patients were selected from institutional databases, 761 and 452 in CABG and PCI group respectively. Only the subjects with left ventricle ejection fraction ≤ 35% and multivessel coronary artery disease were included to the study. The primary outcome measure was long-term all-cause death, the secondary outcomes were recurrent myocardial infarction, urgent repeat revascularization and stroke...
April 20, 2018: Oncotarget
Martial Hamon, Gilles Lemesle, Thibaud Meurice, Olivier Tricot, Nicolas Lamblin, Christophe Bauters
OBJECTIVES: The authors sought to describe the incidence, determinants, and outcome of elective coronary revascularization (ECR) in patients with stable coronary artery disease (CAD). BACKGROUND: Observational data are lacking regarding the practice of ECR in patients with stable CAD receiving modern secondary prevention. METHODS: The authors analyzed coronary revascularization procedures performed during a 5-year follow-up in 4,094 stable CAD outpatients included in the prospective multicenter CORONOR (Suivi d'une cohorte de patients COROnariens stables en région NORd-Pas-de-Calais) registry...
May 14, 2018: JACC. Cardiovascular Interventions
Michał Hawranek, Piotr Desperak, Paweł Gąsior, Aneta Desperak, Andrzej Lekston, Mariusz Gąsior
Introduction: The clinical significance of complete revascularization with percutaneous coronary intervention (CR-PCI) in patients with non-ST-segment acute coronary syndrome (NSTE-ACS) remains uncertain. Aim: To evaluate the impact of CR-PCI during index hospitalization on short and long-term incidence of death and composite endpoint among patients with multivessel coronary artery disease (CAD) presenting with NSTE-ACS. Material and methods: We analyzed consecutive data of 1,592 patients with multivessel CAD from 2006 to 2014...
2018: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
Tisa Saha, Syed Yaseen Naqvi, Sheldon Goldberg
Hybrid coronary revascularization (HCR) combines surgical bypass with percutaneous coronary intervention (PCI) performed either during the same procedure or in a staged approach within 60 days. Coronary artery bypass grafting using the left internal mammary artery (LIMA) has shown excellent long-term patency with improved patient survival. It remains the gold standard treatment for the majority of patients with multivessel coronary artery disease. However, saphenous vein grafts have poor long-term patency. Advances in stent technology have resulted in reduced rates of thrombosis and restenosis, making PCI a viable alternative to coronary surgery in selected patients...
May 7, 2018: Cardiology
Gustavo S Guandalini, Sripal Bangalore
Coronary artery disease in patients with diabetes mellitus (DM) is characterized by extensive atherosclerosis, longer lesions, and diffuse distal disease. Consequently, these patients have worse outcomes after coronary revascularization, regardless of the modality used. Traditionally, coronary artery bypass grafting (CABG) has been regarded as more effective than percutaneous coronary intervention (PCI) in patients with DM, likely because of more complete revascularization and protection against disease progression in the bypass segment...
May 2018: Canadian Journal of Cardiology
Jasmina Ćatić, Ivana Jurin, Marko Lucijanić, Helena Jerkić, Robert Blažeković
Multiple studies have demonstrated the association of red cell distribution width (RDW) with the ultrasound parameters of both systolic and diastolic heart dysfunction. We aimed to further investigate the clinical associations of RDW in the setting of ST-elevation myocardial infarction (STEMI) and to comparatively evaluate its predictive properties regarding systolic and diastolic dysfunction.A total of 89 patients with STEMI were prospectively analyzed. RDW was obtained at the time of STEMI and compared to the parameters of systolic and diastolic dysfunction obtained by transthoracic heart ultrasound on the 5th through 7th day post-STEMI...
May 2018: Medicine (Baltimore)
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