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Multivessel coronary artery disease

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https://www.readbyqxmd.com/read/29029008/complete-arterial-revascularization-using-bilateral-internal-mammary-artery-in-t-graft-technique-for-multivessel-coronary-artery-disease-in-on-or-off-pump-approach-does-gender-lose-its-historical-impact-on-clinical-outcome
#1
Friedrich-Christian Rieß, Christian-Alexander Behrendt, Wagma Amin, Stefan Heller, Lorenz Hansen, Stephan Winkel, Jan Stripling, Henrik Christian Rieß
OBJECTIVES: Higher rates of mortality and morbidity have been reported in women undergoing coronary artery bypass grafting (CABG) compared with men. Different revascularization techniques (on-pump and off-pump) might influence this outcome. METHODS: We retrospectively analysed 3445 consecutively recruited patients (all comers) undergoing complete arterial CABG (CACABG) at a single centre between January 2000 and December 2012. CACABG was performed in all patients using bilateral skeletonized internal mammary artery in T-graft technique, either on-pump (n = 2216) or off-pump (n = 1229)...
September 25, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28986404/predictors-of-successful-chronic-total-occlusion-percutaneous-coronary-interventions-a-systematic-review-and-meta-analysis
#2
Nelson Wang, Jordan Fulcher, Nishan Abeysuriya, Mark Adams, Sean Lal
OBJECTIVE: The aim of this study was to identify positive and negative predictors of technical and clinical success for percutaneous coronary intervention (PCI) of chronic total occlusions (CTO). METHODS: We conducted a systematic review and meta-analysis of studies published between 2000 and 2016 analysing rates of CTO PCI success with respect to demographic and angiographic characteristics. Crude ORs and 95% CIs for each predictor were calculated using a random effects model...
October 6, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28980282/long-term-outcomes-of-patients-with-multivessel-coronary-artery-disease-presenting-non-st-segment-elevation-acute-coronary-syndromes
#3
Piotr Desperak, Michał Hawranek, Paweł Gąsior, Aneta Desperak, Andrzej Lekston, Mariusz Gąsior
BACKGROUND: There is paucity of data concerning the optimal revascularization in patients with multivessel coronary artery disease (CAD) presenting non-ST-segment elevation acute coronary syndrome (NSTE-ACS). The aim was to evaluate long-term outcomes of patients with multivessel CAD presenting NSTE-ACS depending on the management after coronary angiography. METHODS: 3,166 patients with NSTE-ACS hospitalized between 2006-2014 were screened. After exclusions, 1,342 patients were enrolled with multivessel CAD and were divided depending on their management after coronary angiography; the medical-only therapy group (n = 91), the PCI group (n = 1,122), the CABG group (n = 129)...
October 5, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28974830/experience-and-outcomes-of-primary-percutaneous-coronary-intervention-for-patients-with-st-segment-elevation-myocardial-infarction-of-tertiary-care-center-in-bosnia-and-herzegovina
#4
Elmir Jahic
BACKGROUND: Primary percutaneous coronary intervention (PCI) is an emergent percutaneous catheter intervention in the setting of ST-segment elevations myocardial infarction (STEMI), without previous fibrinolytic treatment. AIM: To evaluate the feasibility and outcomes of primary percutaneous coronary interventions for STEMI in regional tertiary care cardiac centre in Bosnia and Herzegovina. METHODS: Between January 2014 and December 2016, consecutive 549 STEMI patients who underwent primary PCI were prospectively enrolled in a primary PCI registry...
June 2017: Medical Archives
https://www.readbyqxmd.com/read/28972063/current-practice-of-state-of-the-art-surgical-coronary-revascularization
#5
REVIEW
Stuart J Head, Milan Milojevic, David P Taggart, John D Puskas
Coronary artery bypass grafting remains one of the most commonly performed major surgeries, with well-established symptomatic and prognostic benefits in patients with multivessel and left main coronary artery disease. This review summarizes current indications, contemporary practice, and outcomes of coronary artery bypass grafting. Despite an increasingly higher-risk profile of patients, outcomes have significantly improved over time, with significant reductions in operative mortality and perioperative complications...
October 3, 2017: Circulation
https://www.readbyqxmd.com/read/28968030/-perspectives-of-intravascular-ultrasound-during-the-myocardial-revascularization-of-elderly-and-senile-patients
#6
D A Vorobevskii
Intravascular Ultrasound (IVUS) of coronary arteries has lately been extensively used in the routine work of catheter laboratories. This method`s availability for qualifying the structure of atherosclerosis plague, degree of stricture formation in artery opening, length of the plaque while choosing the relevant size of stent and also for stent apposition control after implantation, makes IVUS an irreplaceable help in endovascular surgeons` work. Combination of coronary angiography and IVUS best represents the plaqued segments of artery total picture...
2017: Advances in Gerontology, Uspekhi Gerontologii
https://www.readbyqxmd.com/read/28963749/chronic-total-occlusion-in-non-infarct-related-artery-is-associated-with-increased-short-and-long-term-mortality-in-patients-with-st-segment-elevation-acute-myocardial-infarction-complicated-by-cardiogenic-shock-from-the-credo-kyoto-ami-registry
#7
Hiroki Watanabe, Takeshi Morimoto, Hiroki Shiomi, Tetsuma Kawaji, Yutaka Furukawa, Yoshihisa Nakagawa, Kenji Ando, Kazushige Kadota, Takeshi Kimura
OBJECTIVES: We aimed to investigate the effect of chronic total occlusion (CTO) in non-infarct-related artery (IRA) on short- and long-term mortality in ST-segment elevation myocardial infarction (STEMI) patients complicated by cardiogenic shock (CS). BACKGROUND: Previous studies show contradictory results about the clinical effect of CTO in non-IRA on short-term mortality in STEMI patients with CS. METHODS: From the CREDO-Kyoto AMI registry enrolling 5429 patients, the current study population consisted of 313 STEMI patients with multivessel disease complicated by CS who underwent primary PCI for the nonleft main coronary artery culprit lesion within 24 hr after onset...
September 30, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28919628/coronary-artery-bypass-graft-with-endarterectomy-and-stent-removal-in-patient-with-multivessel-in-stent-restenosis
#8
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/28917022/epidemiology-pathogenesis-and-management-of-takotsubo-syndrome
#9
REVIEW
Shams Y-Hassan, Per Tornvall
Takotsubo syndrome is a recently recognized acute cardiac disease entity with a clinical presentation resembling that of an acute coronary syndrome. The typical takotsubo syndrome patient has a unique circumferential left (bi-) ventricular contraction abnormality profile that extends beyond a coronary artery supply territory and appears to follow the anatomical cardiac sympathetic innervation. The syndrome predominantly affects postmenopausal women and is often preceded by emotional or physical stress. Patients with predisposing factors such as malignancy and other chronic comorbidities are more prone to suffer from takotsubo syndrome...
September 15, 2017: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
https://www.readbyqxmd.com/read/28903139/percutaneous-coronary-intervention-vs-coronary-artery-bypass-grafting-in-patients-with-left-main-coronary-artery-stenosis-a-systematic-review-and-meta-analysis
#10
Daniele Giacoppo, Roisin Colleran, Salvatore Cassese, Antonio H Frangieh, Jens Wiebe, Michael Joner, Heribert Schunkert, Adnan Kastrati, Robert A Byrne
Importance: In patients with left main coronary artery (LMCA) stenosis, coronary artery bypass grafting (CABG) has been the standard therapy for several decades. However, some studies suggest that percutaneous coronary intervention (PCI) with drug-eluting stents may be an acceptable alternative. Objective: To compare the long-term safety of PCI with drug-eluting stent vs CABG in patients with LMCA stenosis. Data Sources: PubMed, Scopus, EMBASE, Web of Knowledge, and ScienceDirect databases were searched from December 18, 2001, to February 1, 2017...
September 13, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28889210/ketamine-and-midazolam-differently-impact-post-intubation-hemodynamic-profile-when-used-as-induction-agents-during-emergency-airway-management-in-hemodynamically-stable-patients-with-st-elevation-myocardial-infarction
#11
Marco Zuin, Gianluca Rigatelli, Fabio Dell'Avvocata, Giuseppe Faggian, Luca Conte, Sara Giatti, Flavio Michielan, Loris Roncon
We investigated the incidence of post-intubation hypotension (PIH) in hemodynamically stable patients with STEMI requiring rapid sequences intubation (RSI) and medicated with ketamine or midazolam as induction agent. STEMI patients admitted between 1st January 2009 and 1st January 2017 who did not receive any type of inotropic support before the endotracheal intubation (ETI) was reviewed. PIH was defined as a reduction greater than 20% or a drop of systolic blood pressure (SBP) below 90 mmHg within 10 min from the administration of the induction agent [ketamine (1 mg/kg) or midazolam (0...
September 9, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28883734/prognostic-impact-of-blood-pressure-and-heart-rate-at-admission-on-in-hospital-mortality-after-primary-percutaneous-intervention-for-acute-myocardial-infarction-with-st-segment-elevation-in-western-romania
#12
Diana Aurora Bordejevic, Florina Caruntu, Cristian Mornos, Ioan Olariu, Lucian Petrescu, Mirela Cleopatra Tomescu, Ioana Citu, Adelina Mavrea, Sorin Pescariu
BACKGROUND: The purpose of this retrospective study was to evaluate the prognostic impact of systolic blood pressure (SBP) and heart rate (HR) on in-hospital mortality in ST-segment elevation acute myocardial infarction (STEMI) patients, after primary percutaneous intervention (PCI). PATIENTS AND METHODS: The study included 294 patients admitted for STEMI. They were divided into five groups according to the SBP at admission: group I, <105 mmHg; group II, 105-125 mmHg; group III, 126-140 mmHg; group IV, 141-158 mmHg; and group V, ≥159 mmHg...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28874027/coronary-artery-bypass-surgery-is-superior-to-second-generation-drug-eluting-stents-in-three-vessel-coronary-artery-disease-a-propensity-score-matched-analysis
#13
Hiroshi Tsuneyoshi, Tatsuhiko Komiya, Kazushige Kadota, Takeshi Shimamoto, Jiro Sakai, Toshifumi Hiraoka, Kenji Wada, Hiroyuki Kaneko, Yuka Fujimoto, Yoshimasa Furuichi, Reo Hata, Taiyo Jinno, Osamu Tominaga
OBJECTIVES: Compared with percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG) appears to be a promising revascularization strategy for multivessel coronary disease. Trials comparing these treatments have not used second-generation drug-eluting stents (2nd DES). We conducted a retrospective evaluation of both treatments using a propensity score-matched analysis (PSMA). METHODS: A total of 537 patients with three-vessel with/without left-main-trunk coronary artery disease underwent CABG (n = 239) or primary PCI using 2nd DES (298) at a single institution...
September 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28851544/pci-versus-cabg-in-patients-with-type%C3%A2-1%C3%A2-diabetes%C3%A2-and-multivessel-disease
#14
Thomas Nyström, Ulrik Sartipy, Stefan Franzén, Björn Eliasson, Soffia Gudbjörnsdottir, Mervete Miftaraj, Bo Lagerqvist, Ann-Marie Svensson, Martin J Holzmann
BACKGROUND: It is unknown if coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) may offer a survival benefit in patients with type 1 diabetes (T1D) in need of multivessel revascularization. OBJECTIVES: This study sought to determine if patients with T1D and multivessel disease may benefit from CABG compared with PCI. METHODS: In an observational cohort study, the authors included all patients with T1D who underwent a first multivessel revascularization in Sweden from 1995 to 2013...
September 19, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28840017/complete-versus-culprit-only-revascularization-in-st-elevation-myocardial-infarction-a-perspective-on-recent-trials-and-recommendations
#15
REVIEW
Gabriela Andries, Sahil Khera, Robert J Timmermans, Wilbert S Aronow
The presence of multivessel coronary artery disease (CAD) is strongly associated with higher 30-day mortality, reduced myocardial reperfusion success, reinfarction, and occurrence of major adverse cardiac events (MACE) at 1 year compared with single-vessel CAD. Despite higher morbidity and mortality in patients with ST-elevation myocardial infarction (STEMI) and coexistent multivessel CAD, major guidelines recommended against percutaneous coronary intervention (PCI) on non-culprit lesions at the time of primary PCI in patients with STEMI who are hemodynamically stable...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28838087/quality-of-life-following-coronary-artery-bypass-graft-surgery-vs-percutaneous-coronary-intervention-in-diabetics-with-multivessel-disease-a-five-year-registry-study
#16
Brent M McGrath, Colleen M Norris, Emeleigh Hardwicke-Brown, Robert C Welsh, Kevin R Bainey
Aims: The aim of this study is to investigate the long-term relationship between revascularization technique and health status in diabetics with multivessel disease. Methods and results: Using the Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease (APPROACH) registry, we captured 1319 diabetics with multivessel disease requiring revascularization for an acute coronary syndrome (January 2009-December 2012) and reported health status using the Seattle Angina Questionnaire (SAQ) at baseline, 1, 3 and 5-years [599 underwent coronary artery bypass grafting (CABG); 720 underwent percutaneous coronary intervention (PCI)]...
July 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/28834794/quality-of-life-after-coronary-artery-bypass-graft-surgery-versus-percutaneous-coronary-intervention-what-do-the-trials-tell-us
#17
Alexander Kulik
PURPOSE OF REVIEW: With an ever-aging population, the treatment of multi-vessel coronary artery disease (CAD) has increasingly become focused not only on mortality, but on symptom relief and improving quality of life (QOL). The purpose of this review is to present a summary on the subject of QOL after percutaneous coronary intervention (PCI) and coronary artery bypass graft surgery (CABG), highlighting the latest comparative trials in the field. RECENT FINDINGS: About 1 month after revascularization, patients recovering from either PCI or CABG report improvements in angina frequency...
November 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28818317/reconsidering-the-gatekeeper-paradigm-for-percutaneous-coronary-intervention-in-stable-coronary-disease-management
#18
EDITORIAL
Joshua Schulman-Marcus, William S Weintraub, William E Boden
Major randomized clinical trials over the last decade support the role of optimal medical therapy for the initial management approach for patients with stable coronary artery disease (CAD), whereas percutaneous coronary intervention (PCI) ought to be reserved for patients with persistent symptoms despite optimal medical therapy. Likewise, several studies have continued to demonstrate the superiority of coronary artery bypass grafting surgery over PCI in many patients with extensive multivessel CAD, especially those with diabetes...
October 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28798016/bayesian-analysis-a-practical-approach-to-interpret-clinical-trials-and-create-clinical-practice-guidelines
#19
John A Bittl, Yulei He
Bayesian analysis is firmly grounded in the science of probability and has been increasingly supplementing or replacing traditional approaches based on P values. In this review, we present gradually more complex examples, along with programming code and data sets, to show how Bayesian analysis takes evidence from randomized clinical trials to update what is already known about specific treatments in cardiovascular medicine. In the example of revascularization choices for diabetic patients who have multivessel coronary artery disease, we combine the results of the FREEDOM trial (Future Revascularization Evaluation in Patients with Diabetes Mellitus: Optimal Management of Multivessel Disease) with prior probability distributions to show how strongly we should believe in the new Class I recommendation ("should be done") for a preference of bypass surgery over percutaneous coronary intervention...
August 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28797425/differential-rates-and-clinical-significance-of-periprocedural-myocardial-infarction-after-stenting-or-bypass-surgery-for%C3%A2-multivessel-coronary-disease-according-to-various-definitions
#20
Min Soo Cho, Jung-Min Ahn, Cheol-Hyun Lee, Do-Yoon Kang, Jung-Bok Lee, Pil Hyung Lee, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Duk-Woo Park, Seung-Jung Park
OBJECTIVES: This study sought to estimate the differential incidence and prognostic significance of periprocedural myocardial infarction (MI) according to various definitions. BACKGROUND: In trials comparing percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG), the primary composite endpoint is very sensitive to the definition of MI. Especially, the definition of periprocedural MI has considerably varied, and uniform criteria are still unsettled...
August 14, 2017: JACC. Cardiovascular Interventions
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