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Left main PCI

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https://www.readbyqxmd.com/read/28728654/comparison-of-stenting-versus-bypass-surgery-according-to-the-completeness-of-revascularization-in-severe-coronary-artery-disease-patient-level-pooled-analysis-of-the-syntax-precombat-and-best-trials
#1
Jung-Min Ahn, Duk-Woo Park, Cheol Whan Lee, Mineok Chang, Rafael Cavalcante, Yohei Sotomi, Yoshinobu Onuma, Erhan Tenekecioglu, Minkyu Han, Pil Hyung Lee, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Seong-Wook Park, Patrick W Serruys, Seung-Jung Park
OBJECTIVES: The aim of this study was to compare long-term survival between patients with severe coronary artery disease undergoing coronary artery bypass grafting (CABG) and those undergoing percutaneous coronary intervention (PCI) achieving complete revascularization (CR) or incomplete revascularization. BACKGROUND: The importance of CR in decision making regarding revascularization strategy in patients with severe coronary artery disease is unknown. METHODS: Data were pooled from the SYNTAX (Synergy Between PCI With Taxus and Cardiac Surgery), PRECOMBAT (Premier of Randomized Comparison of Bypass Surgery Versus Angioplasty Using Sirolimus-Eluting Stent in Patients With Left Main Coronary Artery Disease), and BEST (Randomized Comparison of Coronary Artery Bypass Surgery and Everolimus-Eluting Stent Implantation in the Treatment of Patients With Multivessel Coronary Artery Disease) trials...
July 24, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28722295/prevalence-correlates-and-impact-of-coronary-calcification-on-adverse-events-following-pci-with-newer-generation-des-findings-from-a-large-multiethnic-registry
#2
Robert S Copeland-Halperin, Usman Baber, Melissa Aquino, Anitha Rajamanickam, Swathi Roy, Choudhury Hasan, Nitin Barman, Jason C Kovacic, Pedro Moreno, Prakash Krishnan, Joseph M Sweeny, Roxana Mehran, George Dangas, Annapoorna S Kini, Samin K Sharma
OBJECTIVES: We sought to determine the prevalence, predictors, and clinical impact of target lesion calcification in patients undergoing percutaneous coronary intervention (PCI) with newer generation drug-eluting stents (DES) and devices. BACKGROUND: Coronary calcification is independently associated with adverse outcomes following PCI. While newer DES and contemporary devices are considered safer and more efficacious, their influence on outcomes following PCI of heavily calcified lesions is unknown...
July 19, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28722266/second-generation-drug-eluting-stents-versus-bare-metal-stents-for-percutaneous-coronary-intervention-of-the-proximal-left-anterior-descending-artery-an-analysis-of-the-basket-prove-i-and-ii-trials
#3
Fernanda Marinho Mangione, Tor Biering-Sørensen, Kotaro Nochioka, Tannas Jatene, Odilson Marcos Silvestre, Kim Wadt Hansen, Rikke Sørensen, Jan Skov Jensen, Peter Godsk Jorgensen, Raban Jeger, Christoph Kaiser, Matthias Pfisterer, Søren Galatius
OBJECTIVES: To compare mid-term outcomes between patients undergoing proximal left anterior descending artery (LAD) percutaneous coronary intervention (PCI) with second generation drug-eluting stent (DES) or bare-metal stent (BMS). BACKGROUND: PCI with BMS and first-generation DES have shown to be safe options for the treatment of proximal LAD stenosis, however associated with considerable reintervention rates. Overall, second-generation DES has proven to be superior to BMS and first-generation DES, nevertheless, its effect for proximal LAD PCI has not previously been reported...
July 19, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28707446/percutaneous-coronary-intervention-after-a-surgeon-says-no-way
#4
EDITORIAL
Samuel M Butman
The rate of surgical turndowns (1.5-2.5%) in this report that went on to PCI is relatively consistent across centers. Unprotected left main intervention in patients turned down for surgery has high hospital mortality. With certain caveats, the HEART Team approach to these unique patients may be the answer.
July 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28663763/long-term-outcomes-of-pci-vs-cabg-for-ostial-midshaft-lesions-in-unprotected-left-main-coronary-artery
#5
Cheng-Long Guo, Xian-Peng Yu, Bang-Guo Yang, Meng-Meng Li, Ji-Qiang He, Quan Li, Cheng-Xiong Gu, Shu-Zheng Lyu, Jian-Zeng Dong
BACKGROUND: There are limited data on long-term (> 5 years) outcomes of drug-eluting stent (DES) implantation compared with coronary artery bypass grafting (CABG) for ostial/midshaft left main coronary artery (LMCA) lesions. METHODS: Of the 259 consecutive patients in Beijing Anzhen Hospital with ostial/midshaft LMCA lesions, 149 were treated with percutaneous coronary intervention (PCI) with DES and 110 were with CABG. The endpoints of the study were death, repeat revascularization, myocardial infarction (MI), stroke, the composite of cardiac death, and major adverse cardiac and cerebrovascular events (MACCE, the composite of cardiac death, MI, stroke or repeat revascularization)...
April 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28658308/unprotected-left-main-revascularization-percutaneous-coronary-intervention-versus-coronary-artery-bypass-an-updated-systematic-review-and-meta-analysis-of-randomised-controlled-trials
#6
Luca Testa, Azeem Latib, Mario Bollati, Rocco Antonio Montone, Antonio Colombo, Filippo Crea, Francesco Bedogni
BACKGROUND: The optimal treatment of unprotected left main (UPLM) with either PCI or CABG remains uncertain. AIM: The purpose of this study was to determine the comparative safety and efficacy of PCI versus CABG in patients with UPLM disease. METHODS: Search of BioMedCentral, CENTRAL, mRCT, PubMed, major cardiological congresses proceedings and references cross-check (updated November 2016). Outcomes were the rate of MACE [all cause death, MI, stroke], the rates of the individual components of MACE and the rate of target vessel revascularisation (TVR)...
2017: PloS One
https://www.readbyqxmd.com/read/28647690/acute-kidney-injury-after-primary-angioplasty-is-contrast-induced-nephropathy-the-culprit
#7
Oren Caspi, Manhal Habib, Yuval Cohen, Arthur Kerner, Ariel Roguin, Eitan Abergel, Monther Boulos, Michael R Kapeliovich, Rafael Beyar, Eugenia Nikolsky, Doron Aronson
BACKGROUND: Acute kidney injury (AKI) following primary percutaneous coronary intervention (pPCI) is frequently interpreted as contrast-induced AKI but may result from other insults. We aimed to determine the causal association of contrast material exposure and the incidence of AKI following pPCI using a control group of propensity score-matched patients with ST-segment-elevation myocardial infarction who were not exposed to contrast material. METHODS AND RESULTS: We studied 2025 patients with ST-segment-elevation myocardial infarction who underwent pPCI and 1025 patients receiving fibrinolysis or no reperfusion who were not exposed to contrast material during the first 72 hours of hospital stay (control group)...
June 24, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28646403/routine-ct-angiography-to-detect-severe-coronary-artery-disease-prior-to-transcatheter-aortic-valve-replacement
#8
S Chava, G Gentchos, A Abernethy, B Leavitt, E Terrien, H L Dauerman
Patients undergoing TAVR undergo routine CT angiography (CTA) to assess aorto-iliac pathology and annular dimensions. While coronary CTA may exclude severe CAD in younger patients, its efficacy in defining CAD severity prior to TAVR may be limited. We retrospectively studied 50 consecutive patients undergoing both invasive coronary angiography (ICA) and routine pre-TAVR CTA. Severe CAD was defined as ≥50% stenosis by quantitative coronary angiography and compared to a blinded CTA visual estimation of ≥50% stenosis...
August 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28640875/percutaneous-coronary-intervention-in-left-main-coronary-artery-disease-with-or-without-intravascular-ultrasound-a-meta-analysis
#9
Yicong Ye, Ming Yang, Shuyang Zhang, Yong Zeng
This meta-analysis compared IVUS-guided with angiography-guided PCI to determine the effect of IVUS on the mortality in patients with LM CAD. Current guidelines recommend intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) in patients with left main coronary artery disease (LM CAD; Class IIa, level of evidence B). A systematic search of the MEDLINE, Embase, and Cochrane Central Register of Controlled Trials databases was conducted to identify randomized or non-randomized studies comparing IVUS-guided PCI with angiography-guided PCI in LM CAD...
2017: PloS One
https://www.readbyqxmd.com/read/28616647/outcomes-of-direct-stenting-in-patients-with-st-elevated-myocardial-infarction
#10
A Kalayci, V Oduncu, C Y Karabay, A Erkol, A C Tanalp, I H Tanboga, O Candan, C Gecmen, I A Izgi, C Kirma
BACKGROUND: We compared direct stenting (DS) with conventional stenting (CS) - i.e., stenting after predilation - during primary percutaneous coronary intervention (P-PCI) in terms of procedural results and long-term mortality in patients with ST-elevated myocardial infarction (STEMI). METHODS: We retrospectively analyzed 2306 patients (mean age 59 years, 22% female) who underwent P‑PCI within 12 h of symptom onset. Patients were then followed up prospectively for clinical events...
June 14, 2017: Herz
https://www.readbyqxmd.com/read/28616307/pci-or-cabg-for-severe-unprotected-left-main-coronary-artery-disease-making-sense-of-the-noble-and-excel-trials
#11
EDITORIAL
Anthony A Holmes, Sripal Bangalore
No abstract text is available yet for this article.
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28604505/prognostic-value-of-clinical-echocardiographic-and-angiographic-indicators-in-patients-with-large-anterior-st-segment-elevation-myocardial-infarction-as-a-first-acute-coronary-event
#12
Cesare Baldi, Maria V Polito, Rodolfo Citro, Rosario Farina, Tiziana Attisano, Marco Mirra, Paolo Chiodini, Michele R Di Muro, Marco Di Maio, Francesco Vigorito, Renato De Vecchis, Eduardo Bossone, Federico Piscione, Pietro Giudice, Gennaro Galasso
BACKGROUND: The risk of death in patients affected by ST-elevation segment myocardial infarction (STEMI) is well known, but more data are required to define the in-hospital mortality in special subsets. We sought to assess the prognostic value of indicators in patients with large anterior STEMI as a first acute coronary event, undergoing percutaneous coronary intervention (PCI) and intra-aortic balloon pump (IABP). METHODS AND RESULTS: We evaluated 48 consecutive large anterior STEMI patients admitted as first acute coronary event, undergoing in acute phase both PCI and IABP...
June 9, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28595861/comparison-of-outcome-of-coronary-artery-bypass-grafting-versus-drug-eluting-stent-implantation-for-non-st-elevation-acute-coronary-syndrome
#13
Mineok Chang, Cheol Whan Lee, Jung-Min Ahn, Rafael Cavalcante, Yohei Sotomi, Yoshinobu Onuma, Minkyu Han, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Seong-Wook Park, Patrick W Serruys, Seung-Jung Park
There is limited data comparing effectiveness of coronary artery bypass grafting (CABG) versus percutaneous coronary intervention (PCI) with drug-eluting stents in patients with non-ST-elevation acute coronary syndromes (NSTE-ACS). We compared the long-term outcomes of the 2 revascularization strategies in 1,246 patients presented with NSTE-ACS for left main or multivessel coronary artery disease. Data were pooled from the Randomized Comparison of Coronary Artery Bypass Surgery and Everolimus-Eluting Stent Implantation in the Treatment of Patients with Multivessel Coronary Artery Disease (BEST) trial, the Premier of Randomized Comparison of Bypass Surgery versus Angioplasty Using Sirolimus-Eluting Stent in Patients with Left Main Coronary Artery Disease (PRECOMBAT) trial, and the Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) trial...
August 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28595696/left-main-coronary-artery-compression-in-patients-with-pulmonary-arterial-hypertension-and%C3%A2-angina
#14
Nazzareno Galiè, Francesco Saia, Massimiliano Palazzini, Alessandra Manes, Vincenzo Russo, Maria Letizia Bacchi Reggiani, Gianni Dall'Ara, Enrico Monti, Fabio Dardi, Alessandra Albini, Andrea Rinaldi, Enrico Gotti, Nevio Taglieri, Cinzia Marrozzini, Luigi Lovato, Maurizio Zompatori, Antonio Marzocchi
BACKGROUND: Left main coronary artery (LMCA) compression is increasingly recognized as a cause of angina in pulmonary arterial hypertension (PAH). OBJECTIVES: This study aimed to evaluate the prevalence of LMCA extrinsic compression from a dilated pulmonary artery (PA) in patients with PAH and angina or angina-like symptoms, determine the usefulness of screening with computed tomography coronary angiography (CTCA), and assess the safety and efficacy of percutaneous coronary interventions (PCIs)...
June 13, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28595219/-hybrid-coronary-revascularization-of-minimally-invasive-coronary-artery-bypass-grafting-and-percutaneous-coronary-intervention-in-a-patient-with-left-main-coronary-stenosis
#15
Yujiro Kawai, Hirokazu Niitsu, Takashi Yanagisawa, Masayuki Ogihara, Gentaku Hama, Yasuyuki Toyoda, Hikaru Kimura, Miki Horigome, Yasutoshi Tsuda, Yoshikazu Yazaki, Takahiro Takemura
We report a successful case of hybrid coronary revascularization of minimally invasive coronary artery bypass grafting( MICS-CABG) and percutaneous coronary intervention(PCI). The patient was a 78-year-old man with angina pectoris due to left main trunk (LMT) lesion, and had a history of repeated PCI to the left anterior descending artery (LAD) and the left circumflex artery (LCX) for angina pectoris. He presented with a chest pain on effort in June, 2015. A coronary angiogram showed a severe stenosis in the LMT extending to LAD and LCX...
June 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28577674/relationship-between-therapeutic-effects-on-infarct-size-in-acute-myocardial-infarction-and-therapeutic-effects-on-1-year-outcomes-a-patient-level-analysis-of-randomized-clinical-trials
#16
Harry P Selker, James E Udelson, Robin Ruthazer, Ralph B D'Agostino, Melissa Nichols, Ori Ben-Yehuda, Ingo Eitel, Christopher B Granger, Paul Jenkins, Akiko Maehara, Manesh R Patel, E Magnus Ohman, Holger Thiele, Gregg W Stone
BACKGROUND: While infarct size in patients with ST-segment elevation myocardial infarction (STEMI) has been generally associated with long-term prognosis, whether a therapeutic effect on infarct size has a corresponding therapeutic effect on long-term outcomes is unknown. METHODS: Using combined patient-level data from 10 randomized trials of primary percutaneous coronary intervention (PCI) for STEMI, we created multivariable Cox proportional hazard models for one-year heart failure hospitalization and all-cause mortality, which included clinical features and a variable representing treatment effect on infarct size...
June 2017: American Heart Journal
https://www.readbyqxmd.com/read/28571187/study-of-short-and-intermediate-term-clinical-outcomes-of-patients-with-protected-and-unprotected-lmca-stenting
#17
Pooja M Vyas, Jayesh S Prajapati, Sibasis S Sahoo, Iva Vipul Patel, Jagjeet K Deshmukh, Chirag Patel, Roopesh Singhal
INTRODUCTION: Significant unprotected Left Main Coronary Artery (LMCA) disease is detected in 5%-7% of cases undergoing Coronary Angiography (CAG). Present guidelines have revealed the significance of anatomical location in left main artery stenosis and syntax scores for determination of Major Adverse Cardiac Events (MACE). Debate still persists over the best treatment regarding outcomes of Coronary Artery Bypass Grafting (CABG) and LMCA stenting for patients with LMCA disease. AIM: Aim of the study was to evaluate short and intermediate term clinical outcomes of Percutaneous Coronary Intervention (PCI) in LMCA disease in respect to mortality, Cerebrovascular Accidents (CVA), reinfarction, stent restenosis and need for repeat target lesion revascularization...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28567361/unexpected-evolution-of-a-non-stenotic-lesion-in-the-left-main-coronary-artery-of-a-patient-with-non-st-segment-elevation-myocardial-infarction
#18
Alexandru Florin Ispas, Lionel Mangin, Alexandru Paziuc, Loic Belle
A 72-year-old man was referred to our catheterization laboratory 48 hours after a non-ST-segment elevation myocardial infarction. His medical history included coronary artery disease (CAD) (percutaneous coronary intervention of the right coronary artery and chronic total occlusion of the circumflex artery), atrial fibrillation (AF), and chronic kidney disease. An electrocardiogram showed a pre-existent left bundle-branch block and the patient's maximum cardiac troponin concentration was 8.64 µg/L (upper limit of normal: 0...
June 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28567131/the-predictive-value-of-the-syntax-score-in-patients-with-chronic-coronary-artery-disease-undergoing-percutaneous-coronary-intervention-or-coronary-artery-bypass-grafting-a-pilot-study
#19
K Papadopoulos, I Lekakis, E Nicolaides
OBJECTIVES: To evaluate the usefulness of the SYNTAX score (SS) in predicting 1-year clinical outcomes in a population of patients with chronic coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). BACKGROUND: Despite the proven prognostic value of the SS in patients with multivessel and/or left main (LM) CAD, its usefulness in other patient subsets remains uncertain. METHODS: This was a prospective single centre cohort study conducted from September 2012 to November 2014 at the Nicosia General Hospital, Cyprus...
2017: Open Cardiovascular Medicine Journal
https://www.readbyqxmd.com/read/28562382/impact-of-mean-platelet-aggregation-degree-on-long-term-clinical-outcomes-among-patients-undergoing-a-complex-percutaneous-coronary-intervention
#20
Quan Li, Mengmeng Li, Xianpeng Yu, Jiqiang He, Yuechun Gao, Xiaoling Zhang, Changyan Wu, Yawei Luo, Yuchen Zhang, Xuejun Ren
OBJECTIVE: The aim of this study was to evaluate the association between the mean platelet aggregation degree and long-term clinical outcomes in patients receiving a complex percutaneous coronary intervention (CPCI). PATIENTS AND METHODS: We screened 2141 patients after a percutaneous coronary intervention (PCI) treated with aspirin and clopidogrel. CPCI was defined as a procedure targeted to at least one of the following: left main disease, bifurcation lesion, ostial lesion, chronic total occlusion, and small-vessel stenting...
May 30, 2017: Coronary Artery Disease
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