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https://www.readbyqxmd.com/read/29148142/outcomes-of-primary-percutaneous-coronary-intervention-in-acute-myocardial-infarction-due-to-unprotected-left-main-thrombosis-the-asia-pacific-left-main-st-elevation-registry-aster
#1
Jonathan Yap, Gagan D Singh, Jung-Sun Kim, Krishan Soni, Kelvin Chua, Alvin Neo, Choong Hou Koh, Ehrin J Armstrong, Stephen W Waldo, Kendrick A Shunk, Reginald I Low, Myeong-Ki Hong, Yangsoo Jang, Khung Keong Yeo
INTRODUCTION: Prior studies of ULM STEMI have been confined to small cohorts. Recent registry data with larger patient cohorts have shown contrasting results. We aim to study the outcomes of patients with unprotected left main (ULM) ST-elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI). METHODS: The Asia-pacific left main ST-Elevation Registry (ASTER) is a multicenter retrospective registry involving 4 sites in Singapore, South Korea, and the United States...
November 16, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29129258/long-term-outcomes-of-bypass-grafting-versus-drug-eluting-stenting-for-left-main-coronary-artery-disease-results-from-the-iris-main-registry
#2
Pil Hyung Lee, Jong-Young Lee, Cheol Whan Lee, Seungbong Han, Jung-Min Ahn, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Seong-Wook Park, Seung-Jung Park
There are limited data on comparative outcomes and its determinants following coronary artery bypass graft surgery (CABG) and percutaneous coronary intervention (PCI) with drug-eluting stents (DES) for left main coronary artery disease (LMCAD) in a real-world setting. METHODS: A total of 3,504 consecutive patients with LMCAD treated with CABG (n=1,301) or PCI with DES (n=2,203) from the IRIS-MAIN registry were analyzed. The relative treatment effect of one strategy over another was assessed by propensity-score matching method...
November 2017: American Heart Journal
https://www.readbyqxmd.com/read/29128044/incidence-of-left-ventricular-thrombus-in-patients-with-acute-st-segment-elevation-myocardial-infarction-treated-with-percutaneous-coronary-intervention
#3
Tiffany F Mao, Ata Bajwa, Preetham Muskula, Tina R Coggins, Kevin Kennedy, Anthony Magalski, David G Skolnick, Michael L Main
Previous studies using 2-dimensional non-contrast echocardiography have reported a post-ST segment elevation myocardial infarction (STEMI) left ventricular (LV) thrombus incidence of 3% to 24%. However, these studies were not performed with ultrasound contrast agents (UCAs), which improve accuracy in the diagnosis of LV thrombus. We aimed to determine the early incidence and clinical correlates of LV thrombus in a large consecutive cohort of patients with STEMI. This study included consecutive patients admitted to Saint Luke's Mid America Heart Institute with STEMI who also underwent early percutaneous coronary intervention (PCI) and an echocardiogram...
October 10, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29113866/intravascular-ultrasound-enhances-the-safety-of-rotational-atherectomy
#4
REVIEW
Kenichi Sakakura, Kei Yamamoto, Yousuke Taniguchi, Yoshimasa Tsurumaki, Shin-Ichi Momomura, Hideo Fujita
Intravascular ultrasound (IVUS) is mainly used in PCI to treat complex lesions, such as left main bifurcation, chronic total occlusion and calcified lesions. Although IVUS yields useful information such as the presence of napkin-ring calcification, the role of IVUS in rotational atherectomy (RA) is not fully appreciated. Recently, since the deliverability and crossability of IVUS catheters have improved, IVUS should be attempted before RA. Even if the IVUS catheter cannot cross the lesion, IVUS provides information just proximal to the target lesion, which would be useful in the selection of the appropriate guidewire and burr size...
September 23, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29112944/chronic-obstructive-pulmonary-disease-affects-the-angiographic-presentation-and-outcomes-of-patients-with-coronary-artery-disease-treated-with-percutaneous-coronary-interventions
#5
Rafał Januszek, Zbigniew Siudak, Artur Dziewierz, Tomasz Rakowski, Dariusz Dudek, Stanisław Bartuś
INTRODUCTION    The incidence of chronic obstructive pulmonary disease (COPD) in patients treated with percutaneous coronary interventions (PCIs) is underestimated, and the effect of COPD on PCI and atherosclerosis is not fully understood.  OBJECTIVES    The aim of this study was to assess the impact of COPD on periprocedural outcomes of PCIs and its relationship with clinical presentation and type of coronary artery lesions.  PATIENTS AND METHODS    Data were prospectively collected using the National PCI Registry (ORPKI) electronic database of all PCI procedures performed in Poland...
November 7, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/29102437/drug-eluting-stents-versus-coronary-artery-bypass-grafts-for-left-main-coronary-disease-a-meta-analysis-and-review-of-randomised-controlled-trials
#6
Peter Moore, Matthew Burrage, Paul Garrahy, Richard Lim, Andrew McCann, Anthony Camuglia
BACKGROUND: Revascularisation of left main coronary artery (LMCA) disease can be potentially managed with percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG). Recent randomised controlled trial (RCT) data have added to the literature on this subject and this meta-analysis aims to assess the state of the data to assist in guiding patient treatment decisions. METHODS: A systematic literature search of Cochrane Library, Embase, OVID, and PubMed MEDLINE was performed...
October 6, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29102362/drug-eluting-stents-in-elderly-patients-with-coronary-artery-disease-senior-a-randomised-single-blind-trial
#7
Olivier Varenne, Stéphane Cook, Georgios Sideris, Sasko Kedev, Thomas Cuisset, Didier Carrié, Thomas Hovasse, Philippe Garot, Rami El Mahmoud, Christian Spaulding, Gérard Helft, José F Diaz Fernandez, Salvatore Brugaletta, Eduardo Pinar-Bermudez, Josepa Mauri Ferre, Philippe Commeau, Emmanuel Teiger, Kris Bogaerts, Manel Sabate, Marie-Claude Morice, Peter R Sinnaeve
BACKGROUND: Elderly patients regularly receive bare-metal stents (BMS) instead of drug-eluting stents (DES) to shorten the duration of double antiplatelet therapy (DAPT). The aim of this study was to compare outcomes between these two types of stents with a short duration of DAPT in such patients. METHODS: In this randomised single-blind trial, we recruited patients from 44 centres in nine countries. Patients were eligible if they were aged 75 years or older; had stable angina, silent ischaemia, or an acute coronary syndrome; and had at least one coronary artery with a stenosis of at least 70% (≥50% for the left main stem) deemed eligible for percutaneous coronary intervention (PCI)...
October 31, 2017: Lancet
https://www.readbyqxmd.com/read/29097293/quality-of-life-after-everolimus-eluting-stents-or-bypass-surgery-for-treatment-of-left-main-disease
#8
Suzanne J Baron, Khaja Chinnakondepalli, Elizabeth A Magnuson, David E Kandzari, John D Puskas, Ori Ben-Yehuda, Gerrit-Anne van Es, David P Taggart, Marie-Claude Morice, Nicholas J Lembo, W Morris Brown, Adrian Banning, Charles A Simonton, A Pieter Kappetein, Joseph F Sabik, Patrick W Serruys, Gregg W Stone, David J Cohen
BACKGROUND: The EXCEL trial compared outcomes in patients with unprotected left main coronary artery disease (LMCAD) treated with coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) using everolimus-eluting stents. While rates of death, stroke, and myocardial infarction were similar at 36 months, event timing and repeat revascularization rates differed by treatment group. OBJECTIVES: To understand the effects of revascularization strategy from the patient's perspective, we performed a prospective quality of life (QoL) sub-study alongside the EXCEL trial...
October 20, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29081177/-outcome-determinants-in-cardiac-arrest-patients-secondary-to-acute-myocardial-infarction-receiving-extra-corporeal-membrane-oxygenation-combined-with-percutaneous-coronary-intervention-therapy
#9
H X Fu, J F Ma, M F Hu, Z N Zhao, Y Wang, L Miao
Objective: To investigate the clinical efficacy and outcome determinants in cardiac arrest patients secondary to acute myocardial infarction treated with extracorporeal membrane oxygenation (ECMO) and percutaneous coronary intervention (PCI). Methods: The clinical data of 27 patients hospitalized from January 2014 to March 2017 in 3 hospitals were retrospectively analyzed. The clinical data of the surviving group (12 cases) and the death group (15 cases) were compared and the outcome determinants were explored...
October 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/29073947/lesion-complexity-and-outcomes-of-extended-dual-antiplatelet-therapy-after-percutaneous-coronary-intervention
#10
RANDOMIZED CONTROLLED TRIAL
Robert W Yeh, Dean J Kereiakes, P Gabriel Steg, Donald E Cutlip, Kevin J Croce, Joseph M Massaro, Laura Mauri
BACKGROUND: Subjects undergoing coronary stenting with complex lesion anatomy may experience different risks and benefits with prolonged dual antiplatelet therapy. OBJECTIVES: The authors assessed the effect of 30 months versus 12 months of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) based on the presence or absence of anatomically-complex target lesions. METHODS: In the DAPT Study, combined myocardial infarction (MI) or stent thrombosis and moderate/severe bleeding were assessed in enrolled (n = 25,416) and randomized (n = 11,554) subjects...
October 31, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29029526/percutaneous-coronary-intervention-using-drug-eluting-stents-versus-coronary-artery-bypass-graft-surgery-in-left-main-coronary-artery-disease-an-updated-meta-analysis-of-randomized-clinical-trials
#11
Lei Gao, Yuqi Liu, Zhijun Sun, Yabin Wang, Feng Cao, Yundai Chen
OBJECTIVES: To compare the safety and efficacy of percutaneous coronary intervention (PCI) using drug-eluting stent (DES) and coronary artery bypass graft (CABG) for the treatment of left main coronary artery (LMCA) disease. BACKGROUND: Several new randomized trials have recently examined the clinical outcomes of PCI and CABG in LMCA disease. However, the results of these studies were inconsistent. MATERIALS AND METHODS: We searched five online electronic databases to identify all the randomized clinical trials assessing the outcomes of PCI using DES and CABG in patients with LMCA...
September 12, 2017: Oncotarget
https://www.readbyqxmd.com/read/29027735/temporal-trends-in-percutaneous-coronary-interventions-thru-the-drug-eluting-stent-era-insights-from-18-641-procedures-performed-over-12-year-period
#12
Uri Landes, Tamir Bental, Amos Levi, Abid Assali, Hana Vaknin-Assa, Eli I Lev, Eldad Rechavia, Gabriel Greenberg, Katia Orvin, Ran Kornowski
BACKGROUND: The last decade, regarded as the DES era in PCI, has witnessed significant advances in the management of coronary disease. We aimed to assess temporal trends in the practice and outcome of percutaneous coronary intervention (PCI) during the drug eluting stent (DES) era. METHODS: We analyzed 18,641 consecutive PCI's performed between January 2004 and December 2016, distinguished by procedural date (Q1 : 2004-2006, n = 4,865; Q2 : 2007-2009, n = 4,977; Q3 : 2010-2012, n = 4,230; Q4 : 2013-2016, n = 4,569)...
October 13, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29019879/percutaneous-coronary-intervention-versus-cardiac-bypass-surgery-for-left-main-coronary-artery-disease-a-trial-sequential-analysis
#13
Yicong Ye, Ming Yang, Shuyang Zhang, Yong Zeng
BACKGROUND: Several updated meta-analyses comparing percutaneous coronary intervention (PCI) with coronary artery bypass grafting (CABG) for left main coronary artery disease (LM CAD) have been published recently. However, the risk of false-positive results could be high in conventional updated meta-analyses due to repetitive testing of accumulating data. Therefore, we compared these treatment approaches via trial sequential analysis (TSA). METHODS: The MEDLINE, Embase, and Cochrane Central Register of Controlled Trials databases were searched for published randomized controlled trials (RCTs) or subgroups of RCTs comparing PCI and CABG in patients with LM CAD...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28993843/in-hospital-mortality-after-acute-stemi-in-patients-undergoing-primary-pci
#14
M Ali, S A Lange, T Wittlinger, G Lehnert, A G Rigopoulos, M Noutsias
BACKGROUND: Acute myocardial infarction (AMI) is the main cause of global and in-hospital mortality in patients with cardiovascular diseases. We aimed to examine the association between the coronary artery involved and the in-hospital mortality in patients who underwent primary percutaneous coronary intervention (pPCI) after ST segment elevation myocardial infarction (STEMI). METHODS: The in-hospital mortality of STEMI patients who underwent pPCI was assessed at the Department of Cardiology, Harzklinik Goslar, Germany, which has no access to immediate mechanical circulatory support (MCS), between 2013 and 2017...
October 9, 2017: Herz
https://www.readbyqxmd.com/read/28992999/provisional-versus-elective-two-stent-strategy-for-unprotected-true-left-main-bifurcation-lesions-insights-from-a-fails-2-sub-study
#15
Hiroyoshi Kawamoto, Alaide Chieffo, Fabrizio D'Ascenzo, Richard J Jabbour, Toru Naganuma, Enrico Cerrato, Fabrizio Ugo, Marco Pavani, Ferdinando Varbella, Giacomo Boccuzzi, Mauro Pennone, Roberto Garbo, Federico Conrotto, Giuseppe Biondi-Zoccai, Maurizio D'Amico, Claudio Moretti, Javier Escaned, Fiorenzo Gaita, Sunao Nakamura, Antonio Colombo
BACKGROUND: This study sought to investigate the optimal percutaneous coronary intervention (PCI) strategy for true unprotected left main coronary artery (ULMCA) bifurcations. METHODS: The FAILS-2 was a retrospective multi-center study including patients with ULMCA disease treated with second-generation drug-eluting stents. Of these, we compared clinical outcomes of a provisional strategy (PS; n=216) versus an elective two-stent strategy (E2S; n=161) for true ULMCA bifurcations...
October 4, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28974664/percutaneous-stenting-for-unprotected-left-main-chronic-total-occlusion
#16
Nagaraja Moorthy, Rangaraj Ramalingam, K Subramanyam, Shivanand S Patil, Manjunath C Nanjappa
PCI of a left main coronary artery chronic total occlusion followed by PCI of the right coronary artery was performed in a patient refusing CABG surgery.
October 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28966331/three-year-major-clinical-outcomes-of-angiography-guided-single-stenting-technique-in-non-complex-left-main-coronary-artery-diseases
#17
COMPARATIVE STUDY
Yong Hoon Kim, Ae-Young Her, Seung-Woon Rha, Byoung Geol Choi, Minsuk Shim, Se Yeon Choi, Jae Kyeong Byun, Hu Li, Woohyeun Kim, Jun Hyuk Kang, Jah Yeon Choi, Eun Jin Park, Sung Hun Park, Sunki Lee, Jin Oh Na, Cheol Ung Choi, Hong Euy Lim, Eung Ju Kim, Chang Gyu Park, Hong Seog Seo, Dong Joo Oh
There is limited long-term comparative clinical outcome data concerning angiography- versus intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) in non-complex left main coronary artery (LMCA) disease treated with the single stenting technique in the drug-eluting stent (DES) era.The aim of this study was to investigate whether angiography-guided stenting is comparable to IVUS-guided stenting during 3-year clinical follow-up periods in patients with non-complex LM disease treated with the single stenting technique...
October 12, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28966325/rotational-atherectomy-followed-by-drug-coated-balloon-dilation-for-left-main-in-stent-restenosis-in-the-setting-of-acute-coronary-syndrome-complicated-with-right-coronary-chronic-total-occlusion
#18
Jun Shiraishi, Keisuke Shoji, Takashi Yanagiuchi, Masaki Yashige, Akira Shikuma, Daisuke Ito, Masayoshi Kimura, Eigo Kishita, Yusuke Nakagawa, Masayuki Hyogo, Takahisa Sawada
An 83-year-old man presented with recurrent acute coronary syndrome (ACS) at the left main coronary artery (LMCA) complicated with ostial chronic total occlusion (CTO) in the right coronary artery (RCA) (RCA-CTO). At the first LMCA-ACS approximately 1 year earlier, he had undergone LMCA-crossover stenting with a biolimus-eluting stent in the presence of RCA-CTO. At the second LMCA-ACS, we angiographically confirmed severe in-stent restenosis in the distal LMCA, in addition to angled severe stenosis in the just proximal LCx, and performed primary PCI for the LMCA bifurcation lesion under intra-aortic balloon pumping support...
October 21, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28963740/the-prognostic-significance-of-incomplete-revascularization-and-untreated-coronary-anatomy-following-percutaneous-coronary-intervention-an-analysis-of-6-755-patients-with-multivessel-disease
#19
M Bilal Iqbal, Robert D Smith, Rebecca Lane, Niket Patel, Wala Mattar, Tito Kabir, Vasileios Panoulas, Mark Mason, Miles C Dalby, Richard Grocott-Mason, Charles D Ilsley
BACKGROUND: More than half of the patients undergoing percutaneous coronary intervention (PCI) have multivessel disease. Whether complete revascularization impacts long-term mortality or whether selected patients or those with specific coronary anatomy benefit from complete revascularization is unclear. METHODS: A total of 14,452 patients underwent PCI between 2004 and 2015 at Harefield Hospital, UK. Of these, 7,076 patients had multivessel disease. We excluded 321 patients with left main-stem stenosis ≥50%, with 6,755 patients included in the analysis (936 patients had complete revascularization)...
September 30, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28958756/percutaneous-coronary-intervention-with-drug-eluting-stent-versus-coronary-artery-bypass-grafting-a-meta-analysis-of-patients-with-left-main-coronary-artery-disease
#20
Nikolaos Spinthakis, Mohamed Farag, Diana A Gorog, Abhiram Prasad, Hamid Mahmood, Ying Gue, David Wellsted, Ashraf Nabhan, Manivannan Srinivasan
BACKGROUND: The relative efficacy and safety of percutaneous coronary intervention (PCI) with drug-eluting stents (DES), in comparison to coronary artery bypass grafting (CABG) for left main coronary artery disease (LMCAD) remains controversial. METHODS: We performed a meta-analysis of randomised studies comparing patients with LMCAD treated with PCI with DES versus those treated with CABG, with respect to clinical outcomes at 1, 3 and 5years. A secondary meta-analysis was performed according to low (<32), or high (≥33) SYNTAX score...
December 15, 2017: International Journal of Cardiology
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