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Left main coronary artery disease

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https://www.readbyqxmd.com/read/28194409/a-variant-in-cox-2-gene-is-associated-with-left-main-coronary-artery-disease-and-clinical-outcomes-of-coronary-artery-bypass-grafting
#1
Hanning Liu, Zhengxi Xu, Cheng Sun, Dachuan Gu, Xiao Teng, Yan Zhao, Zhe Zheng
As a particular severe phenotype of coronary artery disease (CAD), left main coronary artery disease (LMCAD) is heritable. Genetic variants related to prostaglandin metabolism are associated with LMCAD. Cyclooxygenase-2 (COX-2), a key synthase in prostaglandin pathways, displays high density in atherosclerotic lesions and promotes early atherosclerosis in CAD progression. We hypothesized that genetic variants in COX-2 gene contribute to LMCAD phenotype susceptibility compared to more peripheral coronary artery disease (MPCAD)...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28185417/left-main-coronary-angioplasty-of-a-9-year-old-child-with-bioresorable-vascular-scaffold
#2
Hasmukh Ravat, Swati Garekar, Vishal Changela
Familial hypercholesterolemia is an autosomal dominant disorder due to mutations in the low-density lipoprotein receptor gene, characterized by skin and tendon xanthomas, xanthelasmas, and increased risk of premature coronary artery disease. Here, we report a case of 9-year-old girl who presented with angina and dyspnoea on exertion with xanthomas and an elevated serum cholesterol and triglyceride. She had severe stenosis of the left main coronary artery (LMCA) requiring angioplasty and placement of Bioresorbable vascular scaffold (BVS)...
February 10, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28182034/topical-vasodilator-response-in-skeletonized-internal-mammary-artery-is-there-really-a-difference
#3
Syed Raza Shah, Syed Arbab Shah, Muhammad Ahmed Jangda, Mohammad Danial Yaqub, Ayesha Altaf Jangda, Maham Khan, Muhammad Asim Khan, Brian Tomkins
AIM OF THE STUDY: Coronary artery bypass graft surgery is the gold standard for the treatment of multivessel and left main coronary artery disease. However, there is considerable debate that whether left internal mammary artery (IMA) should be taken as pedicled or skeletonized. This study was conducted to assess the difference in blood flow after the application of topical vasodilator in skeletonized and pedicled IMA. MATERIALS AND METHODS: In this study, each patient underwent either skeletonized (n = 25) or pedicled IMA harvesting (n = 25)...
January 2017: Avicenna Journal of Medicine
https://www.readbyqxmd.com/read/28181211/post-infarct-treatment-with-pyr1-apelin-13-exerts-anti-remodeling-and-anti-apoptotic-effects-in-rats-heart
#4
Yaser Azizi, Alireza Imani, Hamed Fanaei, Safoura Khamse, Mohammad Reza Parvizi, Mahdieh Faghihi
BACKGROUND: Ischemic heart disease (IHD) is the main cause of mortality in the world. After myocardial infarction (MI) cardiomyocytes apoptosis and ventricular remodeling have been occurred. Apelin is a peptide that has been shown to exert cardioprotective effects. AIM: The aim of this study was to investigate anti-apoptotic and anti-remodeling effects of [Pyr¹]apelin-13 in the rat model of post-MI. METHODS: 36 Male Wistar rats were randomly divided into three groups: (1) sham (2) MI and (3) MI treated with [Pyr¹]apelin-13 (MI+Apel)...
February 9, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28169140/influence-of-cardiovascular-risk-factors-on-the-prevalence-of-coronary-atherosclerosis-in-patients-with-angiographically-normal-coronary-arteries
#5
Daniel O Bittner, Lutz Klinghammer, Mohamed Marwan, Jasmin Schmid, Christian Layritz, Udo Hoffmann, Stephan Achenbach, Tobias Pflederer
RATIONALE AND OBJECTIVES: Cardiovascular (CV) disease is predominately influenced by CV risk factors and coronary computed tomography angiography (CTA) is capable of detecting early-stage coronary artery disease. We sought to determine the influence of CV risk factors on the prevalence of nonobstructive atherosclerosis in patients with normal-appearing coronary arteries in invasive coronary angiography (ICA). MATERIALS AND METHODS: In this retrospective analysis, we included 60 consecutive symptomatic patients, having undergone ICA and coronary CTA...
February 3, 2017: Academic Radiology
https://www.readbyqxmd.com/read/28168062/undilatable-stent-neoatherosclerosis-treated-with-ad-hoc-rotational-atherectomy
#6
Michael Koutouzis, Maria Agelaki, Christos Maniotis, Ioannis Tsiafoutis, Vasileios Patris, Mihalis Argyriou
A middle age woman with known ischemic heart disease and old stents in proximal left anterior descending coronary artery (LAD) was admitted to Coronary Care Unit with acute coronary syndrome. The coronary angiography showed one vessel disease with significant restenosis within the previously implanted stents. The lesion was tough and remained undilatable despite high pressure balloon inflation. Eventually, the balloon ruptured creating a massive dissection of the LAD beginning immediately after the distal part of the undilatable lesion...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28165613/outcomes-of-coronary-artery-bypass-graft-surgery-versus-drug-eluting-stents-in-older-adults
#7
Mineok Chang, Cheol Whan Lee, Jung-Min Ahn, Rafael Cavalcante, Yohei Sotomi, Yoshinobu Onuma, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Seong-Wook Park, Patrick W Serruys, Seung-Jung Park
OBJECTIVES: Little data are available to compare coronary artery bypass graft surgery (CABG) vs percutaneous coronary intervention (PCI) with drug-eluting stents (DES) in older adults. We evaluate the long-term outcomes of CABG vs PCI with DES in older adults with left main or multivessel coronary artery disease (CAD). DESIGN: Individual patient-level meta-analysis. SETTINGS: Databases from the BEST, PRECOMBAT, and SYNTAX trials were combined...
February 6, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28163834/does-heart-rate-variability-correlate-with-long-term-prognosis-in-myocardial-infarction-patients-treated-by-early-revascularization
#8
Leonida Compostella, Nenad Lakusic, Caterina Compostella, Li Van Stella Truong, Sabino Iliceto, Fabio Bellotto
AIM: To assess the prevalence of depressed heart rate variability (HRV) after an acute myocardial infarction (MI), and to evaluate its prognostic significance in the present era of immediate reperfusion. METHODS: Time-domain HRV (obtained from 24-h Holter recordings) was assessed in 326 patients (63.5 ± 12.1 years old; 80% males), two weeks after a complicated MI treated by early reperfusion: 208 ST-elevation myocardial infarction (STEMI) patients (in which reperfusion was successfully obtained within 6 h of symptoms in 94% of cases) and 118 non-ST-elevation myocardial infarction (NSTEMI) patients (percutaneous coronary intervention was performed within 24 h and successful in 73% of cases)...
January 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28161261/incomplete-revascularization-is-associated-with-an-increased-risk-for%C3%A2-major-adverse-cardiovascular-events%C3%A2-among-patients-undergoing-noncardiac-surgery
#9
Ehrin J Armstrong, Laura A Graham, Stephen W Waldo, Javier A Valle, Thomas M Maddox, Mary T Hawn
OBJECTIVES: The aim of this study was to determine whether incomplete revascularization is associated with a higher risk for major adverse cardiovascular events (MACE) and myocardial infarction (MI) among patients undergoing noncardiac surgery. BACKGROUND: Patients with coronary artery disease and prior percutaneous coronary intervention (PCI) frequently undergo noncardiac surgery. These patients may have had PCI either on all obstructive lesions (i.e., complete revascularization) or only on some (i...
January 25, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28149317/prevalence-of-non-alcoholic-fatty-liver-disease-in-patients-with-coronary-artery-disease
#10
Babak Baharvand-Ahmadi, Khalil Sharifi, Mehrdad Namdari
BACKGROUND: Several common metabolic risk factors contribute to development of both non-alcoholic fatty liver disease (NAFLD) and coronary artery disease (CAD). The aim was to determine prevalence of NAFLD in patients with CAD. METHODS: This prospective study was carried out from December 2011 to June 2012. All patients with documented diagnosis of CAD with stenosis of one of the main coronary arteries or their branches were included in the study. Ultrasound examination of liver was performed in all patients to diagnose hepatic steatosis...
July 2016: ARYA Atherosclerosis
https://www.readbyqxmd.com/read/28131320/incidence-and-management-of-restenosis-after-treatment-of-unprotected-left-main-disease-with-second-generation-drug-eluting-stents-from-failure-in-left-main-study-with-2nd-generation-stents-cardiogroup-iii-study
#11
Fabrizio D'Ascenzo, Alaide Chieffo, Enrico Cerrato, Fabrizio Ugo, Marco Pavani, Hyroishi Kawamoto, Roberto di Summa, Ferdinando Varbella, Giacomo Boccuzzi, Pierluigi Omedè, Sara Rettegno, Roberto Garbo, Federico Conrotto, Antonio Montefusco, Giuseppe Biondi-Zoccai, Maurizio D'Amico, Claudio Moretti, Javier Escaned, Fiorenzo Gaita, Antonio Colombo
Incidence, predictors, and impact on prognosis of target lesion revascularization (TLR) for patients treated with second-generation drug-eluting stents (DESs) on unprotected left main (ULM) remain to be defined. The present study is a multicenter study including patients treated with a second-generation DES on ULM from June 2007 to January 2015. Rate of TLR was the primary end point. All cause death, myocardial infarction, target vessel revascularization, and stent thrombosis were the secondary end points. A total of 1,270 patients were enrolled: after a follow-up of 650 days (230 to 1,170), 47 (3...
January 6, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28122852/coronary-artery-bypass-surgery-in-young-adults-excellent-perioperative-results-and-long-term-survival
#12
Joana Saraiva, Pedro E Antunes, Manuel J Antunes
OBJECTIVES: To analyse perioperative results, long-term survival and freedom from complications after coronary artery bypass grafting (CABG) in young adults. METHODS: A total of 163 patients, 40 years old or younger, had isolated CABG from January 1989 to December 2010. Pre- and perioperative demographic and clinical data were retrieved from a prospectively organised database. Follow-up data were obtained by letter or telephone interviews. The mean age of the patients was 37...
January 25, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28122463/inflammatory-bowel-disease
#13
Grigorios Tsigkas, Periklis Davlouros, Stefanos Despotopoulos, Stelios Assimakopoulos, Georgios Theocharis, George Hahalis
Patients with inflammatory bowel disease (IBD) have a higher incidence of coronary artery disease (CAD) compared with the general population. Left main coronary artery (LMCA) thrombosis constitutes a very rare but catastrophic manifestation of acute coronary syndrome. Case reports describing young patients with IBD and LMCA thrombosis are scarce. Most importantly, patients with a positive family history of thrombotic events and those with significant genetic or acquired risk factors such as the antiphospholipid antibody syndrome, advanced age, immobilization, pregnancy, oral contraceptive use, obesity, diabetes, and cigarette smoking may have a higher risk of thrombosis among those with active IBD...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/28112467/predictors-of-long-term-outcomes-after-bypass-grafting-versus-drug-eluting-stent-implantation-for-left-main-or-multivessel-coronary-artery-disease
#14
Mineok Chang, Cheol Whan Lee, Jung-Min Ahn, Rafael Cavalcante, Yohei Sotomi, Yoshinobu Onuma, Minkyu Han, Seong-Wook Park, Patrick W Serruys, Seung-Jung Park
BACKGROUND: We assessed predictors of long-term outcomes after coronary artery bypass grafting (CABG) versus those after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) in 3,230 patients with left main or multivessel coronary artery disease (CAD). METHODS AND RESULTS: Data were pooled from the BEST, PRECOMBAT, and SYNTAX trials. Age, chronic kidney disease, chronic obstructive lung disease, left ventricular dysfunction, and peripheral arterial disease (PAD) were common predictors of all-cause mortality...
January 23, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28106619/video-assisted-thoracic-surgery-in-patients-with-previous-sternotomy-and-cardiac-surgery
#15
Derek R Serna-Gallegos, Heather E Merry, Robert J McKenna
OBJECTIVE: Although video-assisted thoracic surgery (VATS) lobectomy has become a standard approach for early-stage 1 lung cancer, concerns exist regarding potential damage to the heart or bypass grafts when VATS is performed after cardiac surgery via median sternotomy. We could find only case reports regarding VATS lobectomy after sternotomy for cardiac surgery. Therefore, we reviewed our series of patients who underwent VATS anatomic resections after sternotomy for cardiac surgery. METHODS: Between 1996 and 2010, there were 87 patients who underwent 88 pulmonary resections after sternotomy for coronary artery bypass grafting (64), valve replacement or repair (12), coronary artery bypass graft and valve replacement (6), and transplant (5)...
January 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28104622/renin-angiotensin-system-inhibitors-for-patients-with-stable-coronary-artery-disease-without-heart-failure-systematic-review-and-meta-analysis-of-randomized-trials
#16
Sripal Bangalore, Robert Fakheri, Simon Wandel, Bora Toklu, Jasmin Wandel, Franz H Messerli
OBJECTIVE:  To critically evaluate the efficacy of renin angiotensin system inhibitors (RASi) in patients with coronary artery disease without heart failure, compared with active controls or placebo. DESIGN:  Meta-analysis of randomized trials. DATA SOURCES:  PubMed, EMBASE, and CENTRAL databases until 1 May 2016. ELIGIBILITY CRITERIA FOR SELECTING STUDIES:  Randomized trials of RASi versus placebo or active controls in patients with stable coronary artery disease without heart failure (defined as left ventricular ejection fraction ≥40% or without clinical heart failure)...
January 19, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28102878/pulmonary-hypertension-associated-with-left-sided-heart-disease
#17
Micha Tobias Maeder, Otto D Schoch, Rebekka Kleiner, Lucas Joerg, Daniel Weilenmann, Swiss Society For Pulmonary Hypertension
Pulmonary hypertension associated with left-sided heart disease (PH-LHD) is the most common type of pulmonary hypertension. In patients with left-sided heart disease, the presence of pulmonary hypertension is typically a marker of more advanced disease, more severe symptoms, and worse prognosis. In contrast to pulmonary arterial hypertension, PH-LHD is characterised by an elevated pulmonary artery wedge pressure (postcapillary pulmonary hypertension) without or with an additional precapillary component (isolated postcapillary versus combined postcapillary and precapillary pulmonary hypertension)...
January 19, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28100876/primary-percutaneous-coronary-intervention-followed-by-valve-surgery-for-acute-coronary-syndrome-at-left-main-trunk-complicated-with-severe-aortic-stenosis
#18
Akira Shikuma, Jun Shiraishi, Kazunari Okawa, Masaki Yashige, Keisuke Shoji, Daisuke Ito, Masayoshi Kimura, Eigo Kishita, Yusuke Nakagawa, Masayuki Hyogo, Akiyuki Takahashi, Takahisa Sawada
An 89-year-old woman appeared to have acute coronary syndrome at the left main trunk (LMT) complicated with severe aortic stenosis, moderate-severe mitral regurgitation, depressed left ventricular (LV) function, and multivessel disease. Because of sustained hypotension even under intra-aortic balloon pumping support during emergency coronary angiograhy, we performed primary percutaneous coronary intervention solely for the LMT lesion using a bare metal stent, leading to recovery from the shock state. On the second hospital day, based on our heart-team consensus, we performed aortic valve replacement and coronary artery bypass grafting surgery, and added edge-to-edge repair (Alfieri stitch) of the mitral valve, resulting in complete revascularization and dramatically improved LV function...
February 7, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28100341/-comparison-on-the-long-term-outcomes-post-percutaneous-coronary-intervention-or-coronary-artery-bypass-grafting-for-bifurcation-lesions-in-unprotected-left-main-coronary-artery
#19
B G Yang, X P Yu, F Chen, S Z Lyu, Q Li, J Q He, F Yuan
Objective: To compare the long-term clinical outcomes of consecutive patients treated with coronary artery bypass grafting (CABG) or percutaneous coronary intervention(PCI) with drug-eluting stents (DES) for bifurcation lesions in unprotected left main coronary artery (ULMCA). Methods: A total of 663 consecutively patients with unprotected left main bifurcation disease (defined as stenosis≥50%) who received either drug-eluting stents (DES) implantation (n=316) or underwent CABG (n=347) between January 2003 and July 2009 in Beijing Anzhen Hospital were enrolled retrospectively in this study...
January 25, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/28081585/drug-eluting-stent-placement-versus-coronary-artery-bypass-surgery-for-unprotected-left-main-coronary-artery-disease-a-meta-analysis-of-randomized-controlled-trials
#20
Sunil Upadhaya, Ramkaji Baniya, Seetharamprasad Madala, Suresh Kumar Subedi, Jahangir Khan, Ravi Kanth Velagapudi, Ghassan Bachuwa
BACKGROUND: Coronary artery bypass grafting (CABG) is the standard of care for treating left main coronary lesions. However, recently published randomized controlled trials (RCT) have shown conflicting results. We sought to compare clinical outcomes of percutaneous coronary intervention (PCI) with drug-eluting stent placement to CABG using a meta-analysis of randomized controlled trials. METHODS: A systemic search of Pubmed, Scopus, Cochrane library, and Clinicaltrials...
January 12, 2017: Journal of Cardiac Surgery
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