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Left main coronary artery disease

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https://www.readbyqxmd.com/read/28324943/overcoming-spatio-temporal-limitations-using-dynamically-scaled-in-vitro-pc-mri-a-flow-field-comparison-to-true-scale-computer-simulations-of-idealized-stented-and-patient-specific-left-main-bifurcations
#1
Susann Beier, John Ormiston, Mark Webster, John Cater, Stuart Norris, Pau Medrano-Gracia, Alistair Young, Kathleen Gilbert, Brett Cowan
The majority of patients with angina or heart failure have coronary artery disease. Left main bifurcations are particularly susceptible to pathological narrowing. Flow is a major factor of atheroma development, but limitations in imaging technology such as spatio-temporal resolution, signal-to-noise ratio (SNRv), and imaging artefacts prevent in vivo investigations. Computational fluid dynamics (CFD) modelling is a common numerical approach to study flow, but it requires a cautious and rigorous application for meaningful results...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28300667/characteristics-of-coronary-artery-disease-among-patients-with-atrial-fibrillation-compared-to-patients-with-sinus-rhythm
#2
Lukas J Motloch, Sara Reda, Robert Larbig, Ariane Wolff, Karolina A Motloch, Bernhard Wernly, Christina Granitz, Michael Lichtenauer, Martin Wolny, Uta C Hoppe
BACKGROUND: With a high prevalence of coronary artery disease (CAD) among patients with atrial fibrillation (AF), CAD is one of the main risk factors for AF. However, little is known about the characteristics of CAD in AF patients. Especially, the question, whether a specific anatomical distribution of coronary artery stenoses might predispose to AF via atrial ischemia remains speculative. To address this issue, we evaluated potential associations between angiographic characteristics of CAD and AF...
March 11, 2017: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/28296170/percutaneous-coronary-intervention-or-coronary-artery-bypass-grafting-for-unprotected-left-main-coronary-artery-disease
#3
Ahmed N Mahmoud, Islam Y Elgendy, Amgad Mentias, Marwan Saad, Walid Ibrahim, Mohammad K Mojadidi, Ramez Nairooz, Parham Eshtehardi, R David Anderson, Habib Samady
BACKGROUND: Recent trials comparing PCI with CABG for unprotected left main disease yielded discrepant evidence. OBJECTIVES: To perform an updated meta-analysis of randomized trials comparing percutaneous coronary intervention (PCI) with coronary artery bypass grafting (CABG) in patients with unprotected left main coronary artery disease. METHODS: Randomized trials comparing PCI versus CABG for patients with unprotected left main coronary artery disease were included...
March 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28290878/-immediate-outcomes-of-coronary-artery-bypass-grafting-in-patients-with-multifocal-atherosclerosis-gender-differences
#4
A N Sumin, E V Korok, R A Gaifulin, S V Ivanov, O L Barbarash
AIM: To assess the impact of presence of multifocal atherosclerosis (MFA) and gender differences on immediate outcomes after coronary artery bypass grafting (CABG) in patients with ischemic heart disease (IHD). MATERIAL AND METHODS: Medical records of patients with MFA, who underwent elective CABG (n=764, 655 men, 109 women) were reviewed retrospectively. RESULTS: Women were older (<0.001), and more often were overweight (<0.001), had diabetes (<0...
August 2016: Kardiologiia
https://www.readbyqxmd.com/read/28275419/early-diagnosis-and-treatment-of-coronary-heart-disease-in-symptomatic-subjects-with-advanced-vascular-atherosclerosis-of-the-carotid-artery-type-iii-and-iv-b-findings-using-ultrasound
#5
Ansgar Adams, Waldemar Bojara, Klaus Schunk
BACKGROUND: A study was conducted as to whether the early diagnosis of coronary heart disease (CHD) in symptomatic patients with advanced atherosclerosis of the carotid artery was more successful using ultrasound technology than exercise electrocardiography (ECG). METHODS: Within the scope of an occupational screening program using subjects from diverse employment sectors, people were given the opportunity to determine their risk of heart attack. During the study, the total plaque area (TPA), the maximum plaque thickness in the carotid artery and the PROCAM scores of 3,513 healthy men and 2,088 healthy women between the ages of 20 and 65 were determined...
February 2017: Cardiology Research
https://www.readbyqxmd.com/read/28271553/mechanical-circulatory-support-in-patients-with-severe-aortic-stenosis-and-left-ventricular-dysfunction-undergoing-percutaneous-coronary-intervention
#6
REVIEW
Mohamad Alkhouli, Ahmed Al Mustafa, Zakeih Chaker, Fahad Alqahtani, Sami Aljohani, David R Holmes
Management of obstructive coronary artery disease in patients with aortic stenosis and severe left ventricular dysfunction is challenging. Mechanical circulatory support at the time of percutaneous coronary interventions may be necessary in these extreme-risk patients. We present a case in which the TandemHeart was used to support a patient with severe aortic stenosis, severe protected left main and circumflex disease, and severe cardiomyopathy and review the literature on this subject.
March 7, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28267960/meta-analysis-of-randomized-control-trials-comparing-drug-eluting-stents-versus-coronary-artery-bypass-grafting-for-significant-left-main-coronary-narrowing
#7
Cheng Qian, Hong Feng, Jianlei Cao, Baozhu Wei, Yanggan Wang
Previous meta-analyses showed that drug-eluting stent (DES) implantation may serve as an alternative to coronary artery bypass grafting (CABG) for unprotected left main coronary artery (ULMCA) stenosis, largely driven by data from registries. Hence, we performed a meta-analysis of randomized controlled trials (RCTs) to overcome this limitation. PubMed, the Cochrane Library, and Scopus were systematically searched through October 2016 to identify eligible RCTs. The primary outcomes were major adverse cardiac and cerebrovascular events (MACCE) at 1-year and long-term (≥3 years) follow-ups...
February 10, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28266826/cardiovascular-disease-update-care-of-patients-after-coronary-artery-bypass-graft
#8
Craig Barstow, Johnathan D McDivitt
Coronary artery bypass graft (CABG) is a surgical procedure in which a vessel, normally the left internal mammary artery and/or a segment of an excised vein (typically from the leg), is grafted to the coronary arteries to bypass a blockage. CABG has been shown to be superior to percutaneous coronary intervention for patients with complex three vessel disease and left main coronary artery disease. All patients undergoing CABG should receive aspirin preoperatively; they also should receive a beta blocker preoperatively to reduce the likelihood of postsurgical atrial fibrillation...
March 2017: FP Essentials
https://www.readbyqxmd.com/read/28250991/polygamy-and-risk-of-coronary-artery-disease-in-men-undergoing-angiography-an-observational-study
#9
Amin Daoulah, Amir Lotfi, Mushabab Al-Murayeh, Salem Al-Kaabi, Salem M Al-Faifi, Osama E Elkhateeb, Mohamed N Alama, Ahmad S Hersi, Ciaran M Dixon, Waleed Ahmed, Mohamed Al-Shehri, Ali Youssef, Ahmed Moustafa Elimam, Ayman S Abougalambou, Waheed Murad, Alawi A Alsheikh-Ali
Epidemiologic evidence suggests a link between psychosocial risk factors such as marital status and coronary artery disease (CAD). Polygamy (multiple concurrent wives) is a distinct marital status practiced in many countries in Asia and the Middle East, but its association with CAD is not well defined. We conducted a multicenter, observational study of consecutive patients undergoing coronary angiography during the period from April 1, 2013, to March 30, 2014. Of 1,068 enrolled patients, 687 were married men...
2017: International Journal of Vascular Medicine
https://www.readbyqxmd.com/read/28244598/exercise-test-predictors-of-severe-coronary-artery-disease-role-of-st-segment-elevation-in-lead-avr
#10
Giulio Russo, Salvatore Emanuele Ravenna, Antonio De Vita, Cristina Aurigemma, Priscilla Lamendola, Gaetano Antonio Lanza, Filippo Crea
BACKGROUND: The role of exercise stress test (EST)-induced ST-segment elevation (STE) in electrocardiographic lead aVR in predicting severe coronary artery disease (CAD) is controversial. HYPOTHESIS: Assessment of lead aVR during EST can be helpful to identify patients with severe CAD. METHODS: We performed maximal EST in 200 patients undergoing coronary angiography for suspect of CAD. Four angiographic findings of severe CAD were considered: (1) left main (LM) disease; (2) LM or equivalent LM (LM/EQLM) disease; (3) LM or proximal left anterior descending (LAD) artery (LM/proxLAD) disease; and (4) LM or 3-vessel (LM/3V) disease...
February 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28242636/percutaneous-coronary-intervention-versus-coronary-artery-bypass-grafting-in-patients-with-left-main-and-multivessel-coronary-artery-disease-do-we-have-the-evidence
#11
Bernard J Gersh, Gregg W Stone, Deepak L Bhatt
No abstract text is available yet for this article.
February 28, 2017: Circulation
https://www.readbyqxmd.com/read/28228950/outcomes-of-coronary-artery-bypass-grafting-versus-percutaneous-coronary-intervention-with-second-generation-drug-eluting-stents-for-patients-with-multivessel-and-unprotected-left-main-coronary-artery-disease
#12
Kyriacos Papadopoulos, Ioannis Lekakis, Evagoras Nicolaides
OBJECTIVES: To compare the efficacy and safety of percutaneous coronary intervention using second-generation drug-eluting stents with those of coronary artery bypass grafting among patients with multivessel disease and/or unprotected left main coronary artery disease in terms of mortality, myocardial infarction, repeat revascularization, and angina. BACKGROUND: Although coronary artery disease is a leading cause of death in the Western world and in many developing countries, its optimal treatment is still a matter of controversy...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/28226721/overcoming-spatio-temporal-limitations-using-dynamically-scaled-in-vitro-pc-mri-a-flow-field-comparison-to-true-scale-computer-simulations-of-idealized-stented-and-patient-specific-left-main-bifurcations
#13
Susann Beier, John Ormiston, Mark Webster, John Cater, Stuart Norris, Pau Medrano-Gracia, Alistair Young, Kathleen Gilbert, Brett Cowan, Susann Beier, John Ormiston, Mark Webster, John Cater, Stuart Norris, Pau Medrano-Gracia, Alistair Young, Kathleen Gilbert, Brett Cowan, Stuart Norris, Brett Cowan, Pau Medrano-Gracia, Kathleen Gilbert, Mark Webster, Alistair Young, Susann Beier, John Cater, John Ormiston
The majority of patients with angina or heart failure have coronary artery disease. Left main bifurcations are particularly susceptible to pathological narrowing. Flow is a major factor of atheroma development, but limitations in imaging technology such as spatio-temporal resolution, signal-to-noise ratio (SNRv), and imaging artefacts prevent in vivo investigations. Computational fluid dynamics (CFD) modelling is a common numerical approach to study flow, but it requires a cautious and rigorous application for meaningful results...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28224974/differences-in-outcomes-in-patients-with-stable-coronary-artery-disease-managed-by-cardiologists-versus-non-cardiologists-the-international-prospective-clarify-registry
#14
Zofia Parma, Philippe Gabriel Steg, Nicola Greenlaw, Roberto Ferrari, Ian Ford, Kim Fox, Jean-Claude Tardif, Joao Morais, Marco Alcocer Gamba, Stefan Kääb, Michał Tendera
INTRODUCTION    Clinical outcomes of patients with stable coronary artery disease (SCAD) may differ between those primarily managed by cardiologists versus non-cardiologists.  OBJECTIVES    Our main objective was to analyze the clinical outcomes of outpatients with SCAD in relation to the specialty of the managing physicians.  PATIENTS AND METHODS    We studied 32,468 outpatients with SCAD included in the CLARIFY registry, with up to 4 years follow-up data. Cardiologists provided medical care in 84...
January 20, 2017: Polskie Archiwum Medycyny Wewnętrznej
https://www.readbyqxmd.com/read/28224927/an-age-and-sex-specific-gene-expression-score-is-associated-with-revascularization-and-coronary-artery-disease-insights-from-the-prospective-multicenter-imaging-study-for-evaluation-of-chest-pain-promise-trial
#15
Deepak Voora, Adrian Coles, Kerry L Lee, Udo Hoffmann, James A Wingrove, Brian Rhees, Lin Huang, Susan E Daniels, Mark Monane, Steven Rosenberg, Svati H Shah, William E Kraus, Geoffrey S Ginsburg, Pamela S Douglas
BACKGROUND: Identifying predictors of coronary artery disease (CAD)-related procedures and events remains a priority. METHODS: We measured an age- and sex-specific gene expression score (ASGES) previously validated to detect obstructive CAD (oCAD) in symptomatic nondiabetic patients in the PROMISE trial. The outcomes were oCAD (≥70% stenosis in ≥1 vessel or ≥50% left main stenosis on CT angiography [CTA]) and a composite endpoint of death, myocardial infarction, revascularization, or unstable angina...
February 2017: American Heart Journal
https://www.readbyqxmd.com/read/28223049/outcomes-of-coronary-artery-bypass-and-stents-for-unprotected-left-main-coronary-stenosis
#16
Yin-Shu Chang, Jia-Xiang Wang, Da-Wei Chang
BACKGROUND: This study assessed the short-, medium-, and long-term outcomes of coronary artery bypass grafting vs stenting for patients with unprotected left main coronary artery disease through a meta-analysis of randomized controlled trials. METHODS: PubMed, Embase, Scopus, Web of Science, Cochrane Library, and major conference proceedings databases were systematically searched for randomized controlled trials of coronary artery bypass grafting compared with stents in unprotected left main coronary artery disease...
February 18, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28220463/can-we-improve-the-outcomes-of-multivessel-disease-using-modified-syntax-and-residual-syntax-scores
#17
REVIEW
Alfredo E Rodriguez, Carlos Fernandez-Pereira, Juan Mieres, Javier Mendoza, Florencia Sartori
PURPOSE OF REVIEW: In spite of the benefits of drug eluting (DES), these advantages were not translated to better outcome when percutaneous coronary interventions (PCI) were compared with coronary artery bypass surgery. PCI strategy allowing stent deployment in all intermediate lesions including small vessels together with DES design may be the reasons of these findings. RECENT FINDINGS: Recently randomized and observational studies demonstrated using functional flow reserve analysis, residual Syntax score risk, or residual ERACI score after PCI that a reasonably incomplete revascularization was associated with good long-term outcome and low events rate at follow-up...
March 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28219921/predictive-value-of-dobutamine-stress-perfusion-echocardiography-in-contemporary-end-stage-liver-disease
#18
Bipul Baibhav, Chetaj A Mahabir, Feng Xie, Valerie K Shostrom, Timothy M McCashland, Thomas R Porter
BACKGROUND: The assessment of cardiac risk in contemporary liver transplantation (LT) has required more sensitive testing for the detection of occult coronary artery disease as well as microvascular and functional cardiac abnormalities. Because dobutamine stress perfusion echocardiography provides an assessment of both regional systolic and diastolic function as well as microvascular perfusion (MVP), we sought to examine its incremental value in this setting. METHODS AND RESULTS: We evaluated the predictive value of dobutamine stress perfusion echocardiography in 296 adult patients with end-stage liver disease and preserved systolic function who underwent LT between 2008 and 2014...
February 20, 2017: Journal of the American Heart Association
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
#19
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
#20
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
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