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Left main coronary artery disease

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https://www.readbyqxmd.com/read/29236974/diabetes-as-an-independent-predictor-of-left-ventricular-longitudinal-strain-reduction-at-rest-and-during-dobutamine-stress-test-in-patients-with-significant-coronary-artery-disease
#1
Karina Wierzbowska-Drabik, Ewa Trzos, Malgorzata Kurpesa, Tomasz Rechcinski, Dawid Miskowiec, Urszula Cieslik-Guerra, Barbara Uznanska-Loch, Maria Sobczak, Jaroslaw Damian Kasprzak
Aims: Diabetes (DM) is a strong cardiovascular risk factor modifying also the left ventricular (LV) function that may be objectively assessed with echocardiographic strain analysis. Although the impact of isolated DM on myocardial deformation has been already studied, few data concern diabetics with coronary artery disease (CAD), especially in all stages of dobutamine stress echocardiography (DSE). We compared LV systolic function during DSE in CAD with and without DM using state-of-the art speckle-tracking quantification and assessed the impact of DM on LV systolic strain...
December 9, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29229216/immediate-complete-revascularization-in-patients-with-st-segment-elevation-myocardial-infarction-and-multivessel-disease-treated-by-primary-percutaneous-coronary-intervention-insights-from-the-orbi-registry
#2
Anna Pimor, Vincent Auffret, Romain Didier, Régis Delaunay, Emmanuelle Filippi, Jean-Philippe Hacot, Djamel Saouli, Gilles Rouault, Philippe Druelles, Emilie Bot, Isabelle Coudert, Bertrand Boulanger, Marielle Le Guellec, Dominique Boulmier, Guillaume Leurent, Marc Bedossa, Martine Gilard, Hervé Le Breton
BACKGROUND: Recent studies demonstrated the superiority of complete revascularization (CR) in patients treated by primary percutaneous coronary intervention (pPCI) in ST-elevation myocardial infarction (STEMI). AIM: To evaluate whether immediate CR improves in-hospital outcomes in patients with STEMI with multivessel disease. METHODS: Data from a prospective multicentre registry including 9365 patients with STEMI were analysed. Patients with multivessel disease and treated with pPCI (n=3412) were included and separated into two groups according to whether immediate CR was performed during the index procedure...
December 8, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29223429/predicting-risk-of-cardiac-events-among-st-segment-elevation-myocardial-infarction-patients-with-conservatively-managed-non-infarct-related-artery-coronary-artery-disease-an-analysis-of-the-duke-databank-for-cardiovascular-disease
#3
RANDOMIZED CONTROLLED TRIAL
Sameer A Hirji, Susanna R Stevens, Linda K Shaw, Erin C Campbell, Christopher B Granger, Manesh R Patel, Michael H Sketch, Tracy Y Wang, E Magnus Ohman, Eric D Peterson, J Matthew Brennan
BACKGROUND: Recent randomized evidence has demonstrated benefit with complete revascularization during the index hospitalization for multivessel coronary artery disease ST-segment elevation myocardial infarction (STEMI) patients; however, this benefit likely depends on the risk of future major adverse cardiovascular events (MACE). METHODS: Using data from Duke University Medical Center (2003-2012), we identified those at high risk for 1-year MACE among 664 STEMI patients with conservatively managed non-infarct-related artery (non-IRA) lesions...
December 2017: American Heart Journal
https://www.readbyqxmd.com/read/29221235/triaging-patients-with-left-main-disease-after-the-excel-and-noble-trials-the-everlasting-saga-of-coronary-artery-bypass-grafting-and-percutaneous-coronary-intervention
#4
EDITORIAL
https://www.readbyqxmd.com/read/29217002/the-delta-2-registry-a-multicenter-registry-evaluating-percutaneous-coronary-intervention-with-new-generation-drug-eluting-stents-in-patients-with-obstructive-left-main-coronary-artery-disease
#5
Alaide Chieffo, Akihito Tanaka, Gennaro Giustino, Ieva Briede, Fadi J Sawaya, Joost Daemen, Hiroyoshi Kawamoto, Emanuele Meliga, Fabrizio D'Ascenzo, Enrico Cerrato, Giulio G Stefanini, Davide Capodanno, Andrea Mangiameli, Christian Templin, Andrejs Erglis, Marie Claude Morice, Roxana Mehran, Nicolas M Van Mieghem, Sunao Nakamura, Mauro De Benedictis, Marco Pavani, Ferdinando Varbella, Marco Pisaniello, Samin K Sharma, Corrado Tamburino, Didier Tchetche, Antonio Colombo
OBJECTIVES: The aim of this study was to evaluate clinical outcomes of unprotected left main coronary artery percutaneous coronary intervention (PCI) with new-generation drug-eluting stents in a "real world" population. BACKGROUND: PCI of the unprotected left main coronary artery is currently recommended as an alternative to coronary artery bypass grafting (CABG) in selected patients. METHODS: All consecutive patients with unprotected left main coronary artery stenosis treated by PCI with second-generation drug-eluting stents were analyzed in this international, all-comers, multicenter registry...
December 11, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29215470/invasive-assessment-of-microvascular-function-in-patients-with-valvular-heart-disease
#6
Takeshi Nishi, Hideki Kitahara, Saito Yuichi, Tomoko Nishi, Takashi Nakayama, Yoshihide Fujimoto, Goro Matsumiya, Yoshio Kobayashi
BACKGROUND: The aim of this study was to investigate microvascular function in patients with valvular heart disease (VHD), which causes chronic left ventricular volume and/or pressure overload, therefore change in coronary microvascular hemodynamics. PATIENTS AND METHODS: We prospectively enrolled 30 patients with VHD considered for surgery (10 aortic stenosis, 12 aortic regurgitation, and eight mitral regurgitation) and 30 controls. Intracoronary physiological assessments were performed in the unobstructed left anterior descending artery using a pressure-temperature sensor guidewire at rest and hyperemia...
December 5, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/29211222/cabg-surgery-remains-the-best-option-for-patients-with-left-main-coronary-disease-in-comparison-with-pci-des-meta-analysis-of-randomized-controlled-trials
#7
Michel Pompeu Barros Oliveira Sá, Artur Freire Soares, Rodrigo Gusmão Albuquerque Miranda, Mayara Lopes Araújo, Alexandre Motta Menezes, Frederico Pires Vasconcelos Silva, Ricardo Carvalho Lima
OBJECTIVE: To compare the safety and efficacy of coronary artery bypass grafting (CABG) with percutaneous coronary intervention (PCI) using drug-eluting stents (DES) in patients with unprotected left main coronary artery (ULMCA) disease. METHODS: MEDLINE, EMBASE, CENTRAL/CCTR, SciELO, LILACS, Google Scholar and reference lists of relevant articles were searched for clinical studies that reported outcomes at 1-year follow-up after PCI with DES and CABG for the treatment of ULMCA stenosis...
September 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29210840/conoscere-e-curare-il-cuore-1986-2016-how-the-heart-has-changed
#8
Alessandro Boccanelli
: The demographic transition, with longer life expectancy, is mainly due to prevention and care of atherosclerotic vascular and heart disease. The cardiovascular patient is now much older and often presents with coexisting geriatric syndromes that affect healthcare goals, outcomes, and the process of care. Numerous mechanisms at cellular level are responsible for cardiovascular aging such as replicative senescence, apoptosis, proteins misfolding, and inflammation. Aging-related modifications are increase in left-ventricular mass, increased left atrial size, myocardial collagen deposition, and calcium deposition in valvular structures and the coronary arteries...
November 27, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29191566/usefulness-of-achieving-%C3%A2-10-mets-with-a-negative-stress-electrocardiogram-to-screen-for-high-risk-obstructive-coronary-artery-disease-in-patients-referred-for-coronary-angiography-after-exercise-stress-testing
#9
Adrián I Löffler, Margarita V Perez, Emmanuel O Nketiah, Jamieson M Bourque, Ellen C Keeley
Functional capacity in exercise stress testing is an independent predictor of cardiac events. Routine use of nuclear perfusion imaging increases radiation burden and cost. Our goal was to assess the clinical utility of exercise functional capacity with stress electrocardiogram (ECG) as an adjunct in predicting the presence of high-risk obstructive coronary artery disease (CAD) on diagnostic coronary angiography. We performed a retrospective study of patients who underwent exercise stress testing for the evaluation of chest pain and underwent diagnostic coronary angiography within the subsequent 3 months...
October 31, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29184509/parp-1-variant-rs1136410-confers-protection-against-coronary-artery-disease-in-a-chinese-han-population-a-two-stage-case-control-study-involving-5643-subjects
#10
Xue-Bin Wang, Ning-Hua Cui, Shuai Zhang, Shu-Ren Guo, Ze-Jin Liu, Liang Ming
Inhibition of poly(ADP-ribose) polymerase (PARP) may protect against coronary artery disease (CAD) in animal models, and rs1136410, a non-synonymous single nucleotide polymorphism (SNP) in PARP-1, has a potential impact on PARP activities in vitro. This two-stage case-control study, involving 2803 CAD patients and 2840 controls, aimed to investigate the associations of PARP-1 rs1136410 with CAD development, lipid levels, PARP activities, 8-hydroxy-2'-dexyguanosine (8-OHdG), and interleukin (IL)-6 levels in a Chinese Han population...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/29163951/coronary-artery-anomalies-unusually-high-incidence-of-anomalies-with-a-malignant-course-in-an-asian-population
#11
Abdulaziz M Alkhulaifi, Nidheesh Chooriyil, Maryam Alkuwari, Abdelnasser N Ghareep, Cornelia Carr
Objectives: Coronary artery anomalies are uncommon, but important cardiac malformations, representing the second commonest cause of death in young athletes. Methods: We utilized computerized tomographic angiography to screen and precisely delineate coronary artery anomalies in patients with minimal cardiac symptoms. Results: During 3.5-year period, we performed 2888 computerized tomographic angiographies. A total of 33 (1.1%; 95% confidence interval = 0...
2017: SAGE Open Medicine
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
#12
MULTICENTER STUDY
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/29113395/association-between-fibrinogen-level-and-the-severity-of-coronary-stenosis-in-418-male-patients-with-myocardial-infarction-younger-than-35-years-old
#13
Xiong-Yi Gao, Bing-Yang Zhou, Min-Zhou Zhang, Xi Zhao, Ping Qing, Cheng-Gang Zhu, Na-Qiong Wu, Yuan-Lin Guo, Ying Gao, Xiao-Lin Li, Yao Wang, Geng Liu, Qian Dong, Li-Heng Guo, Jian-Jun Li
Fibrinogen (Fib) is a useful marker for predicting the severity of coronary artery disease (CAD) in adult population. However, whether Fib can be a predictor for the presence and severity of CAD in very young MI patients (≤35 years old) remains to be determined. A total of 418 males from 61,863 patients with MI who were under 35 years old were sequentially recruited in our study. The patients were divided into two main groups and three subgroups according to coronary angiograph and Gensini score (GS) system: no coronary artery stenosis (group A), the results of the coronary artery stenosis (group B); low GS, intermediate GS and high GS...
October 6, 2017: Oncotarget
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
#14
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/29110669/a-comparison-of-cardiovascular-magnetic-resonance-and-single-photon-emission-computed-tomography-spect-perfusion-imaging-in-left-main-stem-or-equivalent-coronary-artery-disease-a-ce-marc-substudy
#15
James R J Foley, Ananth Kidambi, John D Biglands, Neil Maredia, Catherine J Dickinson, Sven Plein, John P Greenwood
BACKGROUND: Assessment of left main stem (LMS) stenosis has prognostic and therapeutic implications. Data on assessment of LMS disease by cardiovascular magnetic resonance (CMR) and single photon emission computed tomography (SPECT) are limited. CE-MARC is the largest prospective comparison of CMR and SPECT against quantitative invasive coronary angiography (QCA) for detection of coronary artery disease (CAD), and provided the framework for this evaluation. The aims of this study were to compare diagnostic accuracy of visual and quantitative perfusion CMR to SPECT in patients with LMS stable CAD...
November 6, 2017: Journal of Cardiovascular Magnetic Resonance
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
#16
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
#17
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/29099697/left-main-coronary-artery-involvement-in-patients-with-acute-coronary-syndrome-case-report
#18
O Serhiichuk, L Rasputina, M Ovcharuk, N Osovska, O Serhiichik
The degree of left main coronary artery (LM) lesions is one of the main factors that predetermine the survival rate of patients with coronary heart disease. Below is a description of a clinical case of a successful stenting in a young 35 year old patient with a severe LM obstruction and an underlying acute coronary syndrome (ACS). Urgent stenting in such clinical situations have been found to be very effective and safe as demonstrated below in the following case study.
October 2017: Georgian Medical News
https://www.readbyqxmd.com/read/29097293/quality-of-life-after-everolimus-eluting-stents-or-bypass-surgery-for-treatment-of-left-main-disease
#19
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/29096915/double-kissing-crush-versus-provisional%C3%A2-stenting-for-left-main-distal%C3%A2-bifurcation-lesions-dkcrush-v-randomized-trial
#20
RANDOMIZED CONTROLLED TRIAL
Shao-Liang Chen, Jue-Jie Zhang, Yaling Han, Jing Kan, Lianglong Chen, Chunguang Qiu, Tiemin Jiang, Ling Tao, Hesong Zeng, Li Li, Yong Xia, Chuanyu Gao, Teguh Santoso, Chootopol Paiboon, Yan Wang, Tak W Kwan, Fei Ye, Nailiang Tian, Zhizhong Liu, Song Lin, Chengzhi Lu, Shangyu Wen, Lang Hong, Qi Zhang, Imad Sheiban, Yawei Xu, Lefeng Wang, Tanveer S Rab, Zhanquan Li, Guanchang Cheng, Lianqun Cui, Martin B Leon, Gregg W Stone
BACKGROUND: Provisional stenting (PS) is the most common technique used to treat distal left main (LM) bifurcation lesions in patients with unprotected LM coronary artery disease undergoing percutaneous coronary intervention. The double kissing (DK) crush planned 2-stent technique has been shown to improve clinical outcomes in non-LM bifurcations compared with PS, and in LM bifurcations compared with culotte stenting, but has never been compared with PS in LM bifurcation lesions. OBJECTIVES: The authors sought to determine whether a planned DK crush 2-stent technique is superior to PS for patients with true distal LM bifurcation lesions...
November 28, 2017: Journal of the American College of Cardiology
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