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https://www.readbyqxmd.com/read/28438354/coronary-artery-bypass-graft-surgery-versus-percutaneous-coronary-intervention-with-drug-eluting-stents-for-left-main-coronary-artery-disease-a-meta-analysis-of-randomized-trials
#1
Alessandro Putzu, Michele Gallo, Enrico Antonio Martino, Enrico Ferrari, Giovanni Pedrazzini, Tiziano Moccetti, Tiziano Cassina
BACKGROUND: Despite several clinical studies, efficacy of coronary artery bypass grafting (CABG) surgery versus percutaneous coronary intervention (PCI) in patients with left main (LM) disease remains controversial. The objective of this meta-analysis of randomized trials was to evaluate the clinical outcome of CABG versus PCI with drug-eluting stents in LM coronary disease. METHODS: We systematically searched online databases up to March 2017 for randomized trials comparing CABG to PCI with drug-eluting stents...
April 6, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28433215/meta-analysis-of-randomized-controlled-trials-of-percutaneous-coronary-intervention-with-drug-eluting-stents-versus-coronary-artery-bypass-grafting-in-left-main-coronary-artery-disease
#2
Aakash Garg, Sunil V Rao, Sahil Agrawal, Kleanthis Theodoropoulos, Marco Mennuni, Abhishek Sharma, Lohit Garg, Giuseppe Ferrante, Omar A Meelu, Davit Sargsyan, Bernhard Reimers, Marc Cohen, John B Kostis, Giulio G Stefanini
Few randomized controlled trials (RCTs) and observational studies had shown acceptable short-term efficacy and safety of percutaneous coronary intervention (PCI) with drug-eluting stents (DES) compared with coronary artery bypass grafting (CABG) in selected patients with left main coronary artery disease (LMCAD). We aimed to evaluate long-term outcomes of PCI using DES compared with CABG in patients with LMCAD. On November 1, 2016, we searched available databases for published RCTs directly comparing DES PCI with CABG in patients with LMCAD...
March 29, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28431047/impact-of-the-syntax-scores-i-and-ii-in-patients-with-diabetes-and-multivessel-coronary-disease-a-pooled-analysis-of-patient-level-data-from-the-syntax-precombat-and-best-trials
#3
Rafael Cavalcante, Yohei Sotomi, Massimo Mancone, Cheol Whan Lee, Jung-Min Ahn, Yoshinobu Onuma, Pedro A Lemos, Robert-Jan van Geuns, Seung-Jung Park, Patrick W Serruys
Aims: To assess the impact of the SYNTAX scores I and II in outcomes after percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) for patients with diabetes and multivessel disease (MVD). Methods and Results: We performed a patient-level pooled analysis of three large randomized trials of patients with MVD. The impact of coronary anatomic complexity as measured by the SYNTAX score in the differences in outcomes following PCI and CABG was assessed at a median follow-up of 5 years...
April 18, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28427392/percutaneous-intervention-versus-coronary-artery-bypass-graft-surgery-in-left-main-coronary-artery-stenosis-a-systematic-review-and-meta-analysis
#4
Xin-Lin Zhang, Qing-Qing Zhu, Jing-Jing Yang, Yu-Han Chen, Yang Li, Su-Hui Zhu, Jun Xie, Lian Wang, Li-Na Kang, Biao Xu
BACKGROUND: The optimal revascularization technique in patients with left main coronary artery disease (CAD) remains controversial. We aimed to compare the long-term performance of percutaneous coronary intervention (PCI) versus coronary artery bypass graft (CABG) surgery in treatment of left main CAD. METHODS: PubMed, EMBASE, and the Cochrane Library were searched until November 16, 2016. RESULTS: Six randomized controlled trials and 22 matched observational studies including 22,487 patients and 90,167 patient-years of follow-up were included...
April 21, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28421375/obstructive-sleep-apnea-increases-the-risk-of-cardiac-events-after-percutaneous-coronary-intervention-a-meta-analysis-of-prospective-cohort-studies
#5
REVIEW
Hua Qu, Ming Guo, Ying Zhang, Da-Zhuo Shi
PURPOSE: Recent studies have shown an association between obstructive sleep apnea (OSA) and coronary artery disease; however, the association between OSA and cardiac outcomes in patients after percutaneous coronary intervention (PCI) remains undetermined. METHODS: PubMed, EMBASE, and CENTRAL were searched from inception to July 2016 for cohort studies that followed up with patients after PCI, and evaluated their overnight sleep patterns within 1 month for major adverse cardiac events (MACEs) as primary outcomes including cardiac death, non-fatal myocardial infarction (MI), and coronary revascularization and secondary outcomes including re-admission for heart failure and stroke...
April 18, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28420862/clinical-characteristics-treatment-and-prognosis-of-patients-with-acute-severe-heart-failure-of-ischemic-and-non-ischemic-etiology-analysis-from-the-commit-ahf-registry
#6
Mateusz Ostręga, Marek J Gierlotka, Grzegorz Słonka, Paweł Nadziakiewicz, Mariusz Gąsior
INTRODUCTION    There are limited data on the impact of ischemic etiology on clinical status and long-term prognosis among patients with acute severe heart failure (ASHF) not associated with acute coronary syndrome (ACS).  OBJECTIVES    To assess clinical characteristics, treatment and the 12-month mortality of patients with no-ACS ASHF according to etiology.  PATIENTS AND METHODS    The data from 112 patients with ASHF that was not associated with ACS were analyzed: 61 with ischemic (IASHF) and 51 with non-ischemic (NIASHF) etiology...
April 18, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28417608/comparison-of-antithrombotic-agents-during-urgent-percutaneous-coronary-intervention-following-thrombolytic-therapy-a-retrospective-cohort-study
#7
Jaya R Mallidi, Peter Robinson, Paul F Visintainer, Amir S Lotfi, Scott Mulvey, Gregory R Giugliano
BACKGROUND: The optimal antithrombotic regimen for urgent percutaneous coronary interventions (PCI) following thrombolytic therapy for ST segment myocardial infarction (STEMI) is currently unknown. METHODS: We performed a retrospective analysis of all patients referred to our institution from January 2005 to July 2014 who underwent urgent PCI within 24 hr after receiving thrombolytic therapy. The patients were divided into three cohorts based on the anticoagulation strategy during PCI-bivalirudin, heparin alone or heparin plus Glycoprotein IIb/IIIa inhibitor (GPI)...
April 18, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28412039/distal-left-main-trifurcation-disease-in-a-patient-with-porcelain-aorta
#8
Ulises Lopez-Peña, Francisco Garcia-Garcia, Rogelio Robledo-Nolasco, Ernesto Fernandez-Ceseña, Ricardo Borrego-Montoya, Neisser Morales
Coronary trifurcation lesions are a complex subset of lesions and are substantially more complex than bifurcations when treated with percutaneous coronary intervention (PCI) because of higher rates of acute periprocedural complications (dissection, myocardial infarction, acute vessel closure) and less effective long-term outcomes (stent thrombosis, restenosis) as compared to non-bifurcation lesions. We present the case of a 73-year-old man who was admitted to our hospital with symptomatic severe aortic stenosis who was found to have a distal left main trifurcation disease as well as porcelain aorta on work-up...
March 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28408020/risk-stratification-for-patients-in%C3%A2-cardiogenic-shock-after-acute%C3%A2-myocardial%C3%A2-infarction
#9
Janine Pöss, Jelena Köster, Georg Fuernau, Ingo Eitel, Suzanne de Waha, Taoufik Ouarrak, Johan Lassus, Veli-Pekka Harjola, Uwe Zeymer, Holger Thiele, Steffen Desch
BACKGROUND: Mortality in cardiogenic shock (CS) remains high. Early risk stratification is crucial to make adequate treatment decisions. OBJECTIVES: This study sought to develop an easy-to-use, readily available risk prediction score for short-term mortality in patients with CS, derived from the IABP-SHOCK II (Intraaortic Balloon Pump in Cardiogenic Shock) trial. METHODS: The score was developed using a stepwise multivariable regression analysis...
April 18, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28400368/relationship-between-peak-troponin-values-and-long-term-ischemic-events-among-medically-managed-patients-with-acute-coronary-syndromes
#10
Sarah A Goldstein, L Kristin Newby, Derek D Cyr, Megan Neely, Thomas F Lüscher, Eileen B Brown, Harvey D White, E Magnus Ohman, Matthew T Roe, Christian W Hamm
BACKGROUND: The relationship between troponin level and outcomes among patients with non-ST-segment elevation ACS is established, but the relationship of troponin level with long-term outcomes among medically managed non-ST-segment elevation ACS patients receiving contemporary antiplatelet therapy is inadequately defined. METHODS AND RESULTS: In 6763 medically managed non-ST-segment elevation ACS patients randomized in TRILOGY ACS (Targeted Platelet Inhibition to Clarify the Optimal Strategy to Medically Manage Acute Coronary Syndromes) (prasugrel versus clopidogrel), we examined relationships between categories of peak troponin/upper limit of normal (ULN) ratio within 48 hours of the index ACS event (≈4...
April 11, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28400034/association-of-syntax-score-with-short-term-outcomes-among-acute-st-elevation-myocardial-infarction-patients-undergoing-primary-pci
#11
Sarita Choudhary
OBJECTIVE: Syntax score (SX) has emerged as a reproducible angiographic tool to quantify the extent of coronary artery disease based on location and complexity of each lesion. It has been shown to predict long-term clinical outcomes in patients with left main or multi-vessel disease and recently also in ST-segment elevation myocardial infarction undergoing primary PCI. The aim of this study was to evaluate whether the syntax score is associated with short-term cardiovascular outcomes in patients treated with primary percutaneous coronary intervention (PCI) for acute ST-segment elevation myocardial infarction (STEMI)...
April 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28400029/meta-analysis-of-drug-eluting-stents-versus-coronary-artery-bypass-grafting-in-unprotected-left-main-coronary%C3%A2-narrowing
#12
Partha Sardar, Jay Giri, Sammy Elmariah, Saurav Chatterjee, Dhaval Kolte, Amartya Kundu, Ramez Nairooz, Wilbert S Aronow, Theophilus Owan, Debabrata Mukherjee, Dmitriy N Feldman, J Dawn Abbott
Patients with unprotected left main coronary artery (ULMCA) disease are increasingly treated with percutaneous coronary intervention (PCI) using new-generation drug-eluting stents (DES); however, the benefits of DES compared with coronary artery bypass grafting (CABG) in ULMCA remain controversial. This meta-analysis evaluated the effects of PCI with DES compared with CABG for the treatment of ULMCA stenosis. Databases were searched through November 30, 2016. Randomized controlled trials (RCTs) comparing DES with PCI versus CABG for ULMCA stenosis were identified...
March 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28388366/ellagic-acid-protects-against-neuron-damage-in-ischemic-stroke-through-regulating-the-ratio-of-bcl-2-bax-expression
#13
Qing-Shan Liu, Ran Deng, Shuran Li, Xu Li, Keqin Li, Kebaituli Gulibanumu, Xueli Li, Rui Liu
To research the effects of ellagic acid (EA), a low molecular weight polyphenol, on neuron cells and function, and to evaluate whether EA can be safely utilized by humans as a functional food or therapeutic agent, an oxygen-glucose deprivation and reoxygenation (ODG/R) model in primary cultured rat cortical neurons were created in this work. Administration of EA significantly decreased the volume of cerebrum infarction and the neurological deficit scores of the rats; EA treatment also increased the number of Bcl-2-positive cells and the ratio of Bcl-2-positive to Bax-positive neurons in semidarkness zone near brain ischemic focus in the PCI model...
April 7, 2017: Applied Physiology, Nutrition, and Metabolism, Physiologie Appliquée, Nutrition et Métabolisme
https://www.readbyqxmd.com/read/28385315/use-of-antiplatelet-therapy-dapt-for%C3%A2-post-pci-patients-undergoing-noncardiac-surgery
#14
REVIEW
Subhash Banerjee, Dominick J Angiolillo, William E Boden, Joseph G Murphy, Houman Khalili, Ahmed A Hasan, Robert A Harrington, Sunil V Rao
Dual antiplatelet therapy (DAPT) is prescribed to millions of patients worldwide following coronary stenting. DAPT is indicated to lower the risk of ischemic events, such as myocardial infarction, including stent thrombosis, ischemic stroke, or death from cardiovascular causes. A significant number of these patients undergo noncardiac surgery and may require DAPT interruption. This poses a significant clinical dilemma because DAPT interruption exposes patients to the potential risk of stent thrombosis, perioperative myocardial infarction, or both...
April 11, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28381298/ticagrelor-versus-clopidogrel-in-real-world-patients-with-st-elevation-myocardial-infarction-1-year-results-by-propensity-score-analysis
#15
Matteo Vercellino, Federico Ariel Sànchez, Valentina Boasi, Dino Perri, Chiara Tacchi, Gioel Gabrio Secco, Stefano Cattunar, Gianfranco Pistis, Giovanni Mascelli
BACKGROUND: European guidelines recommend the use of ticagrelor versus clopidogrel in patients with ST elevation myocardial infarction (STEMI). This recommendation is based on inconclusive results and subanalyses from clinical trials. Few data are available on the effects of ticagrelor in a real-world population. METHODS: To compare the effects of ticagrelor and clopidogrel in a real-world STEMI population, we conducted a pre-post case-control study examining all patients with STEMI included in the Cardio-STEMI Sanremo registry between February 2011 and June 2013...
April 5, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28377396/optimal-duration-of-dual-antiplatelet-therapy-following-percutaneous-coronary-intervention-protocol-for-an-umbrella-review
#16
Jesse Elliott, Shannon E Kelly, Zemin Bai, Wenfei Liu, Becky Skidmore, Michel Boucher, Derek Y F So, George A Wells
INTRODUCTION: Although dual antiplatelet therapy (DAPT) is routinely given to patients after percutaneous coronary intervention (PCI) with stenting, the optimal duration is unknown. Recent evidence indicates there may be benefits in extending the duration beyond 12 months but such decisions may increase the risk of bleeding. Our objective is to provide a comprehensive overview of the literature for clinicians and policymakers via an umbrella review assessing the optimal duration of DAPT...
April 4, 2017: BMJ Open
https://www.readbyqxmd.com/read/28374179/revascularization-for-advanced-coronary-artery-disease-in-type-2-diabetic-patients-choosing-wisely-between-pci-and-surgery
#17
REVIEW
Louai Razzouk, Frederick Feit, Michael E Farkouh
PURPOSE OF REVIEW: Patients with type 2 diabetes mellitus (T2DM) are at an increased risk of systemic atherosclerosis and advanced coronary artery disease (CAD). Herein, we review clinical trials comparing surgical to percutaneous revascularization in the context of the unique pathophysiology in this patient population, and seek to answer the question of optimal strategy of revascularization. RECENT FINDINGS: Early studies showed a signal towards benefit of surgical revascularization over percutaneous revascularization in this group, but there was a paucity of randomized clinical trials (RCT) to directly support this finding...
May 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28373177/glycemic-control-status-after-percutaneous-coronary-intervention-and-long-term-clinical-outcomes-in-patients-with-type-2-diabetes-mellitus
#18
Jin Kyung Hwang, Seung Hwa Lee, Young Bin Song, Joonghyun Ahn, Keumhee Carriere, Mi Ja Jang, Taek Kyu Park, Seung-Hyuk Choi, Jeong Hoon Yang, Jin-Ho Choi, Sang Hoon Lee, Hyeon-Cheol Gwon, Joo-Yong Hahn
BACKGROUND: Data on the association between glycemic control after percutaneous coronary intervention and clinical outcomes are limited and controversial in diabetic patients. METHODS AND RESULTS: We studied 980 patients with type 2 diabetes mellitus undergoing percutaneous coronary intervention using drug-eluting stents. Based on 2-year glycosylated hemoglobin A (HbA1c) levels, we divided patients into 2 groups of HbA1c<7.0 (n=489) and HbA1c≥7.0 (n=491). Propensity score-matched analysis was performed in 322 pairs...
April 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28371437/percutaneous-coronary-intervention-versus-coronary-artery-bypass-grafting-for-left-main-coronary-artery-disease-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#19
Sharan P Sharma, Khagendra Dahal, Jaspreet Khatra, Alan Rosenfeld, Juyoung Lee
BACKGROUND: It is not clear whether Percutaneous Coronary Intervention (PCI) is as effective and safe as Coronary Artery Bypass Grafting (CABG) for left main coronary artery disease. We aimed to perform a systematic review and meta-analysis of all randomized controlled trials (RCTs) that compared PCI and CABG in left main coronary disease. METHODS: We searched PubMed, EMBASE, Cochrane, Scopus and relevant references for RCTs (inception through, November 20, 2016 without language restrictions) and performed meta-analysis using random effects model...
March 30, 2017: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/28365297/endovascular-therapy-for-acute-stroke
#20
REVIEW
Maria Politi, Andreas Kastrup, Konstantinos Marmagkiolis, Iris Q Grunwald, Panagiotis Papanagiotou
Stroke is the most common cause of permanent disability, the second most common cause of dementia, and the fourth most common cause of death in the Western world. Recently, based on positive multicenter randomized clinical trials, endovascular therapy for acute stroke has undergone a revolution. Routine mechanical thrombectomy in addition to intravenous thrombolysis has been shown to provide excellent outcomes for patients with proximal anterior circulation occlusions. This procedure reduces disability and benefits are seen across a wide range of age and initial stroke severity...
March 30, 2017: Progress in Cardiovascular Diseases
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