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cardiac revascularization

Min-Shan Tsai, Chih-Wei Sung, Wen-Jone Chen, Po-Ya Chuang, Chih-Hung Wang, Yen-Wen Wu, Wei-Tien Chang, Wei-Ting Chen, Chien-Hua Huang
BACKGROUND: The emergent coronary angiography (CAG) is associated with better outcomes in CA survivors. However, the impact of severity and revascularization of coronary artery stenosis on outcomes in cardiac arrest (CA) survivors remains unclear. METHODS: A total of 273 non-traumatic adult CA survivors who underwent emergent CAG from January 2011 to July 2017 were retrospectively recruited. The stenosis and non-revascularization of an individual coronary artery ≥70 % were defined as significant in any of the major coronary arteries based on an operator visual estimate...
February 14, 2019: Resuscitation
Hideki Yano, Shigeo Horinaka, Manami Watahiki, Tomoko Watanabe, Toshihiko Ishimitsu
BACKGROUND: Use of the everolimus-eluting stent (EES) instead of the sirolimus-eluting stent (SES) has been shown to improve clinical outcomes in patients undergoing percutaneous coronary intervention (PCI) out to 3 years. However, it is not known whether the differences in efficacy and safety outcomes remain constant throughout 5 years. METHODS: This was a retrospective, non-randomized, observational study. We followed 1460 consecutive patients undergoing PCI in our institutions from April 2005 to March 2012...
February 13, 2019: Journal of Cardiology
Roberto Ferrari, Ian Ford, Kim Fox, Mario Marzilli, Michal Tendera, Petr Widimský, Jean-Pascal Challeton, Nicolas Danchin
BACKGROUND: About 30% of angina patients have persisting symptoms despite successful revascularization and antianginal therapy. Moreover, in stable patients, percutaneous coronary intervention (PCI) does not improve survival as compared with medical therapy alone. Trimetazidine, an antianginal agent devoid of hemodynamic effect, may help reducing symptoms and improving outcomes after PCI. The ATPCI study is investigating the efficacy and safety of adding trimetazidine to standard-of-care in angina patients who had a recent PCI...
January 15, 2019: American Heart Journal
Jignesh K Patel, Andrew Figueroa, Rian Shah, Haasitha Korlipara, Puja B Parikh
OBJECTIVE: We sought to identify the impact of echocardiographic right ventricular (RV) systolic dysfunction on mortality in adults with cardiac arrest (CA). METHODS: The study population included 147 adults hospitalized with CA who underwent both echocardiogram and coronary angiogram at an academic tertiary medical center. The primary outcome of interest was all-cause in-hospital mortality. RESULTS: Of the 147 patients studied, 20 (13.6%) had evidence of RV systolic dysfunction while 127 (86...
February 12, 2019: Resuscitation
Mauro Chiarito, Gennaro Sardella, Antonio Colombo, Carlo Briguori, Luca Testa, Francesco Bedogni, Franco Fabbiocchi, Anita Paggi, Altin Palloshi, Corrado Tamburino, Alberto Margonato, Carlo Andrea Pivato, Usman Baber, Simone Calcagno, Arturo Giordano, Cosmo Godino, Giulio G Stefanini
Background Polymer-free drug-eluting stents are based on different technologies for drug binding and release without the use of polymer coatings. It is unknown whether different polymer-free drug-eluting stents are comparable in terms of safety and efficacy profiles. Methods and Results Polymer-free BioFreedom biolimus-eluting stents (BES) and polymer-free Cre8 amphilimus-eluting stents (AES) were investigated in 2 recent multicenter registries including 2320 all-comer patients undergoing percutaneous coronary interventions at 22 Italian centers...
February 2019: Circulation. Cardiovascular Interventions
Goro Yoshioka, Nehiro Kuriyama, Nozomi Watanabe, Keiichi Ashikaga, Yoshisato Shibata, Koichi Node
The aims of this study are to evaluate the efficacy of percutaneous coronary intervention (PCI) using full-metal jacket (FMJ) with second-generation drug-eluting stents (DES). A single-center, non-randomized, retrospective study was performed from May 2005 to February 2014 at Miyazaki Medical Association Hospital, Japan. PCI using FMJ with DES was performed to treat 240 very long lesions (> 60 mm) in 240 patients. Subjects were divided into a first-generation or second-generation DES group. The primary endpoint was the incidence of major adverse cardiac events (MACE) at 2 years...
February 14, 2019: Cardiovascular Intervention and Therapeutics
Carolina Santiago de Araújo Pio, Gabriela Chaves, Philippa Davies, Rod Taylor, Sherry Grace
Too few patients utilize cardiac rehabilitation (CR), despite its benefits. The Cochrane review assessing the effectiveness of interventions to increase CR utilization (enrolment, adherence, and completion) was updated. A search was performed through July 2018 of the Cochrane and MEDLINE (Medical Literature Analysis and Retrieval System Online) databases, among other sources. Randomized controlled trials in adults with myocardial infarction, angina, revascularization, or heart failure were included. Interventions had to aim to increase utilization of comprehensive phase II CR...
February 5, 2019: Journal of Clinical Medicine
Lianjun Xu, Zhan Gao, Ying Song, Huanhuan Wang, Jingjing Xu, Ping Jiang, Lin Jiang, Xiaofang Tang, Jue Chen, Lijian Gao, Lei Song, Yin Zhang, Xueyan Zhao, Shubin Qiao, Yuejin Yang, Runlin Gao, Bo Xu, Jinqing Yuan
BACKGROUND: With the advancements of percutaneous coronary interventions (PCI), it is not clear whether unprotected left main (ULM) coronary artery disease (CAD) remains an independent predictor of adverse outcomes after PCI therapy. We have therefore carried out a large cohort study to investigate the impact of ULM disease on 2-year clinical outcomes in Chinese patients undergoing contemporary PCI treatment. METHODS AND RESULTS: From January 2013 to December 2013, 10 724 consecutive patients undergoing PCI were prospectively collected...
February 11, 2019: Coronary Artery Disease
Jarosław Hiczkiewicz, Sylwia Iwańczyk, Aleksander Araszkiewicz, Magdalena Łanocha, Dariusz Hiczkiewicz, Stefan Grajek, Maciej Lesiak
BACKGROUND: The PSP (predilatation, sizing, post-dilatation)-technique was developed to improve the prognosis of patients after bioresorbable vascular scaffold (BVS) implantation. In acute coronary syndrome (ACS) the use of BVS is particularly demanding and carries some potential risk regarding aggressive lesion preparation, proper vessel sizing due to spasm and thrombus inside the artery. The aim herein, was to determine the long-term results of BVS stenting in ACS patients depending on the scaffold implantation technique...
February 14, 2019: Cardiology Journal
Marni J Armstrong, Doreen M Rabi, Danielle A Southern, Alykhan Nanji, William A Ghali, Ronald J Sigal
BACKGROUND: Although suggested by practice guidelines, the need for pre-exercise stress testing in asymptomatic people with diabetes remains controversial. We examined the utility of screening with pre-exercise stress testing in patients with diabetes. METHODS: We completed a cohort study, evaluating patients with diabetes who attended an exercise program intake session between 2007 and 2012. The exposure of interest was referral for pre-exercise stress testing determined by an algorithm requiring sedentary patients with diabetes and ≥ 1 cardiac risk factor to undergo testing...
February 2019: Canadian Journal of Cardiology
Navid Ahmed, Himali Gandhi, Eliany Mejia Lopez, Neeraja Yedlapati, Daniel Spevack
BACKGROUND: Published data on the outcome of coronary artery revascularization in patients with antiphospholipid syndrome (APS) are limited. Because APS is associated with a high rate of arterial thrombosis, there is concern that coronary revascularization in this group may be complicated by increased need for repeat revascularization. We aimed to determine the incidence and timing of repeat revascularization performed in patients with APS undergoing percutaneous coronary interventions (PCI) or coronary artery bypass grafting (CABG)...
January 25, 2019: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Eugenio Stabile, Donato Gerardi, Fabio Magliulo, Drago Zhelev, Vassil Chervenkoff, Kim Taeymans, Doncho Kotasov, Peter Goverde, Giuseppe Giugliano, Bruno Trimarco, Giovanni Esposito
PURPOSE: To report the 1-year outcomes of the prospective Legflow drug-coated balloon (DCB) registry, which evaluated the safety and 12-month efficacy of the Legflow balloon in the treatment of femoropopliteal disease. METHODS: The Legflow is a new generation of DCB that has a homogenous, stable surface coating incorporating 0.1-µm paclitaxel particles. From January 2014 to June 2016, 139 patients (mean age 67.1±10.8 years; 109 men) were enrolled at 4 European institutions...
February 2019: Journal of Endovascular Therapy
Ewa Konduracka, Grażyna Cieślik, Maciej T Małecki, Grzegorz Gajos, Aleksander Siniarski, Krzysztof P Malinowski, Magdalena Kostkiewicz, Lucyna Mastalerz, Jadwiga Nessler, Wiesława Piwowarska
INTRODUCTION It is widely believed that patients with diabetes are at increased risk of severe and premature coronary artery disease (CAD) when compared to non-diabetic individuals. OBJECTIVES To evaluate the prevalence, 7-year incidence, predictors, and outcomes of obstructive and non-obstructive CAD in patients with long-lasting type 1 diabetes. PATIENTS AND METHODS We enrolled 2330 patients at a median age of 50 years with a median diabetes duration of 32 years. All study participants underwent diagnostic work-up for CAD with an exercise treadmill test (ETT) and/or single-photon emission computed tomography (SPECT)...
February 13, 2019: Polish Archives of Internal Medicine
Chadwick D Miller, Jason P Stopyra, Simon A Mahler, L Doug Case, Sujethra Vasu, Ronny A Bell, W Gregory Hundley
BACKGROUND: Patients from racial and ethnic minority groups presenting to the Emergency Department (ED) with chest pain experience lower odds of receiving stress testing compared with nonminorities. Studies have demonstrated that care pathways administered within the ED can reduce health disparities, but this has yet to be studied as a strategy to increase stress testing equity. METHODS: A secondary analysis from 3 randomized clinical trials involving ED patients with acute chest pain was performed to determine whether a care pathway, ACES (Accelerated Chest pain Evaluation with Stress imaging), reduces the racial disparity in index visit cardiac testing between African American (AA) and White patients...
March 2019: Critical Pathways in Cardiology
Xiao-Fei Gao, Zhi-Mei Wang, Feng Wang, Yue Gu, Zhen Ge, Xiang-Quan Kong, Guang-Feng Zuo, Jun-Jie Zhang, Shao-Liang Chen
Intravascular ultrasound (IVUS) guidance is not routinely performed in real-word clinical practice partly because the benefit of IVUS guidance is not well established. This updated meta-analysis aims to compare IVUS-guided and angiography-guided drug-eluting stent (DES) implantation, simultaneously stressing the value of an optimal IVUS-defined procedure. Medline, Scopus, Google Scholar, and Cochrane Controlled Trials Registry were searched for the randomized trials comparing IVUS-guided and angiography-guided DES implantation...
February 12, 2019: International Journal of Cardiovascular Imaging
Cheol Hyun Lee, Do-Yoon Kang, Minkyu Han, Seung-Ho Hur, Seung-Woon Rha, Sung-Ho Her, Ki-Bae Seung, Kee-Sik Kim, Pil-Hyung Lee, Jung-Min Ahn, Seung-Whan Lee, Seong-Wook Park, Duk-Woo Park, Seung-Jung Park
BACKGROUND: Stent parameters (length and diameter) are well-known risk factors for adverse outcomes after percutaneous coronary intervention (PCI) with stenting. This study aimed to investigate the differential cutoff criteria and clinical impact of the length and diameter of various drug-eluting stents (DES) for predicting major cardiovascular events. METHODS: Using patient-level data from seven stent-specific, prospective DES registries, we evaluated 17,068 patients who underwent PCI with either various contemporary DES or first-generation DES between July 2007 and July 2015: 3053 treated with cobalt-chromium everolimus-eluting stents (CoCr-EES), 2976 with platinum-chromium EES (PtCr-EES), 2888 with Resolute zotarolimus-eluting stents (Re-ZES), 782 with Biomatrix biolimus-eluting stents (Bi-BES), 1868 with Nobori BES (No-BES), 1934 with Xience Prime cobalt-chromium EES (Pr-CoCr-EES), and 3567 with first-generation sirolimus-eluting stents (SES)...
February 2, 2019: International Journal of Cardiology
Alberto Repossini, Lorenzo Di Bacco, Flavia Nicoli, Bruno Passaretti, Alessandra Stara, Bejko Jonida, Claudio Muneretto
OBJECTIVE: Minimally invasive direct coronary artery bypass for the left thoracic artery on the left anterior descending artery is a safe and less traumatic surgical technique. We retrospectively evaluated long-term outcomes in a large series of patients undergoing minimally invasive direct coronary artery bypass. METHODS: From 1997 to 2016, 1060 patients underwent minimally invasive direct coronary artery bypass: 646 patients (61%) with isolated proximal left anterior descending disease and 414 patients (39%) with multivessel disease as a part of hybrid coronary revascularization or in association with medical therapy...
December 29, 2018: Journal of Thoracic and Cardiovascular Surgery
Nicole R Marques, Johannes De Riese, Bryan C Yelverton, Christopher McQuitty, Daniel Jupiter, Korey Willmann, Michael Salter, Michael Kinsky, William E Johnston
OBJECTIVE: Identifying fluid responsiveness is critical to optimizing perfusion while preventing fluid overload. An experimental study of hypovolemic shock resuscitation showed the importance of ventricular compliance and peripheral venous pressure (PVP) on fluid responsiveness. The authors tested the hypothesis that reduced ventricular compliance measured using transesophageal echocardiography results in decreased fluid responsiveness after a fluid bolus. DESIGN: Prospective observational study...
January 4, 2019: Journal of Cardiothoracic and Vascular Anesthesia
Ioanna Kosmidou, Björn Redfors, Shmuel Chen, Aaron Crowley, Nicholas J Lembo, Dimitri Karmpaliotis, W Morris Brown, Eric Maupas, Nicolas Durrleman, Alpesh Shah, Michael J Reardon, Ovidiu Dressler, Ori Ben-Yehuda, Arie Pieter Kappetein, Joseph F Sabik, Patrick W Serruys, Gregg W Stone
BACKGROUND: The prognostic impact of high-sensitivity C-reactive protein (CRP) levels in patients with left main coronary artery disease (LMCAD) treated with percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) is unknown. We sought to determine the effect of elevated baseline CRP levels on the 3-year outcomes after LMCAD revascularization and to examine whether CRP influenced the relative outcomes of PCI versus CABG. METHODS: In the EXCEL trial, patients with LMCAD and Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) scores ≤32 were randomized to PCI versus CABG...
January 11, 2019: American Heart Journal
Anja Hanser, Ludger Sieverding, Till-Karsten Hauser, Gesa Wiegand, Michael Hofbeck
OBJECTIVES: To describe the efficacy and safety of stent-retriever thrombectomy in infants with thrombosis of the superior vena cava (SVC) and innominate vein. BACKGROUND: Thrombosis of the SVC and of the innominate vein is a potentially life threatening complication in infants during intensive care treatment following major surgical procedures. To avoid reoperations, we evaluated interventional revascularization by stent-retriever thrombectomy. METHODS: From 2015 to 2017, five infants were diagnosed with acute thrombosis of the SVC and innominate vein following major cardiac or pediatric surgery...
February 9, 2019: Catheterization and Cardiovascular Interventions
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