Role of smooth muscle cells in coronary artery bypass grafting failure

AbstractAtherosclerosis is the underlying pathology of many cardiovascular diseases. The formation and rupture of atherosclerotic plaques in the coronary arteries results in angina and myocardial infarction. Venous coronary artery bypass grafts are designed to reduce the consequences of atherosclerosis in the coronary arteries by diverting blood flow around the atherosclerotic plaques. However, vein grafts suffer a high failure rate due to intimal thickening that occurs as a result of vascular cell injury and activation and can act as ‘a soil’ for subsequent atherosclerotic plaque formation. A clinically-proven method for the reduction of vein graft intimal thickening and subsequent major adverse clinical events is currently not available. Consequently, a greater understanding of the underlying mechanisms of intimal thickenin g may be beneficial for the design of future therapies for vein graft failure. Vein grafting induces inflammation and endothelial cell damage and dysfunction, that promotes vascular smooth muscle cell (VSMC) migration, and proliferation. Injury to the wall of the vein as a result of grafting leads t o the production of chemoattractants, remodelling of the extracellular matrix and cell–cell contacts; which all contribute to the induction of VSMC migration and proliferation. This review focuses on the role of altered behaviour of VSMCs in the vein graft and some of the factors which critically lead to intimal thickening that pre-disposes ...
Source: Cardiovascular Research - Category: Cardiology Source Type: research

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AbstractAimTo evaluate the impact of left ventricular ejection fraction (LVEF) on 3 ‐year outcomes in patients with left main coronary artery disease (LMCAD) undergoing percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) in the EXCEL trial.Methods and resultsThe EXCEL trial randomized patients with LMCAD to PCI with everolimus ‐eluting stents (n = 948) or CABG (n = 957). Among 1804 patients with known baseline LVEF, 74 (4.1%) had LVEF
Source: European Journal of Heart Failure - Category: Cardiology Authors: Tags: Research Article Source Type: research
Conclusions: Decomposition methods are a useful tool in quantifying the contributions of various factors to the white-black gap in high-quality hospital use and could inform local policy aimed at reducing disparities in hospital quality.
Source: Medical Care - Category: Health Management Tags: Online Article: Applied Methods Source Type: research
Publication date: Available online 11 February 2020Source: The Annals of Thoracic SurgeryAuthor(s): Jared P. Beller, William Z. Chancellor, J. Hunter Mehaffey, Robert B. Hawkins, Matthew R. Byler, Alan M. Speir, Mohammed A. Quader, Andy C. Kiser, Leora T. Yarboro, Gorav Ailawadi, Nicholas R. TemanAbstractBackgroundContinuation of dual antiplatelet therapy (DAPT) following coronary artery bypass grafting (CABG) after acute myocardial infarction is recommended by current guidelines. We sought to evaluate guideline adherence over time and factors associated with post-operative DAPT within a regional consortium.MethodsIsolated...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
There are limited data on the outcomes of acute myocardial infarction with cardiogenic shock (AMI-CS) in patients with prior coronary artery bypass grafting (CABG).
Source: International Journal of Cardiology - Category: Cardiology Authors: Source Type: research
Abstract BACKGROUND: Diet and dietary habits are major determinants of human telomere length. Telomerase activity is affected mostly by oxidative stress and inflammation. However, the association of telomerase activity with dietary quality indices has not been evaluated before. In the current work, we aimed to test the association of telomerase activity with dietary antioxidant quality score (DAQ), dietary inflammatory index and dietary patterns in patients who were candidate for coronary artery bypass grafting surgery (CABG). METHODS AND MATERIALS: In the current cross-sectional study, 454 candidates for the...
Source: Eating and weight disorders : EWD - Category: Eating Disorders & Weight Management Authors: Tags: Eat Weight Disord Source Type: research
AbstractAimTo evaluate the impact of left ventricular ejection fraction (LVEF) on 3 ‐year outcomes in patients with left main coronary artery disease (LMCAD) undergoing percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) in the EXCEL trial.Methods and resultsThe EXCEL trial randomized patients with LMCAD to PCI with everolimus ‐eluting stents (n = 948) or CABG (n = 957). Among 1804 patients with known baseline LVEF, 74 (4.1%) had LVEF
Source: European Journal of Heart Failure - Category: Cardiology Authors: Tags: Research Article Source Type: research
Described herein is a 42-year-old woman who suddenly developed a spontaneous isolated coronary arterial dissection which led to massive acute myocardial infarction with shock, unsuccessful coronary artery bypass grafting, transiently successful extracorporeal life support, and finally successful heart transplant. Such a sequence of events is exceedingly rare for patients with coronary dissection and prompted this report.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
Abstract BACKGROUND: Continuation of dual antiplatelet therapy (DAPT) following coronary artery bypass grafting (CABG) after acute myocardial infarction is recommended by current guidelines. We sought to evaluate guideline adherence over time and factors associated with post-operative DAPT within a regional consortium. METHODS: Isolated CABG patients from 2011-2017 that had a myocardial infarction within 21 days prior to surgery were included. Patients were stratified by DAPT prescription at discharge and by time period, early (2011-2014) vs. late (2015-2017). Hierarchical regressions were then performed to e...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
This study aimed to determine whether participation in outpatient CR improves exercise capacity and long-term prognosis in post-CABG Japanese patients in a multicenter cohort.Methods and Results:We enrolled 346 post-CABG patients who underwent cardiopulmonary exercise testing during early (2-3 weeks) and late (3-6 months) time points after surgery. They formed the Active (n=240) and Non-Active (n=106) CR participation groups and were followed for 3.5 years. Primary endpoint was a major adverse cardiac event (MACE): all-cause death or rehospitalization for acute myocardial infarction/unstable angina/worsening heart fail...
Source: Circulation Journal - Category: Cardiology Authors: Tags: Circ J Source Type: research
AbstractPurpose of ReviewTo review the clinical evidence on the use of percutaneous coronary intervention (PCI) revascularization options in left main (LM) disease in comparison with coronary artery bypass graft (CABG). Coronary artery disease (CAD) involving the LM is associated with high morbidity and mortality. Though CABG remains the gold standard for complex CAD involving the LM artery, recent trials have shown a trend towards non-inferiority of the LM PCI when compared with CABG in certain subset of patients.Recent FindingsTwo recent major randomized trials compared the outcomes of PCI versus CABG in the LM and multi...
Source: Current Cardiology Reports - Category: Cardiology Source Type: research
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