Long-term outcomes of percutaneous coronary intervention in grafts and native vessels in coronary artery bypass grafting patients with diabetes mellitus.

Long-term outcomes of percutaneous coronary intervention in grafts and native vessels in coronary artery bypass grafting patients with diabetes mellitus. J Thorac Dis. 2019 Nov;11(11):4798-4806 Authors: Liu D, Cui X, Luo X, Sun Z, Xu B, Qiao S, Yuan J Abstract Background: Atherosclerosis in diabetic patients progresses fast. Evidence on how to choose target vessels of percutaneous coronary interventions (PCIs) in diabetic patients post-coronary artery bypass graft (post-CABG) is insufficient. Methods: One hundred and fifty-seven patients with diabetes and previous CABG, who underwent PCI of either a graft vessel (GV) (n=44) or a native vessel (NV) (n=113) in the National Center for Cardiovascular Disease, China, were studied. In-hospital and long-term clinical outcomes were compared between the groups. Results: Diabetic patients with prior CABG had more PCI to native arteries, but the proportion of grafts PCI increased as time went on. Both groups had similar baseline characteristics. Group GV patients compared with group NV had more totally occluded NVs, less totally occluded grafts and more in-stent restenosis. However, there was no difference in in-hospital mortality and long-term incidence of major adverse cardiac event (MACE), cardiac death, nonfatal myocardial infarction (MI), or revascularization. Multivariate logistic regression analysis showed that PCI success [hazard ratio (HR), 11.488; 95% confidence interval (CI), 1.135-116.303; P
Source: Journal of Thoracic Disease - Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

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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
In this study, we review the current literature in the management of patients with DM and coronary artery disease undergoing a revascularization procedure.RésuméLes patients atteints de diabète sucré (DS) sont exposés à un risque accru de coronaropathie. Le choix d'une stratégie de revascularisation optimale telle que le pontage aortocoronarien ou l'intervention coronarienne percutanée (ICP) peut être difficile pour cette population. De nombreuses données probantes montrent que chez les patients atteints de DS et d'une cardiopathie ischémique multi...
Source: Canadian Journal of Diabetes - Category: Endocrinology Source Type: research
Publication date: Available online 1 September 2019Source: The LancetAuthor(s): Deepak L Bhatt, Philippe Gabriel Steg, Shamir R Mehta, Lawrence A Leiter, Tabassome Simon, Kim Fox, Claes Held, Marielle Andersson, Anders Himmelmann, Wilhelm Ridderstråle, Jersey Chen, Yang Song, Rafael Diaz, Shinya Goto, Stefan K James, Kausik K Ray, Alexander N Parkhomenko, Mikhail N Kosiborod, Darren K McGuire, Robert A HarringtonSummaryBackgroundPatients with stable coronary artery disease and diabetes with previous percutaneous coronary intervention (PCI), particularly those with previous stenting, are at high risk of ischaemic even...
Source: The Lancet - Category: General Medicine Source Type: research
Publication date: Available online 19 August 2019Source: Canadian Journal of DiabetesAuthor(s): Lucas C. Godoy, Caio A.M. Tavares, Michael E. FarkouhAbstractPatients with diabetes (DM) are at increased risk for developing coronary artery disease (CAD). Choosing the optimal revascularization strategy, i.e. coronary artery bypass grafting – CABG – or percutaneous coronary intervention – PCI, may be difficult in this population. A large body of evidence suggests that, for patients with DM and stable multivessel ischemic heart disease, CABG is usually superior to PCI, leading to lower rates of all-cause morta...
Source: Canadian Journal of Diabetes - Category: Endocrinology Source Type: research
Publication date: August 2019Source: Canadian Journal of Cardiology, Volume 35, Issue 8Author(s): Lucas C. Godoy, Patrick R. Lawler, Michael E. Farkouh, Bronwyn Hersen, José C. Nicolau, Vivek RaoAbstractThe prevalence of diabetes mellitus (DM) is rising globally and in Canada. Besides being a risk factor for the development of coronary artery disease, DM is also a marker of poor prognosis in patients with acute coronary syndrome (ACS), increasing the risks for ischemic and bleeding complications. Patients with DM have a high prevalence of multivessel coronary artery disease (MVD) and robust evidence has supported co...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
Abstract BACKGROUND: Mean platelet volume (MPV) has been introduced as a simple and accurate method for assessing platelet function, which can be used as a prognostic marker for cardiovascular events. We investigated whether pre-procedural MPV could predict major adverse cardiac events (MACE) in candidates for elective percutaneous coronary intervention (PCI). METHODS: In this large retrospective cohort, we reviewed the clinical and follow-up data of 4199 candidates (mean age = 59.9 ± 10.3 years; female patients = 1440 [34.3%]) for elective PCI due to unstable angina (UA) or non-ST segment elevation my...
Source: Archives of Iranian Medicine - Category: Middle East Health Authors: Tags: Arch Iran Med Source Type: research
Publication date: January 2019Source: The Annals of Thoracic Surgery, Volume 107, Issue 1Author(s): Noam Fink, Eugenia Nikolsky, Abid Assali, Oz Shapira, Yigal Kassif, Yaron D. Barac, Ariel Finkelstein, Amnon Eitan, Haim Danenberg, Doron Zahger, Gideon Sahar, Shaul Atar, Ehud Raanani, Gil Bolotin, Ilan Goldenberg, Amit SegevBackgroundWe sought to assess real-world implementation of the guidelines in patients with multivessel coronary artery disease (CAD) using a prospective national registry in Israel.MethodsAll consecutive patients with left main or 2- to 3-vessel CAD involving the proximal or mid left anterior descending...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
AbstractBackgroundThe aim of this study was to examine the relationship of albuminuria to cardiovascular disease outcomes in diabetic patients undergoing treatment for stable coronary artery disease.Methods and resultsWe analyzed data from 2176 participants of the Bypass Angioplasty Revascularization Investigation in type ‐2 diabetes (BARI‐2D) trial, a randomized clinical trial comparing Percutaneous coronary intervention/Coronary artery bypass grafting (PCI/CABG) to medical therapy for people with diabetes. The population was stratified by baseline spot urine albumin–creatinine ratio (uACR) into normal (uACR
Source: Catheterization and Cardiovascular Interventions - Category: Cardiovascular & Thoracic Surgery Authors: Tags: CORONARY ARTERY DISEASE Source Type: research
ConclusionMortality (1 –5 years) did not significantly differ between the CABG and PCI patients with T2DM. However, rates of other major adverse events were significantly higher in the PCI patients, suggesting that CABG is more advantageous than PCI in patients with T2DM.
Source: Diabetes Therapy - Category: Endocrinology Source Type: research
Authors: Tajti P, Karatasakis A, Danek BA, Alaswad K, Karmpaliotis D, Jaffer FA, Choi JW, Yeh RW, Patel M, Mahmud E, Burke MN, Krestyaninov O, Khelimskii D, Toma C, Doing AH, Uretsky B, Koutouzis M, Tsiafoutis I, Wyman RM, Garcia S, Holper E, Xenogiannis I, Rangan BV, Banerjee S, Ungi I, Brilakis ES Abstract OBJECTIVES: The effect of chronic kidney disease (CKD) on in-hospital outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. METHODS: We evaluated the prevalence of CKD and its impact on CTO-PCI outcomes in 1979 patients who underwent 2040 procedures b...
Source: The Journal of Invasive Cardiology - Category: Cardiology Tags: J Invasive Cardiol Source Type: research
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