Left ventricular systolic dysfunction in patients with unprotected left main coronary artery disease.

CONCLUSION: For patients with ULMCA disease and LVSD, there was no significant difference between DES and CABG in terms of efficacy and safety. Treatment with DES was an acceptable alternative to CABG. PMID: 32435839 [PubMed - as supplied by publisher]
Source: Herz - Category: Cardiology Tags: Herz Source Type: research

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Debate is ongoing regarding the optimal mode of revascularization for patients with left main coronary artery disease (LMCAD). Longer-term follow-up from randomized trials has recently become available. We recently published a study-level meta-analysis that demonstrated similar mortality after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) when compared with coronary artery bypass grafting (CABG) 1. There were also no differences in cardiac death, stroke or myocardial infarction (MI), although there was a greater risk of unplanned revascularization after PCI.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
We report the first U.S. experience of the recently approved micro-axial surgical heart pump for the treatment of ongoing cardiogenic shock following acute myocardial infarction (AMICGS), postcardiotomy cardiogenic shock (PCCS), cardiomyopathy including myocarditis, high-risk percutaneous coronary intervention (HRPCI), and coronary artery bypass surgery (HRCABG). Demographic, procedural, hemodynamic, and outcome data were obtained from the manufacturer’s quality database of all Impella 5.5 implants at three centers. Fifty-five patients underwent an Impella 5.5 implant for cardiomyopathy (45%), AMICGS (29%), PCCS (13%...
Source: ASAIO Journal - Category: Medical Devices Tags: Adult Circulatory Support Source Type: research
Conclusion: In this cohort, INSTI-based regimens were associated with a 21% decreased risk of incident cardiovascular disease. These finding require validation in other cohorts and with longer follow-up.
Source: JAIDS Journal of Acquired Immune Deficiency Syndromes - Category: Infectious Diseases Tags: Clinical Science Source Type: research
Abstract Objective: To investigate the predictive value of preoperative neutrophil-lymphocyte ratio (NLR) for long-term major adverse cardiac and cerebrovascular events (MACCE), which have not yet been well described, in patients undergoing coronary artery bypass grafting (CABG). Methods: The records of 751 consecutive patients who underwent elective CABG between January 2008 and January 2010 were retrospectively enrolled and stratified according to quartiles of preoperative NLR. At 7.8-year follow-up, MACCE was considered as an endpoint. Results: Overall MACCE was 11.6% of all cases. Long-term myocardial infarction, percu...
Source: Revista Brasileira de Cirurgia Cardiovascular - Category: Cardiovascular & Thoracic Surgery Source Type: research
This article is important because of the recent publication of the 5-year results of the EXCEL (Evaluation of XIENCE Versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization) trial comparing percutaneous coronary intervention (PCI) with coronary artery bypass grafting (CABG) in patients with LMCAD of low or intermediate anatomical complexity. The EXCEL trial has ignited a firestorm of controversy. The investigators concluded that there was no significant difference between PCI and CABG in the primary outcome of death or myocardial infarction (MI) or stroke (major adverse cardiac events, MACEs)...
Source: JAMA Internal Medicine - Category: Internal Medicine Source Type: research
For 3  decades, coronary artery bypass grafting (CABG) has been the standard of care for patients with left main coronary artery stenosis (LMCAS), a practice based on trials that showed improved survival compared with medical management.1 The Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) trial was the first large trial to compare percutaneous coronary intervention (PCI) with CABG in the treatment of coronary artery disease.2 The SYNTAX protocol included a prespecified exploratory analysis in the subgroup of patients with LMCAS that was underpowered for t he primary composit...
Source: The Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Commentary Source Type: research
This study found no difference between the two treatments for the main endpoint. The stenting group had a slightly higher rate of death, but it wasn’t due to cardiac causes. (There were slightly more patients in the stenting group who died from infection and cancer, which was felt to be unrelated to the procedure.) Similar to NOBLE, EXCEL also found that patients undergoing stenting had higher rates of needing bypass surgery or repeat stenting. There was no difference in stroke rates. A recent meta-analysis (a study that pools together and analyzes many studies) found that bypass surgery and stenting were equal in te...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Health Heart Health Surgery Source Type: blogs
AbstractObjectivesCoronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) are common procedures for managing coronary artery disease (CAD); however, optimal methods of comparing post-procedure outcomes are unclear. We evaluated the reliability of Synergy between percutaneous coronary intervention with Taxus and cardiac surgery (SYNTAX) scores and investigated differences in long-term outcomes after CABG among groups with different SYNTAX scores.MethodsAccording to patient selection criteria used in the SYNTAX trial, 368 patients who underwent isolated initial CABG between 2003 and 2014 at Kurash...
Source: General Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Percutaneous coronary intervention (PCI) with drug-eluting stents (DES) has emerged as an acceptable revascularization strategy for select patients with unprotected left main coronary disease (LMCA).1 The EXCEL trial showed no difference between DES and coronary artery bypass surgery (CABG) at 5 years for the composite of death, procedure and non-procedure related myocardial infarction (MI), or stroke,2 however; all-cause mortality was higher with DES at 5 years, which was a secondary end-point.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
Conclusion Three-year prognosis in unstable angina was considerable better in comparison with NSTEMI. On the contrary, after adjustment for baseline differences, the outcomes (death, MI, MACE) in unstable angina and stable angina patients were comparable.
Source: Coronary Artery Disease - Category: Cardiology Tags: PCI Source Type: research
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