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Long-Term (10-Year) Outcomes of Stenting or Bypass Surgery for Acute Coronary Syndromes and Stable Ischemic Heart Disease With Unprotected Left Main Coronary Artery Disease
ConclusionsIn patients with LMCA disease, we have identified no significant interaction between the acuity of clinical indication and the relative treatment effect of PCI versus CABG on 10-year clinical outcomes.
Source: American Heart Journal - August 22, 2019 Category: Cardiology Source Type: research

C-reactive protein and prognosis after percutaneous coronary intervention and bypass graft surgery for left Main coronary artery disease: Analysis from the EXCEL trial
Conclusions: In patients with LMCAD undergoing revascularization, elevated baseline CRP levels were strongly associated with subsequent death, MI and stroke at 3 years, irrespective of the mode of revascularization. Further studies are warranted to determine whether anti-inflammatory therapies may improve the prognosis of high-risk patients with LMCAD following revascularization.
Source: American Heart Journal - January 12, 2019 Category: Cardiology Source Type: research

International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial: Rationale and design
Conclusions ISCHEMIA will provide new scientific evidence regarding whether an invasive management strategy improves clinical outcomes when added to optimal medical therapy in patients with SIHD and moderate or severe ischemia.
Source: American Heart Journal - May 26, 2018 Category: Cardiology Source Type: research

Dual Antiplatelet Therapy for Perioperative Myocardial Infarction Following CABG Surgery
Conclusion One-quarter of CABG patients who had perioperative MI were treated with DAPT. DAPT was not associated with a difference in MI, stroke, or mortality at 30 days, but was associated with fewer re-hospitalizations. Further studies are needed to determine the optimal antiplatelet regimen following perioperative MI. What is already known about this subject? Perioperative myocardial infarction portends poor outcome but optimal management is currently unclear. While dual antiplatelet therapy is standard of care for acute coronary syndrome, its role in perioperative myocardial infarction is unknown. What does this study ...
Source: American Heart Journal - February 11, 2018 Category: Cardiology Source Type: research

Outcomes in elderly and young patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention with bivalirudin versus heparin: pooled analysis from the EUROMAX and HORIZONS-AMI trials
Conclusions In a large group of elderly patients enrolled in the EUROMAX and HORIZONS-AMI trials, bivalirudin was associated with lower 30-day rates of non-CABG major bleeding, subacute ST and NACE, with similar 30-day rates of acute ST and mortality.
Source: American Heart Journal - August 18, 2017 Category: Cardiology Source Type: research

Long-Term Outcomes of Bypass Grafting Versus Drug-Eluting Stenting for Left Main Coronary Artery Disease: Results from the IRIS-MAIN Registry
Conclusions Among patients with significant LMCAD, the long-term risk of the composite outcome of death, myocardial infarction, or stroke was similar between CABG and PCI. Clinical variables that differentially predict adverse outcomes might be useful in triaging appropriate revascularization strategy
Source: American Heart Journal - August 10, 2017 Category: Cardiology Source Type: research

Clinical outcomes with percutaneous coronary revascularization vs coronary artery bypass grafting surgery in patients with unprotected left main coronary artery disease: A meta-analysis of 6 randomized trials and 4,686 patients
Conclusions In patients undergoing revascularization for ULMCAD, PCI was associated with similar rates of mortality compared with CABG at a median follow-up of 39 months, but with an interaction effect suggesting relatively lower mortality with PCI in patients with low SYNTAX score and relatively lower mortality with CABG in patients with high SYNTAX score. Both procedures resulted in similar long-term composite rates of death, myocardial infarction, or stroke, with PCI offering an early safety advantage and CABG demonstrating greater durability.
Source: American Heart Journal - June 2, 2017 Category: Cardiology Source Type: research

Cangrelor reduces the risk of ischemic complications in patients with single-vessel and multi-vessel disease undergoing percutaneous coronary intervention: Insights from the CHAMPION PHOENIX trial
Conclusion In the CHAMPION PHOENIX trial, MVD and SVD patients had similar ischemic outcomes at 48hours and 30days. Cangrelor consistently reduced ischemic complications in both SVD and MVD patients without a significant increase in GUSTO severe bleeding. Clinical perspectives What's known? Cangrelor is a novel, intravenous, potent, and rapidly acting P2Y12 inhibitor that has been demonstrated to reduce the rate of ischemic events at 48hours in patients who received PCI compared with clopidogrel. What's new? In contrast to prior studies, we found that in this modern cohort, patients with SVD and MVD had a similar risk of i...
Source: American Heart Journal - April 18, 2017 Category: Cardiology Source Type: research

Cangrelor reduces the risk of ischemic complications in patients with single and multi-vessel disease undergoing PCI: insights from the CHAMPION PHOENIX Trial
Conclusion In the CHAMPION-PHOENIX trial, MVD and SVD patients had similar ischemic outcomes at 48hours and 30days. Cangrelor consistently reduced ischemic complications in both SVD and MVD patients without a significant increase in GUSTO severe bleeding. Clinical Perspectives. What's known? Cangrelor is a novel, intravenous, potent, and rapidly-acting P2Y12 inhibitor, that has been demonstrated to reduce the rate of ischemic events at 48hours in patients who received PCI compared with clopidogrel. What's new? In contrast to prior studies, we found that in this modern cohort, patients with SVD and MVD had a similar risk of...
Source: American Heart Journal - March 9, 2017 Category: Cardiology Source Type: research

A Randomized, Parallel Group, Double-Blind Study of Ticagrelor compared with Aspirin for Prevention of Vascular Events in Patients Undergoing Coronary Artery Bypass Graft Operation: Rationale and Design of the Ticagrelor in CABG (TiCAB-) Trial
Publication date: Available online 18 June 2016 Source:American Heart Journal Author(s): Antoinette de Waha, Sigrid Sandner, Moritz von Scheidt, Andreas Boening, Katharina Koch-Buettner, Dieter Hammel, Rainer Hambrecht, Bernhard C. Danner, Friedrich A. Schöndube, Gerold Goerlach, Theodor Fischlein, Michael Schmoeckel, Martin Oberhoffer, Rainer Schulz, Thomas Walther, Tibor Ziegelhöffer, Christoph Knosalla, Felix Schönrath, Friedhelm Beyersdorf, Matthias Siepe, Tim Attmann, Martin Misfeld, Friedrich-Wilhelm Mohr, Hans-Hinrich Sievers, Alexander Joost, Leon M. Putman, Günther Laufer, Christia...
Source: American Heart Journal - June 17, 2016 Category: Cardiology Source Type: research

Radial versus Femoral Access for Elderly Patients with Acute Coronary Syndrome undergoing Coronary Angiography and Intervention: Insights from the RIVAL Trial
Conclusions Consistent with the overall RIVAL trial population, elderly patients undergoing cardiac catheterization have lower rates of major bleeding or access site complications and higher rates of access site crossover with radial access compared to femoral access.
Source: American Heart Journal - August 16, 2015 Category: Cardiology Source Type: research

Rationale and Design of the Fractional Flow Reserve versus Angiography for Multivessel Evaluation (FAME) 3 Trial: A Comparison of Fractional Flow Reserve-Guided Percutaneous Coronary Intervention and Coronary Artery Bypass Graft Surgery in Patients with Multivessel Coronary Artery Disease
Conclusion The FAME 3 study will compare in a multicenter, randomized fashion FFR-guided PCI with contemporary drug-eluting stents to CABG in patients with three-vessel coronary artery disease.
Source: American Heart Journal - July 30, 2015 Category: Cardiology Source Type: research

Impact of prasugrel pretreatment and timing of coronary artery bypass grafting on clinical outcomes of patients with non-ST-segment elevation myocardial infarction: from the ACCOAST study
Conclusions In ACCOAST, early (<2.98 days) surgical revascularization carried increased risk of bleeding and ischemic complications without affecting all-cause mortality through 30 days. Baseline troponin and prasugrel pretreatment did not impact ischemic clinical outcomes.
Source: American Heart Journal - July 30, 2015 Category: Cardiology Source Type: research

Ticagrelor versus clopidogrel in Asian patients with acute coronary syndrome: A retrospective analysis from the Platelet Inhibition and Patient Outcomes (PLATO) Trial
Conclusions We observed consistency of effects in Asian patients receiving ticagrelor and clopidogrel in the PLATO study. The relatively modest number of Asian patients in this analysis supports further investigation of larger cohorts to confirm our observations.
Source: American Heart Journal - April 3, 2015 Category: Cardiology Source Type: research

Off-hour admission and outcomes for patients with acute myocardial infarction undergoing percutaneous coronary interventions
Conclusions Patients who were admitted during off-hours did not have higher mortality or readmission rates as compared with ones admitted during regular hours at an academic medical center.
Source: American Heart Journal - December 9, 2014 Category: Cardiology Source Type: research

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