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Association of Postoperative Complications and Outcomes Following Coronary Artery Bypass Grafting
ConclusionsPostoperative complications are associated with an increased risk of both early and late mortality and all-cause rehospitalization, particularly during the “value” window within 90 days of CABG. These findings underscore the need to develop avoidance strategies as well as cost-adjustment methods for each of these complications.
Source: American Heart Journal - February 9, 2020 Category: Cardiology Source Type: research

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

Outcomes of left Main revascularization in patients with acute coronary syndromes and stable ischemic heart disease: Analysis from the EXCEL trial
ConclusionsThe acuity of presentation did not predict outcomes in patients with LMCAD undergoing revascularization, nor did it discriminate patients who derive greater event-free survival from PCI versus CABG.
Source: American Heart Journal - May 4, 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

Preoperative factors associated with worsening in health-related quality of life following coronary artery bypass grafting in the ROOBY trial
Conclusions Among VA patients, less than 20% experienced worse HRQL 1year after CABG. For patients with low symptom burden at baseline, diabetes, smoking, depression, PVD, COPD, and a prior stroke, clinicians should be more cautious in pre-CABG counseling as to their anticipated HRQL improvements.
Source: American Heart Journal - December 25, 2017 Category: Cardiology Source Type: research

Primary percutaneous coronary intervention at centers with and without on-site surgical support: Insights from the blue cross blue shield of Michigan cardiovascular consortium (BMC2)
Conclusions Primary PCI performed at centers with and without cardiac surgery have comparable outcomes and complication rates, when performed with close monitoring of quality and outcomes.
Source: American Heart Journal - October 17, 2017 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

Clinical Outcomes with Percutaneous Coronary Revascularization versus Coronary Artery Bypass Grafting Surgery in Patients with Unprotected Left Main Coronary Artery Disease: A Meta-Analysis of Six Randomized Trials and 4686 Patients
Conclusions In patients undergoing revascularization for ULMCAD, PCI was associated with similar rates of mortality compared to CABG at a median follow-up of 39 months, but with an interaction effect suggesting relatively lower mortality with PCI in low SYNTAX score patients and relatively lower mortality with CABG in high SYNTAX score patients. Both procedures resulted in similar long-term composite rates of death, MI or stroke, with PCI offering an early safety advantage and CABG demonstrating greater durability.
Source: American Heart Journal - May 19, 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

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