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NOBLE trial —is it time to revise the guidelines?
AbstractThe Nordic –Baltic–British left main revascularization trial (NOBLE) is a prospective, randomized, multicentre, non-inferiority trial comparing percutaneous coronary angioplasty (PCI) with coronary artery bypass grafting (CABG) for revascularization of patients with unprotected left main coronary artery (L MCA) stenosis. The primary outcome was a combined endpoint of all-cause mortality, stroke, non-procedural myocardial infarction and repeat revascularization. CABG was found to be superior to PCI with respect to the 5-year MACCE rates (28% vs. 19%) with a hazard ratio (HR) of 1.58 (95% CI 1.24–2.01 ). All-ca...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - June 10, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Incidence, Determinants, and Outcomes of Coronary Perforation During Percutaneous Coronary Intervention in the United Kingdom Between 2006 and 2013: An Analysis of 527 121 Cases From the British Cardiovascular Intervention Society Database Coronary Interventions
Conclusions— Using a national PCI database for the first time, the incidence, predictors, and outcomes of CP were defined. Although CP as a complication of PCI occurred rarely, it was strongly associated with poor outcomes.
Source: Circulation: Cardiovascular Interventions - August 1, 2016 Category: Cardiology Authors: Kinnaird, T., Kwok, C. S., Kontopantelis, E., Ossei-Gerning, N., Ludman, P., deBelder, M., Anderson, R., Mamas, M. A., on behalf of the British Cardiovascular Intervention Society and the National Institute for Cardiovascular Outcomes Research Tags: Percutaneous Coronary Intervention, Revascularization, Stent Coronary Interventions Source Type: research

Coronary Perforation Complicating Percutaneous Coronary Intervention in Patients With a History of Coronary Artery Bypass Surgery: An Analysis of 309 Perforation Cases From the British Cardiovascular Intervention Society Database Coronary Interventions
Conclusions— CP is an infrequent event during PCI-CABG but is closely associated with adverse clinical outcomes. A legacy effect of perforation on 12-month mortality was observed.
Source: Circulation: Cardiovascular Interventions - September 15, 2017 Category: Cardiology Authors: Kinnaird, T., Anderson, R., Ossei-Gerning, N., Cockburn, J., Sirker, A., Ludman, P., de Belder, M., Johnson, T. W., Copt, S., Zaman, A., Mamas, M. A., on behalf of the British Cardiovascular Intervention Society and the National Institute for Cardiovascul Tags: Percutaneous Coronary Intervention, Stent, Treatment Coronary Interventions Source Type: research

Clinical Outcomes of Percutaneous Coronary Intervention for Chronic Total Occlusion in Native Coronary Arteries vs Saphenous Vein Grafts.
CONCLUSION: In this national cohort, CTO-PCI was performed in higher-risk patients, and was associated with more procedural complications but similar short-term or long-term mortality and in-hospital MACE. PMID: 32771995 [PubMed - as supplied by publisher]
Source: The Journal of Invasive Cardiology - August 13, 2020 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Techniques and approaches for revascularisation of left heart coronary diseases.
Abstract Coronary artery disease and its associated clinical sequelae are a significant medical burden to clinicians and patients. Severe coronary artery disease presenting in the context of acute myocardial ischaemia, or stable plaques causing chronic symptoms despite best conservative and pharmacological intervention, are often amenable to further intervention such as coronary artery bypass grafting. This procedure has been extensively compared to newer and less invasive techniques, such as percutaneous coronary intervention, and other minimally invasive procedures such as robotic or endoscopic techniques. This ...
Source: British Journal of Hospital Medicine - August 1, 2020 Category: Internal Medicine Authors: Maskell P, Oo S, Muir AD, Fan KS, Harky A Tags: Br J Hosp Med (Lond) Source Type: research

Age-Stratified Outcome in Treatment of Left Main Coronary Artery Stenosis: A NOBLE Trial Substudy
Conclusions: As the overall NOBLE results show revascularization of LMCA disease, age of 67 years or older was associated with lower 5-year MACCE after CABG compared to PCI. Clinical outcomes were not significantly different in the subgroup younger than 67 years, although no significant interaction was present between age and treatment. Mortality was similar for all subgroups (ClinicalTrials.gov identifier: NCT01496651).Cardiology
Source: Cardiology - April 13, 2021 Category: Cardiology Source Type: research

Females have an increased risk of short ‐term mortality after cardiac surgery compared to males: Insights from a national database
ConclusionFemales in the United Kingdom have an increased risk of short-term mortality after cardiac surgery compared to males. This highlights the need to focus on the understanding of the causes behind these disparities and implementation of strategies to improve outcomes in females.
Source: Journal of Cardiac Surgery - September 18, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Lauren Kari Dixon, Arnaldo Dimagli, Ettorino Di Tommaso, Shubhra Sinha, Daniel P. Fudulu, Manraj Sandhu, Umberto Benedetto, Gianni D. Angelini Tags: ORIGINAL ARTICLE Source Type: research