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Clinical Reasoning: A 66-year-old man with recurrent multi-territory infarcts
A 66-year-old man was referred to our center for evaluation of recurrent infarcts in multiple vascular territories over the preceding 6 months (figure 1). The patient first presented with a 3-month, stuttering course of transient neurologic deficits, including right arm and leg hemiparesis, expressive aphasia, and right homonymous hemianopia. He was initially evaluated at a community Stroke Prevention Clinic. His medical history was significant for several classic vascular risk factors: coronary artery disease requiring a coronary artery bypass graft, dyslipidemia for which he was taking atorvastatin 20 mg daily, and obstr...
Source: Neurology - June 8, 2015 Category: Neurology Authors: Kouzmitcheva, E., Steriade, C., Prica, A., Hazrati, L.-N., Mandell, D. M. Tags: All Cerebrovascular disease/Stroke, All Education RESIDENT AND FELLOW SECTION Source Type: research

Plasma Metal Concentrations and Incident Coronary Heart Disease in Chinese Adults: The Dongfeng-Tongji Cohort
Conclusions: Our study suggested that incident CHD was positively associated with plasma levels of titanium and arsenic, and inversely associated with selenium. Additional research is needed to confirm these findings in other populations. https://doi.org/10.1289/EHP1521 Received: 22 December 2016 Revised: 17 September 2017 Accepted: 19 September 2017 Published: 19 October 2017 Address correspondence to T. Wu, or A. Pan, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hongkong Rd., Wuhan 430030, Hubei, China. Telephone: +86-27-83692347. Email: wut@mails.tjmu.edu.cn or p...
Source: EHP Research - October 20, 2017 Category: Environmental Health Authors: Daniil Lyalko Tags: Research Source Type: research

Early and long term coronary artery bypass grafting outcomes in patients under 45 years of age.
CONCLUSIONS: Young women who underwent CABG were burdened with higher early postoperative morbidity and mortality than young men. However, long-term outcomes (mortality, recurrent angina, and repeated myocardial revascularisation rates) did not differ significantly between the two groups. Regardless of gender, repeated myocardial revascularisation rate was significantly higher among those patients who continued to smoke after the surgery (p < 0.01). PMID: 23348531 [PubMed - in process]
Source: Polish Heart Journal - January 26, 2013 Category: Cardiology Authors: Zwoliński R, Jander S, Ostrowski S, Bartczak K, Adamek Kośmider A, Banyś A, Jaszewski R Tags: Kardiol Pol Source Type: research

Who might benefit from early aspirin after coronary artery surgery?
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether early administration of aspirin might optimize vein graft patency. More than 250 papers were found using the reported search, of which 4 new papers in addition to the previous 7 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Early postoperative aspirin administered within 6 h following coronary artery bypass grafting (CABG) has been show...
Source: Interactive CardioVascular and Thoracic Surgery - August 14, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Gukop, P., Gutman, N., Bilkhu, R., Karapanagiotidis, G. T. Tags: Cardiac - physiology, Education, Congestive Heart Failure, Molecular biology Adult Cardiac Source Type: research

Bypass surgery an “uncommon” cause of memory loss, cognitive decline
Coronary artery bypass surgery (CABG) offers a new lease on life for thousands of people each year whose hearts aren’t getting the blood they need to work properly. But it has also been blamed for “brain fog,” a loss of memory and thinking skills that follows the procedure in some people. Such brain problems are often called cognitive impairment. The operation itself may not be to blame, according to a review in today’s Annals of Internal Medicine. For the review, a team of researchers—mostly from the U. S. Department of Veteran’s Affairs—synthesized data from 17 clinical trials and four w...
Source: New Harvard Health Information - July 22, 2015 Category: Consumer Health News Authors: Howard LeWine, M.D. Tags: Heart Health bypass surgery Coronary artery bypass surgery memory loss Source Type: news

How revascularization on the beating heart with cardiopulmonary bypass compares to off-pump? A meta-analysis of observational studies
Off-pump coronary artery bypass surgery has been a controversial area of debate and the outcome profile of the technique has been thoroughly investigated. Scepticism regarding the reported outcomes and the conduct of the randomized trials comparing this technique with conventional on-pump coronary artery bypass surgery has been widely voiced, and the technique of off-pump surgery remains as an infrequently adopted approach to myocardial revascularization worldwide. Criticisms of the technique are related to lower rates of complete revascularization and its unknown long-term consequences, the significant detrimental effects...
Source: Interactive CardioVascular and Thoracic Surgery - December 26, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Sepehripour, A. H., Chaudhry, U. A., Suliman, A., Kidher, E., Sayani, N., Ashrafian, H., Harling, L., Athanasiou, T. Tags: Education, Molecular biology, Myocardial protection Adult Cardiac Source Type: research

Association of the magnitude of weight loss and changes in physical fitness with long-term cardiovascular disease outcomes in overweight or obese people with type 2 diabetes: a post-hoc analysis of the Look AHEAD randomised clinical trial
We examined whether the incidence of cardiovascular disease in Look AHEAD varied by changes in weight or fitness. Methods Look AHEAD was a randomised clinical trial done at 16 clinical sites in the USA, recruiting patients from Aug 22, 2001, to April 30, 2004. In the trial, 5145 overweight or obese adults aged 45–76 years with type 2 diabetes were assigned (1:1) to an intensive lifestyle intervention or diabetes support and education. In this observational, post-hoc analysis, we examined the association of magnitude of weight loss and fitness change over the first year with incidence of cardiovascular disease. The primar...
Source: The Lancet Diabetes and Endocrinology - August 30, 2016 Category: Endocrinology Source Type: research

Patient perspectives on left main stem revascularization strategies, the OPINION-2 study.
CONCLUSIONS: Overall, patients who are informed about risk and benefits of each treatment modality clearly favor PCI over CABG and particularly value lower short-term morbidity while being aware of higher risk of repeat revascularization. Lower educational level was associated with a higher prevalence of psychosomatic phenotypes and a 14% preference for CABG. Educational and psychosocial background matter in the revascularization strategy decision-making process. PMID: 33041162 [PubMed - as supplied by publisher]
Source: Journal of Cardiology - October 8, 2020 Category: Cardiology Authors: Nuis RJ, Jadoon A, van Dalen BM, Dulfer K, Snelder SM, Yazdi MT, Masdjedi K, den Dekker WK, Diletti R, Wilschut J, Daemen J, Lenzen MJ, Zijlstra F, Smits PC, Van Mieghem NM Tags: J Cardiol Source Type: research

Health ‐related quality of life impacts upon 5‐year survival after coronary artery bypass surgery
ConclusionsPre-CABG HRQoL scores may provide clinically relevant prognostic information beyond traditional risk models and prove useful for patient-provider shared decision-making and enhancing pre-CABG informed consent.
Source: Journal of Cardiac Surgery - November 24, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Muath Bishawi, Brack Hattler, G. Hossein Almassi, Jacquelyn A. Quin, Frederick L. Grover, Joseph F. Collins, Ramin Ebrahimi, Daniel H. Wolbrom, A. Laurie Shroyer, Veterans Affairs Randomized On/Off Bypass Follow ‐up Study (ROOBY‐FS) Group Tags: ORIGINAL ARTICLE Source Type: research