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Percutaneous coronary angioplasty versus coronary artery bypass grafting in the treatment of unprotected left main stenosis: updated 5-year outcomes from the randomised, non-inferiority NOBLE trial
Publication date: Available online 23 December 2019Source: The LancetAuthor(s): Niels R Holm, Timo Mäkikallio, M Mitchell Lindsay, Mark S Spence, Andrejs Erglis, Ian B A Menown, Thor Trovik, Thomas Kellerth, Gintaras Kalinauskas, Lone Juul Hune Mogensen, Per H Nielsen, Matti Niemelä, Jens F Lassen, Keith Oldroyd, Geoffrey Berg, Peteris Stradins, Simon J Walsh, Alastair N J Graham, Petter C Endresen, Ole FröbertSummaryBackgroundPercutaneous coronary intervention (PCI) is increasingly used in revascularisation of patients with left main coronary artery disease in place of the standard treatment, coronary artery bypass gra...
Source: The Lancet - December 24, 2019 Category: General Medicine Source Type: research

Three-year clinical outcome of unprotected left main coronary artery disease patients complicated with chronic kidney disease treated by coronary artery bypass graft versus percutaneous coronary intervention
ConclusionCABG could be considered as the preferred treatment strategy compared with PCI with DES in ULMCAD patients complicated with CKD.
Source: Irish Journal of Medical Science - June 11, 2020 Category: General Medicine Source Type: research

Association of Statin Use With All-Cause and Cardiovascular Mortality in US Veterans 75 and Older
This retrospective cohort study uses Veterans Health Administration data on adults free of atherosclerotic cardiovascular disease (ASCVD) to evaluate the association between new statin use and all-cause and cardiovascular mortality, and a composite of ASCVD events (myocardial infarction, ischemic stroke, and revascularization with CABG surgery or PCI), in veterans 75 years and older.
Source: JAMA - July 7, 2020 Category: General Medicine Source Type: research

Winslow pathway collaterals: an unusual arterial network in Takayasu arteritis.
We present a case of a young male with Takayasu arteritis with middle aortic syndrome and Winslow pathway collaterals with lower limb ischaemia, hypertension, coronary occlusion and stroke. The extensive collateral formation was visible as a clinical finding over the abdominal wall. The identification of these collateral pathways is essential in understanding the extent of haemodynamically significant disease and it alerts to the possibility of surgical injury during procedures like laparotomy or harvesting of internal thoracic artery for coronary artery bypass graft. PMID: 32936107 [PubMed - as supplied by publisher]
Source: Journal of the Royal College of Physicians of Edinburgh - September 17, 2020 Category: General Medicine Tags: J R Coll Physicians Edinb Source Type: research

Net Adverse Clinical Events With Antiplatelet Therapy in Acute Coronary Syndromes
Clopidogrel, prasugrel, and ticagrelor are oral platelet P2Y12 receptor inhibitors that decrease the risk of platelet-mediated coronary artery thrombosis. Clinical guidelines have recommended ticagrelor or prasugrel over clopidogrel in combination with aspirin as dual antiplatelet therapy (DAPT) for 1 year after acute coronary syndrome (ACS), whether or not percutaneous coronary intervention (PCI) is performed. The ticagrelor recommendation was based on the Study of Platelet Inhibition and Patient Outcomes (PLATO) trial, which enrolled 18  624 patients with ACS and randomized them to receive DAPT with either clopidogrel ...
Source: JAMA - October 27, 2020 Category: General Medicine Source Type: research

Disability-free survival after major cardiac surgery: a population-based retrospective cohort study
CMAJ Open. 2021 Apr 16;9(2):E384-E393. doi: 10.9778/cmajo.20200096. Print 2021 Apr-Jun.ABSTRACTBACKGROUND: Cardiovascular research has traditionally been dedicated to "tombstone" outcomes, with little attention dedicated to the patient's perspective. We evaluated disability-free survival as a patient-defined outcome after cardiac surgery.METHODS: We conducted a retrospective cohort study of patients aged 40 years and older who underwent coronary artery bypass grafting (CABG) or single or multiple valve (aortic, mitral, tricuspid) surgery in Ontario between Oct. 1, 2008, and Dec. 31, 2016. The primary outcome was disability...
Source: cmaj - April 17, 2021 Category: General Medicine Authors: Louise Y Sun Anan Bader Eddeen Thierry G Mesana Source Type: research

Efficacy of a glucagon-like peptide-1 agonist and restrictive versus liberal oxygen supply in patients undergoing coronary artery bypass grafting or aortic valve replacement: study protocol for a 2-by-2 factorial designed, randomised clinical trial
The objective of this study is to determine the efficacy of the GLP-1-analogue exenatide versus placebo and restrictive oxygenation (50% fractional inspired oxygen, FiO2) versus liberal oxygenation (100% FiO2) in patients undergoing open heart surgery. Methods and analysis A randomised, placebo-controlled, double blind (for the exenatide intervention)/single blind (for the oxygenation strategy), 2x2 factorial designed single-centre trial on adult patients undergoing elective or subacute CABG and/or surgical AVR. Patients will be randomised in a 1:1 and 1:1 ratio to a 6-hour and 15 min infusion of 17.4 µg of exenatid...
Source: BMJ Open - November 5, 2021 Category: General Medicine Authors: Wiberg, S., Kjaergaard, J., Mogelvang, R., Moller, C. H., Kandler, K., Ravn, H., Hassager, C., Kober, L., Nilsson, J. C. Tags: Open access, Surgery Source Type: research

Surgical aortic valve replacement in the era of transcatheter aortic valve implantation: a review of the UK national database
Conclusions Surgical SAVR±CABG has low mortality risk and a low level of complications in the UK in people of all ages and risk factors. These results should inform consideration of treatment options in people with aortic valve disease.
Source: BMJ Open - October 28, 2021 Category: General Medicine Authors: Jahangiri, M., Bilkhu, R., Embleton-Thirsk, A., Dehbi, H.-M., Mani, K., Anderson, J., Avlonitis, V., Baghai, M., Birdi, I., Booth, K., Bose, A., Briffa, N., Buchan, K., Bhudia, S., Cale, A., Deglurkar, I., Farid, S., Hadjinikolaou, L., Jarvis, M., Javadpo Tags: Open access, Cardiovascular medicine Source Type: research

PROCAM based myocardial infarction risk in relation to global vascular disease risk: observations from the ARCO cohort study
CONCLUSIONS: PROCAM-derived risk calculators are well calibrated for the risk of AMI. PROCAM-AMI should be multiplied by a factor of 4 to obtain ASCVD. PROCAM-AMI does not represent global cardiovascular risk. Corresponding adjustments in the AGLA communication of risk appear necessary.PMID:35201684 | DOI:10.4414/smw.2022.w30111
Source: Swiss Medical Weekly - February 24, 2022 Category: General Medicine Authors: Michel Romanens Ansgar Adams Walter Warmuth Source Type: research

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