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Which aortic clamp strategy is better to reduce postoperative stroke and death: Single center report and a meta-analysis
Background: Stroke is severe complication of coronary artery bypass grafting (CABG) which may be associated with clamp strategy, there are 2 strategies to clamp aorta including single aortic clamp (SAC) and partial aortic clamp (PAC). It is controversial that which clamping strategy is better to reduce the postoperative stroke and death, so this study aims to investigate which is better for reducing postoperative stroke and death within 30 days. Methods: We collected 469 patients who had on-pump CABG in Fuwai Hospital during January 2014 to July 2015. The SAC group consisted of 265 patients while the PAC group include...
Source: Medicine - March 1, 2018 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Coronary revascularisation in patients with diabetes: a chance to be better
Commentary on: Farkouh ME, Domanski M, Sleeper LA, et al.. Strategies for multivessel revascularisation in patients with diabetes. N Engl J Med 2012;367:2375–84. Context In 2009, a pooled analysis of individual patient data from randomised clinical trials comparing percutaneous coronary interventions (PCI) with coronary artery bypass grafting (CABG) showed a survival benefit in favour of CABG.1 Techniques of both PCI and CABG evolved during the last decade with the use of drug-eluting stents (DES) and novel antiplatelet agents. Methods In the FREEDOM trial, patients with diabetes and multivessel coronary artery disea...
Source: Evidence-Based Medicine - November 21, 2013 Category: Internal Medicine Authors: Windecker, S., Stefanini, G. G. Tags: Epidemiologic studies, Drugs: cardiovascular system, Stroke, Interventional cardiology, Ischaemic heart disease Therapeutics Source Type: research

Bypass surgery is more cost-effective than percutaneous coronary interventions for most patients with multivessel or left main coronary artery disease
Commentary on: Cohen DJ, Osnabrugge RL, Magnuson EA, et al; SYNTAX Trial Investigators. Cost-effectiveness of percutaneous coronary intervention with drug-eluting stents versus bypass surgery for patients with 3-vessel or left main coronary artery disease: final results from the Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery (SYNTAX) trial. Circulation 2014;130:1146–57. Context The SYNTAX (SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery) trial compared outcomes of percutaneous coronary intervention (PCI) with drug eluting stents (DES) and coronary a...
Source: Evidence-Based Medicine - March 17, 2015 Category: Internal Medicine Authors: Agarwal, S., Kapadia, S. R. Tags: Health policy, Drugs: cardiovascular system, Stroke, Interventional cardiology, Ischaemic heart disease, Health economics, Health service research Economic analysis Source Type: research

Review: In diabetes with multivessel or left main CAD, PCI increases death/MI/stroke combo compared with CABG.
PMID: 25775351 [PubMed - in process]
Source: Annals of Internal Medicine - March 17, 2015 Category: Internal Medicine Authors: Hlatky MA Tags: Ann Intern Med Source Type: research

In left main CAD, PCI with everolimus-eluting stents was noninferior to CABG for death, MI, or stroke at 3 years.
PMID: 28241294 [PubMed - in process]
Source: Annals of Internal Medicine - February 20, 2017 Category: Internal Medicine Authors: Bates ER Tags: Ann Intern Med Source Type: research

Review: In coronary artery disease, PCI reduces 30-day and 5-year risk for stroke compared with CABG.
PMID: 30452562 [PubMed - in process]
Source: Annals of Internal Medicine - November 20, 2018 Category: Internal Medicine Authors: Bates ER Tags: Ann Intern Med Source Type: research

Worse clinical outcomes following percutaneous coronary intervention with a high SYNTAX score: A systematic review and meta-analysis
Conclusions: Compared with CABG, worse clinical outcomes were observed following PCI in patients with a high SYNTAX score, confirming with evidence, published clinical literatures. Therefore, CABG should be recommended to CAD patients who have been allotted a high SYNTAX score.
Source: Medicine - June 1, 2017 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Clinical outcomes of patients with multivessel coronary artery disease treated with robot-assisted coronary artery bypass graft surgery versus one-stage percutaneous coronary intervention using drug-eluting stents
A number of studies have reported on treatment outcomes of coronary stenting (PCI) for multivessel coronary artery diseases (MVD), and compared them with the conventional coronary artery bypass grafting (CABG). However, the clinical outcomes of robot-assisted CABG (R-CABG) in comparison with PCI in MVD patients have not been investigated. We recruited retrospectively MVD patients receiving R-CABG and PCI with drug-eluting stents for all vessels in one stage between January 2005 and December 2013 at our institution with at least 3 years of outcomes were retrospectively recruited and analyzed. A total of 638 MVD patients w...
Source: Medicine - September 1, 2019 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Impact of time factor and patient characteristics on the efficacy of PCI vs CABG for left main coronary disease: A meta-analysis
Conclusions: The long-term benefit of CABG vs PCI on MACCE in patients with left main coronary disease is consistent across patients with different clinical characteristics. The relative benefit of CABG on MACCE is driven by that of CABG on unplanned revascularization, and becomes greater as time goes on.
Source: Medicine - March 12, 2021 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Coronary Revascularization in Diabetic Patients: A Systematic Review and Bayesian Network Meta-analysis.
CONCLUSION: Coronary artery bypass grafting seems to be the preferred revascularization technique in diabetics, especially if long-term survival is anticipated. However, because of residual uncertainties and increased risk for stroke with CABG, clinical judgment is required when choosing a revascularization technique in patients with diabetes. PRIMARY FUNDING SOURCE: Fonds de recherche du Québec-Santé. PMID: 25402514 [PubMed - in process]
Source: Annals of Internal Medicine - November 18, 2014 Category: Internal Medicine Authors: Tu B, Rich B, Labos C, Brophy JM Tags: Ann Intern Med Source Type: research

79-Year-Old Man With Shortness of Breath and Fevers
A 79-year old man with a history of myocardial infarction and coronary artery bypass grafting in 2000, biventricular systolic heart failure with an ejection fraction of 27%, hypertension, persistent atrial fibrillation for which he was taking high-dose aspirin given a previous history of hemorrhagic stroke, stage 3 chronic kidney disease, left cerebellar ischemic stroke, and implantable cardioverter-defibrillator (ICD) placement 5 years previously presented to his local medical facility with a 2-day history of breathlessness, fevers, and chills.
Source: Mayo Clinic Proceedings - November 7, 2018 Category: Internal Medicine Authors: Jaskanwal D. Sara, Megha Prasad, Suraj Kapa Tags: Residents' clinic Source Type: research

The epidemiology of coronary artery bypass surgery in a community hospital: A comparison between 2 periods
During the last decades, the increased number of percutaneous interventions procedures causes a significant change in the profile of patients referred to coronary artery bypass grafting (CABG). We aimed to study changes in patients’ characteristics and procedural outcomes of patients referred to CABG in a community hospital during the first 15 years of the millennium. A historical cohort study of all patients who underwent CABG in Cape Cod Hospital was performed. The period was divided into 2 sub-periods, 2000 to 2008 and 2009 to 2014. Patients’ characteristics and procedure outcomes were compared. Data on age, sex, c...
Source: Medicine - March 1, 2019 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Clinical outcomes of multivessel coronary artery disease patients revascularized by robot-assisted vs conventional standard coronary artery bypass graft surgeries in real-world practice
The treatment of patients with multivessel coronary artery disease (MVD) by coronary stenting (PCI) and the “gold standard” conventional coronary-artery bypass grafting (C-CABG) has been well explored in the literature. However, the clinical outcomes of robot-assisted CABG (R-CABG) vs C-CABG in MVD patients in real-world practice were unknown. We aimed to study the clinical outcomes of MVD patients who underwent R-CABG (robotic MIDCAB) and C-CABG at our institution between January 2005 and December 2013. A total of 516 MVD patients received CABG were recruited into this study. Among them, 281 patients received R-CAB...
Source: Medicine - January 22, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Prognostic implications of DPP‐4 inhibitor vs. sulfonylurea use on top of metformin in a real world setting – results of the 1 year follow‐up of the prospective DiaRegis registry
ConclusionsThe present results confirm prior randomised controlled trial results in patients with type 2 diabetes from real world clinical practice demonstrating that DPP4‐I on top of prior metformin monotherapy result in similar HbA1c reductions within 12 months but a significant reduction in hypoglycaemia compared with sulfonylurea added to metformin. The reduction in vascular events observed has to be verified in larger cohorts.
Source: International Journal of Clinical Practice - August 28, 2013 Category: Internal Medicine Authors: A. K. Gitt, P. Bramlage, C. Binz, M. Krekler, E. Deeg, D. Tschöpe Tags: Original Paper Source Type: research

The prognostic significance of declining health-related quality of life scores at 6 months after coronary artery bypass surgery
Conclusions: Deteriorating function and HRQoL-scores at 6 months as compared to baseline postoperatively predict later adverse cardiovascular events after CABG.
Source: QJM - April 25, 2014 Category: Internal Medicine Authors: Gunn, J. M., Lautamaki, A. K., Hirvonen, J., Kuttila, K. T. Tags: Original papers Source Type: research

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