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Vrints C, Andreotti F, Koskinas KC, Rossello X, Adamo M, Ainslie J, Banning AP, Budaj A, Buechel RR, Chiariello GA, Chieffo A, Christodorescu RM, Deaton C, Doenst T, Jones HW, Kunadian V, Mehilli J, Milojevic M, Piek JJ, Pugliese F, Rubboli A, Semb AG, Senior R, Ten Berg JM, Van Belle E, Van Craenenbroeck EM, Vidal-Perez R, Winther S. 2024 ESC Guidelines for the management of chronic coronary syndromes. Eur Heart J 2024:ehae177. [PMID: 39210710 DOI: 10.1093/eurheartj/ehae177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/04/2024] Open
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Beerkens FJ, Küçük IT, van Veelen A, de Lind van Wijngaarden RAF, Timmermans MJC, Mehran R, Dangas G, Klautz R, Henriques JPS, Claessen BEPM. Native coronary artery or bypass graft percutaneous coronary intervention in patients after previous coronary artery bypass surgery: A large nationwide analysis from the Netherlands Heart Registration. Int J Cardiol 2024; 405:131974. [PMID: 38493833 DOI: 10.1016/j.ijcard.2024.131974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 02/16/2024] [Accepted: 03/14/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Patients with previous coronary artery bypass surgery (CABG) who require repeat revascularization frequently undergo percutaneous coronary intervention (PCI). We sought to identify factors associated with the decision to intervene on the native vessel versus a bypass graft and investigate their outcomes in a large nationwide prospective registry. METHODS We identified patients who underwent PCI with a history of prior CABG from the Netherlands Heart Registration between 2017 and 2021 and stratified them by isolated native vessel PCI versus PCI including at least one venous- or arterial graft. The primary endpoint of major adverse cardiac events (MACE) was a composite of all-cause death and target vessel revascularization (TVR) at one-year post PCI. The key secondary endpoint was a composite of all-cause death, myocardial infarction (MI), and TVR at 30 days. RESULTS Out of 154,146 patients who underwent PCI, 12,822 (8.3%) had a prior CABG. Isolated native vessel PCI was most frequently performed (75.2%), while an acute coronary syndrome (ACS) presentation was most strongly associated with graft interventions. The primary outcome of MACE at one-year post PCI occurred more frequently in interventions including grafts compared with native vessels alone (19.7% vs. 14.3%; adjOR 1.267; 95% CI 1.101-1.457); p < 0.001) driven by TVR. There was however no difference in mortality or the key secondary endpoint between the two groups. CONCLUSION In this nationwide prospective registry, ACS presentation was strongly associated with bypass graft PCI. At one year after PCI, interventions including bypass grafts had a higher composite of MACE compared with isolated native vessel interventions.
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Affiliation(s)
- Frans J Beerkens
- The Zena and Michael A. Weiner Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - I Tarik Küçük
- Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | - Anna van Veelen
- Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | - Robert A F de Lind van Wijngaarden
- Department of Cardiothoracic Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | | | - Roxana Mehran
- The Zena and Michael A. Weiner Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - George Dangas
- The Zena and Michael A. Weiner Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Robert Klautz
- Department of Cardiothoracic Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | - José P S Henriques
- Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | - Bimmer E P M Claessen
- Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands.
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Guo X, Shen R, Su Y, Ma L. High-density lipoprotein-related inflammatory indices predict repeat revascularization in coronary drug-eluting stenting. Biomark Med 2023; 17:959-969. [PMID: 38230978 DOI: 10.2217/bmm-2023-0399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024] Open
Abstract
Background: HDL-C-related inflammatory indices are potential predictors of repeat revascularization (RR) after coronary drug-eluting stenting. Methods: Multivariable Cox regression with restricted cubic splines and receiver operating curve was used. Results: The median follow-up was 50 months. A total of 521 (35.42%) patients experienced RR. The incidence of RR was positively associated with the monocyte-to-HDL-C ratio, neutrophil-to-HDL-C ratio and lymphocyte-to-HDL-C ratio (log-rank p < 0.05). After being fully adjusted, the largest tertile of monocyte-to-HDL-C ratio, neutrophil-to-HDL-C ratio, white blood cell-to-HDL-C ratio and lymphocyte-to-HDL-C ratio increased the risk by 38, 30, 28 and 37%, respectively. Monocyte-to-HDL-C ratio was dose-responsive and linearly correlated with RR. HDL-C-related inflammatory indices had over 60% predictive ability. Conclusion: HDL-C-related inflammatory indices independently predicted RR after coronary drug-eluting stenting.
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Affiliation(s)
- Xuantong Guo
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, National Clinical Research Center of Cardiovascular Diseases, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100037, China
| | - Ruihuan Shen
- Department of Cardiology, National Center of Gerontology, Institute of Geriatric Medicine, Beijing Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Yanni Su
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, National Clinical Research Center of Cardiovascular Diseases, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100037, China
| | - Lihong Ma
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, National Clinical Research Center of Cardiovascular Diseases, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100037, China
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Alfonso F, Del Val D. Management of Patients With Myocardial Infarction After Coronary Surgery: The Importance of Repeat Revascularization. Am J Cardiol 2023; 196:99-101. [PMID: 37076385 DOI: 10.1016/j.amjcard.2023.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 03/16/2023] [Indexed: 04/21/2023]
Affiliation(s)
- Fernando Alfonso
- Department of Cardiology, Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Aotónoma de Madrid, Centro de investigacion Biomédica en Red en enfermedades CardioVasculares (CIBER-CV), Madrid, Spain.
| | - David Del Val
- Department of Cardiology, Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Aotónoma de Madrid, Centro de investigacion Biomédica en Red en enfermedades CardioVasculares (CIBER-CV), Madrid, Spain
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Dimagli A, Cancelli G, Soletti GJ, Perezgrovas Olaria R, Chadow D, Rahouma M, Girardi L, Gaudino M. Percutaneous coronary intervention versus repeat surgical revascularization in patients with prior coronary artery bypass grafting: A systematic review and meta-analysis. JTCVS OPEN 2022; 12:177-191. [PMID: 36590724 PMCID: PMC9801338 DOI: 10.1016/j.xjon.2022.10.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 10/16/2022] [Accepted: 10/24/2022] [Indexed: 11/07/2022]
Abstract
Objectives Repeat coronary artery bypass grafting (RCABG) and percutaneous coronary intervention (PCI) are both used for the treatment of symptomatic patients with coronary artery disease and prior CABG, but the optimal treatment strategy remains unknown. We sought to perform a systematic review and meta-analysis to compare operative and follow-up outcomes following RCABG versus PCI in patients with prior CABG. Methods Medline and Embase were searched for studies comparing RCABG versus PCI. The primary outcome was follow-up mortality, and secondary outcomes were follow-up repeat revascularization, operative mortality, periprocedural stroke, and myocardial infarction. Time-to-event outcomes were summarized as incidence rate ratios, whereas operative outcomes were summarized as odds ratios. A random effect meta-analysis was performed. Individual patient survival data was extracted from available survival curves and reconstructed using restricted mean survival time. Results Among 2982 articles, 7 studies (9945 patients) were included. In the aggregated data meta-analysis, there was no difference in follow-up survival between RCABG and PCI (incidence rate ratio, 1.02; 95% CI, 0.83-1.25); however, restricted mean survival time analysis of individual data showed a survival benefit for RCABG over PCI (0.7 years; 95% CI, 0.23-1.19 years; P = .004). PCI was found to have a higher incidence rate of follow-up need for repeat revascularization (incidence rate ratio, 1.61; 95% CI, 1.16-2.23), but lower odds for operative mortality and stroke. No difference in the odds for myocardial infarction was found. Conclusions In patients with prior CABG, PCI is associated with better operative outcomes, but RCABG is associated with better survival and freedom from repeat revascularization at follow-up.
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Affiliation(s)
- Arnaldo Dimagli
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York City, NY
| | - Gianmarco Cancelli
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York City, NY
| | | | | | - David Chadow
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York City, NY
| | - Mohamed Rahouma
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York City, NY
| | - Leonard Girardi
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York City, NY
| | - Mario Gaudino
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York City, NY
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Claessen B, Beerkens F, Henriques JP, Dangas GD. Percutaneous Coronary Intervention of Arterial and Vein Grafts. Interv Cardiol 2022. [DOI: 10.1002/9781119697367.ch19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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7
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Beerkens FJ, Claessen BE, Mahan M, Gaudino MFL, Tam DY, Henriques JPS, Mehran R, Dangas GD. Contemporary coronary artery bypass graft surgery and subsequent percutaneous revascularization. Nat Rev Cardiol 2022; 19:195-208. [PMID: 34611327 DOI: 10.1038/s41569-021-00612-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/15/2021] [Indexed: 11/09/2022]
Abstract
Patients who have undergone coronary artery bypass graft (CABG) surgery are susceptible to bypass graft failure and progression of native coronary artery disease. Although the saphenous vein graft (SVG) was traditionally the most-used conduit, arterial grafts (including the left and right internal thoracic arteries and the radial artery) have improved patency rates. However, the need for secondary revascularization remains common, and percutaneous coronary intervention (PCI) has become the most common modality of secondary revascularization after CABG surgery. Procedural characteristics and clinical outcomes differ considerably from those associated with PCI in patients without previous CABG surgery, owing to altered coronary anatomy and differences in conduit pathophysiology. In particular, SVG PCI carries an increased risk of complications, and operators are shifting their focus towards embolic protection strategies and complex native-vessel interventions, increasingly using SVGs as conduits to facilitate native-vessel PCI rather than pursuing SVG PCI. In this Review, we discuss the differences in conduit pathophysiology, changes in CABG surgery techniques, and the latest evidence in terms of PCI in patients with previous CABG surgery, with a particular emphasis on safety and long-term efficacy. We explore the subject of contemporary CABG surgery and subsequent percutaneous revascularization in this complex patient population.
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Affiliation(s)
- Frans J Beerkens
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,The Zena and Michael A. Weiner Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Bimmer E Claessen
- The Zena and Michael A. Weiner Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Cardiology, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Marielle Mahan
- Department of Ophthalmology, MedStar Georgetown University/Washington Hospital Center, Washington, DC, USA
| | - Mario F L Gaudino
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, USA
| | - Derrick Y Tam
- Division of Cardiac Surgery, University of Toronto, Toronto, ON, Canada
| | - José P S Henriques
- Department of Cardiology, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Roxana Mehran
- The Zena and Michael A. Weiner Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - George D Dangas
- The Zena and Michael A. Weiner Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Lawton JS, Tamis-Holland JE, Bangalore S, Bates ER, Beckie TM, Bischoff JM, Bittl JA, Cohen MG, DiMaio JM, Don CW, Fremes SE, Gaudino MF, Goldberger ZD, Grant MC, Jaswal JB, Kurlansky PA, Mehran R, Metkus TS, Nnacheta LC, Rao SV, Sellke FW, Sharma G, Yong CM, Zwischenberger BA. 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol 2022; 79:e21-e129. [PMID: 34895950 DOI: 10.1016/j.jacc.2021.09.006] [Citation(s) in RCA: 558] [Impact Index Per Article: 279.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
AIM The guideline for coronary artery revascularization replaces the 2011 coronary artery bypass graft surgery and the 2011 and 2015 percutaneous coronary intervention guidelines, providing a patient-centric approach to guide clinicians in the treatment of patients with significant coronary artery disease undergoing coronary revascularization as well as the supporting documentation to encourage their use. METHODS A comprehensive literature search was conducted from May 2019 to September 2019, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, the Cochrane Collaboration, CINHL Complete, and other relevant databases. Additional relevant studies, published through May 2021, were also considered. STRUCTURE Coronary artery disease remains a leading cause of morbidity and mortality globally. Coronary revascularization is an important therapeutic option when managing patients with coronary artery disease. The 2021 coronary artery revascularization guideline provides recommendations based on contemporary evidence for the treatment of these patients. The recommendations present an evidence-based approach to managing patients with coronary artery disease who are being considered for coronary revascularization, with the intent to improve quality of care and align with patients' interests.
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Lawton JS, Tamis-Holland JE, Bangalore S, Bates ER, Beckie TM, Bischoff JM, Bittl JA, Cohen MG, DiMaio JM, Don CW, Fremes SE, Gaudino MF, Goldberger ZD, Grant MC, Jaswal JB, Kurlansky PA, Mehran R, Metkus TS, Nnacheta LC, Rao SV, Sellke FW, Sharma G, Yong CM, Zwischenberger BA. 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation 2022; 145:e18-e114. [PMID: 34882435 DOI: 10.1161/cir.0000000000001038] [Citation(s) in RCA: 160] [Impact Index Per Article: 80.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Mahmoud SED, Shahin M, Yousif N, Denegri A, Abo Dahab LH, Lüscher TF. Cardiovascular Risk Profile, Presentation and Management Outcomes of Patients with Acute Coronary Syndromes after Coronary Artery Bypass Grafting. Curr Probl Cardiol 2021; 47:101078. [PMID: 34902394 DOI: 10.1016/j.cpcardiol.2021.101078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 12/05/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Coronary artery bypass (CABG) is an important revascularization procedure with excellent long-term results. However, bypass grafts, particularly venous grafts, develop structural changes and atherosclerotic plaques that may cause angina or even acute coronary syndromes (ACS). Here we aimed to study patients with previous CABG presenting with an ACS and evaluated their cardiovascular (CV) risk profile, clinical presentations, angiographic findings, management strategies and short and long term outcomes. PATIENTS AND METHODS This represents an observational retrospective cross sectional single center study including all consecutive patients with previous CABG presenting with ACS at the University Heart Center of the University Hospital Zurich, Switzerland between January 1, 2000 and December 31, 2016. Mean age was 76.4 years and 83.1% were males. Major adverse cardiovascular and cerebrovascular events (MACCE) at 1-year follow up and long-term follow up were analyzed using Kaplan Meyer survival analysis. RESULTS We included 510 patients with ACS and prior CABG. Most patients were elderly at the time of presentation. 60.2% were diabetics and 58.6% obese, 43.5% hypertensives and 37.8% had hyperlipidemia. 73% (n=372) presented as unstable angina (UA), 22.5% as NSTEMI (n=115) and only 4.5% as STEMI (n=23). The acute events occurred in 4.9% (n=25) before discharge, in 4.9% (n=25) within the first year and in 90.2% (n=460) thereafter. Most of the patients (92.2%; n=470) had stenosed or occluded venous bypass grafts at presentation, while a minority (7.8%; n=40) had significantly narrowed or occluded arterial grafts. CV risk profiles were similar in both groups. However, arterial graft disease occurred earlier after CABG and more likely presented as NSTEMI rather than UA compared to the SVG group. In 54.7% (n=279) primary PCI of the saphenous graft, and in 13.5% (n=69) of the native coronary arteries was performed, while 6.5% (n=33) underwent redo CABG and 25.3% (n=129) received medical treatment only. MACE at 1 year occurred in 12.2% (n=62) with repeated revascularization as the most common event (7.2%; n=37) followed by cardiac death (2.4%; n=12), MI (1.2%; n=6), cerebrovascular infarction (1.2%; n=6) and major bleeding (0.2%; n=1). Hypertensive and obese patients, those with myocardial infarction or an ACS before discharge or during the first year after CABG had higher MACCE. In patients undergoing pPCI the rate of cardiac death and MI at 1 year was lower with an intervention in the native coronary arteries and with redo CABG compared to pPCI of bypass grafts. CONCLUSION Thus, patients with ACS and prior CABG typically present as UA and much less frequently as NSTEMI-ACS and particularly STEMI. Most events occur after one year, particularly with SVG. The 1 year MACCE rate is comparable to those with native coronary artery ACS. Hypertensive and obese patients, those with MI or with an ACS before discharge had higher MACCE rates.
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Affiliation(s)
- Sharaf E D Mahmoud
- Department of Internal Medicine and Cardiology unit, Sohag University, Egypt.
| | - Mohammady Shahin
- University Heart Center, Department of Cardiology, University Hospital Zurich, Switzerland; Department of Internal Medicine and Cardiology unit, Sohag University, Egypt
| | - Nooraldaem Yousif
- University Heart Center, Department of Cardiology, University Hospital Zurich, Switzerland; Mohamed Bin Khalifa Cardiac Centre, Bahrain
| | - Andrea Denegri
- University Heart Center, Department of Cardiology, University Hospital Zurich, Switzerland; Division of Cardiology, Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy
| | - Lotfy H Abo Dahab
- Department of Internal Medicine and Cardiology unit, Sohag University, Egypt
| | - Thomas F Lüscher
- Royal Brompton and Harefield Hospital Trust and Imperial College, National Heart and Lung Institute, London, United Kingdom; Centre for Molecular Cardiology, Zurich University, Switzerland
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Immediate results of minimally invasive redo off-pump coronary artery bypass grafting. ACTA BIOMEDICA SCIENTIFICA 2021. [DOI: 10.29413/abs.2021-6.5.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Coronary heart disease (CHD) ranks first among the causes of death from cardiac events. Patients who have previously undergone surgical treatment – coronary artery bypass grafting (CABG) – are not immune from the return of angina due to the progression of atherosclerosis in the native coronary arteries or degenerative changes in the shunts. Therefore, the issue of redo surgery in this group of patients is debatable.The aim of the research is to show that the use of alternative sternotomy approaches and the rejection of artificial blood circulation (ABC) are considered as possible measures to improve the results of redo CABGs.Materials and methods. In the Cardiac Surgery Unit No. 1 of the Irkutsk Regional Clinical Hospital from 2003 to 2020, 6773 off-pump CABG surgeries were performed. Of these, 6338 (93.6 %) surgeries were performed using median sternotomy and 435 (6.4 %) surgeries were performed using minitoracotomy or subxyphoid access. Of the 6338 CABG surgeries performed using sternotomy, 58 (0.9 %) were performed repeatedly. All redo surgeries during the period under review were performed by minithoracotomy or subxyphoid access. The indication for redo surgery was the return of angina of III or IV functional class, which did not respond to optimal drug therapy. When performing 54 redo surgeries, the access was leftsided mini-thoracotomy. In 3 patients, CABG was performed by subxyphoid access and in 1 patient – from right-sided mini-thoracotomy.Results. 58 redo CABG surgeries were performed. There was no damage to the access of the heart or functioning shunts. Complications were noted in 5 (8.6 %) patients. In 1 case, a second operation was required due to bleeding from the intercostal artery. In other cases, there were rhythm disturbances, or the need for inotropic support.Conclusion. Performing redo off-pump CABG surgeries using mini-accesses reduces the risk of damage to the heart and functioning shunts, eliminates manipulations on the ascending aorta, and avoids difficulties with cardioplegic protection of the myocardium with a functioning mammarocoronary graft.
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Plateletcrit may predict no-reflow after saphenous vein graft interventions in patients with non-ST elevation myocardial infarction. Blood Coagul Fibrinolysis 2021; 32:194-199. [PMID: 33560004 DOI: 10.1097/mbc.0000000000001016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Saphenous vein graft (SVG) percutaneous coronary interventions (PCIs) are procedures with potential complications such as distal embolization, slow or no-reflow phenomenon. Platelets are the main factors in development of thrombus and no-reflow phenomenon. There have been multiple studies that identified the association between plateletcrit (PCT) and cardiovascular outcomes. The aim of the study was to investigate whether PCT can predict the development of no-reflow in patients with non-ST elevation myocardial infarction (NSTEMI) undergoing PCI for SVG disease. A total of 181 patients who underwent PCI for SVG disease with NSTEMI were included retrospectively. Platelet indices on admission were recorded. Patients were divided into two groups according to the development of no-reflow during the procedure: no-reflow (n = 32; 18%) and normal reflow (n = 149; 82%). PCT and platelet count were higher in the no-reflow group (0.254 vs. 0.224, P = 0.020; 265.4 vs. 233, P = 0.011, respectively). The PCT cut-off value for predicting no-reflow was calculated as 0.230 by ROC curve analysis with 68.8% sensitivity and 51.0% specificity. Multivariate logistic regression analysis showed that PCT was an independent predictor of no-reflow (odds ratio: 5.091, confidence interval: 1.356-19.116, P = 0.016). PCT may be useful in identifying patients at risk for developing no-reflow in patient with NSTEMI undergoing SVG PCI.
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Rahman MS, de Winter R, Nap A, Knaapen P. Advances in the Post-coronary Artery Bypass Graft Management of Occlusive Coronary Artery Disease. Interv Cardiol 2021; 16:e33. [PMID: 35106069 PMCID: PMC8785096 DOI: 10.15420/icr.2021.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 06/07/2021] [Indexed: 11/04/2022] Open
Abstract
Revascularisation of chronic total occlusion (CTO) represents one of the most challenging aspects of percutaneous coronary intervention, but advances in equipment and an understanding of CTO revascularisation techniques have resulted in considerable improvements in success rates. In patients with prior coronary artery bypass grafting (CABG) surgery, additional challenges are encountered. This article specifically explores these challenges, as well as antegrade methods of CTO crossing. Techniques, equipment that can be used and reference texts are highlighted with the aim of providing potential CTO operators adequate information to tackle additional complexities likely to be encountered in this cohort of patients. This review forms part of a wider series where additional aspects of patients with prior CABG should be factored into decisions and methods of revascularisation.
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Affiliation(s)
| | - Ruben de Winter
- Department of Cardiology, Amsterdam Medical Centre, VU Medical CentreAmsterdam, the Netherlands
| | - Alex Nap
- Department of Cardiology, Amsterdam Medical Centre, VU Medical CentreAmsterdam, the Netherlands
| | - Paul Knaapen
- Department of Cardiology, Amsterdam Medical Centre, VU Medical CentreAmsterdam, the Netherlands
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Stefanini GG, Alfonso F, Barbato E, Byrne R, Capodanno D, Colleran R, Escaned J, Giacoppo D, Kunadian V, Lansky A, Mehilli J, Neumann FJ, Regazzoli D, Sanz-Sanchez J, Wijns W, Baumbach A. Management of myocardial revascularisation failure: an expert consensus document of the EAPCI. EUROINTERVENTION 2020; 16:e875-e890. [DOI: 10.4244/eij-d-20-00487] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Mori M, Wang Y, Murugiah K, Khera R, Gupta A, Vallabhajosyula P, Masoudi FA, Geirsson A, Krumholz HM. Trends in Reoperative Coronary Artery Bypass Graft Surgery for Older Adults in the United States, 1998 to 2017. J Am Heart Assoc 2020; 9:e016980. [PMID: 33045889 PMCID: PMC7763387 DOI: 10.1161/jaha.120.016980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 06/24/2020] [Indexed: 12/20/2022]
Abstract
Background The likelihood of undergoing reoperative coronary artery bypass graft surgery (CABG) is important for older patients who are considering first-time CABG. Trends in the reoperative CABG for these patients are unknown. Methods and Results We used the Medicare fee-for-service inpatient claims data of adults undergoing isolated first-time CABG between 1998 and 2017. The primary outcome was time to first reoperative CABG within 5 years of discharge from the index surgery, treating death as a competing risk. We fitted a Cox regression to model the likelihood of reoperative CABG as a function of patient baseline characteristics. There were 1 666 875 unique patients undergoing first-time isolated CABG and surviving to hospital discharge. The median (interquartile range) age of patients did not change significantly over time (from 74 [69-78] in 1998 to 73 [69-78] in 2017); the proportion of women decreased from 34.8% to 26.1%. The 5-year rate of reoperative CABG declined from 0.77% (95% CI, 0.72%-0.82%) in 1998 to 0.23% (95% CI, 0.19%-0.28%) in 2013. The annual proportional decline in the 5-year rate of reoperative CABG overall was 6.6% (95% CI, 6.0%-7.1%) nationwide, which did not differ across subgroups, except the non-white non-black race group that had an annual decline of 8.5% (95% CI, 6.2%-10.7%). Conclusions Over a recent 20-year period, the Medicare fee-for-service patients experienced a significant decline in the rate of reoperative CABG. In this cohort of older adults, the rate of declining differed across demographic subgroups.
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Affiliation(s)
- Makoto Mori
- Section of Cardiac SurgeryYale School of MedicineNew HavenCT
- Center for Outcomes Research and EvaluationYale New Haven HospitalNew HavenCT
| | - Yun Wang
- Center for Outcomes Research and EvaluationYale New Haven HospitalNew HavenCT
- Department of BiostatisticsT.H. Chan School of Public HealthHarvard UniversityBostonMA
| | - Karthik Murugiah
- Center for Outcomes Research and EvaluationYale New Haven HospitalNew HavenCT
| | - Rohan Khera
- Division of CardiologyUT Southwestern Medical CenterDallasTX
- Present address:
Center for Outcomes Research and EvaluationYale New Haven HospitalNew HavenCT
- Present address:
Section of Cardiovascular MedicineDepartment of Internal MedicineYale School of MedicineNew HavenCT
| | - Aakriti Gupta
- Center for Outcomes Research and EvaluationYale New Haven HospitalNew HavenCT
- Division of CardiologyColumbia UniversityNew YorkNY
| | | | | | - Arnar Geirsson
- Section of Cardiac SurgeryYale School of MedicineNew HavenCT
| | - Harlan M. Krumholz
- Center for Outcomes Research and EvaluationYale New Haven HospitalNew HavenCT
- Section of Cardiovascular MedicineDepartment of Internal MedicineYale School of MedicineNew HavenCT
- Department of Health Policy and ManagementYale School of Public HealthNew HavenCT
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16
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Mohamed MO, Shoaib A, Gogas B, Patel T, Alraies MC, Velagapudi P, Chugh S, Sharma K, Mohamed W, Murphy GJ, Kwok CS, Rashid M, Bagur R, Mamas MA. Trends of repeat revascularization choice in patients with prior coronary artery bypass surgery. Catheter Cardiovasc Interv 2020; 98:470-480. [PMID: 32890452 DOI: 10.1002/ccd.29234] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 08/06/2020] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To examine rates and predictors repeat revascularization strategies (percutaneous coronary intervention [PCI] and coronary artery bypass grafting [CABG]) in patients with prior CABG. METHODS Using the National Inpatient Sample, patients with a history of CABG hospitalized for revascularization by PCI or CABG from January 2004 to September 2015 were included. Regression analyses were performed to examine predictors of receipt of either revascularization strategy as well as in-hospital outcomes. RESULTS The rate of redo CABG doubled between 2004 (5.3%) and 2015 (10.3%). Patients who underwent redo CABG were more comorbid and experienced significantly worse major adverse cardiovascular and cerebrovascular events (odds ratio [OR]: 5.36 95% CI 5.11-5.61), mortality (OR 2.84 95% CI 2.60,-3.11), bleeding (OR 5.97 95% CI 5.44-6.55) and stroke (OR 2.15 95% CI 1.92-2.41), but there was no difference in cardiac complications between groups. Thoracic complications were high in patients undergoing redo CABG (8%), especially in females. Factors favoring receipt of redo CABG compared to PCI included male sex, age < 80 years, and absence of diabetes and renal failure. CONCLUSION Reoperation in patients with prior CABG has doubled in the United States over a 12-year period. Patients undergoing redo CABG are more complex and associated with worse clinical outcomes than those receiving PCI.
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Affiliation(s)
- Mohamed O Mohamed
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Keele, UK.,Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK
| | - Ahmad Shoaib
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Keele, UK.,Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK
| | - Bill Gogas
- Department of Cardiology, Nanjing University, Nanjing, China
| | - Tejas Patel
- Department of Cardiology, Apex Heart Institute, Ahmadabad, India
| | - M Chadi Alraies
- Department of Cardiology, Wayne State University, Detroit Medical Center, Detroit, Michigan, USA
| | - Poonam Velagapudi
- Department of Cardiology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Sanjay Chugh
- Department of Cardiology, JNU Hospital and Medical Center, Jaipur, Rajasthan, India
| | - Kamal Sharma
- Department of Cardiology, UN MEHTA ICRC, BJ Medical College, Ahmedabad, Gujarat, India
| | - Walid Mohamed
- Department of Cardiac Surgery, University Hospitals of Leicester NHS Foundation Trust, Leicester, UK
| | - Gavin J Murphy
- Department of Cardiac Surgery, University Hospitals of Leicester NHS Foundation Trust, Leicester, UK
| | - Chun Shing Kwok
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Keele, UK.,Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK
| | - Muhammad Rashid
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Keele, UK
| | - Rodrigo Bagur
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Keele, UK
| | - Mamas A Mamas
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Keele, UK.,Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK
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Long-term clinical outcomes after a percutaneous coronary intervention with a drug-eluting stent in patients with unprotected left main coronary artery disease excluded from clinical trials. Coron Artery Dis 2020; 30:239-248. [PMID: 30688673 DOI: 10.1097/mca.0000000000000718] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Major randomized clinical trials assessing clinical outcomes in patients who underwent a percutaneous coronary intervention (PCI) for left main coronary artery disease excluded some high-risk subsets. Whether the effectiveness and safety of a percutaneous approach in this group of patients are comparable with those observed in clinical trials is unclear. We aimed to explore the long-term outcomes of contemporary drug-eluting stent (DES)-based revascularization for left main coronary artery disease in patients presenting with one or more clinical or angiographic characteristics who would have precluded inclusion in randomized trials. PATIENTS AND METHODS Between April 2003 and December 2011, 340 consecutive patients with unprotected left main coronary artery stenosis of at least 50% who underwent successful PCI with DES at Sejong General Hospital (Bucheon, Republic of Korea) were included in this retrospective study. Patients were classified into the exclusion group (group E; n=120) and the inclusion group (group I; n=220) according to the prespecified inclusion and exclusion criteria utilized in clinical trials. RESULTS During the median follow-up of 86 (52-114) months, major adverse cardiac or cerebrovascular events occurred in 69 (31.4%) patients in group I and 46 (38.3%) patients in group E (P=0.155). In the propensity score-matched population, group E was not associated with a higher incidence of major adverse cardiac or cerebrovascular events (hazard ratio: 1.42, 95% confidence interval: 0.76-2.65, P=0.758). Definite or probable stent thrombosis occurred in five patients of group I, with no cases in group E. CONCLUSION In our real-world registry, about a third of patients who underwent PCI for unprotected left main coronary artery stenosis had one or more high-risk characteristics or comorbid conditions that represent exclusion criteria of previous randomized trials. PCI using DES is feasible in these patients.
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18
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Neumann FJ, Sousa-Uva M, Ahlsson A, Alfonso F, Banning AP, Benedetto U, Byrne RA, Collet JP, Falk V, Head SJ, Jüni P, Kastrati A, Koller A, Kristensen SD, Niebauer J, Richter DJ, Seferovic PM, Sibbing D, Stefanini GG, Windecker S, Yadav R, Zembala MO. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur Heart J 2020; 40:87-165. [PMID: 30165437 DOI: 10.1093/eurheartj/ehy394] [Citation(s) in RCA: 3993] [Impact Index Per Article: 998.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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19
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Tarasov RS, Bakovskiĭ KV, Vereshchagin IE, Ivanov SV, Barbarash LS. [Peculiarities of the development of acute coronary syndrome in patients after coronary artery bypass grafting]. ANGIOLOGII︠A︡ I SOSUDISTAI︠A︡ KHIRURGII︠A︡ = ANGIOLOGY AND VASCULAR SURGERY 2020; 26:149-155. [PMID: 32597896 DOI: 10.33529/angio2020226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIM The purpose of the study was to analyse clinical peculiarities of the development of acute coronary syndrome in patients after coronary artery bypass grafting procedures and to evaluate the in-hospital results of treatment PATIENTS AND METHODS: Within the frameworks of a single-centre register over the period from 2006 to 2016 the study included 81 patients (with a total of more than 5000 coronary artery bypass grafting operations performed during this period). We examined the preoperative, intraoperative, and in-hospital periods, as well as the patients' status at the moment of the development of the clinical course of acute coronary syndrome, its structure and terms of manifestation, the dynamics of the coronary bed condition, also carrying out the analysis of treatment strategies and the in-hospital outcomes thereof. RESULTS The development of acute coronary syndrome after coronary artery bypass grafting procedures was revealed in patients with a mean age of 58 (52; 63) years, with a history of postinfarction cardiosclerosis (70.37%), arterial hypertension (92.59%), dyslipidemia (51.83%), obesity (77.78%) and a multiple-vessel lesion of the coronary bed (67.90%) of intermediate risk according to the SYNTAX score estimated as an average of 26 (22; 32) points. In the structure of acute coronary syndrome having developed in patients with previously endured coronary artery bypass grafting operations, prevailing was its form of non-ST-segment elevation (87.65%), predominantly of a low risk (61.73%) which manifested itself averagely 24 (12; 35) months after the operation. The main factor of the development of acute coronary syndrome was progression of atherosclerosis (60.49%). The dominating strategy of treatment was medicamentous therapy (55.56%). The in-hospital mortality rate amounted to 2.47%. In the dynamics of the clinical status of the patients prior to coronary artery bypass grafting by the moment of the manifestation of acute cardiac ischaemia there took place a significant decrease in the left ventricular ejection fraction (p=0.01) and progression of atherosclerosis to the multifocal status (p=0.004). CONCLUSION Patients with acute coronary syndrome, having previously endured coronary artery bypass grafting procedures appear to belong to a special cohort presenting with a series of clinical peculiarities and despite satisfactory in-hospital results do require special attention, with the development of appropriate algorithms for risk stratification and optimal therapeutic decision-making.
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Affiliation(s)
- R S Tarasov
- Research Institute for Complex Problems of Cardiovascular Diseases, Kemerovo, Russia
| | - K V Bakovskiĭ
- Research Institute for Complex Problems of Cardiovascular Diseases, Kemerovo, Russia
| | - I E Vereshchagin
- Research Institute for Complex Problems of Cardiovascular Diseases, Kemerovo, Russia
| | - S V Ivanov
- Research Institute for Complex Problems of Cardiovascular Diseases, Kemerovo, Russia
| | - L S Barbarash
- Research Institute for Complex Problems of Cardiovascular Diseases, Kemerovo, Russia
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20
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Ma X, Dong R, Chen P, Zhao Y, Zeng C, Xin M, Ye Q, Wang J. Percutaneous coronary intervention in diabetic versus non-diabetic patients with prior coronary artery bypass grafting: a propensity score matching study. BMC Cardiovasc Disord 2020; 20:159. [PMID: 32252636 PMCID: PMC7137249 DOI: 10.1186/s12872-020-01447-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 03/25/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The target of this study was to explore the outcomes of percutaneous coronary intervention (PCI) in diabetic versus non-diabetic patients with prior coronary artery bypass grafting (CABG) surgery. METHODS Seven hundred and twenty four patients who had previously received CABG and had been treated using PCI combined with drug-eluting stents (DES) between 2009 and 2017 were selected for a retrospective study and allocated into either a diabetes mellitus (DM) or non-diabetes mellitus (No DM) group. A 1:1 propensity score-matched evaluation was conducted and risk adjusted for analysis. The primary outcomes were cardiac death, myocardial infarction, heart failure and revascularization, with a median follow-up duration of 5.13 years. RESULTS After matching, two-, 5- and 8-year event rate of overall major adverse cardiac events (MACEs) were found to be higher in the DM group (No DM vs DM:15.3, 30.9, 38.5% vs 19.8, 37.8, 52.2%, respectively), although no significant difference was found in the event rate of overall MACEs (hazard ratio [HR]: 1.35; 95% confidence interval [CI]: 1.00 to 1.83 for DM vs No DM; P = 0.052), cardiac death (HR: 0.94; 95% CI: 0.45 to 1.95; P = 0.871), MI (HR: 1.49; 95% CI: 0.95 to 2.32; P = 0.080), HF (HR: 1.54; 95% CI: 0.90 to 2.63 for; P = 0.120) or revascularization (HR: 1.07; 95% CI: 0.72 to 1.59; P = 0.747). Subgroup analysis of PCI in only the NCA showed MACEs (adjusted HR: 1.13; 95% CI: 0.85 to 1.49 for DM vs No DM; P = 0.325), cardiac death (adjusted HR: 0.85; 95% CI: 0.41 to 1.78 for DM vs No DM; P = 0.781), MI (adjusted HR: 1.32; 95% CI: 0.84 to 2.01 for DM vs No DM; P = 0.069), HF (adjusted HR: 1.41; 95% CI: 0.87 to 2.27 for DM vs No DM; P = 0.211) or repeated revascularization (adjusted HR: 0.93; 95% CI: 0.64 to 1.37 for DM vs No DM; P = 0.836). CONCLUSIONS Compared with non-diabetic patients with prior CABG, subsequent implantation of DES in the native coronary artery of diabetic patients resulted in apparently similar outcomes. TRIAL REGISTRATION This study was not registered in an open access database.
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Affiliation(s)
- Xiaolong Ma
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Ran Dong
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Pengfei Chen
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yichen Zhao
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Caiwu Zeng
- Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Meng Xin
- Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Qing Ye
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Jiangang Wang
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
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21
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Ma X, Chen P, Zhao Y, Zeng C, Xin M, Ye Q, Wang J. Coronary Angiography Characteristics of Symptomatic Patients with Prior Coronary Artery Bypass Graft: A Descriptive Study. BIOMED RESEARCH INTERNATIONAL 2019; 2019:1832128. [PMID: 31815124 PMCID: PMC6877980 DOI: 10.1155/2019/1832128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 09/11/2019] [Accepted: 09/21/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The target of this study was to explore the coronary angiography characteristics for symptomatic patients with prior coronary artery bypass graft (CABG). METHODS Between 2009 and 2017, 993 patients who had undergone CABG but subsequently suffered recurrent symptoms in Beijing Anzhen Hospital were selected for this study and divided into either medical therapy (MT) group (n = 351) or percutaneous coronary intervention (PCI) group (n = 642) based on the treatment. Clinical data were analyzed between two groups. RESULTS Patients in the MT group were older and more likely to have chronic lung disease (6.6% vs 3.4%, P=0.026) while patients in the PCI group were more likely to have prior MI (8.8% vs 17.0%, P < 0.001). In the MT group, 54.4% of patients had newly developed lesions both in the graft and native coronary artery while 58.1% in the PCI group (P=0.003), and in the MT group, 80.6% had type C coronary artery disease while 60.1% in the PCI group (P < 0.001). Patients in the MT group presented higher proportion of diffuse lesions (49.3% vs 15.0%, P < 0.001) in native coronary arteries. CONCLUSION Patients receiving MT (35.3%) likely had occluded grafts and type C coronary artery disease featuring as diffuse lesions.
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Affiliation(s)
- Xiaolong Ma
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Pengfei Chen
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yicheng Zhao
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Caiwu Zeng
- Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Meng Xin
- Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Qing Ye
- Department of Cardiac Surgery, Beijing Huaxin Hospital, First Hospital of Tsinghua University, Beijing, China
| | - Jiangang Wang
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
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22
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Locker C, Greiten LE, Bell MR, Frye RL, Lerman A, Daly RC, Greason KL, Said SM, Lahr BD, Stulak JM, Dearani JA, Schaff HV. Repeat Coronary Bypass Surgery or Percutaneous Coronary Intervention After Previous Surgical Revascularization. Mayo Clin Proc 2019; 94:1743-1752. [PMID: 31486379 DOI: 10.1016/j.mayocp.2019.01.048] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 12/11/2018] [Accepted: 01/10/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess long-term survival with repeat coronary artery bypass grafting (RCABG) or percutaneous coronary intervention (PCI) in patients with previous CABG. METHODS From January 1, 2000, through December 31, 2013, 1612 Mayo Clinic patients underwent RCABG (n=215) or PCI (n=1397) after previous CABG. The RCABG cohort was grouped by use of saphenous vein grafts only (n=75), or with additional arterial grafts (n=140); the PCI cohort by, bare metal stents (BMS; n=628), or drug-eluting stents (DES; n=769), and by the treated target into native coronary artery (n=943), bypass grafts only (n=338), or both (n=116). Multivariable regression and propensity score analysis (n=280 matched patients) were used. RESULTS In multivariable analysis, the 30-day mortality was increased in RCABG versus PCI patients (hazard ratio [HR], 5.32; 95%CI, 2.34-12.08; P<.001), but overall survival after 30 days improved with RCABG (HR, 0.72; 95% CI, 0.55-0.94; P=.01). Internal mammary arteries were used in 61% (129 of 215) of previous CABG patients and improved survival (HR, 0.82; 95% CI, 0.69-0.98; P=.03). Patients treated with drug-eluting stent had better 10-year survival (HR, 0.74; 95% CI, 0.59-0.91; P=.001) than those with bare metal stent alone. In matched patients, RCABG had improved late survival over PCI: 48% vs 33% (HR, 0.57; 95% CI, 0.35-0.91; P=.02). Compared with RCABG, patients with PCI involving bypass grafts (n=60) had increased late mortality (HR, 1.62; 95% CI, 1.10-2.37; P=.01), whereas those having PCI of native coronary arteries (n=80) did not (HR, 1.09; 95% CI, 0.75-1.59; P=.65). CONCLUSION RCABG is associated with improved long-term survival after previous CABG, especially compared with PCI involving bypass grafts.
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Affiliation(s)
- Chaim Locker
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN.
| | | | - Malcolm R Bell
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
| | - Robert L Frye
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
| | - Amir Lerman
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
| | - Richard C Daly
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN
| | - Kevin L Greason
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN
| | - Sameh M Said
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN
| | - Brian D Lahr
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN
| | - John M Stulak
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN
| | - Joseph A Dearani
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN
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Neumann FJ, Sousa-Uva M, Ahlsson A, Alfonso F, Banning AP, Benedetto U, Byrne RA, Collet JP, Falk V, Head SJ, Jüni P, Kastrati A, Koller A, Kristensen SD, Niebauer J, Richter DJ, Seferović PM, Sibbing D, Stefanini GG, Windecker S, Yadav R, Zembala MO. 2018 ESC/EACTS Guidelines on myocardial revascularization. EUROINTERVENTION 2019; 14:1435-1534. [PMID: 30667361 DOI: 10.4244/eijy19m01_01] [Citation(s) in RCA: 310] [Impact Index Per Article: 62.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Franz-Josef Neumann
- Department of Cardiology & Angiology II, University Heart Center Freiburg-Bad Krozingen, Bad Krozingen, Germany
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Shavelle DM, Banerjee S, Maini B, Schreiber TL, Kapasi N, O'Neill WW, Popma J, Matthews RV. Comparison of Outcomes of Percutaneous Coronary Intervention on Native Coronary Arteries Versus on Saphenous Venous Aorta Coronary Conduits in Patients With Low Left Ventricular Ejection Fraction and Impella Device Implantation Achieved or Attempted (from the PROTECT II Randomized Trial and the cVAD Registry). Am J Cardiol 2018; 122:966-972. [PMID: 30057231 DOI: 10.1016/j.amjcard.2018.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 05/31/2018] [Accepted: 06/06/2018] [Indexed: 11/17/2022]
Abstract
Patients with prior coronary artery bypass grafting (CABG) represent a high-risk cohort given associated medical conditions and worse outcome of saphenous vein graft compared with native vessel percutaneous coronary intervention (PCI). The goal of the current analysis was to compare clinical outcomes in 591 patients with and without prior CABG and multivessel coronary artery disease or unprotected left main disease and severely reduced left ventricular systolic function underwent Impella supported PCI from the PROTECT II randomized trial and the cVAD Registry. Patients with prior CABG surgery (n = 201) were compared with those without prior CABG surgery (n = 390). The primary end point of this analysis was overall mortality at 30 days. Patients with prior CABG surgery had greater Society of Thoracic Surgery mortality score compared with patients without prior CABG surgery, 7.6 ± 6.4 versus 5.1 ± 5.5, respectively, p <0.001. Saphenous vein graft PCI was performed in 17% of patients with prior CABG surgery. Number of vessels treated was lower in patients with prior CABG surgery compared with patients without prior CABG surgery, 1.66 ± 0.56 versus 1.89 ± 0.64, respectively, p <0.001. Achievement of TIMI 3 flow post PCI and overall PCI success was similar in the two groups. Overall mortality at 30 days was similar in patients with prior CABG surgery compared with patients without prior CABG surgery, 6.75% versus 6.61%, respectively, p = 1.0. In conclusion, in this high-risk cohort of patients underwent hemodynamically supported PCI, prior CABG surgery was not associated with worse outcome. The use of hemodynamic support appears to mitigate the increased risk of PCI associated with prior CABG.
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Affiliation(s)
- David M Shavelle
- Division of Cardiovascular Medicine, University of Southern California, Los Angeles, California.
| | - Subhash Banerjee
- Veterans Affairs North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, Texas
| | | | | | - Neel Kapasi
- Division of Cardiovascular Medicine, University of Southern California, Los Angeles, California
| | | | - Jeffrey Popma
- Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Ray V Matthews
- Division of Cardiovascular Medicine, University of Southern California, Los Angeles, California
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Sousa-Uva M, Neumann FJ, Ahlsson A, Alfonso F, Banning AP, Benedetto U, Byrne RA, Collet JP, Falk V, Head SJ, Jüni P, Kastrati A, Koller A, Kristensen SD, Niebauer J, Richter DJ, Seferovic PM, Sibbing D, Stefanini GG, Windecker S, Yadav R, Zembala MO. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur J Cardiothorac Surg 2018; 55:4-90. [PMID: 30165632 DOI: 10.1093/ejcts/ezy289] [Citation(s) in RCA: 347] [Impact Index Per Article: 57.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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26
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Ellis AG, Trikalinos TA, Wessler BS, Wong JB, Dahabreh IJ. Propensity Score-Based Methods in Comparative Effectiveness Research on Coronary Artery Disease. Am J Epidemiol 2018; 187:1064-1078. [PMID: 28992207 DOI: 10.1093/aje/kwx214] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 03/30/2017] [Indexed: 12/20/2022] Open
Abstract
This review examines the conduct and reporting of observational studies using propensity score-based methods to compare coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), or medical therapy for patients with coronary artery disease. A systematic selection process identified 48 studies: 20 addressing CABG versus PCI; 21 addressing bare-metal stents versus drug-eluting stents; 5 addressing CABG versus medical therapy; 1 addressing PCI versus medical therapy; and 1 addressing drug-eluting stents versus balloon angioplasty. Of 32 studies reporting information on variable selection, 7 relied exclusively on statistical criteria for the association of covariates with treatment, and 5 used such criteria to determine whether product or nonlinear terms should be included in the propensity score model. Twenty-five (52%) studies reported assessing covariate balance using the estimated propensity score, but only 1 described modifications to the propensity score model based on this assessment. The over 400 variables used in the 48 propensity score models were classified into 12 categories and 60 subcategories; only 17 subcategories were represented in at least half of the propensity score models. Overall, reporting of propensity score-based methods in observational studies comparing CABG, PCI, and medical therapy was incomplete; when adequately described, the methods used were often inconsistent with current methodological standards.
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Affiliation(s)
- Alexandra G Ellis
- Center for Evidence Synthesis in Health, School of Public Health, Brown University, Providence, Rhode Island
- Department of Health Services, Policy, and Practice, School of Public Health, Brown University, Providence, Rhode Island
| | - Thomas A Trikalinos
- Center for Evidence Synthesis in Health, School of Public Health, Brown University, Providence, Rhode Island
- Department of Health Services, Policy, and Practice, School of Public Health, Brown University, Providence, Rhode Island
| | - Benjamin S Wessler
- Predictive Analytics and Comparative Effectiveness Center, Tufts Medical Center, Boston, Massachusetts
- Department of Cardiology, Tufts Medical Center, Boston, Massachusetts
| | - John B Wong
- Division of Clinical Decision Making, Department of Medicine, Tufts Medical Center, Boston, Massachusetts
| | - Issa J Dahabreh
- Center for Evidence Synthesis in Health, School of Public Health, Brown University, Providence, Rhode Island
- Department of Health Services, Policy, and Practice, School of Public Health, Brown University, Providence, Rhode Island
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island
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Miyagi T, Asaumi Y, Nishimura K, Nakashima T, Sakamoto H, Nakao K, Kanaya T, Nagai T, Shimabukuro Y, Miyamoto Y, Fujita T, Kusano K, Anzai T, Kobayashi J, Noguchi T, Ogawa H, Yasuda S. Validation of the Coronary Artery Bypass Graft SYNTAX Score (Synergy Between Percutaneous Coronary Intervention With Taxus) as a Prognostic Marker for Patients With Previous Coronary Artery Bypass Graft Surgery After Percutaneous Coronary Intervention. Circ Cardiovasc Interv 2017; 9:CIRCINTERVENTIONS.115.003459. [PMID: 27578838 DOI: 10.1161/circinterventions.115.003459] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 08/02/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND The efficacy and prognosis of percutaneous coronary intervention (PCI) as secondary revascularization in patients with previous coronary artery bypass graft surgery remain uncertain. METHODS AND RESULTS We retrospectively evaluated 434 consecutive patients with previous coronary artery bypass graft surgery hospitalized for PCI between 2004 and 2011 (men 84%, age 71 (interquartile range, 66-76) years) and calculated the coronary artery bypass graft Synergy Between Percutaneous Coronary Intervention With Taxus score (CSS) before (baseline CSS) and after PCI (post-PCI CSS). Patients were divided into 2 groups based on median post-PCI CSS: low-score (≤23; n=217) and high-score groups (>23; n=217). Major adverse cardiovascular events (MACE) were defined as the composite of cardiovascular death, myocardial infarction, and unplanned repeat revascularization for myocardial ischemia. The median baseline and post-PCI CSS were 30 (interquartile range, 21-40) and 23 (interquartile range, 14.5-33.5), respectively. During a median follow-up of 69 months, the prevalence of MACE and cardiac death differed significantly between the 2 post-PCI CSS groups (MACE: low, 13.8%; high, 28.6%; P<0.001; cardiac death: low, 6.2%; high, 16.7%; P=0.002). In multivariable analysis, the high post-PCI CSS divided by the median was associated with substantially greater cumulative MACE (hazard ratio, 2.09; 95% confidence interval, 1.31-3.34; P=0.002) and cardiac death (hazard ratio, 2.02; 95% confidence interval, 1.03-3.98; P=0.042) compared with the low post-PCI CSS. Net reclassification improvement analysis revealed that post-PCI CSS resulted in significantly improved prediction of MACE and cardiac death compared with baseline CSS. CONCLUSIONS In this external validation study, the CSS was a potential prognostic factor after subsequent PCI, even for previous coronary artery bypass graft surgery patients.
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Affiliation(s)
- Tadayoshi Miyagi
- From the Department of Cardiovascular Medicine (T.M., Y.A., T. Nakashima, H.S., K.N., T.K., T. Nagai, K.K., T.A., T. Noguchi, S.Y.), Department of Preventive Medicine and Epidemiologic Informatics (K.N., Y.M.), and Department of Cardiovascular Surgery (T.F., J.K.), National Cerebral and Cardiovascular Center Hospital, Suita, Japan; Division of Cardiology, Okinawa Chubu Hospital, Uruma, Japan (T.M., Y.S.); Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan (T.M., T.A., S.Y.); and National Cerebral and Cardiovascular Center, Suita, Japan (H.O.)
| | - Yasuhide Asaumi
- From the Department of Cardiovascular Medicine (T.M., Y.A., T. Nakashima, H.S., K.N., T.K., T. Nagai, K.K., T.A., T. Noguchi, S.Y.), Department of Preventive Medicine and Epidemiologic Informatics (K.N., Y.M.), and Department of Cardiovascular Surgery (T.F., J.K.), National Cerebral and Cardiovascular Center Hospital, Suita, Japan; Division of Cardiology, Okinawa Chubu Hospital, Uruma, Japan (T.M., Y.S.); Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan (T.M., T.A., S.Y.); and National Cerebral and Cardiovascular Center, Suita, Japan (H.O.).
| | - Kunihiro Nishimura
- From the Department of Cardiovascular Medicine (T.M., Y.A., T. Nakashima, H.S., K.N., T.K., T. Nagai, K.K., T.A., T. Noguchi, S.Y.), Department of Preventive Medicine and Epidemiologic Informatics (K.N., Y.M.), and Department of Cardiovascular Surgery (T.F., J.K.), National Cerebral and Cardiovascular Center Hospital, Suita, Japan; Division of Cardiology, Okinawa Chubu Hospital, Uruma, Japan (T.M., Y.S.); Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan (T.M., T.A., S.Y.); and National Cerebral and Cardiovascular Center, Suita, Japan (H.O.)
| | - Takahiro Nakashima
- From the Department of Cardiovascular Medicine (T.M., Y.A., T. Nakashima, H.S., K.N., T.K., T. Nagai, K.K., T.A., T. Noguchi, S.Y.), Department of Preventive Medicine and Epidemiologic Informatics (K.N., Y.M.), and Department of Cardiovascular Surgery (T.F., J.K.), National Cerebral and Cardiovascular Center Hospital, Suita, Japan; Division of Cardiology, Okinawa Chubu Hospital, Uruma, Japan (T.M., Y.S.); Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan (T.M., T.A., S.Y.); and National Cerebral and Cardiovascular Center, Suita, Japan (H.O.)
| | - Hiroki Sakamoto
- From the Department of Cardiovascular Medicine (T.M., Y.A., T. Nakashima, H.S., K.N., T.K., T. Nagai, K.K., T.A., T. Noguchi, S.Y.), Department of Preventive Medicine and Epidemiologic Informatics (K.N., Y.M.), and Department of Cardiovascular Surgery (T.F., J.K.), National Cerebral and Cardiovascular Center Hospital, Suita, Japan; Division of Cardiology, Okinawa Chubu Hospital, Uruma, Japan (T.M., Y.S.); Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan (T.M., T.A., S.Y.); and National Cerebral and Cardiovascular Center, Suita, Japan (H.O.)
| | - Kazuhiro Nakao
- From the Department of Cardiovascular Medicine (T.M., Y.A., T. Nakashima, H.S., K.N., T.K., T. Nagai, K.K., T.A., T. Noguchi, S.Y.), Department of Preventive Medicine and Epidemiologic Informatics (K.N., Y.M.), and Department of Cardiovascular Surgery (T.F., J.K.), National Cerebral and Cardiovascular Center Hospital, Suita, Japan; Division of Cardiology, Okinawa Chubu Hospital, Uruma, Japan (T.M., Y.S.); Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan (T.M., T.A., S.Y.); and National Cerebral and Cardiovascular Center, Suita, Japan (H.O.)
| | - Tomoaki Kanaya
- From the Department of Cardiovascular Medicine (T.M., Y.A., T. Nakashima, H.S., K.N., T.K., T. Nagai, K.K., T.A., T. Noguchi, S.Y.), Department of Preventive Medicine and Epidemiologic Informatics (K.N., Y.M.), and Department of Cardiovascular Surgery (T.F., J.K.), National Cerebral and Cardiovascular Center Hospital, Suita, Japan; Division of Cardiology, Okinawa Chubu Hospital, Uruma, Japan (T.M., Y.S.); Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan (T.M., T.A., S.Y.); and National Cerebral and Cardiovascular Center, Suita, Japan (H.O.)
| | - Toshiyuki Nagai
- From the Department of Cardiovascular Medicine (T.M., Y.A., T. Nakashima, H.S., K.N., T.K., T. Nagai, K.K., T.A., T. Noguchi, S.Y.), Department of Preventive Medicine and Epidemiologic Informatics (K.N., Y.M.), and Department of Cardiovascular Surgery (T.F., J.K.), National Cerebral and Cardiovascular Center Hospital, Suita, Japan; Division of Cardiology, Okinawa Chubu Hospital, Uruma, Japan (T.M., Y.S.); Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan (T.M., T.A., S.Y.); and National Cerebral and Cardiovascular Center, Suita, Japan (H.O.)
| | - Yuji Shimabukuro
- From the Department of Cardiovascular Medicine (T.M., Y.A., T. Nakashima, H.S., K.N., T.K., T. Nagai, K.K., T.A., T. Noguchi, S.Y.), Department of Preventive Medicine and Epidemiologic Informatics (K.N., Y.M.), and Department of Cardiovascular Surgery (T.F., J.K.), National Cerebral and Cardiovascular Center Hospital, Suita, Japan; Division of Cardiology, Okinawa Chubu Hospital, Uruma, Japan (T.M., Y.S.); Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan (T.M., T.A., S.Y.); and National Cerebral and Cardiovascular Center, Suita, Japan (H.O.)
| | - Yoshihiro Miyamoto
- From the Department of Cardiovascular Medicine (T.M., Y.A., T. Nakashima, H.S., K.N., T.K., T. Nagai, K.K., T.A., T. Noguchi, S.Y.), Department of Preventive Medicine and Epidemiologic Informatics (K.N., Y.M.), and Department of Cardiovascular Surgery (T.F., J.K.), National Cerebral and Cardiovascular Center Hospital, Suita, Japan; Division of Cardiology, Okinawa Chubu Hospital, Uruma, Japan (T.M., Y.S.); Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan (T.M., T.A., S.Y.); and National Cerebral and Cardiovascular Center, Suita, Japan (H.O.)
| | - Tomoyuki Fujita
- From the Department of Cardiovascular Medicine (T.M., Y.A., T. Nakashima, H.S., K.N., T.K., T. Nagai, K.K., T.A., T. Noguchi, S.Y.), Department of Preventive Medicine and Epidemiologic Informatics (K.N., Y.M.), and Department of Cardiovascular Surgery (T.F., J.K.), National Cerebral and Cardiovascular Center Hospital, Suita, Japan; Division of Cardiology, Okinawa Chubu Hospital, Uruma, Japan (T.M., Y.S.); Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan (T.M., T.A., S.Y.); and National Cerebral and Cardiovascular Center, Suita, Japan (H.O.)
| | - Kengo Kusano
- From the Department of Cardiovascular Medicine (T.M., Y.A., T. Nakashima, H.S., K.N., T.K., T. Nagai, K.K., T.A., T. Noguchi, S.Y.), Department of Preventive Medicine and Epidemiologic Informatics (K.N., Y.M.), and Department of Cardiovascular Surgery (T.F., J.K.), National Cerebral and Cardiovascular Center Hospital, Suita, Japan; Division of Cardiology, Okinawa Chubu Hospital, Uruma, Japan (T.M., Y.S.); Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan (T.M., T.A., S.Y.); and National Cerebral and Cardiovascular Center, Suita, Japan (H.O.)
| | - Toshihisa Anzai
- From the Department of Cardiovascular Medicine (T.M., Y.A., T. Nakashima, H.S., K.N., T.K., T. Nagai, K.K., T.A., T. Noguchi, S.Y.), Department of Preventive Medicine and Epidemiologic Informatics (K.N., Y.M.), and Department of Cardiovascular Surgery (T.F., J.K.), National Cerebral and Cardiovascular Center Hospital, Suita, Japan; Division of Cardiology, Okinawa Chubu Hospital, Uruma, Japan (T.M., Y.S.); Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan (T.M., T.A., S.Y.); and National Cerebral and Cardiovascular Center, Suita, Japan (H.O.)
| | - Junjirou Kobayashi
- From the Department of Cardiovascular Medicine (T.M., Y.A., T. Nakashima, H.S., K.N., T.K., T. Nagai, K.K., T.A., T. Noguchi, S.Y.), Department of Preventive Medicine and Epidemiologic Informatics (K.N., Y.M.), and Department of Cardiovascular Surgery (T.F., J.K.), National Cerebral and Cardiovascular Center Hospital, Suita, Japan; Division of Cardiology, Okinawa Chubu Hospital, Uruma, Japan (T.M., Y.S.); Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan (T.M., T.A., S.Y.); and National Cerebral and Cardiovascular Center, Suita, Japan (H.O.)
| | - Teruo Noguchi
- From the Department of Cardiovascular Medicine (T.M., Y.A., T. Nakashima, H.S., K.N., T.K., T. Nagai, K.K., T.A., T. Noguchi, S.Y.), Department of Preventive Medicine and Epidemiologic Informatics (K.N., Y.M.), and Department of Cardiovascular Surgery (T.F., J.K.), National Cerebral and Cardiovascular Center Hospital, Suita, Japan; Division of Cardiology, Okinawa Chubu Hospital, Uruma, Japan (T.M., Y.S.); Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan (T.M., T.A., S.Y.); and National Cerebral and Cardiovascular Center, Suita, Japan (H.O.)
| | - Hisao Ogawa
- From the Department of Cardiovascular Medicine (T.M., Y.A., T. Nakashima, H.S., K.N., T.K., T. Nagai, K.K., T.A., T. Noguchi, S.Y.), Department of Preventive Medicine and Epidemiologic Informatics (K.N., Y.M.), and Department of Cardiovascular Surgery (T.F., J.K.), National Cerebral and Cardiovascular Center Hospital, Suita, Japan; Division of Cardiology, Okinawa Chubu Hospital, Uruma, Japan (T.M., Y.S.); Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan (T.M., T.A., S.Y.); and National Cerebral and Cardiovascular Center, Suita, Japan (H.O.)
| | - Satoshi Yasuda
- From the Department of Cardiovascular Medicine (T.M., Y.A., T. Nakashima, H.S., K.N., T.K., T. Nagai, K.K., T.A., T. Noguchi, S.Y.), Department of Preventive Medicine and Epidemiologic Informatics (K.N., Y.M.), and Department of Cardiovascular Surgery (T.F., J.K.), National Cerebral and Cardiovascular Center Hospital, Suita, Japan; Division of Cardiology, Okinawa Chubu Hospital, Uruma, Japan (T.M., Y.S.); Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan (T.M., T.A., S.Y.); and National Cerebral and Cardiovascular Center, Suita, Japan (H.O.)
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McKavanagh P, Yanagawa B, Zawadowski G, Cheema A. Management and Prevention of Saphenous Vein Graft Failure: A Review. Cardiol Ther 2017; 6:203-223. [PMID: 28748523 PMCID: PMC5688971 DOI: 10.1007/s40119-017-0094-6] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Indexed: 12/16/2022] Open
Abstract
Coronary artery bypass grafting (CABG) remains a vital treatment for patients with multivessel coronary artery disease (CAD), especially diabetics. The long-term benefit of the internal thoracic artery graft is well established and remains the gold standard for revascularization of severe CAD. It is not always possible to achieve complete revascularization through arterial grafts, necessitating the use of saphenous vein grafts (SVG). Unfortunately, SVGs do not have the same longevity, and their failure is associated with significant adverse cardiac outcomes and mortality. This paper reviews the pathogenesis of SVG failure, highlighting the difference between early, intermediate, and late failure. It also addresses the different surgical techniques that affect the incidence of SVG failure, as well as the medical and percutaneous prevention and treatment options in contemporary practice.
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Affiliation(s)
- Peter McKavanagh
- Terrence Donnelly Heart Center, Divisions of Cardiology and Cardiac Surgery, St Michael's Hospital, University of Toronto, Toronto, Canada.
| | - Bobby Yanagawa
- Terrence Donnelly Heart Center, Divisions of Cardiology and Cardiac Surgery, St Michael's Hospital, University of Toronto, Toronto, Canada
| | - George Zawadowski
- Terrence Donnelly Heart Center, Divisions of Cardiology and Cardiac Surgery, St Michael's Hospital, University of Toronto, Toronto, Canada
| | - Asim Cheema
- Terrence Donnelly Heart Center, Divisions of Cardiology and Cardiac Surgery, St Michael's Hospital, University of Toronto, Toronto, Canada
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Scarsini R, Zivelonghi C, Pesarini G, Vassanelli C, Ribichini FL. Repeat revascularization: Percutaneous coronary intervention after coronary artery bypass graft surgery. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2016; 17:272-8. [PMID: 27215852 DOI: 10.1016/j.carrev.2016.04.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 04/14/2016] [Accepted: 04/22/2016] [Indexed: 01/25/2023]
Abstract
Repeat myocardial revascularization procedures are markedly different from de novo interventions, with increased procedural risk and technical-demanding complexity. However the number of patients previously treated with coronary artery bypass graft (CABG) that need a repeat revascularization due to graft failure is increasing consistently. Late graft failure, usually caused by saphenous vein grafts (SVG) attrition, is certainly not uncommon. However PCI on degenerated SVG presents higher complication rate and worse clinical outcome compared with native arteries interventions. In acute graft failure setting, PCI represents a valuable option to treat postoperative myocardial infarction.
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Affiliation(s)
- Roberto Scarsini
- University of Verona, Department of Medicine, Section of Cardiology, Italy.
| | - Carlo Zivelonghi
- University of Verona, Department of Medicine, Section of Cardiology, Italy
| | - Gabriele Pesarini
- University of Verona, Department of Medicine, Section of Cardiology, Italy
| | - Corrado Vassanelli
- University of Verona, Department of Medicine, Section of Cardiology, Italy
| | - Flavio L Ribichini
- University of Verona, Department of Medicine, Section of Cardiology, Italy
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30
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Comparison of clinical outcomes in patients presenting with an acute coronary syndrome due to stent thrombosis or saphenous vein graft occlusion and undergoing percutaneous coronary intervention. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2015; 16:441-6. [DOI: 10.1016/j.carrev.2015.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 10/20/2015] [Indexed: 12/15/2022]
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Qi X, Xu M, Yang H, Zhou L, Mao Y, Song H, Li Q, Yang C. Comparing mortality and myocardial infarction between coronary artery bypass grafting and drug-eluting stenting in patients with diabetes mellitus and multivessel coronary artery disease: a meta-analysis. Arch Med Sci 2014; 10:411-8. [PMID: 25097568 PMCID: PMC4107246 DOI: 10.5114/aoms.2014.43734] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2013] [Revised: 11/13/2013] [Accepted: 12/23/2013] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION We aim to compare the midterm outcomes between coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in diabetic patients who had multivessel coronary artery diseases (CAD). MATERIAL AND METHODS A comprehensive literature search was conducted to identify the related clinical studies with a follow-up for 1 year at least. The endpoints were death, myocardial infarction, and major adverse cardiac and cerebrovascular events (MACCE). RESULTS Finally, the analysis of ten studies involving 5,264 patients showed that patients with CABG had worse baseline characteristics, a higher rate of stable angina pectoris, a higher percentage of triple-vessel disease, higher incidence of chronic total occlusion and a higher SYNTAX score. However, there was no significant difference in mortality between the two groups. Additionally, the rates of myocardial infarction and MACCE were markedly decreased in the CABG group. CONCLUSIONS The strategy of CABG is better than PCI for diabetic patients with multivessel CAD. The CABG can significantly reduce the rates of myocardial infarction and MACCE and is comparable in mortality despite the worse baseline characteristics.
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Affiliation(s)
- Xiaolong Qi
- Institute of Digestive Disease, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Mingxin Xu
- Institute of Digestive Disease, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Haitao Yang
- Division of Cardiology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Lin Zhou
- Division of Cardiology, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yu Mao
- Division of Cardiology, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Haoming Song
- Division of Cardiology, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Quan Li
- Division of Anesthesiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Changqing Yang
- Institute of Digestive Disease, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
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Improved Short-Term Outcomes with Off-Pump Reoperative Coronary Artery Bypass Grafting. INNOVATIONS-TECHNOLOGY AND TECHNIQUES IN CARDIOTHORACIC AND VASCULAR SURGERY 2014; 9:49-53. [DOI: 10.1097/imi.0000000000000031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Objective Reoperative coronary surgery patients are usually sicker and older, and the procedure is more technically demanding. Comparisons between coronary surgery with (coronary artery bypass [CAB] surgery on cardiopulmonary bypass [CPB]) and without (off-pump CAB [OPCAB]) the pump have been conducted; however, few studies showed results in reoperative cases. We investigate the potential superiority of one technique over the other in redo coronary surgeries. Methods Our institutional Society of Thoracic Surgery database was used to gather the data for 266 isolated reoperative coronary artery surgeries from January 2004 to July 2011. These were divided into the CAB surgery in CPB group (n = 204) and the OPCAB group (n = 62). Results Baseline characteristics of the two groups were similar, except for a significantly higher prevalence of cerebrovascular disease among the off-pump group ( P = 0.01). There was also a trend toward fewer vessels bypassed among the same group ( P = 0.07). Risk adjustment was done using multivariable analyses for detection of independent effects. The use of CPB was an independent predictor of increased rates of postoperative events (odds ratio, 3.9; P = 0.004) and atrial fibrillation (odds ratio, 5.9; P < 0.005) and longer intensive care unit (0.006) and hospital stay (0.004). Conclusions Redo OPCAB seems to offer favorable short-term outcomes compared with redo CAB. Our results suggest a reduced rate of overall postoperative events, decreased new postoperative atrial fibrillation, reduced hours stayed in the intensive care unit, and fewer days stayed from surgery to discharge. This was not associated with an increase in morbidity and mortality. A randomized study with a larger number of patients and with a longer follow-up is needed.
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Ramlawi B, Bedeir K, Garcia-Morales L, Rodriguez L, Reardon M, Ramchandani M. Improved Short-Term Outcomes with Off-Pump Reoperative Coronary Artery Bypass Grafting. INNOVATIONS-TECHNOLOGY AND TECHNIQUES IN CARDIOTHORACIC AND VASCULAR SURGERY 2014. [DOI: 10.1177/155698451400900109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Basel Ramlawi
- Houston Methodist DeBakey Heart & Vascular Center, Houston, TX USA
| | - Kareem Bedeir
- Houston Methodist DeBakey Heart & Vascular Center, Houston, TX USA
| | | | - Limael Rodriguez
- Houston Methodist DeBakey Heart & Vascular Center, Houston, TX USA
| | - Michael Reardon
- Houston Methodist DeBakey Heart & Vascular Center, Houston, TX USA
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Maluenda G, Pichard AD. Optimal Stenting in Saphenous Vein Graft Intervention. Interv Cardiol Clin 2013; 2:307-313. [PMID: 28582137 DOI: 10.1016/j.iccl.2012.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Percutaneous interventions of (usually degenerated) saphenous vein grafts (SVG) are associated with higher risk of distal embolization and worse clinical outcomes, including target vessel revascularization, myocardial infarction, and death, as compared with percutaneous coronary intervention of native coronary arteries. Embolic protection devices have demonstrated value in reducing the risk of embolization and postprocedural enzyme elevation after SVG interventions. Frequently, however, such devices are not used or cannot be used. As a result, novel stenting strategies intended to decrease the risk of periprocedural myocardial infarction seem to play a major role in enhancing the results following SVG interventions.
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Affiliation(s)
- Gabriel Maluenda
- Division of Cardiology, Department of Internal Medicine, Washington Hospital Center, 110 Irving Street, Northwest, Suite 4B-1, Washington, DC 20010, USA
| | - Augusto D Pichard
- Division of Cardiology, Department of Internal Medicine, Washington Hospital Center, 110 Irving Street, Northwest, Suite 4B-1, Washington, DC 20010, USA.
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35
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Gyenes G, Norris CM, Graham MM. Percutaneous revascularization improves outcomes in patients with prior coronary artery bypass surgery. Catheter Cardiovasc Interv 2012. [DOI: 10.1002/ccd.24711] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Gabor Gyenes
- Division of Cardiology; Department of Medicine; University of Alberta; Edmonton; Alberta; Canada
| | - Colleen M. Norris
- Division of Cardiology; Department of Medicine; University of Alberta; Edmonton; Alberta; Canada
| | - Michelle M. Graham
- Division of Cardiology; Department of Medicine; University of Alberta; Edmonton; Alberta; Canada
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Fihn SD, Gardin JM, Abrams J, Berra K, Blankenship JC, Dallas AP, Douglas PS, Foody JM, Gerber TC, Hinderliter AL, King SB, Kligfield PD, Krumholz HM, Kwong RY, Lim MJ, Linderbaum JA, Mack MJ, Munger MA, Prager RL, Sabik JF, Shaw LJ, Sikkema JD, Smith CR, Smith SC, Spertus JA, Williams SV. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease: Executive Summary. J Am Coll Cardiol 2012. [DOI: 10.1016/j.jacc.2012.07.012] [Citation(s) in RCA: 114] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Fihn SD, Gardin JM, Abrams J, Berra K, Blankenship JC, Dallas AP, Douglas PS, Foody JM, Gerber TC, Hinderliter AL, King SB, Kligfield PD, Krumholz HM, Kwong RYK, Lim MJ, Linderbaum JA, Mack MJ, Munger MA, Prager RL, Sabik JF, Shaw LJ, Sikkema JD, Smith CR, Smith SC, Spertus JA, Williams SV. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease: executive summary: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation 2012. [PMID: 23182125 DOI: 10.1016/j.jacc.2012.07.013] [Citation(s) in RCA: 1231] [Impact Index Per Article: 102.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Fihn SD, Gardin JM, Abrams J, Berra K, Blankenship JC, Dallas AP, Douglas PS, Foody JM, Gerber TC, Hinderliter AL, King SB, Kligfield PD, Krumholz HM, Kwong RYK, Lim MJ, Linderbaum JA, Mack MJ, Munger MA, Prager RL, Sabik JF, Shaw LJ, Sikkema JD, Smith CR, Smith SC, Spertus JA, Williams SV. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease: executive summary: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation 2012; 126:3097-137. [PMID: 23166210 DOI: 10.1161/cir.0b013e3182776f83] [Citation(s) in RCA: 276] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Fihn SD, Gardin JM, Abrams J, Berra K, Blankenship JC, Dallas AP, Douglas PS, Foody JM, Gerber TC, Hinderliter AL, King SB, Kligfield PD, Krumholz HM, Kwong RYK, Lim MJ, Linderbaum JA, Mack MJ, Munger MA, Prager RL, Sabik JF, Shaw LJ, Sikkema JD, Smith CR, Smith SC, Spertus JA, Williams SV, Anderson JL. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation 2012; 126:e354-471. [PMID: 23166211 DOI: 10.1161/cir.0b013e318277d6a0] [Citation(s) in RCA: 465] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Zhang F, Yang Y, Hu D, Lei H, Wang Y. Percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG) in the treatment of diabetic patients with multi-vessel coronary disease: a meta-analysis. Diabetes Res Clin Pract 2012; 97:178-84. [PMID: 22513345 DOI: 10.1016/j.diabres.2012.03.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Revised: 03/18/2012] [Accepted: 03/20/2012] [Indexed: 11/22/2022]
Abstract
Diabetes is prevalent in patients with coronary artery disease. In diabetic patients with multi-vessel coronary disease, percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are widely used for revascularization. We aimed to compare the effectiveness and safety of PCI and CABG in these patients. Nine randomized controlled trials were identified in which a total of 1047 diabetic patients were randomly assigned to PCI and 1054 to CABG. Results showed that five-year mortality was significantly higher in diabetic patients after PCI than after CABG (risk difference (RD) of 7%; P<0.001); repeated revascularization was more common after PCI than after CABG (one-year RD of 13%; P<0.001); major adverse cardiac and cerebrovascular events were also more frequent after PCI (one-year RD of 12%; P<0.001); however, the cerebrovascular accident rate was lower in the PCI group than the CABG group (one-year RD of -2%; P=0.004). Conclusively, in diabetic patients with multi-vessel coronary disease, CABG was not only more effective than PCI in reducing mortality but also led to fewer repeated revascularizations and fewer major adverse cardiac and cerebrovascular events. Despite these benefits, CABG did put diabetic patients at higher risk for cerebrovascular accident than PCI.
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Affiliation(s)
- Fan Zhang
- School of Public Health and Health Management, Chongqing Medical University, Chongqing, China
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Cockburn J, Poliacikova P, Hildick-Smith D, Colombo A, Buchanan GL, von Birgelen C. How should I treat a patient with significant angina and a severe left anterior descending artery stenosis beyond the insertion of a left internal mammary artery jump graft (diagonal to LAD)? EUROINTERVENTION 2012; 8:400-7. [PMID: 22829513 DOI: 10.4244/eijv8i3a60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- James Cockburn
- Sussex Cardiac Centre, Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom
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Abstract
CABG surgery is an effective way to improve symptoms and prognosis in patients with advanced coronary atherosclerotic disease. Despite multiple improvements in surgical technique and patient treatment, graft failure after CABG surgery occurs in a time-dependent fashion, particularly in the second decade after the intervention, in a substantial number of patients because of atherosclerotic progression and saphenous-vein graft (SVG) disease. Until 2010, repeat revascularization by either percutaneous coronary intervention (PCI) or surgical techniques was performed in these high-risk patients in the absence of specific recommendations in clinical practice guidelines, and within a culture of inadequate communication between cardiac surgeons and interventional cardiologists. Indeed, some of the specific technologies developed to reduce procedural risk, such as embolic protection devices for SVG interventions, are largely underused. Additionally, the implementation of secondary prevention, which reduces the need for reintervention in these patients, is still suboptimal. In this Review, graft failure after CABG surgery is examined as a clinical problem from the perspective of holistic patient management. Issues such as the substrate and epidemiology of graft failure, the choice of revascularization modality, the specific problems inherent in repeat CABG surgery and PCI, and the importance of secondary prevention are discussed.
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Affiliation(s)
- Javier Escaned
- Cardiovascular Institute, Hospital Clínico San Carlos, Calle del Profesor Martín Lagos s/n, 28040 Madrid, Spain.
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Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, Chambers CE, Ellis SG, Guyton RA, Hollenberg SM, Khot UN, Lange RA, Mauri L, Mehran R, Moussa ID, Mukherjee D, Nallamothu BK, Ting HH. 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. Catheter Cardiovasc Interv 2012; 79:453-95. [PMID: 22328235 DOI: 10.1002/ccd.23438] [Citation(s) in RCA: 125] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Douglas JS. Percutaneous coronary intervention in patients with prior coronary bypass surgery in 2012. Interv Cardiol 2012. [DOI: 10.2217/ica.11.96] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Hillis LD, Smith PK, Anderson JL, Bittl JA, Bridges CR, Byrne JG, Cigarroa JE, DiSesa VJ, Hiratzka LF, Hutter AM, Jessen ME, Keeley EC, Lahey SJ, Lange RA, London MJ, Mack MJ, Patel MR, Puskas JD, Sabik JF, Selnes O, Shahian DM, Trost JC, Winniford MD, Jacobs AK, Anderson JL, Albert N, Creager MA, Ettinger SM, Guyton RA, Halperin JL, Hochman JS, Kushner FG, Ohman EM, Stevenson W, Yancy CW. 2011 ACCF/AHA guideline for coronary artery bypass graft surgery: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Thorac Cardiovasc Surg 2012; 143:4-34. [PMID: 22172748 DOI: 10.1016/j.jtcvs.2011.10.015] [Citation(s) in RCA: 197] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, Chambers CE, Ellis SG, Guyton RA, Hollenberg SM, Khot UN, Lange RA, Mauri L, Mehran R, Moussa ID, Mukherjee D, Nallamothu BK, Ting HH. 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: Executive Summary. J Am Coll Cardiol 2011. [DOI: 10.1016/j.jacc.2011.08.006] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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48
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Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, Chambers CE, Ellis SG, Guyton RA, Hollenberg SM, Khot UN, Lange RA, Mauri L, Mehran R, Moussa ID, Mukherjee D, Nallamothu BK, Ting HH. 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. Circulation 2011; 124:2574-609. [PMID: 22064598 DOI: 10.1161/cir.0b013e31823a5596] [Citation(s) in RCA: 381] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. J Am Coll Cardiol 2011; 58:e44-122. [PMID: 22070834 DOI: 10.1016/j.jacc.2011.08.007] [Citation(s) in RCA: 1724] [Impact Index Per Article: 132.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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50
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Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, Chambers CE, Ellis SG, Guyton RA, Hollenberg SM, Khot UN, Lange RA, Mauri L, Mehran R, Moussa ID, Mukherjee D, Nallamothu BK, Ting HH, Ting HH. 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. Circulation 2011; 124:e574-651. [PMID: 22064601 DOI: 10.1161/cir.0b013e31823ba622] [Citation(s) in RCA: 902] [Impact Index Per Article: 69.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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