Tag: CABG


PCI vs CABG in Patients with Unprotected Left Main Coronary Artery Disease

Key Takeaways

  • This meta-analysis evaluated 6 randomized controlled trials to determine outcome differences between percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) among patients with unprotected left main coronary artery disease ([ULMCAD] n = 4686).
  • Compared with CABG, PCI correlated with significantly lower rates of 30-day stroke (P = 0.007), death or MI (P = 0.04), or all-cause death, MI, or stroke (P = 0.01).
  • In the PCI group, there was a significantly lower rate of 30-day stroke incidence (P = 0.007) and all-cause death, MI, or stroke (P = 0.01).
  • The authors found no significant difference in outcomes at long-term follow-up (median 39 months) between the two groups.
Reference: Palmerini T et al. Am Heart J. 2017;190:54-63.
Continue readingPCI vs CABG in Patients with Unprotected Left Main Coronary Artery Disease

Utility of the SYNTAX II Score for Deciding Between PCI and CABG

Reference: Escaned J et al. Eur Heart J. 2017;38(42):3124-3134. Patients selected for percutaneous coronary intervention (PCI) using the Syntax Score II in the SYNTAX II trial showed favorable 1-year post-intervention clinical outcomes compared to patients selected for PCI in the SYNTAX I trial, according to findings from the SYNTAX II trial.1 SYNTAX II The SYNTAX … Continue reading “Utility of the SYNTAX II Score for Deciding Between PCI and CABG”

CABG SYNTAX for Predicting Post-PCI Events in CAD Patients with Previous CABG

Key Takeaways The coronary artery bypass (CABG) SYNTAX score (CSS) was studied to determine its prognostic significance in patients who have previously received CABG and who were undergoing PCI as a secondary revascularization strategy. The SYNTAX score is an objective scoring system commonly used to identify the optimal revascularization strategy for patients with coronary artery … Continue reading “CABG SYNTAX for Predicting Post-PCI Events in CAD Patients with Previous CABG”

Impact of PCI vs No PCI Before CABG on Short- and Long-Term Survival

Coronary artery bypass surgery (CABG) is a typical treatment of choice for coronary heart disease (CHD) patients who have previously received percutaneous coronary intervention (PCI). Prior PCI is often used to stabilize symptoms and improve outcomes following treatment. Multiple staged PCIs may be used as an alternative revascularization strategy for CABG. The impact of prior PCI on CABG outcomes, however, has remained a subject of debate. Continue readingImpact of PCI vs No PCI Before CABG on Short- and Long-Term Survival

PCI with Everolimus Eluting Stents vs CABG for Left Main Coronary Artery Disease: The EXCEL Trial

Key Takeaways

  • Coronary-artery bypass is a standard treatment of choice for left main coronary artery disease patients, but some trials suggest PCI with stenting could be a good alternative therapeutic option.
  • The EXCEL randomized trial found that complete revascularization via PCI with everolimus-eluting stents is noninferior to CABG for left-main CAD with respect to the study’s primary and secondary endpoints.
Patients with left main coronary artery disease (CAD) are at a significantly high risk for cardiovascular events due to vessel occlusion that compromises flow in up to three-fourths of the left ventricle. Bypass surgery had been the standard treatment of choice for left main CAD in the past, yet innovations and advancements in cardiology has led to the use of more refined and less invasive therapies. Continue readingPCI with Everolimus Eluting Stents vs CABG for Left Main Coronary Artery Disease: The EXCEL Trial

CABG Beneficial for Older Patients with Heart Failure and Left Ventricular Systolic Dysfunction

Ten-Year Follow-Up Analysis of STICH Trial Key Takeaways CABG lowered cardiovascular-related mortality for heart failure patients in the STICH trial. Increasing age tends to diminish benefits received from surgical revascularization. Cardiovascular death was higher among younger patients enrolled in STICH at 10 years’ follow-up. While mortality increases with advancing age, CABG plus guideline-directed medical therapy … Continue reading “CABG Beneficial for Older Patients with Heart Failure and Left Ventricular Systolic Dysfunction”

Why Complete Revascularization Should be the Standard for Most High-Risk PCI Cases, Dr. Jeffrey Moses

Dr. Jeffrey Moses, Director of Interventional Cardiac Therapeutics at Columbia University Medical Center, NY and Director of Complex Coronary Interventions at St. Francis Hospital, has been a pioneer in developing the techniques and data to optimize complex PCI. At this year’s Hartzler Interventional Cardiology Symposium, Dr. Moses presents a strong case for why complete revascularization … Continue reading “Why Complete Revascularization Should be the Standard for Most High-Risk PCI Cases, Dr. Jeffrey Moses”

Ischemic CAD Testing Underutilized in New Heart Failure Patients

Written by Christopher Chalk, DC, MPH

Ischemic coronary artery disease (CAD) testing appears to be significantly underused in patients newly diagnosed with heart failure (HF) at both initial hospitalization and within a 90 day follow-up period, according to a new retrospective cohort study of 67,161 patients.Dr. Doshi from Columbia University Medical Center and colleagues reported their findings in the August 2016 edition of the Journal of The American College of Cardiology. “The principle finding of this analysis was that almost three-quarters of patients with new-onset HF did not receive any ischemic CAD testing within 90 days of index admission,” the authors commented. The percentage of patients with known CAD in this study population (53.7%) combined with the poor outcomes of concomitant CAD and HF underscore the importance of the problem, according to the researchers.

Results

Patients with a diagnosis of new-onset HF as the primary diagnosis with at least a 90-day continuous follow-up were taken from the Truven MarketScan and Medicare Supplemental databases (n = 67,161) from 2010 to 2014. Continue readingIschemic CAD Testing Underutilized in New Heart Failure Patients