Association of Insulin Resistance with de novo Coronary Stenosis after Percutaneous Coronary Artery Intervention in Hemodialysis Patients

2008 ◽  
Vol 109 (1) ◽  
pp. c9-c17 ◽  
Author(s):  
Masato Nishimura ◽  
Toshiko Tokoro ◽  
Masasya Nishida ◽  
Tetsuya Hashimoto ◽  
Hiroyuki Kobayashi ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Coronary Artery ◽  
Coronary Stenosis ◽  
De Novo ◽  
Hemodialysis Patients ◽  
Percutaneous Coronary

scholarly journals Percutaneous coronary intervention in a 4-month-old infant for stenosis of both coronary arteries after arterial switch operation for transposition of the great arteries

2021 ◽  
pp. 1-3
Author(s):  
Hanna Kim ◽  
Jinyoung Song ◽  
I-Seok Kang
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Coronary Stenosis ◽  
Left Coronary Artery ◽  
Arterial Switch Operation ◽  
Coronary Intervention ◽  
Arterial Switch ◽  
Switch Operation ◽  
Percutaneous Coronary ◽  
The Right

Abstract We present a case of percutaneous coronary intervention in a 4-month-old infant with both severe coronary stenosis and acute heart failure after arterial switch operation for transposition of the great arteries. Under extracorporeal membrane oxygenation, balloon angioplasty of the left coronary artery with a 2.0 × 15-mm balloon and stent implantation on the right coronary artery with a 2.25 × 26-mm stent were performed successfully. Echocardiography after the intervention showed recovered cardiac function and no complications.

scholarly journals Ten-year all-cause death in elderly patients undergoing percutaneous coronary intervention or coronary artery bypass grafting: a prespecified subgroup analysis of the SYNTAX Extended Survival study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Ono ◽  
K Takahashi ◽  
H Hara ◽  
C Gao ◽  
R Wang ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Elderly Patients ◽  
De Novo ◽  
Artery Bypass ◽  
Coronary Intervention ◽  
The Elderly ◽  
Percutaneous Coronary ◽  
Artery Disease ◽  
Extended Survival

Abstract Background Coronary artery disease is the leading cause of death among elderly men and women worldwide. The aging society worldwide will lead to increasing numbers of elderly patients with multivessel coronary artery disease. Although age is recognized as one of the most important factors in a decision-making for revascularization of multivessel coronary artery disease, the very long-term outcomes in patients undergoing revascularization by percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) is still unclear. Objectives The aim of the present study was to investigate the association between revascularization strategies and 10-year outcomes in elderly patients. Methods The SYNTAX Extended Survival (SYNTAXES) study (NCT 03417050) is an investigator-driven extension of follow-up of a multicentre, randomised controlled trial done in 85 hospitals across 18 North American and European countries, enrolling 1,800 patients with de novo three-vessel disease (3VD) and/or left main coronary artery disease (LMCAD) randomized to revascularization strategy with CABG versus PCI in the SYNTAX trial. Patients were divided into two groups according to the prespecified threshold of 70 years old; elderly patients (>70 years) and non-elderly patients (≤70 years). The primary endpoint of this study was all-cause death at 10 years. Results Out of 1,800 patients, 575 patients (31.9%) were classified as elderly (>70 years). The mean age ± standard deviation (SD) of the elderly patients and the non-elderly patients was 75.8±3.6 years and 60.1±7.4 years, respectively. Of note, elderly patients were more frequently female than non-elderly patients (33.6% vs. 17.1%, p<0.001). As expected, the elderly patients had higher prevalence of chronic kidney disease (43.4% vs. 7.9%, p<0.001), had higher anatomical SYNTAX score (30.2±11.8 vs 28.0±11.2 p<0.001) when compared to those of the non-elderly patients. Up to 10 years, all-cause death occurred in 42.7% and 18.9% in the elderly and non-elderly patients, respectively (Log-rank p<0.001). The cubic spline curve showed an exponentially increase in all-cause death at 10 years according to the increase of age both in the PCI arm and the CABG arm. At 10 years, there was no significant difference in the risk of all-cause death between CABG vs. PCI either in elderly patients (41.5% vs. 44.0%; Log-rank p=0.53) or non-elderly patients (16.6% vs. 21.1%; Log-rank p=0.051). Conclusion CABG and PCI were equipoise in terms of risk of all-cause death at 10 years in patients with de novo 3VD and/or LMCAD irrespective of their age when stratified according to the prespecified threshold of 70 years old. Kaplan-Meier curves Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): German Foundation of Heart Research

scholarly journals Prognostic Impacts of Comorbid Significant Coronary Stenosis and Coronary Artery Spasm in Patients With Stable Coronary Artery Disease

2021 ◽  
Vol 10 (2) ◽  
Author(s):  
Kiyotaka Hao ◽  
Jun Takahashi ◽  
Yoku Kikuchi ◽  
Akira Suda ◽  
Koichi Sato ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Coronary Stenosis ◽  
Cardiovascular Events ◽  
Coronary Artery Spasm ◽  
Coronary Spasm ◽  
Coronary Intervention ◽  
Major Adverse Cardiovascular Events ◽  
Percutaneous Coronary ◽  
Significant Coronary Stenosis

BACKGROUND Stable coronary artery disease is caused by a variable combination of organic coronary stenosis and functional coronary abnormalities, such as coronary artery spasm. Thus, we examined the clinical importance of comorbid significant coronary stenosis and coronary spasm. METHODS AND RESULTS We enrolled 236 consecutive patients with suspected angina who underwent acetylcholine provocation testing for coronary spasm and fractional flow reserve (FFR) measurement. Among them, 175 patients were diagnosed as having vasospastic angina (VSA), whereas the remaining 61 had no VSA (non‐VSA group). The patients with VSA were further divided into the following 3 groups based on angiography and FFR: no organic stenosis (≤50% luminal stenosis; VSA‐alone group, n=110), insignificant stenosis of FFR>0.80 (high‐FFR group, n=36), and significant stenosis of FFR≤0.80 (low‐FFR group, n=29). The incidence of major adverse cardiovascular events, including cardiovascular death, nonfatal myocardial infarction, urgent percutaneous coronary intervention, and hospitalization attributed to unstable angina was evaluated. All patients with VSA received calcium channel blockers, and 28 patients (95%) in the low‐FFR group underwent a planned percutaneous coronary intervention. During a median follow‐up period of 656 days, although the incidence of major adverse cardiovascular events was low and comparable among non‐VSA, VSA‐alone, and high‐FFR groups, the low‐FFR group had an extremely poor prognosis (non‐VSA group, 1.6%; VSA‐alone group, 3.6%; high‐FFR group, 5.6%; low‐FFR group, 27.6%) ( P <0.001). Importantly, all 8 patients with major adverse cardiovascular events in the low‐FFR group were appropriately treated with percutaneous coronary intervention and calcium channel blockers. CONCLUSIONS These results indicate that patients with VSA with significant coronary stenosis represent a high‐risk population despite current guideline‐recommended therapies, suggesting the importance of routine coronary functional testing in this population.

scholarly journals Bioabsorbable Vascular Scaffolds Eluting with Everolimus: for Percutaneous Coronary Intervention of Patients with de-novo Coronary Artery Lesion: Our Experiences at a Tertiary Hospital

2014 ◽  
Vol 6 (2) ◽  
pp. 122-126
Author(s):  
AHMW Islam ◽  
S Munwar ◽  
S Talukder ◽  
AQM Reza ◽  
T Ahmed ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
De Novo ◽  
Positive Family History ◽  
Coronary Intervention ◽  
Coronary Artery Lesion ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Percutaneous Coronary ◽  
Vascular Scaffold

Background: Aim of the study was to evaluate the primary procedural success of percutaneous coronary intervention (PCI) of de-novo coronary artery lesion by using Bioabsorbable Vascular Scaffold (BVS) ABSORB stents eluting Everolimus. Methods: Total 16 patients were enrolled in this very preliminary study of BVS absorb. Among them, Male: 11 and Female: 5. Total 20 stents were deployed. Mean age were for Male: 56 yrs, for Female: 60 yrs. Associated coronary artery disease (CAD) risk factors were Dyslipidemia, High Blood pressure, Diabetes Mellitus, Positive family history (FH) for CAD and Smoking. Patients were followed up clinically. Results: Among the study group; 13 (81%) were Dyslipidemic, 10(62.5%) were hypertensive; 6 (37.5%) patients were Diabetic, FH 3(18.75%), and 2(18%) were all male smoker. Female patients were more obese [Body Mass Index (BMI) M 25: F 27] and developed CAD in advance age. A common stented territory was for left anterior descending artery (LAD): 6 (37.5%), left circumflex artery (LCX) 5 (25%), right coronary artery (RCA) 6(37.5%). One patient had both LCX and LAD stenting. Total 3 patients had double/overlapping stent in RCA lesion. Territory wise distributions of BVS ABSORB stent were for LAD 6(30%), RCA 9 (45%), and LCX 5 (25%). There was no periprocedural or postprocedural complication. Conclusion: BVS ABSORB Everolimus eluting vascular scaffold showed favorable clinical outcome without any major cardiac events (acute or late stent thrombosis, MI or death) over a period of 9 month. Thus, BVS ABSORB would be favorable alternative to other available drug eluting metallic stents. DOI: http://dx.doi.org/10.3329/cardio.v6i2.18352 Cardiovasc. j. 2014; 6(2): 122-126

Prior percutaneous coronary intervention and surgical revascularization

2021 ◽  
pp. 475-486
Author(s):  
Suvitesh Luthra ◽  
Sunil K. Ohri ◽  
David P. Taggart
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
De Novo ◽  
Artery Bypass ◽  
Coronary Intervention ◽  
Bypass Grafting ◽  
Surgical Revascularization ◽  
Stent Restenosis ◽  
Percutaneous Coronary ◽  
In Stent Restenosis

Surgical revascularization may be needed after a prior percutaneous coronary intervention (percutaneous coronary intervention) due to further progression of de novo disease or failure of percutaneous coronary intervention due to in-stent restenosis or stent thrombosis. The proportion of patients referred for coronary artery bypass grafting with prior percutaneous coronary intervention varies between institutions from 5% to 30%.

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