Left-main PCI is only appropriate for a minority of patients

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An atricle published in Cardiovascular Business on November 8, 2011 is very much in-line with our previous publications on this website about optimal treatment of Coronary Artery Disease that includes a Left Main Stenosis and/or three vessel disease: SAN FRANCISCO—CABG is the preferred treatment strategy for patients with left main disease, according to Michael J. Mack, MD, president of the Society for Thoracic Surgeons …

Weight Gains After Dieting

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As is well known, although restriction of diet often results in initial weight loss, more than 80 per cent of obese dieters fail to maintain their reduced weight.  A new study from Australia involved 50 overweight or obese patients without diabetes in a 10-week weight-loss program using a very-low-energy diet. Levels of appetite-regulating hormones were measured at baseline, at the end of …

Computed Tomography Coronary Angiography (CTCA) screening for Coronary Artery Disease

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The major risk factors of inappropriate diet, physical inactivity, high cholestreol (> 250 mg%), high BMI (>26) and hypertension (>155 mmHg) and smoking, explain at least 75% of new cases of Coronary Artery Disease (CAD). In the absence of these risk factors, CAD is a rare cause of death. Two studies have addressed the issue of predicting the risk of …

Treatment of Chronic Kidney Disease (CKD) and multi-vessel CAD

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CABG is associated with better survival than PCI with DES in patients with non Hemodialysis Dependent (HD) Chronic Kidney Disease (CKD) and multivessel CAD, but CABG patients have a greater short-term risk of needing permanent  hemodialysis. A new study, published in the American Journal of Cardiology, compared the short- and long-term outcomes of coronary artery bypass grafting (CABG) and percutaneous …

The ABCS of Preventing Heart Attacks and Strokes

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Each year, more than 2 million Americans have a heart attack or stroke, of whom more than 800,000 of them die; cardiovascular disease is the leading cause of death in the United States and the largest cause of lower life expectancy among blacks. Related medical costs and productivity losses approach $450 billion annually, and inflation-adjusted direct medical costs are projected …

Diastolic Dysfunction and Risk of Heart Failure

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Left ventricular diastolic dysfunction is highly prevalent, tends to worsen over time, and is associated with advancing age. Worsening diastolic function can be detected even in apparently healthy persons, the conclusion by the authors of a recent article published in JAMA. Randomly selected participants 45 years or older (N = 2042) underwent clinical evaluation, medical record abstraction, and echocardiography (examination 1 [1997-2000]). Diastolic …

“Pump Head”

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Decreased Oxygen blood levels in the brain during heart surgery correlates to increased risk of suffering from the mental impairment dubbed “pump head”.Heart surgery patients in whom a heart-lung machine was used often find their brain function slipping for months or years afterward. Studies have shown that 20-40% of patients set to undergo CABG surgery already had some degree of …

Occluded Artery Trial

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The Coronary Intervention for Persistent Occlusion after Myocardial Infarction (Occluded Artery Trial, (OAT) study evaluated treatment of 2166 high-risk, but otherwise stable survivors of a myocardial infarction and persistent total occlusion of the infarct-related coronary artery. High risk criteria included an ejection fraction of <50% or proximal occlusion (TIMI flow =0-1). Treatment was randomized to either routine PCI or stenting with …

Patients with three vessel disease should undergo PCI!

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Point-Counter point 2 Best way to revascularize patients with main stem and three-vessel lesions: Patients should undergo PCI![i] The optimal revascularization strategy for multivessel disease is under controversial discussion for long time. Until now, technical innovations have been faster than performance of clinical trials, making results of randomized studies outdated at the time of appearance. Recently, the SYNTAX trial[ii] has been …