In the ISCHEMIA Trial, 5179 patients with moderate or severe myocardial ischemia were randomized equally into two groups based on initial management strategy: initial invasive strategy (angiography and revascularization when feasible) and medical therapy, or initial conservative strategy (medical therapy alone and angiography if medical therapy faile
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Coronary Disease - Surgery
February 20, 2020
This study of Medicare beneficiaries evaluated how often CABG was performed related to narrow intervals around a patient's birthday.
Percutaneous Coronary Angioplasty Versus Coronary Artery Bypass Grafting in Treatment of Unprotected Left Main Stenosis (NOBLE): A Prospective, Randomised, Open-Label, Non-Inferiority Trial
January 10, 2020
''CABG was significantly better than PCI (p=0·0066........''
The Discussion Continues as the EXCEL Authors Respond to EACTS's Withdrawal of Support of the LMS Chapter of the EACTS/ESC Revascularization Guidelines
December 19, 2019
Following the withdrawal of the support of EACTS for the left main stem chapter of the EACTS/ESC Chapter of the revascularisation guidelines following the BBC Newsnight documentary of this, and the withdrawal of Professor David Taggart as an author of the EXCEL trial published in the NEJM, the EXCEL trial authors have published a very robust defence
November 6, 2019
In this randomized trial, percutaneous coronary intervention and CABG had equivalent outcomes for the composite of death, stroke, or myocardial infarction at five years for patients with left main disease of low or intermediate anatomical complexity.
Outcomes of Second Arterial Conduits in Patients Undergoing Multivessel Coronary Artery Bypass Graft Surgery
October 29, 2019
This article reviews real-life outcomes of 42,714 patients undergoing coronary bypass grafting from 2005 to 2012.
Peripheral Vasoconstriction During Mental Stress and Adverse Cardiovascular Outcomes in Patients With Coronary Artery Disease
October 26, 2019
Interesting clinicolaboratory experiment: Any translational value for the coronary surgeon and the cardiologist remains to be seen, especially regarding the risk stratification and prioritization for urgent (inpatient) revascularisation. Also, the value of the observation for the cardiovascular anesthetist may be important with regards to induction
October 18, 2019
Using data from the FREEDOM (Future Revascularizaiton Evaluation in Patients with Diabetes Mellitus: Optimal Management of Multivessel Disease) trial, the authors developed an 8 variable model that predicts individual risk of major acute cardiovascular events in diabetic patients with multivessel disease.
The Gender Gap in ACS: Sex-Specific Thresholds of High-Sensitivity Troponin in Patients With Suspected Acute Coronary Syndrome
October 15, 2019
Using gender specific thresholds for abnormalities in cardiac troponin I, the rate of injury among women increased by 42%. This did not translate into improved management of women, who remained about half as likely to undergo revascularization, receive dual antiplatet therapy, or undergo other interventions.
Antithrombotic Treatment After Coronary Artery Bypass Graft Surgery: Systematic Review and Network Meta-Analysis
October 11, 2019
This timely review examines the use of single and mutiple agents to decrease saphenous graft failure after CABG. These are difficult and expensive studies to perform, requiring repeat imaging after surgery, a procedure patients are often reluctant to undergo.