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
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Coronary Disease - Surgery
Peripheral Vasoconstriction During Mental Stress and Adverse Cardiovascular Outcomes in Patients With Coronary Artery Disease
October 26, 2019
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.
Skeletonisation Contributing to a Reduction of Sternal Wound Complications: a Retrospective Study in OPCAB Patients
September 18, 2019
This is a retrospective study in OPCAB patients comparing patients who received skeletonized versus nonskeletonized SIMA and BIMA grafts. They reported patients with any sternal wound complication including redness or minor drainage that healed naturally.
CABG Improves Outcomes in Patients With Ischemic Cardiomyopathy: 10-Year Follow-Up of the STICH Trial
September 14, 2019
This study reports ten year outcomes of the STICH trial. Comparing CABG to medical therapy groups, the authors note that CABG reduced all cause, cardiovascular, and heart failure hospitalizations. This included time-to-first and recurrent events. This was due to fewer total cardiovascular hospitalizations, the majority due to heart failure.
September 2, 2019
The authors reviewed the New York State database. Patients with single arterial grafts were compared to those with multiple arterial grafts. Propensity matching was performed based on 38 baseline characteristics. Twenty percent had multiple arterial grafting.
Effects of Intracoronary Nicorandil on Myocardial Microcirculation and Clinical Outcomes in Patients With Acute Myocardial Infarction: A Meta-Analysis of Randomized Controlled Trials
August 29, 2019
An interesting meta-analysis discouraging perhaps the use of this KATP modulator, especially after surgical revascularization where optimization of serum potassium is generally sought.
August 22, 2019
A robust RCT that denies association of nuclear CT-defined myocardial viability and long-term benefit from surgical coronary revascularisation. It is worth following the discussion this manuscript is certain to generate..
Novel Machine Learning Approach to Identify Preoperative Risk Factors Associated With Super-Utilization of Medicare Expenditure Following Surgery
August 15, 2019
Using a machine learning algorithm, resource utilization among more than 1 million Medicare patients undergoing one of 6 operations including CABG and lung resection was analyzed. Super users comprised 4.8% of the cohort but consumed 31.7% of the resources. Risk factors for super use included paraplegia/hemiplegia, weight loss, and CHF combined wit