Posts Tagged ‘PCI’

Stents or Bypass Surgery for Left Main Coronary Artery Disease

Posted by • December 8th, 2016

EXCEL (Evaluation of XIENCE versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization) was an international, open-label, multicenter randomized trial that compared everolimus-eluting stents with coronary-artery bypass grafting (CABG) in patients with left main coronary artery disease. A new Original Article explains how at 3 years, PCI was noninferior to CABG with respect… Read More…

Coronary-Artery Bypass Grafting

Posted by • May 20th, 2016

Appropriate selection of patients for coronary-artery bypass grafting (CABG) is critical to ensure good outcomes. The evaluation of patients for CABG relies on a systematic assessment of the characteristics and coronary anatomy known to be associated with a survival benefit from CABG as compared with medical therapy or percutaneous coronary intervention (PCI). There is increasing… Read More…

Chronic Stable Angina

Posted by • March 25th, 2016

Angina is the initial manifestation in approximately half of all patients who present with coronary artery disease. The presence of chronic angina approximately doubles the risk of major cardiovascular events. Management of angina includes lifestyle changes and pharmacologic treatment to reduce cardiovascular risks, antianginal therapies (beta-blockers, long-acting nitrates, calcium-channel blockers, and — recently in the United States —… Read More…

CABG or PCI in Patients with Coronary Disease?

Posted by • March 16th, 2015

The great singer Whitney Houston posed a question over 25 years ago that many still ponder today.  “Where,” she asked, “do broken hearts go?” Of course, her classic song asks us to imagine a destination for the pain wrought by the dissolution of love.  Physicians, however, have more concrete possibilities in mind when asking where to… Read More…

Preventive Angioplasty in STEMI

Posted by • September 20th, 2013

Patients with acute STEMI were randomly assigned to undergo infarct-vessel-only PCI or preventive PCI (PCI to noninfarct arteries with stenoses). The rate of the primary outcome of cardiac death, myocardial infarction, or refractory angina was lower with preventive PCI. Patients with acute STEMI are effectively treated with emergency angioplasty, or PCI, to restore blood flow to… Read More…

Cardiac Arrest after MI

Posted by • September 13th, 2013

In the latest Case Record of the Massachusetts General Hospital, a 52-year-old man was brought to the emergency department with chest pain and ST-segment elevation. Seconds after his arrival, cardiac arrest occurred. CPR was begun, and nine external countershocks were administered, without resolution. Management decisions were made. The 2013 STEMI guidelines indicate that primary percutaneous coronary… Read More…

Matters of the Heart: Multivessel Revascularization in Diabetic Patients

Posted by • December 19th, 2012

Your patient, Mr. Smith, is a good man with a bad heart.  He’s had diabetes for years and was recently diagnosed with three-vessel coronary artery disease (CAD).  Even mild exertion gives him chest pain.  Now that it’s winter, he wants to shovel the driveway, but his wife (an outspoken woman) will have none of it. “He… Read More…

Cold Steel or Caged Balloon? The ASCERT Study Adds to the Revascularization Rivalry

Posted by • April 18th, 2012

Mac versus PC, Republicans versus Democrats, chocolate versus vanilla … life is full of rivalries, and the world of medicine is no exception. Take cardiology and cardiac surgery, for example. Who’s better at mending a particular group of blood-starved hearts? The answer depends on the group of hearts – and perhaps on the group you ask…. Read More…

Adjunctive Antithrombotic Therapy During PCI

Posted by • November 23rd, 2011

The ISAR-REACT 4 trial compared the combination of abciximab and unfractionated heparin with bivalirudin in patients with non–STsegment elevation MI who were undergoing coronary stenting. The two regimens had similar efficacy, but there was more bleeding with abciximab and heparin. Identifying the most appropriate adjunctive antithrombotic therapy before, during, and after percutaneous coronary intervention (PCI) has… Read More…