Abstract：
PURPOSE OF REVIEW:To review the clinical evidence on the use of percutaneous coronary intervention (PCI) revascularization options in left main (LM) disease in comparison with coronary artery bypass graft (CABG). Coronary artery disease (CAD) involving the LM is associated with high morbidity and mortality. Though CABG remains the gold standard for complex CAD involving the LM artery, recent trials have shown a trend towards non-inferiority of the LM PCI when compared with CABG in certain subset of patients. RECENT FINDINGS:Two recent major randomized trials compared the outcomes of PCI versus CABG in the LM and multi-vessel disease with LM involvement. The NOBLE trial included patients with all range of Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery (SYNTAX) scores and utilized biolimus drug-eluting stent (DES). The trial concluded that MACCE (major adverse cardiac and cerebrovascular event) was significantly higher with PCI (28%) when compared with CABG (18%) but overall stroke and motility were not different. EXCEL trial evaluated the same treatment option in low to intermediate SYNTAX score population with third-generation everolimus DES platform as PCI option. Results showed no significant differences in the composite primary endpoints of death, stroke, and myocardial infarction (MI) at the end of 30 days (22% versus 19.2%, p = 0.13), although repeat revascularization was higher in PCI group (16.9% versus 10%). Recent evidence suggests that PCI is an acceptable alternative to treat symptomatic LM stenosis in select group of patients. In low to medium SYNTAX score, particularly in patients without diabetes mellitus, PCI remains a viable option. Future trials focusing on evaluating subset of patients who would benefit from one particular revascularization option in comparison with other is warranted.
journal_name
Curr Cardiol Repjournal_title
Current cardiology reportsauthors
Nagarajarao HS,Ojha CP,Mulukutla V,Ibrahim A,Mares AC,Paul TKdoi
10.1007/s11886-020-1268-8subject
Has Abstractpub_date
2020-02-08 00:00:00pages
16issue
4eissn
1523-3782issn
1534-3170pii
10.1007/s11886-020-1268-8journal_volume
22pub_type
杂志文章,评审abstract：:Anticoagulation has proven to be a key component in the management of acute coronary syndromes (ACS). Pharmacological agents with various modes of action are utilized to reduce thrombus development by impairing thrombin formation, platelet activation, and platelet aggregation. The optimal management of these patients ...
journal_title：Current cardiology reports
pub_type： 杂志文章,评审
doi：10.1007/s11886-012-0286-6
更新日期：2012-08-01 00:00:00
abstract：PURPOSE OF REVIEW:This review describes the dynamic relationship between diabetes mellitus (DM) and coronary artery disease (CAD) with respect to different revascularization strategies and how angiographic tools such as the Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) score can supplement clinical decisi...
journal_title：Current cardiology reports
pub_type： 杂志文章,评审
doi：10.1007/s11886-018-0971-1
更新日期：2018-03-23 00:00:00
abstract：PURPOSE OF REVIEW:To review methodological and logistical aspects of CT myocardial perfusion, current clinical evidence and possible future directions, with specific focus on use in patients with coronary artery disease (CAD). RECENT FINDINGS:CT myocardial perfusion imaging may be performed as an add-on to standard co...
journal_title：Current cardiology reports
pub_type： 杂志文章,评审
doi：10.1007/s11886-017-0937-8
更新日期：2017-10-25 00:00:00
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journal_title：Current cardiology reports
pub_type： 杂志文章,评审
doi：10.1007/s11886-003-0110-4
更新日期：2003-11-01 00:00:00
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journal_title：Current cardiology reports
pub_type： 杂志文章,评审
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journal_title：Current cardiology reports
pub_type： 杂志文章,评审
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更新日期：2017-09-14 00:00:00
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journal_title：Current cardiology reports
pub_type： 杂志文章,评审
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更新日期：2014-12-01 00:00:00
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journal_title：Current cardiology reports
pub_type： 杂志文章,评审
doi：10.1007/s11886-020-01363-5
更新日期：2020-08-08 00:00:00
abstract：PURPOSE OF THE REVIEW:Coronary artery disease is a major cause of mortality and morbidity in the world, and PCI and CABG account for over a million procedures performed annually in the USA. The goal of percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) is to achieve complete revasculariz...
journal_title：Current cardiology reports
pub_type： 杂志文章,评审
doi：10.1007/s11886-018-0957-z
更新日期：2018-03-06 00:00:00
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journal_title：Current cardiology reports
pub_type： 杂志文章,评审
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更新日期：2003-07-01 00:00:00
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journal_title：Current cardiology reports
pub_type： 杂志文章
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更新日期：2019-07-29 00:00:00
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journal_title：Current cardiology reports
pub_type： 杂志文章,评审
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更新日期：2018-03-24 00:00:00
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journal_title：Current cardiology reports
pub_type： 杂志文章,评审
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更新日期：2008-11-01 00:00:00
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journal_title：Current cardiology reports
pub_type： 杂志文章,评审
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更新日期：2001-09-01 00:00:00
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journal_title：Current cardiology reports
pub_type： 杂志文章,评审
doi：10.1007/s11886-018-1008-5
更新日期：2018-06-14 00:00:00
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journal_title：Current cardiology reports
pub_type： 杂志文章,评审
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更新日期：2006-09-01 00:00:00
abstract：:Four non-communicable diseases-cardiovascular disease, chronic respiratory disease, diabetes mellitus, and cancer-account for over 60 % of all deaths globally. In recognition of this significant epidemic, the United Nations set forth a target of reducing the four major NCDs by 25 % by 2025. Cardiovascular disease alon...
journal_title：Current cardiology reports
pub_type： 杂志文章,评审
doi：10.1007/s11886-015-0679-4
更新日期：2016-01-01 00:00:00
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journal_title：Current cardiology reports
pub_type： 杂志文章,评审
doi：10.1007/s11886-000-0006-5
更新日期：2000-03-01 00:00:00
abstract：:Recent advances in clinical cardiac SPECT instrumentation are reviewed from a systems perspective. New hardware technologies include pixelated scintillator and semiconductor detector elements; photodetectors such as position-sensitive photomultiplier tubes (PSPMT), avalanche photodiodes (APD) and silicon photomultipli...
journal_title：Current cardiology reports
pub_type： 杂志文章,评审
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更新日期：2013-08-01 00:00:00
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journal_title：Current cardiology reports
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更新日期：1999-09-01 00:00:00
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journal_title：Current cardiology reports
pub_type： 杂志文章,评审
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更新日期：2018-09-01 00:00:00
abstract：:Diabetic patients who present with an acute coronary syndrome (ACS) have a particularly adverse prognosis, largely contributed by increased platelet reactivity and higher burden of disease severity. Diabetic patients with ACS derive a greater benefit from established therapies, particularly platelet-inhibiting therapi...
journal_title：Current cardiology reports
pub_type： 杂志文章,评审
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更新日期：2010-07-01 00:00:00
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journal_title：Current cardiology reports
pub_type： 杂志文章,评审
doi：10.1007/s11886-001-0086-x
更新日期：2001-07-01 00:00:00
abstract：:Although differences diminish with age, outcomes are overall worse for women compared to men who present with suspected acute coronary syndrome. The reasons for this discrepancy are multifactorial, including sex-related differences in atherosclerosis biology and fluid dynamics, as well as a premature conclusion by pro...
journal_title：Current cardiology reports
pub_type： 杂志文章,评审
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更新日期：2016-09-01 00:00:00
abstract：:Patients with pre-diabetes have a tenfold higher risk of developing Type 2 DM and a twofold higher risk of developing coronary heart disease compared to non-diabetics. Interventions targeted at those in an early stage of impaired glucose metabolism can delay or prevent diabetes. Effects of these interventions on cardi...
journal_title：Current cardiology reports
pub_type： 杂志文章,评审
doi：10.1007/s11886-015-0562-3
更新日期：2015-03-01 00:00:00
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journal_title：Current cardiology reports
pub_type： 杂志文章,评审
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更新日期：2020-07-28 00:00:00
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journal_title：Current cardiology reports
pub_type： 杂志文章,评审
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更新日期：2012-06-01 00:00:00
abstract：PURPOSE OF REVIEW:Coronary artery bypass grafting is a preferred strategy for complete coronary revascularization in patients who have multi-vessel coronary artery disease, left ventricular dysfunction, and/or diabetes. Both arterial (internal thoracic artery/radial artery) and venous grafts are utilized to bypass the ...
journal_title：Current cardiology reports
pub_type： 杂志文章,评审
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更新日期：2019-03-22 00:00:00
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journal_title：Current cardiology reports
pub_type： 杂志文章,评审
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更新日期：2005-03-01 00:00:00
abstract：PURPOSE OF REVIEW:In this review, we summarise the evidence on the association between cardiovascular disease (CVD) and cognitive impairment and explore the role of the nitric oxide (NO) pathway as a causal mechanism. RECENT FINDINGS:Evidence from epidemiological studies suggests that the presence of CVD and its risk ...
journal_title：Current cardiology reports
pub_type： 杂志文章,评审
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更新日期：2017-08-11 00:00:00
