Abstract:
BACKGROUND:Collaterals limit infarct size, preserve viability, and reduce mortality in patients with acute myocardial infarction. In patients with stable coronary disease, collaterals are associated with less angina and ischemia during angioplasty and fewer ischemic events during follow-up. The role of collaterals has not been studied in patients undergoing off-pump or on-pump bypass surgery. METHODS AND RESULTS:The population consisted of the 281 patients randomized to off-pump or on-pump CABG in the Octopus Study. Collaterals were defined on the baseline angiogram with the Rentrop score and were present in 49% and 51% of the patients in the off-pump and on-pump group, respectively. Perioperative myocardial infarction was defined by a creatine kinase-MB to CK ratio >10% and occurred in 18.2% in the off-pump group and 32.5% in the on-pump group. The unadjusted OR of perioperative myocardial infarction in the presence of collaterals was 0.31 (95% CI 0.17 to 0.84) in the off-pump group and 1.06 (95% CI 0.29 to 3.85) in the on-pump group After adjustment for age, gender, hypertension, hypercholesterolemia, diabetes, multivessel disease, ventricular dysfunction, incomplete revascularization, and ischemic time, the OR was 0.34 (95% CI 0.14 to 0.84) in the off-pump group and 1.28 (95% CI 0.30 to 5.40) in the on-pump group, respectively. Kaplan-Meier estimates of event-free survival at 1 year were 87% in patients with and 69% in those without collaterals after off-pump CABG. These estimates were 66% and 63%, respectively, after on-pump CABG. CONCLUSIONS:Collaterals protect against perioperative myocardial infarction during off-pump surgery but not during on-pump surgery and are associated with a better 1-year event-free survival.
journal_name
Circulationjournal_title
Circulationauthors
Nathoe HM,Buskens E,Jansen EW,Suyker WJ,Stella PR,Lahpor JR,van Boven WJ,van Dijk D,Diephuis JC,Borst C,Moons KG,Grobbee DE,de Jaegere PPdoi
10.1161/01.CIR.0000143105.42988.FDsubject
Has Abstractpub_date
2004-09-28 00:00:00pages
1738-42issue
13eissn
0009-7322issn
1524-4539pii
01.CIR.0000143105.42988.FDjournal_volume
110pub_type
临床试验,杂志文章,随机对照试验相关文献
CIRCULATION文献大全abstract:BACKGROUND:Hemodynamic stability after Norwood palliation often requires manipulation of pulmonary vascular resistance to alter the pulmonary-to-systemic blood flow ratio (Qp:Qs). Qp:Qs is often estimated from arterial saturation (SaO2), a practice based on 2 untested assumptions: constant systemic arteriovenous O2 dif...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.103.22.2699
更新日期:2001-06-05 00:00:00
abstract:BACKGROUND:A positive association was previously reported between angiotensin-converting enzyme (ACE) gene polymorphism and several cardiovascular diseases, such as myocardial infarction, left ventricular hypertrophy, and restenosis after percutaneous transluminal coronary angioplasty. Plasma ACE activity and carotid-w...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.91.4.951
更新日期:1995-02-15 00:00:00
abstract::A 28-year-old female undergoing elective total hip replacement experienced an anaphylactic reaction to succinylcholine. Hemodynamics, plasma histamine and catecholamines were measured. The tachycardia experienced during the reaction appeared to be secondary to the sympathoadrenal response rather than a direct chronotr...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.63.1.210
更新日期:1981-01-01 00:00:00
abstract:BACKGROUND:Albuminuria is an established risk marker for both cardiovascular and renal outcomes. Albuminuria can be reduced with drugs that block the renin-angiotensin system (RAS). We questioned whether the short-term drug-induced change in albuminuria would predict the long-term cardioprotective efficacy of RAS inter...
journal_title:Circulation
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1161/01.CIR.0000139860.33974.28
更新日期:2004-08-24 00:00:00
abstract:BACKGROUND:Inotropic drugs are often used to treat acute, severe heart failure resulting from acute myocardial infarction and other unstable coronary artery syndromes. However, catecholamine inotropic agents may potentiate coronary thrombosis via a platelet alpha2-adrenergic mechanism, thus exacerbating the original pr...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.96.5.1647
更新日期:1997-09-02 00:00:00
abstract:BACKGROUND:Bolus thrombolytic therapy is a simplified means of administering thrombolysis that facilitates rapid time to treatment. TNK-tissue plasminogen activator (TNK-tPA) is a highly fibrin-specific single-bolus thrombolytic agent. METHODS AND RESULTS:In TIMI 10B, 886 patients with acute ST-elevation myocardial in...
journal_title:Circulation
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1161/01.cir.98.25.2805
更新日期:1998-12-22 00:00:00
abstract:BACKGROUND:The signal transduction mechanism linking mitochondrial ATP synthesis with cytosolic ATP utilization in heart changes during postnatal development in vivo. This maturational process occurs in parallel with accumulation of mitochondrial adenine nucleotide translocator (ANT), which provides a possible site for...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.102.11.1323
更新日期:2000-09-12 00:00:00
abstract::We assessed the reversibility of functional and morphological changes of arterialized vein segments by returning them to the venous circulation. Thirteen dogs underwent right carotid and femoral veno-arterial grafting. After 12 weeks, veno-arterial grafts were removed for contractility (norepinephrine [NE] and 5-hydro...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1990-11-01 00:00:00
abstract:BACKGROUND:Chronic thromboembolic pulmonary hypertension (CTEPH) is a disorder characterized by pulmonary arterial hypertension as a consequence of organized thrombotic material in the central pulmonary arteries. Incomplete resolution of acute pulmonary emboli is believed to be pathogenically important; however, the me...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.86.4.1241
更新日期:1992-10-01 00:00:00
abstract::The sensitivity of the baroreceptor reflex in nine patients with borderline hypertension (mean age 19.1 plus or minus 0.2 years) was compared to that in six normal subjects of comparable age (mean 18.8 plus or minus 0.3 years) and that in 14 patients with established hypertension (mean age 48.3 plus or minus 3.1 years...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.51.4.738
更新日期:1975-04-01 00:00:00
abstract:BACKGROUND:The formation of prostacyclin (PGI(2)), thromboxane (TX) A(2), and isoprostanes is markedly enhanced in atherosclerosis. We examined the relative contribution of cyclooxygenase (COX)-1 and -2 to the generation of these eicosanoids in patients with atherosclerosis. METHODS AND RESULTS:The study population co...
journal_title:Circulation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1161/01.cir.102.8.840
更新日期:2000-08-22 00:00:00
abstract:BACKGROUND:Aortopulmonary collaterals (APC) have been associated with an increased risk of choreoathetosis after deep hypothermic circulatory arrest (DHCA). To study the effects of APC on cerebral hemodynamics and metabolism before and after DHCA, a piglet model was developed. METHODS AND RESULTS:Protocol 1: Eight 4- ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.92.9.490
更新日期:1995-11-01 00:00:00
abstract:BACKGROUND:The goal of this study was to examine a possible association between systemic microinflammation, as reflected by C-reactive protein (CRP) serum levels, and coronary vasomotion in patients with coronary risk factors but with angiographically normal coronary arteries. METHODS AND RESULTS:Coronary vasomotor fu...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000140264.56496.76
更新日期:2004-08-31 00:00:00
abstract:BACKGROUND:Associations between left ventricular (LV) geometry and the insulin resistance syndrome have been found, mostly in small studies of middle-aged hypertensives. The purpose of this study was to elucidate these associations through the use of a large sample of elderly men. METHODS AND RESULTS:We investigated 4...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.101.22.2595
更新日期:2000-06-06 00:00:00
abstract:BACKGROUND:Left ventricular (LV) mass is an important predictor of heart failure and cardiovascular mortality, yet determinants of LV mass are incompletely understood. Pulmonary hyperinflation in chronic obstructive pulmonary disease (COPD) may contribute to changes in intrathoracic pressure that increase LV wall stres...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.113.001653
更新日期:2013-04-09 00:00:00
abstract:BACKGROUND:The extent of microvascular obstruction during acute coronary occlusion may determine the eventual magnitude of myocardial damage and thus, patient prognosis after infarction. By contrast-enhanced MRI, regions of profound microvascular obstruction at the infarct core are hypoenhanced and correspond to greate...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.97.8.765
更新日期:1998-03-03 00:00:00
abstract:BACKGROUND:Anisotropic conduction properties may provide a substrate for reentrant arrhythmias. We investigated the age-dependent changes of structural and functional anisotropy in isolated right atria from infant (1 to 2 months), young (6 to 12 months), and old (6 to 10 years) dogs. METHODS AND RESULTS:The histology ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.0000015506.36371.0d
更新日期:2002-04-30 00:00:00
abstract:BACKGROUND:Q waves on a 12-lead ECG are markers of a prior myocardial infarction (MI). However, they may regress or even disappear over time, and there is no specific ECG sign of a non-Q-wave MI. Fragmented QRS complexes (fQRSs), which include various RSR' patterns, without a typical bundle-branch block are markers of ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.105.595892
更新日期:2006-05-30 00:00:00
abstract:BACKGROUND:Assessment of systemic right ventricular (RV) function is a key point in the follow-up of patients with transposition of the great arteries (TGA). Current echocardiographic assessment of RV function is at best an estimate, and cardiac magnetic resonance (CMR) is considered the gold standard. However, this te...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000147284.54140.73
更新日期:2004-11-16 00:00:00
abstract::Intermittent aortic root infusion of a cold solution containing either potassium chloride (KCl) or diltiazem was performed in 32 dogs during a 2-hour aortic clamping. Half of the dogs in each group had a critical stenosis created on the circumflex artery before cardiopulmonary bypass. Global left ventricular (LV) func...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.65.6.1078
更新日期:1982-06-01 00:00:00
abstract:BACKGROUND:According to the American Heart Association, passive smoking is an important risk factor for coronary heart disease (CHD), but the mechanisms underlying this association are not fully understood. We studied the acute effect of passive smoking on the factors that influence the development of CHD: the antioxid...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.97.20.2012
更新日期:1998-05-26 00:00:00
abstract:BACKGROUND:Several authors have reported cases in which 201Tl scintigraphy demonstrated perfusion abnormality in the septum of patients with left bundle branch block (LBBB) and normal coronary arteriogram. The mechanism of this abnormality, however, remains to be clarified. METHODS AND RESULTS:To determine whether LBB...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.85.3.1125
更新日期:1992-03-01 00:00:00
abstract:BACKGROUND:Venous thromboembolism can be a presenting symptom of cancer, but the association between lower limb arterial thrombosis and cancer is unknown. We therefore examined cancer risk and prognosis of cancer in patients with lower limb arterial thrombosis. METHODS:Using nationwide population-based Danish medical ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.117.032617
更新日期:2018-08-14 00:00:00
abstract:BACKGROUND:Although autonomic imbalance is known to be characteristics of patients with clinically overt symptomatic congestive heart failure, it is currently unknown whether this autonomic response arises early in the course of left ventricular dysfunction or is restricted to the later stages of circulatory failure. ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.92.3.555
更新日期:1995-08-01 00:00:00
abstract::Procainamide, a type 1A antiarrhythmic drug, blocks sodium channels and reduces the maximum rate of rise of the cardiac action potential (Vmax) in a rate-dependent fashion. In vitro, the magnitude of this rate-dependent reduction in Vmax is greater in tissue that is partially depolarized at rest than in tissue with a ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.76.6.1380
更新日期:1987-12-01 00:00:00
abstract::Defibrillation/cardioversion thresholds were measured in 33 patients undergoing defibrillator implants. Each patient had a 12 cm2 patch placed near the left ventricular apex via a thoracotomy and a 10 cm2 spring lead placed pervenously at the right atrial-superior vena caval junction. Ventricular tachycardia of stable...
journal_title:Circulation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1161/01.cir.69.4.766
更新日期:1984-04-01 00:00:00
abstract:BACKGROUND:Unstable atherosclerotic lesions typically have an abundant inflammatory cell infiltrate, including activated T cells, macrophages, and mast cells, which may decrease plaque stability. The pathophysiology of inflammatory cell recruitment and activation in the human atheroma is incompletely described. METHOD...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.102.18.2185
更新日期:2000-10-31 00:00:00
abstract::Six cases of classical dissecting aneurysm of the aorta complicating aortic valvular disease in which aortic stenosis was dominant are described. In three of the cases the aortic complication occurred after the natural aortic valve had been replaced by a prosthetic valve. The longest postoperative period was four mont...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.53.1.169
更新日期:1976-01-01 00:00:00
abstract::Twenty-four hour noninvasive ambulatory blood pressure and heart rate monitoring was performed on patients who underwent orthotopic cardiac transplantation, as part of the investigation of the de novo hypertension that developes in such patients. Patients with essential hypertension served as control subjects. The res...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.73.3.401
更新日期:1986-03-01 00:00:00
abstract:BACKGROUND:Treatment of aortocaval fistulae (ACFs) by open surgery is known to be a high-risk procedure. In this experimental study, we developed a percutaneous model of ACF to test a new nonsurgical method of treatment of ACF using endovascular stent grafts. METHODS AND RESULTS:An ACF was created percutaneously in ei...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.94.1.108
更新日期:1996-07-01 00:00:00