Genetics of coronary artery disease: should they impact the choice of revascularization?

Abstract:

PURPOSE OF REVIEW:Patients with multivessel coronary artery disease (CAD) may undergo revascularization by either percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG). This review will discuss the use of polygenic risk scores for risk-stratification of patients with multivessel CAD in order to guide the choice of revascularization. RECENT FINDINGS:A 57-single nucleotide polymorphism (SNP)-polygenic risk score can accurately risk-stratify patients with CAD and identify those who will receive greater benefit from statin therapy. The most recent genomic studies reveal 243 different SNPs are now significantly associated with CAD. Randomized clinical trials comparing PCI vs. CABG (FREEDOM, SYNTAX, NOBLE, EXCEL) have uncovered factors related to CAD severity (diabetes, SYNTAX score) are critical determinants of outcomes after revascularization. SUMMARY:There is a need to discover predictors of outcomes after PCI vs. CABG to improve clinical decision-making in multivessel CAD. High polygenic risk score is associated with increased CAD severity and better outcomes with statin therapy. Randomized clinical trials indicate CAD severity is associated with better outcomes after CABG compared with PCI. Accordingly, polygenic risk score could also be associated with better outcomes after CABG vs. PCI and used to optimize revascularization for patients with multivessel CAD.

journal_name

Curr Opin Cardiol

authors

Hui SK,Lindale E,Sun L,Ruel M

doi

10.1097/HCO.0000000000000560

subject

Has Abstract

pub_date

2018-11-01 00:00:00

pages

605-612

issue

6

eissn

0268-4705

issn

1531-7080

journal_volume

33

pub_type

杂志文章,评审
  • Cardiac allograft vasculopathy: pathology, prevention and treatment.

    abstract:PURPOSE OF REVIEW:Cardiac transplantation is a recognized therapy for end-stage heart failure. Graft coronary artery disease is a chief determinant of long-term survival following cardiac transplantation. There are multiple purported etiologies for graft coronary artery disease including both immunologic and nonimmunol...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/01.hco.0000203184.89158.16

    authors: Kass M,Haddad H

    更新日期:2006-03-01 00:00:00

  • Reverse ventricular remodeling: mechanical options.

    abstract:PURPOSE OF REVIEW:The aim of this review is to update the cardiovascular clinician on the current status of surgical therapies aimed at achieving reverse ventricular remodeling. RECENT FINDINGS:Relevant research focusing on mechanical options for reverse ventricular remodeling will be referenced and summarized. SUMMA...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/01.hco.0000221583.48748.d9

    authors: McGee EC,Gillinov AM,McCarthy PM

    更新日期:2006-05-01 00:00:00

  • Ion channels and ventricular arrhythmias: cellular and ionic mechanisms underlying the Brugada syndrome.

    abstract::Brugada syndrome is characterized by ST segment elevation in the right precordial leads, V1-V3 (unrelated to ischemia or structural disease), normal QT intervals, apparent right bundle branch block, and sudden cardiac death, particularly in men of Asian origin. An autosomal dominant mode of inheritance with variable e...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199905000-00013

    authors: Antzelevitch C

    更新日期:1999-05-01 00:00:00

  • Evolving concepts on benefits and risks associated with therapeutic strategies to raise HDL.

    abstract:PURPOSE OF REVIEW:To provide an update on high-density lipoprotein (HDL) biology and emerging new HDL-based therapies for athero-thrombosis. RECENT FINDINGS:Atherosclerotic cardiovascular disease remains a major public health threat despite a significant decline over the past three decades. Although current medical th...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0b013e32833f0382

    authors: Shah PK

    更新日期:2010-11-01 00:00:00

  • Optimizing the treatment of heart failure.

    abstract::The introduction of new drugs, and a re-evaluation of older drugs, have radically changed the pharmacological management of heart failure. Angiotensin converting enzyme (ACE) inhibitors, digitalis, diuretics and the combination of nitrates and hydralazine are now used. The first Cooperative North Scandinavian Enalapri...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199407000-00005

    authors: Giles TD

    更新日期:1994-07-01 00:00:00

  • Fibrates in the treatment of cardiovascular risk and atherogenic dyslipidaemia.

    abstract:PURPOSE:New data have emerged over the last few years about the role of fibrates in treatment of microvascular and macrovascular disease. RECENT FINDINGS:Endpoint studies have been conducted with fibrates in coronary heart disease (CHD) since 1971 and initial results were contradictory. Fibrates later showed benefits ...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0b013e32832c0b3d

    authors: Wierzbicki AS

    更新日期:2009-07-01 00:00:00

  • Global patterns of health care for acute coronary syndromes.

    abstract:PURPOSE OF REVIEW:Despite similar guidelines, remarkable global differences exist in the management of acute coronary syndromes. This review describes recent insights in global patterns of patient baseline characteristics, treatment strategies, medication use, and outcome in acute coronary syndromes. RECENT FINDINGS:R...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/01.hco.0000142063.30214.d2

    authors: Sinnaeve PR,Van de Werf FJ

    更新日期:2004-11-01 00:00:00

  • Statins for primary prevention of cardiovascular disease: the benefits outweigh the risks.

    abstract:PURPOSE OF REVIEW:Statins significantly reduce cardiovascular morbidity and mortality in patients with and without coronary heart disease. Recently, much debate has focused on use of statins for primary prevention following a class-wide safety label change by the US Food and Drug Administration amidst concerns of worse...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0b013e32836429e6

    authors: Minder CM,Blumenthal RS,Blaha MJ

    更新日期:2013-09-01 00:00:00

  • Genetic testing in cardiovascular medicine: current landscape and future horizons.

    abstract:PURPOSE OF REVIEW:The number of clinically available genetic tests for heritable cardiovascular diseases has recently increased because of novel gene discoveries and advancements in DNA sequencing technologies. The purpose of this review is to provide up-to-date genetic testing information and guidance on how to incorp...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0b013e32835fb728

    authors: Sturm AC,Hershberger RE

    更新日期:2013-05-01 00:00:00

  • Genetic testing in cardiovascular diseases.

    abstract:PURPOSE OF REVIEW:The review is designed to outline the major developments in genetic testing in the cardiovascular arena in the past year or so. This is an exciting time in genetic testing as whole exome and whole genome approaches finally reach the clinic. These new approaches offer insight into disease causation in ...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0000000000000055

    authors: Arndt AK,MacRae CA

    更新日期:2014-05-01 00:00:00

  • Antithrombotic drugs in cardiovascular medicine: a year in review.

    abstract:PURPOSE OF REVIEW:To provide an up to date review of the most recent randomized clinical trials in the field of antithrombotic drugs for cardiovascular diseases. RECENT FINDINGS:In 2017, low-dose anti-Xa treatment added to aspirin proved to be more efficacious than either treatment alone in patients with stable athero...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0000000000000530

    authors: Ibrahim H,Rondina M,Welt FGP

    更新日期:2018-07-01 00:00:00

  • Update on digoxin and other oral positive inotropic agents for chronic heart failure.

    abstract::The benefit of digoxin in chronic heart failure has been debated fervently for decades. In the 1970s, the use of digoxin was challenged due to the high incidences of digitalis toxicity and the lack of data on the effects of digoxin in patients with chronic heart failure. In the 1980s, interest in digoxin was renewed a...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199705000-00004

    authors: Reddy S,Benatar D,Gheorghiade M

    更新日期:1997-05-01 00:00:00

  • Ultrafiltration for congestive heart failure: the past and the present.

    abstract:PURPOSE OF REVIEW:To provide an overview on the most recent evidence for the use of extracorporeal and peritoneal ultrafiltration in heart failure, focusing on the major publications from the last few years. RECENT FINDINGS:There have been several studies investigating the possible use of extracorporeal and peritoneal...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章

    doi:10.1097/HCO.0000000000000139

    authors: Marenzi G,Kazory A,Agostoni P

    更新日期:2015-03-01 00:00:00

  • Mechanical circulatory support of the failing heart.

    abstract::Over the past 30 years, there have been significant pharmacological and technological advances in the treatment of cardiogenic shock. Although most patients who develop cardiogenic shock can be effectively treated with conventional therapy, including inotropic and vasodilating drugs and intra-aortic balloon pumps, a s...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199403000-00013

    authors: Votapka TV,Pennington DG

    更新日期:1994-03-01 00:00:00

  • Apoptosis as a therapeutic target in acutely ischemic myocardium.

    abstract::In addition to necrosis, apoptosis makes a significant contribution to cell death following acute myocardial ischemia; apoptosis is particularly enhanced during reperfusion. Several studies are beginning to indicate that the cell death by apoptosis may be preventable. A boost in the research in this direction has been...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-200309000-00009

    authors: Garg S,Hofstra L,Reutelingsperger C,Narula J

    更新日期:2003-09-01 00:00:00

  • Coarctation of the aorta: evaluation and management.

    abstract:PURPOSE OF REVIEW:Coarctation of the aorta is the discrete narrowing of the proximal descending aorta and is the sixth most common lesion in congenital heart disease. Repair of the coarctation can relieve the obstruction, but recurrent coarctation and future aneurysm formation can occur, and a heightened risk of vascul...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0b013e328330cc22

    authors: Tanous D,Benson LN,Horlick EM

    更新日期:2009-11-01 00:00:00

  • Institutional and national trends in isolated mitral valve surgery over the past decade.

    abstract:PURPOSE OF REVIEW:To review trends in practice for mitral valve surgery in the US over the past decade. RECENT FINDINGS:Advances in the understanding of mitral valve pathophysiology and the technology involved with mitral valve surgery have led to significant changes of the current practice for mitral valve surgery, w...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0b013e3282f4624f

    authors: Ad N,Barnett SD,Speir AM,Massimiano PS

    更新日期:2008-03-01 00:00:00

  • Update about atrial fibrillation genetics.

    abstract:PURPOSE OF REVIEW:Atrial fibrillation is an important cause of morbidity in the aging population. The mechanisms responsible for the triggering and maintenance of the chaotic atrial rhythm are still poorly understood. In this review, we will focus on the genetic aspects of atrial fibrillation, to understand causality, ...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章

    doi:10.1097/HCO.0000000000000387

    authors: Pérez-Serra A,Campuzano O,Brugada R

    更新日期:2017-05-01 00:00:00

  • The molecular genetics of hypertrophic cardiomyopathy.

    abstract::Hypertrophic cardiomyopathy has been shown to be a genetically heterogeneous disorder, linked to at least four different loci on chromosomes 14, 1, 15, and 11. Thus far, three genes have been identified that harbor mutations leading to hypertrophic cardiomyopathy. These genes--cardiac beta myosin heavy chain, alpha tr...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199505000-00010

    authors: Elstein E

    更新日期:1995-05-01 00:00:00

  • Antithrombotic therapy and venous graft disease.

    abstract::Venous graft disease is a thromboproliferative process and places a serious limitation on the symptom-free survival of patients after coronary artery bypass grafting. The efficacy of antithrombotics, especially during the first year after surgery, is suggested by an understanding of the four described phases of diseas...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199811000-00012

    authors: Schussheim AE,Fuster V

    更新日期:1998-11-01 00:00:00

  • The intrinsic cardiac nervous system and atrial fibrillation.

    abstract:PURPOSE OF REVIEW:Radiofrequency ablation techniques to cure cardiac arrhythmias have focused on destroying myocardial tissue involved in abnormal excitation or conduction. This review will address recent basic and clinical studies which suggest that targeting autonomic nerves and ganglia on the large vessels and the h...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/01.hco.0000198980.40390.e4

    authors: Scherlag BJ,Po S

    更新日期:2006-01-01 00:00:00

  • Trials comparing coronary artery bypass grafting with percutaneous transluminal coronary angioplasty and primary stent implantation in patients with multivessel coronary artery disease.

    abstract::With marked improvements in stent technology as adjunct to balloon angioplasty for multivessel coronary disease, several newer trials are currently in progress reviewing the optimal revascularization strategy. This review provides background from older studies and addresses the current progress and design of these new...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-200011000-00003

    authors: Bakhai A,Stables RH,Prasad S,Sigwart U

    更新日期:2000-11-01 00:00:00

  • Identification of patients with hypertrophic cardiomyopathy at high risk for sudden death.

    abstract::Patients with hypertrophic cardiomyopathy are at increased risk for sudden death. Recent studies have improved our ability to risk-stratify such patients and have elucidated several potential mechanisms of sudden death and syncope. Certain noninvasive tests, such as signal-averaged electrocardiography and measurements...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199501000-00003

    authors: Chang AC,McAreavey D,Fananapazir L

    更新日期:1995-01-01 00:00:00

  • Adenosine single photon emission computed tomography for assessing risk after myocardial infarction: recent developments.

    abstract:PURPOSE OF REVIEW:While the prognostic power of adenosine single photon emission computed tomography myocardial perfusion imaging has been validated in multiple patient populations including those with known or suspected coronary artery disease, the utility of this modality in assessing risk after an acute myocardial i...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0b013e32820652c9

    authors: Dorfman TA,Iskandrian AE

    更新日期:2007-09-01 00:00:00

  • Drug therapy of chronic heart failure in the elderly: the current state of clinical-trial evidence.

    abstract:PURPOSE OF REVIEW:beta-Blockers, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, aldosterone receptor antagonists, and digoxin are the most common drug classes used to treat chronic heart failure. We examine current clinical trial evidence concerning heart-failure management in the elderly. ...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/01.hco.0000231411.15049.20

    authors: Dulin BR,Krum H

    更新日期:2006-07-01 00:00:00

  • Hypertrophic cardiomyopathy: do sudden death prevention strategies in children differ between Europe and North America?

    abstract:PURPOSE OF REVIEW:Hypertrophic cardiomyopathy (HCM) is the second most common childhood heart muscle disease and is the most common cause of unexpected sudden cardiac death in young people. The purpose of this review is to describe the risk of sudden death, to assess which of the criteria conventionally used as indicat...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0b013e32835dd020

    authors: Östman-Smith I,Rossano JW,Shaddy RE

    更新日期:2013-03-01 00:00:00

  • Evidence supporting secondary prevention strategies.

    abstract::Currently 14 million individuals in the United States have coronary disease. Within the next 2 decades, this number is expected to increase to 21 million persons. To minimize the excessive risk of recurrent cardiac events in these people, evidence-based, cost-effective prevention strategies must be developed. This rev...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199907000-00005

    authors: Blazing MA,O'Connor CM

    更新日期:1999-07-01 00:00:00

  • Incidence, definition, diagnosis, and management of the cardiac resynchronization therapy nonresponder.

    abstract:PURPOSE OF REVIEW:Cardiac resynchronization therapy (CRT) reduces morbidity and mortality in patients with mild-to-severe heart failure. However, up to 40% of CRT recipients are nonresponders. This review addresses important aspects with regard to the identification and management of CRT nonresponders. RECENT FINDINGS...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,meta分析,评审

    doi:10.1097/HCO.0000000000000140

    authors: Zhang Q,Zhou Y,Yu CM

    更新日期:2015-01-01 00:00:00

  • Magnetic resonance for the assessment of myocardial viability.

    abstract:PURPOSE OF REVIEW:Cardiac magnetic resonance imaging has an expanding role as a preferred modality for the detection and characterization of myocardial viability. RECENT FINDINGS:Improving the accuracy of cardiac magnetic resonance for detecting viable myocardium has been one focus of investigators. In segments with i...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/01.hco.0000240584.68720.ae

    authors: Isbell DC,Kramer CM

    更新日期:2006-09-01 00:00:00

  • Genes, hypertension, and intermediate phenotypes.

    abstract::Although it has been recognized for almost 70 years that there is a substantial genetic component to the pathogenesis of hypertension, only recently have systematic efforts been made to identify the responsible genetically determined mechanisms. In the case of several rare syndromes, spectacular progress has been made...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199609000-00002

    authors: Hollenberg NK

    更新日期:1996-09-01 00:00:00