Abstract:
BACKGROUND:Elderly patients with ischaemic heart disease are often treated more conservatively and for longer than younger patients, but this strategy may result in subsequent invasive intervention of more advanced and higher risk coronary disease. METHODS:We performed a retrospective analysis of 109 patients aged > or = 70 years (mean age 74 years, 66% men), who presented with angina refractory to maximal medical treatment or unstable angina over a 2-year period (1988-1990), to compare the relative risks and benefits of myocardial revascularisation [coronary artery bypass grafting (CABG) and percutaneous transluminal coronary angioplasty (PTCA)] in this higher-risk age group. RESULTS:Sixty patients underwent CABG and 49 patients PTCA. There were eight periprocedural deaths in total (six in the CABG group, and two in the PTCA group, P = 0.29). Six patients in the CABG group suffered a cerebrovascular accident (two fatal). Acute Q-wave myocardial infarction occurred in one patient in the CABG group and in two patients in the PTCA group. The length of hospital stay was longer for the CABG group (CABG group 11.4 +/- 5.4 days, range 7-30 days, PTCA group 7.4 +/- 7.6 days, range 1-39 days, P = 0.01). Outcome was assessed using the major cardiac event rate (MACE; i.e. the rate of death, myocardial infarction, repeat CABG or PTCA). The cumulative event-free survival in the CABG group in 1, 2 and 3 years was 87, 85 and 85%, respectively. In contrast, in the PTCA group it was 55, 48 and 48% (P = 0.0001). Age, sex, number of diseased vessels, degree of revascularisation and left ventricular function were not predictive of the recurrence of angina in both groups. Actuarial survival (total mortality, including perioperative mortality) was lower at 1 year in the CABG group due to the higher perioperative mortality, but similar in both groups after the second year (P = 0.62). CONCLUSIONS:Elderly patients with refractory or unstable angina who are revascularised surgically have a better long-term outcome (less frequent event rate of the composite end-point--myocardial infarction, revascularisation procedures and death) compared with those who are revascularised with PTCA. This benefit is been realised after the second year. Total mortality is similar in both groups after the second year. Therefore elderly patients who are fit for surgery should not be denied the benefits of CABG. PTCA may be regarded as a complementary and satisfactory treatment, especially for those whose life expectancy is limited to less than 2 years. The use of stents may improve outcome in the PTCA group and this needs to be evaluated.
journal_name
Coron Artery Disjournal_title
Coronary artery diseaseauthors
Vassilikos VP,Lim R,Kreidieh I,Nathan AW,Edmondson SJ,Rees GM,Banim SO,Dymond DSdoi
10.1097/00019501-199711000-00006subject
Has Abstractpub_date
1997-11-01 00:00:00pages
705-9issue
11-12eissn
0954-6928issn
1473-5830journal_volume
8pub_type
杂志文章abstract:BACKGROUND:Electrogram fractionation can result when multiple groups of cardiac cells are excited asynchronously within the recording region of a mapping electrode. The spatial resolution of an electrode thus plays an important role in mapping complex rhythms. METHODS:We used a computational model, validated against e...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/MCA.0b013e3283507a9b
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:There is growing interest in the role of microbes in the pathogenesis of coronary atherosclerosis but most of the evidence has been seroepidemiologic. It would be useful to know more about the cytology and histology of coronary lesions containing clearly depicted microbes. OBJECTIVE:To define carefully the ...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/00019501-200103000-00005
更新日期:2001-03-01 00:00:00
abstract::This review provides a brief introduction to the basic concepts of MRA techniques with specific discussions on imaging of coronary arteries. These techniques, especially those for imaging of coronary arteries, are still rapidly evolving. The goals of future research include obtaining faster imaging, higher SNR, and hi...
journal_title:Coronary artery disease
pub_type: 杂志文章,评审
doi:10.1097/00019501-199905000-00002
更新日期:1999-05-01 00:00:00
abstract::Chest pain and dyspnea are common presentations for symptomatic individuals with suspected coronary artery disease (CAD) in the primary care office and cardiology clinics. However, it is imperative to properly diagnose who should undergo further evaluation for cardiac etiologies of chest pain, with either noninvasive ...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/MCA.0000000000000999
更新日期:2021-01-18 00:00:00
abstract:OBJECTIVE:To determine whether a quantitative measurement of peak systolic velocity (PSV) during dobutamine stress echocardiography (DSE) detects severe coronary artery disease (CAD) and predicts mortality in patients with end-stage renal disease. METHODS:One hundred and forty renal transplant candidates had DSE and c...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/MCA.0b013e32832ac5eb
更新日期:2009-05-01 00:00:00
abstract:OBJECTIVES:To evaluate the efficacy and safety of intracoronary administration of prourokinase via balloon catheter during primary percutaneous coronary interventions in patients with acute ST-segment elevation myocardial infarction. METHODS:Acute ST-segment elevation myocardial infarction patients underwent primary p...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/MCA.0000000000000898
更新日期:2021-01-01 00:00:00
abstract:OBJECTIVE:Erectile dysfunction and coronary artery disease share similar risk factors. Although phosphodiesterase-5 inhibitors used to treat erectile dysfunction do not adversely affect hemodynamic parameters in patients with coronary artery disease, their effects on myocardial blood flow are unknown. METHODS:In a ran...
journal_title:Coronary artery disease
pub_type: 杂志文章,随机对照试验
doi:10.1097/00019501-200609000-00001
更新日期:2006-09-01 00:00:00
abstract:BACKGROUND:Although lipid-lowering therapy affects the luminal size of atherosclerotic coronary arteries the role of vascular remodeling has not been systematically studied. DESIGN/METHODS:Serial three-dimensional volumetric intravascular ultrasound (IVUS) was used to study remodeling, which was defined as changes in ...
journal_title:Coronary artery disease
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/00019501-200402000-00007
更新日期:2004-02-01 00:00:00
abstract:BACKGROUND:Restenosis after coronary angioplasty is considered to be caused mainly by increased migration and proliferation of smooth muscle cells (SMC). The concept of local, site-specific delivery of pharmacologic therapies has opened the door for new, high-dose drug regimes. METHODS AND RESULTS:SMC were isolated by...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/00019501-199703000-00011
更新日期:1997-03-01 00:00:00
abstract::Ischemic heart disease is a major cause of morbidity and mortality throughout the world. Percutaneous coronary intervention (PCI) has rapidly evolved from balloon angioplasty to drug-eluting stents over the past 25 years and has become an important treatment option for coronary heart disease. During PCI, atherosclerot...
journal_title:Coronary artery disease
pub_type: 杂志文章,评审
doi:10.1097/MCA.0b013e32833729e3
更新日期:2011-03-01 00:00:00
abstract:AIM:This study aimed to investigate whether patients with very low left ventricular ejection fractions (LVEF) should be accepted for reoperative coronary artery bypass grafting (CABG). STUDY POPULATION:Between January 1990 and December 1993, 1681 patients underwent primary CABG and 308 (15.5%) reoperative CABG. One hu...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/00019501-199505000-00010
更新日期:1995-05-01 00:00:00
abstract:AIMS:The clinical effectiveness of sirolimus-eluting stents (SES) for treatment of patients with saphenous vein graft disease is not well defined. This analysis sought to evaluate the clinical follow-up after treatment of stenotic saphenous vein grafts using SES in a large patient registry. Patients treated with SES fo...
journal_title:Coronary artery disease
pub_type: 杂志文章,多中心研究
doi:10.1097/MCA.0b013e3282ef5b40
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND:We examined the effects of rosuvastatin treatment on triglyceride levels and lipid measures in a parallel-group multicenter trial (4522IL/0035) in patients with hypertriglyceridemia (Fredrickson Type IIb or IV). METHODS:After a 6-week dietary lead-in period while on a National Cholesterol Education Program ...
journal_title:Coronary artery disease
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/00019501-200403000-00008
更新日期:2004-03-01 00:00:00
abstract:BACKGROUND:The aim of this study was to identify psychosocial variables that, in addition to known medical factors, predict the long-term outcome after a first myocardial infarction. PATIENTS AND METHODS:The study population consisted of 222 men aged 30-60 years who entered an inpatient rehabilitation program a mean o...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/00019501-199502000-00009
更新日期:1995-02-01 00:00:00
abstract:OBJECTIVES:The aim of this study is to determine the prevalence of coronary artery ectasia and its relationship to atheromatous changes in participants undergoing coronary computed tomography angiography. BACKGROUND:Coronary artery ectasia occasionally encountered on conventional coronary angiography is considered a m...
journal_title:Coronary artery disease
pub_type: 临床试验,杂志文章
doi:10.1097/MCA.0b013e3280144be1
更新日期:2007-05-01 00:00:00
abstract:OBJECTIVE:Atrial fibrillation is one of the most common arrhythmias associated with not only increased morbidity after coronary artery bypass grafting but also increased healthcare costs. Many factors are associated with atrial fibrillation onset after coronary artery bypass grafting. We prospectively examined which fa...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/MCA.0b013e3281689a2c
更新日期:2007-08-01 00:00:00
abstract:BACKGROUND:Anemia is associated with an increased risk of mortality in patients who underwent percutaneous coronary intervention (PCI) in the bare-metal stent era. However, there have been no data concerning the clinical importance of anemia improvement during the follow-up period after discharge from the hospital duri...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/MCA.0b013e3283564869
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVES:Although the relationship between atherosclerosis and inflammatory cells has been recognized in recent years, the effect of interleukin-6 (IL-6) genetic variants associated with atherosclerosis is still controversial. Therefore, we investigated the association between IL-6 polymorphism and levels of IL-6 in ...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/MCA.0b013e3282f27bf7
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND:We have demonstrated previously that, when repeated reperfusion is performed after reocclusion, there is a decrease in the amount of myocardial salvage, despite early reperfusion. Treatment with nisoldipine induced a beneficial effect by reduction of infarct size in this experimental model. OBJECTIVE:To stu...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/00019501-200003000-00013
更新日期:2000-03-01 00:00:00
abstract:BACKGROUND:This study was designed to evaluate whether differences between sexes exist in serum-lipoprotein (a) [Lp(a)] and arterial-wall-apolipoprotein (a) [Apo(a)] levels in patients with advanced coronary artery disease. METHODS:The concentrations of Lp(a) in serum and Apo(a) in aortic biopsies were studied in 76 m...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/00019501-199504000-00013
更新日期:1995-04-01 00:00:00
abstract:AIM:To determine how hypertension affects the left ventricular diastolic function of patients with effort angina. METHODS:We performed radionuclide ventriculography in 14 patients with isolated stenosis of the left anterior descending coronary artery and in seven healthy volunteers. RESULTS:Neither global nor regiona...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:
更新日期:1994-10-01 00:00:00
abstract:OBJECTIVES:Atherosclerosis and osteoporosis (OP) are common diseases in elderly individuals and may share common pathogenetic mechanisms. The aim of this study was to investigate the association between bone mineral density (BMD) and coronary artery calcium (CAC) in postmenopausal women. METHODS:In this cross-sectiona...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/MCA.0000000000000402
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND:Blunted heart rate variability (HRV) and presence of ventricular late potentials (VLPs) are known to correlate with an increased risk of ventricular tachycardia and sudden cardiac death in acute myocardial infarction (AMI). In the present study, we investigated the effect of glucose-insulin-potassium (GIK) s...
journal_title:Coronary artery disease
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00019501-200109000-00010
更新日期:2001-09-01 00:00:00
abstract::Chronic total occlusions (CTOs) are routinely encountered during coronary angiography, but subsequent revascularization rates are low. This has likely been driven by a historical belief that there is minimal clinical benefit and poor success rates with a percutaneous coronary intervention (PCI). However, in the curren...
journal_title:Coronary artery disease
pub_type: 杂志文章,评审
doi:10.1097/MCA.0000000000000490
更新日期:2017-08-01 00:00:00
abstract:AIMS:To evaluate the hypothesis that angiotensin-converting enzyme inhibitor therapy with ramipril reduces baseline levels of C-reactive protein in patients at high cardiovascular risk. METHODS:Secondary prevention patients were screened for eligibility and treated with ramipril for 6 month. Baseline and 6-month highl...
journal_title:Coronary artery disease
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1097/00019501-200510000-00002
更新日期:2005-11-01 00:00:00
abstract::Potentially hazardous short ischemic episodes increase the tolerance of myocardium to ischemia paradoxically. This condition decreases the infarct area markedly caused by a longer duration of coronary occlusion. This phenomenon is known as 'ischemic preconditioning' and its powerful cardioprotective effect has been sh...
journal_title:Coronary artery disease
pub_type: 杂志文章,评审
doi:10.1097/00019501-200605000-00013
更新日期:2006-05-01 00:00:00
abstract:OBJECTIVES:Little is known about the impact of sex-specific differences in calculating the pretest probability (PTP) of obstructive coronary artery disease. We sought to determine whether the calculation of PTP differ by sex in symptomatic patients referred to coronary computed tomographic angiography (CCTA). PATIENTS...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/MCA.0000000000000696
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:The N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) is a sensitive indicator of hemodynamic stress and its increased level is associated with higher mortality in acute coronary syndrome (ACS) patients. Virtual histology-intravascular ultrasound (VH-IVUS) can provide quantitative information on plaque ...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/MCA.0b013e32832a196e
更新日期:2009-12-01 00:00:00
abstract:AIM:The aim of this meta-analysis was to evaluate the efficacy of drug-eluting balloons (DEBs) plus bare-metal stents (BMS) for the treatment of de-novo coronary lesions. METHODS AND RESULTS:Eleven trials involving 1279 patients were included in this study. The main endpoints were as follows: late lumen loss (LLL), bi...
journal_title:Coronary artery disease
pub_type: 杂志文章,meta分析
doi:10.1097/MCA.0000000000000372
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:To maintain the integrity of tissues, endothelial cells play critical roles. Fas ligand (FasL) is well known to deliver a death signal through its receptor, Fas. The Fas/FasL system may concomitantly induce expressions of interleukin-8 (IL-8) and monocyte chemoattractant protein-1 (MCP-1) besides triggering ...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/00019501-200302000-00010
更新日期:2003-02-01 00:00:00