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Coronary Intervention & Surgery

 

New-onset atrial fibrillation (NOAF) occurred in 18 percent of patients undergoing coronary artery bypass grafting (CABG) but just 0.1 percent of those receiving PCI, according to an analysis of the international EXCEL trial published in the Journal of the American College of Cardiology. What’s more, the patients who developed NOAF within a few days of surgery were at a 3.02-fold risk of death and a 4.19-fold risk of suffering a stroke over the following three years.

A day after announcing the FDA’s expanded approval for cardiogenic shock associated with cardiomyopathy, device manufacturer Abiomed said its Impella 2.5 and Impella CP pumps are now indicated for temporary ventricular support during high-risk percutaneous coronary intervention (PCI) regardless of a patient’s ejection fraction.

Unfractionated heparin (UFH) has overtaken bivalirudin as the anticoagulant of choice for treating end-stage renal disease (ESRD) patients undergoing PCI, according to a new study, but UFH may be associated with worse in-hospital outcomes.

A simple tool to predict neurological outcomes for sufferers of out-of-hospital cardiac arrest (OHCA) could help clinicians determine when invasive coronary management is futile, a study in JACC: Cardiovascular Interventions suggests.

Compliance with guideline-directed medical therapy (GDMT) is low following coronary revascularization—but especially low after coronary artery bypass grafting (CABG), possibly influencing the common comparisons between CABG and percutaneous coronary intervention (PCI).

 

Recent Headlines

Post-operative AFib common in CABG, linked to future stroke, death

New-onset atrial fibrillation (NOAF) occurred in 18 percent of patients undergoing coronary artery bypass grafting (CABG) but just 0.1 percent of those receiving PCI, according to an analysis of the international EXCEL trial published in the Journal of the American College of Cardiology. What’s more, the patients who developed NOAF within a few days of surgery were at a 3.02-fold risk of death and a 4.19-fold risk of suffering a stroke over the following three years.

FDA expands Impella heart pumps’ indication for high-risk PCI

A day after announcing the FDA’s expanded approval for cardiogenic shock associated with cardiomyopathy, device manufacturer Abiomed said its Impella 2.5 and Impella CP pumps are now indicated for temporary ventricular support during high-risk percutaneous coronary intervention (PCI) regardless of a patient’s ejection fraction.

Bivalirudin outperforms heparin for ESRD patients undergoing PCI

Unfractionated heparin (UFH) has overtaken bivalirudin as the anticoagulant of choice for treating end-stage renal disease (ESRD) patients undergoing PCI, according to a new study, but UFH may be associated with worse in-hospital outcomes.

Many OHCA patients don’t benefit from immediate coronary treatment

A simple tool to predict neurological outcomes for sufferers of out-of-hospital cardiac arrest (OHCA) could help clinicians determine when invasive coronary management is futile, a study in JACC: Cardiovascular Interventions suggests.

Secondary prevention is poor following revascularization—particularly for CABG

Compliance with guideline-directed medical therapy (GDMT) is low following coronary revascularization—but especially low after coronary artery bypass grafting (CABG), possibly influencing the common comparisons between CABG and percutaneous coronary intervention (PCI).

Long-term study supports CABG over PCI in young patients with severe CAD

Younger patients with three-vessel coronary artery disease benefit more from coronary artery bypass grafting (CABG) than percutaneous coronary intervention (PCI) in the long run, suggests a study presented Jan. 30 at the Society of Thoracic Surgeons’ annual meeting in Fort Lauderdale, Florida.

LAA closure cuts risk of thromboembolism in AFib patients

Left atrial appendage (LAA) closure at the time of cardiac surgery may reduce the risk of thromboembolism in older patients with atrial fibrillation (AFib), according to an observational study published in the Journal of the American Medical Association.

Physicians overestimate degree of stenosis, prompting inappropriate PCIs

A cross-sectional study of nearly 1,300 patients revealed Chinese physicians systematically overestimate the severity of coronary stenosis, perhaps even more so than in the United States, likely leading to many patients being inappropriately treated with percutaneous coronary intervention (PCI).

Untreated lesions twice as likely to cause 2nd heart attack

The risk of another heart attack following percutaneous coronary intervention (PCI) was twice as likely to originate from a previously untreated lesion versus the stented lesion, according to a study of a large Swedish cohort published in the Journal of the American Heart Association.

Coronary revascularization safer, cheaper in England vs. New York

Patients are significantly more likely to die within one year of coronary artery bypass graft (CABG) surgery or PCI in New York state than in England where the procedures are roughly four times cheaper, according to a study in Open Heart.

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