Most Read Articles
Jairia Dela Cruz, 5 days ago
Use of aspirin in the primary prevention of cardiovascular disease (CVD) in patients with no prior CVD history yields protection against the risks of acute myocardial infarction (AMI) and ischaemic stroke, but at the expense of an increase of similar magnitude in the incidence of major bleeding, according to the results of a recent meta-analysis presented at the European Society of Cardiology (ESC) Congress 2019 in Paris, France.
Dr Margaret Shi, 4 days ago

A comprehensive model of care delivered by nonphysician health workers (NPHWs), involving primary care physicians and families that was informed by local context, substantially improved blood pressure (BP) control and cardiovascular disease (CVD) risk, according to results of the HOPE 4 trial reported at the European Society of Cardiology (ESC) Congress 2019 and World Congress of Cardiology (WCC) 2019.

Off-pump CABG tied to higher mortality in patients with left main disease

13 Aug 2019

Off-pump, compared with on-pump, coronary artery bypass grafting (CABG) in patients with left main disease results in a lower rate of revascularization of the coronary arteries supplying the inferolateral wall and an increased risk of 3-year all-cause death, results of the EXCEL* trial have shown.

Of the 923 CABG patients, 652 underwent on-pump surgery and 271 off-pump. The extent of disease was similar between the two groups, but patients in the off-pump arm had a lower rate of revascularization of the left circumflex coronary artery (84.1 percent vs 90.0 percent; p=0.01) and right coronary artery (31.1 percent vs 40.6 percent; p=0.007).

After inverse probability of treatment weighting (IPTW) adjustment for baseline difference, an association was found between off-pump surgery and a significant increase in the risk of 3-year all-cause death (8.8 percent vs 4.5 percent; hazard ratio [HR], 1.94, 95 percent CI, 1.10–3.41; p=0.02), as well as a nonsignificant difference in the risk for the composite endpoint of death, myocardial infarction or stroke (11.8 percent vs 9.2 percent; HR, 1.28, 0.82–2.00; p=0.28).

The EXCEL trial compared percutaneous coronary intervention with everolimus-eluting stents with CABP in patients with left main disease. CABG was performed with or without cardiopulmonary bypass (on-pump vs off-pump surgery) according to the discretion of the operator. IPTW for treatment effect estimation was used to compare the 3-year outcomes in the off-pump and on-pump groups.

“Concerns remain for a greater risk of incomplete revascularization and reduced survival with off-pump CABG surgery compared with on-pump surgery particularly in patients with left main disease and extensive underlying myocardial ischaemia,” the authors said.

*Evaluation of XIENCE versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization

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Most Read Articles
Jairia Dela Cruz, 5 days ago
Use of aspirin in the primary prevention of cardiovascular disease (CVD) in patients with no prior CVD history yields protection against the risks of acute myocardial infarction (AMI) and ischaemic stroke, but at the expense of an increase of similar magnitude in the incidence of major bleeding, according to the results of a recent meta-analysis presented at the European Society of Cardiology (ESC) Congress 2019 in Paris, France.
Dr Margaret Shi, 4 days ago

A comprehensive model of care delivered by nonphysician health workers (NPHWs), involving primary care physicians and families that was informed by local context, substantially improved blood pressure (BP) control and cardiovascular disease (CVD) risk, according to results of the HOPE 4 trial reported at the European Society of Cardiology (ESC) Congress 2019 and World Congress of Cardiology (WCC) 2019.