Canadian Cardiovascular Society/Canadian Association of Interventional Cardiology/Canadian Society of Cardiac Surgery Position Statement on Revascularization—Multivessel Coronary Artery Disease

Teo, Koon; Cohen, Éric A.; Buller, Christopher E.; Hassan, Ansar; Carere, Ronald G.; Cox, Jafna L.; Ly, Hung Q.; Fedak, Paul W.M.; Chan, Kwan L.; Légaré, Jean‐François; Connelly, Kim A.; Tanguay, Jean‐François; Ye, Jian; Gupta, Milan; Mancini, G.B. John; Dagenais, Gilles R.; Williams, Randall; Teoh, Kevin; Latter, David A.; Townley, Richard; Meyer, Steven

doi:10.1016/j.cjca.2014.09.034

Cited by 46 publications

(36 citation statements)

References 44 publications

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“…Coronary artery disease (CAD) is one of the greatest causes of morbidity and mortality throughout the world. It accounts for roughly one-half of all cardiovascular deaths [ 1 , 2 ]. Although tobacco use and lipid metabolism disorder are the classical risk factors for CAD, some studies have found that CAD shows strong familial aggregation, and a gene variant is also a key risk marker for CAD patients [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Lipoprotein Lipase (LPL) Polymorphism and the Risk of Coronary Artery Disease: A Meta-Analysis

Xie

2017

IJERPH

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Background: In recent years, the lipoprotein lipase (LPL) polymorphism has been extensively investigated as a potential risk factor for coronary artery disease (CAD). However, the results of these studies have been inconsistent. Therefore, we performed this meta-analysis to explore the association between LPL polymorphism and CAD risk. Methods: The literature was searched from electronic databases such as Embase, China Biological Medicine Database, PubMed, Knowledge Infrastructure, and China National Web of Science by the key words “coronary artery disease”, “lipoprotein lipase” and “polymorphism”. All of the studies included in this manuscript met the inclusion and exclusion criteria. An odds ratio (OR) analysis using a 95% confidence interval (CI) was employed to assess the association of the LPL polymorphism with CAD susceptibility. Results: We performed a meta-analysis of 14 case-control studies including HindIII, Ser447X and PvuII polymorphism. A statistically significant increase in the risk of CAD was associated with LPL HindIII polymorphism. This included HindIII H+H+ genotype (OR = 1.28, 95% CI = 1.09–1.49, p = 0.002, I2 = 43%) and H+ allele genotype (OR = 1.27, 95% CI = 1.03–1.58, p = 0.03, I2 = 67%). Ser447X XX genotype (OR = 2.37, 95% CI = 1.33–4.24, p = 0.004, I2 = 53%) was also associated with CAD risk. However, PvuII polymorphism was found to have no significant association with CAD risk. Conclusions: LPL HindIII polymorphism was significantly associated with the risk of CAD. For Ser447X polymorphism, it was found that only XX genotype was significantly associated with CAD risk. Furthermore, PvuII polymorphism had no significant association with CAD risk. It was considered that LPL HindIII polymorphism might serve as a potential biomarker for CAD risk.

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Section: Introductionmentioning

confidence: 99%

Lipoprotein Lipase (LPL) Polymorphism and the Risk of Coronary Artery Disease: A Meta-Analysis

Xie

2017

IJERPH

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“…Frailty is an emerging concept; collaborative efforts towards defining the optimal method towards measuring frailty and disability deserve further exploration. Multidisciplinary teams involving cardiac surgery, cardiology, geriatric medicine, physiotherapy and occupational therapy may help address the diverse elements specific to the elderly that contribute to increased risk [ 32 ]. A 64-slice-coronary computed tomography shows promise as a non-invasive alternative to the standard coronary angiography to detect CABG graft stenosis [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Predicting operative mortality in octogenarians for isolated coronary artery bypass grafting surgery: a retrospective study

Luc

Graham

Norris

et al. 2017

BMC Cardiovasc Disord

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BackgroundAvailable cardiac surgery risk scores have not been validated in octogenarians. Our objective was to compare the predictive ability of the Society of Thoracic Surgeons (STS) score, EuroSCORE I, and EuroSCORE II in elderly patients undergoing isolated coronary artery bypass grafting surgery (CABG).MethodsAll patients who underwent isolated CABG (2002 – 2008) were identified from the Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease (APPROACH) registry. All patients aged 80 and older (n = 304) were then matched 1:2 with a randomly selected control group of patients under age 80 (n = 608 of 4732). Risk scores were calculated. Discriminatory accuracy of the risk models was assessed by plotting the areas under the receiver operator characteristic (AUC) and comparing the observed to predicted operative mortality.ResultsOctogenarians had a significantly higher predicted mortality by STS Score (3 ± 2% vs. 1 ± 1%; p < 0.001), additive EuroSCORE (8 ± 3% vs. 4 ± 3%; p < 0.001), logistic EuroSCORE (15 ± 14% vs. 5 ± 6%; p < 0.001), and EuroSCORE II (4 ± 3% vs. 2 ± 2%; p < 0.001) compared to patients under age 80 years. Observed mortality was 2% and 1% for patients age 80 and older and under age 80, respectively (p = 0.323). AUC revealed areas for STS, additive and logistic EuroSCORE I and EuroSCORE II, respectively, for patients age 80 and older (0.671, 0.709, 0.694, 0.794) and under age 80 (0.829, 0.750, 0.785, 0.845).ConclusionAll risk prediction models assessed overestimated surgical risk, particularly in octogenarians. EuroSCORE II demonstrated better discriminatory accuracy in this population. Inclusion of new variables into these risk models, such as frailty, may allow for more accurate prediction of true operative risk.

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“…Furthermore, a high prevalence (54%) of additional atherosclerotic lesions distant from the culprit lesion was found by intravascular ultrasound imaging . Therefore, multivessel coronary artery atherosclerosis is encountered frequently in clinical practice . In such cases, differentiating ischemia‐producing lesions from the others is critical, because ischemia‐guided revascularization has been shown to have more favorable clinical outcomes than those with anatomical revascularization because it avoids inappropriate procedures or under‐treatment of ischemia‐producing lesions .…”

Section: Discussionmentioning

confidence: 99%

The influence of side branch stenosis on fractional flow reserve assessment of the main branch in a swine model

Song

Kim

et al. 2016

Cathet Cardio Intervent

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Canadian Cardiovascular Society/Canadian Association of Interventional Cardiology/Canadian Society of Cardiac Surgery Position Statement on Revascularization—Multivessel Coronary Artery Disease

Cited by 46 publications

References 44 publications

Lipoprotein Lipase (LPL) Polymorphism and the Risk of Coronary Artery Disease: A Meta-Analysis

Lipoprotein Lipase (LPL) Polymorphism and the Risk of Coronary Artery Disease: A Meta-Analysis

Predicting operative mortality in octogenarians for isolated coronary artery bypass grafting surgery: a retrospective study

The influence of side branch stenosis on fractional flow reserve assessment of the main branch in a swine model

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