Multivessel Coronary Artery Disease

Bryer, Emily; Stein, Elliot A.; Goldberg, Sheldon

doi:10.1016/j.mayocpiqo.2020.07.014

Cited by 12 publications

(7 citation statements)

References 19 publications

(25 reference statements)

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“…19 Multivessel CAG was defined as luminal stenosis of ≥70% in ≥2 major coronary arteries or in one coronary artery in addition to a ≥50% stenosis of the LMCA. 20 To evaluate the severity and extent of CAD, angiographic SS were calculated. 21 The study population was divided into 2 groups, according to CAD severity: low SS (≤22) and intermediate-high SS (>22) groups.…”

Section: Coronary Angiography and Severity Assessmentmentioning

confidence: 99%

Relation Between Serum Uric Acid to Albumin Ratio and Severity of Chronic Coronary Artery Disease

Yalcinkaya¹,

Karacali²,

Ilhan³

et al. 2023

Angiology

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Uric acid (UA) to albumin ratio (UAR) is an emerging marker to predict coronary artery disease (CAD)-related events. There is limited data on the relationship between UAR and the severity of the disease in chronic CAD patients. We aimed to evaluate UAR as an indicator for CAD severity using the Syntax score (SS). We retrospectively enrolled 558 patients with stable angina pectoris and underwent coronary angiography (CAG). Patients were divided into 2 groups, according to CAD severity: low SS (≤22) and intermediate-high SS (>22) groups. UA levels were higher and albumin levels were lower in the intermediate-high SS score group ( P < .001). UAR levels were significantly higher in the intermediate-high SS group ( P < .001). Also, there was a significant correlation between UAR levels and SS (r = .55, 95% confidence interval (CI): .49–.60, P < .001). In multivariable analysis, UAR >1.34 (Odds ratio, 3.8 [2.3–6.2]; P < .001) was an independent predictor of intermediate-high SS while albumin and UA levels were not. In conclusion, UAR predicted disease burden in chronic CAD patients. It may prove useful as a simple and readily available marker to select patients for further evaluation.

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Section: Coronary Angiography and Severity Assessmentmentioning

confidence: 99%

Relation Between Serum Uric Acid to Albumin Ratio and Severity of Chronic Coronary Artery Disease

Yalcinkaya¹,

Karacali²,

Ilhan³

et al. 2023

Angiology

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“…15 MVD was defined as severe stenosis (>70% luminal narrowing) in two or more coronary arteries and >50% in left anterior descending according to invasive coronary angiography. 16 The information of coronary angiography was evaluated by ≥2 cardiologists with at least 5 years of clinical experience. Complete revascularization refers to performing non-culprit lesion PCI during PPCI.…”

Section: Definitionsmentioning

confidence: 99%

Impact of Stress Hyperglycemia on the Timing of Complete Revascularization in Non-diabetes Patients with ST Elevation Myocardial Infarction and Multivessel Disease

et al. 2022

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Background: Stress hyperglycemia (SHG) is related to an increased risk of mortality in diabetic patients with ST elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). However, data are limited in non-diabetic patients especially in patients with multivessel disease (MVD). Methods and Results: In this retrospective study, 742 non-diabetic patients with STEMI and MVD were divided into SHG group and non-SHG group. The overall incidence of SHG was 24.9%. The incidence of no-reflow (NR) phenomenon (18.4% vs 11.8%; P = .024) and in-hospital mortality (1.6% vs .2%; P = .020) in SHG group were significantly higher than those in non-SHG group. SHG was associated with 30-day MACE (hazard ratio, 4.265; 95% confidence interval (CI), 1.354–13.439; P = .013), but not 1-year. Multivariate logistic analysis showed that SHG (odds ratio: 1.691, 95% CI: 1.072–2.667, P = .024) was an independent predictor of NR. If complete revascularization (CR) was performed during PPCI, the incidence of NR would be significantly higher. Conclusion: In non-diabetic patients with STEMI and MVD, SHG is associated with increased SF-NR and short-term adverse events, and CR during PPCI further increases the risk of NR.

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“…1,2 Multivessel CAD (MVCAD) is characterized by the presence of ≥50% diameter stenosis of two or more epicardial coronary arteries and carries a significantly higher risk of mortality compared to single-vessel disease. 3,4 Coronary artery bypass grafting (CABG) is the standard of care for MVCAD wherein grafting of the left internal mammary artery (LIMA) to the diseased left anterior descending (LAD) artery is performed and vein grafts (VG) and/or arterial grafts are used for the remaining obstructed coronary arteries. [5][6][7] Compared to percutaneous coronary intervention (PCI), the long-term survival advantage of CABG arising from the excellent durability of LIMA-LAD grafts, lower rates of hospital readmission, repeat revascularization, and major adverse cardiac and cerebral event (MACCE) make it the preferred therapeutic intervention in MVCAD.…”

Section: Introductionmentioning

confidence: 99%

“…Coronary artery disease (CAD) is a leading cause of morbidity and mortality with 18.2 million adults of age ≥20 years living with CAD and 360,000 CAD‐related deaths occurring annually in the United States 1,2 . Multivessel CAD (MVCAD) is characterized by the presence of ≥50% diameter stenosis of two or more epicardial coronary arteries and carries a significantly higher risk of mortality compared to single‐vessel disease 3,4 . Coronary artery bypass grafting (CABG) is the standard of care for MVCAD wherein grafting of the left internal mammary artery (LIMA) to the diseased left anterior descending (LAD) artery is performed and vein grafts (VG) and/or arterial grafts are used for the remaining obstructed coronary arteries 5–7 .…”

Section: Introductionmentioning

confidence: 99%

Hybrid coronary revascularization (HCR) versus coronary artery bypass grafting (CABG) in multivessel coronary artery disease (MVCAD): A meta‐analysis of 14 studies comprising 4226 patients

Nagraj

Tzoumas

Kakargias

et al. 2022

Cathet Cardio Intervent

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Objectives To compare the outcomes of hybrid coronary revascularization (HCR) with traditional coronary artery bypass grafting (CABG) in multivessel coronary artery disease (MVCAD). Background HCR has emerged as an alternative to CABG in patients with MVCAD. Through minimally invasive surgical techniques, HCR carries the potential for faster recovery postoperatively, fewer complications, and lower utilization of resources. Methods Systematic search of electronic databases was conducted up to December 2021 and studies comparing HCR with CABG in the treatment of MVCAD were included in this meta‐analysis. Primary outcomes of interest were incidence of 5‐year mortality and major adverse cardiac and cerebral event (MACCE). Results Fourteen studies (12 observational studies and 2 randomized controlled trials) comprising 4226 patients were included. The rates of 5‐year mortality (odds ratios [OR]: 1.55; 95% confidence interval [CI]: 0.92−2.62; I2 = 83.0%) and long‐term MACCE (OR: 0.97; 95% CI: 0.47−2.01; I2 = 74.7%) were comparable between HCR and CABG groups. HCR was associated with a significantly lower likelihood of perioperative blood transfusion (OR: 0.36; 95% CI: 0.25−0.51; I2 = 55.9%), shorter mean hospital stay (weighted mean difference: −2.04; 95% CI: −2.60 to −1.47; I2 = 54%), and risk of postoperative acute kidney injury (OR: 0.45; 95% CI: 0.23−0.88; p = 0.02). CABG demonstrated a lower likelihood of requiring long‐term repeat revascularization (OR: 1.51; 95% CI: 1.03−2.20; I2 = 18%) over a follow‐up duration of 29.14 ± 21.75 months. Conclusion This meta‐analysis suggests that HCR is feasible and safe for the treatment of MVCAD. However, benefits of HCR should be carefully weighed against the increased long‐term risk of repeat‐revascularization when selecting patients, and further studies evaluating differences in long‐term mortality between HCR and CABG are required.

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Multivessel Coronary Artery Disease

Cited by 12 publications

References 19 publications

Relation Between Serum Uric Acid to Albumin Ratio and Severity of Chronic Coronary Artery Disease

Relation Between Serum Uric Acid to Albumin Ratio and Severity of Chronic Coronary Artery Disease

Impact of Stress Hyperglycemia on the Timing of Complete Revascularization in Non-diabetes Patients with ST Elevation Myocardial Infarction and Multivessel Disease

Hybrid coronary revascularization (HCR) versus coronary artery bypass grafting (CABG) in multivessel coronary artery disease (MVCAD): A meta‐analysis of 14 studies comprising 4226 patients

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