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Coronary Artery Disease: HELP
Articles by David R. Holmes
Based on 87 articles published since 2010
(Why 87 articles?)
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Between 2010 and 2020, D. R. Holmes wrote the following 87 articles about Coronary Artery Disease.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4
1 Guideline Antithrombotic Therapy in Patients With Atrial Fibrillation Treated With Oral Anticoagulation Undergoing Percutaneous Coronary Intervention. 2018

Angiolillo, Dominick J / Goodman, Shaun G / Bhatt, Deepak L / Eikelboom, John W / Price, Matthew J / Moliterno, David J / Cannon, Christopher P / Tanguay, Jean-Francois / Granger, Christopher B / Mauri, Laura / Holmes, David R / Gibson, C Michael / Faxon, David P. ·Division of Cardiology, University of Florida College of Medicine-Jacksonville (D.J.A.). · St. Michael's Hospital, University of Toronto, and the Canadian Heart Research Centre, Canada (S.G.G.). · Canadian Virtual Coordinating Centre for Global Collaborative Cardiovascular Research Centre, University of Alberta, Canada (S.G.G.). · Brigham and Women's Hospital Heart & Vascular Center and Harvard Medical School, Boston, MA (D.L.B., C.P.C., L.M., D.P.F.). · Department of Medicine, Population Health Research Institute, Thrombosis & Atherosclerosis Research Institute, Hamilton, Canada (J.W.E.). · Division of Cardiovascular Diseases, Scripps Clinic, La Jolla, CA (M.J.P.). · Division of Cardiovascular Medicine and Gill Heart Institute, University of Kentucky, Lexington (D.J.M.). · Department of Medicine, Montreal Heart Institute, Université de Montréal, Canada (J.-F.T.). · Duke Clinical Research Institute, Duke University, Durham, NC (C.B.G.). · Mayo Clinic, Rochester, MN (D.R.H.). · Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (C.M.G.). ·Circulation · Pubmed #30571525.

ABSTRACT: The optimal antithrombotic treatment regimen for patients with atrial fibrillation undergoing percutaneous coronary intervention with stent implantation represents a challenge in clinical practice. In 2016, an updated opinion of selected experts from the United States and Canada on the treatment of patients with atrial fibrillation undergoing percutaneous coronary intervention was reported. After the 2016 North American consensus statement on the management of antithrombotic therapy in patients with atrial fibrillation undergoing percutaneous coronary intervention, results of pivotal clinical trials assessing the type of oral anticoagulant agent and the duration of antiplatelet treatment have been published. On the basis of these results, this focused update on the antithrombotic management of patients with atrial fibrillation undergoing percutaneous coronary intervention recommends that a non-vitamin K antagonist oral anticoagulant be preferred over a vitamin K antagonist as the oral anticoagulant of choice. Moreover, a double-therapy regimen (oral anticoagulant plus single antiplatelet therapy with a P2Y

2 Guideline Antithrombotic Therapy in Patients With Atrial Fibrillation Undergoing Percutaneous Coronary Intervention: A North American Perspective-2016 Update. 2016

Angiolillo, Dominick J / Goodman, Shaun G / Bhatt, Deepak L / Eikelboom, John W / Price, Matthew J / Moliterno, David J / Cannon, Christopher P / Tanguay, Jean-Francois / Granger, Christopher B / Mauri, Laura / Holmes, David R / Gibson, C Michael / Faxon, David P. ·From the Division of Cardiology, University of Florida College of Medicine-Jacksonville (D.J.A.) · St Michael's Hospital, University of Toronto, and the Canadian Heart Research Centre · Canadian VIGOUR Centre, University of Alberta, Edmonton (S.G.G.) · Brigham and Women's Hospital Heart & Vascular Center and Harvard Medical School, Boston, MA (D.L.B., D.P.F.) · Department of Medicine, Population Health Research Institute, Thrombosis & Atherosclerosis Research Institute, Hamilton, ON, Canada (J.W.E.) · Division of Cardiovascular Diseases, Scripps Clinic, La Jolla CA (M.J.P.) · Division of Cardiovascular Medicine and Gill Heart Institute, University of Kentucky, Lexington (D.J.M.) · Brigham and Women's Hospital, Harvard Clinical Research Institute, Harvard Medical School, Boston, MA (C.P.C., L.M.) · Department of Medicine, Montreal Heart Institute, Université de Montréal, QC, Canada (J.-F.T.) · Duke Clinical Research Institute, Duke University, Durham, NC (C.B.G.) · Mayo Clinic, Rochester, MN (D.R.H.) · and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (C.M.G.). ·Circ Cardiovasc Interv · Pubmed #27803042.

ABSTRACT: The optimal antithrombotic treatment regimen for patients with atrial fibrillation undergoing percutaneous coronary intervention with stent implantation is an emerging clinical problem. Currently, there is limited evidenced-based data on the optimal antithrombotic treatment regimen, including antiplatelet and anticoagulant therapies, for these high-risk patients with practice guidelines, thus, providing limited recommendations. Over the past years, expert consensus documents have provided guidance to clinicians on how to manage patients with atrial fibrillation undergoing percutaneous coronary intervention. Given the recent advancements in the field, the current document provides an updated opinion of selected North American experts from the United States and Canada on the treatment of patients with atrial fibrillation undergoing percutaneous coronary intervention. In particular, this document provides the current views on (1) embolic/stroke risk, (2) ischemic/thrombotic cardiac risk, and (3) bleeding risk, which are pivotal for discerning the choice of antithrombotic therapy. In addition, we describe the recent advances in pharmacology, stent designs, and clinical trials relevant to the field. Ultimately, we provide expert consensus-derived recommendations, using a pragmatic approach, on the management of patients with atrial fibrillation undergoing percutaneous coronary intervention.

3 Guideline ACCF/SCAI/STS/AATS/AHA/ASNC/HFSA/SCCT 2012 appropriate use criteria for coronary revascularization focused update: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, American Society of Nuclear Cardiology, and the Society of Cardiovascular Computed Tomography. 2012

Anonymous810721 / Patel, Manesh R / Dehmer, Gregory J / Hirshfeld, John W / Smith, Peter K / Spertus, John A / Anonymous820721 / Masoudi, Frederick A / Dehmer, Gregory J / Patel, Manesh R / Smith, Peter K / Chambers, Charles E / Ferguson, T Bruce / Garcia, Mario J / Grover, Frederick L / Holmes, David R / Klein, Lloyd W / Limacher, Marian C / Mack, Michael J / Malenka, David J / Park, Myung H / Ragosta, Michael / Ritchie, James L / Rose, Geoffrey A / Rosenberg, Alan B / Russo, Andrea M / Shemin, Richard J / Weintraub, William S / Anonymous830721 / Wolk, Michael J / Bailey, Steven R / Douglas, Pamela S / Hendel, Robert C / Kramer, Christopher M / Min, James K / Patel, Manesh R / Shaw, Leslee / Stainback, Raymond F / Allen, Joseph M / Anonymous840721 / Anonymous850721 / Anonymous860721 / Anonymous870721 / Anonymous880721 / Anonymous890721 / Anonymous900721 / Anonymous910721. · ·J Thorac Cardiovasc Surg · Pubmed #22424518.

ABSTRACT: The American College of Cardiology Foundation (ACCF), Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and the American Association for Thoracic Surgery, along with key specialty and subspecialty societies, conducted an update of the appropriate use criteria (AUC) for coronary revascularization frequently considered. In the initial document, 180 clinical scenarios were developed to mimic patient presentations encountered in everyday practice and included information on symptom status, extent of medical therapy, risk level as assessed by noninvasive testing, and coronary anatomy. This update provides a reassessment of clinical scenarios the writing group felt to be affected by significant changes in the medical literature or gaps from prior criteria. The methodology used in this update is similar to the initial document, and the definition of appropriateness was unchanged. The technical panel scored the clinical scenarios on a scale of 1 to 9. Scores of 7 to 9 indicate that revascularization is considered appropriate and likely to improve patients' health outcomes or survival. Scores of 1 to 3 indicate revascularization is considered inappropriate and unlikely to improve health outcomes or survival. Scores in the mid-range (4 to 6) indicate a clinical scenario for which the likelihood that coronary revascularization will improve health outcomes or survival is uncertain. In general, as seen with the prior AUC, the use of coronary revascularization for patients with acute coronary syndromes and combinations of significant symptoms and/or ischemia is appropriate. In contrast, revascularization of asymptomatic patients or patients with low-risk findings on noninvasive testing and minimal medical therapy are viewed less favorably. The technical panel felt that based on recent studies, coronary artery bypass grafting remains an appropriate method of revascularization for patients with high burden of coronary artery disease (CAD). Additionally, percutaneous coronary intervention may have a role in revascularization of patients with high burden of CAD. The primary objective of the appropriate use criteria is to improve physician decision making and patient education regarding expected benefits from revascularization and to guide future research.

4 Editorial Here Today, Gone Tomorrow. 2016

Holmes, David R / Mack, Michael J. ·Mayo Clinic, Rochester, Minnesota. Electronic address: holmes.david@mayo.edu. · Baylor Scott & White Health, Plano, Texas. ·J Am Coll Cardiol · Pubmed #26892412.

ABSTRACT: -- No abstract --

5 Editorial Moore's Law: Apples and Oranges. 2015

Holmes, David R / Mack, Michael J. ·Department of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota. Electronic address: holmes.david@mayo.edu. · Heart Hospital Baylor Plano, Baylor University, Dallas, Texas. ·JACC Cardiovasc Interv · Pubmed #26585616.

ABSTRACT: -- No abstract --

6 Editorial Art and science. 2014

Holmes, David R. ·Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, Minnesota. Electronic address: holmes.david@mayo.edu. ·J Am Coll Cardiol · Pubmed #25236347.

ABSTRACT: -- No abstract --

7 Editorial Do we need a better mouse trap? 2011

Holmes, David R / Sandhu, Gurpreet S. · ·Eur Heart J · Pubmed #20462976.

ABSTRACT: -- No abstract --

8 Review Revascularization for Left Main and Multivessel Coronary Artery Disease: Current Status and Future Prospects after the EXCEL and NOBLE Trials. 2018

Al-Hijji, Mohammed / El Sabbagh, Abdallah / Holmes, David R. ·Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA. · Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA. holmes.david@mayo.edu. ·Korean Circ J · Pubmed #29856140.

ABSTRACT: Revascularization of severe left main and multivessel coronary artery disease has been shown to improve survival in both stable ischemic heart disease and acute coronary syndrome. While revascularization with coronary artery bypass surgery for these disease entities carries class I recommendation in most current guidelines, recent trials has shown potential comparable survival and cardiovascular outcomes between percutaneous and surgical interventions in patients with less complex coronary anatomy. Despite the conflicting results observed in the most recent left main revascularization trials, Everolimus-Eluting Stents or Bypass Surgery for Left Main Coronary Artery Disease (EXCEL) and Nordic-Baltic-British left main revascularization (NOBLE), both treatment strategies remain important for the management of left main disease (LMD) and multivessel disease (MVD) reflecting on the importance of heart team discussion. This review is focused on revascularization of LMD and MVD in patients who are not presenting with ST-segment elevation myocardial infarction, encompassing the evidence from historic and contemporary trials which shaped up current practices. This review discusses the heart team approach to guide decision making, including special populations that are not represented in clinical trials.

9 Review Mechanical circulatory support in patients with severe aortic stenosis and left ventricular dysfunction undergoing percutaneous coronary intervention. 2017

Alkhouli, Mohamad / Al Mustafa, Ahmed / Chaker, Zakeih / Alqahtani, Fahad / Aljohani, Sami / Holmes, David R. ·WVU Heart and Vascular Institute, West Virginia University School of Medicine, Morgantown, West Virginia. · Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota. ·J Card Surg · Pubmed #28271553.

ABSTRACT: Management of obstructive coronary artery disease in patients with aortic stenosis and severe left ventricular dysfunction is challenging. Mechanical circulatory support at the time of percutaneous coronary interventions may be necessary in these extreme-risk patients. We present a case in which the TandemHeart was used to support a patient with severe aortic stenosis, severe protected left main and circumflex disease, and severe cardiomyopathy and review the literature on this subject.

10 Review Revascularization in stable coronary artery disease: a combined perspective from an interventional cardiologist and a cardiac surgeon. 2016

Holmes, David R / Taggart, David P. ·Mayo Clinic College of Medicine and Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA. · Cardiovascular Surgery, Oxford University, John Radcliffe Hospital, UK david.taggart@ouh.nhs.uk. ·Eur Heart J · Pubmed #26994152.

ABSTRACT: It is now half a century since the start of coronary bypass graft surgery (CABG) with the first percutaneous coronary intervention (PCI) following just over a decade later. The relative merits of PCI vs. CABG for stable coronary artery disease (stable-CAD) have continued to be debated ever since and have been the focus of around 20 randomized trials and numerous registry studies, systematic reviews, and meta-analyses. The aim of this review is to identify areas of agreement, disagreement, and uncertainties in the role of PCI and CABG in patients with stable-CAD.

11 Review Controversies surrounding percutaneous coronary intervention in the diabetic patient. 2016

Martinez, Sara C / Holmes, David R. ·a Division of Cardiovascular Disease , Mayo Clinic , Rochester , MN , USA. ·Expert Rev Cardiovasc Ther · Pubmed #26837264.

ABSTRACT: Diabetic patients with coronary artery disease are common and complex, with an aggressive progression of atherosclerosis, increased rate of stent complications, and increased rates of incomplete revascularization in multivessel disease compared to non-diabetic patients. In this review, we first discuss the pathophysiologic elements of insulin resistance and presentations of coronary artery disease in diabetic patients. Next, we outline the evolution and present the data on revascularization strategies on diabetic patient outcomes. The overall conclusion of our review is that a strategy of complete and durable revascularization and guideline-directed medical therapy currently provides the best possible chance at closing the gap between outcomes in patients with and without diabetes.

12 Review Sudden cardiac death from the perspective of coronary artery disease. 2014

Sara, Jaskanwal D / Eleid, Mackram F / Gulati, Rajiv / Holmes, David R. ·Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN. · Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN. Electronic address: holmes.david@mayo.edu. ·Mayo Clin Proc · Pubmed #25440727.

ABSTRACT: Sudden cardiac death accounts for approximately 50% of all deaths attributed to cardiovascular disease in the United States. It is most commonly associated with coronary artery disease and can be its initial manifestation or may occur in the period after an acute myocardial infarction. Decreasing the rate of sudden cardiac death requires the identification and treatment of at-risk patients through evidence-based pharmacotherapy and interventional strategies aimed at primary and secondary prevention. For this review, we searched PubMed for potentially relevant articles published from January 1, 1970, through March 1, 2014, using the following key search terms: sudden cardiac death, ischemic heart disease, coronary artery disease, myocardial infarction, and cardiac arrest. Searches were enhanced by scanning bibliographies of identified articles, and those deemed relevant were selected for full-text review. This review outlines various mechanisms for sudden cardiac death in the setting of coronary artery disease, describes risk factors for sudden cardiac death, explores the management of cardiac arrest, and outlines optimal practice for the monitoring and treatment of patients after an acute ST-segment elevation myocardial infarction to decrease the risk of sudden death.

13 Review The rationale for Heart Team decision-making for patients with stable, complex coronary artery disease. 2013

Head, Stuart J / Kaul, Sanjay / Mack, Michael J / Serruys, Patrick W / Taggart, David P / Holmes, David R / Leon, Martin B / Marco, Jean / Bogers, Ad J J C / Kappetein, A Pieter. ·Department of Cardiothoracic Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands. ·Eur Heart J · Pubmed #23425523.

ABSTRACT: Stable complex coronary artery disease can be treated with coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), or medical therapy. Multidisciplinary decision-making has gained more emphasis over the recent years to select the most optimal treatment strategy for individual patients with stable complex coronary artery disease. However, the so-called 'Heart Team' concept has not been widely implemented. Yet, decision-making has shown to remain suboptimal; there is large variability in PCI-to-CABG ratios, which may predominantly be the consequence of physician-related factors that have raised concerns regarding overuse, underuse, and inappropriate selection of revascularization. In this review, we summarize these and additional data to support the statement that a multidisciplinary Heart Team consisting of at least a clinical/non-invasive cardiologist, interventional cardiologist, and cardiac surgeon, can together better analyse and interpret the available diagnostic evidence, put into context the clinical condition of the patient as well as consider individual preference and local expertise, and through shared decision-making with the patient can arrive at a most optimal joint treatment strategy recommendation for patients with stable complex coronary artery disease. In addition, other aspects of Heart Team decision-making are discussed: the organization and logistics, involvement of physicians, patients, and assisting personnel, the need for validation, and its limitations.

14 Review Drug-eluting coronary-artery stents. 2013

Stefanini, Giulio G / Holmes, David R. ·Department of Cardiology, Bern University Hospital, Bern, Switzerland. giulio.stefanini@insel.ch ·N Engl J Med · Pubmed #23323902.

ABSTRACT: -- No abstract --

15 Review Complete versus incomplete revascularization with coronary artery bypass graft or percutaneous intervention in stable coronary artery disease. 2012

Gössl, Mario / Faxon, David P / Bell, Malcolm R / Holmes, David R / Gersh, Bernard J. ·Division of Cardiovascular Diseases, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. ·Circ Cardiovasc Interv · Pubmed #22896575.

ABSTRACT: -- No abstract --

16 Review How to treat patients with ST-elevation acute myocardial infarction and multi-vessel disease? 2011

Widimsky, Petr / Holmes, David R. ·Cardiocenter, Third Faculty of Medicine, Charles University Prague, Hospital Kralovske Vinohrady, Prague 10, Czech Republic. widim@fnkv.cz ·Eur Heart J · Pubmed #21118854.

ABSTRACT: Over 50% of ST-segment elevation myocardial infarction (STEMI) patients suffer multi-vessel coronary artery disease, which is known to be associated with worse prognosis. Treatment strategies used in clinical practice vary from acute multi-vessel percutaneous coronary intervention (PCI), through staged PCI procedures to a conservative approach with primary PCI of only the infarct-related artery (IRA) and subsequent medical therapy unless recurrent ischaemia occurs. Each approach has advantages and disadvantages. This review paper summarizes the international experience and authors' opinion on this clinically important question. Multi-vessel disease in STEMI is not a single entity and thus the treatment approach should be individualized. However, the following general rules can be proposed till future large randomized trials prove otherwise: (i) Single-vessel acute PCI should be the default strategy (to treat only the IRA during the acute phase of STEMI). (ii) Acute multi-vessel PCI can be justified only in exceptional patients with multiple critical (>90%) and potentially unstable lesions. (iii) Significant lesions of the non-infarct arteries should be treated either medically or by staged revascularization procedures-both options are currently acceptable.

17 Review Use of drug-eluting stents in patients with coronary artery disease and renal insufficiency. 2010

El-Menyar, Ayman A / Al Suwaidi, Jassim / Holmes, David R. ·Department of Cardiology and Cardiovascular Surgery, Hamad General Hospital and Weill Cornell Medical College in Qatar, Doha, Qatar. ·Mayo Clin Proc · Pubmed #20118392.

ABSTRACT: Renal insufficiency (RI) has been shown to be associated with increased major adverse cardiovascular events after percutaneous coronary intervention. We reviewed the impact of RI on the pathogenesis of coronary artery disease and outcomes after percutaneous coronary intervention in the form of drug-eluting stent (DES) implantation in these high-risk patients. We searched the English-language literature indexed in MEDLINE, Scopus, and EBSCO Host research databases from 1990 through January 2009, using as search terms coronary revascularization, drug-eluting stent, and renal insufficiency. Studies that assessed DES implantation in patients with various degrees of RI were selected for review. Most of the available data were extracted from observational studies, and data from randomized trials formed the basis of a post hoc analysis. The outcomes after coronary revascularization were less favorable in patients with RI than in those with normal renal function. In patients with RI, DES implantation yielded better outcomes than did use of bare-metal stents. Randomized trials are needed to define optimal treatment of these high-risk patients with coronary artery disease.

18 Clinical Trial New Volumetric Analysis Method for Stent Expansion and its Correlation With Final Fractional Flow Reserve and Clinical Outcome: An ILUMIEN I Substudy. 2018

Nakamura, Daisuke / Wijns, William / Price, Matthew J / Jones, Michael R / Barbato, Emanuele / Akasaka, Takashi / Lee, Stephen W-L / Patel, Sandeep M / Nishino, Setsu / Wang, Wei / Gopinath, Ajay / Attizzani, Guilherme F / Holmes, David / Bezerra, Hiram G. ·Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio. · Cardiovascular Research Center, OLV Hospital, Aalst, Belgium; The Lambe Institute for Translational Medicine and CURAM, National University of Ireland, Galway, Ireland. · Scripps Clinic, La Jolla, California. · Baptist Health Lexington, Lexington, Kentucky. · Cardiovascular Research Center, OLV Hospital, Aalst, Belgium. · Wakayama Medical University, Wakayama, Japan. · University of Hong Kong, Queen Mary Hospital, Hospital Authority, Pok Fu Lam, Hong Kong. · Mayo Clinic, Rochester, Minnesota. · Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio. Electronic address: hiram.bezerra@uhhospitals.org. ·JACC Cardiovasc Interv · Pubmed #30093052.

ABSTRACT: OBJECTIVES: This study sought to compare conventional methodology (CM) with a newly described optical coherence tomography (OCT)-derived volumetric stent expansion analysis in terms of fractional flow reserve (FFR)-derived physiology and device-oriented composite endpoints (DoCE). BACKGROUND: The analysis of coronary stent expansion with intracoronary imaging has used CM that relies on the analysis of selected single cross-sections for several decades. The introduction of OCT with its ability to perform semiautomated volumetric analysis opens opportunities to redefine optimal stent expansion. METHODS: A total of 291 lesions treated with post-stent OCT and FFR were enrolled. The expansion index was calculated by using a novel volumetric algorithm and was defined as: ([actual lumen area / ideal lumen area] × 100) for each frame of the stented segment. The minimum expansion index (MEI) was defined as the minimum value of expansion index along the entire stented segment. MEI and conventional lumen expansion metrics were compared for the ability to predict post-stent low FFR (<0.90) and DoCE at 1 year. RESULTS: There was a stronger correlation between MEI and final FFR, compared with CM and final FFR (r = 0.690; p < 0.001) versus (r = 0.165; p = 0.044). MEI was significantly lower in patients with DoCE than those without DoCE (72.18 ± 8.23% vs. 81.48 ± 11.03%; p < 0.001), although stent expansion by CM was similar between patients with and without DoCE (85.05 ± 22.19% and 83.73 ± 17.52%; p = 0.858), respectively. CONCLUSIONS: OCT analysis of stent expansion with a newly described volumetric method, but not with CM, yielded data that were predictive of both an acute improvement in FFR-derived physiology and DoCE.

19 Clinical Trial The impact of a second arterial graft on 5-year outcomes after coronary artery bypass grafting in the Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery Trial and Registry. 2015

Parasca, Catalina A / Head, Stuart J / Mohr, Friedrich W / Mack, Michael J / Morice, Marie-Claude / Holmes, David R / Feldman, Ted E / Colombo, Antonio / Dawkins, Keith D / Serruys, Patrick W / Kappetein, Arie Pieter / Anonymous5470832. ·Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands. · Department of Cardiac Surgery, Herzzentrum Universität Leipzig, Leipzig, Germany. · The Heart Hospital, Baylor Health Care Systems, Plano, Tex. · Department of Cardiology, Institut Cardiovasculaire Paris Sud, Massy, France. · Department of Cardiovascular Disease, Mayo Clinic, Rochester, Minn. · Department of Cardiology, North Shore University Health System, Evanston, Ill. · Department of Cardiology, San Raffaele Scientific Institute, Milan, Italy. · Boston Scientific Corporation, Natick, Mass. · Department of Cardiology, Erasmus University Medical Center, Rotterdam, The Netherlands. · Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands. Electronic address: a.kappetein@erasmusmc.nl. ·J Thorac Cardiovasc Surg · Pubmed #26055439.

ABSTRACT: OBJECTIVE: Despite various evidence supporting the advantages of multiple arterial grafting, inconsistencies in use of the procedure have resulted in high variability in the acceptance and practice of arterial grafting. The purpose of this study was to assess the effects of an arterial versus venous second grafts on outcomes at 5-year follow-up in the coronary artery bypass grafting population from the Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery (SYNTAX) trial. METHODS: Patients (n = 1419) with an arterial graft to the left anterior descending artery and ≥1 other graft were included and divided according to the second graft's type: 2nd-graft-arterial group (n = 456) and 2nd-graft-venous group (n = 963). Five-year outcomes were compared between subgroups. Event rates were estimated with Kaplan-Meier analyses. Propensity-score matching was used, to control for selection bias due to nonrandom group assignment in a 1:1 manner, resulting in 432 pairs with balanced baseline characteristics. RESULTS: In unmatched groups, the 2nd-graft-arterial group had significantly lower rates of death (8.9% vs 13.1%; P = .02), and composite safety endpoint of death/stroke/myocardial infarction (13.3% vs 18.7%; P = .02), compared with the 2nd-graft-venous group. The rate of major adverse cardiac or cerebrovascular events was similar between groups (22.9% vs 25.5%; P = .30), because it includes the rate of repeat revascularization (12.6% in the 2nd-graft-arterial group vs 9.6% in the 2nd-graft-venous group; P = .10). After propensity-score matching, no statistically significant differences were found between groups. CONCLUSIONS: This study reveals comparable 5-year outcomes with arterial and venous conduits as second grafts after an arterial graft anastomosed to the left anterior descending artery. This study demonstrates the multi-institutional variation in patient selection and operator technique with regard to arterial revascularization, although extended follow-up beyond 5 years is required to estimate its impact on long-term outcomes. CLINICAL TRIAL NUMBER: NCT00114972.

20 Article Percutaneous coronary intervention versus coronary artery bypass grafting in patients with three-vessel or left main coronary artery disease: 10-year follow-up of the multicentre randomised controlled SYNTAX trial. 2019

Thuijs, Daniel J F M / Kappetein, A Pieter / Serruys, Patrick W / Mohr, Friedrich-Wilhelm / Morice, Marie-Claude / Mack, Michael J / Holmes, David R / Curzen, Nick / Davierwala, Piroze / Noack, Thilo / Milojevic, Milan / Dawkins, Keith D / da Costa, Bruno R / Jüni, Peter / Head, Stuart J / Anonymous4281003. ·Department of Cardiothoracic Surgery, Erasmus University Medical Centre, Rotterdam, Netherlands. Electronic address: d.thuijs@erasmusmc.nl. · Department of Cardiothoracic Surgery, Erasmus University Medical Centre, Rotterdam, Netherlands; Medtronic, Maastricht, Netherlands. · Department of Cardiology, Imperial College London, London, UK. · University Department of Cardiac Surgery, Heart Centre Leipzig, Leipzig, Germany. · Department of Cardiology, Cardiovascular Institute Paris-Sud, Hopital Privé Jacques Cartier, Ramsay Générale de Santé, Massy, France. · Department of Cardiothoracic Surgery, Baylor University Medical Centre, Dallas, TX, USA. · Department of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, MN, USA. · University Hospital Southampton NHS Foundation Trust and School of Medicine, University of Southampton, Southampton, UK. · Department of Cardiothoracic Surgery, Erasmus University Medical Centre, Rotterdam, Netherlands. · Shockwave Medical Inc, Santa Clara, CA, USA. · Applied Health Research Centre, Li Ka Shing Knowledge Institute of St Michael's Hospital, University of Toronto, Toronto, ON, Canada; Institute of Primary Health Care, University of Bern, Bern, Switzerland. · Applied Health Research Centre, Li Ka Shing Knowledge Institute of St Michael's Hospital, University of Toronto, Toronto, ON, Canada; Department of Medicine, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. · Department of Cardiothoracic Surgery, Erasmus University Medical Centre, Rotterdam, Netherlands; Medtronic, Minneapolis, MN, USA. ·Lancet · Pubmed #31488373.

ABSTRACT: BACKGROUND: The Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) trial was a non-inferiority trial that compared percutaneous coronary intervention (PCI) using first-generation paclitaxel-eluting stents with coronary artery bypass grafting (CABG) in patients with de-novo three-vessel and left main coronary artery disease, and reported results up to 5 years. We now report 10-year all-cause death results. METHODS: The SYNTAX Extended Survival (SYNTAXES) study is an investigator-driven extension of follow-up of a multicentre, randomised controlled trial done in 85 hospitals across 18 North American and European countries. Patients with de-novo three-vessel and left main coronary artery disease were randomly assigned (1:1) to the PCI group or CABG group. Patients with a history of PCI or CABG, acute myocardial infarction, or an indication for concomitant cardiac surgery were excluded. The primary endpoint of the SYNTAXES study was 10-year all-cause death, which was assessed according to the intention-to-treat principle. Prespecified subgroup analyses were performed according to the presence or absence of left main coronary artery disease and diabetes, and according to coronary complexity defined by core laboratory SYNTAX score tertiles. This study is registered with ClinicalTrials.gov, NCT03417050. FINDINGS: From March, 2005, to April, 2007, 1800 patients were randomly assigned to the PCI (n=903) or CABG (n=897) group. Vital status information at 10 years was complete for 841 (93%) patients in the PCI group and 848 (95%) patients in the CABG group. At 10 years, 244 (27%) patients had died after PCI and 211 (24%) after CABG (hazard ratio 1·17 [95% CI 0·97-1·41], p=0·092). Among patients with three-vessel disease, 151 (28%) of 546 had died after PCI versus 113 (21%) of 549 after CABG (hazard ratio 1·41 [95% CI 1·10-1·80]), and among patients with left main coronary artery disease, 93 (26%) of 357 had died after PCI versus 98 (28%) of 348 after CABG (0·90 [0·68-1·20], p INTERPRETATION: At 10 years, no significant difference existed in all-cause death between PCI using first-generation paclitaxel-eluting stents and CABG. However, CABG provided a significant survival benefit in patients with three-vessel disease, but not in patients with left main coronary artery disease. FUNDING: German Foundation of Heart Research (SYNTAXES study, 5-10-year follow-up) and Boston Scientific Corporation (SYNTAX study, 0-5-year follow-up).

21 Article Pregnancy history, coronary artery calcification and bone mineral density in menopausal women. 2018

Beckman, J P / Camp, J J / Lahr, B D / Bailey, K R / Kearns, A E / Garovic, V D / Jayachandran, M / Miller, V M / Holmes, D R. ·a Department of Surgery , Mayo Clinic , Rochester , MN , USA. · b Department of Physiology and Biomedical Engineering , Mayo Clinic , Rochester , MN , USA. · c Department of Health Science Research, Division of Biostatistics , Mayo Clinic , Rochester , MN , USA. · d Department of General Internal Medicine, Division of Endocrinology , Mayo Clinic , Rochester , MN , USA. · e Department of General Internal Medicine, Division of Nephrology and Hypertension , Mayo Clinic , Rochester , MN , USA. ·Climacteric · Pubmed #29189095.

ABSTRACT: OBJECTIVE: This study examined relationships, by pregnancy histories, between bone mineral density (BMD) and coronary artery calcification (CAC) in postmenopausal women. METHODS: Forty women identified from their medical record as having pre-eclampsia (PE) were age/parity-matched with 40 women having a normotensive pregnancy (NP). Vertebral (T4-9) BMD and CAC were assessed by quantitative computed tomography in 73 (37 with PE and 36 with NP) of the 80 women. Analyses included linear regression using generalized estimating equations. RESULTS: Women averaged 59 years of age and 35 years from the index pregnancy. There were no significant differences in cortical, trabecular or central BMD between groups. CAC was significantly greater in the PE group (p = 0.026). In multivariable analysis, CAC was positively associated with cortical BMD (p = 0.001) and negatively associated with central BMD (p = 0.036). There was a borderline difference in the association between CAC and central BMD by pregnancy history (interaction, p = 0.057). CONCLUSIONS: Although CAC was greater in women with a history of PE, vertebral BMD did not differ between groups. However, both cortical and central BMD were associated with CAC. The central BMD association was marginally different by pregnancy history, suggesting perhaps differences in underlying mechanisms of soft tissue calcification.

22 Article The impact of chronic kidney disease on outcomes following percutaneous coronary intervention versus coronary artery bypass grafting in patients with complex coronary artery disease: five-year follow-up of the SYNTAX trial. 2018

Milojevic, Milan / Head, Stuart J / Mack, Michael J / Mohr, Friedrich W / Morice, Marie-Claude / Dawkins, Keith D / Holmes, David R / Serruys, Patrick W / Kappetein, A Pieter. ·Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands. ·EuroIntervention · Pubmed #29155387.

ABSTRACT: AIMS: The aim of this study was to investigate short-term and five-year follow-up results from patients randomised to coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) with paclitaxel-eluting stents in the SYNTAX trial, focusing on patients with chronic kidney disease (CKD). METHODS AND RESULTS: Baseline glomerular filtration rate estimates (eGFR) were available in 1,638 patients (PCI=852 and CABG=786). The Kidney Disease: Improving Global Outcomes (KDIGO) threshold was used to define staging of CKD. At five years, death was significantly higher in patients with CKD compared to patients with normal kidney function after PCI (26.7% vs. 10.8%, p<0.001) and CABG (21.2% vs. 10.6%, p=0.005). Comparing PCI with CABG, there was a significant interaction according to kidney function for death (pint=0.017) but not the composite endpoint of death/stroke/MI (pint=0.070) or MACCE (pint=0.15). In patients with CKD, the rate of MACCE was significantly higher after PCI compared with CABG (42.1% vs. 31.5%, p=0.019), driven by repeat revascularisation (21.9% vs. 8.9%, p=0.004) and all-cause death (26.7% vs. 21.2%, p=0.14). In patients with CKD who also had diabetes, PCI versus CABG was significantly worse in terms of death/stroke/MI (47.9% vs. 24.4%, p=0.005) and all-cause death (40.9% vs. 17.7%, p=0.004). CONCLUSIONS: During a five-year follow-up, adverse event rates were comparable between PCI and CABG patients with moderate CKD but significantly higher compared to the patients with impaired or normal kidney function. The negative impact of CKD on long-term outcome following PCI appears to be stronger when compared to CABG, especially in the CKD patients with diabetes and extensive coronary disease.

23 Article Rationale and design of the Drug-Eluting Stents vs Bare-Metal Stents in Saphenous Vein Graft Angioplasty (DIVA) Trial. 2017

Brilakis, Emmanouil S / Banerjee, Subhash / Edson, Robert / Shunk, Kendrick / Goldman, Steven / Holmes, David R / Bhatt, Deepak L / Rao, Sunil V / Smith, Mark W / Sather, Mike / Colling, Cindy / Kar, Biswajit / Nielsen, Lori / Conner, Todd / Wagner, Todd / Rangan, Bavana V / Ventura, Beverly / Lu, Ying / Holodniy, Mark / Shih, Mei-Chiung. ·VA North Texas Health Care System, Dallas. · Minneapolis Heart Institute, Minneapolis, Minnesota. · University of Texas Southwestern Medical School, Dallas. · VA Cooperative Studies Program Coordinating Center, Mountain View, California. · San Francisco VA Medical Center, San Francisco, California. · University of California, San Francisco. · University of Arizona Sarver Heart Center, Tucson. · Mayo Clinic, Rochester, Minnesota. · VA Boston Healthcare System, Boston, Massachusetts. · Brigham and Women's Hospital Heart and Vascular Center, Boston, Massachusetts. · Harvard Medical School, Boston, Massachusetts. · Durham VA Medical Center, Durham, North Carolina. · Duke University, Durham, North Carolina. · Truven Health Analytics, Ann Arbor, Michigan. · VA Cooperative Studies Program Clinical Research Pharmacy Coordinating Center, Albuquerque, New Mexico. · University of Texas Medical School, Houston. · Michael E. DeBakey VA Medical Center, Houston, Texas. · VA Health Economics Resource Center, Menlo Park, California. · Stanford University, Department of Surgery, Palo Alto, California. · Stanford University, Department of Biomedical Data Science, Palo Alto, California. · Stanford University, Department of Medicine, Palo Alto, California. ·Clin Cardiol · Pubmed #28841230.

ABSTRACT: VA Cooperative Studies Program #571 (DIVA) was designed to evaluate the efficacy of drug-eluting stents (DES) for reducing aortocoronary saphenous vein bypass graft (SVG) failure when compared with bare-metal stents (BMS) in participants undergoing stenting of de novo SVG lesions. Participants undergoing clinically indicated stenting of de novo SVG lesions were randomized in a 1:1 ratio to DES or BMS. Randomization was stratified by presence/absence of diabetes mellitus and the number of target SVG lesions (1 vs ≥2) within each participating site. At sites that did not routinely administer 12-months of dual antiplatelet therapy after SVG stenting participants without acute coronary syndromes received 1 month of open-label clopidogrel, followed by 11 months of clopidogrel for those assigned to DES and 11 months of placebo for those assigned to BMS. The primary endpoint was the 12-month incidence of target-vessel failure (defined as the composite of cardiac death, target-vessel myocardial infarction, or target-vessel revascularization). Secondary endpoints included the incidence of other clinical endpoints and the incremental cost-effectiveness of DES relative to BMS. Due to lower-than-anticipated target-vessel failure rates, target enrollment was increased from 519 to 762. The study had randomized 599 participants when recruitment ended in December 2015. The DIVA trial will provide clarity on the appropriate stent type for de novo SVG lesions.

24 Article Influence of practice patterns on outcome among countries enrolled in the SYNTAX trial: 5-year results between percutaneous coronary intervention and coronary artery bypass grafting. 2017

Milojevic, Milan / Head, Stuart J / Mack, Michael J / Mohr, Friedrich W / Morice, Marie-Claude / Dawkins, Keith D / Holmes, David R / Serruys, Patrick W / Kappetein, Arie Pieter. ·Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, Netherlands. · Department of Cardiovascular Surgery, Heart Hospital Baylor Plano, Baylor Healthcare System, Plano, TX, USA. · Department of Cardiovascular Surgery, Herzzentrum Universität Leipzig, Leipzig, Germany. · Department of Cardiology, Institut Hospitalier Jacques Cartier, Massy, France. · Boston Scientific Corporation, Natick, MA, USA. · Division of Cardiovascular Disease and Internal Medicine, Mayo Clinic, Rochester, MN, USA. · Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands. ·Eur J Cardiothorac Surg · Pubmed #28520861.

ABSTRACT: OBJECTIVES: To examine differences among participating countries in baseline characteristics, clinical practice, medication strategies and outcomes of patients randomized to coronary artery bypass grafting and percutaneous coronary intervention in the SYNTAX trial. METHODS: In SYNTAX, centres in 18 different countries enrolled 1800 patients, of which 8 countries enrolled ≥80 patients, what was projected to be a large enough sample size to be included in the analysis. Baseline characteristics, practice patterns and clinical outcomes were compared between the USA (n = 245), the UK (n = 267), Italy (n = 197), France (n = 208), Germany (n = 179), Netherlands (n = 148), Belgium (n = 91) and Hungary (n = 83). The remaining patients from other participating countries were pooled together (n = 382). RESULTS: Five-year results demonstrated significantly different outcomes between countries. After adjustment, percutaneous coronary intervention patients in France had lower rates of major adverse cardiac and cerebrovascular events [hazard ratio (HR) = 0.60, 95% confidence interval (CI) 0.37-0.98], while the incidence of repeat revascularization was higher in Hungary (HR = 1.89, 95% CI 1.14-3.42). Coronary artery bypass grafting showed the lowest rate of repeat revascularization in the UK (HR = 0.32, 95% CI 0.12-0.85). There were numerous differences in the risk profile of patients between participating countries, as well as marked differences in surgical practice across countries in the use of blood cardioplegia (range 3.1-89.0%; P < 0.001), bilateral internal mammary artery usage (range 7.8-68.2%; P < 0.001) and off-pump procedures (range 3.9-44.4%; P < 0.001). Variation was also found for percutaneous coronary intervention in the number of implanted stents (range 4.0 ± 2.3 to 6.1 ± 2.6; P < 0.001) as well as for the entire stents length (range 69.0 ± 45.1 to 124.1 ± 60.9; P < 0.001). Remarkable differences were observed in the prescription of post-coronary artery bypass grafting medication in terms of acetylsalicylic acid (range 79.6-95.0%; P = 0.004), thienopyridine (6.8-31.1%; P < 0.001) and statins (41.3-89.1%; P < 0.001). CONCLUSIONS: Patient characteristics and clinical patterns are significantly different between countries, resulting in significantly different 5-year outcomes. This article presents specific data that can further improve outcomes in each country. Clinical Trials Registry: NCT00114972.

25 Article Incidence, Characteristics, Predictors, and Outcomes of Repeat Revascularization After Percutaneous Coronary Intervention and Coronary Artery Bypass Grafting: The SYNTAX Trial at 5 Years. 2016

Parasca, Catalina A / Head, Stuart J / Milojevic, Milan / Mack, Michael J / Serruys, Patrick W / Morice, Marie-Claude / Mohr, Friedrich W / Feldman, Ted E / Colombo, Antonio / Dawkins, Keith D / Holmes, David R / Kappetein, Pieter A / Anonymous2840891. ·Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands. · Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands. Electronic address: s.head@erasmusmc.nl. · The Heart Hospital, Baylor Health Care Systems, Plano, Texas. · Department of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands. · Department of Cardiology, Institut Cardiovasculaire Paris Sud, Hopital Privé Jacques Cartier, Générale de Santé, Massy, France. · Department of Cardiac Surgery, Herzzentrum Universität Leipzig, Leipzig, Germany. · Department of Cardiology, North Shore University Health System, Evanston, Illinois. · Department of Cardiology, San Raffaele Scientific Institute, Milan, Italy. · Boston Scientific Corporation, Natick, Massachusetts. · Department of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota. ·JACC Cardiovasc Interv · Pubmed #28007201.

ABSTRACT: OBJECTIVES: The study sought to determine the incidence, predictors, characteristics, and outcomes of repeat revascularization during 5-year follow-up of the SYNTAX (Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery) trial. BACKGROUND: Limited in-depth long-term data on repeat revascularization are available from randomized trials comparing percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). METHODS: Incidence and timing of repeat revascularization and its relation to the long-term composite safety endpoint of death, stroke, and myocardial infarction were analyzed in the SYNTAX trial (n = 1,800) using Kaplan-Meier analysis. RESULTS: At 5 years, repeat revascularization occurred more often after initial PCI than after initial CABG (25.9% vs. 13.7%, respectively; p < 0.001), and more often consisted of multiple repeat revascularizations (9.0% vs. 2.8%, respectively; p = 0.022). Significantly more repeat PCI procedures were performed on de novo lesions in patients after initial PCI than initial CABG (33.3% vs. 13.4%, respectively; p < 0.001). At 5-year follow-up, patients who underwent repeat revascularization versus patients not undergoing repeat revascularization had significantly higher rates of the composite safety endpoint of death, stroke, and myocardial infarction after initial PCI (33.8% vs. 16.6%, respectively; p < 0.001), and a trend was found after initial CABG (22.4% vs. 15.8%, respectively; p = 0.07). After multivariate adjustment, repeat revascularization was an independent predictor of the composite safety endpoint after both initial PCI (hazard ratio [HR]: 2.2; 95% confidence interval [CI]: 1.6 to 3.0; p < 0.001) and initial CABG (HR: 1.8; 95% CI: 1.2 to 2.9; p = 0.011). CONCLUSIONS: Repeat revascularization rates are significantly higher after initial PCI than after initial CABG for complex coronary disease. Repeat revascularization is an independent predictor of death, stroke, and myocardial infarction for myocardial revascularization.

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