Pick Topic
Review Topic
List Experts
Examine Expert
Save Expert
  Site Guide ··   
Coronary Artery Disease: HELP
Articles by May K. Lee
Based on 6 articles published since 2010
(Why 6 articles?)
||||

Between 2010 and 2020, May Lee wrote the following 6 articles about Coronary Artery Disease.
 
+ Citations + Abstracts
1 Article Cardiac Medication Use in Patients with Acute Myocardial Infarction and Nonobstructive Coronary Artery Disease. 2017

Adatia, Falisha / Galway, Shannon / Grubisic, Maja / Lee, May / Daniele, Patrick / Humphries, Karin H / Sedlak, Tara L. ·1 Vancouver General Hospital , Vancouver, Canada . · 2 University of British Columbia , Vancouver, Canada . · 3 BC Centre for Improved Cardiovascular Health , Vancouver, Canada . ·J Womens Health (Larchmt) · Pubmed #28384014.

ABSTRACT: IMPORTANCE: Patients with acute myocardial infarction (MI) and nonobstructive coronary artery disease (CAD) have an elevated cardiac event rate, suggesting that these patients may benefit from cardiac medication. OBJECTIVE: We evaluated the rates of cardiac medication use 3 months before angiography and 3 months following clinically indicated angiography for MI in patients with no CAD, nonobstructive CAD, and obstructive CAD. We also examined the sex differences in cardiac medication use 3 months following angiography in patients by extent of angiographic CAD. METHODS: We studied patients ≥20 years old with MI undergoing coronary angiography in British Columbia, Canada, from January 1, 2008, to March 31, 2010 (n = 3,841). No CAD, nonobstructive CAD, and obstructive CAD were defined as 0%, 1% to 49%, and ≥50% luminal narrowing in any epicardial coronary artery, respectively. Medication use, 3 months before and 3 months following angiography, was obtained through British Columbia PharmaNet for angiotensin-converting enzyme inhibitors (ACE-Is), angiotensin receptor blockers (ARBs), calcium channel blockers (CCBs), beta-blockers, statins, and antiplatelet agents. Optimal medical therapy (OMT) was defined as filled prescriptions for all three: ACE-Is/ARBs, beta-blockers, and statins. RESULTS: Following angiography, in all medication categories except CCBs, patients with no CAD and nonobstructive CAD had significantly lower rates of prescriptions filled than patients with obstructive CAD (all p < 0.001). After adjusting for age and prior medication use, patients with nonobstructive CAD were still less likely to receive these medications than patients with obstructive CAD, including OMT with an odds ratio = 0.25 (95% confidence interval: 0.18-0.36). There were no significant sex differences in medication use 3 months postangiography. CONCLUSIONS: In post-MI patients, medication use following angiography is significantly lower in nonobstructive CAD than obstructive CAD at 3 months. While sex was not an independent predictor of medication use 3 months post-catheterization, future studies should explore methods of improving medication use in both females and males with nonobstructive CAD post-MI.

2 Article Sex Differences in Cardiac Medication Use Post-Catheterization in Patients Undergoing Coronary Angiography for Stable Angina with Nonobstructive Coronary Artery Disease. 2017

Galway, Shannon / Adatia, Falisha / Grubisic, Maja / Lee, May / Daniele, Patrick / Humphries, Karin H / Sedlak, Tara L. ·1 Department of Medicine, Vancouver General Hospital , Vancouver, Canada . · 2 University of British Columbia , Vancouver, Canada . · 3 BC Centre for Improved Cardiovascular Health , Vancouver, Canada . ·J Womens Health (Larchmt) · Pubmed #28384013.

ABSTRACT: BACKGROUND: Treatment of patients with stable angina and nonobstructive coronary artery disease (CAD) has not been well characterized. We comparatively evaluated medication use in males and females with stable angina with no CAD, nonobstructive CAD, and obstructive CAD. METHODS: We studied all patients ≥20 years old with stable angina undergoing coronary angiography in British Columbia (BC), Canada, from January 2008 to March 2010 (n = 7,535). No CAD, nonobstructive CAD, and obstructive CAD were defined as 0%, 1%-49%, and ≥50% luminal narrowing in any epicardial coronary artery, respectively. Medication use, 3 months before and 3 months following angiography, was obtained through BC PharmaNet for angiotensin-converting enzyme inhibitors (ACE-I), angiotensin receptor blockers (ARBs), calcium channel blockers (CCBs), beta-blockers, statins, antiplatelet agents, and prescriptions for all three ACE-I/ARBs, beta-blockers, and statins (combination therapy). RESULTS: Following angiography, patients with no and nonobstructive CAD had significantly lower rates of prescription use of all medications, including combination therapy, than patients with obstructive CAD (p < 0.001). Use of ACE-I/ARBs, beta-blockers, statins, and combination therapy did not differ by sex, but females had higher use of CCB in all CAD groups, and clopidogrel in nonobstructive and obstructive CAD groups, compared to males. CONCLUSIONS: In patients with stable angina, medication use following angiography is low in nonobstructive CAD with only 58.9% prescribed a statin and 19.4% on combination therapy at 3 months. There are no important sex differences in medication use in any CAD category post-angiography. Future studies should explore methods of improving quality of care in patients with nonobstructive CAD.

3 Article Ischemic Predictors of Outcomes in Women With Signs and Symptoms of Ischemia and Nonobstructive Coronary Artery Disease. 2016

Sedlak, Tara L / Guan, Meijiao / Lee, May / Humphries, Karin H / Johnson, B Delia / Pepine, Carl J / Merz, C Noel Bairey. ·Vancouver General Hospital, Vancouver, British Columbia, Canada2Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. · British Columbia Centre for Improved Cardiovascular Health, Vancouver, British Columbia, Canada. · Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada3British Columbia Centre for Improved Cardiovascular Health, Vancouver, British Columbia, Canada. · Department of Cardiovascular Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania. · Department of Epidemiology, University of Florida, Gainesville. · Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Los Angeles, California. ·JAMA Cardiol · Pubmed #27438329.

ABSTRACT: -- No abstract --

4 Article Sex and Ethnic Differences in Outcomes of Acute Coronary Syndrome and Stable Angina Patients With Obstructive Coronary Artery Disease. 2016

Izadnegahdar, Mona / Mackay, Martha / Lee, May K / Sedlak, Tara L / Gao, Min / Bairey Merz, C Noel / Humphries, Karin H. ·From the Division of Cardiology (M.I., K.H.H.), School of Nursing (M.M.), and Vancouver General Hospital, Leslie Diamond Women's Heart Health Clinic (T.L.S.), University of British Columbia, Canada · Heart Centre (M.M.) and Providence Health Care Research Institute (M.M., M.K.L., K.H.H.), St. Paul's Hospital, British Columbia, Canada · BC Centre for Improved Cardiovascular Health, British Columbia, Canada (M.I., M.K.L., M.G., K.H.H.) · Centre for Health Evaluation and Outcomes Research, Canada (M.M., K.H.H.) · and Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Los Angeles, CA (C.N.B.M.). ·Circ Cardiovasc Qual Outcomes · Pubmed #26908856.

ABSTRACT: BACKGROUND: The joint contribution of sex, ethnicity, and initial clinical presentation to the long-term outcomes of patients undergoing coronary angiography for acute coronary syndrome (ACS) or stable angina, in whom there is angiographic evidence for obstructive coronary artery disease, remains unknown. METHODS AND RESULTS: We conducted a population-based cohort study on 49 556 adult ACS or stable angina patients with angiographic evidence of obstructive coronary artery disease (≥ 50% stenosis) in British Columbia. The 2-year composite outcome was all-cause death and hospital readmissions for myocardial infarction, heart failure, cerebrovascular accident, or angina after the index angiography. Sex and ethnic differences in the composite outcome were examined by clinical presentation using the Cox proportional-hazards and logistic regression models. Overall, 25.6% were women, 9.5% were South Asians, 3.0% were Chinese, and 65.9% presented with ACS. Regardless of ethnicity, women were more likely than men to have adverse outcomes, but the magnitude of the sex difference was greater in the ACS patients (P(interaction) for sex and clinical presentation=0.03). Angina readmission accounted for 45% of the composite outcome and was the main component for all groups with the exception of Chinese women with ACS. Furthermore, women were more likely than men to be readmitted for angina (odds ratio [95% confidence interval], 1.13 [1.04-1.22]). CONCLUSIONS: Higher rates of adverse events among women with obstructive coronary artery disease, regardless of ethnicity, as well as high rates of angina readmission, highlight the need for more targeted interventions to reduce the burden of angina because this presentation is clearly not benign.

5 Article Sex differences in clinical outcomes in patients with stable angina and no obstructive coronary artery disease. 2013

Sedlak, Tara L / Lee, May / Izadnegahdar, Mona / Merz, C Noel Bairey / Gao, Min / Humphries, Karin H. ·Vancouver General Hospital, Vancouver, British Columbia, Canada. ·Am Heart J · Pubmed #23816019.

ABSTRACT: BACKGROUND: We comparatively evaluated clinical outcomes in men and women presenting with stable angina with no coronary artery disease (CAD), nonobstructive CAD, and obstructive CAD on coronary angiography. METHODS: We studied all patients ≥20 years with stable angina, undergoing coronary angiography in British Columbia, Canada, from July 1999 to December 2002 (n = 13,695) with maximum follow-up to 3 years. No CAD, nonobstructive CAD, and obstructive CAD were defined as 0%, 1% to 49%, and ≥50% luminal narrowing in any epicardial coronary artery, respectively. Freedom from major adverse cardiac events (MACEs), which included the combined end points of all-cause mortality, nonfatal acute myocardial infarction, nonfatal stroke, and heart failure admissions, was estimated using the Kaplan-Meier method. Hazard ratios (HRs) and 95% CIs for MACE were estimated up to 3 years postcatheterization and compared between sex and CAD groups. RESULTS: Within the first year, women with nonobstructive CAD had a higher risk of MACE than men with nonobstructive CAD (adjusted HR 2.43, 95% CI 1.08-5.49). Furthermore, women with nonobstructive CAD had a 2.55-fold higher risk of MACE than women with no CAD (95% CI 1.33-4.88). In contrast, men with nonobstructive CAD had a similar risk as men with no CAD (adjusted HR 0.61, 95% CI 0.26-1.45). The differences in MACE according to extent of CAD were not evident in the longer term. CONCLUSIONS: Women with stable angina and nonobstructive CAD are 3 times more likely to experience a cardiac event within the first year of cardiac catheterization than men. A prospective trial to examine the impact of medical therapy on MACE in patients with nonobstructive CAD is warranted.

6 Article Impact of coronary artery disease on outcomes after transcatheter aortic valve implantation. 2010

Masson, Jean-Bernard / Lee, May / Boone, Robert H / Al Ali, Abdullah / Al Bugami, Saad / Hamburger, Jaap / John Mancini, G B / Ye, Jian / Cheung, Anson / Humphries, Karin H / Wood, David / Nietlispach, Fabian / Webb, John G. ·St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada. ·Catheter Cardiovasc Interv · Pubmed #20665855.

ABSTRACT: BACKGROUND: Coronary artery disease (CAD) negatively impacts prognosis of patients undergoing surgical aortic valve replacement and revascularization is generally recommended at the time of surgery. Implications of CAD and preprocedural revascularization in the setting of transcatheter aortic valve implantation (TAVI) are not known. METHOD: Patients who underwent successful TAVI from January 2005 to December 2007 were retrospectively divided into five groups according to the extent of CAD assessed with the Duke Myocardial Jeopardy Score: no CAD, CAD with DMJS 0, 2, 4, and > or =6. Study endpoints included 30-day and 1-year survival, evolution of symptoms, left ventricular ejection fraction (LVEF), and mitral regurgitation (MR) and need of revascularization during follow-up. RESULTS: One hundred and thirty-six patients were included, among which 104 (76.5%) had coexisting CAD. Thirty-day mortality in the five study groups was respectively 6.3, 14.6, 7.1, 5.6, and 17.7% with no statistically significant difference between groups (P = 0.56). Overall survival rate at one year was 77.9% (95% CL: 70.9, 84.9) with no difference between groups (P = 0.63). Symptoms, LVEF, and MR all significantly improved in the first month after TAVI, but the extent of improvement did not differ between groups (P > 0.08). Revascularization after TAVI was uncommon. CONCLUSION: The presence of CAD or nonrevascularized myocardium was not associated with an increased risk of adverse events in this initial cohort. On the basis of these early results, complete revascularization may not constitute a prerequisite of TAVI. This conclusion will require re-assessment as experience accrues in patients with extensive CAD.