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Coronary Artery Disease: HELP
Articles by Timo H. Mäkikallio
Based on 9 articles published since 2008
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Between 2008 and 2019, Timo Mäkikallio wrote the following 9 articles about Coronary Artery Disease.
 
+ Citations + Abstracts
1 Review Mortality after coronary artery bypass grafting versus percutaneous coronary intervention with stenting for coronary artery disease: a pooled analysis of individual patient data. 2018

Head, Stuart J / Milojevic, Milan / Daemen, Joost / Ahn, Jung-Min / Boersma, Eric / Christiansen, Evald H / Domanski, Michael J / Farkouh, Michael E / Flather, Marcus / Fuster, Valentin / Hlatky, Mark A / Holm, Niels R / Hueb, Whady A / Kamalesh, Masoor / Kim, Young-Hak / Mäkikallio, Timo / Mohr, Friedrich W / Papageorgiou, Grigorios / Park, Seung-Jung / Rodriguez, Alfredo E / Sabik, Joseph F / Stables, Rodney H / Stone, Gregg W / Serruys, Patrick W / Kappetein, Arie Pieter. ·Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, Netherlands. Electronic address: s.head@erasmusmc.nl. · Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, Netherlands. · Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands. · Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea. · Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark. · Icahn School of Medicine at Mount Sinai, New York, NY, USA; Peter Munk Cardiac Centre and the Heart and Stroke Richard Lewar Centre, University of Toronto, Toronto, ON, Canada. · Norwich Medical School University of East Anglia and Norfolk and Norwich University Hospital, Norwich, UK. · Icahn School of Medicine at Mount Sinai, New York, NY, USA. · Stanford University School of Medicine, Stanford, CA, USA. · Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil. · Richard L Roudebush VA Medical Center, Indianapolis, IN, USA. · Department of Cardiology, Oulu University Hospital, Oulu, Finland. · Department of Cardiac Surgery, Herzzentrum Universität Leipzig, Leipzig, Germany. · Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, Netherlands; Department of Biostatistics, Erasmus University Medical Center, Rotterdam, Netherlands. · Cardiac Unit, Otamendi Hospital, Buenos Aires, Argentina. · Department Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA. · Institute of Cardiovascular Medicine and Science, Liverpool Heart and Chest Hospital, Liverpool, UK. · Columbia University Medical Center and the Center for Clinical Trials, Cardiovascular Research Foundation, New York, NY, USA. · Imperial College London, London, UK. ·Lancet · Pubmed #29478841.

ABSTRACT: BACKGROUND: Numerous randomised trials have compared coronary artery bypass grafting (CABG) with percutaneous coronary intervention (PCI) for patients with coronary artery disease. However, no studies have been powered to detect a difference in mortality between the revascularisation strategies. METHODS: We did a systematic review up to July 19, 2017, to identify randomised clinical trials comparing CABG with PCI using stents. Eligible studies included patients with multivessel or left main coronary artery disease who did not present with acute myocardial infarction, did PCI with stents (bare-metal or drug-eluting), and had more than 1 year of follow-up for all-cause mortality. In a collaborative, pooled analysis of individual patient data from the identified trials, we estimated all-cause mortality up to 5 years using Kaplan-Meier analyses and compared PCI with CABG using a random-effects Cox proportional-hazards model stratified by trial. Consistency of treatment effect was explored in subgroup analyses, with subgroups defined according to baseline clinical and anatomical characteristics. FINDINGS: We included 11 randomised trials involving 11 518 patients selected by heart teams who were assigned to PCI (n=5753) or to CABG (n=5765). 976 patients died over a mean follow-up of 3·8 years (SD 1·4). Mean Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) score was 26·0 (SD 9·5), with 1798 (22·1%) of 8138 patients having a SYNTAX score of 33 or higher. 5 year all-cause mortality was 11·2% after PCI and 9·2% after CABG (hazard ratio [HR] 1·20, 95% CI 1·06-1·37; p=0·0038). 5 year all-cause mortality was significantly different between the interventions in patients with multivessel disease (11·5% after PCI vs 8·9% after CABG; HR 1·28, 95% CI 1·09-1·49; p=0·0019), including in those with diabetes (15·5% vs 10·0%; 1·48, 1·19-1·84; p=0·0004), but not in those without diabetes (8·7% vs 8·0%; 1·08, 0·86-1·36; p=0·49). SYNTAX score had a significant effect on the difference between the interventions in multivessel disease. 5 year all-cause mortality was similar between the interventions in patients with left main disease (10·7% after PCI vs 10·5% after CABG; 1·07, 0·87-1·33; p=0·52), regardless of diabetes status and SYNTAX score. INTERPRETATION: CABG had a mortality benefit over PCI in patients with multivessel disease, particularly those with diabetes and higher coronary complexity. No benefit for CABG over PCI was seen in patients with left main disease. Longer follow-up is needed to better define mortality differences between the revascularisation strategies. FUNDING: None.

2 Review Clinical outcomes with percutaneous coronary revascularization vs coronary artery bypass grafting surgery in patients with unprotected left main coronary artery disease: A meta-analysis of 6 randomized trials and 4,686 patients. 2017

Palmerini, Tullio / Serruys, Patrick / Kappetein, Arie Pieter / Genereux, Philippe / Riva, Diego Della / Reggiani, Letizia Bacchi / Christiansen, Evald Høj / Holm, Niels R / Thuesen, Leif / Makikallio, Timo / Morice, Marie Claude / Ahn, Jung-Min / Park, Seung-Jung / Thiele, Holger / Boudriot, Enno / Sabatino, Mario / Romanello, Mattia / Biondi-Zoccai, Giuseppe / Cavalcante, Raphael / Sabik, Joseph F / Stone, Gregg W. ·Polo Cardio-Toraco-Vascolare, Policlinico S. Orsola, Bologna, Italy. · International Centre for Circulatory Health, NHLI, Imperial College London, London, United Kingdom. · Department of Cardiothoracic Surgery, Erasmus Medical Center, Rotterdam, the Netherlands. · Columbia University Medical Center and the Cardiovascular Research Foundation, New York, NY; Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada; Morristown Medical Center, Morristown, NJ. · Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark. · Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark. · Department of Cardiology, Oulu University Hospital, Oulu, Finland. · MC Moriec Ramsay Générale de Santé, ICPS, Massy, France. · The Heart Institute, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea. · University Heart Center Lübeck and the German Center for Cardiovascular Research (DZHK), Lübeck, Germany. · Department of Internal Medicine/Cardiology, University Heart Center, Leipzig, Germany. · Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy; Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy. · Department of Interventional Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands. · The Cleveland Clinic Foundation, Cleveland, OH. · Columbia University Medical Center and the Cardiovascular Research Foundation, New York, NY. Electronic address: gs2184@columbia.edu. ·Am Heart J · Pubmed #28760214.

ABSTRACT: Some but not all randomized controlled trials (RCT) have suggested that percutaneous coronary intervention (PCI) with drug-eluting stents may be an acceptable alternative to coronary artery bypass grafting (CABG) surgery for the treatment of unprotected left main coronary artery disease (ULMCAD). We therefore aimed to compare the risk of all-cause mortality between PCI and CABG in patients with ULMCAD in a pairwise meta-analysis of RCT. METHODS: Randomized controlled trials comparing PCI vs CABG for the treatment of ULMCAD were searched through MEDLINE, EMBASE, Cochrane databases, and proceedings of international meetings. RESULTS: Six trials including 4,686 randomized patients were identified. After a median follow-up of 39 months, there were no significant differences between PCI vs CABG in the risk of all-cause mortality (hazard ratio [HR] 0.99, 95% CI 0.76-1.30) or cardiac mortality. However, a significant interaction for cardiac mortality (P CONCLUSIONS: In patients undergoing revascularization for ULMCAD, PCI was associated with similar rates of mortality compared with CABG at a median follow-up of 39 months, but with an interaction effect suggesting relatively lower mortality with PCI in patients with low SYNTAX score and relatively lower mortality with CABG in patients with high SYNTAX score. Both procedures resulted in similar long-term composite rates of death, myocardial infarction, or stroke, with PCI offering an early safety advantage and CABG demonstrating greater durability.

3 Clinical Trial Comparison of 30-day and 5-year outcomes of percutaneous coronary intervention versus coronary artery bypass grafting in patients aged≤50 years (the Coronary aRtery diseAse in younG adultS Study). 2014

Biancari, Fausto / Gudbjartsson, Tomas / Heikkinen, Jouni / Anttila, Vesa / Mäkikallio, Timo / Jeppsson, Anders / Thimour-Bergström, Linda / Mignosa, Carmelo / Rubino, Antonino S / Kuttila, Kari / Gunn, Jarmo / Wistbacka, Jan-Ola / Teittinen, Kari / Korpilahti, Kari / Onorati, Francesco / Faggian, Giuseppe / Vinco, Giulia / Vassanelli, Corrado / Ribichini, Flavio / Juvonen, Tatu / Axelsson, Tomas A / Sigurdsson, Axel F / Karjalainen, Pasi P / Mennander, Ari / Kajander, Olli / Eskola, Markku / Ilveskoski, Erkki / D'Oria, Veronica / De Feo, Marisa / Kiviniemi, Tuomas / Airaksinen, K E Juhani. ·Department of Surgery, Oulu University Hospital, Oulu, Finland. Electronic address: faustobiancari@yahoo.it. · Department of Cardiothoracic Surgery, Landspitali University Hospital, Reykjavík, Iceland. · Department of Surgery, Oulu University Hospital, Oulu, Finland. · Department of Internal Medicine, Oulu University Hospital, Oulu, Finland. · Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Göteborg, Sweden. · Cardiac Surgery Unit, Azienda Ospedaliero Universitaria (A.O.U.) Policlinico-Vittorio Emanuele, University of Catania, Catania, Italy. · Heart Center, Turku University Hospital and University of Turku, Turku, Finland. · Department of Anesthesiology, Vaasa Central Hospital, Vaasa, Finland. · Department of Surgery, Vaasa Central Hospital, Vaasa, Finland. · Department of Internal Medicine, Vaasa Central Hospital, Vaasa, Finland. · Division of Cardiac Surgery, University of Verona Medical School, Verona, Italy. · Division of Cardiology, Department of Medicine, University of Verona Medical School, Verona, Italy. · Department of Cardiology, Faculty of Medicine, University of Iceland, Reykjavík, Iceland. · Heart Center, Satakunta Central Hospital, Pori, Finland. · Heart Center, Tampere University Hospital, Tampere, Finland. · Department of Cardiothoracic and Respiratory Sciences, V. Monaldi Hospital, Naples, Italy. ·Am J Cardiol · Pubmed #24878127.

ABSTRACT: Data on the outcome of young patients after coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) are scarce. Data on 2,209 consecutive patients aged≤50 years who underwent CABG or PCI were retrospectively collected from 15 European institutions. PCI and CABG had similar 30-day mortality rates (0.8% vs 1.4%, p=0.27), late survival (at 5 years, 97.8% vs 94.9%, p=0.082), and freedom from stroke (at 5 years, 98.0% and 98.0%, p=0.731). PCI was associated with significantly lower freedom from major adverse cardiac and cerebrovascular events (at 5 years, 73.9% vs 85.0%, p<0.0001), repeat revascularization (at 5 years, 77.6% vs 92.5%, p<0.0001), and myocardial infarction (at 5 years, 89.9% vs 96.6%, p<0.0001) compared with CABG. These findings were confirmed in propensity score-adjusted and matched analyses. Freedom from major adverse cardiac and cerebrovascular events after PCI was particularly low in diabetics (at 5 years, 58.0% vs 75.9%, p<0.0001) and in patients with multivessel disease (at 5 years, 63.6% vs 85.1%, p<0.0001). PCI in patients with ST elevation myocardial infarction was associated with significantly better 5-year survival (97.5% vs 88.8%, p=0.001), which was driven by its lower 30-day mortality rate (1.5% vs 6.0%, p=0.017). In conclusion, patients aged≤50 years have an excellent immediate outcome after either PCI or CABG with similar long-term survival when used according to the current clinical practice. PCI was associated with significantly lower freedom from myocardial infarction and repeat revascularization.

4 Clinical Trial Randomized comparison of final kissing balloon dilatation versus no final kissing balloon dilatation in patients with coronary bifurcation lesions treated with main vessel stenting: the Nordic-Baltic Bifurcation Study III. 2011

Niemelä, Matti / Kervinen, Kari / Erglis, Andrejs / Holm, Niels R / Maeng, Michael / Christiansen, Evald H / Kumsars, Indulis / Jegere, Sanda / Dombrovskis, Andis / Gunnes, Pål / Stavnes, Sindre / Steigen, Terje K / Trovik, Thor / Eskola, Markku / Vikman, Saila / Romppanen, Hannu / Mäkikallio, Timo / Hansen, Knud N / Thayssen, Per / Aberge, Lars / Jensen, Lisette O / Hervold, Anders / Airaksinen, Juhani / Pietilä, Mikko / Frobert, Ole / Kellerth, Thomas / Ravkilde, Jan / Aarøe, Jens / Jensen, Jan S / Helqvist, Steffen / Sjögren, Iwar / James, Stefan / Miettinen, Heikki / Lassen, Jens F / Thuesen, Leif / Anonymous1020682. ·Division of Cardiology, Department of Internal Medicine, University of Oulu, Finland. matti.niemela@ppshp.fi ·Circulation · Pubmed #21173348.

ABSTRACT: BACKGROUND: It is unknown whether the preferred 1-stent bifurcation stenting approach with stenting of the main vessel (MV) and optional side branch stenting using drug-eluting stents should be finalized by a kissing balloon dilatation (FKBD). Therefore, we compared strategies of MV stenting with and without FKBD. METHODS AND RESULTS: We randomized 477 patients with a bifurcation lesion to FKBD (n=238) or no FKBD (n=239) after MV stenting. The primary end point was major adverse cardiac events: cardiac death, non-procedure-related index lesion myocardial infarction, target lesion revascularization, or stent thrombosis within 6 months. The 6-month major adverse cardiac event rates were 2.1% and 2.5% (P=1.00) in the FKBD and no-FKBD groups, respectively. Procedure and fluoroscopy times were longer and more contrast media was needed in the FKBD group than in the no-FKBD group. Three hundred twenty-six patients had a quantitative coronary assessment. At 8 months, the rate of binary (re)stenosis in the entire bifurcation lesion (MV and side branch) was 11.0% versus 17.3% (P=0.11), in the MV was 3.1% versus 2.5% (P=0.68), and in the side branch was 7.9% versus 15.4% (P=0.039) in the FKBD versus no-FKBD groups, respectively. In patients with true bifurcation lesions, the side branch restenosis rate was 7.6% versus 20.0% (P=0.024) in the FKBD and no-FKBD groups, respectively. CONCLUSIONS: MV stenting strategies with and without FKBD were associated with similar clinical outcomes. FKBD reduced angiographic side branch (re)stenosis, especially in patients with true bifurcation lesions. The simple no-FKBD procedures resulted in reduced use of contrast media and shorter procedure and fluoroscopy times. Long-term data on stent thrombosis are needed. Clinical Trial Registration- URL: http://clinicaltrials.gov. Unique identifier: NCT00914199.

5 Article Percutaneous coronary angioplasty versus coronary artery bypass grafting in treatment of unprotected left main stenosis (NOBLE): a prospective, randomised, open-label, non-inferiority trial. 2016

Mäkikallio, Timo / Holm, Niels R / Lindsay, Mitchell / Spence, Mark S / Erglis, Andrejs / Menown, Ian B A / Trovik, Thor / Eskola, Markku / Romppanen, Hannu / Kellerth, Thomas / Ravkilde, Jan / Jensen, Lisette O / Kalinauskas, Gintaras / Linder, Rikard B A / Pentikainen, Markku / Hervold, Anders / Banning, Adrian / Zaman, Azfar / Cotton, Jamen / Eriksen, Erlend / Margus, Sulev / Sørensen, Henrik T / Nielsen, Per H / Niemelä, Matti / Kervinen, Kari / Lassen, Jens F / Maeng, Michael / Oldroyd, Keith / Berg, Geoff / Walsh, Simon J / Hanratty, Colm G / Kumsars, Indulis / Stradins, Peteris / Steigen, Terje K / Fröbert, Ole / Graham, Alastair N J / Endresen, Petter C / Corbascio, Matthias / Kajander, Olli / Trivedi, Uday / Hartikainen, Juha / Anttila, Vesa / Hildick-Smith, David / Thuesen, Leif / Christiansen, Evald H / Anonymous831283. ·Department of Cardiology, Oulu University Hospital, Oulu, Finland. · Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark. · Department of Cardiology, Golden Jubilee National Hospital, Clydebank, Scotland. · Belfast Heart Centre, Belfast Trust, Belfast, Northern Ireland. · Latvia Centre of Cardiology, Paul Stradins Clinical Hospital, Riga, Latvia. · Craigavon Cardiac Centre, Craigavon, Northern Ireland. · Department of Cardiology, University of Northern Norway, Tromsø, Norway. · Heart Hospital, Tampere University Hospital, Tampere, Finland. · Heart Center, Kuopio University Hospital, Kuopio, Finland. · Department of Cardiology, Örebro University Hospital, Örebro, Sweden. · Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark. · Department of Cardiology, Odense University Hospital, Odense, Denmark. · Department of Cardiology, Vilnius University Hospital, Vilnius, Lithuania. · Department of Cardiology, Danderyd Hospital, Stockholm, Sweden. · Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland. · Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway. · Oxford Heart Centre, Oxford, UK. · Department of Cardiology, Freeman Hospital and Institute of Cellular Medicine, Newcastle, UK. · Heart and Lung Centre, New Cross Hospital, Wolverhampton, UK. · Department of Cardiology, Haukeland University Hospital, Bergen, Norway. · Department of Cardiology, East Tallinn Hospital, Tallinn, Estonia. · Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; Department of Health Research and Policy (Epidemiology), Stanford University, Stanford, CA, USA. · Department of Cardiac Surgery, Aarhus University Hospital, Skejby, Aarhus, Denmark. · Department of Cardiovascular Surgery, University of Northern Norway, Tromsø, Norway. · Department of Cardiology, Karolinska University Hospital, Huddinge, Stockholm, Sweden. · Sussex Cardiac Centre, Brighton and Sussex University Hospital, Brighton, UK. · Department of Cardiac Surgery, Oulu University Hospital, Finland. · Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark. Electronic address: evald.christiansen@dadlnet.dk. ·Lancet · Pubmed #27810312.

ABSTRACT: BACKGROUND: Coronary artery bypass grafting (CABG) is the standard treatment for revascularisation in patients with left main coronary artery disease, but use of percutaneous coronary intervention (PCI) for this indication is increasing. We aimed to compare PCI and CABG for treatment of left main coronary artery disease. METHODS: In this prospective, randomised, open-label, non-inferiority trial, patients with left main coronary artery disease were enrolled in 36 centres in northern Europe and randomised 1:1 to treatment with PCI or CABG. Eligible patients had stable angina pectoris, unstable angina pectoris, or non-ST-elevation myocardial infarction. Exclusion criteria were ST-elevation myocardial infarction within 24 h, being considered too high risk for CABG or PCI, or expected survival of less than 1 year. The primary endpoint was major adverse cardiac or cerebrovascular events (MACCE), a composite of all-cause mortality, non-procedural myocardial infarction, any repeat coronary revascularisation, and stroke. Non-inferiority of PCI to CABG required the lower end of the 95% CI not to exceed a hazard ratio (HR) of 1·35 after up to 5 years of follow-up. The intention-to-treat principle was used in the analysis if not specified otherwise. This trial is registered with ClinicalTrials.gov identifier, number NCT01496651. FINDINGS: Between Dec 9, 2008, and Jan 21, 2015, 1201 patients were randomly assigned, 598 to PCI and 603 to CABG, and 592 in each group entered analysis by intention to treat. Kaplan-Meier 5 year estimates of MACCE were 29% for PCI (121 events) and 19% for CABG (81 events), HR 1·48 (95% CI 1·11-1·96), exceeding the limit for non-inferiority, and CABG was significantly better than PCI (p=0·0066). As-treated estimates were 28% versus 19% (1·55, 1·18-2·04, p=0·0015). Comparing PCI with CABG, 5 year estimates were 12% versus 9% (1·07, 0·67-1·72, p=0·77) for all-cause mortality, 7% versus 2% (2·88, 1·40-5·90, p=0·0040) for non-procedural myocardial infarction, 16% versus 10% (1·50, 1·04-2·17, p=0·032) for any revascularisation, and 5% versus 2% (2·25, 0·93-5·48, p=0·073) for stroke. INTERPRETATION: The findings of this study suggest that CABG might be better than PCI for treatment of left main stem coronary artery disease. FUNDING: Biosensors, Aarhus University Hospital, and participating sites.

6 Article Effects of exercise prescription on daily physical activity and maximal exercise capacity in coronary artery disease patients with and without type 2 diabetes. 2012

Karjalainen, Jaana J / Kiviniemi, Antti M / Hautala, Arto J / Niva, Jarkko / Lepojärvi, Samuli / Mäkikallio, Timo H / Piira, Olli-Pekka / Huikuri, Heikki V / Tulppo, Mikko P. ·Department of Exercise and Medical Physiology, Verve Research, Oulu, Finland. ·Clin Physiol Funct Imaging · Pubmed #23031065.

ABSTRACT: BACKGROUND: Promotion of and adherence to increased physical activity (PA) is an important part of the prevention and treatment of coronary artery disease (CAD). We hypothesized that individually tailored home-based exercise prescriptions will increase long-term PA and maximal exercise capacity among CAD patients without and with type 2 diabetes (CAD+T2D). METHODS: Physical activity of patients with CAD (n = 44) and CAD+T2D (n = 39), matched by age, sex and ejection fraction, was measured over 5 days with an accelerometer pre- and postexercise prescription. PA was assessed as the average time per day of moderate (METs = 2-5) and high (METs > 5) intensities. Six-month exercise prescriptions were introduced based on individual maximal heart rate reserve. RESULTS: At the baseline, patients with CAD+T2D engaged in less moderate-intensity PA (2:40 ± 1:23 versus 3:24 ± 1:17 h, P = 0·014) and exhibited a non-significant trend to reduced high-intensity PA (2:08 ± 2:57 versus 5:02 ± 9:19 min, P = 0·091) compared with patients with CAD. High-intensity PA increased markedly in CAD (5:02 ± 9:19 versus 9:59 ± 15:03 min) and patients with CAD+T2D (2:08 ± 2:57 versus 6:14 ± 10:18 min) after exercise prescription (main effect for time P = 0·001). Also maximal exercise capacity increased in both groups (main effect for time P< 0·001). CONCLUSION: Patients with CAD with T2D are physically less active than CAD patients without diabetes in their daily life. Individually tailored home-based exercise prescriptions are an effective way to promote more active lifestyles and improve fitness in both patient groups.

7 Article Determinants of heart rate recovery in coronary artery disease patients with and without type 2 diabetes. 2012

Karjalainen, Jaana J / Kiviniemi, Antti M / Hautala, Arto J / Piira, Olli-Pekka / Lepojärvi, E Samuli / Mäkikallio, Timo H / Huikuri, Heikki V / Tulppo, Mikko P. ·Institute of Clinical Medicine, Department of Internal Medicine, University of Oulu, Finland. ·Auton Neurosci · Pubmed #23006231.

ABSTRACT: Cardiovascular autonomic dysfunction, which is a common complication of diabetes, is associated with increased mortality in patients with coronary artery disease (CAD). However, the reasons of autonomic dysfunction in CAD patients with or without diabetes are not well known. We examine the association between heart rate recovery (HRR) and other potential factors among CAD patients with and without type 2 diabetes (T2D). Correlations between HRR 60s after exercise (HRR(60)), characteristics, laboratory and echocardiographic variables, exercise capacity and physical activity were assessed in 50 CAD patients with T2D and 55 patients with CAD alone. HRR(60) had the closest univariate correlation with physical activity and exercise capacity in patients with T2D (r=0.38, p=0.006 and r=0.37, p=0.008, respectively). Age, exercise capacity and high-density lipoprotein cholesterol level explained 30% of the HRR(60) in patients with T2D (p=0.001), while the high intensity physical activity was the only predictor of HRR(60) in CAD patients (12%, p=0.010). HRR(60) was reduced in patients with T2D as compared with those without (34±9 vs. 39±9bpm, p=0.005), but the difference was no longer significant after adjustments for physical activity, exercise capacity, body mass index and the use of calcium antagonists and nitrates (p=0.273). In conclusion, blunted HRR is more common among CAD patients with T2D than in those without, and this is more closely related to physical activity and obesity than to the duration of T2D or associated co-morbidities.

8 Article Randomized comparison of coronary bifurcation stenting with the crush versus the culotte technique using sirolimus eluting stents: the Nordic stent technique study. 2009

Erglis, Andrejs / Kumsars, Indulis / Niemelä, Matti / Kervinen, Kari / Maeng, Michael / Lassen, Jens F / Gunnes, Pål / Stavnes, Sindre / Jensen, Jan S / Galløe, Anders / Narbute, Inga / Sondore, Dace / Mäkikallio, Timo / Ylitalo, Kari / Christiansen, Evald H / Ravkilde, Jan / Steigen, Terje K / Mannsverk, Jan / Thayssen, Per / Hansen, Knud Nørregaard / Syvänne, Mikko / Helqvist, Steffen / Kjell, Nikus / Wiseth, Rune / Aarøe, Jens / Puhakka, Mikko / Thuesen, Leif / Anonymous560647. ·Latvian Centre of Cardiology, Paul Stradins Clinical University Hospital, Riga, Latvia. a.a.erglis@stradini.lv ·Circ Cardiovasc Interv · Pubmed #20031690.

ABSTRACT: BACKGROUND: In a number of coronary bifurcation lesions, both the main vessel and the side branch need stent coverage. Using sirolimus eluting stents, we compared 2 dedicated bifurcation stent techniques, the crush and the culotte techniques in a randomized trial with separate clinical and angiographic end-points. METHODS AND RESULTS: A total of 424 patients with a bifurcation lesion were randomized to crush (n=209) and culotte (n=215) stenting. The primary end point was major adverse cardiac events; cardiac death, myocardial infarction, target vessel revascularization, or stent thrombosis after 6 months. At 6 months there were no significant differences in major adverse cardiac event rates between the groups; crush 4.3%, culotte 3.7% (P=0.87). Procedure and fluoroscopy times and contrast volumes were similar in the 2 groups. The rates of procedure-related increase in biomarkers of myocardial injury were 15.5% in crush versus 8.8% in culotte group (P=0.08). A total of 324 patients had a quantitative coronary assessment at the index procedure and after 8 months. The angiographic end-points of in-segment and in-stent restenosis of main vessel and/or side branch after 8 months were found in 12.1% versus 6.6% (P=0.10) and in 10.5% versus 4.5% (P=0.046) in the crush and culotte groups, respectively. CONCLUSIONS: Both the crush and the culotte bifurcation stenting techniques were associated with similar and excellent clinical and angiographic results. Angiographically, there was a trend toward less in-segment restenosis and significantly reduced in-stent restenosis following culotte stenting.

9 Minor Everolimus-Eluting Stents or Bypass Surgery for Left Main Coronary Disease. 2017

Christiansen, Evald H / Mäkikallio, Timo / Holm, Niels R. ·Aarhus University Hospital, Aarhus, Denmark evald.christiansen@dadlnet.dk. · Oulu University Hospital, Oulu, Finland. · Aarhus University Hospital, Aarhus, Denmark. ·N Engl J Med · Pubmed #28296611.

ABSTRACT: -- No abstract --