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Coronary Artery Disease: HELP
Articles by Issam D. Moussa
Based on 18 articles published since 2008
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Between 2008 and 2019, Issam Moussa wrote the following 18 articles about Coronary Artery Disease.
 
+ Citations + Abstracts
1 Guideline 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. 2013

Levine, Glenn N / Bates, Eric R / Blankenship, James C / Bailey, Steven R / Bittl, John A / Cercek, Bojan / Chambers, Charles E / Ellis, Stephen G / Guyton, Robert A / Hollenberg, Steven M / Khot, Umesh N / Lange, Richard A / Mauri, Laura / Mehran, Roxana / Moussa, Issam D / Mukherjee, Debabrata / Nallamothu, Brahmajee K / Ting, Henry H / Anonymous5470709 / Anonymous5480709 / Anonymous5490709. · ·Catheter Cardiovasc Interv · Pubmed #22065485.

ABSTRACT: -- No abstract --

2 Guideline 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. 2012

Levine, Glenn N / Bates, Eric R / Blankenship, James C / Bailey, Steven R / Bittl, John A / Cercek, Bojan / Chambers, Charles E / Ellis, Stephen G / Guyton, Robert A / Hollenberg, Steven M / Khot, Umesh N / Lange, Richard A / Mauri, Laura / Mehran, Roxana / Moussa, Issam D / Mukherjee, Debabrata / Nallamothu, Brahmajee K / Ting, Henry H / Anonymous640718 / Anonymous650718 / Anonymous660718. · ·Catheter Cardiovasc Interv · Pubmed #22328235.

ABSTRACT: -- No abstract --

3 Guideline Staging of multivessel percutaneous coronary interventions: an expert consensus statement from the Society for Cardiovascular Angiography and Interventions. 2012

Blankenship, James C / Moussa, Issam D / Chambers, Charles C / Brilakis, Emmanouil S / Haldis, Thomas A / Morrison, Douglas A / Dehmer, Gregory J / Anonymous1360710. ·Geisinger Medical Center, Danville, Pennsylvania 17822, USA. jblankenship@geisinger.edu ·Catheter Cardiovasc Interv · Pubmed #22072562.

ABSTRACT: Percutaneous coronary interventions (PCIs) to treat multivessel coronary artery disease (MVCAD) may involve single-vessel or multivessel interventions, performed in one or more stages. This consensus statement reviews factors that may influence choice of strategy and includes six recommendations to guide decisions regarding staging of PCI. Every patient who undergoes PCI should receive optimal therapy for coronary disease, ideally before starting the procedure. Multivessel PCI at the time of diagnostic catheterization should be considered only if informed consent included the risks and benefits of multivessel PCI and the risks and benefits of alternative treatments. When considering multivessel PCI, the interventionist should develop a strategy regarding which stenoses to treat or evaluate, and their order, method, and timing. This strategy should maximize patient benefits, minimize patient risk, and consider the factors described in this article. For planned multivessel PCI, additional vessel(s) should be treated only if the first vessel is treated successfully and if anticipated contrast and radiation doses and patient and operator conditions are favorable. After the first stage of the planned multistage PCI, the need for subsequent PCI should be reviewed before it is performed. Third party payers and quality auditors should recognize that multistage PCI for MVCAD is neither an indication of poor quality nor an attempt to increase reimbursement when performed according to recommendations in this article.

4 Editorial Myocardial Infarction After Percutaneous Coronary Intervention and Coronary Artery Bypass Graft Surgery: Time for a Unifying Common Definition. 2017

Moussa, Issam D / Stone, Gregg W. ·Division of Cardiovascular Diseases and Hypertension, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey. Electronic address: issam.moussa@rutgers.edu. · Division of Cardiology, New York Presbyterian Hospital and Columbia University Medical Center, New York, New York. ·JACC Cardiovasc Interv · Pubmed #28797426.

ABSTRACT: -- No abstract --

5 Editorial Retrospective comparison of single versus two stents for PCI of distal unprotected LMCA disease: apples aren't oranges and inverse probability weighting won't make them so! 2011

Moussa, Issam D. · ·Catheter Cardiovasc Interv · Pubmed #21520381.

ABSTRACT: -- No abstract --

6 Editorial Kissing versus crushing stents! Don't let the words deceive you! 2010

Moussa, Issam D. · ·Catheter Cardiovasc Interv · Pubmed #20162695.

ABSTRACT: -- No abstract --

7 Editorial Unprotected left main PCI in patients with diabetes mellitus: how data are reported also matters. 2009

Moussa, Issam D. · ·Catheter Cardiovasc Interv · Pubmed #19213085.

ABSTRACT: -- No abstract --

8 Review ACCF/AHA/SCAI 2013 update of the clinical competence statement on coronary artery interventional procedures: a report of the American College of Cardiology Foundation/American Heart Association/American College of Physicians Task Force on Clinical Competence and Training (Writing Committee to Revise the 2007 Clinical Competence Statement on Cardiac Interventional Procedures). 2013

Harold, John G / Bass, Theodore A / Bashore, Thomas M / Brindis, Ralph G / Brush, John E / Burke, James A / Dehmer, Gregory J / Deychak, Yuri A / Jneid, Hani / Jollis, James G / Landzberg, Joel S / Levine, Glenn N / McClurken, James B / Messenger, John C / Moussa, Issam D / Muhlestein, J Brent / Pomerantz, Richard M / Sanborn, Timothy A / Sivaram, Chittur A / White, Christopher J / Williams, Eric S. · ·J Am Coll Cardiol · Pubmed #23665367.

ABSTRACT: -- No abstract --

9 Review Bifurcation lesion morphology and intravascular ultrasound assessment. 2011

Costa, Ricardo A / Costa, Marco A / Moussa, Issam D. ·Instituto Dante Pazzanese de Cardiologia, Av Dr Dante Pazzanese, 500-Vila Mariana, São Paulo 04012-180, Brazil. rcosta@dantepazzanese.org.br ·Int J Cardiovasc Imaging · Pubmed #21409536.

ABSTRACT: This repot reviews the angiographic and intravascular (IVUS) assessment of coronary bifurcation lesions. Overall, bifurcation lesion anatomy and morphology is critical for technical decision making, and a key factor for successful bifurcation PCI. Optimal viewing is essential for proper angiographic assessment, especially for evaluation of the degree of SB involvement. Current classifications based on the presence or absence of significant angiographic stenosis within the three segments of the bifurcation anatomy may not provide sufficient anatomic and morphologic information to guide technical decision making. Dedicated 2D bifurcation quantitative coronary angiography with segmental analysis of the bifurcation provides greater accuracy for quantification of the degree of stenosis in the PV and especially the SB ostium. IVUS assessment at preprocedure provides valuable information regarding vessel size, and plaque morphology and distribution (particularly in relation to the SB ostium) that may help select treatment strategy. At postprocedure, IVUS imaging evaluates stent apposition within the stented segment(s) and the appropriateness of stent expansion particularly at the SB ostium, what may impact long-term outcomes.

10 Review Coronary artery bifurcation interventions: the disconnect between randomized clinical trials and patient centered decision-making. 2011

Moussa, Issam D. ·Greenberg Division of Cardiology, Department of Medicine, Weill Medical College of Cornell University, New York, New York, USA. imoussa9@aol.com ·Catheter Cardiovasc Interv · Pubmed #21351230.

ABSTRACT: The current evidence-base pertaining to PCI in coronary bifurcation lesions is not adequate to inform decision making in all patients, hence a gap still exists between the evidence-base and patient-centered decision-making. Although meta-analyses of the existing RCTs improve the statistical power of the data they do not remedy the problem of trial design. The reason for the gap between "evidence" and patient-centered decision-making is that the research methodology used in the RCTs does not simulate the questions asked in practice. The purpose of this review is to make the case for a counter perspective to the narrative that provisional stenting (PS) [stenting the main vessel (MV), with additional stenting of the side branch (SB) only in the case of an unsatisfactory result] is better than elective double stenting (EDS) of both branches in all patients. Namely, that neither approach should be the default strategy in all patients with bifurcation lesions and a decision as to which technique to use should be based on the patient's bifurcation anatomy. The majority of patients with bifurcation lesions will have anatomy that can be safely treated with PS; however, some patients have "at risk" bifurcation anatomy where PS may be associated with high risk of side branch occlusion.

11 Review When are two stents needed? Which technique is the best? How to perform? 2010

Latib, Azeem / Moussa, Issam / Sheiban, Imad / Colombo, Antonio. ·Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy. ·EuroIntervention · Pubmed #21930497.

ABSTRACT: -- No abstract --

12 Review Coronary revascularization for patients with unprotected left main coronary artery disease: evidence, guidelines, and judgment! Making clinical decisions in 2009. 2009

Moussa, Issam D / Wong, S Chiu / Feldman, Ted. ·Department of Medicine, Division of Cardiology, Weill Medical College of Cornell University, New York, New York 10021, USA. ism9003@med.cornell.edu ·Catheter Cardiovasc Interv · Pubmed #19434750.

ABSTRACT: The current clinical practice guidelines categorize the use of coronary artery bypass graft (CABG) surgery for revascularization of patients with unprotected left main coronary artery disease (ULMCAD) as a class IA recommendation while it categorize the use of percutaneous coronary interventions (PCI) as a class III recommendation. The evidence underlying these recommendations is weak and out dated. The purpose of this review is to critically reevaluate current state-of-the-art with respect to revascularization of patients with ULMCAD who are acceptable surgical candidates. In doing so we will highlight the divergence between practice guidelines and patient-centered clinical decision-making; critically appraise the "evidence" underlying the current practice guidelines; review the emerging data regarding utility of CABG versus PCI in these patients; and finally discuss the elements of a contemporary approach to clinical decision-making in light of the current state of knowledge.

13 Article Trends in cause of death after percutaneous coronary intervention. 2014

Spoon, Daniel B / Psaltis, Peter J / Singh, Mandeep / Holmes, David R / Gersh, Bernard J / Rihal, Charanjit S / Lennon, Ryan J / Moussa, Issam D / Simari, Robert D / Gulati, Rajiv. ·Divisions of Cardiovascular Diseases (D.B.S., P.J.P., M.S., D.R.H., B.J.G., C.S.R., R.D.S., R.G.) and Biomedical Statistics and Informatics (R.J.L.), Mayo Clinic, Rochester, MN · and Division of Cardiovascular Diseases (I.D.M.), Mayo Clinic, Jacksonville, FL. ·Circulation · Pubmed #24515993.

ABSTRACT: BACKGROUND: The impact of changing demographics on causes of long-term death after percutaneous coronary intervention (PCI) remains incompletely defined. METHODS AND RESULTS: We evaluated trends in cause-specific long-term mortality after index PCI performed at a single center from 1991 to 2008. Deaths were ascertained by scheduled prospective surveillance. Cause was determined via telephone interviews, medical records, autopsy reports, and death certificates. Competing-risks analysis of cause-specific mortality was performed using 3 time periods of PCI (1991-1996, 1997-2002, and 2003-2008). Final follow-up was December 31, 2012. A total of 19 077 patients survived index PCI hospitalization, of whom 6988 subsequently died (37%, 4.48 per 100 person-years). Cause was determined in 6857 (98.1%). Across 3 time periods, there was a 33% decline in cardiac deaths at 5 years after PCI (incidence: 9.8%, 7.4%, and 6.6%) but a 57% increase in noncardiac deaths (7.1%, 8.5%, and 11.2%). Only 36.8% of deaths in the recent era were cardiac. Similar trends were observed regardless of age, extent of coronary disease, or PCI indication. After adjustment for baseline variables, there was a 50% temporal decline in cardiac mortality but no change in noncardiac mortality. The decline in cardiac mortality was driven by fewer deaths from myocardial infarction/sudden death (P<0.001) but not heart failure (P=0.85). The increase in noncardiac mortality was primarily attributable to cancer and chronic diseases (P<0.001). CONCLUSIONS: This study found a marked temporal switch from predominantly cardiac to predominantly noncardiac causes of death after PCI over 2 decades. The decline in cardiac mortality was independent of changes in baseline clinical characteristics. These findings have implications for patient care and clinical trial design.

14 Article ACCF/AHA/SCAI 2013 update of the clinical competence statement on coronary artery interventional procedures: a report of the American College of Cardiology Foundation/American Heart Association/American College of Physicians Task Force on Clinical Competence and Training (writing committee to revise the 2007 clinical competence statement on cardiac interventional procedures). 2013

Harold, John G / Bass, Theodore A / Bashore, Thomas M / Brindis, Ralph G / Brush, John E / Burke, James A / Dehmer, Gregory J / Deychak, Yuri A / Jneid, Hani / Jollis, James G / Landzberg, Joel S / Levine, Glenn N / McClurken, James B / Messenger, John C / Moussa, Issam D / Muhlestein, J Brent / Pomerantz, Richard M / Sanborn, Timothy A / Sivaram, Chittur A / White, Christopher J / Williams, Eric S / Anonymous5860757 / Anonymous5870757 / Anonymous5880757 / Anonymous5890757. · ·Circulation · Pubmed #23658439.

ABSTRACT: -- No abstract --

15 Article Optimal diameter of diseased bifurcation segment: a practical rule for percutaneous coronary intervention. 2012

Huo, Yunlong / Finet, Gérard / Lefèvre, Thierry / Louvard, Yves / Moussa, Issam / Kassab, Ghassan S. ·Department of Biomedical Engineering, Indiana University, Indianapolis, IN 46202, USA. ·EuroIntervention · Pubmed #22433194.

ABSTRACT: AIMS: The percutaneous repair of a diseased segment should consider the dimensions of other segments of a bifurcation in order to ensure the optimality of flow through the bifurcation. The question is, if the diameters of two segments of a bifurcation are known, can an optimal diameter of the third diseased segment be determined such that the bifurcation has an optimal geometry for flow transport? Various models (i.e., Murray, Finet, area-preservation and HK models) that express a diameter relationship of the three segments of a bifurcation have been proposed to answer the question. METHODS AND RESULTS: In this study the four models were compared with experimental measurements on epicardial coronary bifurcations of patients and swine. The HK model is found to be in agreement with morphometric measurements of all bifurcation types and is based on the minimum energy hypothesis while Murray and area-preservation models are in agreement with experimental measurements for bifurcations with daughter diameter ratio (i.e., small daughter diameter/large daughter diameter) ≤0.25 and Finet model is in agreement for bifurcations with daughter diameter ratio ≥0.75. CONCLUSIONS: The HK model provides a comprehensive rule for the percutaneous reconstruction of the diameters of diseased vessels and has a physical basis.

16 Article Selective autoretroperfusion preserves myocardial function during coronary artery ligation in swine. 2011

Choy, Jenny S / Svendsen, Mark / Lu, Xiao / Zheng, Hai / Sulkin, Matthew S / Sinha, Anjan K / Morales, Celina / Moussa, Issam / Navia, José A / Kassab, Ghassan S. ·Department of Biomedical Engineering, Indiana University Purdue University Indianapolis, USA. ·Acute Card Care · Pubmed #21539459.

ABSTRACT: BACKGROUND: External pumps have been previously used to minimize edema and hemorrhage caused by coronary retroperfusion. The objective of this study was to use a pump-less approach (selective autoretroperfusion, SARP) to preserve myocardial function after acute coronary artery ligation. METHODS: In five experimental pigs, the LAD artery was ligated distal to the first diagonal and retroperfusion was instituted for three hours from a brachiocephalic artery at 50 mmHg pressure through an adjustable occluder on the cannula. In eight control pigs, the LAD artery was ligated distal to the second diagonal for the same duration with no SARP. RESULTS: ECG showed more prominent S-T segment elevation in the untreated control group despite the more distal ligation. The degree of myocardial contraction was significantly attenuated in the control group but was largely preserved in the SARP treated group. The myocytes were well preserved in the SARP group with no rupture of venous microvessels. Myocyte edema and disruption was observed in the control group with only mild extracellular edema in the SARP treated group. CONCLUSION: SARP preserved myocardial function with no damage to the myocyte and venules during three hours of acute LAD ligation.

17 Article Relation of troponin I levels following nonemergent percutaneous coronary intervention to short- and long-term outcomes. 2009

Feldman, Dmitriy N / Minutello, Robert M / Bergman, Geoffrey / Moussa, Issam / Wong, S Chiu. ·New York Presbyterian Hospital, Weill Cornell Medical College, New York, USA. dnf9001@med.cornell.edu ·Am J Cardiol · Pubmed #19840564.

ABSTRACT: Increases of creatine kinase (CK) and CK-MB cardiac enzymes after nonemergent percutaneous coronary intervention (PCI) have been associated with an increased risk of cardiovascular events during follow-up. However, there are limited data about the incidence and prognostic significance of an isolated increase of cardiac troponin I (cTnI) without an increase in CK-MB after PCI. The aim of this study was to evaluate the impact of an isolated cTnI increase on long-term survival in patients undergoing nonemergent PCI with normal CK-MB levels after PCI. Using the 2004/2005 Cornell Angioplasty Registry, we evaluated the clinical outcomes in 1,601 patients (undergoing elective or urgent PCI) with normal preprocedure cTnI and CK-MB and normal CK-MB levels after the procedure. Patients were divided into 2 groups based on the presence of cTnI increase after PCI. The mean follow-up period was 24.6 +/- 7.6 months. An increase in cTnI was observed in 831 patients (51.9%). Drug-eluting stents were used in 87% of patients and glycoprotein IIb/IIIa inhibitors were administered in 48% of patients. Incidence of in-hospital major adverse cardiovascular events was low, 0.1% versus 0% (p = 1.000), in patients with versus without cTnI increases, respectively. By 2 years of follow-up, Kaplan-Meier survival rates were 94.1% versus 96.4% (log-rank p = 0.020) in those with versus without cTnI increases, respectively. By multivariate Cox regression analysis, an increase in cTnI after PCI (hazard ratio 1.62, 95% confidence interval 1.01 to 2.59, p = 0.047) was an independent predictor of increased long-term mortality. In conclusion, an isolated increase in cTnI after nonemergent PCI is common, not associated with more frequent adverse in-hospital outcomes compared to patients with normal cTnI, and provides long-term prognostic information regarding mortality.

18 Article Prevalence and prediction of previously unrecognized peripheral arterial disease in patients with coronary artery disease: the Peripheral Arterial Disease in Interventional Patients Study. 2009

Moussa, Issam D / Jaff, Michael R / Mehran, Roxana / Gray, William / Dangas, George / Lazic, Zoran / Moses, Jeffery W. ·Division of Cardiology, New York Presbyterian Hospital/Weill Cornell Medical Center, Weill Medical College of Cornell University, New York, New York, USA. ·Catheter Cardiovasc Interv · Pubmed #19213068.

ABSTRACT: BACKGROUND: Peripheral arterial disease (PAD) is under diagnosed in primary care practices, yet the extent of unrecognized PAD in patients with coronary artery disease (CAD) is unknown. OBJECTIVE: To assess the prevalence of previously unrecognized PAD in patients undergoing coronary angiography and/or intervention and to determine the relationship between presence of PAD and severity of CAD. METHODS: The Peripheral Arterial Disease in Interventional Patients Study (PIPS) is a prospective cohort study conducted at an inpatient service of a tertiary referral center. A total of 800 patients referred for coronary angiography without prior diagnosis of PAD aged 70 years or older or aged 50-69 years with a history of tobacco use and/or diabetes mellitus were included. Evaluation involved a medical history, a questionnaire to assess symptoms and functional status, and measurement of the ankle-brachial index (ABI). PAD was considered present if the ABI was 0.90 or less. RESULTS: The prevalence of previously unrecognized PAD was 15%, 95% CI (12.6-17.7) and was highest among patients over 70 years of age (25.2%) and in women (23.3%). Among patients with CAD, those with PAD had higher prevalence of left main and multivessel coronary artery disease (87.2% vs. 75.5%, P = 0.006). Alternatively, patients with multivessel CAD had a twofold higher risk of being diagnosed with previously unrecognized PAD compared with those with single vessel CAD [adjusted OR = 2.02, (95% CI 1.03-3.98)]. CONCLUSIONS: PAD is often overlooked even in patients with known ischemic heart disease under specialist cardiovascular care. Overlooked PAD in this population increases in frequency with advanced age, in women, and in the presence of other traditional cardiovascular risk factors. Furthermore, the presence of PAD in this population identifies a subgroup with more severe form of CAD.