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1. Causes of Cardiovascular and Non-Cardiovascular Death in the ISCHEMIA Trial

Author

Sidhu MS, Alexander KP, Huang Z, O'Brien SM, Chaitman BR, Stone GW, Newman JD, Boden WE, Maggioni AP, Steg PG, Ferguson TB, Demkow M, Peteiro J, Wander GS, Phaneuf DC, De Belder MA, Doerr R, Alexanderson-Rosas E, Polanczyk CA, Henriksen PA, Conway DSG, Miro V, Sharir T, Lopes RD, Min JK, Berman DS, Rockhold FW, Balter S, Borrego D, Rosenberg YD, Bangalore S, Reynolds HR, Hochman JS, Maron DJ, and ISCHEMIA Research Group

Subjects
Death, Revascularization, Endpoints, Medical Therapy, Stable Coronary Artery Disease
Abstract

BACKGROUND: The ISCHEMIA trial demonstrated no overall difference in the composite primary endpoint and the secondary endpoints of cardiovascular (CV) death/myocardial infarction or all-cause mortality between an initial invasive or conservative strategy among participants with chronic coronary disease and moderate or severe myocardial ischemia. Detailed cause-specific death analyses have not been reported. METHODS: We compared overall and cause-specific death rates by treatment group using Cox models with adjustment for pre-specified baseline covariates. Cause of death was adjudicated by an independent Clinical Events Committee as cardiovascular (CV), non-CV, and undetermined. We evaluated the association of risk factors and treatment strategy with cause of death. RESULTS: Four-year cumulative incidence rates for CV death were similar between invasive and conservative strategies [2.6% vs. 3.0%; hazard ratio (HR) 0.98; 95% CI (0.70 - 1.38)], but non-CV death rates were higher in the invasive strategy [3.3% vs. 2.1%; HR 1.45 (1.00 - 2.09)]. Overall, 13% of deaths were attributed to undetermined causes (38/289). Fewer undetermined deaths [0.6% vs. 1.3%; HR 0.48 (0.24 - 0.95)] and more malignancy deaths [2.0% vs. 0.8%; HR 2.11 (1.23 - 3.60)] occurred in the invasive strategy than in the conservative strategy. CONCLUSIONS: In ISCHEMIA, all-cause and CV death rates were similar between treatment strategies. The observation of fewer undetermined deaths and more malignancy deaths in the invasive strategy remains unexplained. These findings should be interpreted with caution in the context of prior studies and the overall trial results.

Published
2022

2. Baseline Characteristics and Risk Profiles of Participants in the ISCHEMIA Randomized Clinical Trial

Author

Hochman, JS, Reynolds, HR, Bangalore, S, O'Brien, SM, Alexander, KP, Senior, R, Boden, WE, Stone, GW, Goodman, SG, Lopes, RD, Lopez-Sendon, J, White, HD, Maggioni, AP, Shaw, LJ, Min, JK, Picard, MH, Berman, DS, Chaitman, BR, Mark, DB, Spertus, JA, Cyr, DD, Bhargava, B, Ruzyllo, W, Wander, GS, Chernyavskiy, AM, Rosenberg, YD, Maron, DJ, Mavromatis, K, Miller, T, Banerjee, S, Abdul-Nour, K, Stone, PH, Jang, JJ, Weitz, S, Arnold, S, Shapiro, MD, El-Hajjar, M, McFalls, EO, Khouri, MG, Goldberg, JL, Goldweit, R, Cohen, RA, Winchester, DE, Kronenberg, M, Heitner, JF, Dauber, IM, Cannan, C, Sudarshan, S, Mehta, PK, Hedgepeth, CM, Sahul, Z, Booth, D, Setty, S, Barua, RS, Hage, F, Dajani, K, Arif, I, Trejo (Gutierrez), JF, Gemignani, A, Meadows, JL, Call, JT, Hannan, J, Martin, ET, Vorobiof, G, Moorman, A, Kinlay, S, Rayos, G, Seedhom, A, Kumkumian, G, Sedlis, SP, Tamis-Holland, JE, Saba, S, Badami, U, Marzo, K, Robbins, IH, Hamroff, GS, Little, RW, Lui, CY, Hu, B, Labovitz, AJ, Rodriguez, F, Deedwania, P, Sweeny, J, Spizzieri, C, Hochberg, CP, Salerno, WD, Wyman, R, Zarka, A, Haldis, T, Kohn, JA, Girotra, S, Almousalli, O, Krishnam, MS, Coram, R, Thomas, S, El Shahawy, M, Stafford, J, Abernethy, WB, Zurick, A, Meyer, TM, Rutkin, B, Bokhari, S, Sokol, SI, Hamzeh, I, Turner, MC, Good, AP, Shammas, NW, Chilton, R, Nguyen, PK, Jezior, M, Gordon, PC, Stenberg, R, Pedalino, RP, Wiesel, J, Juang, GJ, Al-Amoodi, M, Wohns, D, Lader, EW, Mumma, M, Dharmarajan, L, McGarvey, JFX, Downes, TR, Cheong, B, Potluri, S, Mastouri, RA, Li, D, Giedd, K, Old, W, Burt, F, Sokhon, K, Gopal, D, Valeti, US, Kobashigawa, J, Govindan, SC, Manjunath, CN, Pandit, N, Dwivedi, SK, Mathew, A, Gadkari, MA, Satheesh, S, Mathur, A, Christopher, J, Oomman, A, Naik, S, Grant, P, Kachru, R, Kumar, A, Kaul, U, Gamma, RA, De Belder, MA, Nageh, T, Lindsay, SJ, Hoye, A, Donnelly, P, Chauhan, A, Barr, C, Alfakih, K, Henriksen, P, Okane, P, De Silva, R, Conway, DSG, Sirker, AA, Hoole, SP, Witherow, FN, Johnston, N, Luckie, M, Sobolewska, J, Jeetley, P, Travill, C, Braganza, D, Henderson, R, Berry, C, Moriarty, AJ, Glover, JD, Mikhail, G, Gosselin, G, Diaz, A, Phaneuf, DC, Garg, P, Chow, BJW, Bainey, KR, Cheema, AN, Cha, J, Howarth, AG, Wong, G, Uxa, A, Galiwango, P, Lam, A, Mehta, S, Udell, J, Genereux, P, Hameed, A, Daba, L, Hueb, W, Smanio, PEP, De Quadros, AS, Vitola, JV, Marin-Neto, JA, Polanczyk, CA, Carvalho, AC, Alves Junior, AR, Dracoulakis, MDA, Figueiredo, E, Caramori, PR, Tumelero, R, Dall'Orto, F, Mesquita, CT, Ribeiro da Silva, EE, Saraiva, JF, Costantini, C, Demkow, M, Mazurek, T, Drozdz, J, Szwed, H, Witkowski, A, Gajos, G, Pruszczyk, P, Loboz-Grudzien, K, Lesiak, M, Reczuch, KW, Kalarus, Z, Musial, WJ, Bockeria, L, Bershtein, LL, Demchenko, EA, Lopez-Sendon, JL, Peteiro, J, Gonzalez Juanatey, JR, Sionis, A, Miro, V, Ortuno, FM, Blancas, MG, Luena, JEC, Fernandez-Aviles, F, Chen, J, Wu, Y, Ma, Y, Ji, Z, Yang, X, Lin, W, Zeng, H, Fu, X, Yang, B, Wang, S, Cheng, G, Zhao, Y, Fang, X, Zeng, Q, Su, X, Li, Q, Nie, S-P, Yu, Q, Wang, J, Zhang, S, Perna, GP, Provasoli, S, Monti, L, Di Chiara, A, Mortara, A, Galvani, M, Sicuro, M, Calabro, P, Tarantini, G, Racca, E, Briguori, C, Amati, R, Russo, A, Poh, K-K, Foo, D, Chua, T, Doerr, R, Sechtem, U, Schulze, PC, Nickenig, G, Schuchlenz, H, Lang, IM, Huber, K, Vertes, A, Varga, A, Fontos, G, Merkely, B, Kerecsen, G, Hinic, S, Beleslin, BD, Cemerlic-Adjic, N, Davidovic, G, Dekleva, MN, Stankovic, G, Apostolovic, S, Escobedo, J, Rosas, EA, Selvanayagam, JB, Thambar, ST, Beltrame, JF, Hillis, GS, Thuaire, C, Steg, P-G, Slama, MS, El Mahmoud, R, Nicollet, E, Barone-Rochette, G, Furber, A, Laucevicius, A, Kedhi, E, Riezebos, RK, Suryapranata, H, Ramos, R, Pinto, FJ, Ferreira, N, Guzman, L, Figal, JC, Alvarez, C, Courtis, J, Schiavi, L, Rubio, M, Devlin, GP, Stewart, RAH, Kedev, S, Held, C, Aspberg, J, Sharir, T, Kerner, A, Fukuda, K, Yasuda, S, Nishimura, S, Goetschalckx, K, Hung, C-L, Ntsekhe, M, Moccetti, T, Abdelhamid, M, Pop, C, Popescu, BA, Al-Mallah, MH, Ramos, WEM, Kuanprasert, S, Yamwong, S, Khairuddin, A, Ferguson, B, Harrington, R, Williams, D, Berger, J, Newman, J, Sidhu, M, Dzavik, V, Jiang, L, Keltai, M, Kohsaka, S, Maggioni, A, Mancini, GBJ, Merz, CNB, Weintraub, W, Ballantyne, C, Calfas, KJ, Davidson, M, Friedrich, M, Hachamovitch, R, Kwong, R, Harrell, F, Kullo, I, McManus, B, Cohen, DJ, Bugiardini, R, Celutkiene, J, Lyubarova, R, Mattina, D, Nwosu, S, Broderick, S, Cyr, D, Rockhold, F, Anstrom, K, Jones, P, Phillips, L, Hayes, SW, Friedman, JD, Gerlach, RJ, Kwong, RY, Mongeon, FP, Hung, J, Scherrer-Crosbie, M, Zeng, X, Ali, Z, Arsanjani, R, Budoff, M, Leipsic, J, Nakanishi, R, Youn, T, Orso, F, Zhang, H, Zhang, L, Diaz, R, Van de Werf, F, Fleg, J, Kirby, R, Jeffries, N, and Hochman JS, Reynolds HR, Bangalore S, O'Brien SM, Alexander KP, Senior R, Boden WE, Stone GW, Goodman SG, Lopes RD, Lopez-Sendon J, White HD, Maggioni AP, Shaw LJ, Min JK, Picard MH, Berman DS, Chaitman BR, Mark DB, Spertus JA, Cyr DD, Bhargava B, Ruzyllo W, Wander GS, Chernyavskiy AM, Rosenberg YD, Maron DJ, Mavromatis K, Miller T, Banerjee S, Abdul-Nour K, Stone PH, Jang JJ, Weitz S, Arnold S, Shapiro MD, El-Hajjar M, McFalls EO, Khouri MG, Goldberg JL, Goldweit R, Cohen RA, Winchester DE, Kronenberg M, Heitner JF, Dauber IM, Cannan C, Sudarshan S, Mehta PK, Hedgepeth CM, Sahul Z, Booth D, Setty S, Barua RS, Hage F, Dajani K, El-Hajjar M, Arif I, Trejo JF, Gemignani A, Meadows JL, Call JT, Hannan J, Martin ET, Vorobiof G, Moorman A, Kinlay S, Rayos G, Seedhom A, Kumkumian G, Sedlis SP, Tamis-Holland JE, Saba S, Badami U, Marzo K, Robbins IH, Hamroff GS, Little RW, Lui CY, Booth D, Hu B, Labovitz AJ, Maron DJ, Rodriguez F, Deedwania P, Sweeny J, Spizzieri C, Hochberg CP, Salerno WD, Wyman R, Zarka A, Haldis T, Kohn JA, Girotra S, Almousalli O, Krishnam MS, Coram R, Thomas S, El Shahawy M, Stafford J, Abernethy WB, Zurick A, Meyer TM, Rutkin B, Bokhari S, Sokol SI, Hamzeh I, Turner MC, Good AP, Shammas NW, Chilton R, Nguyen PK, Jezior M, Gordon PC, Stenberg R, Pedalino RP, Wiesel J, Juang GJ, Al-Amoodi M, Wohns D, Lader EW, Mumma M, Dharmarajan L, McGarvey JFX, Downes TR, Cheong B, Potluri S, Mastouri RA, Li DY, Giedd K, Old W, Burt F, Sokhon K, Gopal D, Valeti US, Kobashigawa J, Govindan SC, Manjunath CN, Pandit N, Dwivedi SK, Wander G, Bhargava B, Mathew A, Gadkari MA, Satheesh S, Mathur A, Christopher J, Oomman A, Naik S, Christopher J, Grant P, Kachru R, Kumar A, Christopher J, Kaul U, Gamma RA, de Belder MA, Nageh T, Lindsay SJ, Hoye A, Donnelly P, Chauhan A Barr C, Alfakih K, Henriksen P, Okane P, de Silva R, Conway DSG, Sirker AA, Hoole SP, Witherow FN, Johnston N, Luckie M, Sobolewska J, Jeetley P, Travill C, Braganza D, Henderson R, Berry C, Moriarty AJ, Glover JD, Mikhail G, Gosselin G, Diaz A, Phaneuf DC, Garg P, Chow BJW, Bainey KR, Cheema AN, Cheema AN, Cha J, Howarth AG, Wong G, Uxa A, Galiwango P, Lam A, Mehta S, Udell J, Genereux P, Hameed A, Daba L, Hueb W, Smanio PEP, de Quadros AS, Vitola JV, Marin-Neto JA, Polanczyk CA, Carvalho AC, Alves AR, Dracoulakis MDA, Figueiredo E, Caramori PR, Tumelero R, Dall'Orto F, Mesquita CT, da Silva EER, Saraiva JF, Costantini C, Demkow M, Mazurek T, Drozdz J, Szwed H, Witkowski A, Gajos G, Pruszczyk P, Loboz-Grudzien K, Lesiak M, Reczuch KW, Kalarus Z, Musial WJ, Bockeria L, Chernyavskiy AM, Bershtein LL, Demchenko EA, Lopez-Sendon JL, Peteiro J, Juanatey JRG, Sionis A, Miro V, Ortuno FM, Blancas MG, Luena JEC, Fernandez-Aviles F, Chen JY, Wu YJ, Ma YT, Ji Z, Yang XC, Lin WH, Zeng HS, Fu, X, Yang B, Wang ST, Cheng G, Zhao YL, Fang XH, Zeng QT, Su X, Li QX, Nie SP, Yu Q, Wang JA, Zhang SY, Perna GP, Provasoli S, Monti L, Di Chiara A, Mortara A, Galvani M, Sicuro M, Calabro P, Tarantini G, Racca E , Briguori C, Amati R, Russo A, Poh KK, Foo D, Chua, Doerr R, Sechtem U, Schulze PC, Nickenig G, Schuchlenz H, Lang IM, Huber K, Vertes A, Varga A, Fontos G, Merkely B, Kerecsen G, Hinic S, Beleslin BD, Cemerlic-Adjic N, Davidovic G, Dekleva MN, Stankovic G, Apostolovic S, Escobedo J, Rosas EA, Selvanayagam JB, Thambar ST, Beltrame JF, Hillis GS, Thuaire C, Steg PG, Slama MS, El Mahmoud R, Nicollet E, Barone-Rochette G, Furber A, Laucevicius A, Kedhi E, Riezebos RK, Suryapranata H, Ramos R, Pinto FJ, Ferreira N, Guzman L, Figal JC, Alvarez C, Courtis J, Schiavi L, Rubio M, Devlin GP, Stewart RAH, Kedev S, Held C, Aspberg, J, Sharir T, Kerner A, Fukuda K, Yasuda S, Nishimura S , Goetschalckx K, Hung CL, Ntsekhe M, Moccetti T, Abdelhamid M, Pop C, Popescu BA, Al-Mallah MH, Ramos WEM, Kuanprasert S, Yamwong S, Khairuddin A, O'Brien SM, Boden WE, Ferguson B, Harrington R, Stone GW, Williams D, Berger J, Newman J, Sidhu M, Mark DB, Shaw LJ, Spertus JA, Berman DS, Chaitman BR, Doerr R, Dzavik V, Goodman SG, Gosselin G, Held C, Jiang LX, Keltai M, Kohsaka S, Lopes RD, Lopez-Sendon JL, Maggioni A, Mancini GBJ, Merz CNB, Min JK, Picard MH, Ruzyllo W, Selvanayagam JB, Senior R, Steg PG, Szwed H, Weintraub W, White HD, Ballantyne C, Calfas KJ, Davidson M, Stone PH, Friedrich M, Hachamovitch R, Kwong R, Harrell F, Kullo I, McManus B, Cohen DJ, Bugiardini R, Celutkiene J, Escobedo J , Hoye A, Lyubarova R, Mattina D, Peteiro J, Nwosu S, Broderick S, Cyr D, Rockhold F, Anstrom K, Jones P, Phillips L, Hayes SW, Friedman JD, Gerlach RJ, Kwong RY, Mongeon FP, Hung J, Scherrer-Crosbie M, Zeng X, Ali Z, Genereux P, Arsanjani R, Budoff M, Leipsic J, Nakanishi R, Youn T , Orso F, Carvalho AC, Zhang HB, Zhang LH, Diaz R, Van de Werf F, Goetschalckx K, Rosenberg YD, Fleg J, Kirby R, Jeffries N.

Subjects
medicine.medical_specialty, Cardiac & Cardiovascular Systems, IMPACT, medicine.medical_treatment, Population, 030204 cardiovascular system & hematology, Revascularization, law.invention, MEDICAL THERAPY, ISCHEMIA Research Group, Angina, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, Severity of illness, SCORE, medicine, BENEFIT, 030212 general & internal medicine, cardiovascular diseases, education, education.field_of_study, OUTCOMES, Science & Technology, business.industry, PCI, medicine.disease, Clinical trial, PROGNOSTIC VALUE, Stenosis, Cardiology, Cardiovascular System & Cardiology, CORONARY-ARTERY-DISEASE, REVASCULARIZATION, Cardiology and Cardiovascular Medicine, business, ECHOCARDIOGRAPHY, Life Sciences & Biomedicine
Abstract

Importance It is unknown whether coronary revascularization, when added to optimal medical therapy, improves prognosis in patients with stable ischemic heart disease (SIHD) at increased risk of cardiovascular events owing to moderate or severe ischemia. Objective To describe baseline characteristics of participants enrolled and randomized in the International Study of Comparative Health Effectiveness With Medical and Invasive Approaches (ISCHEMIA) trial and to evaluate whether qualification by stress imaging or nonimaging exercise tolerance test (ETT) influenced risk profiles. Design, Setting, and Participants The ISCHEMIA trial recruited patients with SIHD with moderate or severe ischemia on stress testing. Blinded coronary computed tomography angiography was performed in most participants and reviewed by a core laboratory to exclude left main stenosis of at least 50% or no obstructive coronary artery disease (CAD) (

Published
2019

3. Third universal definition of myocardial infarction

Author

Thygesen, K, Alpert, Js, Jaffe, As, Simoons, Ml, Chaitman, Br, White, Hd, the Writing Group on behalf of the Joint ESC/ACCF/AHA/WHF Task Force for the Universal Definition of Myocardial Infarction, Authors/Task Force Members Chairpersons, Biomarker, Subcommittee, Katus, Ha, Apple, Fs, Lindahl, B, Morrow, Da, Ecg, Subcommittee, Clemmensen, Pm, Johanson, P, Hod, H, Imaging, Subcommittee, Underwood, R, Bax, Jj, Bonow, Ro, Pinto, F, Gibbons, Rj, Classification, Subcommittee, Fox, Ka, Atar, D, Newby, Lk, Galvani, M, Hamm, Cw, Intervention, Subcommittee, Uretsky, Bf, Gabriel Steg, P, Wijns, W, Bassand, Jp, Menasché, P, Ravkilde, J, Trials, Registries, Subcommittee, Ohman, Em, Antman, Em, Wallentin, Lc, Armstrong, Pw, Heart Failure Subcommittee, Januzzi, Jl, Nieminen, Ms, Gheorghiade, M, Filippatos, G, Epidemiology, Subcommittee, Luepker, Rv, Fortmann, Sp, Rosamond, Wd, Levy, D, Wood, D, Global Perspective Subcommittee, Smith, Sc, Hu, D, Lopez Sendon JL, Robertson, Rm, Weaver, D, Tendera, M, Bove, Aa, Parkhomenko, An, Vasilieva, Ej, Mendis, S, ESC Committee for Practice Guidelines, Baumgartner, H, Ceconi, Claudio, Dean, V, Deaton, C, Fagard, R, Funck Brentano, C, Hasdai, D, Hoes, A, Kirchhof, P, Knuuti, J, Kolh, P, Mcdonagh, T, Moulin, C, Popescu, Ba, Reiner, Z, Sechtem, U, Sirnes, Pa, Torbicki, A, Vahanian, A, Windecker, S, Document, Reviewers, Morais, J, Aguiar, C, Almahmeed, W, Arnar, Do, Barili, F, Bloch, Kd, Bolger, Af, Bøtker, He, Bozkurt, B, Bugiardini, R, Cannon, C, de Lemos, J, Eberli, Fr, Escobar, E, Hlatky, M, James, S, Kern, Kb, Moliterno, Dj, Mueller, C, Neskovic, An, Pieske, Bm, Schulman, Sp, Storey, Rf, Taubert, Ka, Vranckx, P, Wagner, D. R., Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD, Lindahl B, Morrow DA, Clemmensen PM, Johanson P, Hod H, Underwood R, Bax JJ, Bonow JJ, Pinto F, Gibbons RJ, Fox KA, Atar D, Newby LK, Galvani M, Hamm CW, Uretsky BF, Steg PG, Wijns W, Bassand JP, Menasche P, Ravkilde J, Ohman EM, Antman EM, Wallentin LC, Armstrong PW, Januzzi JL, Nieminen MS, Gheorghiade M, Filippatos G, Luepker RV, Fortmann SP, Rosamond WD, Levy D, Wood D, Smith SC, Hu D, Lopez-Sendon JL, Robertson RM, Weaver D, Tendera M, Bove AA, Parkhomenko AN, Vasilieva EJ, Mendis S, Baumgartner H, Ceconi C, Dean V, Deaton C, Fagard R, Funck-Brentano C, Hasdai D, Hoes A, Kirchhof P, Knuuti J, Kolh P, McDonagh T, Moulin C, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Torbicki A, Vahanian A, Windecker S, Morais J, Aguiar C, Almahmeed W, Arnar DO, Barili F, Bloch KD, Bolger AF, Botker HE, Bozkurt B, Bugiardini R, Cannon C, de Lemos J, Eberli FR, Escobar E, Hlatky M, James S, Kern KB, Moliterno DJ, Mueller C, Neskovic AN, Pieske BM, Schulman SP, Storey RF, Taubert KA, Vranckx P, Wagner DR., Cardiology, lLindahl B, K. Thygesen, J. S. Alpert, A. S. Jaffe, M. L. Simoon, B. R. Chaitman, H. D. White, H. A. Katu, F. S. Apple, B. Lindahl, D. A. Morrow, P. M. Clemmensen, P. Johanson, H. Hod, R. Underwood, J. J. Bax, R. O. Bonow, F. Pinto, R. J. Gibbon, K. A. Fox, D. Atar, L. K. Newby, M. Galvani, C. W. Hamm, B. F. Uretsky, P. Gabriel Steg, W. Wijn, J.-P. Bassand, P. Menasche, J. Ravkilde, E. M. Ohman, E. M. Antman, L. C. Wallentin, P. W. Armstrong, J. L. Januzzi, M. S. Nieminen, M. Gheorghiade, G. Filippato, R. V. Luepker, S. P. Fortmann, W. D. Rosamond, D. Levy, D. Wood, S. C. Smith, D. Hu, J.-L. Lopez-Sendon, R. M. Robertson, D. Weaver, M. Tendera, A. A. Bove, A. N. Parkhomenko, E. J. Vasilieva, S. Mendi, H. Baumgartner, C. Ceconi, V. Dean, C. Deaton, R. Fagard, C. Funck-Brentano, D. Hasdai, A. Hoe, P. Kirchhof, J. Knuuti, P. Kolh, T. McDonagh, C. Moulin, B. A. Popescu, Z. Reiner, U. Sechtem, P. A. Sirne, A. Torbicki, A. Vahanian, S. Windecker, J. Morai, C. Aguiar, W. Almahmeed, D. O. Arnar, F. Barili, K. D. Bloch, A. F. Bolger, H. E. Botker, B. Bozkurt, R. Bugiardini, C. Cannon, J. de Lemo, F. R. Eberli, E. Escobar, M. Hlatky, S. Jame, K. B. Kern, D. J. Moliterno, C. Mueller, A. N. Neskovic, B. M. Pieske, S. P. Schulman, R. F. Storey, K. A. Taubert, P. Vranckx, D. R. Wagner, Thygesen, K, Alpert, J, Jaffe, A, Simoons, Ml, Chaitman, Br, White, Hd, Katus, Ha, Apple, F, Lindahl, B, Morrow, Da, Clemmensen, Pm, Johanson, P, Hod, H, Underwood, R, Bax, Jj, Bonow, Jj, Pinto, F, Gibbons, Rj, Fox, Ka, Atar, D, Newby, Lk, Galvani, M, Hamm, Cw, Uretsky, Bf, Steg, Pg, Wijns, W, Bassand, Jp, Menasche, P, Ravkilde, J, Ohman, Em, Antman, Em, Wallentin, Lc, Armstrong, Pw, Januzzi, Jl, Nieminen, M, Gheorghiade, M, Filippatos, G, Luepker, Rv, Fortmann, Sp, Rosamond, Wd, Levy, D, Wood, D, Smith, Sc, Hu, D, Lopez-Sendon, Jl, Robertson, Rm, Weaver, D, Tendera, M, Bove, Aa, Parkhomenko, An, Vasilieva, Ej, Mendis, S, Baumgartner, H, Ceconi, C, Dean, V, Deaton, C, Fagard, R, Funck-Brentano, C, Hasdai, D, Hoes, A, Kirchhof, P, Knuuti, J, Kolh, P, Mcdonagh, T, Moulin, C, Popescu, Ba, Reiner, Z, Sechtem, U, Sirnes, Pa, Torbicki, A, Vahanian, A, Windecker, S, Morais, J, Aguiar, C, Almahmeed, W, Arnar, Do, Barili, F, Bloch, Kd, Bolger, Af, Botker, He, Bozkurt, B, Bugiardini, R, Cannon, C, de Lemos, J, Eberli, Fr, Escobar, E, Hlatky, M, James, S, Kern, Kb, Moliterno, Dj, Mueller, C, Neskovic, An, Pieske, Bm, Schulman, Sp, Storey, Rf, Taubert, Ka, Vranckx, P, and Wagner, Dr

Subjects
High-sensitivity troponin, Ticagrelor, Chest pain unit, Quality Assurance, Health Care, Epidemiology, medicine.medical_treatment, Myocardial Infarction, Myocardial ischaemia, Global Health, Early invasive strategy, Electrocardiography, Stent, Myocardial Revascularization, Myocardial infarction, Coronary Artery Bypass, Intraoperative Complications, Left bundle branch block, Health Policy, Electrocardiography in myocardial infarction, Cangrelor, Stents, Acute coronary syndrome, Cardiology and Cardiovascular Medicine, Prasugrel, Diagnostic Imaging, medicine.medical_specialty, Public Policy, Risk Assessment, Vorapaxar, Percutaneous Coronary Intervention, Physiology (medical), Terminology as Topic, Humans, Enoxaparin, Bypass surgery, Community and Home Care, Heart Failure, Rhythm monitoring, Aspirin, Unstable angina, Angioplasty, Recommendation, ta3121, medicine.disease, Myocardial infarction diagnosis, Bivalirudin, Biomarkers, Time Factors, Platelet inhibition, Consensus Development Conferences as Topic, Diagnostic Techniques, Cardiovascular, Myocardial Ischemia, Guideline, Diabete, Nitrate, Left ventricular hypertrophy, Coronary artery disease, Rivaroxaban, Recurrence, Apixaban, Clinical Trials as Topic, Graft Occlusion, Vascular, Atherothrombosi, Acute cardiac care, Right bundle branch block, Clopidogrel, Dabigatran, Prosthesis Failure, AHA Scientific Statements, Practice Guidelines as Topic, Cardiology, Biological Markers, Radiology, Critical Care, Glycoprotein IIb/IIIa inhibitor, European Society of Cardiology, Diagnosis, Differential, Anticoagulation, Internal medicine, medicine, Beta-blocker, cardiovascular diseases, Heparin, business.industry, Revascularization, Cardiovascular Surgical Procedures, MYOCARDIAL INFARCTION, Statin, Percutaneous coronary intervention, Arrhythmias, Cardiac, Cardiac Imaging Techniques, Fondaparinux, Heart failure, Non-ST-elevation myocardial infarction, business
Abstract

ACCF : American College of Cardiology Foundation ACS : acute coronary syndrome AHA : American Heart Association CAD : coronary artery disease CABG : coronary artery bypass grafting CKMB : creatine kinase MB isoform cTn : cardiac troponin CT : computed tomography CV : coefficient of variation ECG : electrocardiogram ESC : European Society of Cardiology FDG : fluorodeoxyglucose h : hour(s) HF : heart failure LBBB : left bundle branch block LV : left ventricle LVH : left ventricular hypertrophy MI : myocardial infarction mIBG : meta-iodo-benzylguanidine min : minute(s) MONICA : Multinational MONItoring of trends and determinants in CArdiovascular disease) MPS : myocardial perfusion scintigraphy MRI : magnetic resonance imaging mV : millivolt(s) ng/L : nanogram(s) per litre Non-Q MI : non-Q wave myocardial infarction NSTEMI : non-ST-elevation myocardial infarction PCI : percutaneous coronary intervention PET : positron emission tomography pg/mL : pictogram(s) per millilitre Q wave MI : Q wave myocardial infarction RBBB : right bundle branch block sec : second(s) SPECT : single photon emission computed tomography STEMI : ST elevation myocardial infarction ST–T : ST-segment –T wave URL : upper reference limit WHF : World Heart Federation WHO : World Health Organization Myocardial infarction (MI) can be recognised by clinical features, including electrocardiographic (ECG) findings, elevated values of biochemical markers (biomarkers) of myocardial necrosis, and by imaging, or may be defined by pathology. It is a major cause of death and disability worldwide. MI may be the first manifestation of coronary artery disease (CAD) or it may occur, repeatedly, in patients with established disease. Information on MI rates can provide useful information regarding the burden of CAD within and across populations, especially if standardized data are collected in a manner that …

Published
2012
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4. Technical consideration in multiple valve and coronary artery surgery

Author

Okies Je, Albert Starr, Phillips Sj, and Chaitman Br

Subjects
Pulmonary and Respiratory Medicine, Cardiac output, medicine.medical_specialty, business.industry, medicine.medical_treatment, Mitral valve replacement, medicine.disease, Angina, medicine.anatomical_structure, Aortic valve replacement, Internal medicine, Concomitant, Mitral valve, cardiovascular system, medicine, Cardiology, Surgery, Myocardial infarction, Cardiology and Cardiovascular Medicine, business, Artery
Abstract

Twelve patients at the University of Oregon Medical School Hospitals have undergone simultaneous double valve and aorto-coronary bypass graft operations. All were in Functional Class III or IV and most had angina pectoris. Nine patients had aortic and mitral valve replacement: Six patients had concomitant single aorto-coronary bypass grafts, 2 had concomitant double bypass grafts, and 1 patient had concomitant triple bypass grafting. The tenth patient had mitral valve re-replacement, tricuspid annuloplasty, and a single bypass graft. The eleventh patient had aortic valve replacement, mitral commissurotomy, and triple bypass grafting. The twelfth patient had aortic valve replacement, mitral commissurotomy, and single bypass grafting. The first 3 patients operated upon died 1, 6, and 19 days after the operation of acute myocardial infarction, low cardiac output, and related problems. The next 9 consecutive patients have survived operation. Five are in Functional Class I and 2 are in Functional Class II and free of angina 3 to 19 months later. The eighth patient is slowly improving after a prolonged, complicated hospital course. There was one late death at 6 weeks (arrhythmia). The improved survival rate is related to refinements in technique which expedite the procedure and allow maximum protection of the myocardium. Frequent intermittent coronary artery perfusion of the beating heart in conjunction with a systematic, modular approach to the procedure has allowed major cardiac reconstruction to be accomplished at low risks to the patient.

Published
1974
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