Endocannabinoid system: A new player in the percutaneous and surgical treatment of coronary artery disease?

Background and Aim of the Study: Ischemic mitral valve regurgitation (IMR) in patients undergoing coronary artery bypass grafting (CABG) is associated with worse long-term outcomes. The aim of this study was to assess the impact of mitral valve repair with CABG in patients with moderate IMR. Method: This observational study enrolled 3,215 consecutive patients from the Juntendo CABG registry with moderate IMR and multivessel coronary artery disease who underwent CABG between 2002 and 2017. The CABG alone and CABG with mitral valve surgery (MVs) groups were compared. The propensity score was calculated for each patient. Long-term all-cause death, cardiac death, and major adverse cardiac and cerebrovascular events (MACCEs) were compared between the two groups. Results: A total of 101 patients who underwent CABG had moderate IMR in our database. Propensity score matching selected 40 pairs for final analysis. MVs was associated with increased risks of postoperative atrial fibrillation, blood transfusion, and longer hospitalization. There were no differences between the two groups in long-term outcomes, including all-cause mortality, cardiac mortality, and the incidence of MACCEs. Conclusions: Surgical treatment of moderate IMR combined with CABG was as safe as CABG alone, with no differences in long-term outcomes. Further studies are needed to determine the effects of MVs in patients with moderate IMR and severe coronary artery disease.

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Surgical treatment for thoracic aortic aneurysm with coronary artery disease

Journal of the Japanese Coronary Association ◽

10.7793/jcoron.19.010 ◽

2013 ◽

Vol 19 (1) ◽

pp. 78-83

Author(s):

Masahito Minakawa ◽

Ikuo Fukuda

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Surgical Treatment ◽

Aortic Aneurysm ◽

Thoracic Aortic Aneurysm ◽

Artery Disease

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Simultaneous occurrence of coronary artery disease and lung cancer: what is the best surgical treatment strategy?: Table 1:

Interactive Cardiovascular and Thoracic Surgery ◽

10.1093/icvts/ivu218 ◽

2014 ◽

Vol 19 (4) ◽

pp. 673-681 ◽

Cited By ~ 14

Author(s):

Christos E. Tourmousoglou ◽

Efstratios Apostolakis ◽

Dimitrios Dougenis

Keyword(s):

Lung Cancer ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Surgical Treatment ◽

Treatment Strategy ◽

Simultaneous Occurrence ◽

Artery Disease

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Effects of Preoperative HbA1c Levels on the Postoperative Outcomes of Coronary Artery Disease Surgical Treatment in Patients with Diabetes Mellitus and Nondiabetic Patients: A Systematic Review and Meta-Analysis

Journal of Diabetes Research ◽

10.1155/2020/3547491 ◽

2020 ◽

Vol 2020 ◽

pp. 1-14

Author(s):

Jinjing Wang ◽

Xufei Luo ◽

Xinye Jin ◽

Meng Lv ◽

Xueqiong Li ◽

...

Keyword(s):

Myocardial Infarction ◽

Coronary Artery Disease ◽

Renal Failure ◽

Coronary Artery ◽

Surgical Treatment ◽

Meta Analysis ◽

Postoperative Outcomes ◽

Diabetic Patients ◽

Artery Disease ◽

Hba1c Levels

Aims. To investigate the effect of preoperative HbA1c levels on the postoperative outcomes of coronary artery disease surgery in diabetic and nondiabetic patients. Methods and Results. The MEDLINE (via PubMed), Cochrane Library, Web of Science, Embase, Wanfang Data, China National Knowledge Infrastructure (CNKI), and Chinese Biology Medicine (CBM) databases were used to search the effects of different preoperative HbA1c levels on the postoperative outcomes of coronary artery disease surgical treatment in diabetic and nondiabetic patients from inception to December 2018. Two review authors worked in an independent and duplicate manner to select eligible studies, extract data, and assess the risk of bias of the included studies. We used a meta-analysis to synthesize data and analyze subgroups, sensitivity, and publication bias as well as the GRADE methodology if appropriate. The literature search retrieved 886 records initially, and 23 cohort studies were included in the meta-analysis. In this meta-analysis, we found that there was a reduced incidence of surgical site infections (OR=2.94, 95% CI 2.18-3.98), renal failure events (OR=1.63, 95% CI 1.13-2.33), and myocardial infarction events (OR=1.69, 95% CI 1.16-2.47), as well as a shortened hospital stay (MD=1.08, 95% CI 0.46-1.71), in diabetic patients after coronary artery disease surgical treatment with lower preoperative HbA1c levels. For nondiabetic patients, a higher preoperative HbA1c level resulted in an increase in the incidence of mortality (OR=2.23, 95% CI 1.01-4.90) and renal failure (OR=2.33, 95% CI 1.32-4.12). No significant difference was found between higher and lower preoperative HbA1c levels in the incidence of mortality (OR=1.06, 95% CI 0.88-1.26), stroke (OR=1.49, 95% CI 0.94-2.37), or atrial fibrillation (OR=0.94, 95% CI 0.67-1.33); the length of ICU stay (MD=0.20, 95% CI -0.14-0.55); or sepsis incidence (OR=2.49, 95% CI 0.99-6.25) for diabetic patients or for myocardial infarction events (OR=1.32, 95% CI 0.27-6.31) or atrial fibrillation events (OR=0.99, 95% CI 0.74-1.33) for nondiabetic patients. The certainty of evidence was judged to be moderate or low. Conclusion. This meta-analysis showed that higher preoperative HbA1c levels may potentially increase the risk of surgical site infections, renal failure, and myocardial infarction and reduce the length of hospital stay in diabetic subjects after coronary artery disease surgical treatment and increase the risk of mortality and renal failure in nondiabetic patients. However, there was great inconsistency in defining higher preoperative HbA1c levels in the studies included; we still need high-quality RCTs with a sufficiently large sample size to further investigate this issue in the future. This trial is registered with CRD42019121531.

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