P1003New onset atrial fibrillation after stenting of the right coronary artery in patients with ischemic disease of the heart

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
D Payziev ◽  
S I Azizov ◽  
J K Uzokov ◽  
S A Iskhakov
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Coronary Artery ◽  
Sinus Rhythm ◽  
Right Coronary Artery ◽  
Short Term ◽  
Ischemic Disease ◽  
The Right ◽  
New Onset

Abstract Background Atrial fibrillation (AF) is a major heart rhythm disorder among population older age. Percutaneous coronary intervention (PCI) with stenting of the right coronary artery may increase the new onset AF. Aim of the study was to estimate the new onset AF after stenting of the right coronary artery (RCA) in patients with stable ischemic disease of the heart and its effect on short-term prognosis. Methods 765 patients in whom performed PCI with stenting of the proximal and medial segment of RCA were enrolled in this study (aged 41-71 years; mean age 55.8 ± 12.0 years; male 51%). Short-term outcomes were analyzed in median 1.1-year follow-up due to the development of new onset AF. Results Among 765 patients, after PCI in RCA developed AF in 58 patients (7.5%) within follow-up. Among them, 40 patients (5.2%) with type 2 diabetes mellitus, 37 patients (4.8%) hypertension, 34 patients (4.4%) older than 60 years old, 30 patients (3.9%) myocardial infarction in history. Restoration of sinus rhythm (cardioversion rate) was in 86%. Majority of the patients in whom sinus rhythm was not recovered were older (11.0%) and diabetic mellitus (8.0%). The propensity-matched model showed that new onset AF was associated with an increased risk of bleeding during the procedure (OR 1.4; 95% confidence interval, 1.27-1.74) and heart failure (OR 1.27; 95% confidential interval, 1.16-1.45). Conclusion: New onset AF is common within short-term period after PCI in proximal and distal segments of the RCA and it was independently associated with post procedural complications and heart failure.

Short-term Assessment of Radial Artery Grafts With Multidetector Computed Tomography

2020 ◽  
Author(s):  
En Qiao ◽  
Yuetang Wang ◽  
Jun Yu ◽  
Xu Wang ◽  
Xinjin Luo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Multidetector Computed Tomography ◽  
Radial Artery ◽  
Right Coronary Artery ◽  
Left Internal Mammary Artery ◽  
Graft Patency ◽  
Short Term ◽  
The Right

Abstract Background The clinical use of radial artery (RA) in coronary artery bypass grafting (CABG) is still limited worldwide, although it has been recommended by several guidelines, and the application of multidetector computed tomography (MDCT) in the evaluation of graft patency is still to be verified. This study aims to report the short-term results of RA in CABG with MDCT. Methods The study population consists of 41 consecutive patients undergoing elective CABG with the RA graft between 2007 to 2008, with MDCT performed to evaluate graft patency during follow-up, and target vessels for the RA were non-left anterior descending coronary arteries with > 70% stenosis. Results MDCT could clearly show the structure and patency of grafts, even for complex coronary artery revascularization. A total of 150 distal anastomoses were assessed by MDCT during follow-up (mean, 8.9 ± 5.1 months). Functional graft patency of the left internal mammary artery (LIMA) was 92.9% (39/42), with the RA patency of 84.4% (38/45) and the patency of saphenous vein graft (SVG) of 81.1% (30/37). And the RA targeting the left coronary artery system might have better patency than that of the RA targeting the right coronary artery system (25/29, 86.2% vs 13/16, 81.3%, p = 0.686). Conclusions MDCT could provide excellent visualization of grafts in CABG. The short-term patency rate of RA grafts is good, and the RA might be associated with better patency when targeted to the left but not the right coronary artery.

scholarly journals Short-term assessment of radial artery grafts with multidetector computed tomography

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
En Qiao ◽  
Yuetang Wang ◽  
Jun Yu ◽  
Xu Wang ◽  
Xinjin Luo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Multidetector Computed Tomography ◽  
Radial Artery ◽  
Right Coronary Artery ◽  
Left Internal Mammary Artery ◽  
Graft Patency ◽  
Short Term ◽  
The Right

Abstract Background The clinical use of the radial artery (RA) in coronary artery bypass grafting (CABG) is still limited worldwide, although it has been recommended by several guidelines. Multidetector computed tomography (MDCT) is widely used to evaluate graft patency, as invasive coronary angiography could cause potentially serious risks including bleeding, dissection and stroke. This study aims to report the short-term results of the RA in CABG with MDCT. Methods The study population consists of 41 consecutive patients undergoing elective CABG with the RA graft between 2017 to 2018, with MDCT performed to evaluate graft patency during follow-up, and target vessels for the RA were non-left anterior descending coronary arteries with > 70% stenosis. Results A total of 150 grafts were assessed by MDCT during follow-up (mean, 8.9 ± 5.1 months). MDCT could clearly show the structure and patency of grafts, even for complex coronary artery revascularization. Graft patency of the left internal mammary artery was 92.9% (39/42), with the RA patency of 84.4% (38/45) and the patency of the saphenous vein graft of 81.1% (30/37). And the RA anastomosed to the left coronary artery system might have better patency than the RA anastomosed to the right coronary artery system (25/29, 86.2% vs 13/16, 81.3%, p = 0.686). Conclusions The short-term patency rate of RA grafts is good, and the RA might be associated with better patency when anastomosed to the left but not the right coronary artery. MDCT could provide excellent visualization of grafts in CABG.

Anomalous right coronary artery from the pulmonary artery (ARCAPA), and aberrant right subclavian artery in a 2-month infant with heart failure

2013 ◽  
Vol 24 (5) ◽  
pp. 935-937 ◽  
Author(s):  
Mohammad Mahdavi ◽  
Koorosh Vahidshahi ◽  
Ramin Baghai Tehrani ◽  
Hamidreza Poor Ali-Akbar ◽  
Mohammad Rad Godarzi
Keyword(s):  
Heart Failure ◽  
Coronary Artery ◽  
Pulmonary Artery ◽  
Subclavian Artery ◽  
Right Coronary Artery ◽  
Male Infant ◽  
Aberrant Right Subclavian Artery ◽  
Infancy And Childhood ◽  
The Right

AbstractAnomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is a very rare congenital heart anomaly. Most of the cases are asymptomatic during infancy and childhood. We report ARCAPA associated with aberrant right subclavian artery in a 2-month male infant presenting with heart failure. We used computed tomography angiography for confirming the diagnosis and also for post-operative follow-up.

Long-term impact of new-onset atrial fibrillation complicating acute myocardial infarction on heart failure: insights from the NOAFCAMI-SH registry

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S.L Xu ◽  
J Luo ◽  
H.Q Li ◽  
Z.Q Li ◽  
B.X Liu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Acute Myocardial Infarction ◽  
Natural Science ◽  
Funding Source ◽  
Onset Atrial Fibrillation ◽  
New Onset

Abstract Background New-onset atrial fibrillation (NOAF) complicating acute myocardial infarction (AMI) has been associated with poor survival, but the clinical implication of NOAF on subsequent heart failure (HF) is still not well studied. We aimed to investigate the relationship between NOAF following AMI and HF hospitalization. Methods This retrospective cohort study was conducted between February 2014 and March 2018, using data from the New-Onset Atrial Fibrillation Complicating Acute Myocardial Infarction in ShangHai registry, where all participants did not have a documented AF history. Patients with AMI who discharged alive and had complete echocardiography and follow-up data were analyzed. The primary outcome was HF hospitalization, which was defined as a minimum of an overnight hospital stay of a participant who presented with symptoms and signs of HF or received intravenous diuretics. Results A total of 2075 patients were included, of whom 228 developed NOAF during the index AMI hospitalization. During up to 5 years of follow-up (median: 2.7 years), 205 patients (9.9%) experienced HF hospitalization and 220 patients (10.6%) died. The incidence rate of HF hospitalization among patients with NOAF was 18.4% per year compared with 2.8% per year for those with sinus rhythm. After adjustment for confounders, NOAF was significantly associated with HF hospitalization (hazard ratio [HR]: 3.14, 95% confidence interval [CI]: 2.30–4.28; p<0.001). Consistent result was observed after accounting for the competing risk of all-cause death (subdistribution HR: 3.06, 95% CI: 2.18–4.30; p<0.001) or performing a propensity score adjusted multivariable model (HR: 3.28, 95% CI: 2.39–4.50; p<0.001). Furthermore, the risk of HF hospitalization was significantly higher in patients with persistent NOAF (HR: 5.81; 95% CI: 3.59–9.41) compared with that in those with transient NOAF (HR: 2.61; 95% CI: 1.84–3.70; p interaction = 0.008). Conclusion NOAF complicating AMI is strongly associated with an increased long-term risk of heart. Cumulative incidence of outcome Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): 1. National Natural Science Foundation of China, 2. Natural Science Foundation of Shanghai

scholarly journals Anomalous origin of the right coronary artery with interarterial course: a mid-term follow-up of 28 cases

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Francisco Albuquerque ◽  
Pedro de Araújo Gonçalves ◽  
Hugo Marques ◽  
António Ferreira ◽  
Pedro Freitas ◽  
...  
Keyword(s):  
Coronary Artery ◽  
High Risk ◽  
Right Coronary Artery ◽  
Cardiac Death ◽  
Anomalous Origin ◽  
Cardiac Symptoms ◽  
Asymptomatic Patients ◽  
Increased Risk ◽  
The Right

AbstractAnomalous origin of the right coronary artery from the opposite sinus (right-ACAOS) with interarterial course (IAC) has been associated with increased risk of sudden cardiac death (SCD). Widespread use of coronary computed tomography angiography (CCTA) has led to increased recognition of this condition, even among healthy individuals. Our study sought to examine the prevalence, anatomical characteristics, and outcomes of right-ACAOS with IAC in patients undergoing CCTA for suspected coronary artery disease (CAD). We conducted a retrospective analysis of consecutive patients referred for CCTA at one tertiary hospital from January 2012 to December 2020. Patients exhibiting right-ACAOS with IAC were analyzed for cardiac symptoms and mid-term occurrence of first MACE (cardiac death, SCD, non-fatal myocardial infarction (MI) or revascularization of the anomalous vessel). CCTAs were reviewed for anatomical high-risk features and concomitant CAD. Among 10,928 patients referred for CCTA, 28 patients with right-ACAOS with IAC were identified. Mean age was 55 ± 17 years, 64% were male and 11 (39.3%) presented stable cardiac symptoms. Most patients had at least one high risk anatomical feature. During follow-up, there were no cardiac deaths or aborted SCD episodes and only 1 patient underwent surgical revascularization of the anomalous vessel. Right-ACAOS with IAC is an uncommon finding (prevalence of 0.26%). In a contemporary population of predominantly asymptomatic patients who survived this condition well into adulthood, most patients were managed conservatively with a low event rate. Additional studies are needed to support medical follow-up as the preferred option in this setting.

scholarly journals N-terminal Pro-brain Natriuretic Peptide plasma levels are Associated With a Short-Term Diagnosis of Cancer in Patients with Coronary Artery Disease

2020 ◽  
Author(s):  
José Tuñón ◽  
Álvaro Aceña ◽  
Ana Pello ◽  
Sergio Ramos-Cillán ◽  
Juan Martínez-Milla ◽  
...  
Keyword(s):  
Heart Failure ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Plasma Levels ◽  
High Sensitivity ◽  
Short Term ◽  
Artery Disease

Abstract Background N-terminal pro-brain natriuretic peptide (NT-proBNP) plasma levels are increased in patients with cancer. In this paper we test whether NT-proBNP may identify patients who are going to receive a future cancer diagnosis (CD) in the short term. Methods We studied 962 patients with stable coronary artery disease and free of cancer and heart failure at baseline. NT-proBNP, galectin-3, monocyte chemoattractant protein-1, high-sensitivity C-reactive protein, high-sensitivity cardiac troponin I (hsTnI), and calcidiol (vitamin D) plasma levels were assessed. The primary outcome was new CD. Results After 5.40 (2.81-6.94) years of follow-up, 59 patients received a CD. NT-proBNP [HR 1.036 CI (1.015-1.056) per increase in 100 pg/ml; p=0.001], previous atrial fibrillation [HR 3.140 CI (1.196-8.243); p=0.020], and absence of previous heart failure [HR 0.067 CI (0.006-0.802); p=0.033] were independent predictors of a receiving a CD in first three years of follow-up. None of the variables analyzed predicted a CD beyond this time. A previous history of heart failure was present in 3.3% of patients receiving a CD in the first three years of follow-up, in 0.0% of those receiving this diagnosis beyond three years, and in 12.3% of patients not developing cancer (p=0.036). Conclusions In patients with coronary artery disease, NT-proBNP is an independent predictor of CD in the first three years of follow-up but not later, suggesting that it could be detecting subclinical undiagnosed cancers. The existence of previous heart failure does not account for these differences. New studies in large populations are needed to confirm these findings.

Direct Reimplantation Procedure in Anomalous Aortic Origin of the Right Coronary Artery: Long-Term Single Center Outcomes

2021 ◽  
Vol 12 (6) ◽  
pp. 693-699
Author(s):  
Daouda Amadou ◽  
Julia Mitchell ◽  
Christian Bulescu ◽  
Olivier Metton ◽  
Roland Henaine ◽  
...  
Keyword(s):  
Physical Activity ◽  
Coronary Artery ◽  
Right Coronary Artery ◽  
Early Death ◽  
Time Lapse ◽  
Single Center ◽  
Complete Restoration ◽  
Single Center Study ◽  
The Right

Background: Anomalous aortic origin of the right coronary artery is known to be a cause of sudden cardiac death in athletes. There are no specific guidelines concerning treatment strategy in the literature. The aim of this study is to describe and report our experience of direct reimplantation technique in the treatment of this anomaly. Methods: This was a retrospective single center study of 30 patients who underwent surgery in the congenital heart disease unit of Louis Pradel Heart and Lung Hospital between January 2003 and December 2016. The mean follow-up was seven years (3 months-17 years). Results: Thirty patients underwent surgery. The median age was 17 years (0.2-52 years). There were 24 males. The median weight was 58 kg (3.6-118 kg). Fourteen patients were actively engaged in sports. Twenty-six patients had exertional chest pain or syncope. The median time lapse between diagnosis and intervention was 4.5 months (0.5-179 months). Twenty-seven (90%) patients underwent reimplantation of the anomalous coronary artery without transverse aortotomy, while in 3 (10%) patients transverse aortotomy was used to facilitate reimplantation to avoid tension at the anastomosis. There was no early death; one late death occurred in the third postoperative month. At the last follow-up, all patients had returned to normal physical activity without evidence of ischemia. Conclusions: Direct reimplantation allows for a complete restoration of the coronary anatomy and enables patients to return to normal physical activity. Our study shows encouraging results using a direct reimplantation technique without aortotomy.

3269Impact of type 2 diabetes on incidence and phenotype of heart failure in patients with atrial fibrillation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Polovina ◽  
I Milinkovic ◽  
G Krljanac ◽  
I Veljic ◽  
I Petrovic-Djordjevic ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Type 2 Diabetes ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Diabetic Patients ◽  
History Of ◽  
New Onset

Abstract Background Type 2 diabetes (T2DM) portends adverse prognosis in patients with atrial fibrillation (AF). Whether T2DM independently increases the risk of incident heart failure (HF) in AF is uncertain. Also, HF phenotype developing in patients with vs. those without T2DM has not been characterised. Purpose In AF patients without a history of prior HF, we aimed to assess: 1) the impact of T2DM on the risk of new-onset HF; and 2) the association between T2DM and HF phenotype developing during the prospective follow-up. Methods We included diabetic and non-diabetic AF patients, without a history of HF. Baseline T2DM status was inferred from medical history, haemoglobin A1c levels and oral glucose tolerance test. Study outcome was the first hospital admission or emergency department treatment for new-onset HF during the prospective follow-up. The phenotype of new-onset HF was determined by echocardiographic exam performed following clinical stabilisation (at hospital discharge, or within a month after HF diagnosis). HF phenotype was defined as HFrEF (left ventricular ejection fraction [LVEF] <40%), HFmrEF (LVEF 40–49%) or HFpEF (LVEF≥50%). Cox regression analyses adjusted for age, sex, baseline LVEF, comorbidities, smoking status, alcohol intake, AF type (paroxysmal vs. non-paroxysmal) and T2DM treatment was used to analyse the association between T2DM and incident HF. Results Among 1,288 AF patients without prior HF (mean age: 62.1±12.7 years; 61% male), T2DM was present in 16.5%. Diabetic patients had higher mean baseline LVEF compared with nondiabetic patients (50.0±6.2% vs. 57.6±9.0%; P<0.001). During the median 5.5-year follow-up, new-onset HF occurred in 12.4% of patients (incidence rate, 2.9; 95% confidence interval [CI], 2.5–3.3 per 100 patient-years). Compared with non-diabetic patients, those with T2DM had a hazard ratio of 2.1 (95% CI, 1.6–2.8; P<0.001) for new-onset HF, independent of baseline LVEF or other factors. In addition, diabetic patients had a significantly greater decline in covariate-adjusted mean LVEF (−10.4%; 95% CI, −9.8% to −10.8%) at follow-up, compared with nondiabetic patients (−4.0%; 95% CI, −3.8% to −4.2%), P<0.001. The distribution of HF phenotypes at follow-up is presented in Figure. Among patients with T2DM, HFrEF (56.9%) was the most common phenotype of HF, whereas in patients without T2DM, HF mostly took the phenotype of HFpEF (75.0%). Conclusions T2DM is associated with an independent risk of new-onset HF in patients with AF and confers a greater decline in LVEF compared to individuals without T2DM. HFrEF was the most prevalent presenting phenotype of HF in AF patients with T2DM.

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