In patients with coronary artery disease and heart failure, the addition of coronary-artery bypass grafting to medical therapy has no effect on the overall risk of death from any cause, but assessment of suitability for surgery may predict survival benefit in subgroups

2012 ◽  
Vol 17 (6) ◽  
pp. 178-179
Author(s):  
Terrence M Yau ◽  
Ting Zhang
PPAR Research ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Izabela Wojtkowska ◽  
Andrzej Tysarowski ◽  
Katarzyna Seliga ◽  
Janusz A. Siedlecki ◽  
Zbigniew Juraszyński ◽  
...  

Genetic research has elucidated molecular mechanisms of heart failure (HF). Peroxisome proliferator-activated receptors (PPARs) seem to be important in etiology of HF. The aim of study was to find the correlation between PPARγexpression during development of HF in patients and coronary artery disease (CAD) after coronary artery bypass-grafting (CABG).Methods and Results. We followed up 157 patients (mean age 63) with CAD without clinical, laboratory, or echo parameters of HF who underwent CABG. Clinical and laboratory status were assessed before CABG and at 1, 12, and 24 months. During CABG slices of aorta (Ao) and LV were collected for genetic research. HF was defined as LVEF <40% or NT-proBNP >400 pg/mL or 6MWT <400 m. Patients were divided into 2 groups: with and without HF. PPARγexpression in Ao and LV was not increased in both groups at 2-year follow-up. Sensitivity of PPARγexpression in Ao above 1.1075 in detection of HF was 20.5% (AUC 0.531, 95% CI 0.442–0.619). Positive predictive value (Ppv) was 85.7%. Sensitivity and specificity of PPARγexpression in the LV in detection of HF were 58% and 92.9%, respectively (AUC 0.540, 95% CI 0.452–0.626). Ppv was 73.2%.Conclusion. PPARγexpression in Ao and LV was comparable and should not be used as predictive factor for development of HF in patients with CAD after CABG.


Aorta ◽  
2017 ◽  
Vol 05 (05) ◽  
pp. 132-138 ◽  
Author(s):  
Adem Diken ◽  
Adnan Yalçınkaya ◽  
Sertan Özyalçın

Background: In procedures involving surgical maneuvers such as cannulation, clamping, or proximal anastomosis where aortic manipulation is inevitable, a preliminary assessment of atherosclerotic plaques bears clinical significance. In the present study, our aim was to evaluate the frequency and distribution of aortic calcifications in patients undergoing coronary artery bypass grafting (CABG) surgery to propose a morphological classification system. Methods: A total of 443 consecutive patients with coronary artery disease were included in this study. Preoperative non-contrast enhanced computed tomography images, in-hospital follow-up data, and patient characteristics were retrospectively evaluated. Results: Whereas 33% of patients had no calcifications at any site in the aorta, 7.9%, 75.4%, and 16.7% had calcifications in the ascending aorta, aortic arch, and descending aorta, respectively. Focal small calcifications were the most common type of lesions in the ascending aorta (3.9%), whereas 9 patients (1.4%) had porcelain ascending aorta. We defined four types of patients with increasing severity and extent of calcifications. Conclusions: Based on the frequency and distribution of calcifications in the thoracic aorta, we propose a classification system from least to most severe for coronary artery disease patients who are candidates for CABG.


1981 ◽  
Vol 47 (4) ◽  
pp. 923-930 ◽  
Author(s):  
William S. Knapp ◽  
John S. Douglas ◽  
Joseph M. Graver ◽  
Ellis L. Jones ◽  
Spencer B. King ◽  
...  

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