Male Patients with Takayasu Arteritis and Coronary Artery Involvement are Prone to have Serious Coronary Stenosis and High Mortality

2021 ◽  
Vol 19 ◽  
Author(s):  
Weiping Ci ◽  
Yinan Zhao ◽  
Tao Bi
Keyword(s):  
Coronary Artery ◽  
Takayasu Arteritis ◽  
Coronary Stenosis ◽  
Limited Information ◽  
Cardiac Events ◽  
Coronary Artery Involvement ◽  
Coronary Lesions ◽  
Angiographic Findings

Background: Takayasu arteritis (TAK) is a rare autoimmune vasculitis that predominantly affects the aorta and its major branches, including the coronary arteries. Limited information is available regarding sex-specific differences in coronary artery involvement among TAK patients. Objective: To assess the differences in coronary angiographic findings and the long-term outcomes between male and female TAK patients having coronary artery involvement. Methods: This retrospective cohort study included 87 TAK patients, grouped by sex, who underwent coronary angiography. General characteristics, clinical features, coronary angiographic findings, and therapeutic strategies were obtained from medical records. Major Adverse Cardiac Events (MACE), including death from any cause; myocardial infarction; repeated coronary artery revascularization; and rehospitalization due to unstable or progressive angina, or heart failure occurring during follow-up, were also recorded. Results: A total of 207 coronary lesions with stenosis were found in 87 TAK patients. The prevalence of ostial coronary lesions was lower in men than in women (9.1 vs. 23.9%, p=0.031). We observed less moderate stenosis (6.8 vs 22.7%, p=0.018) and more severe stenosis or occlusion (70.5 vs 46.0%, p=0.004) in the coronary lesions of male TAK patients. During the up to 7-year follow-up, death from any cause was greater in men than in women (21.4 vs. 1.5%, p=0.003); no other significant differences in MACE occurrence were observed between sexes. Conclusions: Among TAK patients with coronary artery involvement, males tend to have more severe coronary stenosis and a higher risk for long-term mortality than females.

Abstract 192: Long Term Coronary Angiography of Giant Coronary Aneurysms after Kawasaki Disease in Mexican Children

Circulation ◽  
2015 ◽  
Vol 131 (suppl_2) ◽  
Author(s):  
Luis M Garrido-Garcia ◽  
Jose L Colin ◽  
Alfredo Bobadilla-Aguirre
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Coronary Angiography ◽  
Coronary Stenosis ◽  
Unknown Etiology ◽  
Coronary Artery Lesions ◽  
Mexican Children ◽  
Coronary Aneurysms

Kawasaki Disease (KD) is an acute febrile illness characterized by systemic vasculitis of unknown etiology. Coronary artery aneurysms (CAA), is one of the most important aspects of this disease. Some patients with KD develop giant coronary aneurysms (z-score > 10) and coronary stenosis, leading to ischemic heart disease. Objective: To determine the outcome of giant coronary artery lesions caused by KD and the value of coronary angiography in the evaluation and follow-up of coronary artery lesions in Mexican children. Materials and Methods: From our Institutional database, 34 patients (23 men and 11 women) who developed giant aneurysms from 1995 to December 2013 were identified. Information on patient demographics, catheter and surgical interventions, and most recent status was collected from medical records. Results: The average age at onset of KD was 13.5 months, and the median observational period was 70 mo. (5 to 163 mo.). During this period 11 patients showed CAA regression, 21 patients persist with CAA and 2 patients died at follow-up. In 9 patients with persistent giant CAA or coronary stenosis we performed cardiac catheterization to evaluate the coronary anatomy and findings of myocardial ischemia. Coronary bypass was performed to alleviate coronary ischemia in 1 patient, this patient developed dilated cardiomyopathy one year after the surgery and died. The overall survival rate in our series is 97%. Conclusions: Despite being a small series, the long-term survival of patients with KD complicated by giant coronary aneurysms in our center is relatively good. However further research should focus on the indications for and effectiveness of percutaneous and surgical coronary interventions.

scholarly journals FFR guided PCI on long coronary lesions: 2-year clinical results with 2nd or newer generation DES

2016 ◽  
Vol 23 (1) ◽  
pp. 5-10
Author(s):  
Arvydas Baranauskas ◽  
Vilhelmas Bajoras ◽  
Povilas Budrys ◽  
Aleksandras Laucevičius ◽  
Giedrius Davidavičius
Keyword(s):  
Coronary Artery ◽  
Treatment Strategies ◽  
Clinical Results ◽  
Drug Eluting Stent ◽  
Target Vessel ◽  
Coronary Artery Lesions ◽  
Cardiac Events ◽  
Stent Length ◽  
Coronary Lesions

Background. Despite improvements in drug-eluting stent (DES) technology, treatment strategies for long coronary artery lesions remain a controversial issue. The aim of our study was to evaluate the long-term clinical results after FFR guided PCI on long coronary lesions. Materials and methods. A total of 74 consecutive patients with significant (mean FFR 0.61 ± 0.11) coronary artery lesions ≥30 mm in length were included in the prospective study. All patients were treated with FFR guided PCI implanting newer generation Biolimus, Everolimus or Zotarolimus eluting stents. Clinical endpoints – target vessel revascularization (TVR) and major adverse cardiac events (MACE)  –  were recorded at 1 and 2 years. Results. 100% angiographic procedure success was achieved, the mean post procedural FFR was 0.88 ± 0.06. At 2-year follow-up, 6 (8.1%) patients had ischemia driven TVR, all within the first 12 months. There were no target vessel related acute coronary syndromes and definite stent thromboses in the study group. At 2 years, the total MACE rate was 29.7%. There was a trend towards a higher TVR rate in patients with overlapping DES vs single DES implanted (9.6 vs 4.5%, p = 0.6). On regression analysis, the total stent length had no influence on the TVR rate. Conclusions. At 2 years after stenting long coronary lesions with newer generation DES the TVR rate was 8.1%, which is acceptable in the high cardiovascular risk population with diffuse coronary artery disease. The total stent length did not affect the long-term clinical outcomes.

scholarly journals Angiographic findings and surgical treatments of coronary artery involvement in Takayasu arteritis

2003 ◽  
Vol 125 (3) ◽  
pp. 570-577 ◽  
Author(s):  
Masahiro Endo ◽  
Yasuko Tomizawa ◽  
Hiroshi Nishida ◽  
Shigeyuki Aomi ◽  
Makoto Nakazawa ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Takayasu Arteritis ◽  
Coronary Artery Involvement ◽  
Surgical Treatments ◽  
Angiographic Findings

Abstract 1516: Does A Normal Coronary Angiography Really Mean A Good Prognosis In Patients With Acute Coronary Syndromes?

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Dariusz Dudek ◽  
Rafal Depukat ◽  
Bernadeta Chyrchel ◽  
Zbigniew Siudak ◽  
Artur Dziewierz ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Coronary Angiography ◽  
Cardiac Events ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Adverse Cardiac Events ◽  
Normal Coronary Angiography ◽  
Coronary Lesions

Introduction: Coronary angiography remains gold standard for diagnosis of coronary artery disease (CAD) and acute coronary syndrome (ACS). Among patients (pts) referred to cath-lab with diagnosis of ACS exists a subgrup presenting symptoms of myocardial ischaemia and no criticial coronary lesions in angiography. The long-term outcome is not well established and managing treatment for such patients is still challenging. Aim: Evaluation of clinical outcome and received pharmacotherapy in pts with ACS and no significant coronary lesions. Methods: We collected data of consecutive pts admitted to cath-lab between July 2004 and June 2006 with diagnosis of ACS and coronary angiography considered as normal or near-normal (lesions under 50% of stenosis assessed visually). We analyzed demographic data, angiographic, electrocardiographic and laboratory tests results. During long-term follow-up received treatment, major adverse cardiac events were assessed. Results: One hundred eight pts (56 females; mean age 58.5 +/−13.5 years) admitted to cath-lab with diagnosis of acute myocardial infarction (38%) or unstable angina (62%) had normal or near normal coronary angiography. Mean LVEF was 52.6 +/− 12.9%, prevalence of CAD risk factors was: hypertension 72.2%, hypercholesterolemia 51.8%, diabetes mellitus 13.0%. The treatment administered during the hospitalization and follow-up is shown in table . During the mean follow-up of 16.5 months (range 6–30 months) all-cause mortality rate was 9.3%, cardiovascular mortality rate was 7.4%, repeat hospitalization for cardiovascular reasons 20.4%. Conclusions: Long-term outcome of patients with ACS and nonobstructive coronary angiography is not as benign as it is commonly thought. These patients have high rate of major adverse cardiac events and rehospitalization for cardiovascular reasons. They also are not receiving therapy directed at aggressive antiatherosclerotic therapy with statins, ACE-I and b-blockers. Treatment administered during the hospitalization, at discharge and during the follow-up

Left coronary artery atresia in the young: long-term follow-up without exercise restriction

2019 ◽  
Vol 29 (12) ◽  
pp. 1543-1545
Author(s):  
Silvana Molossi ◽  
Tam Doan
Keyword(s):  
Coronary Artery ◽  
Left Coronary Artery ◽  
Left Main Coronary Artery ◽  
Competitive Sports ◽  
Left Main ◽  
Cardiac Events ◽  
Long Term Follow Up ◽  
Exercise Restriction

AbstractAn 11-year-old male was presented with exertional chest pain and was diagnosed with atresia of the left main coronary artery. A stress nuclear perfusion imaging was negative at initial presentation, and a vasodilator stress cardiac MRI was again negative 5 years later. The patient has fully participated in competitive sports for 6 years with no occurrence of cardiac events.

scholarly journals Clinical Outcomes of Self-Made Polyurethane-Covered Stent Implantation for the Treatment of Coronary Artery Perforations

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Xiaoyue Song ◽  
Qing Qin ◽  
Shufu Chang ◽  
Rende Xu ◽  
Mingqiang Fu ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Clinical Outcomes ◽  
Cardiac Death ◽  
Coronary Intervention ◽  
Target Lesion ◽  
Covered Stents ◽  
Cardiac Events ◽  
Coronary Artery Perforation

Objectives. The present study aimed to investigate the short- and long-term clinical outcomes of self-made polyurethane-covered stents (PU-CS) in patients for the management of coronary artery perforation (CAP) during percutaneous coronary intervention (PCI). Background. Coronary artery perforation is reckoned as a serious complication in PCI and associated with considerable morbidity and mortality. Covered stents have been used for treating the life-threatening CAP during PCI. But in some catheterization laboratories, no commercial CS is immediately available when there is an urgent need for CS to rescue the coronary rupture site. Methods. We retrospectively identified 24 patients who underwent 31 self-made PU-CS implantations due to CAP in Zhongshan Hospital, Fudan University, from June 2015 to January 2020. Results. The total procedural success rate of CS to seal the perforation was 79.2%. Nine patients (37.5%) developed cardiac tamponade, of which 8 patients (33.3%) underwent pericardiocentesis and 4 patients (16.7%) underwent cardiac surgeries. Except for 4 cardiac death cases (16.7%), none of myocardial infarction (MI), target lesion revascularization (TLR), and stent thrombosis (ST) was reported during hospital stay. Data from 22 patients (91.7%) were available at 610.4 ± 420.9 days of follow-up. Major adverse cardiac events (MACE) occurred in 6 patients (27.3%), including 5 cases of cardiac death and one TLR case. Conclusions. Self-made PU-CS demonstrates high rates of successful delivery and sealing of severe CAP during PCI. Although the in-hospital mortality remains high after PU-CS implantation, the long-term follow-up shows favorable clinical outcomes, indicating the feasibility of PU-CS in treating CAP.

Patient Selection and Procedural Considerations for Coronary Orbital Atherectomy System

2016 ◽  
Vol 11 (1) ◽  
pp. 33
Author(s):  
Yohei Sotomi ◽  
◽  
◽  
◽  
◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Rotational Atherectomy ◽  
Percutaneous Coronary ◽  
Orbital Atherectomy ◽  
Long Term Follow Up ◽  
Coronary Lesions ◽  
Calcified Coronary Lesions

Despite advances in technology, percutaneous coronary intervention (PCI) of severely calcified coronary lesions remains challenging. Rotational atherectomy is one of the current therapeutic options to manage calcified lesions, but has a limited role in facilitating the dilation or stenting of lesions that cannot be crossed or expanded with other PCI techniques due to unfavourable clinical outcome in long-term follow-up. However the results of orbital atherectomy presented in the ORBIT I and ORBIT II trials were encouraging. In addition to these encouraging data, necessity for sufficient lesion preparation before implantation of bioresorbable scaffolds lead to resurgence in the use of atherectomy. This article summarises currently available publications on orbital atherectomy (Cardiovascular Systems Inc.) and compares them with rotational atherectomy.

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