PRECOMBAT: PCI viable for unprotected left main disease

The SYNTAX study, which randomised patients with complex severe coronary disease to either CABG or PCI, found that CABG remains a superior treatment option for the majority of these patients.  However, in a substudy of patients who had left main stem (LMS) disease, SYNTAX suggested equipoise between the two treatments.  Since then, the debate about […]

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CABG rates decline in USA over the last decade

Coronary revascularisation, either by coronary artery bypass surgery (CABG) or percutaneous coronary intervention (PCI), is one of the most commonly performed procedures in the USA.  Over the last ten years a number of technological and pharmacological improvements have changed the landscape of coronary revascularisation and led to a number of changes in guidelines and appropriateness […]

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Cardiac enzyme rises post CABG predict worse outcomes

The significance of myocardial enzyme elevations following coronary artery bypass surgery (CABG) remains controversial.  Although a ‘significant’ enzyme rise is felt to indicate a worse long-term prognosis, several smaller studies have suggested that even small enzyme rises within 24hours of surgery are significant.  This analysis aimed to define whether a threshold exists below which enzyme […]

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Fewer strokes complicate CABG

Stroke is a serious complication of coronary artery bypass grafting (CABG), occurring in around 1.3% of patients undergoing coronary surgery in the USA.  In this study, Tarakji et al. aimed to examine the prevalence and timing of perioperative stroke in the modern era, to identify patient and surgical factors associated with stroke and its timing, […]

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Stent or Surgery? It depends on the SYNTAX

As percutaneous coronary intervention (PCI) continues to evolve, its ability to treat complex coronary artery disease (CAD) continues to improve.The SYNTAX (Synergy between PCI with Taxus and Cardiac Surgery) trial was designed to assess whether modern percutaneous techniques have assumed parity with coronary artery bypass surgery (CABG) for the treatment of complex (3 vessel or […]

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Off-pump CABG lowers early post-operative risk in women

Previous studies of patients undergoing coronary artery bypass grafting (CABG) describe, in the majority, an increased rate of early mortality and morbidity among women as compared with men. Retrospective reviews of large observational studies have shown decreased early risk-adjusted mortality and morbidity among patients undergoing off pump CABG (OPCABG) as compared with those placed on […]

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