Contemporary coronary artery bypass graft surgery and subsequent percutaneous revascularization

Beerkens, Frans; Claessen, Bimmer E.; Mahan, Marielle; Gaudino, Mario; Tam, Derrick Y.; Henriques, José P.S.; Mehran, Roxana; Dangas, George

doi:10.1038/s41569-021-00612-6

Cited by 46 publications

(32 citation statements)

References 111 publications

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“…Phase 1 was the screening phase in which aortic tissue samples from 17 TAD patients and 8 MI patients with atherosclerosis undergoing coronary artery bypass grafting (CABG) without aortic dilatation (population 1) were collected. During the CABG, the ascending aorta wall with a diameter of about 5–7 mm was cut, followed by anastomosing a saphenous vein graft to the ascending aorta ( 21 ). All the samples were subjected to label-free quantitative proteomics analysis to explore differentially expressed proteins.…”

Section: Methodsmentioning

confidence: 99%

Potential Clinical Value of Biomarker-Guided Emergency Triage for Thoracic Aortic Dissection

Qiu

Yang

et al. 2022

Front. Cardiovasc. Med.

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Aim: Thoracic aortic dissection (TAD) is a high-risk vascular disease. The mortality rate of untreated TADs in 24 h was as high as 50%. Thus, rapid diagnosis of TAD in the emergency department would get patients to the right treatments to save their lives.Methods: We profiled the proteome of aortic tissues from TAD patients using a label-free quantification proteomics method. The differentially expressed proteins were screened and subjected to bioinformatics analysis. Candidate biomarkers were selected and validated in independent serum samples using enzyme-linked immunosorbent assays (ELISAs). The diagnostic values were further predicted via receiver operating characteristic (ROC) curve analysis.Results: A total of 1,141 differentially expressed proteins were identified in aortic tissues from 17 TAD patients and eight myocardial infarction (MI) patients. Six proteins were selected as candidate biomarkers for ELISAs in an independent training set of 20 serum samples (TAD = 10, MI = 10). Of these proteins, four with a P-value < 0.01 were further validated in another independent set of 64 serum samples (TAD = 32, MI = 32) via ELISAs. ITGA2, COL2A1, and MIF had P-values < 0.0001, and their areas under the curve (AUCs) were 0.801 (95% CI: 0.691–0.911), 0.773 (95% CI: 0.660–0.887), and 0.701 (95% CI: 0.574–0.828), respectively.Conclusion: ITGA2, COL2A1, and MIF were identified as promising biomarkers for discriminating TAD from emergency patients with severe chest pain. Biomarker-guided emergency triage could further shorten the time for patients to get more effective treatments.

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Section: Methodsmentioning

confidence: 99%

Potential Clinical Value of Biomarker-Guided Emergency Triage for Thoracic Aortic Dissection

Qiu

Yang

et al. 2022

Front. Cardiovasc. Med.

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“…This could have affected our study findings, especially rates of repeat revascularization between HCR and CABG on long‐term follow‐up. Additionally, while CABG may indeed provide a lower need for future revascularization, 52,53 these results may be influenced by the fact that patients who underwent CABG often present with culprit graft lesions that are not feasible for treatment with PCI or repeat surgery, thereby resulting in a lower incidence of repeat revascularization events 54 . Recent data also reveal that long‐term rates of repeat revascularization remained similar irrespective of CABG performed with total arterial revascularization versus non‐total arterial revascularization, that is, CABG with at least one arterial and one saphenous venous graft 55 .…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, while CABG may indeed provide a lower need for future revascularization, 52,53 these results may be influenced by the fact that patients who underwent CABG often present with culprit graft lesions that are not feasible for treatment with PCI or repeat surgery, thereby resulting in a lower incidence of repeat revascularization events. 54 Recent data also reveal that long-term rates of repeat revascularization remained similar irrespective of CABG performed with total arterial revascularization versus non-total arterial revascularization, that is, CABG with at least one arterial and one saphenous venous graft. 55 An additional important point to consider, especially in respect to HCR, would be the nature of repeat revascularization procedure performed, that is, PCI versus CABG.…”

Section: Sensitivity Analysis Including Only Rctsmentioning

confidence: 94%

Hybrid coronary revascularization (HCR) versus coronary artery bypass grafting (CABG) in multivessel coronary artery disease (MVCAD): A meta‐analysis of 14 studies comprising 4226 patients

Nagraj

Tzoumas

Kakargias

et al. 2022

Cathet Cardio Intervent

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Objectives To compare the outcomes of hybrid coronary revascularization (HCR) with traditional coronary artery bypass grafting (CABG) in multivessel coronary artery disease (MVCAD). Background HCR has emerged as an alternative to CABG in patients with MVCAD. Through minimally invasive surgical techniques, HCR carries the potential for faster recovery postoperatively, fewer complications, and lower utilization of resources. Methods Systematic search of electronic databases was conducted up to December 2021 and studies comparing HCR with CABG in the treatment of MVCAD were included in this meta‐analysis. Primary outcomes of interest were incidence of 5‐year mortality and major adverse cardiac and cerebral event (MACCE). Results Fourteen studies (12 observational studies and 2 randomized controlled trials) comprising 4226 patients were included. The rates of 5‐year mortality (odds ratios [OR]: 1.55; 95% confidence interval [CI]: 0.92−2.62; I2 = 83.0%) and long‐term MACCE (OR: 0.97; 95% CI: 0.47−2.01; I2 = 74.7%) were comparable between HCR and CABG groups. HCR was associated with a significantly lower likelihood of perioperative blood transfusion (OR: 0.36; 95% CI: 0.25−0.51; I2 = 55.9%), shorter mean hospital stay (weighted mean difference: −2.04; 95% CI: −2.60 to −1.47; I2 = 54%), and risk of postoperative acute kidney injury (OR: 0.45; 95% CI: 0.23−0.88; p = 0.02). CABG demonstrated a lower likelihood of requiring long‐term repeat revascularization (OR: 1.51; 95% CI: 1.03−2.20; I2 = 18%) over a follow‐up duration of 29.14 ± 21.75 months. Conclusion This meta‐analysis suggests that HCR is feasible and safe for the treatment of MVCAD. However, benefits of HCR should be carefully weighed against the increased long‐term risk of repeat‐revascularization when selecting patients, and further studies evaluating differences in long‐term mortality between HCR and CABG are required.

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“…The mechanisms underlying graft failure requiring secondary coronary revascularization depend on the timing or type of graft (venous graft or arterial graft) after CABG surgery 4) . Early after…”

Section: Epidemiologymentioning

confidence: 99%

Therapeutic Strategies and Future Directions of Management for Patients with a History of Coronary Artery Bypass Grafting Who Require Secondary Coronary Revascularization

Asaumi

Miyagi

Otsuka

et al. 2023

Journal of Coronary Artery Disease

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Secondary coronary revascularizations can be required due to the progression of coronary artery lesions and degeneration of bypass grafts in the long term after initial coronary artery bypass graft (CABG) surgery. It is therefore necessary to clarify the clinical characteristics of these patients and how to improve their prognosis. Optimal medical treatments, including medications, smoking cessation, and cardiac rehabilitation, are essential baseline management to prevent the progression of native coronary atherosclerosis and degradation of bypass grafts among all post-CABG patients who undergo secondary coronary revascularization as well as those who undergo initial CABG surgery in order to avoid situations requiring secondary coronary revascularization. All coronary revascularization procedures should be built upon these firm optimal medical treatments. Percutaneous coronary intervention is the current mainstay of secondary coronary revascularization approaches for patients who have symptoms of heart failure or angina pectoris because of the low invasiveness of the technique and no need for re-sternotomy. Redo-CABG is an option, especially for young patients without patency for internal thoracic artery to left anterior descending artery graft. The individualization of these approaches and improvements in medications and coronary revascularization procedures may improve the clinical outcomes and prognosis of this subgroup.

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Contemporary coronary artery bypass graft surgery and subsequent percutaneous revascularization

Cited by 46 publications

References 111 publications

Potential Clinical Value of Biomarker-Guided Emergency Triage for Thoracic Aortic Dissection

Potential Clinical Value of Biomarker-Guided Emergency Triage for Thoracic Aortic Dissection

Hybrid coronary revascularization (HCR) versus coronary artery bypass grafting (CABG) in multivessel coronary artery disease (MVCAD): A meta‐analysis of 14 studies comprising 4226 patients

Therapeutic Strategies and Future Directions of Management for Patients with a History of Coronary Artery Bypass Grafting Who Require Secondary Coronary Revascularization

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