Fifty years of coronary artery bypass grafting

Melly, Ludovic; Torregrossa, Gianluca; Lee, Timothy J.; Jansens, Jean-Luc; Puskas, John D.

doi:10.21037/jtd.2018.02.43

Cited by 204 publications

(168 citation statements)

References 71 publications

Supporting

Mentioning

157

Contrasting

Unclassified

Order By: Relevance

“…CABG remains as one of the most common cardiac surgery procedures worldwide . Our study provides a comprehensive assessment of monocyte and DC responses in CABG patients which were significantly modulated post‐surgery.…”

Section: Discussionmentioning

confidence: 99%

Coronary artery bypass grafting is associated with immunoparalysis of monocytes and dendritic cells

Perros

Esguerra‐Lallen

Rooks

et al. 2020

J Cellular Molecular Medi

View full text Add to dashboard Cite

Coronary artery bypass grafting (CABG) triggers a systemic inflammatory response that may contribute to adverse outcomes. Dendritic cells (DC) and monocytes are immunoregulatory cells potentially affected by CABG, contributing to an altered immune state. This study investigated changes in DC and monocyte responses in CABG patients at 5 time-points: admission, peri-operative, ICU, day 3 and day 5. Whole blood from 49 CABG patients was used in an ex vivo whole blood culture model to prospectively assess DC and monocyte responses. Lipopolysaccharide (LPS) was added in parallel to model responses to an infectious complication. Co-stimulatory and adhesion molecule expression and intracellular mediator production was measured by flow cytometry. CABG modulated monocyte and DC responses. In addition, DC and monocytes were immunoparalysed, evidenced by failure of co-stimulatory and adhesion molecules (eg HLA-DR), and intracellular mediators (eg IL-6) to respond to LPS stimulation. DC and monocyte modulation was associated with prolonged ICU length of stay and post-operative atrial fibrillation. DC and monocyte cytokine production did not recover by day 5 post-surgery. This study provides evidence that CABG modulates DC and monocyte responses. Using an ex vivo model to assess immune competency of CABG patients may help identify biomarkers to predict adverse outcomes. K E Y W O R D Scardiac surgery, coronary artery bypass, Dendritic cells, immune modulation, immunoparalysis, monocytes

show abstract

Section: Discussionmentioning

confidence: 99%

Coronary artery bypass grafting is associated with immunoparalysis of monocytes and dendritic cells

Perros

Esguerra‐Lallen

Rooks

et al. 2020

J Cellular Molecular Medi

View full text Add to dashboard Cite

show abstract

“…• Coronary artery bypass grafting (CABG): The CAGB procedure is considered more invasive compared to PCI. The procedure includes bypassing stenosed coronary arteries [42]. Thus, vein or artery grafts are used to anastomose occluded vessels.…”

Section: Vitamin D Metabolismmentioning

confidence: 99%

Potential Beneficial Effects of Vitamin D in Coronary Artery Disease

et al. 2019

View full text Add to dashboard Cite

Vitamin D plays a pivotal role in bone homeostasis and calcium metabolism. However, recent research has indicated additional beneficial effects of vitamin D on the cardiovascular system. This review aims to elucidate if vitamin D can be used as an add-on treatment in coronary artery disease (CAD). Large-scale epidemiological studies have found a significant inverse association between serum 25(OH)-vitamin D levels and the prevalence of essential hypertension. Likewise, epidemiological data have suggested plasma levels of vitamin D to be inversely correlated to cardiac injury after acute myocardial infarction (MI). Remarkably, in vitro trials have showed that vitamin D can actively suppress the intracellular NF-κB pathway to decrease CAD progression. This is suggested as a mechanistic link to explain how vitamin D may decrease vascular inflammation and atherosclerosis. A review of randomized controlled trials with vitamin D supplementation showed ambiguous results. This may partly be explained by heterogeneous study groups. It is suggested that subgroups of diabetic patients may benefit more from vitamin D supplementation. Moreover, some studies have indicated that calcitriol rather than cholecalciferol exerts more potent beneficial effects on atherosclerosis and CAD. Therefore, further studies are required to clarify these assumptions.

show abstract

“…One could anticipate that when presented to patients, the dynamics of their decision-making might be clarified and less onerous. Actual HCR procedures across centers varies, and techniques and outcomes compared to PCI and CABG require further research [11,12].…”

Section: Limitations and Delimitationsmentioning

confidence: 99%

“…Two procedures are available to restore coronary arterial flow when pathology becomes critical or life-threating, each with a different design, distinct effects on the coronary vasculature, benefits, disadvantages, and outcomes. Coronary artery bypass grafting (CABG) via sternotomy became available in the 1960s after the introduction of machinery permitting cardiopulmonary bypass [11]. Techniques, safety, and outcomes improved, among which was thoracoscopic harvesting of the left internal thoracic artery, followed by minimally invasive and robotic surgery.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Trends in Guideline-Driven Revascularization in Diabetic Patients with Multivessel Coronary Heart Disease

Rumana

Kones²,

Taheer

et al. 2019

JCDD

View full text Add to dashboard Cite

In diabetes patients with chronic ≥3 vessel disease, coronary artery bypass grafting (CABG) holds a class I recommendation in the American College of Cardiology and American Heart Association (ACC/AHA) 2011 guidelines, and this classification has not changed to date. Much of the literature has focused upon whether CABG or percutaneous coronary intervention (PCI) produces better outcomes; there is a paucity of data comparing the odds of receiving these procedures. A secondary analysis was conducted in a de-identified database comprised of 30,482 patients satisfying the entry criteria. Odds of occurrence (CABG, PCI) were determined as the binary dependent variable in period 1, (17 October 2009 through 31 December 2011), and period 2 (1 January 2013 through 16 March 2015), before and after the 2011 guidelines, while controlling for gender, ethnicity/race, and ischemic heart disease as covariates. The odds of performing CABG rather than PCI in period 2 were not statistically significantly different than in period 1 (p = 0.400). The logistic regression model chi-square statistic was statistically significant, with χ2 (7) = 308.850, p < 0.0001. The Wald statistic showed that ethnicity/race (African American, Caucasian, Hispanic and Other), gender, and heart disease contributed significantly to the prediction model with p < 0.05, but ethnicity ‘Unknown’ did not. The odds of CABG versus PCI in period 2 were 0.98 times those in period 1 95% confidence interval (CI) = (0.925, 1.032), statistically controlling for covariates. There was no significant rise in the odds of undergoing a CABG among this dataset of high-risk patients with diabetes and multivessel coronary heart disease. Modern practice has evolved regarding patient choice and additional variables that impact the final revascularization method employed. The degree to which odds of occurrence of procedures are a reliable surrogate for provider compliance with guidelines remains uncertain.

show abstract

Fifty years of coronary artery bypass grafting

Cited by 204 publications

References 71 publications

Coronary artery bypass grafting is associated with immunoparalysis of monocytes and dendritic cells

Coronary artery bypass grafting is associated with immunoparalysis of monocytes and dendritic cells

Potential Beneficial Effects of Vitamin D in Coronary Artery Disease

Trends in Guideline-Driven Revascularization in Diabetic Patients with Multivessel Coronary Heart Disease

Contact Info

Product

Resources

About