High-risk cardiac revascularization and clinical trials / edited by Douglass A. Morrison, Patrick W. Serruys.

Format:

Book

Contributor:

Morrison, Douglass Andrew, 1947-

Serruys, P. W.

Language:

English

Subjects (All):

Myocardial Revascularization.

Coronary Artery Bypass.

Cardiovascular Diseases--therapy.

Clinical Trials as Topic.

Treatment Outcome.

Coronary Disease--surgery.

Myocardial revascularization.

Cardiovascular system--Diseases.

Cardiovascular system.

Coronary heart disease--Surgery.

Coronary heart disease.

Medical Subjects:

Myocardial Revascularization.

Coronary Artery Bypass.

Cardiovascular Diseases--therapy.

Clinical Trials as Topic.

Treatment Outcome.

Coronary Disease--surgery.

Physical Description:

xii, 580 pages : illustrations ; 24 cm

Other Title:

High risk cardiac revascularization and clinical trials

Place of Publication:

London : Martin Dunitz, 2002.

Summary:

Since the first coronary angioplasty procedure was carried out in 1977, there have been many developments in the field of interventional cardiology. As technologies and technique have evolved, the subset of patients considered suitable for percutaneous intervention has correspondingly widened, and non-surgical therapies have become both accepted practice and viable alternatives to surgical myocardial revascularization.

Over the years several trials have been designed to test the success of these therapies for patients with multi-vessel obstructive coronary artery disease, and to compare survival rates with those receiving surgical treatment (namely coronary bypass surgery). However, early trials did not include higher-risk patients, the defining features of whom include older age, decreased left ventricular function and, in particular, previous bypass surgery. Recent trials, such as AWESOME, have addressed this imbalance, and more are proposed (i.e. STICH). In the interim, the compilation of information on outcomes of the high-risk patient, as presented in this book, will remain the best source of decision-making for the clinician faced with the common clinical dilemma of surgery versus intervention for those patients who fail medical treatment.

Supported by over 100 illustrations, this text examines and compares medical and surgical management of cardiovascular disease for the high-risk cardiac patient. There is comprehensive coverage of relevant trials (and the lessons learned from them) along with an examination of evolving medical technology (including drug therapy). In both cases, long-term outcome of various forms of management is emphasized. The book is a valuable source of information for the interventional or non-invasive cardiologist, cardiac surgeon and trainee.

Contents:

An interventionalist's perspective / Spencer B King III 3

A cardiac surgeon's perspective / Robert H Jones 5

Section I Is the medical management optimal?

1. What constitutes medically refractory in the new millennium? / Douglass A Morrison, Jerome Sacks 11

2. Beta-blocking agents / Jason R Wollmuth, Douglass A Morrison 25

3. Statins and other lipid-lowering agents / Douglass A Morrison, Stephen P Thomson 43

4. Angiotensin-converting enzyme inhibitors / Hoang M Thai, Douglass A Morrison 61

5. Anticoagulants in unstable angina and acute myocardial infarction / Kodangudi B Ramanathan 73

6. Antiplatelet therapy / H Daniel Lewis, Jr 85

Section II The benefits of revascularization

7. To prolong a life: summary of the coronary bypass trials / Robert C Brooks, Katherine M Detre 97

8. To improve a life: relief of symptoms, exercise tolerance, ACME and RITA-2 / Edward D Folland 107

9. Rationale and design for the Clinical Outcomes Utilizing Revascularization and Aggressive druG Evaluation (COURAGE) trial / William E Boden 121

10. Results of randomized controlled trials in patients with non-ST segment elevation acute coronary syndromes (TIMI-IIIB, VANQWISH, FRISC-II, TACTICS TIMI-18) / William E Boden 135

Section III Comparative trials of CABG versus PCI

11. Bypass Angioplasty Revascularization Investigation (BARI) / Martial G Bourassa 145

12. The RITA trials / Robert A Henderson 163

13. Emory angioplasty versus surgery trial / Spencer B King III 177

14. Percutaneous coronary intervention and coronary bypass surgery in high-risk patients: a look from the South / Alfredo E Rodriguez 187

15. The MASS trials / Luiz A Machado Cesar, Whady A Hueb 203

16. The AWESOME trial / Douglass A Morrison, Jerome Sacks, William G Henderson, Gulshan Sethi 217

17. Randomized comparison of coronary artery bypass surgery and stenting for the treatment of multi-vessel disease / Patrick W Serruys, Felix Unger 235

Section IV Differential risks/differential benefits: patient subsets

18. Re-operative revascularization / Bruce W Lytle 257

19. Elective stenting of left main coronary artery disease / Seung-Jung Park 265

20. Coronary interventions in acute myocardial infarction / Vincent S DeGeare, Cindy L Grines 283

21. Acute myocardial infarction: SMASH perspective / Jean-Christophe E Stauffer, Philip M Urban 311

22. Cardiogenic shock: SHOCK trial perspective / Debabrata Mukherjee, Eric R Bates, Judith S Hochman 327

23. Cardiogenic shock: a VA perspective / Douglass A Morrison, Jerome Sacks 337

24. Chronic occlusions / Haresh Mehta, Bernhard Meier 347

Section V Comorbidity

25. Chroni pulmonary disease / Darryl Weiman, Kodangudi B Ramanathan, Douglass A Morrison 363

26. Cerebrovascular and peripheral vascular co-morbidity / Douglass A Morrison, Gumpanart Veerakul, Krisada Sastravaha 373

27. Liver disease / Edmund J Bini, Chris E Lascarides 387

28. Renal function and high-risk coronary artery procedures / Stuart B Pett Jr 415

29. High-risk coronary interventions in diabetic patients / Steven P Sedlis, Jeffrey D Lorin 425

Section VI Adding value to the revascularization option

30. Off-pump coronary artery bypass in high-risk patients / Rick A Esposito 453

31. Support for percutaneous coronary interventions: IABP, CPS and beyond / Carl L Tommaso 469

32. Stents and high-risk cardiac revascularization / David R Holmes Jr, Douglass A Morrison 479

33. Pharmacologic support for PCI: glycoprotein IIb/IIIa receptor blockers / Douglass A Morrison 489

34. Myocardial protection for high-risk coronary surgery / Vladimir Birjiniuk, Diane Panton Lapsley 503

Section VII What can be done after the revascularization to discourage recidivism?

35. Cardiac rehabilitation / Shefali Vora, Victor Froelicher 511

Section VIII Medicine vs PCI vs CABG in 2001 for high-risk unstable angina

36. Cost comparisons of PCI vs CABG / Kevin T Stroupe 549

37. High-risk myocardial ischemia in 2002: medicine, PCI and CABG / Douglass A Morrison, Jerome Sacks 559.

Notes:

Includes bibliographical references and index.

ISBN:

1841841854

OCLC:

50845607