Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Apr 2019
Randomized Controlled Trial Comparative StudyContemporary Outcomes Following Coronary Artery Bypass Graft Surgery for Left Main Disease.
Although results of percutaneous coronary intervention (PCI) have been steadily improving, whether surgical outcomes have improved over time is not fully elucidated. ⋯ Over a 5- to 7-year period, significant improvement in event-free survival after surgical revascularization for LM disease at 3 years was noted between the SYNTAX and EXCEL trials, consistent with improving results with cardiac surgery over time. (Synergy Between PCI With Taxus and Cardiac Surgery [SYNTAX]; NCT00114972; Evaluation of XIENCE Versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization [EXCEL]; NCT01205776).
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J. Am. Coll. Cardiol. · Apr 2019
Percutaneous Coronary Intervention in Older Patients With ST-Segment Elevation Myocardial Infarction and Cardiogenic Shock.
Older adults ≥75 years of age carry an increased risk of mortality after ST-segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock. ⋯ This large and contemporary analysis shows that utilization of PCI in older adults with STEMI and cardiogenic shock is increasing and paralleled by a substantial reduction in mortality. Although clinical judgment is critical, older adults should not be excluded from early revascularization based on age in the absence of absolute contraindications.
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J. Am. Coll. Cardiol. · Apr 2019
Acute Noncardiac Organ Failure in Acute Myocardial Infarction With Cardiogenic Shock.
There are limited data on acute noncardiac multiorgan failure in cardiogenic shock complicating acute myocardial infarction (AMI-CS). ⋯ There has been a steady increase in the prevalence of multiorgan failure in AMI-CS. Presence of multiorgan failure was independently associated with higher in-hospital mortality and greater resource utilization.
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J. Am. Coll. Cardiol. · Apr 2019
Characterization and Management of Arrhythmic Events in Young Patients With Brugada Syndrome.
Information on young patients with Brugada syndrome (BrS) and arrhythmic events (AEs) is limited. ⋯ Young BrS patients with AE represent a very arrhythmogenic group. Current management after first arrhythmia episode is associated with high recurrence rate. Alternative therapies, besides defibrillator implantation, should be considered.