Question: Dear Doctor T, A friend died of a heart attack this past Sat. while on a mountain bike ride. He was 46, not overweight, lived a clean lifestyle. It came as a shock to me. Was he most likely born with a heart defect or had family history of heart disease? Cause I’m wondering how this could happen to …
Cost-Effectiveness of PCI with Drug Eluting Stents versus CABG
Cost-Effectiveness of PCI with Drug Eluting Stents versus Bypass Surgery for Patients with Diabetes and Multi-vessel Coronary Artery Disease: Results from the FREEDOM Trial. Not only did patients with diabetes and multi-vessel CAD experience significantly better clinical outcomes after revascularization with CABG than PCI with a drug-eluting stent, according to results of the FREEDOM trial, based on lifetime projections, CABG was found to be more …
SYNTAX Trial after Five Years: Final Results
In the SYNTAX trial 1800 patients with previously untreated left-main or three-vessel disease were randomized to CABG or PCI. As expected, differences in long-term outcomes of Coronary Artery Bypass Grafting vs. PCI, already present after year one, have continued to become more obvious during the next four years: SYNTAX five-year results for patients with three-vessel disease: SYNTAX five-year results for …
Stents and Stroke
LONDON – Stroke patients over 70 who get stents to keep their arteries open may be doubling their risk of having another stroke or dying compared to patients who get surgery instead, a new study says. European researchers examined past studies from more than 3,400 stroke patients, including 1,725 who got stents and 1,708 who had surgery, and found that …
Coronary Artery Bypass Grafting is Superior to Percutaneous Coronary Intervention in Diabetics with Coronary Artery Disease
A dramatic increase in percutaneous coronary intervention (PCI), coupled with a similar decrease in coronary artery bypass grafting (CABG) has characterized the treatment of coronary artery disease for the 20 years. The just released FREEDOM trial results[1] have once again confirmed that diabetic patients with coronary artery disease have better outcomes with CABG than with PCI – even if contemporaneous …
SYNTAX Trial: Four-year follow-up analysis
SYNTAX was an 1800-patient trial randomizing patients with left main coronary disease and/or three-vessel disease to either CABG or PCI using the Taxus drug-eluting stent (DES). Findings In patients with severe, multi-vessel coronary disease, coronary artery bypass grafting (CABG) continues as the standard of care of revascularization. Death and MI rates did become significantly greater in the PCI group after …
The FREEDOM Trial: Revascularization in Patients with Diabetes
The Future Revascularization Evaluation in Patients with Diabetes Mellitus: Optimal Management of Multivessel Disease (FREEDOM) study enrolled 1,900 patients over a 5-year period from 2005 through 2010. Contemporary PCI and CABG techniques and currently recommended ancillary medical therapies were examined to determine whether CABG or PCI with drug-eluting stents are the superior approach to revascularization in patients with diabetes and …
The Best Cardiology Blogs
Ask Dr T was nominated in September 2012 as one of The Best Cardiology Blogs on Internetmedicine, “where Internet meets medicine” in the company of others that include The American College of Cardiology, Dr. Topol, Dr. Cresman and Harvard Health Publications
Dick Cheney and modern heart failure treatment
Former Vice President Dick Cheney was released from the hospital on April 3rd, 2012, 10 days after getting a heart transplant. Cheney waited nearly two years for the transplant. During his life he sustained five heart attacks, the first at age 37 and the most recent one in 2010. What is remarkable about this is not his age (71), but …
Heart surgery and personality changes
Question: My husband had a heart attack 17 yrs. ago at age 37. He had a 5-way bypass surgery at age 40. After the surgery there was a drastic change in his personality. I expected that recovery would take a little while, but he was completely different. He went from being an easy-going, sharp, good-natured person to very angry and …
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