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1. Kim WJ, Park DW, Yun SC, Lee JY, Lee SW, Kim YH, Lee CW, Park SW, Park SJ: Impact of diabetes mellitus on the treatment effect of percutaneous or surgical revascularization for patients with unprotected left main coronary artery disease: a subgroup analysis of the MAIN-COMPARE study. JACC Cardiovasc Interv; 2009 Oct;2(10):956-63
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Impact of diabetes mellitus on the treatment effect of percutaneous or surgical revascularization for patients with unprotected left main coronary artery disease: a subgroup analysis of the MAIN-COMPARE study.
  • OBJECTIVES: This study sought to investigate whether the outcome of drug-eluting stent (DES) treatment and that of coronary artery bypass grafting (CABG) differed in diabetic and nondiabetic patients with unprotected left main coronary artery (LMCA) disease.
  • BACKGROUND: Diabetes mellitus has been shown to be a risk factor for adverse events and a major determinant in selection of a revascularization strategy in patients with multivessel or LMCA disease.
  • METHODS: A total of 1,474 patients with unprotected LMCA stenosis who received DES (n = 784) or underwent CABG (n = 690) were examined.
  • We compared the effects of these 2 treatments on long-term clinical outcomes (death; the composite of death, Q-wave myocardial infarction [MI], or stroke; and target vessel revascularization [TVR]), according to diabetic status.
  • RESULTS: After adjustment of covariates, the risk of death (hazard ratio [HR]: 0.95, 95% confidence interval [CI]: 0.62 to 1.46, p = 0.83) and the composite of death, Q-wave MI, or stroke (HR: 0.96, 95% CI: 0.65 to 1.42, p = 0.85) at 3 years were similar in the DES and CABG groups.
  • However, the rate of TVR was significantly higher in the DES group (HR: 4.31, 95% CI: 2.28 to 8.15, p < 0.001).
  • We also did not observe a diabetes-associated excess risk of death (p(interaction) = 0.90 and 0.16), or a composite of death, Q-wave MI, or stroke (p(interaction) = 0.68 and 0.93), or TVR (p(interaction) = 0.23 and 0.92), between patients receiving either treatment.
  • CONCLUSIONS: The prognostic impact of diabetes on long-term treatment with DES or CABG for patients with unprotected LMCA disease was minimal.
  • [MeSH-major] Angioplasty, Balloon, Coronary. Coronary Artery Bypass. Coronary Stenosis / therapy. Diabetic Angiopathies / therapy
  • [MeSH-minor] Aged. Drug-Eluting Stents. Female. Humans. Kaplan-Meier Estimate. Korea / epidemiology. Male. Middle Aged. Myocardial Infarction / etiology. Proportional Hazards Models. Registries. Risk Assessment. Risk Factors. Severity of Illness Index. Stroke / etiology. Time Factors. Treatment Outcome

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  • [CommentIn] JACC Cardiovasc Interv. 2009 Oct;2(10):964-6 [19850256.001]
  • (PMID = 19850255.001).
  • [ISSN] 1876-7605
  • [Journal-full-title] JACC. Cardiovascular interventions
  • [ISO-abbreviation] JACC Cardiovasc Interv
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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2. Lee JY, Park DW, Yun SC, Lee SW, Kim YH, Lee CW, Hong MK, Park SW, Park SJ: Long-term clinical outcomes of sirolimus- versus paclitaxel-eluting stents for patients with unprotected left main coronary artery disease: analysis of the MAIN-COMPARE (revascularization for unprotected left main coronary artery stenosis: comparison of percutaneous coronary angioplasty versus surgical revascularization) registry. J Am Coll Cardiol; 2009 Aug 25;54(9):853-9
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  • [Title] Long-term clinical outcomes of sirolimus- versus paclitaxel-eluting stents for patients with unprotected left main coronary artery disease: analysis of the MAIN-COMPARE (revascularization for unprotected left main coronary artery stenosis: comparison of percutaneous coronary angioplasty versus surgical revascularization) registry.
  • OBJECTIVES: The aim of this study was to evaluate long-term clinical outcomes after implantation of sirolimus-eluting stents (SES) or paclitaxel-eluting stents (PES) among patients with unprotected left main coronary artery (LMCA) disease.
  • BACKGROUND: There have been few comparisons of long-term outcomes among currently available drug-eluting stents (DES) for the treatment of LMCA disease.
  • METHODS: A total of 858 consecutive patients with unprotected LMCA stenosis were treated with SES (n = 669) or PES (n = 189) between May 2003 and June 2006.
  • CONCLUSIONS: In consecutive patients with unprotected LMCA disease undergoing DES implantation, SES and PES showed similar long-term clinical outcomes in terms of death, MI, repeat revascularization, and stent thrombosis.
  • [MeSH-major] Angioplasty, Balloon, Coronary. Coronary Artery Disease / therapy. Coronary Stenosis / therapy. Paclitaxel / administration & dosage. Sirolimus / administration & dosage
  • [MeSH-minor] Aged. Drug-Eluting Stents. Female. Humans. Immunosuppressive Agents / therapeutic use. Male. Middle Aged. Treatment Outcome. Tubulin Modulators / therapeutic use

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  • [Copyright] 2009 by the American College of Cardiology Foundation
  • (PMID = 19695467.001).
  • [ISSN] 1558-3597
  • [Journal-full-title] Journal of the American College of Cardiology
  • [ISO-abbreviation] J. Am. Coll. Cardiol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Immunosuppressive Agents; 0 / Tubulin Modulators; P88XT4IS4D / Paclitaxel; W36ZG6FT64 / Sirolimus
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3. Hsu JT, Chu CM, Chang ST, Kao CL, Chung CM: Percutaneous coronary intervention versus coronary artery bypass graft surgery for the treatment of unprotected left main coronary artery stenosis: in-hospital and one year outcome after emergent and elective treatments. Int Heart J; 2008 May;49(3):355-70
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  • [Title] Percutaneous coronary intervention versus coronary artery bypass graft surgery for the treatment of unprotected left main coronary artery stenosis: in-hospital and one year outcome after emergent and elective treatments.
  • This study attempts to compare the risks and benefits of provisional stenting with drug eluting stents and bypass surgery for left main coronary artery (LMCA) stenosis.
  • Recent improvements in interventional technologies have increased interest in percutaneous treatment of LMCA stenosis.
  • However, application of percutaneous techniques to LMCA has been sporadic and controversial.
  • In-hospital and one year outcomes of coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) cases were compared.
  • From September, 2003 to June, 2005, a total of 59 consecutive patients with de novo unprotected LMCA stenosis were treated with either CABG or PCI.
  • Twenty patients received non-intravascular ultrasound-guided PCI with a stent in the LMCA.
  • At 30-day follow-up, the major adverse cardiac and cerebrovascular event (MACE) rates of mortality, myocardial infarction, cerebral vascular accident, and target vessel revascularization were 25.6% in the CABG group and 5% in the PCI group (P=0.054).
  • [MeSH-major] Angioplasty, Balloon, Coronary. Coronary Artery Bypass. Coronary Stenosis / therapy
  • [MeSH-minor] Aged. Drug-Eluting Stents. Female. Humans. Male. Middle Aged. Risk Factors. Treatment Outcome

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  • (PMID = 18612192.001).
  • [ISSN] 1349-2365
  • [Journal-full-title] International heart journal
  • [ISO-abbreviation] Int Heart J
  • [Language] eng
  • [Publication-type] Case Reports; Comparative Study; Journal Article
  • [Publication-country] Japan
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4. Lindsey JB, Brilakis ES, Banerjee S: Acute coronary syndrome due to extrinsic compression of the left main coronary artery in a patient with severe pulmonary hypertension: successful treatment with percutaneous coronary intervention. Cardiovasc Revasc Med; 2008 Jan-Mar;9(1):47-51
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  • [Title] Acute coronary syndrome due to extrinsic compression of the left main coronary artery in a patient with severe pulmonary hypertension: successful treatment with percutaneous coronary intervention.
  • A patient with severe pulmonary (arterial) hypertension (PH) presented with a non-ST segment elevation myocardial infarction and recurrent angina at rest.
  • Coronary angiography showed severe ostial left main coronary artery (LMCA) stenosis; coronary arteries were otherwise normal.
  • Intravascular ultrasonography (IVUS) showed deformation of the LMCA due to extrinsic compression from a markedly dilated main pulmonary artery, which was confirmed by cardiac computed tomography.
  • The LMCA was successfully stented using a paclitaxel-eluting stent resulting in complete resolution of angina.
  • Extrinsic compression of the LMCA should be considered in patients with severe PH and angina; IVUS may aid in the diagnosis.
  • Percutaneous stent implantation may be the preferred treatment in this high-risk group of patients.
  • [MeSH-major] Acute Coronary Syndrome / therapy. Angioplasty, Balloon, Coronary. Coronary Stenosis / therapy. Hypertension, Pulmonary / complications. Pulmonary Artery / pathology
  • [MeSH-minor] Angina Pectoris / etiology. Angina Pectoris / therapy. Cardiovascular Agents / administration & dosage. Coronary Angiography. Dilatation, Pathologic. Drug-Eluting Stents. Female. Humans. Middle Aged. Paclitaxel / administration & dosage. Platelet Aggregation Inhibitors / therapeutic use. Severity of Illness Index. Tomography, X-Ray Computed. Treatment Outcome. Ultrasonography, Interventional

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  • (PMID = 18206638.001).
  • [ISSN] 1878-0938
  • [Journal-full-title] Cardiovascular revascularization medicine : including molecular interventions
  • [ISO-abbreviation] Cardiovasc Revasc Med
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Cardiovascular Agents; 0 / Platelet Aggregation Inhibitors; P88XT4IS4D / Paclitaxel
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5. White CW, Gobel FL, Campeau L, Knatterud GL, Forman SA, Forrester JS, Geller NL, Herd JA, Hickey A, Hoogwerf BJ, Hunninghake DB, Rosenberg Y, Terrin ML, Post Coronary Artery Bypass Graft Trial Investigators: Effect of an aggressive lipid-lowering strategy on progression of atherosclerosis in the left main coronary artery from patients in the post coronary artery bypass graft trial. Circulation; 2001 Nov 27;104(22):2660-5
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  • [Title] Effect of an aggressive lipid-lowering strategy on progression of atherosclerosis in the left main coronary artery from patients in the post coronary artery bypass graft trial.
  • BACKGROUND: The Post Coronary Artery Bypass Graft Trial, designed to compare the effects of two lipid-lowering regimens and low-dose anticoagulation versus placebo on progression of atherosclerosis in saphenous vein grafts of patients who had had CABG surgery, demonstrated that aggressive lowering of LDL cholesterol levels to a mean yearly cholesterol level from 93 to 97 mg/dL compared with a moderate reduction to a level of 132 to 136 mg/dL decreased the progression of atherosclerosis in saphenous vein grafts.
  • This secondary analysis tested the hypothesis that a similar decrease in progression of atherosclerosis would also be present in native coronary arteries as measured in the left main coronary artery (LMCA).
  • METHODS AND RESULTS: A sample of 402 patients was randomly selected from 1102 patients who had baseline and follow-up views of the LMCA suitable for analysis.
  • Patients treated with the aggressive lipid-lowering strategy had less progression of atherosclerosis in the LMCA as measured by changes in minimum (P=0.0003) lumen diameter or the maximum percent stenosis (P=0.001), or the presence of substantial progression (P=0.008), or vascular occlusion (P=0.005) when compared with the moderate strategy.
  • CONCLUSIONS: A strategy of aggressive lipid lowering results in significantly less atherosclerosis progression than a moderate approach in LMCAs.
  • [MeSH-major] Anticholesteremic Agents / therapeutic use. Coronary Artery Bypass. Coronary Artery Disease / diagnosis. Coronary Artery Disease / therapy. Coronary Vessels / drug effects
  • [MeSH-minor] Anticoagulants / therapeutic use. Cholesterol, LDL / blood. Cholestyramine Resin / therapeutic use. Coronary Angiography. Disease Progression. Female. Follow-Up Studies. Humans. Lipids / blood. Lovastatin / therapeutic use. Male. Middle Aged. Postoperative Period. Saphenous Vein / transplantation. Treatment Outcome

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  • [CommentIn] Circulation. 2001 Nov 27;104(22):2635-7 [11723009.001]
  • (PMID = 11723015.001).
  • [ISSN] 1524-4539
  • [Journal-full-title] Circulation
  • [ISO-abbreviation] Circulation
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Anticholesteremic Agents; 0 / Anticoagulants; 0 / Cholesterol, LDL; 0 / Lipids; 11041-12-6 / Cholestyramine Resin; 9LHU78OQFD / Lovastatin
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6. Park SJ, Kim YH: Percutaneous coronary intervention as an alternative to bypass surgery for unprotected LMCA stenosis. Expert Rev Cardiovasc Ther; 2008 Sep;6(8):1107-14
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  • [Title] Percutaneous coronary intervention as an alternative to bypass surgery for unprotected LMCA stenosis.
  • Hemodynamically significant left main coronary artery (LMCA) stenosis is found in approximately 4% of diagnostic coronary angiograms and is known as unprotected LMCA stenosis if the left coronary artery and left circumflex artery have no patent previous grafts.
  • Previous randomized studies have demonstrated a significant reduction in mortality when revascularization by coronary artery bypass graft (CABG) surgery was undertaken compared with medical treatment.
  • However, with the advent of drug-eluting stents (DES), the long-term outcomes of PCI with DES to treat unprotected LMCA stenoses have been reported to be acceptable.
  • Therefore, apart from the current guidelines, PCI for unprotected LMCA stenosis in many countries is often undertaken in individuals who are at very high risk of CABG or refuse to undergo a sternotomy.
  • Future randomized studies comparing CABG versus PCI using DES for treatment of unprotected LMCA stenosis would be a great advance in the clinical knowledge of adopting appropriate treatments.
  • [MeSH-major] Angioplasty, Balloon, Coronary. Coronary Artery Bypass. Coronary Stenosis / therapy. Stents
  • [MeSH-minor] Coronary Restenosis / epidemiology. Coronary Restenosis / prevention & control. Drug-Eluting Stents. Humans. Platelet Aggregation Inhibitors / therapeutic use. Randomized Controlled Trials as Topic. Registries. Treatment Outcome. Ultrasonography, Interventional

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  • (PMID = 18793113.001).
  • [ISSN] 1744-8344
  • [Journal-full-title] Expert review of cardiovascular therapy
  • [ISO-abbreviation] Expert Rev Cardiovasc Ther
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Platelet Aggregation Inhibitors
  • [Number-of-references] 39
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7. Nomura T, Nakagawa Y, Urakabe Y, Naito D, Enomoto S, Nishikawa S, Keira N, Matsubara H, Tatsumi T: Subacutely progressed extensive aortic dissection complicated with catheter-induced dissection in left main coronary artery. J Cardiol; 2009 Aug;54(1):128-33
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  • [Title] Subacutely progressed extensive aortic dissection complicated with catheter-induced dissection in left main coronary artery.
  • A 64-year-old man complaining of resting angina underwent emergent coronary angiogram and significant stenosis in the mid-left anterior descending artery was discovered.
  • Although deployment of the drug-eluting Cypher stent relieved the stenosis, the guiding catheter accidentally induced coronary dissection in the left main coronary artery (LMCA).
  • 20 days later, although asymptomatic, extensive aortic dissection was detected from the coronary sinus of Valsalva to the femoral artery.
  • 64-Row multidetector computed tomography demonstrated that the dissection originated from the LMCA and retrogradely expanded to the aorta.
  • This type of dissection is a rare complication related to coronary intervention and even in such a clinical setting, asymptomatic delayed progression of retrograde aortic dissection has not previously been reported to our knowledge.
  • [MeSH-major] Aneurysm, Dissecting / complications. Aortic Aneurysm / complications. Cardiac Catheterization / adverse effects. Coronary Disease / etiology
  • [MeSH-minor] Coronary Stenosis / therapy. Dissection. Humans. Iatrogenic Disease. Male. Middle Aged

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  • (PMID = 19632532.001).
  • [ISSN] 1876-4738
  • [Journal-full-title] Journal of cardiology
  • [ISO-abbreviation] J Cardiol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
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8. Chen SL, Ye F, Zhang JJ, Liu ZZ, Lin S, Zhu ZS, Sun XW, Li F, Zhang AP, Chen JG, Ji QJ, Qian J, Chen F, Kwan TW: Distal left main coronary bifurcation lesions predict worse outcome in patients undergoing percutaneous implantation of drug-eluting stents: results from the Drug-Eluting Stent for the Treatment of Left Main Disease (DISTAL) Study. Cardiology; 2009;113(4):264-73
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  • [Title] Distal left main coronary bifurcation lesions predict worse outcome in patients undergoing percutaneous implantation of drug-eluting stents: results from the Drug-Eluting Stent for the Treatment of Left Main Disease (DISTAL) Study.
  • OBJECTIVES: We investigated the clinical outcome of stenting of unprotected left main coronary artery (LMCA).
  • METHODS: We studied 164 patients with nonbifurcated LMCA lesions (group A) and 96 patients with distal bifurcated lesions (group B).
  • There were significant differences in major adverse cardiac events at 1 (p = 0.014) and 2 years (p = 0.002) between group B (19.8%, 25.0%) and group A (9.1%, 10.4%), mainly due to increased target-vessel revascularization (16.7, 21.9% in group B vs. 6.1, 7.3% in group A, p = 0.006 and 0.001, respectively).
  • The double-stent technique was associated with worse outcomes at 1 year in group B compared to group A.
  • Bifurcation lesions (HR 3.42, 95% CI 1.34-5.61, p = 0.001), diabetes (HR 2.68, 95% CI 2.01-12.11, p = 0.015), three-vessel disease (HR 0.83, 95% CI 0.27-0.96, p = 0.001), incomplete revascularization (HR 0.15, 95% CI 0.11-0.35, p = 0.001) and stent diameter (HR 5.05, 95% CI 2.71-10.01, p = 0.03) were the independent factors of major adverse cardiac events in the whole patient cohort.
  • CONCLUSION: Stenting unprotected distal bifurcated LMCA was associated with unfavorable results when compared to stenting other LMCA lesions.
  • [MeSH-major] Angioplasty, Balloon, Coronary / adverse effects. Coronary Angiography. Coronary Artery Disease / radiography. Coronary Artery Disease / therapy. Drug-Eluting Stents / adverse effects
  • [MeSH-minor] Aged. Disease-Free Survival. Female. Follow-Up Studies. Humans. Kaplan-Meier Estimate. Male. Middle Aged. Predictive Value of Tests. Prevalence. Proportional Hazards Models. Registries. Risk Factors. Stroke Volume. Treatment Failure. Treatment Outcome

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  • [Copyright] Copyright 2009 S. Karger AG, Basel.
  • [CommentIn] Cardiology. 2009;113(4):260-3 [19246904.001]
  • (PMID = 19246905.001).
  • [ISSN] 1421-9751
  • [Journal-full-title] Cardiology
  • [ISO-abbreviation] Cardiology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Switzerland
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9. Godino C, Parodi G, Furuichi S, Latib A, Barbagallo R, Goktekin O, Cera M, Mueller R, Tamburino C, Grube E, Di Mario C, Reimers B, Chieffo A, Antoniucci D, Colombo A, Sangiorgi GM: Long-term follow-up (four years) of unprotected left main coronary artery disease treated with paclitaxel-eluting stents (from the TRUE Registry). EuroIntervention; 2010 Apr;5(8):906-16
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  • [Title] Long-term follow-up (four years) of unprotected left main coronary artery disease treated with paclitaxel-eluting stents (from the TRUE Registry).
  • AIMS: Limited data are available on the long-term outcome following PCI with paclitaxel-eluting stent (PES) implantation in patients with unprotected left main coronary artery (LMCA).
  • The objective of this study was to evaluate "real world" long-term outcome following paclitaxel-eluting stent (PES) implantation for unprotected LMCA disease in patients enrolled in the TRUE registry.
  • METHODS AND RESULTS: From March 2003 to October 2004, 93 consecutive patients (81.7% male) underwent PCI for unprotected LMCA disease.
  • The target lesion involved the distal LMCA in 68 (73.1%) patients.
  • Double stenting techniques were performed in 46 (67.6%) distal LMCA, of these 50% were stented using the Crush technique.
  • In-segment restenosis occurred in 16 (20.3%) patients and was focal in 72.4% of cases and significantly higher in patients with distal LMCA (36.8% vs. 13.6%, p<0.04).
  • At a median follow-up of 1,450 days (IQR 1281-1595), the overall incidence of MACE was 35.5% and the TLR rate was 25.8% and significantly higher in patients with bifurcation stenting (32.3% vs. 8%, p<0.02).
  • CONCLUSIONS: Treatment of unprotected LMCA disease with PES, after four years follow-up, appears to be safe and effective with a low rate of cardiac mortality and overall risk of ST.
  • The need for target lesion revascularisation in 25.8% of patients highlights the need for more effective PCI especially in patients with distal LMCA disease.
  • [MeSH-major] Angioplasty, Balloon, Coronary / instrumentation. Cardiovascular Agents / administration & dosage. Coronary Artery Disease / therapy. Drug-Eluting Stents. Paclitaxel / administration & dosage
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Chi-Square Distribution. Coronary Angiography. Coronary Restenosis / etiology. Disease-Free Survival. Europe / epidemiology. Female. Follow-Up Studies. Hospital Mortality. Humans. Kaplan-Meier Estimate. Logistic Models. Male. Middle Aged. Myocardial Infarction / etiology. Prosthesis Design. Registries. Risk Assessment. Risk Factors. Severity of Illness Index. Thrombosis / etiology. Time Factors. Treatment Outcome

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  • [CommentIn] EuroIntervention. 2011 Feb;6(7):904-5 [21252030.001]
  • (PMID = 20542775.001).
  • [ISSN] 1969-6213
  • [Journal-full-title] EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
  • [ISO-abbreviation] EuroIntervention
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Cardiovascular Agents; P88XT4IS4D / Paclitaxel
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10. Batyraliev TA, Fetser DV, Preobrazhenskiĭ DV, Pershukov IV, Sidorenko BA: [Percutaneous coronary interventions on unprotected left main coronary artery: contemporary outlook of the problem]. Kardiologiia; 2009;49(5):81-92
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  • [Title] [Percutaneous coronary interventions on unprotected left main coronary artery: contemporary outlook of the problem].
  • Coronary bypass surgery in patients with lesions in unprotected left main coronary artery (LMCA) remains gold standard of treatment.
  • Is PCI of LMCA justified, what is complication rate of PCI of LMCA?
  • In order to answer these questions we analyzed modern studies in which PCI with the use of standard metal and drug eluting stents were carried out in patients with lesions in unprotected LMCA.
  • [MeSH-major] Angioplasty, Balloon, Coronary / methods. Coronary Disease / therapy
  • [MeSH-minor] Humans. Treatment Outcome

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  • (PMID = 19463146.001).
  • [ISSN] 0022-9040
  • [Journal-full-title] Kardiologiia
  • [ISO-abbreviation] Kardiologiia
  • [Language] rus
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Russia (Federation)
  • [Number-of-references] 39
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11. Kim HS, Kim YH, Lee SW, Park DW, Lee CW, Hong MK, Kim JJ, Park SW, Park SJ: Safety and effectiveness of sirolimus-eluting stent implantation for in-stent restenosis of the unprotected left main coronary artery. Int J Cardiol; 2008 Feb 20;124(1):118-20
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  • [Title] Safety and effectiveness of sirolimus-eluting stent implantation for in-stent restenosis of the unprotected left main coronary artery.
  • The present study examined the alternative treatment of sirolimus-eluting stent (SES) implantation for in-stent restenosis (ISR) of the unprotected left main coronary artery (LMCA).
  • Twelve patients underwent SES deployment for bare-metal ISR in the LMCA.
  • ISR were 24+/-11 mm in length and located at the ostial (n=1) and distal (n=11) portion of LMCA.
  • Bifurcation lesions were treated with one of three techniques: the stent crossing the left circumflex artery (n=7), kissing stenting (n=2) or the Crush technique (n=2).
  • Periprocedural CK-MB elevation > or = 3 times normal occurred in 2 patients.
  • There were no cases of significant narrowing in the left circumflex artery after the procedure.
  • The present study suggests that SES implantation may be a feasible therapeutic option for treating ISR in unprotected LMCA.
  • [MeSH-major] Coronary Restenosis / therapy. Drug-Eluting Stents. Graft Occlusion, Vascular / therapy. Immunosuppressive Agents / administration & dosage. Sirolimus / administration & dosage
  • [MeSH-minor] Coronary Angiography. Female. Humans. Male. Middle Aged. Safety. Treatment Outcome. Ultrasonography, Interventional

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  • (PMID = 17383034.001).
  • [ISSN] 1874-1754
  • [Journal-full-title] International journal of cardiology
  • [ISO-abbreviation] Int. J. Cardiol.
  • [Language] eng
  • [Publication-type] Letter; Research Support, Non-U.S. Gov't
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Immunosuppressive Agents; W36ZG6FT64 / Sirolimus
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12. Park SJ: Is stenting a preferred option for unprotected left main coronary artery disease in the drug-eluting stent era? Indian Heart J; 2007 Mar-Apr;59(2 Suppl B):B105-12

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Is stenting a preferred option for unprotected left main coronary artery disease in the drug-eluting stent era?
  • Coronary artery bypass graft (CABG) has been the established treatment for left main coronary artery (LMCA) disease.
  • LMCA disease has been considered to be a challenge for interventional cardiologist for more than 25 years.
  • The early experience with drug-eluting stent (DES) in unprotected LMCA reveals reduced rates of restenosis and associated clinical outcomes when compared with patients who were treated with BMS.
  • Moreover, recent non-randomized study demonstrated that no differences in either mortality or the combined occurrence of major adverse cardiovascular and cerebrovascular events were observed at the 1-year follow-up between DES and CABG.
  • However, up to now, effectiveness of DES is not enough to replace CABG in LMCA revascularization.
  • The ongoing randomized trial comparing DES vs. CABG (PRE-COMBAT and SYNTAX) may help to address this issue.
  • Based on these trials, it is likely that, for selected patients, DES may be regarded as a preferred revascularization strategy for LMCA disease.
  • [MeSH-major] Angioplasty, Balloon, Coronary. Coronary Disease / therapy. Coronary Restenosis / prevention & control. Drug-Eluting Stents
  • [MeSH-minor] Coronary Artery Bypass. Hospital Mortality. Humans. Randomized Controlled Trials as Topic

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  • (PMID = 19153426.001).
  • [ISSN] 0019-4832
  • [Journal-full-title] Indian heart journal
  • [ISO-abbreviation] Indian Heart J
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] India
  • [Number-of-references] 39
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13. Murasato Y: Impact of three-dimensional characteristics of the left main coronary artery bifurcation on outcome of crush stenting. Catheter Cardiovasc Interv; 2007 Feb 1;69(2):248-56

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Impact of three-dimensional characteristics of the left main coronary artery bifurcation on outcome of crush stenting.
  • BACKGROUND: Crush stenting with drug-eluting stents is used to treat left main coronary artery (LMCA) bifurcations.
  • However, the rate of restenosis at the left circumflex (LCX) artery ostium is high.
  • The impact of the three-dimensional (3D) structure of LMCA bifurcation on the outcome of crush stenting with respect to restenosis has not been described.
  • OBJECTIVES: This study examined the stent expansion, deformity, overlapping, and apposition after crush stenting of LMCA bifurcations.
  • METHODS: Bare metal stents were crushed at LMCA bifurcations in a 3D model that reproduced actual angles, such that the stent deployed from the LMCA to the left anterior descending (LAD) artery crushed the stent deployed from the LMCA to the LCX, followed by kissing balloon inflation.
  • RESULTS: In the 3D model, one stent overlapped the other in the distal LMCA, in contrast to the nearly parallel position of the stents observed in a separate two-dimensional model.
  • A narrow LMCA-LCX angle was associated with less expansion of the LCX stent at the ostium than more distally, and with a higher likelihood of incomplete stent apposition.
  • CONCLUSIONS: Overlap of the LAD stent over, as opposed to under, the LCX stent was associated with close apposition of the stent to the vessel on the myocardial side, at the ostium of the LCX artery, where atherosclerotic plaques are likely to be present.
  • The spatial plaque burden and bifurcation angle should be closely examined before crush stenting, and segments should not be left unstented over large plaques.
  • [MeSH-major] Blood Vessel Prosthesis Implantation / methods. Coronary Stenosis / therapy. Stents
  • [MeSH-minor] Humans. Prosthesis Design. Treatment Outcome

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  • [Copyright] (c) 2006 Wiley-Liss, Inc.
  • (PMID = 17211894.001).
  • [ISSN] 1522-1946
  • [Journal-full-title] Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
  • [ISO-abbreviation] Catheter Cardiovasc Interv
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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14. Topaz O, Polkampally PR, Mohanty PK, Rizk M, Bangs J, Bernardo NL: Excimer laser debulking for percutaneous coronary intervention in left main coronary artery disease. Lasers Med Sci; 2009 Nov;24(6):955-60
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Excimer laser debulking for percutaneous coronary intervention in left main coronary artery disease.
  • Excimer laser has been successfully applied to complex atherosclerotic plaques in acute coronary syndromes; however, its role in debulking in left main coronary artery disease has not been fully explored.
  • Details of a series of 20 patients who underwent excimer laser revascularization of a spectrum of left main coronary artery lesions are presented.
  • The left main coronary artery was characterized as protected, semi-protected, poorly protected, or unprotected, depending on the presence or absence of patent bypass grafts to the left anterior descending (LAD) and circumflex (CX) arteries.
  • A fully protected left main coronary artery (LMCA) was present in only 20% of the patients.
  • The target lesions included 11(55%) distal LMCA stenoses, six (30%) ostial stenoses, and one (5%) mid-portion lesions.
  • Two (10%) patients had in-stent re-stenosis of the entire length of the LMCA.
  • Successful LMCA intervention was performed in 19 (95%) patients, while in-hospital complications occurred in only one (5%) patient.
  • Subacute/late stent thrombosis developed 3 months after the procedure in one patient, and two patients died from non-cardiac causes during follow-up.
  • Lesions in LMCAs can be revascularized in selected patients by laser debulking and adjunct stenting.
  • Inadequate protection by bypass grafts and decreased left ventricular function do not contradict utilization of excimer laser.
  • Small laser catheters and high energy levels are required during laser debulking of stenoses of left main coronary arteries.
  • [MeSH-major] Angioplasty, Balloon, Laser-Assisted / methods. Coronary Artery Disease / therapy. Lasers, Excimer / therapeutic use
  • [MeSH-minor] Aged. Aged, 80 and over. Angioplasty, Balloon, Coronary / methods. Coronary Angiography. Drug-Eluting Stents. Female. Humans. Male. Middle Aged. Retrospective Studies. Stents. Thrombolytic Therapy

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  • (PMID = 19238505.001).
  • [ISSN] 1435-604X
  • [Journal-full-title] Lasers in medical science
  • [ISO-abbreviation] Lasers Med Sci
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] England
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15. Martínez-Ríos MA, Méndez-Ortíz A, Gaspar J, Barragán-García R, Fernández-de-la-Reguera G, González-Quesada CJ: Left main coronary artery stenosis treatment with two paclitaxel-eluting stents in a patient with cardiac allograft vasculopathy. Arch Cardiol Mex; 2008 Oct-Dec;78(4):407-12
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Left main coronary artery stenosis treatment with two paclitaxel-eluting stents in a patient with cardiac allograft vasculopathy.
  • Cardiac transplantation is a well defined therapy for end stage heart failure.
  • After the first year of transplantation, allograft coronary artery disease (ACAD) is the second main cause of death.
  • Once ACAD has been established, treatments such as coronary angioplasty, coronary stenting, and coronary bypass are performed.
  • We present a case of successful stenting of the left main coronary artery (LMCA) in a patient with ACAD.
  • Coronary angiogram showed a severe stenosis in the proximal segment of the LMCA; we performed stenting with a paclitaxel-eluting stent (PES).
  • Six months after the procedure, the patient had an elective angiogram, where we discovered a new severe occlusion distally to the former stent; a second PES was implanted.
  • Our report suggests the efficacy of PES as ACAD treatment of the unprotected LMCA.
  • [MeSH-major] Antineoplastic Agents, Phytogenic / administration & dosage. Coronary Stenosis / therapy. Drug-Eluting Stents. Heart Transplantation / adverse effects. Paclitaxel / administration & dosage
  • [MeSH-minor] Coronary Restenosis / therapy. Humans. Male. Middle Aged

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  • (PMID = 19205549.001).
  • [ISSN] 1405-9940
  • [Journal-full-title] Archivos de cardiología de México
  • [ISO-abbreviation] Arch Cardiol Mex
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Mexico
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Phytogenic; P88XT4IS4D / Paclitaxel
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16. Chieffo A, Morici N, Maisano F, Bonizzoni E, Cosgrave J, Montorfano M, Airoldi F, Carlino M, Michev I, Melzi G, Sangiorgi G, Alfieri O, Colombo A: Percutaneous treatment with drug-eluting stent implantation versus bypass surgery for unprotected left main stenosis: a single-center experience. Circulation; 2006 May 30;113(21):2542-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Percutaneous treatment with drug-eluting stent implantation versus bypass surgery for unprotected left main stenosis: a single-center experience.
  • BACKGROUND: Improvements in results with percutaneous coronary intervention (PCI) with drug-eluting stents (DES) may extend their use in patients with left main coronary artery (LMCA) stenosis.
  • METHODS AND RESULTS: Two hundred forty-nine patients with LMCA stenosis were treated with PCI and DES implantation (n=107) or coronary artery bypass grafting (CABG) (n=142), in a single center, between March 2002 and July 2004.
  • At 1 year, there was no statistical difference in the occurrence of death in PCI versus CABG both for the unadjusted (OR=0.291; 95% CI=0.054 to 1.085; P=0.0710) and adjusted analyses (OR=0.331; 95% CI=0.055 to 1.404; P=0.1673).
  • CONCLUSIONS: At 1 year, in this single-center, retrospective experience, there was no difference in the degree of protection against death, stroke, myocardial infarction, and revascularization between PCI with DES and CABG for LMCA disease.
  • [MeSH-major] Angioplasty, Balloon, Coronary. Coronary Artery Bypass. Coronary Stenosis / therapy. Stents

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  • [CommentIn] Circulation. 2006 Nov 7;114(19):e573; author reply e575 [17088469.001]
  • [CommentIn] Circulation. 2006 Nov 7;114(19):e574; author reply e575 [17088470.001]
  • [CommentIn] Circulation. 2006 May 30;113(21):2480-4 [16735688.001]
  • (PMID = 16717151.001).
  • [ISSN] 1524-4539
  • [Journal-full-title] Circulation
  • [ISO-abbreviation] Circulation
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Pharmaceutical Preparations
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17. Park DW, Kim YH, Yun SC, Lee JY, Kim WJ, Kang SJ, Lee SW, Lee CW, Kim JJ, Choo SJ, Chung CH, Lee JW, Park SW, Park SJ: Long-term outcomes after stenting versus coronary artery bypass grafting for unprotected left main coronary artery disease: 10-year results of bare-metal stents and 5-year results of drug-eluting stents from the ASAN-MAIN (ASAN Medical Center-Left MAIN Revascularization) Registry. J Am Coll Cardiol; 2010 Oct 19;56(17):1366-75
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Long-term outcomes after stenting versus coronary artery bypass grafting for unprotected left main coronary artery disease: 10-year results of bare-metal stents and 5-year results of drug-eluting stents from the ASAN-MAIN (ASAN Medical Center-Left MAIN Revascularization) Registry.
  • OBJECTIVES: This study sought to evaluate the long-term safety and effectiveness of percutaneous coronary intervention (PCI), as compared with coronary artery bypass grafting (CABG), for unprotected left main coronary artery (LMCA) disease.
  • BACKGROUND: Data on the long-term (beyond 5-year) comparative results of treatment of unprotected LMCA disease with stent implantation or CABG are limited.
  • METHODS: We performed a 10-year clinical follow-up of 350 patients with unprotected LMCA disease who underwent PCI with bare-metal stents (BMS) (n = 100) or CABG (n = 250) from January 1995 to April 1999, and 5-year clinical follow-up of 395 patients with unprotected LMCA disease who underwent PCI with drug-eluting stents (DES) (n = 176) or CABG (n = 219) from January 2003 to May 2004.
  • In the 5-year follow-up cohort of DES and concurrent CABG, there was no significant difference in the adjusted risk of death (HR: 0.83; 95% CI: 0.34 to 2.07; p = 0.70) or the risk of the composite outcome (HR: 0.91; 95% CI: 0.45 to 1.83; p = 0.79).
  • The rates of TVR were also higher in the DES group than the CABG group (HR: 6.22; 95% CI: 2.26 to 17.14; p < 0.001).
  • CONCLUSIONS: For the treatment of unprotected LMCA disease, PCI with stent implantation showed similar long-term mortality and rates of death, Q-wave MI, or stroke.
  • However, stenting, even with DES, was associated with higher rates of repeat revascularization than was CABG.
  • [MeSH-major] Coronary Artery Bypass. Coronary Artery Disease / therapy. Stents
  • [MeSH-minor] Coronary Disease / therapy. Drug-Eluting Stents / adverse effects. Female. Follow-Up Studies. Humans. Male. Middle Aged. Myocardial Infarction / mortality. Survival Rate. Treatment Outcome

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  • [Copyright] Copyright © 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
  • (PMID = 20946993.001).
  • [ISSN] 1558-3597
  • [Journal-full-title] Journal of the American College of Cardiology
  • [ISO-abbreviation] J. Am. Coll. Cardiol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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18. Tyczyński P, Witkowski A, Chojnowska L, Litwiński P, Dabrowski M, Ryzyłło W: [Angioplasty of the unprotected left main coronary artery stenosis with standby cardiopulmonary support--a case report]. Kardiol Pol; 2007 Mar;65(3):286-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Angioplasty of the unprotected left main coronary artery stenosis with standby cardiopulmonary support--a case report].
  • Stenosis of the unprotected left main coronary artery (LMCA) is a classical indication for coronary artery bypass graft surgery (CABG).
  • Percutaneous coronary intervention (PCI) of LMCA may be an alternative to surgical treatment if atherosclerosis of distal segments is very advanced.
  • The ongoing Syntax trial will clarify whether angioplasty of LMCA with drug-eluting stents can be equivalent to CABG.
  • We present a case of a patient with occluded right coronary artery, severe stenoses of the LMCA, left anterior descending artery and left circumflex artery, and poor left ventricular ejection fraction in whom PCI for stenosis of unprotected LMCA with standby cardiopulmonary support was performed.
  • [MeSH-major] Angioplasty, Balloon, Coronary. Cardiopulmonary Bypass. Coronary Artery Bypass. Coronary Artery Disease / therapy. Coronary Stenosis / therapy
  • [MeSH-minor] Coronary Angiography. Humans. Male. Middle Aged. Treatment Outcome

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  • (PMID = 17436158.001).
  • [ISSN] 0022-9032
  • [Journal-full-title] Kardiologia polska
  • [ISO-abbreviation] Kardiol Pol
  • [Language] pol
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Poland
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19. Safley AM, Sebastian S, Collins TS, Tirado CA, Stenzel TT, Gong JZ, Goodman BK: Molecular and cytogenetic characterization of a novel translocation t(4;22) involving the breakpoint cluster region and platelet-derived growth factor receptor-alpha genes in a patient with atypical chronic myeloid leukemia. Genes Chromosomes Cancer; 2004 May;40(1):44-50
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  • [Title] Molecular and cytogenetic characterization of a novel translocation t(4;22) involving the breakpoint cluster region and platelet-derived growth factor receptor-alpha genes in a patient with atypical chronic myeloid leukemia.
  • We report a case of BCR-ABL-negative atypical chronic myeloid leukemia (CML) with translocation t(4;22) (q12;q11.2) juxtaposing the breakpoint cluster region (BCR) and platelet-derived growth factor receptor-alpha (PDGFRA) genes.
  • The patient was a 57-year-old man with a history of stage IV diffuse large B-cell lymphoma, status post-6 cycles of combination chemotherapy in 1999, who presented in August 2002 with enlarged lymph nodes, anemia, and marked leukocytosis (50 x 10(9) g/dL) consistent with a myeloproliferative disorder (MPD).
  • A bone marrow biopsy showed granulocytic hyperplasia, neutrophilia, and mild eosinophilia.
  • Initial cytogenetic evaluation by interphase FISH for BCR-ABL, to rule out a translocation 9;22, showed a variant signal pattern consistent with rearrangement of BCR at 22q11.2, but not ABL at 9q34.
  • Analysis of the patient's cDNA by polymerase chain reaction (PCR) for BCR-ABL was negative.
  • PCR amplification and subsequent sequence analysis demonstrated an in-frame 5'-BCR/3'-PDGFRA fusion in the patient's cDNA.
  • However, although the incidence of MPD involving translocations of PDGFRB has been well established, to our knowledge there are only two previous reports describing a BCR-PDGFRA fusion gene, in 3 patients diagnosed with atypical CML.
  • Here, we report the molecular and cytogenetic characterization of a patient with BCR-PDGFRA-positive MPD who had a complete hematologic response after treatment with imatinib mesylate.
  • [MeSH-major] Chromosome Breakage / genetics. Chromosomes, Human, Pair 22 / genetics. Chromosomes, Human, Pair 4 / genetics. Cytogenetic Analysis / methods. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / genetics. Protein-Tyrosine Kinases. Receptor, Platelet-Derived Growth Factor alpha / genetics. Translocation, Genetic / genetics
  • [MeSH-minor] Humans. Male. Middle Aged. Myeloproliferative Disorders / genetics. Oncogene Proteins, Fusion / genetics. Proto-Oncogene Proteins / genetics. Proto-Oncogene Proteins c-bcr. Reading Frames / genetics

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  • [Copyright] Copyright 2004 Wiley-Liss, Inc.
  • (PMID = 15034867.001).
  • [ISSN] 1045-2257
  • [Journal-full-title] Genes, chromosomes & cancer
  • [ISO-abbreviation] Genes Chromosomes Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Oncogene Proteins, Fusion; 0 / Proto-Oncogene Proteins; EC 2.7.10.1 / Protein-Tyrosine Kinases; EC 2.7.10.1 / Receptor, Platelet-Derived Growth Factor alpha; EC 2.7.11.1 / BCR protein, human; EC 2.7.11.1 / Proto-Oncogene Proteins c-bcr
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20. Khattab AA, Hamm CW, Senges J, Toelg R, Geist V, Bonzel T, Kelm M, Levenson B, Neumann FJ, Nienaber CA, Pfannebecker T, Sabin G, Schneider S, Tebbe U, Richardt G, German Cypher Registry: Sirolimus-eluting stent treatment for unprotected versus protected left main coronary artery disease in widespread clinical routine: 6-month and 3-year clinical follow-up results from the prospective multicentre German Cypher Registry. Heart; 2007 Oct;93(10):1251-5
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  • [Title] Sirolimus-eluting stent treatment for unprotected versus protected left main coronary artery disease in widespread clinical routine: 6-month and 3-year clinical follow-up results from the prospective multicentre German Cypher Registry.
  • BACKGROUND: Percutaneous coronary intervention (PCI) of left main coronary artery (LMCA) disease in the bare stent era was limited by high restenosis rates which eventually resulted in sudden death in unprotected cases.
  • Clinical and angiographic restenosis has been substantially reduced by drug-eluting stents, reviving therefore this indication for PCI despite the absence of direct comparative studies with coronary artery bypass graft surgery.
  • OBJECTIVE: To assess the acute, mid- and long-term outcomes of patients treated with sirolimus-eluting stents for unprotected LMCA stenoses and to compare them with those treated for protected LMCA disease in the same time period from the German Cypher Registry.
  • Eighty-two patients treated for unprotected LMCA disease were compared with 118 patients treated for protected LMCA stenoses.
  • RESULTS: One-third of the patients in both groups were treated for the distal left main bifurcation.
  • The cumulative combined incidence of all-cause death, non-fatal MI and target vessel revascularisation at 6 months was 14.1% in the unprotected LMCA group and 13.1% in the protected group (hazard ratio = 0.81 (95% CI 0.37 to 1.74), p = 0.8).
  • CONCLUSION: Sirolimus-eluting stent treatment of unprotected and protected LMCA stenoses is technically feasible in widespread routine clinical use.
  • Acceptable long-term clinical results can be achieved, with no particular safety concerns about treatment of unprotected LMCA disease.
  • [MeSH-major] Angioplasty, Balloon, Coronary / methods. Coronary Stenosis / therapy. Sirolimus / administration & dosage. Stents. Tubulin Modulators / administration & dosage
  • [MeSH-minor] Aged. Disease-Free Survival. Drug Implants. Female. Follow-Up Studies. Humans. Male. Prospective Studies. Registries. Treatment Outcome

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  • (PMID = 17890701.001).
  • [ISSN] 1468-201X
  • [Journal-full-title] Heart (British Cardiac Society)
  • [ISO-abbreviation] Heart
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Drug Implants; 0 / Tubulin Modulators; W36ZG6FT64 / Sirolimus
  • [Other-IDs] NLM/ PMC2000930
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21. Van Mieghem CA, Cademartiri F, Mollet NR, Malagutti P, Valgimigli M, Meijboom WB, Pugliese F, McFadden EP, Ligthart J, Runza G, Bruining N, Smits PC, Regar E, van der Giessen WJ, Sianos G, van Domburg R, de Jaegere P, Krestin GP, Serruys PW, de Feyter PJ: Multislice spiral computed tomography for the evaluation of stent patency after left main coronary artery stenting: a comparison with conventional coronary angiography and intravascular ultrasound. Circulation; 2006 Aug 15;114(7):645-53

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Multislice spiral computed tomography for the evaluation of stent patency after left main coronary artery stenting: a comparison with conventional coronary angiography and intravascular ultrasound.
  • BACKGROUND: Surveillance conventional coronary angiography (CCA) is recommended 2 to 6 months after stent-supported left main coronary artery (LMCA) percutaneous coronary intervention due to the unpredictable occurrence of in-stent restenosis (ISR), with its attendant risks.
  • Multislice computed tomography (MSCT) is a promising technique for noninvasive coronary evaluation.
  • We evaluated the diagnostic performance of high-resolution MSCT to detect ISR after stenting of the LMCA.
  • METHODS AND RESULTS: Seventy-four patients were prospectively identified from a consecutive patient population scheduled for follow-up CCA after LMCA stenting and underwent MSCT before CCA.
  • Overall, the accuracy of MSCT for detection of angiographic ISR was 93%.
  • The sensitivity, specificity, and positive and negative predictive values were 100%, 91%, 67%, and 100%, respectively.
  • When analysis was restricted to patients with stenting of the LMCA with or without extension into a single major side branch, accuracy was 98%.
  • When both branches of the LMCA bifurcation were stented, accuracy was 83%.
  • CONCLUSIONS: Current MSCT technology, in combination with optimal heart rate control, allows reliable noninvasive evaluation of selected patients after LMCA stenting.
  • MSCT is safe to exclude left main ISR and may therefore be an acceptable first-line alternative to CCA.
  • [MeSH-major] Coronary Angiography / methods. Coronary Restenosis / radiography. Myocardial Revascularization / methods. Stents. Tomography, Spiral Computed / methods
  • [MeSH-minor] Adrenergic beta-Antagonists / pharmacology. Aged. Coronary Artery Disease / physiopathology. Coronary Artery Disease / therapy. Coronary Vessels / physiopathology. Coronary Vessels / ultrasonography. Female. Heart Rate / drug effects. Heart Rate / physiology. Humans. Male. Middle Aged. Predictive Value of Tests. Prospective Studies. Risk Factors. Sensitivity and Specificity. Ultrasonography, Interventional

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  • [CommentIn] Circulation. 2006 Aug 15;114(7):616-9 [16908783.001]
  • (PMID = 16894038.001).
  • [ISSN] 1524-4539
  • [Journal-full-title] Circulation
  • [ISO-abbreviation] Circulation
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Adrenergic beta-Antagonists
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22. Hasegawa T, Ako J, Koo BK, Miyazawa A, Sakurai R, Chang H, Dens J, Verheye S, Grube E, Honda Y, Fitzgerald PJ: Analysis of left main coronary artery bifurcation lesions treated with biolimus-eluting DEVAX AXXESS plus nitinol self-expanding stent: intravascular ultrasound results of the AXXENT trial. Catheter Cardiovasc Interv; 2009 Jan 1;73(1):34-41
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Analysis of left main coronary artery bifurcation lesions treated with biolimus-eluting DEVAX AXXESS plus nitinol self-expanding stent: intravascular ultrasound results of the AXXENT trial.
  • OBJECTIVE: To assess the efficacy of the AXXESS stent on the treatment of left main coronary artery (LMCA) bifurcation lesions using IVUS.
  • BACKGROUND: The treatment of LMCA bifurcation lesions remains challenging even with the use of drug-eluting stents.
  • The AXXESS system is a biolimus A9-eluting self-expanding stent, dedicated to the treatment of bifurcation lesions.
  • METHODS: Data were obtained from the AXXENT trial, a prospective, single-arm, multicenter study designed to evaluate the efficacy of the AXXESS stent on the treatment of LMCA bifurcation lesions.
  • Volumetric and cross-sectional analyses within the AXXESS stent, and cross-sectional analyses at the ostia of left anterior descending (LAD) and left circumflex coronary arteries (LCX) were performed.
  • RESULTS: Within the AXXESS stent, percent neointimal volume obstruction was (3.0 +/- 4.1)% with a minimal lumen area of 10.3 +/- 2.6 mm(2).
  • CONCLUSIONS: The AXXESS stent in the LMCA showed enlargement through 6-months follow-up and significant neointimal suppression.
  • [MeSH-major] Alloys. Angioplasty, Balloon, Coronary / instrumentation. Cardiovascular Agents / administration & dosage. Coronary Stenosis / therapy. Drug-Eluting Stents. Sirolimus / analogs & derivatives. Stents. Ultrasonography, Interventional
  • [MeSH-minor] Aged. Cell Proliferation. Coronary Angiography. Coronary Restenosis / etiology. Coronary Restenosis / prevention & control. Coronary Vessels / pathology. Europe. Female. Humans. Male. Middle Aged. Prospective Studies. Prosthesis Design. Time Factors. Treatment Outcome. Tunica Intima / pathology. United States

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  • [Copyright] (c) 2008 Wiley-Liss, Inc.
  • [CommentIn] Catheter Cardiovasc Interv. 2009 Jan 1;73(1):42-3 [19089935.001]
  • (PMID = 19089934.001).
  • [ISSN] 1522-726X
  • [Journal-full-title] Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
  • [ISO-abbreviation] Catheter Cardiovasc Interv
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Multicenter Study
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Alloys; 0 / Biolimus A9; 0 / Cardiovascular Agents; 52013-44-2 / nitinol; W36ZG6FT64 / Sirolimus
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23. Valgimigli M, Malagutti P, Rodriguez-Granillo GA, Garcia-Garcia HM, Polad J, Tsuchida K, Regar E, Van der Giessen WJ, de Jaegere P, De Feyter P, Serruys PW: Distal left main coronary disease is a major predictor of outcome in patients undergoing percutaneous intervention in the drug-eluting stent era: an integrated clinical and angiographic analysis based on the Rapamycin-Eluting Stent Evaluated At Rotterdam Cardiology Hospital (RESEARCH) and Taxus-Stent Evaluated At Rotterdam Cardiology Hospital (T-SEARCH) registries. J Am Coll Cardiol; 2006 Apr 18;47(8):1530-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Distal left main coronary disease is a major predictor of outcome in patients undergoing percutaneous intervention in the drug-eluting stent era: an integrated clinical and angiographic analysis based on the Rapamycin-Eluting Stent Evaluated At Rotterdam Cardiology Hospital (RESEARCH) and Taxus-Stent Evaluated At Rotterdam Cardiology Hospital (T-SEARCH) registries.
  • OBJECTIVES: This study sought to investigate whether the anatomical location of the disease carries prognostic implications in patients undergoing drug-eluting stent (DES) implantation for the left main coronary artery (LMCA) stenosis.
  • BACKGROUND: Liberal use of DES, compared with a bare metal stent (BMS), has resulted in an improved outcome in patients undergoing LMCA intervention.
  • METHODS: From April 2002 to June 2004, 130 patients received DES as part of the percutaneous intervention for LMCA stenoses in our institution.
  • Distal LMCA disease (DLMD) was present in 94 patients.
  • They were at higher surgical risk and presented with a greater coronary disease extent compared with patients without DLMD.
  • CONCLUSIONS: Distal LMCA disease carries independent prognostic implications, and it may help in selecting the most appropriate patient subset for LMCA intervention beyond the conventional surgical risk status in the DES era.
  • [MeSH-major] Angioplasty, Balloon, Coronary. Coronary Angiography. Coronary Disease / radiography. Coronary Disease / therapy. Paclitaxel / administration & dosage. Sirolimus / administration & dosage. Stents
  • [MeSH-minor] Aged. Female. Humans. Male. Middle Aged. Multivariate Analysis. Predictive Value of Tests. Treatment Outcome

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  • (PMID = 16630987.001).
  • [ISSN] 1558-3597
  • [Journal-full-title] Journal of the American College of Cardiology
  • [ISO-abbreviation] J. Am. Coll. Cardiol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] P88XT4IS4D / Paclitaxel; W36ZG6FT64 / Sirolimus
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24. Deng YB, Yang HY, Li CL, Chang Q: Angiotensin receptor antagonist losartan improves endothelial function of epicardial coronary arteries in patients with essential hypertension. Clin Cardiol; 2002 Sep;25(9):422-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Angiotensin receptor antagonist losartan improves endothelial function of epicardial coronary arteries in patients with essential hypertension.
  • BACKGROUND: Angiotensin II can impair endothelial function, which is mediated by the angiotensin II type 1 receptor subtype.
  • HYPOTHESIS: The study sought to determine whether treatment with the angiotensin II type 1 receptor antagonist losartan would restore the normal dilation of the left main coronary artery (LMCA) by cold pressor test in patients with essential hypertension, as shown by echocardiography.
  • Measurements of the cold pressor test-induced and nitroglycerin-induced changes in LMCA diameter by echocardiography were performed at the end of the washout period and after 12 weeks of losartan administration.
  • RESULTS: The percent change in LMCA diameter induced by the cold pressor test in hypertensive patients (-3.5 +/- 8.8%) was significantly lower than that in control subjects (10.2 +/- 3.7%, p<0.0001).
  • After losartan treatment, the percent change (13.9 +/- 8.4%) was significantly higher than that before losartan treatment (-3.5 +/- 8.8%, p < 0.0001), but not significandy different between the 17 hypertensive patients with satisfactory control of blood pressure (13.8 +/- 9.1%) and the 13 hypertensive patients without satisfactory control of blood pressure (14.0 +/- 7.7%, p = 0.9).
  • Losartan treatment in patients with essential hypertension did not modify the percent change in LMCA diameter caused by sublingual administration of nitroglycerin (23.2 +/- 14.0% vs. 27.3 +/- 13.7%, p = 0.2).
  • CONCLUSIONS: This study demonstrates that treatment with losartan normalized response of the LMCA to the cold pressor test in patients with mild to moderate essential hypertension and that this effect is not dependent on the reduction of blood pressure.
  • [MeSH-major] Angiotensin Receptor Antagonists. Antihypertensive Agents / therapeutic use. Coronary Vessels / physiopathology. Hypertension / drug therapy. Hypertension / physiopathology. Losartan / therapeutic use
  • [MeSH-minor] Adult. Blood Pressure. Case-Control Studies. Cold Temperature. Echocardiography. Female. Humans. Male. Middle Aged. Treatment Outcome

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  • (PMID = 12269521.001).
  • [ISSN] 0160-9289
  • [Journal-full-title] Clinical cardiology
  • [ISO-abbreviation] Clin Cardiol
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Angiotensin Receptor Antagonists; 0 / Antihypertensive Agents; JMS50MPO89 / Losartan
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25. Han Y, Wang S, Jing Q, Li Y, Liu H, Ma Y, Wang Z, Wang D, Luan B, Wang G, Chen T: Comparison of long-term efficacy of the paclitaxel-eluting stent versus the bare-metal stent for treatment of unprotected left main coronary artery disease. Am J Cardiol; 2009 Jan 15;103(2):194-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Comparison of long-term efficacy of the paclitaxel-eluting stent versus the bare-metal stent for treatment of unprotected left main coronary artery disease.
  • The use of paclitaxel-eluting stents (PES) for the treatment of unprotected left main coronary artery (LMCA) disease is controversial.
  • Between January 2003 and December 2006, a total of 287 patients undergoing percutaneous coronary intervention for LMCA lesions were consecutively registered.
  • PES recipients had distal left main bifurcation lesions more frequently compared with BMS recipients (72 vs 42%, p<0.01).
  • In conclusion, PES implantation provides a safe, effective therapy for unprotected LMCA disease and decreases the risk of major adverse cardiac events compared with BMS at a mean follow-up of 35 months.
  • [MeSH-major] Coronary Artery Disease / therapy. Drug-Eluting Stents. Paclitaxel / administration & dosage. Stents. Tubulin Modulators / administration & dosage
  • [MeSH-minor] China / epidemiology. Coronary Angiography. Female. Humans. Male. Middle Aged. Registries. Risk Factors. Treatment Outcome

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  • (PMID = 19121435.001).
  • [ISSN] 1879-1913
  • [Journal-full-title] The American journal of cardiology
  • [ISO-abbreviation] Am. J. Cardiol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Tubulin Modulators; P88XT4IS4D / Paclitaxel
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26. Tanigawa J, Sutaria N, Goktekin O, Di Mario C: Treatment of unprotected left main coronary artery stenosis in the drug-eluting stent era. J Interv Cardiol; 2005 Dec;18(6):455-65
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Treatment of unprotected left main coronary artery stenosis in the drug-eluting stent era.
  • Coronary angiography is often inadequate for estimating the severity of ambiguous left main coronary artery (LMCA) stenoses.
  • Our assessment of these lesions can be improved by the techniques of intravascular ultrasound and fractional flow reserve which provide indices of stenosis severity to enable the prediction of future events and planning of treatment.
  • For patients requiring LMCA revascularization, coronary artery bypass graft (CABG) surgery has been gold standard for decades.
  • LMCA stenosis remains one of the few serious challenges for the interventional cardiologists and, in the bare metal stent era, the long-term results were not sufficient to replace CABG surgery, mainly because of the high restenosis rate.
  • Drug-eluting stents (DES) have dramatically reduced the restenosis rate and early results in small series (approximately 300 patients in total) treated with DES in LMCA have been encouraging, especially for lesions at the ostium and in the left main shaft.
  • Before changes are made in the guidelines for treatment, we must wait for a refinement in the technique and stent design used for bifurcational left main lesion and the results of randomized, specific multicenter studies (SYNTAX trial).
  • It is likely that, for selected patients, LMCA stenosis will be regarded as an indication for PCI.
  • [MeSH-major] Blood Vessel Prosthesis Implantation. Coronary Stenosis / drug therapy. Drug Delivery Systems. Stents
  • [MeSH-minor] Angioplasty, Balloon, Coronary. Atherectomy, Coronary. Coronary Artery Bypass. Coronary Restenosis / prevention & control. Humans. Immunosuppressive Agents / administration & dosage. Sirolimus / administration & dosage

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  • [Copyright] (J Interven Cardiol 2005;18:455-465).
  • (PMID = 16336426.001).
  • [ISSN] 0896-4327
  • [Journal-full-title] Journal of interventional cardiology
  • [ISO-abbreviation] J Interv Cardiol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Immunosuppressive Agents; W36ZG6FT64 / Sirolimus
  • [Number-of-references] 60
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27. Rdzanek A, Pietrasik A, Kochman J, Wilczynska J, Opolski G: Acute coronary syndrome caused by left main coronary artery plaque rupture and thrombosis - resolution after pharmacological treatment. Int J Cardiol; 2007 May 2;117(3):e92-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Acute coronary syndrome caused by left main coronary artery plaque rupture and thrombosis - resolution after pharmacological treatment.
  • In coronary angiography a lesion in the left main coronary artery (LMCA) is found.
  • Intravascular ultrasound (IVUS) examination confirms the diagnosis of the ruptured plaque with the presence of thrombus.
  • Because of the well preserved lumen area a decision to continue intensive pharmacotherapy is made.
  • The article discusses different management strategies in patients with confirmed ruptured plaque in LMCA.
  • [MeSH-major] Angina, Unstable / drug therapy. Angina, Unstable / etiology. Coronary Artery Disease / complications. Myocardial Infarction / drug therapy. Myocardial Infarction / etiology. Thrombosis / complications
  • [MeSH-minor] Acute Disease. Aged. Humans. Male. Remission Induction. Rupture, Spontaneous. Syndrome

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  • (PMID = 17350118.001).
  • [ISSN] 1874-1754
  • [Journal-full-title] International journal of cardiology
  • [ISO-abbreviation] Int. J. Cardiol.
  • [Language] eng
  • [Publication-type] Case Reports; Letter
  • [Publication-country] Netherlands
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28. Cholteesupachai J, Udayachalerm W, Srimahachota S, Buddhari W, Chaipromprasit J, Songmuang SB, Suithichaiyakul T: In-hospital and mid-term outcomes of stent implantation in patients with protected and unprotected left main coronary artery disease; King Chulalongkorn Memorial Hospital experiences. J Med Assoc Thai; 2009 Jun;92(6):755-60
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] In-hospital and mid-term outcomes of stent implantation in patients with protected and unprotected left main coronary artery disease; King Chulalongkorn Memorial Hospital experiences.
  • BACKGROUND: Left Main Coronary Artery (LMCA) disease is now uniformly treated with coronary artery by pass grafting (CABG).
  • However some patients with LMCA disease did not receive CABG because of high operative risks as well as those who refused CABG Recent studies demonstrated the feasibility of stenting for LM stenosis, although data remain limited.
  • OBJECTIVE: To evaluate in-hospital and mid-term outcomes of using bare metal stent (BMS) and drug eluting stent (DES) in protected and unprotected left main coronary artery disease at King Chulalongkorn Memorial Hospital.
  • The authors reviewed the outcomes of patients who underwent percutaneous coronary intervention on left main coronary artery lesions in our hospital from July 2000 to August 2007.
  • RESULTS: In eight years the authors reviewed 64 consecutive protected and unprotected LMCA patients who underwent PCI with stent placement.
  • Altogether left main coronary artery stents were successfully deployed in all patients.
  • DES usage was 64%.
  • Bifurcation technique for distal left main coronary artery was executed in 32 patients (50%), included single stent in 62 (97%), two stents in 2(3%).
  • CONCLUSION: Stent Implantation was technically feasible and safely applied for the treatment ofprotected and unprotected left main coronary artery lesions in patients, with acceptable in-hospital and mid-term outcomes.
  • More randomized and controlled clinical trials are needed to confirm the long-term effects of stents for LMCA disease.
  • [MeSH-major] Coronary Artery Disease / therapy. Coronary Restenosis / prevention & control. Stents
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Coronary Angiography. Drug-Eluting Stents. Feasibility Studies. Female. Humans. Male. Middle Aged. Retrospective Studies. Time Factors. Treatment Outcome

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  • (PMID = 19530580.001).
  • [ISSN] 0125-2208
  • [Journal-full-title] Journal of the Medical Association of Thailand = Chotmaihet thangphaet
  • [ISO-abbreviation] J Med Assoc Thai
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Thailand
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29. Dubois C, Dens J, Sinnaeve P, Belmans A, Van Cleemput J, Mendez M, Piessens J, Desmet W: Results of percutaneous coronary intervention of the unprotected left main coronary artery in 143 patients and comparison of 30-day mortality to results of coronary artery bypass grafting. Am J Cardiol; 2008 Jan 1;101(1):75-81
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Results of percutaneous coronary intervention of the unprotected left main coronary artery in 143 patients and comparison of 30-day mortality to results of coronary artery bypass grafting.
  • Percutaneous coronary intervention (PCI) of the unprotected left main coronary artery (LMCA) is controversial.
  • In 143 patients who underwent PCI of the unprotected LMCA, 30-day mortality was compared with predicted cumulative risk-adjusted perioperative surgical mortality based on logistic European System for Cardiac Operative Risk Evaluation.
  • The overall major adverse cardiac event rate at 1 year was 34.3%, reflecting the high-risk profile of the patient population.
  • Angiographic follow-up in 90 of the 118 patients alive at 6 months showed binary restenosis of 6% in patients treated with drug-eluting stents versus 29% in patients receiving bare-metal stents (p < or =0.01).
  • In conclusion, PCI for unprotected LMCA disease was associated with acceptable short- and medium-term outcomes in patients at low to intermediate risk of bypass surgery.
  • However, in selected indications, PCI of the LMCA can offer an alternative to surgery, especially when using drug-eluting stents.
  • [MeSH-major] Angioplasty, Balloon, Coronary. Coronary Artery Bypass. Coronary Artery Disease / mortality. Coronary Artery Disease / therapy
  • [MeSH-minor] Acute Coronary Syndrome / therapy. Aged. Aged, 80 and over. Coronary Restenosis / epidemiology. Female. Humans. Male. Myocardial Infarction / epidemiology. Outcome Assessment (Health Care). Retreatment. Risk Adjustment. Sirolimus / administration & dosage. Sirolimus / analogs & derivatives. Stents

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  • (PMID = 18157969.001).
  • [ISSN] 0002-9149
  • [Journal-full-title] The American journal of cardiology
  • [ISO-abbreviation] Am. J. Cardiol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biolimus A9; W36ZG6FT64 / Sirolimus
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30. Park SJ, Park DW: Left main stenting: is it a different animal? EuroIntervention; 2010 Dec;6 Suppl J:J112-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Left main stenting: is it a different animal?
  • For several decades, coronary-artery bypass grafting (CABG) has been regarded as the treatment of choice for patients with unprotected left main coronary artery (LMCA) disease.
  • However, because of marked advancements in techniques of percutaneous coronary intervention (PCI) with stenting and CABG, as well as adjunctive pharmacologic therapy, a new evaluation and review of current indications for optimal revascularisation therapy for LMCA disease may be required to determine the standard of care for these patients.
  • The available current evidence suggests that the composite outcome of death, myocardial infarction and stroke is similar in patients with LMCA disease who are treated with PCI with stenting or CABG, the only difference was the rate of repeat revascularisation.
  • Although PCI can be performed successfully in most LMCA lesions, "high-risk" anatomic subsets, especially involving distal LMCA bifurcation lesions, continue to present unique technical challenges to interventional cardiologists, and, therefore, an integrated approach combing advanced devices, tailored techniques, adjunctive support of physiologic and morphologic evaluation, and adjunctive pharmacologic agents should be reinforced to improve clinical outcomes.
  • [MeSH-major] Angioplasty, Balloon, Coronary. Coronary Artery Disease / therapy. Stents
  • [MeSH-minor] Drug-Eluting Stents. Humans. Metals. Patient Selection. Prosthesis Design. Risk Assessment. Risk Factors. Treatment Outcome

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  • (PMID = 21930474.001).
  • [ISSN] 1969-6213
  • [Journal-full-title] EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
  • [ISO-abbreviation] EuroIntervention
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Metals
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31. Park SJ, Kim YH: Percutaneous coronary intervention for unprotected left main coronary artery stenosis. Cardiol Clin; 2010 Feb;28(1):81-95
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Percutaneous coronary intervention for unprotected left main coronary artery stenosis.
  • Because of the long-term benefit of coronary artery bypass graft (CABG) surgery in medical therapy, CABG has been the standard treatment of unprotected left main coronary artery (LMCA) stenosis.
  • However, with the advancement of techniques and equipment, the percutaneous interventional approach for implantation of coronary stents has been shown to be feasible for patients with unprotected LMCA stenosis.
  • The recent introduction of drug-eluting stents (DESs), together with advances in periprocedural and postprocedural adjunctive pharmacotherapies, has improved outcomes of percutaneous coronary interventions (PCIs) for these complex coronary lesions.
  • This review evaluates the current outcomes of PCI with DES in research conducted in several countries.
  • [MeSH-major] Angioplasty, Balloon, Coronary. Coronary Artery Disease / therapy. Coronary Stenosis / therapy
  • [MeSH-minor] Drug-Eluting Stents. Humans. Patient Selection. Prognosis

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  • (PMID = 19962051.001).
  • [ISSN] 1558-2264
  • [Journal-full-title] Cardiology clinics
  • [ISO-abbreviation] Cardiol Clin
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Netherlands
  • [Number-of-references] 69
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32. Wu XM, Liu CP, Lin WC, Kao HL: Long-term outcome of percutaneous coronary intervention for unprotected left main coronary artery disease. Int J Cardiol; 2010 Feb 4;138(3):272-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Long-term outcome of percutaneous coronary intervention for unprotected left main coronary artery disease.
  • OBJECTIVES: The aim of this study is to evaluate the in-hospital, 30 day and long-term outcomes after percutaneous coronary intervention for unprotected left main coronary artery disease.
  • BACKGROUNDS: Left main coronary artery (LMCA) diseases stenosis is a strong indication for coronary artery bypass grafting (CABG).
  • With improved device technology, percutaneous coronary intervention (PCI) with drug-eluting stent (DES) stents had been recently advocated as an alternative procedure for the unprotected LMCA disease.
  • METHODS: Between January 2003 and February 2007, all unprotected LMCA PCI procedures were retrospectively collected.
  • RESULTS: Fifty five consecutive patients with >50% diameter stenosis of LMCA undergoing PCI were analyzed.
  • 41 patients (75%) received DES implantation.
  • The majority of cases (n=33) were treated with a double-stent strategy.
  • The clinical follow-up time was 867+/-410 days (range 20-1715).
  • CONCLUSIONS: Our results showed that PCI with stenting was an acceptable treatment option for patients with LMCA stenosis.
  • Involvement of the LMCA bifurcation remains a predictor for unfavorable outcome.
  • [MeSH-major] Angioplasty, Balloon, Coronary / mortality. Coronary Artery Disease / mortality. Coronary Artery Disease / therapy. Drug-Eluting Stents / statistics & numerical data
  • [MeSH-minor] Aged. Coronary Restenosis / mortality. Databases, Factual. Female. Humans. Hyperlipidemias / mortality. Kaplan-Meier Estimate. Male. Middle Aged. Multivariate Analysis. Myocardial Infarction / mortality. Predictive Value of Tests. Prevalence. Retrospective Studies. Time Factors. Treatment Outcome

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  • [Copyright] Copyright 2008 Elsevier Ireland Ltd. All rights reserved.
  • [CommentIn] Int J Cardiol. 2010 Sep 24;144(1):90-1 [19157586.001]
  • (PMID = 18804295.001).
  • [ISSN] 1874-1754
  • [Journal-full-title] International journal of cardiology
  • [ISO-abbreviation] Int. J. Cardiol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Netherlands
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33. Vecchio S, Chechi T, Vittori G, Biondi Zoccai GG, Lilli A, Spaziani G, Giuliani G, Falchetti E, Margheri M: Outlook of drug-eluting stent implantation for unprotected left main disease: insights on long-term clinical predictors. J Invasive Cardiol; 2007 Sep;19(9):381-7
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  • [Title] Outlook of drug-eluting stent implantation for unprotected left main disease: insights on long-term clinical predictors.
  • BACKGROUND: Percutaneous coronary intervention (PCI) has been increasingly employed to treat unprotected left main coronary artery (LMCA) stenosis, with variable success.
  • This strategy has been applied to patients undergoing drug-eluting stent (DES) implantation for unprotected LMCA stenosis.
  • METHODS: From April 2003 to June 2006, 114 consecutive patients with de novo unprotected LMCA stenosis underwent PCI with DES, and were followed over a mean period of 17.1 +/- 9.1 months.
  • RESULTS: LMCA stenting was successfully performed in all patients.
  • In-hospital mortality was 3.5%, with no in-hospital non-fatal MI or emergency coronary artery bypass grafts.
  • All non-surviving patients were at high surgical risk (EuroSCORE > 6) and had a significantly higher EuroSCORE than surviving patients that patients with a EuroSCORE < or = 11 had significantly improved survival rates over those with a EuroSCORE > 11 (p < 0.0001).
  • Acute coronary syndromes, as clinical presentation, and non-ostial LMCA disease were also significantly more common within non-surviving patients (100% vs. 67%; p < 0.05, and 92.3% vs. 66.3%; p = 0.05, respectively).
  • CONCLUSIONS: Stenting of unprotected LMCA appears to be associated with a favorable mid-term outlook, especially in selected patients.
  • [MeSH-major] Angioplasty, Balloon, Coronary / mortality. Coronary Artery Disease / therapy. Coronary Restenosis / prevention & control. Immunosuppressive Agents / administration & dosage. Sirolimus / administration & dosage. Stents
  • [MeSH-minor] Aged. Aged, 80 and over. Antineoplastic Agents, Phytogenic / administration & dosage. Coronary Angiography. Drug Delivery Systems. Female. Follow-Up Studies. Humans. Male. Paclitaxel / administration & dosage. Predictive Value of Tests. Prognosis. Prospective Studies. Risk Factors. Survival Rate. Treatment Outcome

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  • [CommentIn] J Invasive Cardiol. 2007 Sep;19(9):388-9 [17827508.001]
  • (PMID = 17827507.001).
  • [ISSN] 1557-2501
  • [Journal-full-title] The Journal of invasive cardiology
  • [ISO-abbreviation] J Invasive Cardiol
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Phytogenic; 0 / Immunosuppressive Agents; P88XT4IS4D / Paclitaxel; W36ZG6FT64 / Sirolimus
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34. Parodi G, Maehara A, Giuliani G, Kubo T, Mintz GS, Migliorini A, Valenti R, Carrabba N, Antoniucci D: Optical coherence tomography in unprotected left main coronary artery stenting. EuroIntervention; 2010 May;6(1):94-9
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  • [Title] Optical coherence tomography in unprotected left main coronary artery stenting.
  • AIMS: Delayed or incomplete stent endothelisation and stent malapposition may predispose to DES thrombosis that can be a catastrophic event in the left main coronary artery (LMCA).
  • OCT can accurately identify stent struts and arterial tissue, but is limited by the need of vessel blood clearance and penetration; also no data exist on its use in LMCA.
  • We sought to verify whether optical coherence tomography (OCT) can accurately assess arterial wall response after drug eluting stent (DES) implantation in the LMCA.
  • METHODS AND RESULTS: OCT images were obtained in 15 patients (mean age 70.7 + or - 8.0 years) six months after LMCA DES implantation.
  • Acquisitions were performed without proximal balloon occlusion during isoosmolar contrast injection through a 6 Fr guiding catheter without side holes at a speed of 2-3 mL/sec.
  • Offline image analyses were performed to evaluate assessable stent area (all slices), strut coverage, apposition, and abnormal tissue responses for every three slices (= every 0.45 mm).
  • Out of 1,281 struts, 1,136 (88.7%) were well apposed and fully covered, 101 (7.8%) were uncovered; and 45 (3.5%) were malapposed although nine of the malapposed struts (20%) were covered by some tissue.
  • In five patients OCT detected abnormal intraluminal tissue, and in two cases this finding was related to uncovered struts.
  • CONCLUSIONS: OCT assessment of vascular response after LMCA DES implantation is safe and feasible.
  • Further development of OCT imaging technology will be necessary for complete evaluation of LMCA stents.
  • [MeSH-major] Angioplasty, Balloon, Coronary / instrumentation. Coronary Artery Disease / therapy. Coronary Vessels / pathology. Drug-Eluting Stents. Tomography, Optical Coherence
  • [MeSH-minor] Aged. Coronary Angiography. Feasibility Studies. Humans. Image Interpretation, Computer-Assisted. Middle Aged. Pilot Projects. Predictive Value of Tests. Thrombosis / etiology. Thrombosis / pathology. Time Factors. Treatment Outcome

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  • (PMID = 20542803.001).
  • [ISSN] 1969-6213
  • [Journal-full-title] EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
  • [ISO-abbreviation] EuroIntervention
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] France
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35. Koldehoff M, Beelen DW, Trenschel R, Steckel NK, Peceny R, Ditschkowski M, Ottinger H, Elmaagacli AH: Outcome of hematopoietic stem cell transplantation in patients with atypical chronic myeloid leukemia. Bone Marrow Transplant; 2004 Dec;34(12):1047-50
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  • [Title] Outcome of hematopoietic stem cell transplantation in patients with atypical chronic myeloid leukemia.
  • Atypical chronic myeloid leukemia (aCML) occurs rarely and is associated with a poor prognosis when treated with conventional chemotherapy.
  • We evaluated the outcome of aCML after allogeneic hematopoietic stem cell transplantation (HSCT).
  • One patient who was transplanted in advanced disease with bone marrow from his twin brother relapsed 19 months post transplant.
  • Analysis of the leukocyte chimerism of peripheral white blood cells and bone marrow buffy coat cells by VNTR-polymerase chain reaction (PCR) and single-nucleotide polymorphism real-time PCR revealed complete chimerism in all patients who had received an allogeneic transplant.
  • One patient suffering from cerebral toxoplasmosis died 9 months post transplant.
  • All other patients were alive at the time of analysis.
  • Our findings suggest that the outcome of allogeneic or syngeneic transplantation in patients with aCML may not be worse than the outcome of transplantation for BCR-ABL-positive CML.
  • [MeSH-major] Hematopoietic Stem Cell Transplantation / methods. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / therapy
  • [MeSH-minor] Adult. Female. Follow-Up Studies. Graft vs Host Disease. Humans. Male. Middle Aged. Opportunistic Infections. Remission Induction. Retrospective Studies. Tissue Donors. Transplantation Chimera. Transplantation, Homologous. Transplantation, Isogeneic. Treatment Outcome


36. Gotzmann M, Bojara W, Germing A, Mügge A, Laczkovics A, Thiessen C, Tannapfel A, Lindstaedt M: Differential diagnosis of non-atherosclerotic left main coronary artery stenosis. BMJ Case Rep; 2009;2009:bcr0820080776

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Differential diagnosis of non-atherosclerotic left main coronary artery stenosis.
  • A left main coronary artery (LMCA) stenosis without any atherosclerotic changes elsewhere in the coronary artery tree is a rare finding, and some uncommon reasons for luminal narrowing should be considered.
  • An unusual case of non-atherosclerotic LMCA stenosis is reported.A middle-aged patient presented with acute myocardial infarction.
  • An immediate coronary angiography was ordered and revealed a subtotal mid LMCA stenosis.
  • A drug-eluting stent was successfully implanted in the LMCA.Operative revascularisation was recommended.
  • Histopathological examination of the tumour revealed a poorly differentiated squamous cell carcinoma.Postoperatively, the patient was treated with chemotherapy (carboplatin and docetaxel).
  • Five years after the first admission to our hospital, the patient died as a result of ventricular fibrillation.The differential diagnosis of non-atherosclerotic LMCA stenoses is discussed.

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  • (PMID = 21687045.001).
  • [ISSN] 1757-790X
  • [Journal-full-title] BMJ case reports
  • [ISO-abbreviation] BMJ Case Rep
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC3027375
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37. Ng MK, Yeung AC: Left main coronary artery disease: is CABG still the gold standard? Rev Cardiovasc Med; 2005;6(4):187-93
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Left main coronary artery disease: is CABG still the gold standard?
  • Severe stenosis of the left main coronary artery (LMCA) is a coronary artery-disease manifestation of critical prognostic importance.
  • As a consequence of the survival advantage conferred by coronary artery bypass grafting (CABG) over medical therapy, lesions in the LMCA have been considered a standard indication for CABG for nearly 3 decades.
  • Initial attempts to treat LMCA disease percutaneously by balloon angioplasty resulted in poor clinical outcomes, leading many to regard significant LMCA disease as a contraindication for percutaneous coronary intervention (PCI).
  • However, the development and refinement of coronary stenting over the last 15 years, followed by the recent introduction of drug-eluting stents, has fueled renewed interest in percutaneous treatment of LMCA disease.
  • Outcomes of recent studies using sirolimus- and/or paclitaxel-eluting stents for treatment of LMCA disease have yielded rates of in-hospital and 1-year mortality that compare favorably with those of surgery.
  • This article will review the natural history of LMCA disease, the outcomes of CABG for LMCA disease, and the history and recent developments regarding PCI for LMCA disease.
  • [MeSH-major] Angioplasty, Balloon, Coronary. Coronary Artery Bypass. Coronary Artery Disease / therapy. Coronary Stenosis / therapy. Stents

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  • (PMID = 16379014.001).
  • [ISSN] 1530-6550
  • [Journal-full-title] Reviews in cardiovascular medicine
  • [ISO-abbreviation] Rev Cardiovasc Med
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 35
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38. Qarawani D, Menachem N, Ganem D, Hasin Y: Unprotected left main stenting, short- and long-term outcomes. Acute Card Care; 2010 Dec;12(4):124-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Unprotected left main stenting, short- and long-term outcomes.
  • BACKGROUND: Coronary bypass surgery is recommended for the treatment of left main coronary stenosis.
  • OBJECTIVES: To present the in-hospital and long-term clinical and angiographic outcome of a consecutive group of patients undergoing stenting for unprotected left main coronary artery (LMCA) disease, and to compare the clinical and angiographic outcomes of drug-eluting stent (DES) versus metal stent (BMS).
  • METHODS: 238 consecutive patients underwent unprotected LMCA stenting.
  • 165 received BMS and 73 received DES.
  • The overall angiographic LM restenosis rate show a trend toward lower rate in the DES group than the BMS group (9.6% versus 13.8%, P = 0.08).
  • There was no difference in one year mortality (4.1% versus 4.2%) and AMI (2.7% versus 2.8%) between DES and BMS.
  • Drug-eluting stent implantation for unprotected LMCA stenosis appears safe with regard to acute and long-term complications and is more effective in preventing restenosis compared to BMS implantation.
  • [MeSH-major] Acute Coronary Syndrome / therapy. Coronary Artery Disease / therapy. Drug-Eluting Stents
  • [MeSH-minor] Aged. Angioplasty, Balloon, Coronary / adverse effects. Angioplasty, Balloon, Coronary / contraindications. Coronary Artery Bypass / adverse effects. Coronary Artery Bypass / contraindications. Coronary Vessels / pathology. Coronary Vessels / surgery. Follow-Up Studies. Hospital Mortality. Humans. Long-Term Care. Middle Aged. Treatment Outcome

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  • (PMID = 21039084.001).
  • [ISSN] 1748-295X
  • [Journal-full-title] Acute cardiac care
  • [ISO-abbreviation] Acute Card Care
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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39. Lichtman MA, Rowe JM: The relationship of patient age to the pathobiology of the clonal myeloid diseases. Semin Oncol; 2004 Apr;31(2):185-97
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  • [Title] The relationship of patient age to the pathobiology of the clonal myeloid diseases.
  • The incidence of the major clonal myeloid diseases, clonal cytopenias, acute, subacute (oligoblastic), and chronic myelogenous leukemia, polycythemia vera, thrombocythemia, and idiopathic myelofibrosis increases in a log-linear manner from young adulthood through advanced age.
  • In older patients, diseases requiring cytotoxic treatment are more difficult and less successful to manage because comorbid conditions and poor performance status are more prevalent, decreasing the tolerance to therapy and increasing the frequency of side effects.
  • This age effect is highlighted by the dramatically less favorable outcome in older than younger patients with acute myeloid leukemia with similar "favorable" cytogenetic changes.
  • In addition, in acute and subacute myeloid leukemia in older patients, the disease is intrinsically more resistant to therapy.
  • Overexpression of drug resistance genes and unfavorable genetic mutations are more prevalent in older patients and provide evidence that acute myeloid leukemia is often qualitatively different in these patients.
  • Although improved drug schedules have led to significant improvements in event-free survival in younger patients, these improvements have been far less evident in older patients.
  • New approaches, especially the development of drugs aimed at new targets, will be required to obtain a high frequency of long-term remissions in older patients.
  • Agents that reverse inherent cellular drug resistance, farnesyltransferase inhibitors, BCL-2 inhibitors, and FLT3 inhibitors are early examples of such approaches.
  • [MeSH-major] Leukemia, Myeloid

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  • (PMID = 15112149.001).
  • [ISSN] 0093-7754
  • [Journal-full-title] Seminars in oncology
  • [ISO-abbreviation] Semin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 95
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40. Kim U, Park JS, Seol SH, Yang TH, Kim SM, Kim DK, Kim DI, Kim DS, Lee WJ, Lee SH, Hong GR, Shin DG, Kim YJ, Shim BS, Cho YK, Kim HS, Nam CW, Hur SH, Kim KB, Kim YN: Two-year outcomes of the sirolimus-eluting stent according to unprotected left main lesion. Clin Cardiol; 2009 Jun;32(6):332-6
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  • [Title] Two-year outcomes of the sirolimus-eluting stent according to unprotected left main lesion.
  • BACKGROUND: The data of long-term outcomes of sirolimus-eluting stent (SES) according to lesion location of unprotected left main coronary artery (LMCA) is scarce.
  • HYPOTHESIS: The purpose of this study was to evaluate the long-term outcomes after implantation of the SES in LMCA.
  • METHODS: A total of 84 patients (51 males) who had undergone SES implantation for the treatment of native LMCA stenosis were enrolled.
  • Although angiographic success and in-hospital MACE rates were similar in both groups with 1 cardiac death due to acute stent thrombosis in group 2, at 2-year follow-up, the MACE rate was significantly higher in group 2 than in group 1 at 2 years (22.2% vs 2.6%, respectively, P = 0.008).
  • CONCLUSIONS: Interventional treatment using SES in left main lesions showed favorable short-term and long-term outcomes in selected patients with lesion location being an important determinant of clinical and angiographic outcomes.
  • [MeSH-major] Angioplasty, Balloon, Coronary / instrumentation. Cardiovascular Agents / administration & dosage. Cardiovascular Diseases / prevention & control. Coronary Stenosis / therapy. Drug-Eluting Stents. Sirolimus / administration & dosage
  • [MeSH-minor] Aged. Coronary Angiography. Coronary Restenosis / etiology. Coronary Restenosis / prevention & control. Female. Humans. Kaplan-Meier Estimate. Male. Middle Aged. Myocardial Infarction / etiology. Myocardial Infarction / prevention & control. Thrombosis / etiology. Thrombosis / prevention & control. Time Factors. Treatment Outcome

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  • [Copyright] 2009 Wiley Periodicals, Inc.
  • (PMID = 19569064.001).
  • [ISSN] 1932-8737
  • [Journal-full-title] Clinical cardiology
  • [ISO-abbreviation] Clin Cardiol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Cardiovascular Agents; W36ZG6FT64 / Sirolimus
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41. Cortes J, Giles F, O'Brien S, Thomas D, Albitar M, Rios MB, Talpaz M, Garcia-Manero G, Faderl S, Letvak L, Salvado A, Kantarjian H: Results of imatinib mesylate therapy in patients with refractory or recurrent acute myeloid leukemia, high-risk myelodysplastic syndrome, and myeloproliferative disorders. Cancer; 2003 Jun 1;97(11):2760-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Results of imatinib mesylate therapy in patients with refractory or recurrent acute myeloid leukemia, high-risk myelodysplastic syndrome, and myeloproliferative disorders.
  • BACKGROUND: Imatinib mesylate is a selective tyrosine kinase inhibitor of c-abl, bcr/abl, c-kit, and platelet-derived growth factor-receptor (PDGF-R).
  • c-kit is expressed in most patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) and PDGF has been implicated in the pathogenesis of myeloproliferative disorders (MPD).
  • Forty-eight patients with AML (n = 10), MDS (n = 8), myelofibrosis (n = 18), atypical chronic myeloid leukemia (CML; n = 7), chronic myelomonocytic leukemia (CMML; n = 3), or polycythemia vera (n = 2) were treated with imatinib 400 mg daily.
  • One patient with atypical CML had erythroid hematologic improvement.
  • Both patients with polycythemia vera needed fewer phlebotomies (from 2-3 per year to none during the 8 months of therapy and from 3-6 per year to 1 during 9 months of therapy).
  • Treatment was well tolerated.
  • The side effects were similar to those observed in patients with CML.
  • CONCLUSIONS: Within these small subgroups of disease types, single-agent imatinib did not achieve a significant clinical response among patients with AML, MDS, atypical CML, or CMML without PDGF-R fusion genes.
  • Therefore, a combination treatment regimen including imatinib may be more effective.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Leukemia, Myeloid, Acute / drug therapy. Myelodysplastic Syndromes / drug therapy. Myeloproliferative Disorders / drug therapy. Piperazines / therapeutic use. Pyrimidines / therapeutic use
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Benzamides. Humans. Imatinib Mesylate. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Leukemia, Myelomonocytic, Chronic / drug therapy. Middle Aged. Polycythemia Vera / drug therapy. Primary Myelofibrosis / drug therapy. Recurrence


42. Barragan P, Fajadet J, Sheiban I, Serruys P, Colombo A, Seabra-Gomes R, Goy JJ, Cook S, Rubino P, Lefèvre T: Elective implantation of sirolimus-eluting stents for bifurcated and non-bifurcated unprotected left main coronary artery lesions: clinical outcomes at one year. EuroIntervention; 2008 Aug;4(2):262-70
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  • [Title] Elective implantation of sirolimus-eluting stents for bifurcated and non-bifurcated unprotected left main coronary artery lesions: clinical outcomes at one year.
  • AIMS: Recent studies of drug-eluting stents for unprotected left main coronary artery (LMCA) disease have been encouraging.
  • METHODS AND RESULTS: This retrospective study included 228 consecutive patients (mean age = 68 +/- 11 years, 80.6% men, 26.3% diabetics) who underwent implantation of SES for de novo LMCA stenoses.
  • The main objective of this study was to measure the rate of major adverse cardiac events (MACE), including death, myocardial infarction and target lesion revascularisation (TLR) at 12 months.
  • CONCLUSIONS: SES implants in high-risk patients with LMCA stenoses were associated with a low 1-year MACE rate.
  • [MeSH-major] Angioplasty, Balloon, Coronary. Coronary Artery Disease / therapy. Immunosuppressive Agents / administration & dosage. Sirolimus / administration & dosage
  • [MeSH-minor] Aged. Aged, 80 and over. Coronary Circulation. Coronary Vessels / pathology. Drug-Eluting Stents / statistics & numerical data. Female. Follow-Up Studies. Humans. Inpatients / statistics & numerical data. Male. Middle Aged. Outpatients / statistics & numerical data. Retrospective Studies. Treatment Outcome

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  • (PMID = 19110793.001).
  • [ISSN] 1774-024X
  • [Journal-full-title] EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
  • [ISO-abbreviation] EuroIntervention
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Immunosuppressive Agents; W36ZG6FT64 / Sirolimus
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43. Furuichi S, Sangiorgi GM, Palloshi A, Godino C, Airoldi F, Montorfano M, Chieffo A, Michev I, Carlino M, Colombo A: Drug-eluting stent implantation in coronary trifurcation lesions. J Invasive Cardiol; 2007 Apr;19(4):157-62

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Drug-eluting stent implantation in coronary trifurcation lesions.
  • BACKGROUND: There is no specific study evaluating the outcome of DES implantation in trifurcation lesions.
  • OBJECTIVE: To evaluate the mid-term clinical and angiographic outcome of drug-eluting stent (DES) implantation in trifurcation lesions.
  • RESULTS: A total of 15 consecutive patients undergoing percutaneous coronary intervention with DES in de novo trifurcation lesions were identified.
  • Lesions were located as follows: 13 (86.7%) at the distal left main coronary artery (LMCA) comprising the left anterior descending artery (LAD), the left circumflex artery (LCX) and an intermediate branch; 1 between the LAD, diagonal, and septal branches; and 1 between the LCX, obtuse marginal and posterior lateral branches.
  • TLR occurred in 3 patients (20%) with LMCA lesions.
  • CONCLUSION: Most trifurcation lesions were found in the distal LMCA.
  • DES implantation in trifurcation lesions can be performed with a low incidence of death, Q-wave MI or stent thrombosis.
  • [MeSH-major] Coronary Disease / therapy. Prosthesis Implantation / methods. Stents

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  • [CommentIn] J Invasive Cardiol. 2007 Jun;19(6):284; author reply 284-5 [17541134.001]
  • (PMID = 17404400.001).
  • [ISSN] 1557-2501
  • [Journal-full-title] The Journal of invasive cardiology
  • [ISO-abbreviation] J Invasive Cardiol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Immunosuppressive Agents
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44. Toms DR, Cannick L, Stuart RK, Jenrette JM, Terwiliger L: Helical tomotherapy for extramedullary hematopoiesis involving the pericardium in a patient with chronic myeloid leukemia. Jpn J Radiol; 2010 Jul;28(6):476-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Helical tomotherapy for extramedullary hematopoiesis involving the pericardium in a patient with chronic myeloid leukemia.
  • The phenomenon occurs in a number of disease states, notably in myelofibrosis, thalassemia, immune thrombocytopenic purpura, sickle cell anemia, polycythemia vera, and myelodysplastic syndrome.
  • Reported treatments include red blood cell transfusions, surgical excision, decompressive laminectomy in cases of cord compression, chemotherapy, and irradiation.
  • Radiation therapy is highly effective for treating hematopoietic tissue because such tissues are extremely radiosensitive.
  • Megavoltage helical tomotherapy is a technical advance in the delivery of radiation therapy, allowing more conformal and precise treatments.
  • The present case report describes a patient with the diagnosis of atypical chronic myeloid leukemia and myelofibrosis who subsequently developed EMH of the pericardium with effusion and tamponade.
  • The patient tolerated treatment well without acute adverse effects.
  • [MeSH-major] Heart Diseases / radiotherapy. Hematopoiesis, Extramedullary / radiation effects. Leukemia, Myeloid / complications. Pericardium / radiation effects. Tomography, Spiral Computed / methods

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  • (PMID = 20661700.001).
  • [ISSN] 1867-108X
  • [Journal-full-title] Japanese journal of radiology
  • [ISO-abbreviation] Jpn J Radiol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
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45. Yan Z, Yang B, Wang QS, Wang LL, Han XP, Ren F, Yu L: [Clinical pathological features of the 8p11 myeloproliferative syndrome]. Zhongguo Shi Yan Xue Ye Xue Za Zhi; 2010 Oct;18(5):1321-6
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  • This study was aimed to investigate the clinico-pathological features, diagnosis and treatment of the 8p11 (eight p11) myeloproliferative syndrome (EMS).
  • Karyotypes were determined by conventional cytogenetic method, and bcr/abl fusion gene was detected by reverse transcription-polymerase chain reaction (RT-PCR).
  • The results indicated that EMS was a relatively rare disease characterized by the occurrence of a bcr/abl-negative myeloproliferative disorder and a T-cell lymphoblastic lymphoma (T-LBL).
  • Bone marrow examination showed myeloid hyperplasia or myeloproliferative neoplasm, often accompanied by eosinophilia.
  • Flow cytometric immunophenotyping showed increased myelomonoblasts; cytogenetic analysis showed a translocation at the 8p11 locus; RT-PCR demonstrated non bcr/abl fusion gene.
  • At the molecular level, all cases carried a chromosomal abnormality involving the fibroblast growth factor receptor 1 (FGFR1) at chromosome 8p11.
  • The most common partner is ZNF198 on chromosome 13q11-12.
  • Majority of patients terminate in acute myeloid leukemia which is resistant to conventional chemotherapy.
  • In conclusion, EMS is myeloid and lymphoid neoplasm, associates with FGFR1 rearrangements.
  • It is usually misdiagnosed as T-LBL, atypical chronic myeloid leukemia (aCML) or chronic myelogenous-monocytic leukemia (CMML).

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  • (PMID = 21129285.001).
  • [ISSN] 1009-2137
  • [Journal-full-title] Zhongguo shi yan xue ye xue za zhi
  • [ISO-abbreviation] Zhongguo Shi Yan Xue Ye Xue Za Zhi
  • [Language] CHI
  • [Publication-type] Case Reports; English Abstract; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] China
  • [Chemical-registry-number] EC 2.7.10.1 / FGFR1 protein, human; EC 2.7.10.1 / Receptor, Fibroblast Growth Factor, Type 1
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46. Ma YH, Cheng WZ, Gong F, Ma AL, Yu QW, Zhang JY, Hu CY, Chen XH, Zhang DQ: Active Chinese mistletoe lectin-55 enhances colon cancer surveillance through regulating innate and adaptive immune responses. World J Gastroenterol; 2008 Sep 14;14(34):5274-81

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • AIM: To investigate the potential role of active Chinese mistletoe lectin-55 (ACML-55) in tumor immune surveillance.
  • The experimental treatment was orally administered with ACML-55 or PBS, followed by the inoculation of colon cancer cell line CT26.
  • RESULTS: Our results showed, compared to PBS treated mice, ACML-55 treatment significantly delayed colon cancer development in colon cancer-bearing Balb/c mice in vivo.
  • Treatment with ACML-55 enhanced both Ag specific activation and proliferation of CD4+ and CD8+ T cells, and increased the number of tumor Ag specific CD8+ T cells.
  • Interestingly, ACML-55 treatment also showed increased cell number of NK, and gammadeltaT cells, indicating the role of ACML-55 in activation of innate lymphocytes.
  • CONCLUSION: Our results demonstrate that ACML-55 therapy can enhance function in immune surveillance in colon cancer-bearing mice through regulating both innate and adaptive immune responses.
  • [MeSH-major] Antineoplastic Agents / pharmacology. Colonic Neoplasms / immunology. Colonic Neoplasms / prevention & control. Drugs, Chinese Herbal / pharmacology. Mistletoe. Plant Lectins / pharmacology
  • [MeSH-minor] Animals. CD4-Positive T-Lymphocytes / drug effects. CD4-Positive T-Lymphocytes / immunology. CD8-Positive T-Lymphocytes / drug effects. CD8-Positive T-Lymphocytes / immunology. Cell Line, Tumor. Disease Models, Animal. Female. Immunity, Innate / drug effects. Interferon-gamma / biosynthesis. Killer Cells, Natural / drug effects. Killer Cells, Natural / immunology. Lymphocyte Activation / drug effects. Male. Mice. Mice, Inbred BALB C. Monitoring, Immunologic. Phytotherapy

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  • (PMID = 18785279.001).
  • [ISSN] 2219-2840
  • [Journal-full-title] World journal of gastroenterology
  • [ISO-abbreviation] World J. Gastroenterol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Drugs, Chinese Herbal; 0 / Plant Lectins; 82115-62-6 / Interferon-gamma
  • [Other-IDs] NLM/ PMC2744057
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47. Huang KP, Chase AJ, Cross NC, Reiter A, Li TY, Wang TF, Chu SC, Lu XY, Li CC, Kao RH: Evolutional change of karyotype with t(8;9)(p22;p24) and HLA-DR immunophenotype in relapsed acute myeloid leukemia. Int J Hematol; 2008 Sep;88(2):197-201
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Evolutional change of karyotype with t(8;9)(p22;p24) and HLA-DR immunophenotype in relapsed acute myeloid leukemia.
  • Most of them are atypical chronic myeloid leukemia (CML) or other myeloproliferative disorders (MPD), and are predominantly in the male.
  • We report a female patient with acute myeloid leukemia (AML) initially presenting with normal karyotype and negative HLA-DR expression who achieved complete remission after standard chemotherapy.
  • The disease relapsed 7 months later with cytogenetic change of t(8;9)(p22;p24).
  • Flow cytometry analysis showed evolutional change of immunophenotype from negative to positive HLA-DR expression and fluorescence in situ hybridization (FISH) analysis demonstrated a PCM1-JAK2 fusion gene.
  • [MeSH-major] Autoantigens / genetics. Cell Cycle Proteins / genetics. HLA-DR Antigens / genetics. Janus Kinase 2 / genetics. Leukemia, Myeloid, Acute / genetics. Oncogene Proteins, Fusion / genetics. Translocation, Genetic
  • [MeSH-minor] Chromosome Aberrations. Chromosomes, Human, Pair 8. Chromosomes, Human, Pair 9. Fatal Outcome. Female. Flow Cytometry. Gene Expression Regulation, Leukemic. Humans. Immunophenotyping. Middle Aged. Recurrence

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  • (PMID = 18594780.001).
  • [ISSN] 0925-5710
  • [Journal-full-title] International journal of hematology
  • [ISO-abbreviation] Int. J. Hematol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Autoantigens; 0 / Cell Cycle Proteins; 0 / HLA-DR Antigens; 0 / Oncogene Proteins, Fusion; 0 / PCM1 protein, human; EC 2.7.10.2 / JAK2 protein, human; EC 2.7.10.2 / Janus Kinase 2
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48. Cortes J, Kantarjian H: Beyond chronic myelogenous leukemia: potential role for imatinib in Philadelphia-negative myeloproliferative disorders. Cancer; 2004 May 15;100(10):2064-78
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  • [Title] Beyond chronic myelogenous leukemia: potential role for imatinib in Philadelphia-negative myeloproliferative disorders.
  • The myeloproliferative disorders (MPDs) are chronic malignant conditions originating from the clonal expansion of a multipotential hematopoietic stem cell.
  • These diseases include polycythemia vera (PV), essential thrombocythenia, atypical chronic myeloid leukemia, idiopathic hypereosinophilic syndrome (HES), agnogenic myeloid metaplasia with myelofibrosis, and others.
  • For example, a constitutively activated PDGFR fusion tyrosine kinase (FIP1L1-PDGFRA) was identified in some patients with HES, a disease characterized by sustained overproduction of eosinophils that has been classified by the World Health Organization as a chronic subtype of the MPDs.
  • Imatinib is a selective inhibitor of PDGFRs, c-Kit, Abl and Arg protein-tyrosine kinases, as well as Bcr-Abl, the oncogenic tyrosine kinase that causes chronic myeloid leukemia.
  • The efficacy of imatinib in treating HES, systemic mast cell disease, chronic myelomonocytic leukemia associated with PDGFRbeta fusion genes, and (to a lesser extent) PV and idiopathic myelofibrosis was reviewed from institutional experience and a review of the literature.
  • Insight into the molecular pathogenesis of MPDs will improve the definitions of different disease categories and suggests that signal transduction inhibition is likely to be an increasingly important treatment option in the future.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative / drug therapy. Myeloproliferative Disorders / drug therapy. Philadelphia Chromosome. Piperazines / therapeutic use. Pyrimidines / therapeutic use
  • [MeSH-minor] Benzamides. Clinical Trials as Topic. Enzyme Inhibitors / therapeutic use. Humans. Imatinib Mesylate. Protein-Tyrosine Kinases / antagonists & inhibitors


49. Nassar H, Gotsman I, Gerganski P, Moseri M, Lotan C, Gotsman M: Cutting balloon angioplasty and stent implantation for aorto-ostial lesions: clinical outcome and 1-year follow-up. Clin Cardiol; 2009 Apr;32(4):183-6
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  • BACKGROUND: Percutaneous interventions for aorto-ostial narrowing of native coronary arteries are challenging because of early elastic recoil after the procedure and the high restenosis rate.
  • HYPOTHESIS: The purpose of the study was to evaluate the clinical outcomes of cutting balloon angioplasty and stent implantation for aorto-ostial lesions with a 1-year clinical follow-up.
  • RESULTS: Forty-eight patients underwent balloon angioplasty; 36 of whom had lesions in the ostial right coronary artery, and 12 of whom had lesions in the left main coronary artery (LMCA).
  • This technique should be compared with implantation of drug-eluting stents (DESs) in a controlled study.
  • [MeSH-major] Angioplasty, Balloon, Coronary. Coronary Artery Disease / therapy. Stents
  • [MeSH-minor] Aged. Cohort Studies. Female. Follow-Up Studies. Humans. Male. Retrospective Studies. Treatment Outcome

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  • (PMID = 19353700.001).
  • [ISSN] 0160-9289
  • [Journal-full-title] Clinical cardiology
  • [ISO-abbreviation] Clin Cardiol
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] United States
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50. Wittman B, Horan J, Baxter J, Goldberg J, Felgar R, Baylor E, Cromwell B, Cross N, Bennett JM: A 2-year-old with atypical CML with a t(5;12)(q33;p13) treated successfully with imatinib mesylate. Leuk Res; 2004 May;28 Suppl 1:S65-9
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  • [Title] A 2-year-old with atypical CML with a t(5;12)(q33;p13) treated successfully with imatinib mesylate.
  • Atypical chronic myelogenous leukemia (aCML) is a myelodysplastic/myeloproliferative disorder that usually occurs in older adults.
  • Here we report a pediatric patient with aCML and a t(5;12)(q33;p13) with a corresponding fusion gene ETV6-PDGFRB.
  • Because the PDGFRB tyrosine kinase is one of the known targets of tyrosine kinase inhibitors, this patient achieved cytogenetic and molecular remission with treatment with imatinib mesylate (formerly STI571; now Gleevec in the United States and Glivec in Europe).
  • [MeSH-major] Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / genetics. Piperazines / therapeutic use. Pyrimidines / therapeutic use

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  • (PMID = 15036944.001).
  • [ISSN] 0145-2126
  • [Journal-full-title] Leukemia research
  • [ISO-abbreviation] Leuk. Res.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Benzamides; 0 / ETV6-PDGFRB fusion protein, human; 0 / Oncogene Proteins, Fusion; 0 / Piperazines; 0 / Pyrimidines; 8A1O1M485B / Imatinib Mesylate
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51. Hu SS, Gao RL, Gao PX, Li LH, Xiong H, Xu B, Yang YJ, Yuan JQ, Zheng Z: [Efficacy of one-stop hybrid revascularization for treatment of unprotected left main coronary artery disease]. Zhonghua Xin Xue Guan Bing Za Zhi; 2010 Jan;38(1):23-6
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  • [Title] [Efficacy of one-stop hybrid revascularization for treatment of unprotected left main coronary artery disease].
  • OBJECTIVE: To evaluate the efficacy of one-stop hybrid coronary revascularization [simultaneous minimally invasive direct coronary artery bypass surgery (MIDCAB) and percutaneous coronary intervention (PCI) procedures performed in an enhanced (or called "hybrid") operative unit] for the treatment of unprotected left main coronary artery (ULMCA) disease.
  • Proximal lesions were evidenced in 5 patients and distal or bifurcation lesions in 11 patients.
  • MIDCAB procedure for grafting of the left intramammary artery (LIMA) with the left anterior descending (LAD) artery was first performed via lower partial ministernotomy on the beating heart, followed by PCI on the LMCA disease and non-LAD coronary lesions.
  • RESULTS: Operation was successful in all patients underwent the one-stop hybrid procedure.
  • A total of 25 non-LAD coronary lesions were treated by PCI and 29 stents (27 drug-eluting stents and 2 bare-mental stents) were implanted to 23 lesions and coronary angioplasty was performed in the remaining lesions.
  • There was no death, perioperative myocardial infarction, stroke or repeat revascularization during the procedure and the follow-up period.
  • LIMA grafts and stents were patent in 5 patients at 1-year follow-up.
  • CONCLUSIONS: Our initial experience demonstrates that one-stop hybrid coronary revascularization provides a reasonable, feasible and safe alternative for selected patients with LMCA diseases.
  • [MeSH-major] Coronary Artery Disease / therapy. Myocardial Revascularization / methods
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Angioplasty, Balloon, Coronary. Coronary Artery Bypass, Off-Pump. Female. Humans. Male. Middle Aged. Treatment Outcome

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  • (PMID = 20398483.001).
  • [ISSN] 0253-3758
  • [Journal-full-title] Zhonghua xin xue guan bing za zhi
  • [ISO-abbreviation] Zhonghua Xin Xue Guan Bing Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] China
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52. Mehilli J, Kastrati A, Byrne RA, Bruskina O, Iijima R, Schulz S, Pache J, Seyfarth M, Massberg S, Laugwitz KL, Dirschinger J, Schömig A, LEFT-MAIN Intracoronary Stenting and Angiographic Results: Drug-Eluting Stents for Unprotected Coronary Left Main Lesions Study Investigators: Paclitaxel- versus sirolimus-eluting stents for unprotected left main coronary artery disease. J Am Coll Cardiol; 2009 May 12;53(19):1760-8
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  • [Title] Paclitaxel- versus sirolimus-eluting stents for unprotected left main coronary artery disease.
  • OBJECTIVES: The aim of this trial was to compare the safety and efficacy of paclitaxel-eluting stents (PES) and sirolimus-eluting stents (SES) for treatment of unprotected left main coronary artery (uLMCA) disease.
  • METHODS: In this randomized study, 607 patients with symptomatic coronary artery disease undergoing percutaneous coronary intervention for uLMCA were enrolled: 302 were assigned to receive a PES (Taxus, Boston Scientific, Natick, Massachusetts) and 305 assigned to receive a SES (Cypher, Cordis, Johnson & Johnson, New Brunswick, New Jersey).
  • The primary end point was the combined incidence of death, myocardial infarction, and target lesion revascularization (TLR) at 1 year.
  • The secondary end point was angiographic restenosis on the basis of the LMCA area analysis at follow-up angiography.
  • RESULTS: At 1 year the cumulative incidence of death, myocardial infarction, or TLR was 13.6% in the PES and 15.8% in the SES group (relative risk [RR]: 0.85, 95% confidence interval [CI]: 0.56 to 1.29, p = 0.44).
  • CONCLUSIONS: Implantation of either PES or SES in uLMCA lesions is safe and effective; both of these drug-eluting stents provide comparable clinical and angiographic outcomes. (Drug-Eluting-Stents for Unprotected Left Main Stem Disease [ISAR-LEFT-MAIN]; NCT00133237).
  • [MeSH-major] Coronary Artery Disease / drug therapy. Coronary Restenosis / drug therapy. Drug-Eluting Stents. Immunosuppressive Agents / therapeutic use. Paclitaxel / therapeutic use. Sirolimus / therapeutic use. Tubulin Modulators / therapeutic use
  • [MeSH-minor] Aged. Angioplasty, Balloon, Coronary. Confidence Intervals. Coronary Angiography. Female. Humans. Incidence. Male. Myocardial Infarction / drug therapy. Myocardial Infarction / therapy. Platelet Aggregation Inhibitors / therapeutic use. Risk. Ticlopidine / analogs & derivatives. Ticlopidine / therapeutic use

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  • [CommentIn] J Am Coll Cardiol. 2009 May 12;53(19):1769-72 [19422983.001]
  • (PMID = 19422982.001).
  • [ISSN] 1558-3597
  • [Journal-full-title] Journal of the American College of Cardiology
  • [ISO-abbreviation] J. Am. Coll. Cardiol.
  • [Language] eng
  • [Databank-accession-numbers] ClinicalTrials.gov/ NCT00133237
  • [Publication-type] Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Immunosuppressive Agents; 0 / Platelet Aggregation Inhibitors; 0 / Tubulin Modulators; A74586SNO7 / clopidogrel; OM90ZUW7M1 / Ticlopidine; P88XT4IS4D / Paclitaxel; W36ZG6FT64 / Sirolimus
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53. Wu C, Hannan EL, Walford G, Faxon DP: Utilization and outcomes of unprotected left main coronary artery stenting and coronary artery bypass graft surgery. Ann Thorac Surg; 2008 Oct;86(4):1153-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Utilization and outcomes of unprotected left main coronary artery stenting and coronary artery bypass graft surgery.
  • BACKGROUND: Limited contemporary information is available on outcomes for patients with unprotected left main coronary artery (LMCA) disease who are revascularized.
  • METHODS: We examined the relative frequency, severity of illness, and outcomes of stenting and coronary artery bypass graft (CABG) surgery for treating unprotected LMCA disease in New York between January 1, 2000 and December 31, 2004.
  • A total of 135 stent patients were matched to 135 CABG patients on baseline characteristics identified by a propensity model as predictors of type of procedure received.
  • In the drug-eluting stent era between October 1, 2003 and December 31, 2004, the same trends in mortality (hazard ratio = 0.73, p = 0.69) and repeat revascularization (hazard ratio = 0.10, p = 0.03) were observed among the 56 pairs of matched CABG and drug-eluting stent patients.
  • CONCLUSIONS: Most patients with LMCA disease who needed coronary revascularization received CABG surgery; stent patients were sicker.
  • However, more studies comparing these procedures are needed, especially in the drug-eluting stent era.
  • [MeSH-major] Angioplasty, Balloon, Coronary / methods. Cause of Death. Coronary Artery Bypass / methods. Coronary Stenosis / mortality. Coronary Stenosis / therapy. Stents
  • [MeSH-minor] Adult. Age Distribution. Aged. Aged, 80 and over. Coronary Angiography. Coronary Vessels / pathology. Coronary Vessels / surgery. Female. Follow-Up Studies. Humans. Incidence. Male. Middle Aged. Postoperative Complications / epidemiology. Postoperative Complications / pathology. Probability. Registries. Retrospective Studies. Risk Assessment. Sensitivity and Specificity. Sex Distribution. Survival Analysis. Treatment Outcome

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  • [CommentIn] Ann Thorac Surg. 2009 May;87(5):1651-2; author reply 1652-3 [19379945.001]
  • (PMID = 18805151.001).
  • [ISSN] 1552-6259
  • [Journal-full-title] The Annals of thoracic surgery
  • [ISO-abbreviation] Ann. Thorac. Surg.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Netherlands
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54. Ben-Dor I, Vaknin-Assa H, Lev E, Brosh D, Fuchs S, Assali A, Kornowski R: Clinical results of unprotected left main coronary stenting. Isr Med Assoc J; 2009 Mar;11(3):154-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Clinical results of unprotected left main coronary stenting.
  • BACKGROUND: Although unprotected left main coronary artery disease is considered by contemporary guidelines to be an indication for surgery, percutaneous coronary intervention may be necessary in patients at high surgical risk.
  • OBJECTIVES: To assess the outcome of angioplasty in the treatment of unprotected LMCA disease.
  • METHODS: Angiographic and clinical data were collected prospectively for all patients who underwent emergent or nonemergent (planned) therapeutic PCI for unprotected LMCA disease at our center from 2003 to 2007.
  • Baseline values were compared with findings at 1, 6 and 12 months after the procedure.
  • RESULTS: The study group comprised 71 consecutive patients with a mean age of 74 +/- 12 years; 63% were men, and 31% had diabetes.
  • Forty-three patients had a planned procedure and 28 an emergent procedure.
  • Forty-nine percent of the procedures were performed with bare metal stents and 51% with drug-eluting stents.
  • The overall mortality rate was 11.3% at 1 month, 18.3% at 6 months and 19.7% at 12 months.
  • Elective PCI was associated with significantly lower mortality (2.3% vs. 25% at 1 month, 4.6% vs. 39% at 6 months and 6.9% vs. 39% at 12 months), and the use of drug-eluting stents was associated with lower rates of target vessel revascularization and major adverse cardiac events than use of bare metal stents (2.8% vs. 14% at 1 month, 8.3% vs. 43% at 6 and 12 months).
  • Variables that correlated with increased mortality or MACE at 6 and 12 months were cardiogenic shock, emergent PCI, ejection fraction < 35%, renal failure, distal left main stenosis location, and reference diameter < 3 mm.
  • CONCLUSIONS: PCI is a feasible and relatively safe therapeutic option for unprotected LMCA.
  • The use of drug-eluting stents may improve the intermediate-term restenosis rate.
  • [MeSH-major] Angioplasty, Balloon, Coronary. Coronary Stenosis / therapy
  • [MeSH-minor] Aged. Coronary Angiography. Drug-Eluting Stents. Female. Humans. Male. Middle Aged. Stents. Treatment Outcome

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  • (PMID = 19544705.001).
  • [ISSN] 1565-1088
  • [Journal-full-title] The Israel Medical Association journal : IMAJ
  • [ISO-abbreviation] Isr. Med. Assoc. J.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Israel
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55. Han YL, Wang SL, Jin QM, Liu HW, Ma YY, Wang ZL, Wang DM, Luan B, Wang G: Efficacy of stenting for unprotected left main coronary artery disease in 297 patients. Chin Med J (Engl); 2006 Apr 5;119(7):544-50
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Efficacy of stenting for unprotected left main coronary artery disease in 297 patients.
  • BACKGROUND: Angioplasty in the unprotected left main coronary artery (LMCA) has been controversial.
  • This study aims to evaluate the safety and clinical effectiveness of stenting, including bare metal stent and drug eluting stent (DES), for treatment of unprotected LMCA disease.
  • METHODS: Between September 1997 and December 2005, a total of 297 consecutive patients underwent percutanous coronary intervention (PCI) on LMCA lesions in our hospital.
  • Their in-hospital data and clinical follow-up outcomes were analyzed and those in pre-DES "era" (group I, from September 1997 to December 2002) were compared with those in DES "era" (group II, from January 2003 to December 2004.
  • Patients in 2005 for the time of follow-up less than one year were not included in this group).
  • Stents failed to be implanted after balloon predilation in two patients, who received coronary artery bypass graft (CABG) successfully.
  • Bifurcation techniques for distal LMCA executed in 206 patients (69.4%, 206/297), included crossover stenting in 156 (75.7%), T stenting in 4 (1.9%), provisional T stenting in 28 (13.6%), kissing stenting in 5 (2.4%) and stent crushing in 13 (6.3%) patients.
  • During their hospital stay, 5 (1.7%) patients died after PCI procedure, of which 4 died from cardiac origin and one of renal failure.
  • Besides, 2 (0.7%) developed subacute thrombosis (SAT) and 16 (5.4%) performed target lesion revascularization (TLR).
  • CONCLUSIONS: As new PCI strategies and intervention devices such as DES are developed, coronary stenting, which might have brought better in-hospital and long-term outcomes than CABG, are proved to be technically successful and can be safely applied for the treatment of LMCA lesions in the experienced center for coronary intervention.
  • [MeSH-major] Coronary Disease / therapy. Stents

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  • (PMID = 16620694.001).
  • [ISSN] 0366-6999
  • [Journal-full-title] Chinese medical journal
  • [ISO-abbreviation] Chin. Med. J.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] China
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56. Chieffo A, Park SJ, Meliga E, Sheiban I, Lee MS, Latib A, Kim YH, Valgimigli M, Sillano D, Magni V, Biondi-Zoccai G, Montorfano M, Airoldi F, Rogacka R, Carlino M, Michev I, Lee CW, Hong MK, Park SW, Moretti C, Bonizzoni E, Sangiorgi GM, Tobis J, Serruys PW, Colombo A: Late and very late stent thrombosis following drug-eluting stent implantation in unprotected left main coronary artery: a multicentre registry. Eur Heart J; 2008 Sep;29(17):2108-15
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Late and very late stent thrombosis following drug-eluting stent implantation in unprotected left main coronary artery: a multicentre registry.
  • AIMS: To evaluate the occurrence of late and very late stent thrombosis (ST) following elective drug-eluting stent (DES) implantation in unprotected left main coronary artery (LMCA) stenosis in a large multicentre registry.
  • METHODS AND RESULTS: All 731 consecutive patients who had sirolimus- or paclitaxel-eluting stent electively implanted in de novo lesions on unprotected LMCA in five centres were included.
  • Four (0.5%) patients had a definite ST: three early (two acute and one subacute) and one late ST, no cases of very late definite ST were recorded.
  • Therefore, 7/731 (0.95%) patients had a definite or a probable ST and all were on dual antiplatelet therapy at the time of the event.
  • CONCLUSION: Elective treatment of LMCA stenosis with DES appears safe with a 0.9% incidence of definite and probable ST at 29.5 ± 13.7 months.
  • [MeSH-major] Coronary Restenosis / prevention & control. Drug-Eluting Stents. Graft Occlusion, Vascular / etiology. Paclitaxel / administration & dosage. Sirolimus / administration & dosage. Tubulin Modulators / administration & dosage
  • [MeSH-minor] Aged. Female. Hospitalization. Humans. Male. Middle Aged. Myocardial Revascularization / methods. Registries. Treatment Outcome

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  • [CommentIn] Eur Heart J. 2008 Sep;29(17):2064-6 [18664463.001]
  • (PMID = 18565967.001).
  • [ISSN] 1522-9645
  • [Journal-full-title] European heart journal
  • [ISO-abbreviation] Eur. Heart J.
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article; Multicenter Study
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Tubulin Modulators; P88XT4IS4D / Paclitaxel; W36ZG6FT64 / Sirolimus
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57. Uno K, Inukai T, Kayagaki N, Goi K, Sato H, Nemoto A, Takahashi K, Kagami K, Yamaguchi N, Yagita H, Okumura K, Koyama-Okazaki T, Suzuki T, Sugita K, Nakazawa S: TNF-related apoptosis-inducing ligand (TRAIL) frequently induces apoptosis in Philadelphia chromosome-positive leukemia cells. Blood; 2003 May 1;101(9):3658-67
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  • [Title] TNF-related apoptosis-inducing ligand (TRAIL) frequently induces apoptosis in Philadelphia chromosome-positive leukemia cells.
  • Tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL) and Fas ligand (FasL) have been implicated in antitumor immunity and therapy.
  • In the present study, we investigated the sensitivity of Philadelphia chromosome (Ph1)-positive leukemia cell lines to TRAIL- or FasL-induced cell death to explore the possible contribution of these molecules to immunotherapy against Ph1-positive leukemias.
  • TRAIL, but not FasL, effectively induced apoptotic cell death in most of 5 chronic myelogenous leukemia-derived and 7 acute leukemia-derived Ph1-positive cell lines.
  • Moreover, primary leukemia cells from Ph1-positive acute lymphoblastic leukemia patients were also sensitive to TRAIL, but not to FasL, depending on DR4/DR5 expression.
  • Fas-associated death domain protein (FADD) and caspase-8, components of death-inducing signaling complex (DISC), as well as FLIP (FLICE [Fas-associating protein with death domain-like interleukin-1-converting enzyme]/caspase-8 inhibitory protein), a negative regulator of caspase-8, were expressed ubiquitously in Ph1-positive leukemia cell lines irrespective of their differential sensitivities to TRAIL and FasL.
  • Notably, TRAIL could induce cell death in the Ph1-positive leukemia cell lines that were refractory to a BCR-ABL-specific tyrosine kinase inhibitor imatinib mesylate (STI571; Novartis Pharma, Basel, Switzerland).
  • These results suggested the potential utility of recombinant TRAIL as a novel therapeutic agent and the possible contribution of endogenously expressed TRAIL to immunotherapy against Ph1-positive leukemias.
  • [MeSH-major] Apoptosis / drug effects. Arabidopsis Proteins. Intracellular Signaling Peptides and Proteins. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / pathology. Membrane Glycoproteins / pharmacology. Neoplastic Stem Cells / drug effects. Precursor Cell Lymphoblastic Leukemia-Lymphoma / pathology. Tumor Necrosis Factor-alpha / pharmacology
  • [MeSH-minor] Amino Acid Chloromethyl Ketones / pharmacology. Apoptosis Regulatory Proteins. Benzamides. CASP8 and FADD-Like Apoptosis Regulating Protein. Carrier Proteins / physiology. Caspase 1 / physiology. Death Domain Receptor Signaling Adaptor Proteins. Drug Resistance, Neoplasm. Drug Screening Assays, Antitumor. Enzyme Inhibitors / pharmacology. Fas Ligand Protein. Fatty Acid Desaturases / physiology. Fusion Proteins, bcr-abl / antagonists & inhibitors. Humans. Imatinib Mesylate. Leupeptins / pharmacology. NF-kappa B / antagonists & inhibitors. Neoplasm Proteins / antagonists & inhibitors. Neoplasm Proteins / physiology. Peptides / pharmacology. Piperazines / pharmacology. Pyrimidines / pharmacology. Receptors, TNF-Related Apoptosis-Inducing Ligand. Receptors, Tumor Necrosis Factor / physiology. Recombinant Proteins / pharmacology. TNF-Related Apoptosis-Inducing Ligand. Tumor Cells, Cultured / drug effects. Tumor Cells, Cultured / pathology

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  • (PMID = 12506034.001).
  • [ISSN] 0006-4971
  • [Journal-full-title] Blood
  • [ISO-abbreviation] Blood
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Amino Acid Chloromethyl Ketones; 0 / Apoptosis Regulatory Proteins; 0 / Arabidopsis Proteins; 0 / Benzamides; 0 / CASP8 and FADD-Like Apoptosis Regulating Protein; 0 / CFLAR protein, human; 0 / Carrier Proteins; 0 / Death Domain Receptor Signaling Adaptor Proteins; 0 / Enzyme Inhibitors; 0 / FASLG protein, human; 0 / Fas Ligand Protein; 0 / Intracellular Signaling Peptides and Proteins; 0 / Leupeptins; 0 / Membrane Glycoproteins; 0 / NF-kappa B; 0 / Neoplasm Proteins; 0 / Peptides; 0 / Piperazines; 0 / Pyrimidines; 0 / Receptors, TNF-Related Apoptosis-Inducing Ligand; 0 / Receptors, Tumor Necrosis Factor; 0 / Recombinant Proteins; 0 / SN50 peptide; 0 / TNF-Related Apoptosis-Inducing Ligand; 0 / TNFRSF10A protein, human; 0 / TNFRSF10B protein, human; 0 / TNFSF10 protein, human; 0 / Tumor Necrosis Factor-alpha; 0 / benzyloxycarbonylvalyl-alanyl-aspartyl fluoromethyl ketone; 110044-82-1 / acetylleucyl-leucyl-norleucinal; 8A1O1M485B / Imatinib Mesylate; EC 1.14.19.- / Fatty Acid Desaturases; EC 1.14.99.- / Fad7 protein, Arabidopsis; EC 2.7.10.2 / Fusion Proteins, bcr-abl; EC 3.4.22.36 / Caspase 1
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58. Park DW, Seung KB, Kim YH, Lee JY, Kim WJ, Kang SJ, Lee SW, Lee CW, Park SW, Yun SC, Gwon HC, Jeong MH, Jang YS, Kim HS, Kim PJ, Seong IW, Park HS, Ahn T, Chae IH, Tahk SJ, Chung WS, Park SJ: Long-term safety and efficacy of stenting versus coronary artery bypass grafting for unprotected left main coronary artery disease: 5-year results from the MAIN-COMPARE (Revascularization for Unprotected Left Main Coronary Artery Stenosis: Comparison of Percutaneous Coronary Angioplasty Versus Surgical Revascularization) registry. J Am Coll Cardiol; 2010 Jul 6;56(2):117-24
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Long-term safety and efficacy of stenting versus coronary artery bypass grafting for unprotected left main coronary artery disease: 5-year results from the MAIN-COMPARE (Revascularization for Unprotected Left Main Coronary Artery Stenosis: Comparison of Percutaneous Coronary Angioplasty Versus Surgical Revascularization) registry.
  • OBJECTIVES: We performed the long-term follow-up of a large cohort of patients in a multicenter study receiving left main coronary artery (LMCA) revascularization.
  • BACKGROUND: Limited information is available on long-term outcomes for patients with unprotected LMCA disease who underwent coronary stent procedure or coronary artery bypass grafting (CABG).
  • METHODS: We evaluated 2,240 patients with unprotected LMCA disease who received coronary stents (n = 1,102; 318 with bare-metal stents and 784 with drug-eluting stents) or underwent CABG (n = 1,138) between 2000 and 2006 and for whom complete follow-up data were available for at least 3 to 9 years (median 5.2 years).
  • The 5-year adverse outcomes (death; a composite outcome of death, Q-wave myocardial infarction [MI], or stroke; and target vessel revascularization [TVR]) were compared with the use of the inverse probability of treatment weighted method and propensity-score matching.
  • RESULTS: After adjustment for differences in baseline risk factors with the inverse probability of treatment weighting, the 5-year risk of death (hazard ratio [HR]: 1.13; 95% confidence interval [CI]: 0.88 to 1.44, p = 0.35) and the combined risk of death, Q-wave MI, or stroke (HR: 1.07; 95% CI: 0.84 to 1.37, p = 0.59) were not significantly different for patients undergoing stenting versus CABG.
  • Similar results were obtained in comparisons of bare-metal stent with concurrent CABG and of drug-eluting stent with concurrent CABG.
  • CONCLUSIONS: During 5-year follow-up, stenting showed similar rates of mortality and of the composite of death, Q-wave MI, or stroke but higher rates of TVR as compared with CABG for patients with unprotected LMCA disease.
  • [MeSH-major] Coronary Disease / therapy. Stents
  • [MeSH-minor] Coronary Artery Bypass. Drug-Eluting Stents. Female. Follow-Up Studies. Humans. Male. Middle Aged. Treatment Outcome

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  • [Copyright] Copyright 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
  • (PMID = 20451344.001).
  • [ISSN] 1558-3597
  • [Journal-full-title] Journal of the American College of Cardiology
  • [ISO-abbreviation] J. Am. Coll. Cardiol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Multicenter Study
  • [Publication-country] United States
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59. Garcia JL, Font de Mora J, Hernandez JM, Queizan JA, Gutierrez NC, Hernandez JM, San Miguel JF: Imatinib mesylate elicits positive clinical response in atypical chronic myeloid leukemia involving the platelet-derived growth factor receptor beta. Blood; 2003 Oct 1;102(7):2699-700
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Imatinib mesylate elicits positive clinical response in atypical chronic myeloid leukemia involving the platelet-derived growth factor receptor beta.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / genetics. Piperazines / therapeutic use. Pyrimidines / therapeutic use. Receptor, Platelet-Derived Growth Factor beta / genetics


60. Breccia M, Russo E, De Propris MS, Frustaci A, Alimena G: Atypical chronic myeloid leukaemia with CD117-positive blast cells treated with imatinib: A report of two cases. Acta Haematol; 2006;116(3):211-2
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  • [Title] Atypical chronic myeloid leukaemia with CD117-positive blast cells treated with imatinib: A report of two cases.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Piperazines / therapeutic use. Proto-Oncogene Proteins c-kit / analysis. Pyrimidines / therapeutic use

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  • (PMID = 17016042.001).
  • [ISSN] 0001-5792
  • [Journal-full-title] Acta haematologica
  • [ISO-abbreviation] Acta Haematol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Benzamides; 0 / Piperazines; 0 / Pyrimidines; 8A1O1M485B / Imatinib Mesylate; EC 2.7.10.1 / Proto-Oncogene Proteins c-kit
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