Prognostic implications of silent myocardial ischemia

Article Abstract:

Detection of asymptomatic myocardial ischemia with electrocardiographic (ECG) testing may indicate the risk of future heart problems and lead to effective, preventative treatment. Myocardial ischemia is the shortage of blood supply to part of the heart due to partially blocked blood vessels. Myocardial ischemia that does not cause symptoms may be detected by inexpensive ECG tests instead of extremely expensive exercise stress tests and heart imaging tests. Studies suggest that ischemia detected by ECGs may indicate severe, complicated coronary artery disease. The results of a 1996 study suggest that ischemia detected by ECG monitoring after a heart attack indicate a high short-term risk of death or heart problems. However, the presence or absence of ischemia may have no bearing on long-term risk. Other studies have suggested that treatment with beta-blockers or widening of blood vessels may improve the outcome of people with such ischemia.

Editorial, Ischemia

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Coronary bypass surgery with internal-thoracic-artery grafts - effects on survival over a 15-year period

Article Abstract:

Coronary-artery bypass patients with internal-thoracic-artery (ITA) grafts appear to survive longer compared to patients with a saphenous-vein graft. Although the ITA graft has produced lower rates of disease recurrence, the vein graft has been used more often. Researchers surveyed 15 institutions to compare the survival of 749 patients with ITA bypass grafts and 4,888 patients with saphenous-vein grafts. Survival rates were consistently higher in the patients with an ITA graft throughout the 15-year follow-up period. An accelerated decline in survival of patients with a vein graft was apparent after eight years. The ITA graft had a more important influence on long-term survival than the progression of coronary disease. Patients with adverse risk factors also benefitted from ITA grafts.

Surgery, Blood vessels, Coronary artery bypass, Chest, Thorax, Saphenous vein

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Effect of ticlopidine on the long-term patency of saphenous-vein bypass grafts in the legs

Article Abstract:

Ticlopidine may improve the long-term patency of arterial bypass grafts in the legs. The saphenous vein can be used to bypass blockages in blood flow and increase circulation in the legs, but these too can become blocked in the years following surgery. Researchers assigned 243 patients to receive ticlopidine, a clot inhibitor, or placebo following revascularization. Two years after surgery, 66.4% of surviving patients taking ticlopidine had functioning grafts, versus 51.2% of patients taking the placebo. Ticlopidine may increase the long-term utility of vein grafts in the legs.

Care and treatment, Prevention, Ticlopidine, Vascular grafts, Graft occlusion, Vascular, Vascular graft occlusion, Vascular patency

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