Search

Your search keyword '"Kamal Dhaliwal"' showing total 2 results
Start Over Author "Kamal Dhaliwal"
2 results on '"Kamal Dhaliwal"'

1. Coronary artery aneurysms: outcomes following medical, percutaneous interventional and surgical management

Author

Douglas Johnston, Beni Rai Verma, Shashank Shekhar, Manpreet Kaur, Muhammad Shahzeb Khan, Chandramohan Meenakshisundaram, Samir Kapadia, Kinjal Banerjee, Safi Khan, Ankur Kalra, Shameer Khubber, Rajdeep Chana, Kamal Dhaliwal, Mohomed Gad, Muhummad Zia Khan, Yasser Sammour, Rayji Tsutsui, Rishi Puri, Faisal G Bakaeen, Conrad Simpfendorfer, Stephen Ellis, and Gosta Pettersson

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Background Coronary artery aneurysms (CAAs) are increasingly diagnosed on coronary angiography; however, controversies persist regarding their optimal management. In the present study, we analysed the long-term outcomes of patients with CAAs following three different management strategies.Methods We performed a retrospective review of patient records with documented CAA diagnosis between 2000 and 2005. Patients were divided into three groups: medical management versus percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG). We analysed the rate of major cardiovascular and cerebrovascular events (MACCEs) over a period of 10 years.Results We identified 458 patients with CAAs (mean age 78±10.5 years, 74.5% men) who received medical therapy (N=230) or underwent PCI (N=52) or CABG (N=176). The incidence of CAAs was 0.7% of the total catheterisation reports. The left anterior descending was the most common coronary artery involved (38%). The median follow-up time was 62 months. The total number of MACCE during follow-up was 155 (33.8%); 91 (39.6%) in the medical management group vs 46 (26.1%) in the CABG group vs 18 (34.6%) in the PCI group (p=0.02). Kaplan-Meier survival analysis showed that CABG was associated with better MACCE-free survival (p log-rank=0.03) than medical management. These results were confirmed on univariate Cox regression, but not multivariate regression (OR 0.773 (0.526 to 1.136); p=0.19). Both Kaplan-Meier survival and regression analyses showed that dual antiplatelet therapy (DAPT) and anticoagulation were not associated with significant improvement in MACCE rates.Conclusion Our analysis showed similar long-term MACCE risks in patients with CAA undergoing medical, percutaneous and surgical management. Further, DAPT and anticoagulation were not associated with significant benefits in terms of MACCE rates. These results should be interpreted with caution considering the small size and potential for selection bias and should be confirmed in large, randomised trials.

Published
2021
Full Text
View/download PDF

2. Coronary artery aneurysms: outcomes following medical, percutaneous interventional and surgical management

Author

Stephen G. Ellis, Conrad Simpfendorfer, Muhummad Zia Khan, Mohomed Gad, Safi U. Khan, Manpreet Kaur, Shameer Khubber, Chandramohan Meenakshisundaram, Kamal Dhaliwal, Douglas R. Johnston, Samir R. Kapadia, Rajdeep Chana, Faisal G. Bakaeen, Kinjal Banerjee, Gösta B. Pettersson, Beni R Verma, Shashank Shekhar, Ankur Kalra, Rishi Puri, Muhammad Shahzeb Khan, Rayji S. Tsutsui, and Yasser Sammour

Subjects
Male, medicine.medical_specialty, Percutaneous, coronary aneurysm, medicine.medical_treatment, Coronary Artery Disease, 030204 cardiovascular system & hematology, Coronary Angiography, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Fibrinolytic Agents, Internal medicine, Humans, Diseases of the circulatory (Cardiovascular) system, Medicine, Thrombolytic Therapy, cardiovascular diseases, 030212 general & internal medicine, Coronary Artery Bypass, Survival analysis, Aged, Retrospective Studies, coronary vessels, business.industry, Proportional hazards model, Incidence (epidemiology), percutaneous coronary intervention, Percutaneous coronary intervention, Drug-Eluting Stents, medicine.disease, Treatment Outcome, medicine.anatomical_structure, RC666-701, Conventional PCI, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies, Artery
Abstract

BackgroundCoronary artery aneurysms (CAAs) are increasingly diagnosed on coronary angiography; however, controversies persist regarding their optimal management. In the present study, we analysed the long-term outcomes of patients with CAAs following three different management strategies.MethodsWe performed a retrospective review of patient records with documented CAA diagnosis between 2000 and 2005. Patients were divided into three groups: medical management versus percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG). We analysed the rate of major cardiovascular and cerebrovascular events (MACCEs) over a period of 10 years.ResultsWe identified 458 patients with CAAs (mean age 78±10.5 years, 74.5% men) who received medical therapy (N=230) or underwent PCI (N=52) or CABG (N=176). The incidence of CAAs was 0.7% of the total catheterisation reports. The left anterior descending was the most common coronary artery involved (38%). The median follow-up time was 62 months. The total number of MACCE during follow-up was 155 (33.8%); 91 (39.6%) in the medical management group vs 46 (26.1%) in the CABG group vs 18 (34.6%) in the PCI group (p=0.02). Kaplan-Meier survival analysis showed that CABG was associated with better MACCE-free survival (p log-rank=0.03) than medical management. These results were confirmed on univariate Cox regression, but not multivariate regression (OR 0.773 (0.526 to 1.136); p=0.19). Both Kaplan-Meier survival and regression analyses showed that dual antiplatelet therapy (DAPT) and anticoagulation were not associated with significant improvement in MACCE rates.ConclusionOur analysis showed similar long-term MACCE risks in patients with CAA undergoing medical, percutaneous and surgical management. Further, DAPT and anticoagulation were not associated with significant benefits in terms of MACCE rates. These results should be interpreted with caution considering the small size and potential for selection bias and should be confirmed in large, randomised trials.

Published
2021
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results