showing 16 related works from this author
Coronary artery bypass graft versus percutaneous coronary intervention with drug-eluting stent implantation for diabetic patients with unprotected le…
2013
textabstractAims: Data regarding the impact on clinical outcomes of PCI with DES implantation vs. CABG to treat unprotected left main coronary artery (ULMCA) disease in diabetic patients are still insufficient. The present study evaluated the short-term and long-term results of percutaneous and surgical revascularisation in diabetic patients with ULMCA disease in a large population. Methods and results: A total of 826 diabetic patients with ULMCA stenosis who received DES (n=520) or underwent CABG (n=306) were selected and analysed from the DELTA registry. In-hospital MACCE was significantly higher in the CABG group, mainly driven by a higher incidence of MI. At four-year follow-up, freedom…
Long-term outcomes of percutaneous coronary interventions or coronary artery bypass grafting for left main coronary artery disease in octogenarians (…
2014
Percutaneous coronary intervention (PCI) with drug-eluting stents is an accepted alternative to surgery for the treatment of unprotected left main coronary artery (ULMCA) disease, but the long-term outcome in elderly patients is unclear. Aim of our study was to compare the clinical outcomes of octogenarians with ULMCA disease treated either with PCI with drug-eluting stents or coronary artery bypass grafting (CABG). The primary study end point was the composite of death, cerebrovascular accident, and myocardial infarction at follow-up. A total of 304 consecutive patients with ULMCA stenosis treated with PCI or CABG and aged 80 years were selected and analyzed in a large multinational regist…
Diagnosis of silent coronary ischemia with selective coronary revascularization might improve 2-year survival of patients with critical limb-threaten…
2021
Abstract Background Patients with critical limb-threatening ischemia (CLTI) have had poor long-term survival after lower extremity revascularization owing to coexistent coronary artery disease. A new cardiac diagnostic test, coronary computed tomography-derived fractional flow reserve (FFRCT), can identify patients with ischemia-producing coronary stenosis who might benefit from coronary revascularization. We sought to determine whether the diagnosis of silent coronary ischemia before limb salvage surgery with selective postoperative coronary revascularization can reduce the incidence of adverse cardiac events and improve the survival of patients with CLTI compared with standard care. Metho…
TCT-361 Heart Team Approach to CAD Management in Patients Undergoing Elective Vascular Surgery Who Have Asymptomatic Ischemia-producing Coronary Sten…
2018
Patients undergoing peripheral vascular surgery (PVS) are at increased risk of post-op MI/death due to unrecognized CAD. Coronary CTA-derived fractional flow reserve (FFRCT) reliably identifies lesion-specific ischemia (LSI) in stable chest pain patients but has not been used in PVS patients. We
Decrease in annual incidence of acute coronary syndrome and restructuring of coronary care in Latvia
2014
Abstract Introduction Improvement in coronary heart disease prevention and treatment, as well as availability of coronary care facilities, is important for the reduction of acute coronary syndrome (ACS) incidence. Centralized acute coronary care system is crucial to provide optimal hospitalization and management algorithm for ACS patients. Aim The aim of the current report was to assess the annual incidence of ACS and the quality of acute coronary care in Latvia. Methods The Data from The Latvian Registry of Acute Coronary Syndromes were analyzed covering the time period from 2005 to 2010. Results Since the year 2005 the annual incidence of hospitalization due to ACS decreased significantly…
Intravascular Ultrasound-based Imaging Modalities for Tissue Characterisation
2014
Atherosclerosis is the leading cause of cardiovascular mortality and morbidity in the developed world. Intravascular ultrasound (IVUS) is a widely used imaging modality providing complementary diagnostic information to angiography regarding the vessel wall of the coronary arteries. IVUS has been used for assessment of ambiguous angiographic lesions, evaluation of new interventional devices and in atherosclerosis progression-regression trials. However, the standard gray-scale IVUS has limited value for the accurate identification of specific plaque components. This limitation has been partially over- come by introduction of new IVUS-based imaging methods such as: virtual histology IVUS, iMAP…
Diagnosis and management of silent coronary ischemia in patients undergoing carotid endarterectomy.
2021
Abstract Background Coronary artery disease is the primary cause of death in patients with carotid artery disease and silent ischemia is a marker for adverse coronary events. A new noninvasive cardiac diagnostic test, coronary computed tomography-derived fractional flow reserve (FFRCT) can reliably identify ischemia-producing coronary stenosis in patients with coronary artery disease and help to select patients for coronary revascularization. The purpose of this study is to determine the prevalence of silent coronary ischemia in patients undergoing carotid endarterectomy (CEA) and to evaluate the usefulness of FFRCT in selecting patients for coronary revascularization to decrease cardiac ev…
Pre-operative Diagnosis of Silent Coronary Ischaemia May Reduce Post-operative Death and Myocardial Infarction and Improve Survival of Patients Under…
2019
Objective Patients undergoing peripheral vascular surgery have increased risk of death and myocardial infarction (MI), which may be due to unsuspected (silent) coronary ischaemia. The aim was to determine whether pre-operative diagnosis of silent ischaemia using coronary computed tomography (CT) derived fractional flow reserve (FFRCT) can facilitate multidisciplinary care to reduce post-operative death and MI, and improve survival. Methods This was a single centre prospective study with historic controls. Patients with no cardiac symptoms undergoing lower extremity surgical revascularisation with pre-operative coronary CTA-FFRCT testing were compared with historic controls with standard pre…
A nationwide cross-sectional epidemiological study of cardiovascular risk factors as a tool for management of primary and secondary prevention in Lat…
2021
Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): EUROPEAN SOCIAL FUND MINISTRY OF HEALTH, LATVIA Background. An increasing prevalence (PREV.) of noncomunicable diseases is a major public health concern in Latvia. Regular nationwide epidemiological studies present an opportunity to estimate the dinamics of PREV of health risk factors (RF) and thus assist in planning resources and improving prevention strategies at national level. Objective. The aim was to analyze the PREV of cardiovascular RF identified in a epidemiological study in 2019-2020. To assess changes in RF prevalence, the results were compared to data from a simi…
Original paper: A new type of polyphenols-containing dietary supplement for correction of lipids and inflammatory markers in patients with coronary a…
2018
Abstract Objective: To evaluate the impact of two original compositions of polyphenols-containing dietary supplement on lipid profile and level of C-reactive protein (CRP) in patients with angiographycally verified coronary artery disease (CAD). Design and methods: 167 patients were selected during their scheduled post-event elective bicycle stress-test examination. All patients received standard CAD therapy and permanent statin therapy and had elevated total cholesterol (TC > 5.0 mmol/L) and/or CRP (>3.5 mg/L) levels. The study consisted of 2 days of polyphenol depletion followed by a 12-week supplementation period in a randomized, blinded, placebo-uncontrolled parallel design. Two d…
058 THE ROLE OF FEMALE SEX IN THE CONTEMPORARY TREATMENT OF THE LEFT MAIN CORONARY ARTERY INSIGHTS FROM THE W-DELTA (WOMEN-DRUG ELUTING STENT FOR LEF…
2013
Background The optimal revascularization strategy of women with unprotected left main coronary artery (ULMCA) disease is unknown. Therefore, the aim of this study was to evaluate long-term clinical outcomes in this cohort treated with percutaneous coronary intervention (PCI) utilising drug-eluting stents (DES) versus coronary artery bypass grafting (CABG). Methods All consecutive women from the Drug Eluting stent for LefT main coronary Artery disease (DELTA) Registry with ULMCA disease treated by PCI with DES or CABG were analysed. A propensity matching was performed to adjust for baseline differences between the 2 treatment groups. Results In total, 818 women were included: 489 (59.8%) und…
Tissue characteristics in non-culprit lesions during the acute coronary event and at ten months follow-up
2013
Introduction: It is not well established how the medication recommended in the guidelines will affect plaque compositional changes in non-culprit segments after STEMI. We hypothesized that the proportion of necrotic tissue in the non-culprit lesion in the culprit artery would decrease ten months after STEMI. Methods: In 63 consecutive STEMI patients the non-culprit segment in the culprit artery was analyzed with iMap intravascular ultrasound (IVUS) at the time of the index procedure and 10 months later. The non-culprit segment was identified as being 20mm proximal to the most stenotic culprit segment. All patients were recommended to receive the drug therapy outlined in the STEMI guidelines…
Long-Term Clinical Outcomes After Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting for Ostial/Midshaft Lesions in Unprotecte…
2014
Objectives The aim of this study was to report the long-term clinical outcomes after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) versus coronary artery bypass grafting (CABG) for ostial/midshaft lesions in an unprotected left main coronary artery (ULMCA). Background Data regarding outcomes in these patients are limited. Methods Of a total of 2,775 patients enrolled in the DELTA multinational registry, 856 patients with isolated ostial/midshaft lesions in an ULMCA treated by PCI with DES (n = 482) or CABG (n = 374) were analyzed. Results At a median follow-up period of 1,293 days, there were no significant differences in the propensity score-adjusted analyses for …
Long-Term Clinical Outcomes After Percutaneous Coronary Intervention for Ostial/Mid-Shaft Lesions Versus Distal Bifurcation Lesions in Unprotected Le…
2013
Objectives The aim of this study was to compare, in a large all-comer registry, the long-term clinical outcomes after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) for ostial/mid-shaft lesions versus distal bifurcation lesions in unprotected left main coronary artery (ULMCA) stenosis. Background Limited data are available regarding clinical outcomes following DES implantation at the different ULMCA sites. Methods Patients with ULMCA stenosis treated by PCI with DES were analyzed in this multinational registry. Results A total of 1,612 patients were included: 482 were treated for ostial/mid-shaft lesions versus 1,130 for distal bifurcation lesions. At a median follo…
Drug-Eluting Stent for Left Main Coronary Artery Disease
2012
Objectives The aim of this study was to compare, in a large all-comers registry, major adverse cardiac and cerebrovascular events (MACCE) after percutaneous coronary intervention (PCI) with first-generation drug-eluting stents (DES) versus coronary artery bypass grafting (CABG) in unprotected left main coronary artery (ULMCA) stenosis. Background Percutaneous coronary intervention with DES implantation in ULMCA has been shown to be a feasible and safe approach at midterm clinical follow-up. Methods All consecutive patients with ULMCA stenosis treated by PCI with DES versus CABG were analyzed in this multinational registry. A propensity score analysis was performed to adjust for baseline dif…
Management of coronary artery disease patients in Latvia compared with practice in Central-Eastern Europe and globally: Analysis of the CLARIFY regis…
2015
Background and objective: Management of outpatients with stable coronary artery disease (CAD) is important in secondary prevention. The objective was to describe differences in the characteristics of CAD patients in Latvia compared with other countries. Materials and methods: CLARIFY is an ongoing international, prospective, observational, longitudinal registry of outpatients with CAD. Data regarding treated outpatients with established CAD from the CLARIFY registry in Latvia (n = 120) were compared with those from the rest of Central-Eastern Europe (CEE) (n = 2888) and worldwide (n = 33,163). Results: Patients in Latvia had a larger waist circumference (101 [95–109] vs. 99 [91–106] in CEE,…