Coronary artery bypass grafting (CABG) is recommended over percutaneous coronary intervention (PCI) for patients with significant unprotected left main coronary artery disease. This retrospective analysis sought to provide long-term outcome data comparing PCI with newer generation drug-eluting stents and CABG.<\/p>\n
This previously published, prospective, randomised, open-label, non-inferiority trial1 enrolled patients with unprotected left main coronary artery stenosis at 36 hospitals in Denmark, Estonia, Finland, Germany, Latvia, Lithuania, Norway, Sweden, and the UK.<\/p>\n
Eligibility was determined by a multidisciplinary heart team and defined by clinical criteria (chronic or acute coronary syndrome and a life expectancy of >1 year) and angiographic criteria (left main coronary artery diameter stenosis \u226550% or fractional flow reserve \u22640\u00b780 in the left main ostium, mid-shaft, or bifurcation). Patients with ST elevation myocardial infarction within 24 h or considered at too high risk for CABG or PCI were excluded<\/strong>.<\/p>\n Dr Ray O\u2019Connor<\/p>\n Patients with angiographically confirmed significant left main coronary artery disease were randomly assigned (1:1) to PCI or CABG using an online system and stratified by site, sex, distal left main coronary artery bifurcation lesions, and diabetes.<\/p>\n The primary outcome was the difference in 10-year all-cause mortality in the intention-to-treat (ITT) population. <\/strong>From 2008, to 2015, 1201 patients were randomly assigned to PCI (n=598) or CABG (n=603).<\/p>\n Seventeen patients were lost to follow-up before one year. 592 patients in each group were included in the ITT population. Mean age was 66\u00b72 years in the PCI group and 66\u00b72 years in the CABG group. 256 (22%) of 1,184 participants were female and 928 (78%) were male. There was no difference in all-cause mortality at 10 years (136 [23%] of 592 in the PCI group and 145 [25%] of 592 in the CABG group; hazard ratio 0\u00b793 [95% CI 0\u00b774\u20131\u00b718]; p=0\u00b756). No significant difference in all-cause mortality was identified.<\/p>\n The authors concluded that there was no significant difference in all-cause mortality at 10 years between PCI and CABG for patients with unprotected left main coronary artery disease and no additional complex lesions, indicating that PCI is equally as safe as CABG in patients eligible for both treatments. <\/strong>These results will aid heart teams in developing an individualised patient-centred strategy.<\/p>\n Antiplatelet agents post CABG<\/strong> The primary endpoint was a composite of all-cause death, non-fatal myocardial infarction, stroke, readmission due to acute coronary syndrome, and Bleeding Academic Research Consortium type \u22653 bleeding. The primary analysis was done in the intention-to treat population. From 2014, to 2018, 5530 patients were enrolled and 5,438 were randomly assigned to the aspirin group (n=2,728) or the clopidogrel group (n=2710).<\/p>\n Clinical follow-up status was ascertained on May 1, 2025, resulting in a median follow-up duration of 10\u00b75 years after PCI and a completion rate of 92\u00b78%. Clopidogrel was associated with a lower rate of the primary composite endpoint than aspirin (Kaplan\u2013Meier estimate 25\u00b74% for the clopidogrel group vs 28\u00b75% for the aspirin group; hazard ratio 0\u00b786 [95% CI 0\u00b777\u20130\u00b796].<\/p>\n CVD in different groups Additionally, the additional literature review in the study revealed a significant lack of cardiac-focused interventions in this population, thus the authors build on existing models to propose new CVD-specific interventions. The looked at data collected from PubMed and Scopus until October 22, 2024.<\/p>\n All observational studies that assessed homeless populations and met inclusion criteria were analysed. The primary outcomes reported were mortality, morbidity and hospitalisation due to CVD. These measures were collectively analysed to evaluate the overall CVD burden.<\/p>\n The search strategy identified 22 studies, of which 12 were suitable for meta-analysis. The authors analysed data from 226,205 adults spanning more than 1,000,000 person-years and sought to characterise CVD distribution by demographic subgroups. The findings indicate that homeless adults experience greater morbidity and mortality due to CVD than non-homeless adults (pooled OR 2.77).<\/p>\n Subgroup analyses by age, sex and geographic region were performed, but no significant differences in CVD morbidity and mortality were found. The authors concluded that homeless adults have approximately three times greater odds of CVD than the general population. The risk of CVD remains elevated regardless of demographic subgroup. The findings emphasise the urgent need for targeted interventions within this population<\/strong> and highlight its associated risk factors, providing a foundation for the development of targeted interventions and policies.<\/p>\n CVD in cannabis users<\/strong> Original pharmaco-epidemiological studies providing risk estimates on cannabis-related MACE (ie, cardiovascular death, non-fatal acute coronary syndrome (ACS) including myocardial infarction (MI) or non-fatal stroke) published from 2016 to 2023 were included. Overall, 24 articles were included from 3,012 initial records, including 17 cross-sectional studies, six cohort studies and 1 case-control study.<\/p>\n Exposure corresponded to the use of cannabis in all studies, with one focused on medical cannabis. The estimated risk ratio (RR) was 1.29 for ACS, 1.20 for stroke and 2.10 for cardiovascular death. As measured in two studies, no statistically significant association was found for the composite outcome combining ACS and stroke. The focused analysis restricted to cohort studies yielded comparable results to the primary model (RR=1.32). The authors concluded that their <\/strong>findings reveal positive associations between cannabis use and MACE<\/strong>. These findings should encourage investigating cannabis use in all patients presenting with serious cardiovascular disorders.<\/p>\n CVD and colorectal cancer<\/strong> A total of 23 studies were included: 11 studies (5,462,791 patients) from six countries or regions assessed morbidity risk, and 12 studies (307,857 patients) from nine countries evaluated postoperative prognosis. CVD was associated with increased risks for colorectal cancer (CRC) (RR 1.24), postoperative arrhythmia (RR 3.05), and all-cause mortality (RR 1.56).<\/p>\n Subgroup analysis shows that heart failure (HF) may be a risk factor for CRC (RR 1.39) and all-cause mortality (RR 1.68). Among female patients, HF (RR 2.32) and heart failure with preserved ejection fraction (HFpEF) (RR 2.54) show associations with CRC.<\/p>\n The authors concluded that CVD was associated with increased risks of CRC incidence and all-cause mortality in CRC patients, with HF specifically linked to both outcomes. However, no conclusive associations emerged between CVD and postoperative complications beyond arrhythmia. <\/strong> References:<\/strong><\/p>\n![\"Dr](\"https:\/\/www.europesays.com\/ie\/wp-content\/uploads\/2025\/08\/Dr_ray_o_Connor_100.jpg\")
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The long-term clinical outcomes of clopidogrel monotherapy versus aspirin monotherapy after percutaneous coronary intervention (PCI) are uncertain. This trial2 was a 10-year follow-up of the HOST-EXAM trial to assess the very long-term effects of clopidogrel versus aspirin monotherapy in this setting. In HOST-EXAM, patients who had completed dual antiplatelet therapy without clinical events for 6\u201318 months after PCI were randomly assigned to receive clopidogrel 75 mg once daily or aspirin 100 mg once daily.<\/p>\n![\"\"](\"https:\/\/www.europesays.com\/ie\/wp-content\/uploads\/2025\/11\/link_box-you-might25.jpg\")
<\/a>Clopidogrel was also associated with a lower rate of the thrombotic endpoint (17\u00b73% vs 20\u00b70%) and bleeding endpoint (9\u00b71% vs 10\u00b78%). All-cause mortality was similar between groups. The authors concluded that during 10 years of follow-up, clopidogrel monotherapy, compared with aspirin monotherapy, was associated with lower rates of the primary composite, ischaemic, and bleeding outcomes, but not all-cause mortality after PCI. These findings support consideration of clopidogrel as an alternative to aspirin for long-term antiplatelet monotherapy during the chronic maintenance phase after PCI.<\/strong><\/p>\n
<\/strong>CVD in homeless people<\/strong>
The burden of CVD among the homeless population has been rising, driven by factors such as lack of healthcare access, rising mental health disorders and substance use. This systematic review and meta-analysis3 aimed to systematically analyse the CVD burden among homeless adults and characterise its prevalence and risk factors.<\/p>\n
Awareness has recently risen about the potential associated risks to the CV health of cannabis users. The objective of this systematic review and meta-analysis4 was to evaluate the possible association between major adverse cardiovascular events (MACE) and the use of cannabis or cannabinoids.<\/p>\n
Colorectal cancer (CRC) and CVD are major global health burdens, sharing common risk factors like obesity, smoking, and diabetes. While CRC\u2019s impact on CVD has been studied, the reverse association remains less explored. This systematic review and meta-analysis5 aimed to investigate the relationship between CVD and the morbidity and prognosis of CRC. The study was conducted across nine databases (PubMed, Embase, Cochrane, Scopus, Web of Science, CINAHL complete, SPORT Discus, PsycINFO and CNKI) from 2000, to 2025.<\/p>\n![\"\"\/](\"https:\/\/www.europesays.com\/ie\/wp-content\/uploads\/2026\/01\/imt_end6.jpg\" "\\"\\"")
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