000			03892nam a22006497a 4500
008			240723s20242024 xxu||||| |||| 00| 0 eng d
022			_a1471-2261
024			_a10.1186/s12872-024-03841-y [pii]
024			_aPMC10985918 [pmc]
040			_aOvid MEDLINE(R)
099			_a38566019
245			_aShifting perspectives in coronary involvement of polyarteritis nodosa: case of 3-vessel occlusion treated with 4-vessel CABG and review of literature. [Review]
251			_aBMC Cardiovascular Disorders. 24(1):190, 2024 Apr 02.
252			_aBMC Cardiovasc Disord. 24(1):190, 2024 Apr 02.
253			_aBMC cardiovascular disorders
260			_c2024
260			_p2024 Apr 02
260			_fFY2024
265			_sepublish
265			_tMEDLINE
501			_aAvailable online from MWHC library: 2001 - present
520			_aBACKGROUND: Polyarteritis Nodosa (PAN) is a systemic vasculitis (SV) historically thought to spare the coronary arteries. Coronary angiography and contemporary imaging reveal coronary stenosis and dilation, which are associated with significant morbidity and mortality. Coronary arteries in PAN are burdened with accelerated atherosclerosis from generalized inflammation adding to an inherent arteritic process. Traditional atherosclerotic risk factors fail to approximate risk. Few reports document coronary pathology and optimal therapy has been guarded.
520			_aCONCLUSIONS: When graft selection avoids the vascular territory of SV's, CABG offers definitive therapy. We have contributed report of a novel CABG configuration in addition to reviewing, updating and discussing the literature. Accumulating evidence suggests discrete clinical symptoms warrant suspicion for coronary involvement. Copyright © 2024. The Author(s).
520			_aMETHODS: Database publication query of English literature from 1990-2022.
520			_aRESULTS: Severity of coronary involvement eludes laboratory monitoring, but coronary disease associates with several clinical symptoms. Framingham risk factors inadequately approximate disease burden. Separating atherosclerosis from arteritis requires advanced angiographic methods. Therapy includes anticoagulation, immunosuppression and revascularization. PCI has been the mainstay, though stenting is confounded by vagarious alteration in luminal diameter and reports of neointimization soon after placement.
546			_aEnglish
650			_a*Atherosclerosis
650			_a*Coronary Artery Disease
650			_a*Percutaneous Coronary Intervention
650			_a*Polyarteritis Nodosa
650			_aAtherosclerosis/et [Etiology]
650			_aCoronary Artery Bypass
650			_aCoronary Artery Disease/dg [Diagnostic Imaging]
650			_aCoronary Artery Disease/et [Etiology]
650			_aCoronary Artery Disease/th [Therapy]
650			_aHumans
650			_aPercutaneous Coronary Intervention/mt [Methods]
650			_aPolyarteritis Nodosa/co [Complications]
650			_aPolyarteritis Nodosa/dg [Diagnostic Imaging]
650			_aPolyarteritis Nodosa/th [Therapy]
650			_aTreatment Outcome
650			_zCurated
651			_aMedStar Heart & Vascular Institute
651			_aMedStar Washington Hospital Center
656			_aCardiovascular Disease Fellowship
656			_aInternal Medicine Residency
656			_aMedStar Georgetown University Hospital/MedStar Washington Hospital Center
657			_aCase Reports
657			_aJournal Article
657			_aReview
700			_aBigham, Grace _bMGUH _cInternal Medicine Residency _dMD
700			_aHaider, Syed W _bMHVI
700			_aLahti, Steven _bMWHC _cCardiovascular Disease Fellowship _dMD
790			_aWalter DJ, Bigham GE, Lahti S, Haider SW
856			_uhttps://dx.doi.org/10.1186/s12872-024-03841-y _zhttps://dx.doi.org/10.1186/s12872-024-03841-y
942			_cART _dArticle
999			_c14300 _d14300