Women Cardiac Care Conference 2025: Clinical Presentation & Revascularization Discussion
Explore the clinical presentation and revascularization discussion at the 17th National Annual Conference on Women's Cardiac Care in 2025. Learn about a patient's history, medications, and planned interventions for cardiac treatment. Discover insights on survival and symptom improvement through revascularization compared to medical therapy. Get valuable information on the latest educational applications in cardiology.
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Presentation Transcript
17th National Annual Conference Women Cardiac Care (WCC) 2025 March 29th 2025, New Delhi
Disclosures Annapoorna S. Kini, MD, MRCP, FACC Nothing to disclose Isha Randive, MD Nothing to disclose
Live Case #1 Present Clinical Presentation Presented with CCS class IV angina, inferolateral T wave changes and HSTn. Positive stress MPI for inferior ischemia 6 mths ago, managed medically WCC 2025 Patient Demographics 66 yrs, F CAD Risk Factors Hypertension - controlled Hyperlipidemia controlled NIDDM - Uncontrolled SAQ-7: 35, BMI 36 HbA1c:8.8/ LDL:58/ CRP:6.6/ SCr:0.8 Clinical Variables s/p multiple PCIs in last 18yrs, H/o 2 NSTEMIs in the past, LVEF 60% on echo Medications Aspirin, Clopidogrel, Ranolazine, Metoprolol XL, Rosuvastatin, Ezetimibe, Candesartan, Insulin, Metformin+Sitaglaptin, Empagliflozin Cath: Cath on March 28th, 2025 revealed 2 V+LM CAD, LVEF 60%, Syntax score 24 and STS 1.2. Pt has declined CABG over the years. Pt underwent DES of RCA and did well. Clopidogrel switched to Prasugrel despite PRU 198. Furosemide added for high EDP. Plan: Now planned for HD-IVUS guided PCI of LM and LCx bifurcation and OM2 using NCB/CBPTCA/RA+/- IVL and provisional DES strategy.
AUC 2017: Left Main + 2/3 V CAD WCC 2025 A after heart team discussion Patel et al., J Am Coll Cardiol 2017;69:2212
Revascularization to Improve Survival &/or Symptoms in CCS/CCD Compared to Medical Therapy Indications to improve symptoms improve survival WCC 2025 Anatomic indications to SIHD/CCD Refractory (intolerable/frequent) angina on optimal medical therapy? YES No Left main disease? Revascularization Class 1 YES No Significant LM stenosis and high anatomic complexity CAD? SS >32 MV CAD with anatomy suitable for PCI or CBAG? YES No YES No Ischemic CM EF 50%? Suitable candidate for CABG? GDMT No YES No YES Heart Team discussion Class 1 Suitable candidate for CABG? CABG Class 1 CABG Class 1 PCI Class 2a YES No GDMT with or without PCI EF <35% EF 35-50% Heart Team discussion Class 1 CABG Class 1 CABG Class 2a PCI CABG Class 2b Class 2b GDMT with or without PCI
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