The impact of myocardial bridge on coronary artery spasm and long-term clinical outcomes in patients without significant atherosclerotic stenosis

2018 ◽  
Vol 270 ◽  
pp. 8-12 ◽  
Author(s):  
Purumeh Nam ◽  
Byoung Geol Choi ◽  
Se Yeon Choi ◽  
Jae Kyeong Byun ◽  
Ahmed Mashaly ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Clinical Outcomes ◽  
Coronary Artery Spasm ◽  
Myocardial Bridge ◽  
Atherosclerotic Stenosis ◽  
The Impact

Abstract 19863: Impact of Coronary Artery Fixed Lesion on 3-years Clinical Outcomes in Vasospastic Angina Patients with Myocardial Bridge

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Seung Woon Rha ◽  
Se-Whan Lee ◽  
Won-Yong Shin ◽  
Seung-Jin Lee ◽  
Dong-Kyu Jin ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Clinical Outcomes ◽  
Cardiac Death ◽  
Univariate Analysis ◽  
Coronary Artery Spasm ◽  
Provocation Test ◽  
Vasospastic Angina ◽  
Myocardial Bridge ◽  
Coronary Lesion

Background: It is not known whether the presence of angiographic fixed coronary lesion (FCL) can negatively impact on long-term major clinical outcomes in vasospastic angina patients (pts) with myocardial bridge (MB). Methods: A total 5,882 patients (pts) underwent coronary angiography with acetylcholine (Ach) provocation test from Nov 2004 to Oct 2010. Among them, total 563 pts who had MB and documented significant coronary artery spasm (CAS) by Ach provocation test were enrolled. Study populations were categorized into two groups; the fixed coronary lesion (FCL) group (n=216) and the non-FCL group (n=347). Cumulative major clinical outcomes were compared between the two groups up to 3 years. Results: Baseline characteristics were similar between the two groups except the incidence of elderly, hypertension, diabetes, and dyslipidemia were higher in the FCL group. In univariate analysis, only the composite end-point consisted of cardiac death, de Novo percutaneous coronary intervention (PCI), myocardial infarction (MI), and cerebrovascular accident (CVA) was higher in FCL group (Table). However, in multivariate regression analysis, the incidences of cardiac death, PCI, MI, CVA, recurrent chest pain, and other composite end-points were similar between the two groups up to 3 years. Conclusions: In our study, the presence of angiographic fixed coronary lesion in vasospastic angina pts with MB was not a predictor of adverse long-term clinical outcomes.

The impact of acetylcoline-provoked coronary artery spasm on long-term prognosis of previous coronary revascularization

2017 ◽  
Vol 263 ◽  
pp. e49
Author(s):  
Eun Mi Lee ◽  
Hong Seog Seo ◽  
Kyeong Ho Yun ◽  
Cheol Ung Choi ◽  
Jin Won Kim ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Revascularization ◽  
Coronary Artery Spasm ◽  
Long Term Prognosis ◽  
The Impact

scholarly journals The Impact of Successful Chronic Total Occlusion Percutaneous Coronary Intervention on Long-Term Clinical Outcomes in Real World

2020 ◽  
Author(s):  
Xuhe Gong ◽  
Li Zhou ◽  
Xiaosong Ding ◽  
Hui Chen ◽  
Hongwei Li
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Clinical Outcomes ◽  
Real World ◽  
Cardiac Death ◽  
Coronary Intervention ◽  
Increased Risk ◽  
Percutaneous Coronary ◽  
The Impact

Abstract Background: Coronary chronic total occlusions (CTOs) are correlated with increased risk of adverse clinical outcomes. The optimal treatment strategy for CTO has not been well established. We sought to examine the impact of CTO percutaneous coronary intervention (PCI) on long-term clinical outcome in the real world.Methods: A total of 592 consecutive patients with CTO in Beijing Friendship Hospital from June 2017 to December 2019 were enrolled, 29 patients were excluded due to Coronary artery bypass grafting (CABG). After exclusion, 563 patients were divided into the no-revascularized group (CTO-NR group, n=263) and successful revascularized group (CTO-R group, n=300). The primary endpoint was cardiac death; Secondary endpoint was major adverse cardiac and cerebrovascular events (MACCE), a composite of all-cause death, cardiac death, recurrent myocardial infarction, target lesion revascularization, re-hospitalization, heart failure, and stroke.Results: Percent of Diabetes mellitus (53.2% vs 39.7), Chronic kidney disease (8.7% vs 3.7%), CABG history (7.6% vs 1%), three vessel disease(96.2% vs 90%) and left main coronary artery disease (25.1% vs 13.7%) was significantly higher in the CTO-NR group than in success PCI group (all P<0.05). Moreover, the CTO-NR group has lower EF (0.58±0.11 vs 0.61±0.1, p=0.001) and FS (0.31±0.07 vs 0.33±0.07, p=0.002). At a median follow-up of 12 months, CTO revascularization was superior to CTO no-revascularization in terms of cardiac death (adjusted hazard ratio [HR]: 0.27, 95% conference interval [CI] 0.11-0.64). The superiority of CTO revascularization was consistent for MACCE (HR: 0.55, 95% CI 0.35-0.79). At multivariable Cox hazards regression analysis, CTO revascularization remains one of the independent predictors of lower risk of cardiac death and MACCE.Conclusions: Successful revascularization by PCI may bring more clinical benefits. The presence of LVEF＜0.5 and LM-disease was associated with an incidence of cardiac death; CTO revascularization was a protected predictor of cardiac death.

scholarly journals The Impact of Smoking on Clinical Outcomes after Percutaneous Coronary Intervention in Women Compared to Men

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Seyyed Saeed Mohammadi ◽  
Mohammad Javad Zibaeenezhad ◽  
Mehrab Sayadi ◽  
Soorena Khorshidi ◽  
Ehsan Hadiyan ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Clinical Outcomes ◽  
Coronary Intervention ◽  
Drug Eluting Stent ◽  
Percutaneous Coronary ◽  
History Of ◽  
Stable Cad ◽  
The Impact

Background. For decades, cardiovascular diseases (CVD) have been known as men’s disease. However, recent research studies showed that they have become more common in women. Smoking is a strong risk factor for CVD especially that of coronary artery disease (CAD). Several studies reported that women are more susceptible to drastic sequels of smoking than men. There is limited data regarding the impact of smoking on post-revascularization clinical events stratified by gender. This study aimed to investigate if gender significantly changes the incidence of adverse clinical outcomes after percutaneous coronary intervention (PCI) among those with history of smoking. Methods. Participants were selected from two hospitals from 2003 to 2019. Among patients who had PCI (index PCI), those with stable CAD who underwent elective PCI were included. Exclusion criteria were defined as primary PCI and those with multiple prior revascularizations. Participants were followed up seeking for major adverse cardiac events (MACE) including revascularization (PCI or coronary artery bypass grafting), myocardial infarction, and coronary death in three time intervals according to the time of index PCI (short term: up to 24 hours, mid-term: 24 hours to less than 6 months, and long term: more than 6 months). Results. Of the 1799 patients, 61% were men and 47.08% had history of smoking (75% of the smokers were men). At the time of index PCI, smokers were significantly younger than nonsmokers. Also, MACE were significantly higher in smokers than nonsmokers, which was particularly pronounced at the long-term interval. In the nonsmokers group, there was no difference in MACE occurrence between men and women. However, of the smokers, women showed significantly higher MACE rate compared with men peers. Conclusion. Smoking makes women more prone to MACE in comparison to men among patients with stable CAD after PCI with drug-eluting stent.

scholarly journals Impact of established cardiovascular disease on 10-year death after coronary revascularization for complex coronary artery disease

2021 ◽  
Author(s):  
Rutao Wang ◽  
Scot Garg ◽  
Chao Gao ◽  
Hideyuki Kawashima ◽  
Masafumi Ono ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Revascularization ◽  
Long Term Outcomes ◽  
Vital Status ◽  
Increased Risk ◽  
Artery Disease ◽  
The Impact

Abstract Aims To investigate the impact of established cardiovascular disease (CVD) on 10-year all-cause death following coronary revascularization in patients with complex coronary artery disease (CAD). Methods The SYNTAXES study assessed vital status out to 10 years of patients with complex CAD enrolled in the SYNTAX trial. The relative efficacy of PCI versus CABG in terms of 10-year all-cause death was assessed according to co-existing CVD. Results Established CVD status was recorded in 1771 (98.3%) patients, of whom 827 (46.7%) had established CVD. Compared to those without CVD, patients with CVD had a significantly higher risk of 10-year all-cause death (31.4% vs. 21.7%; adjusted HR: 1.40; 95% CI 1.08–1.80, p = 0.010). In patients with CVD, PCI had a non-significant numerically higher risk of 10-year all-cause death compared with CABG (35.9% vs. 27.2%; adjusted HR: 1.14; 95% CI 0.83–1.58, p = 0.412). The relative treatment effects of PCI versus CABG on 10-year all-cause death in patients with complex CAD were similar irrespective of the presence of CVD (p-interaction = 0.986). Only those patients with CVD in ≥ 2 territories had a higher risk of 10-year all-cause death (adjusted HR: 2.99, 95% CI 2.11–4.23, p < 0.001) compared to those without CVD. Conclusions The presence of CVD involving more than one territory was associated with a significantly increased risk of 10-year all-cause death, which was non-significantly higher in complex CAD patients treated with PCI compared with CABG. Acceptable long-term outcomes were observed, suggesting that patients with established CVD should not be precluded from undergoing invasive angiography or revascularization. Trial registration SYNTAX: ClinicalTrials.gov reference: NCT00114972. SYNTAX Extended Survival: ClinicalTrials.gov reference: NCT03417050. Graphic abstract

Impact of Hybrid Operating Rooms on Long-Term Clinical Outcomes Following Fenestrated and Branched Endovascular Aortic Repair

2021 ◽  
pp. 152660282199672
Author(s):  
Giovanni Tinelli ◽  
Marie Bonnet ◽  
Adrien Hertault ◽  
Simona Sica ◽  
Gian Luca Di Tanna ◽  
...  
Keyword(s):  
Operating Room ◽  
Clinical Outcomes ◽  
Cox Regression ◽  
Statistical Significance ◽  
Aortic Aneurysms ◽  
Study Patient ◽  
Cox Regression Analysis ◽  
Significant Difference ◽  
The Impact

Purpose: Evaluate the impact of hybrid operating room (HOR) guidance on the long-term clinical outcomes following fenestrated and branched endovascular repair (F-BEVAR) for complex aortic aneurysms. Materials and Methods: Prospectively collected registry data were retrospectively analyzed to compare the procedural, short- and long-term outcomes of consecutive F-BEVAR performed from January 2010 to December 2014 under standard mobile C-arm versus hybrid room guidance in a high-volume aortic center. Results: A total of 262 consecutive patients, including 133 patients treated with a mobile C-arm equipped operating room and 129 with a HOR guidance, were enrolled in this study. Patient radiation exposure and contrast media volume were significantly reduced in the HOR group. Short-term clinical outcomes were improved despite higher case complexity in the HOR group, with no statistical significance. At a median follow-up of 63.3 months (Q1 33.4, Q3 75.9) in the C-arm group, and 44.9 months (Q1 25.1, Q3 53.5, p=0.53) in the HOR group, there was no statistically significant difference in terms of target vessel occlusion and limb occlusion. When the endograft involved 3 or more fenestrations and/or branches (complex F-BEVAR), graft instability (36% vs 25%, p=0.035), reintervention on target vessels (20% vs 11%, p=0.019) and total reintervention rates (24% vs 15%, p=0.032) were significantly reduced in the HOR group. The multivariable Cox regression analysis did not show statistically significant differences for long-term death and aortic-related death between the 2 groups. Conclusion: Our study suggests that better long-term clinical outcomes could be observed when performing complex F-BEVAR in the latest generation HOR.

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