Long-term clinical outcomes after upgrade to resynchronization therapy: A propensity score–matched analysis

Abstract Background Although European guideline recommends that statin should be given to all patients with acute myocardial infarction (AMI), irrespective of cholesterol concentration, limited studies were focused on the long-term effects of statin therapy between ST-segment elevation MI (STEMI) and non-ST-segment elevation MI (NSTEMI). Purpose The authors conducted the study to compare the relative beneficial role of statin on 2-year major clinical outcomes between STEMI and NSTEMI in patients who underwent successful PCI with DES. Methods Finally, a total of 26317 AMI patients who underwent stent implantation and who were prescribed the statin were enrolled and they were separated into two groups; the STEMI group (n=15002) and the NSTEMI group (n=11315). The clinical endpoint was the occurrence of major adverse cardiac events (MACE) defined as all-cause death, recurrent myocardial infarction (re-MI), total coronary revascularization (target lesion revascularization [TLR], target vessel revascularization [TVR], non-TVR) during 2-year follow-up period. Results After propensity score-matched (PSM) analysis, two PSM groups (7746 pairs, n=15492, C-statistic = 0.766) were generated. In the total study population, the cumulative incidences of MACE, all-cause death, and cardiac death were significantly higher in the NSTEMI group. However, after PSM, the cumulative incidence of all-cause death (Hazard ratio, 1.386; 95% CI, 1.133–1.696; p=0.002) was significantly higher in the NSTEMI group. The cumulative incidences of MACE, cardiac death, re-MI, total revascularization, TLR, TVR, and non-TVR were similar between the two groups (Table 1). Outcomes Cumulative Events at 2-year (%) Hazard Ratio (95% CI) p value STEMI NSTEMI Log-rank Propensity score matched patients MACE 532 (7.2) 584 (8.1) 0.092 1.106 (0.984–1.244) 0.092 All-cause death 163 (2.2) 224 (3.1) 0.001 1.386 (1.133–1.696) 0.002 Cardiac death 121 (1.5) 148 (2.0) 0.088 1.232 (0.969–1.566) 0.089 Re-MI 117 (1.6) 107 (1.5) 0.545 0.922 (0.710–1.199) 0.545 Total revascularization 291 (4.1) 307 (4.4) 0.422 1.068 (0.910–1.254) 0.423 TLR 92 (1.3) 89 (1.2) 0.880 0.978 (0.731–1.309) 0.880 TVR 173 (2.4) 184 (2.6) 0.478 1.078 (0.876–1.327) 0.478 Non-TVR 123 (1.7) 130 (1.9) 0.593 1.070 (0.836–1.369) 0.539 Conclusion The mortality reduction capability of statin was more prominent in the STEMI group compared with the NSTEMI group.

Download Full-text

THE IMPACT OF IMPROVEMENT OF MITRAL REGURGITATION ON LONG TERM CLINICAL OUTCOMES IN PATIENTS UNDERGOING CARDIAC RESYNCHRONIZATION THERAPY.

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(10)60035-6 ◽

2010 ◽

Vol 55 (10) ◽

pp. A4.E34

Author(s):

Kenji Ando ◽

Satoshi Shizuta ◽

Takeshi Arita ◽

Riki Fujii ◽

Kouichi Inoue ◽

...

Keyword(s):

Mitral Regurgitation ◽

Cardiac Resynchronization Therapy ◽

Clinical Outcomes ◽

Cardiac Resynchronization ◽

Resynchronization Therapy ◽

The Impact

Download Full-text

P869Impact of different nitrate therapies on long-term clinical outcomes of patients with vasospastic angina: a propensity score-matched analysis

European Heart Journal ◽

10.1093/eurheartj/ehx501.p869 ◽

2017 ◽

Vol 38 (suppl_1) ◽

Author(s):

T.K. Park ◽

J.H. Yang ◽

Y.B. Song ◽

J.Y. Hahn ◽

J.H. Choi ◽

...

Keyword(s):

Propensity Score ◽

Clinical Outcomes ◽

Vasospastic Angina

Download Full-text

Laminectomy alone versus laminectomy with fusion for degenerative cervical myelopathy: a long-term study of a national cohort

European Spine Journal ◽

10.1007/s00586-021-07067-w ◽

2021 ◽

Author(s):

Eddie de Dios ◽

Robert F. Heary ◽

Lars Lindhagen ◽

Anna MacDowall

Keyword(s):

Propensity Score ◽

Propensity Score Matching ◽

Clinical Outcomes ◽

Cervical Myelopathy ◽

Outcome Measure ◽

Instrumented Fusion ◽

Patient Reported ◽

National Cohort ◽

Degenerative Cervical Myelopathy

Abstract Purpose To compare patient-reported 5-year clinical outcomes between laminectomy alone versus laminectomy with instrumented fusion in patients with degenerative cervical myelopathy in a population-based cohort. Methods All patients in the national Swedish Spine Register (Swespine) from January 2006 until March 2019, with degenerative cervical myelopathy, were assessed. Multiple imputation and propensity score matching based on clinicodemographic and radiographic parameters were used to compare patients treated with laminectomy alone with patients treated with laminectomy plus posterior-lateral instrumented fusion. The primary outcome measure was the European Myelopathy Score, a validated patient-reported outcome measure. The scale ranges from 5 to 18, with lower scores reflecting more severe myelopathy. Results Among 967 eligible patients, 717 (74%) patients were included. Laminectomy alone was performed on 412 patients (mean age 68 years; 149 women [36%]), whereas instrumented fusion was added for 305 patients (mean age 68 years; 119 women [39%]). After imputation, the propensity for smoking, worse myelopathy scores, spondylolisthesis, and kyphosis was slightly higher in the fusion group. After imputation and propensity score matching, there were on average 212 pairs patients with a 5-year follow-up in each group. There were no important differences in patient-reported clinical outcomes between the methods after 5 years. Due to longer hospitalization times and implant-related costs, the mean cost increase per instrumented patient was approximately $4700 US. Conclusions Instrumented fusions generated higher costs and were not associated with superior long-term clinical outcomes. These findings are based on a national cohort and can thus be regarded as generalizable.

Download Full-text