scholarly journals TCT-818 A Comparison Of Transradial Approach Versus Transfemoral Approach For Percutaneous Coronary Intervention In Women: A Propensity Score Matching Analysis

2014 ◽  
Vol 64 (11) ◽  
pp. B239
Author(s):  
Peiyuan He ◽  
Yuejin Yang ◽  
Shubin Qiao ◽  
Bo Xu ◽  
Yongjian Wu ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Coronary Intervention ◽  
Transfemoral Approach ◽  
Transradial Approach ◽  
Propensity Score Matching Analysis ◽  
Percutaneous Coronary

scholarly journals Late survival benefit of percutaneous coronary intervention compared with medical therapy in patients with coronary chronic total occlusion: a 10-year follow-up study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T.K Park ◽  
S.H Choi ◽  
J.M Lee ◽  
J.H Yang ◽  
Y.B Song ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Treatment Strategy ◽  
Initial Treatment ◽  
Cardiac Death ◽  
Chronic Total Occlusion ◽  
Coronary Intervention ◽  
Total Occlusion ◽  
Percutaneous Coronary

Abstract Background As an initial treatment strategy, percutaneous coronary intervention (PCI) for coronary chronic total occlusion (CTO) did not show mid-term survival benefits compared with optimal medical therapy (OMT). Purpose To compare 10-year clinical outcomes between OMT and PCI in CTO patients. Methods Between March 2003 and February 2012, 2,024 patients with CTO were enrolled in a single center registry and followed for about 10 years. We excluded CTO patients who underwent coronary artery bypass grafting, and classified patients into the OMT group (n=664) or PCI group (n=883) according to initial treatment strategy. Propensity-score matching was performed to minimize potential selection bias. The primary outcome was cardiac death. Results In the PCI group, 699 patients (79.2%) underwent successful revascularization. Clinical and angiographic characteristics revealed more comorbidities and more complex lesions in the OMT group than in the PCI group. At 10 years, the PCI group had lower risks of cardiac death (10.4% versus 22.3%; HR 0.43; 95% CI 0.32 to 0.57; p<0.001) than the OMT group. After the propensity-score matching analyses, the PCI group had lower risks of cardiac death (13.6% versus 20.8%; HR 0.62; 95% CI 0.44 to 0.88; p=0.007), acute myocardial infarction (6.3% versus 11.2%; HR 0.55; 95% CI 0.34 to 0.91; p=0.02), any revascularization (23.9% versus 32.2%; HR 0.67; 95% CI 0.51 to 0.88; p=0.004) than the OMT group. The beneficial effects of CTO PCI were consistent across various subgroups (all p-values for interaction: non-significant). Conclusions As an initial treatment strategy, PCI reduced late cardiac death compared with OMT in CTO patients. Cardiac death in matched population Funding Acknowledgement Type of funding source: None

scholarly journals A kórelőzményben szereplő revascularisatiós műtét rövid és hosszú távú prognosztikai jelentősége szívinfarktus miatt kezelt betegekben

2021 ◽  
Vol 162 (5) ◽  
pp. 177-184
Author(s):  
András Jánosi ◽  
Tamás Ferenci ◽  
András Komócsi ◽  
Péter Andréka
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
St Elevation

Összefoglaló. Bevezetés: A szívinfarktust megelőző revascularisatiós beavatkozások prognosztikai jelentőségével kapcsolatban kevés elemzés ismeretes, hazai adatokat eddig nem közöltek. Célkitűzés: A szerzők a Nemzeti Szívinfarktus Regiszter adatait felhasználva elemezték a koszorúér-revascularisatiós szívműtétet (CABG) túlélt betegek prognózisát heveny szívinfarktusban. Módszer: Az adatbázisban 2014. 01. 01. és 2017. 12. 31. között 55 599 beteg klinikai és kezelési adatait rögzítették: 23 437 betegnél (42,2%) ST-elevációval járó infarktus (STEMI), 32 162 betegnél (57,8%) ST-elevációval nem járó infarktus (NSTEMI) miatt került sor a kórházi kezelésre. Vizsgáltuk a CABG után fellépő infarktus miatt kezelt betegek klinikai adatait és prognózisát, amelyeket azon betegek adataival hasonlítottunk össze, akiknél nem szerepelt szívműtét a kórelőzményben (kontrollcsoport). Eredmények: A betegek többsége mindkét infarktustípusban férfi volt (62%, illetve 59%). Az indexinfarktust megelőzően a betegek 5,33%-ánál (n = 2965) történt CABG, amely az NSTEMI-betegeknél volt gyakoribb (n = 2357; 7,3%). A CABG-csoportba tartozó betegek idősebbek voltak, esetükben több társbetegséget (magas vérnyomás, diabetes mellitus, perifériás érbetegség) rögzítettek. Az indexinfarktus esetén a katéteres koszorúér-intervenció a kontrollcsoport STEMI-betegeiben gyakoribb volt a CABG-csoporthoz viszonyítva (84% vs. 71%). Az utánkövetés 12 hónapja során a betegek 4,7–12,2%-ában újabb infarktus, 13,7–17,3%-ában újabb katéteres koszorúér-intervenció történt. Az utánkövetés alatt a CABG-csoportban magasabbnak találtuk a halálozást. A halálozást befolyásoló tényezők hatásának korrigálására Cox-féle regressziós analízist, illetve ’propensity score matching’ módszert alkalmaztunk. Mindkét módszerrel történt elemzés azt mutatta, hogy a kórelőzményben szereplő koszorúér-revascularisatiós műtét nem befolyásolta a túlélést. Amennyiben a beteg kórelőzményében szerepelt a koszorúérműtét, az indexinfarktus nagyobb eséllyel volt NSTEMI, mint STEMI (HR: 1,612; CI 1,464–1,774; p<0,001). Következtetés: A kórelőzményben szereplő koszorúér-revascularisatiós műtét nem befolyásolta a szívinfarktus miatt kezelt betegek életkilátásait. Orv Hetil. 2021; 162(5): 177–184. Summary. Introduction: Little analysis is known about the prognostic significance of revascularization interventions before myocardial infarction; no domestic data have been reported so far. Method: The authors use data from the Hungarian Myocardial Infarction Registry to analyze the prognosis of patients with acute myocardial infarction who had previous coronary artery bypass grafting (CABG). Between 01. 01. 2014. and 31. 12. 2017, 55 599 patients were recorded in the Registry: 23 437 patients (42.2%) had ST-elevation infarction (STEMI) and 31 162 patients (57.8%) had non-ST-elevation infarction (NSTEMI). The clinical data and prognosis of patients treated for infarction after CABG were compared with those of patients without a CABG history. Results: The majority of patients were male (59% and 60%, respectively). Prior to index infarction, CABG occurred in 5.33% of patients (n = 2965), which was more common in NSTEMI (n = 2357; 7.3%). The CABG patients were older and had more comorbidities (hypertension, diabetes mellitus, peripheral vascular disease). For index infarction, percutaneous coronary intervention was more common in STEMI patients in the control group compared to CABG (84% vs. 71%). At 12 months of follow-up, 4.7–12.2% of patients had reinfarction, and 13.7–17.3% had another percutaneous coronary intervention. During the full follow-up, the CABG group had higher mortality. Cox regression analysis and propensity score matching were used to correct for the effect of other factors influencing mortality. Both analyses showed CABG did not affect survival. In the CABG group, the index infarction was more likely to be NSTEMI than STEMI (HR: 1.612; CI 1.464–1.774; p<0.001). Conclusion: The history of CABG does not affect the life expectancy of patients treated for an acute myocardial infarction. Orv Hetil. 2021; 162(5): 177–184.

Impact of Pre-Existing Depression in Patients With Coronary Artery Disease Undergoing Percutaneous Coronary Intervention; A Nationwide Cohort Study

2020 ◽  
Author(s):  
Jangho Park ◽  
Sangwoo Park ◽  
Yong-Giun Kim ◽  
Soe Hee Ann ◽  
Hyun Woo Park ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
All Cause Mortality ◽  
Artery Disease ◽  
The Impact

Abstract The impact of pre-existing depression on mortality in individuals with established coronary artery disease (CAD) remains unclear. We evaluate the clinical implications of pre-existing depression in patients who underwent percutaneous coronary intervention (PCI). Based on National Health Insurance claims data in Korea, patients without a known history of CAD who underwent PCI between 2013 and 2017 were enrolled. The study population was divided into patients with angina (n=50,256) or acute myocardial infarction (AMI; n=40,049). The primary endpoint, defined as all-cause death, was compared between the non-depression and depression groups using propensity score matching analysis. After propensity score matching, there were 4,262 and 2,346 matched pairs of patients with angina and AMI, respectively. During the follow-up period, there was no significant difference in the incidence of all-cause death in the angina (hazard ratio [HR] of depression, 1.013; 95% confidence interval [CI]: 0.893-1.151) and AMI (HR, 0.991; 95% CI: 0.865-1.136) groups. However, angina patients less than 65 years of age with depression had higher all-cause mortality (HR, 1.769; 95% CI: 1.240-2.525). In Korean patients undergoing PCI, pre-existing depression is not associated with poorer clinical outcomes. However, in younger patients with angina, depression is associated with higher all-cause mortality.

Abstract 13529: Percutaneous Coronary Intervention in Ambulatory Surgery Centers: Is It Safe?

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Kevin Li ◽  
Neil M Kalwani ◽  
Paul A Heidenreich ◽  
William F Fearon
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Ambulatory Surgery ◽  
Coronary Intervention ◽  
Bleeding Complications ◽  
Intravascular Imaging ◽  
Ambulatory Surgery Centers ◽  
Increased Risk ◽  
Percutaneous Coronary

Introduction: In January 2020, Medicare began reimbursing for percutaneous coronary intervention (PCI) performed in ambulatory surgery centers (ASCs), but little is known about characteristics and outcomes of patients who have undergone ASC PCI previously. Methods: Using commercial insurance claims from the MarketScan® Databases, we characterized patients 18 years or older who underwent hospital outpatient department (HOPD) or ASC PCI for stable ischemic heart disease between April 1, 2007, and December 1, 2016. We used propensity score matching of HOPD and ASC PCI cohorts to measure the association between treatment setting and 30-day outcomes (myocardial infarction, bleeding complications, and all-cause admission). Results: The unmatched sample consisted of 95,492 HOPD and 849 ASC PCI patients. Patients were more likely to undergo ASC PCI if they were younger than 65 (OR 1.72, 95% CI 1.43-2.06), lived in the southern U.S., or were covered by managed (OR 2.31, 95% CI 1.73-3.08) or consumer-driven (OR 2.57, 95% CI 1.73-3.82) compared to comprehensive health plans. ASC PCI was less likely in patients with a history of stroke (OR 0.45, 95% CI 0.28-0.72). Intravascular imaging and physiology testing were more frequently performed in HOPD than in ASC PCI (18.3% vs. 12.5%, respectively; p < 0.001). After propensity-score matching, ASC PCI was associated with increased odds of bleeding complications (OR 2.43, 95% CI 1.22-4.84, p = 0.011). Differences in other outcomes were not statistically significant. Conclusions: Patients undergoing outpatient elective PCI in ASCs were younger and more likely to live in the southern U.S or have managed or consumer-driven health insurance plans. Intravascular imaging and physiology testing were performed more frequently in HOPD than in ASC PCI. PCI in the ASC setting was also associated with an increased risk of bleeding complications. Further study of this population is warranted as ASC PCI volume increases under Medicare.

scholarly journals Comparison of the incidence of periprocedural myocardial infarction between percutaneous coronary intervention with versus without rotational atherectomy using propensity score-matching

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yusuke Mizuno ◽  
Kenichi Sakakura ◽  
Hiroyuki Jinnouchi ◽  
Yousuke Taniguchi ◽  
Takunori Tsukui ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Myocardial Damage ◽  
Coronary Intervention ◽  
Slow Flow ◽  
Percutaneous Coronary ◽  
High Incidence ◽  
Periprocedural Myocardial Infarction

AbstractComplications such as slow flow are frequently observed in percutaneous coronary intervention (PCI) with rotational atherectomy (RA). However, it remains unclear whether the high incidence of slow flow results in the high incidence of periprocedural myocardial infarction (PMI), reflecting real myocardial damage. The aim of this study was to compare the incidence of PMI between PCI with versus without RA using propensity score-matching. We included 1350 elective PCI cases, which were divided into the RA group (n = 203) and the non-RA group (n = 1147). After propensity score matching, the matched RA group (n = 190) and the matched non-RA group (n = 190) were generated. The primary interest was to compare the incidence of PMI between the matched RA and non-RA groups. Before propensity score matching, the incidence of slow flow and PMI was greater in the RA group than in the non-RA group. After matching, the incidence of slow flow was still greater in the matched RA group than in the matched non-RA group (16.8% vs. 9.5%, p = 0.048). However, the incidence of PMI was similar between the matched RA and matched non-RA group (7.4% vs. 5.3%, p = 0.528, standardized difference: 0.086). In conclusion, although use of RA was associated with greater risk of slow flow, use of RA was not associated with PMI after a propensity score-matched analysis. The fact that RA did not increase the risk of myocardial damage in complex lesions would have an impact on revascularization strategy for severely calcified coronary lesions.

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