scholarly journals LONG-TERM ADVERSE OUTCOMES IN PATIENTS WITH PERCUTANEOUS CORONARY INTERVENTION (PCI) IN BYPASS GRAFTS. A CAUSE FOR CONCERN

2021 ◽  
Vol 77 (18) ◽  
pp. 1046
Author(s):  
Wan Kim ◽  
Gregory Hirsch ◽  
Catherine Kells ◽  
Ata-Ur-Rehman Quraishi ◽  
Helen Bishop ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Adverse Outcomes ◽  
Bypass Grafts ◽  
Percutaneous Coronary

Gamma-Glutamyl Transferase-to-Platelet Ratio as a Novel Predictor of Long-Term Adverse Outcomes in Patients after Undergoing Percutaneous Coronary Intervention: A Retrospective Cohort Study

2019 ◽  
Vol 119 (06) ◽  
pp. 1021-1030 ◽  
Author(s):  
Ying-Ying Zheng ◽  
Ting-Ting Wu ◽  
You Chen ◽  
Xian-Geng Hou ◽  
Yi Yang ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Retrospective Cohort ◽  
Independent Predictor ◽  
Coronary Intervention ◽  
Adverse Outcomes ◽  
Gamma Glutamyl Transferase ◽  
Bleeding Events ◽  
Percutaneous Coronary ◽  
Glutamyl Transferase

Background Gamma-glutamyl transferase (GGT) has been shown to be involved in the pathogenesis of both coronary artery disease (CAD) and liver disease, and it has been reported that the GGT-to-platelet ratio (GPR) is an independent predictor for adverse outcomes from liver fibrosis and hepatic carcinoma. However, the relation between the GPR and adverse outcomes in CAD patients after percutaneous coronary intervention (PCI) has not been investigated. Methods A total of 5,636 patients enrolled in Clinical Outcomes and Risk Factors of Patients with Coronary Heart Disease after PCI, a retrospective cohort study, from January 2008 to December 2016, were divided into two groups according to GPR (GPR < 0.12, n = 2,769 and GPR ≥ 0.12, n = 2,867). The primary outcome was long-term mortality including all-cause mortality (ACM) and cardiac mortality (CM) after PCI. The average follow-up time was 35.9 ± 22.6 months. Results We found that there were significant differences between the two groups in the incidences of ACM (p = 0.011), CM (p = 0.001), major adverse cardiovascular events (MACEs, p < 0.024), major adverse cardiovascular and cerebrovascular events (MACCEs, p = 0.014) and bleeding events (p = 0.003). Multivariate Cox regression analyses showed that GPR was an independent predictor for ACM (hazard ratio [HR]: 1.536 [95% confidence interval [CI]:1.162–2.032], p = 0.003), CM (HR: 1.763 [95% CI: 1.283–2.424], p < 0.001), MACCEs (HR: 1.269 [95% CI: 1.066–1.511], p = 0.007) and MACEs (HR: 1.308 [95% CI: 1.089–1.570], p = 0.004) in stable CAD patients but that it was an independent predictor for only the incidence of bleeding events (HR: 3.104 [95% CI: 1.680–5.736], p < 0.001) in acute coronary syndrome (ACS) patients. Conclusion This study indicates that GPR is an independent and novel predictor of adverse long-term outcomes in CAD patients who underwent PCI.

scholarly journals Premature Discontinuation of Dual Antiplatelet Therapy After Coronary Stenting in Veterans: Characteristics and Long‐Term Outcomes

2021 ◽  
Author(s):  
Scott Kinlay ◽  
Lien Quach ◽  
Jean Cormack ◽  
Natalie Morgenstern ◽  
Ying Hou ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
First Generation ◽  
Second Generation ◽  
Dual Antiplatelet Therapy ◽  
Coronary Intervention ◽  
Adverse Outcomes ◽  
Drug Eluting Stents ◽  
Percutaneous Coronary ◽  
Drug Eluting

Background Premature discontinuation of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention is related to higher short‐term risks of adverse outcomes. Whether these risks persist in the long‐term is uncertain. Methods and Results We assessed all patients having percutaneous coronary intervention with coronary second‐ or first‐generation drug‐eluting stents in the Veterans Affairs healthcare system between 2006 and 2012 who were free of major ischemic or bleeding events in the first 12 months. The characteristics of patients who stopped DAPT prematurely (1–9 months duration), compared with >9 to 12 months, or extended duration (>12 months) were assessed by odds ratios (ORs) from multivariable logistic models. The risk of adverse clinical outcomes over a mean 5.1 years in patients who stopped DAPT prematurely was assessed by hazard ratios (HRs) and 95% CIs from Cox regression models. A total of 14 239 had second‐generation drug‐eluting stents, and 8583 had first‐generation drug‐eluting stents. Premature discontinuation of DAPT was more likely in Black patients (OR, 1.54; 95% CI, 1.40–1.68), patients with greater frailty (OR, 1.04; 95% CI, 1.03–1.05), and patients with higher low‐density lipoprotein cholesterol, and less likely in patients on statins (OR, 0.87; 95% CI, 0.80–0.95). Patients who stopped DAPT prematurely had higher long‐term risks of death (second‐generation drug‐eluting stents: HR, 1.35; 95% CI, 1.19–1.56), myocardial infarction (second‐generation drug‐eluting stents: HR, 1.46; 95% CI, 1.22–1.74), and repeated coronary revascularization (second‐generation drug‐eluting stents: HR, 1.24; 95% CI, 1.08–1.41). Conclusions Patients who stop DAPT prematurely have features that reflect greater frailty, poorer medication use, and other social factors. They continue to have higher risks of major adverse outcomes over the long‐term and may require more intensive surveillance many years after percutaneous coronary intervention.

scholarly journals Monocyte-to-albumin Ratio as a Novel Predictor of Long-term Adverse Outcomes in Patients after Percutaneous Coronary Intervention

2021 ◽  
Author(s):  
Zeng-Lei Zhang ◽  
Qian-Qian Guo ◽  
Jun-Nan Tang ◽  
Jian-Chao Zhang ◽  
Meng-Die Cheng ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Cox Regression ◽  
Coronary Intervention ◽  
Adverse Outcomes ◽  
Major Adverse Cardiovascular Events ◽  
Monocyte Count ◽  
Albumin Ratio ◽  
Kaplan Meier ◽  
Percutaneous Coronary

Background: Monocyte count and serum albumin (Alb) have been proven to be involved in the process of systemic inflammation. Therefore, we investigated the prognostic value of monocyte-to-albumin ratio (MAR) in patients who underwent percutaneous coronary intervention (PCI). Methods：We enrolled a total of 3561 patients in this study from January 2013 to December 2017. They were divided into two groups according to MAR cutoff value (MAR &lt; 0.014, n = 2220; and MAR ≥ 0.014, n = 1119) as evaluated by receiver operating characteristic (ROC) curve. The average follow-up time was 37.59 ± 22.24 months. Results: The two groups differed significantly in the incidences of all-cause mortality (ACM; P &lt; 0.001), cardiac mortality (CM; P &lt; 0.001), major adverse cardiovascular events (MACEs; P = 0.038), and major adverse cardiovascular and cerebrovascular events (MACCEs; P = 0.037). Multivariate Cox regression analyses revealed MAR as an independent prognostic factor for ACM and CM. The incidence of ACM increased 56.5% (hazard ratio [HR] = 1.565; 95% confidence interval [CI], 1.086–2.256; P = 0.016) and that of CM increased 76.3% (HR = 1.763; 95% CI, 1.106–2.810; P = 0.017) in patients in the higher-MAR group. Kaplan–Meier survival analysis suggested that patients with higher MAR tended to have an increased accumulated risk of ACM ( Log rank P &lt; 0.001) and CM (Log rank P &lt; 0.001). Conclusion: The findings of the present study suggested that MAR was a novel independent predictor of long-term mortality in patients who underwent PCI.

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