scholarly journals Study of Global Longitudinal Strain and N Terminal Pro BNP as Predictors of Outcome in Acute ST-Segment Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Interventions

2021 ◽  
Vol 23 (Supplement_D) ◽  
Author(s):  
Gehan Magdy ◽  
Salah El-tahhan ◽  
Fatema Al-zahraa Ahmed ◽  
Mahmoud Hasanein
Keyword(s):  
Adverse Outcome ◽  
Global Longitudinal Strain ◽  
P Value ◽  
Roc Curve Analysis ◽  
St Segment Elevation ◽  
Acute Stemi ◽  
St Segment ◽  
Percutaneous Coronary ◽  
The Mean

Abstract Background Risk stratification of patients presenting with Acute ST-segment elevation myocardial infarction (STEMI) is of greatest importance as it may help to start early therapeutic procedures that could improve the outcome. Our study is designed to assess the prognostic value of N-terminal pro brain natriuretic peptide (NT-proBNP) and global longitudinal strain (GLS) of the left ventricle measured by 2 dimensional speckle tracking echocardiography (STE) in patients presenting with acute STEMI and treated by primary percutaneous coronary interventions (PPCI). Patients and Methods the study prospectively included 100 patients(their age 55.69 ±8.70 years, and 75% were males)presented to our institute (from march 2019 to December 2019) by acute STEMI and treated by PPCI within 12 hour of the onset of chest pain, excluding those with left ventricular ejection fraction ≤40%, left bundle branch block, atrial fibrillation, significant valvular disease, patients with non cardiac causes that interfere with NT-Pro BNP level eg.(renal failure, chronic obstructive pulmonary disease, acute respiratory distress syndrome, pneumonia, liver cirrhosis, hyperthyroidism, and on those on chemotherapy). All patients were subjected to peripheral samples of plasma for analysis of NT- proBNP and 2dimentional STE for calculation of the GLS, both were done within 24 hours of admission, and follow up of all patients were done for 6 months to assess outcome. Results The mean GLS for all patients was -10.41 ± 3.59%, and the mean NT- proBNP (2090.1 ± 1375.8) pg/ml. 20 patients (20%) had adverse events during the 6 month follow up including (1(1%) had all cause mortality, 2(2%) had cardiovascular mortality, 6(6%) had reinfarction, 11(11%) had heart failure hospitalization, and according to ROC curve analysis the GLS cut off value of (≤- 8) was able to discriminate patients with adverse outcome (AUC=0.971, p value<0.001,CI=“0.940-1.001”,sensitivity=90%, specificity=91.67%, PPV=78.3%, NPV=96.5%) (figure 1, 2), also according to ROC curve analysis NT-pro BNP cut off value of (>2318pg/ml) was able to discriminate patients with adverse outcome (AUC=0.802,p value<0.001, CI=“0.685-0.920”, sensitivity=89%, specificity=75%, PPV=51.6%, NPV=91.8%) (Figure 3, 4). There was a statistically significant inverse correlation between GLS and NT- ProBNP (r=-0.492*, p value<0.001). In multivariate COX regression analysis for the parameters affecting the outcome, GLS was shown to be the most significant parameter in the prediction of reaching adverse outcome in STEMI patients (p value=0.003, OR “95%C.I”= 0.721 (0.580–0.896). Conclusions our study concluded that both GLS and NT-proBNP are significantly related to adverse outcome with more superiority of the GLS to NT- pro BNP in adverse outcome prediction in patients acute STEMI treated by PPCI.

In-hospital and long-term outcomes of ST-segment elevation myocardial infarction patients undergoing primary percutaneous coronary intervention

2021 ◽  
Author(s):  
Dogac Oksen ◽  
Mert Sarilar ◽  
Gursu Demirci ◽  
Ismail Haberal ◽  
Okay Abaci
Keyword(s):  
Myocardial Infarction ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Long Term Outcomes ◽  
St Segment Elevation ◽  
St Segment ◽  
Percutaneous Coronary ◽  
The Mean

Objectives: We evaluated in-hospital and long-term outcomes of patients who underwent primary percutaneous coronary intervention (PCI) in a tertiary center. Patients and Methods: We examined 1550 patients (mean age: 58.5 years, 83.1% male) admitted with acute ST-segment elevation myocardial infarction (AMI) who underwent primary PCI and were followed-up prospectively. The primary outcomes were in-hospital death and major adverse cardiac events (MACE) at follow-up. Results: The mean duration of ischemia at admission was 2.85 ± 2.49 hours; and the mean door-to-device time was 43.2 ± 20.3 minutes. During hospitalization, all-cause mortality occurred in 73 patients (4.7%). Multivariate analysis revealed that advanced age, impaired left ventricular ejection function, high Killip functional class, hemoglobin level at admission, ventricular arrhythmias, and advanced atrioventricular block were independent predictors of poor prognosis (OR: 1.07, 0.93, 15.34, 1.44, 3.79, and 4.26, respectively). Among discharged patients with a median follow-up of 49.5 (25‒73) months, 12.4% experienced all-cause mortality, 12.5% had recurrent myocardial infarction (MI), and 2.3% had a cerebrovascular accident. The strongest independent MACE predictors were impaired left ventricular function, poor glomerular filtration rate, low albumin level, and a history of cerebrovascular disease (HR: 0.97, 0.99, 0.65, and 2.50, respectively). Secondary outcomes were contrast-induced acute kidney injury (16.7%), ventricular arrhythmias (6.1%), advanced atrioventricular block (3.7%), atrial fibrillation (7.6%), and major bleeding (1.6%). Conclusion: AMI still has a poor long-term prognosis. These results emphasize the advantages of rapid, non-delayed revascularization. Patients should be followed-up closely after discharge in both the short- and long-term.

P5525Impact of clinical presentation at admission on long-term clinical outcomes in patients undergoing percutaneous coronary interventions - a contemporary registry data

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
L Piatek ◽  
L Zandecki ◽  
J Kurzawski ◽  
A Janion-Sadowska ◽  
M Zabojszcz ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Unstable Angina ◽  
Stable Angina ◽  
Clinical Presentation ◽  
P Value ◽  
Cardiac Events ◽  
St Segment Elevation ◽  
St Segment ◽  
Adverse Cardiac Events ◽  
Percutaneous Coronary

Abstract Background Both unstable angina (UA) and non-ST-segment elevation myocardial infarction (NSTEMI) are still classified together in non-ST-elevation acute coronary syndromes despite the fact they substantially differ in both clinical profile and prognosis. Purpose The aim of the present study was to evaluate contemporary clinical characteristics and outcomes of UA patients after percutaneous coronary intervention (PCI) in comparison with stable angina (SCAD) and myocardial infarction (NSTEMI as well as STEMI) in Swietokrzyskie District of Poland in years 2014–2017. Methods A total of 7'187 patients after PCI from ORPKI Registry (38% with diagnosis of UA) were included into the analysis. Impact of clinical presentation (UA, SCAD, NSTEMI, STEMI) on 3-year outcomes were determined. Results UA patients were older that SCAD but younger than NSTEMI individuals. Diabetes and hypertension were more often encountered into UA group than in NSTEMI but less often than in SCAD cases. In UA group the percentage of previous myocardial infarction (MI), PCI or coronary artery bypass grafting (CABG) was the highest among all analyzed groups. In 3-year observation the risk of death as well as myocardial infarction (MI) and major adverse cardiac events (MACE) in unstable angina after PCI was higher than in stable angina but considerably lower than in NSTEMI group. Multivariate analysis confirmed that prognosis in NSTEMI was substantially worse in comparison with UA (RR 1.365, 95% CI: 1.126–1.655, p=0.0015). On the contrary there were no difference in mortality risk between UA and SCAD patients (RR 1.189, 95% CI: 0.932–1.518, p=0.1620). Parallel results were observed in respect of MI and MACE. Independ predictors of death were: age, kidney disease, hypertension, diabetes, previous stroke or previous PCI. Multivariate logistic regression analyse Clinical presentation Death Myocardial infarction MACE RR 95% CI p-value RR 95% CI p-value RR 95% CI p-value NSTEMI/UA 1.365 1.126–1.655 0.0015 1.822 1.076–3.055 0.0260 1.514 1.267–1.807 <0.0001 NSTEMI/SCAD 1.624 1.251–2.109 0.0003 1.882 0.982–3.789 0.0568 1.604 1.275–2.094 <0.0001 UA/SCAD 1.189 0.932–1.518 0.1620 1.033 0.557–2.034 0.9219 1.060 0.855–1.323 0.6023 MACE, major adverse cardiac events; NSTEMI, non-ST-segment elevation myocardial infarction; UA, unstable angina; SCAD, stable angina. Conclusion Unstable angina accounted for 38% of all cases and was the most common diagnosis in patients that underwent PCI in that time. 3-year prognosis in UA was considerable better in comparison with NSTEMI. On contrary there was no difference in outcomes (death, MI, MACE) between UA and SCAD patients.

scholarly journals The role of single nucleotide polymorphism of val66met (rs6265) of the brain-derived neurotropic factor in formation of endpoints after st-segment elevation myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
O.V Petyunina ◽  
M.P Kopytsya ◽  
A.E Berezin ◽  
A.A Berezin
Keyword(s):  
Single Nucleotide Polymorphism ◽  
Bdnf Gene ◽  
Nucleotide Polymorphism ◽  
Single Nucleotide ◽  
St Segment Elevation ◽  
Acute Stemi ◽  
End Point ◽  
St Segment ◽  
The Brain

Abstract Background The single nucleotide polymorphism (SNP) Val66Met (rs6265) of the brain-derived neurotrophic factor (BDNF) gene is a possible candidate that is associated with the development of psychopathology and combines it with cardiovascular events. Purpose To research the possible associations of single-nucleotide polymorphism of Val66Met BDNF gene with the occurrence of endpoints after 6 months of follow-up after ST segment elevation myocardial infarction (STEMI). Methods 256 acute STEMI patients after successful primary percutaneous coronary intervention (PCI) were enrolled in the study. TIMI III blood flow restoring through culprit artery was determined. The study of SNP of Val66Met (rs6265) of the BDNF gene was performed by real-time polymerase chain reaction. The emotional state of the patients and its relationship with stress were assessed with the questionnaire “Depression, Anxiety and Stress-21”. All acute STEMI patients received adjuvant treatment due to current ESC recommendations. All procedures performed in the study involving human participants were in accordance with the ethical standards and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards and approved by the local ethics committee. Written inform consent was obtained from each patient. The primary endpoint was combined event (follow-up major adverse cardiac events – MACEs and hospitalization) that occurred within 6-month of the discharge from the hospital. MACEs were defined as the composite of CV death, recurrent angina, newly diagnosed heart failure. Results The frequency of genotypes Val66Met gene for BDNF in STEMI patients (n=256) was the following: 66ValVal=74.2% (n=190), 66ValMet + 66MetMet – 25.8% (n=66). The 66ValMet + 66MetMet polymorphism in the BDNF gene, stress and anxiety on 10–14 days before the event, as well as reduced left ventricular ejection fraction (LVEF), were independently associated with combined 6 months clinical end point after STEMI. Severity of depression according to depression scale was more profound in individuals with 66ValMet+66MetMet polymorphysms in BDNF gene (P=0.045) than in patients with 66ValVal genotype. Univariate and multivariate linear regressions has shown that 66ValMet+66MetMet genotype in BDNF gene, anxiety and stress before event, LVEF had independent power on dependent variable entitled combined end point after 6 month observation for STEMI patients with successful revascularization (P=0.0395). Kaplan-Meier curves demonstrated that STEMI patients with 66ValVal genotype in BDNF gene had a lower accumulation of combined end point compared with acute STEMI patients with 66ValMet+66ValMet polymorphism (Cox-criterion, P=0.019; log-rang criterion, P=0.03). Conclusion The Val66Met polymorphism in BDNF gene was found as an independent predictor for combined 6-month clinical end points after acute STEMI treated primary PCI. Funding Acknowledgement Type of funding source: None

scholarly journals Comparison of the Effects of Ticagrelor and Clopidogrel on Inflammatory Factors, Vascular Endothelium Functions and Short-Term Prognosis in Patients with Acute ST-Segment Elevation Myocardial Infarction Undergoing Emergency Percutaneous Coronary Intervention: a Pilot Study

2018 ◽  
Vol 48 (1) ◽  
pp. 385-396 ◽  
Author(s):  
Chang-Zheng Gao ◽  
Qian-Qian Ma ◽  
Jing Wu ◽  
Rui Liu ◽  
Fen Wang ◽  
...  
Keyword(s):  
Vascular Endothelium ◽  
Coronary Intervention ◽  
Control Group ◽  
Vascular Endothelial ◽  
St Segment Elevation ◽  
Acute Stemi ◽  
St Segment ◽  
Percutaneous Coronary ◽  
Significant Difference ◽  
Hs Crp

Background/Aims: Acute ST-segment elevation of myocardial infarction (STEMI) is the most severe type of acute coronary syndrome (ACS). Particular attention has been focused on studying the pathogenesis of STEMI, and how to prevent thrombosis, reduce inflammatory reaction, stabilize plaques and improve vascular endothelial functions to preserve the survived myocardium. This study aimed to compare the anti-inflammatory endothelium-protective effects, clinical prognosis, and relevant bleeding risks of ticagrelor versus clopidogrel in patients with STEMI who underwent urgent percutaneous coronary intervention (PCI) and provide certain experimental evidence and a theoretical basis for the selection of safe and effective drugs and their proper dosage, thereby further guiding clinical medication. Methods: We sequentially enrolled 193 patients (104 males and 89 females) admitted to hospital due to acute STEMI. These patients underwent urgent PCI between December 2013 and May 2015 and met the inclusion criteria. They were assigned (1: 1) into two groups according to different treatments, 97 patients in the ticagrelor group (treatment group), and 96 patients in the clopidogrel group (control group). Levels of hypersensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), and endothelial cell-specific molecule 1 (ESM-1) taken at admission and 24 h, 4 days, and 7 days after administration, as well as the correlation between the levels of IL-6, hs-CRP, and ESM-1, were determined in the two groups. At the same time, the effects of treatment with ticagrelor and clopidogrel on the efficacy endpoint events (ischemic and safety) were explored. Results: No statistically significant difference was found in the levels of hs-CRP, IL-6, or ESM-1 at admission between the two groups (P> 0.05); Their levels were significantly elevated 24 h after administration, with statistical differences between two groups (P< 0.05). Furthermore, a downward trend with statistically significant differences was found on Day 4 and Day 7 (P< 0.05); ESM-1 levels increased along with increases of hs-CRP and IL-6 levels, indicating ESM-1 was positively correlated with hs-CRP (r=0.523, P< 0.001) and IL-6 (r=0.431, P< 0.001); and the occurrence rates of ischemic endpoint events at 30 days were lower in the treatment group than in the control group. The occurrence of safety endpoint events was higher than in the control group; however, no statistically significant difference was found (P> 0.05). Conclusions: Compared with clopidogrel, ticagrelor appears to rapidly reduce the prevalence of inflammatory reactions and stabilize the functions of vascular endothelium to improve the stability of atherosclerotic plaque and decrease the occurrence rate of thrombosis as well as ischemic outcome events without any obvious increase in the risk of bleeding in patients with acute STEMI receiving urgent PCI. This renders it a potential drug for clinical practice. At the same time, measurement of ESM-1, a new biological marker for vascular endothelial function disorder, could possibly become a simple, effective, and practical new method for clinical evaluation of risk stratification of patients with acute STEMI at admission.

scholarly journals OUTCOME OF PRIMARY PERCUTANEOUS CORONARY INTERVENTION IN PATIENTS WITH ACUTE ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION ARRIVING IN ARMY CARDIAC CENTER LAHORE

2021 ◽  
Vol 70 (Suppl-4) ◽  
pp. S781-86
Author(s):  
Khurram Shahzad ◽  
Jahanzab Ali ◽  
Ayaz Ahmad ◽  
Ahmad Usman ◽  
Amna Rashdi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Primary Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Percutaneous Coronary ◽  
The Mean ◽  
Cardiac Center

Objective: To evaluate the feasibility and outcomes of primary percutaneous coronary intervention (PCI) as a mode of treatment in acute ST segment elevation myocardial infarction (STEMI). Study Design: Descriptive cross sectional study. Place and Duration of Study: The study was conducted in Army Cardiac Center Lahore, from Nov 2019 to Feb 2020. Methodology: All patients diagnosed as acute ST-segment elevation myocardial infarction during the study period were offered primary percutaneous coronary intervention among treatment options. Patients who chose primary percutaneous coronary intervention were included in the study. Informed consent was taken. Patient demographics, risk factors, time variables, procedural characteristics and in-hospital adverse events were evaluated. Results: On admission, Out of 50, 30 (60%) of the patients were current smokers, 25 (50%) were hypertensive, 22 (44%) were diabetic, and 1 (2%) had cardiogenic shock. The mean time from symptom onset to hospital arrival was 5 hours and the mean door-to-balloon time was 34 minutes. Culprit coronary artery was the left anterior descending artery (LAD) in 56% cases and multi-vessel disease was present in 38% cases. Primary percutaneous coronary intervention involved balloon dilatation (2%) and stent implantation (98%). The incidence of postprocedural angiographic no-reflow was 0%. All-cause mortality was 1%. Conclusion: This study has shown efficiency, feasibility and safety in performing of primary percutaneous coronary intervention with excellent outcomes in Army Cardiac Center Lahore. In order to further improve its outcomes, our goal should be to decrease reperfusion time which can be achieved by reducing patient delay, increasing public awareness and improving the management of first medical contact.

scholarly journals Myocardial Work and long-term prognosis in patients after ST-segment elevation acute myocardial infarction

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A Timoteo ◽  
L Moura Branco ◽  
A Galrinho ◽  
T Mano ◽  
P Rio ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Global Longitudinal Strain ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
All Cause Mortality ◽  
Elevation Acute Myocardial Infarction

Abstract Background Left ventricular (LV) global longitudinal strain has demonstrated incremental prognostic value over LV ejection fraction (LVEF) in patients with ST-segment-elevation acute myocardial infarction. However, LV global longitudinal strain (GLS) does not take into consideration the effect of afterload. Myocardial work (MW) by speckle-tracking echocardiography integrates blood pressure measurements (afterload) with LV GLS and it has been recently demonstrated that Global Work Efficiency (GWE) is associated with long-term all-cause mortality. It remains to be demonstrated if MW indices are associated with hard cardiovascular endpoints. The present study aimed to investigate the prognostic value of global LV MW obtained from pressure-strain loops with echocardiography in patients with ST-segment-elevation myocardial infarction. Methods A total of 100 consecutive ST-segment-elevation myocardial infarction patients (mean age, 61±12 years; 75% men) that survived to discharge were retrospectively analysed. LVEF, GLS and all LVMW indices were measured by transthoracic echocardiography before discharge (4.6±2.0 days after admission). All patients had at least a two-year follow-up (mean follow-up of 833±172 days). Outcomes: all-cause mortality, major acute cardiovascular events (a composite of cardiovascular mortality, myocardial infarction, stroke, unplanned cardiovascular admission) and heart failure hospitalization. Results In the two-year follow-up, 6 patients died, there were 17 patients with MACE, and 3 patients were hospitalized with heart failure. We confirmed that for all-cause mortality, GWE showed higher discrimination, compared to GLS (Table 1), with a cut-off of 83% (log-rank &lt;0,001). For MACE, the performance of all methods is suboptimal, with an AUC &lt;0.65 for all variables, except for GLS. For heart failure admission, performance is slightly better, but GLS is still the better parameter to predict this event. Conclusions LVGWE is a better predictor of all-cause mortality compared to GLS, but MW indices failed to demonstrate a prognostic impact in long-term cardiovascular events. Prospective studies are warranted to confirm this finding. FUNDunding Acknowledgement Type of funding sources: None. Table 1

scholarly journals Identification of familial hypercholesterolemia in acute coronary syndrome patients: are we missing the mark?

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
P Garcia Bras ◽  
G Portugal ◽  
A Castelo ◽  
V Ferreira ◽  
J Reis ◽  
...  
Keyword(s):  
Family History ◽  
Familial Hypercholesterolemia ◽  
Cholesterol Level ◽  
Ldl Cholesterol ◽  
Density Lipoprotein ◽  
St Segment Elevation ◽  
St Segment ◽  
All Cause Mortality ◽  
The Mean

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Patients (P) with familial hypercholesterolemia (FH) have considerable elevation in levels of low-density lipoprotein (LDL) cholesterol and a higher risk of premature coronary artery disease (CAD) and acute coronary syndromes (ACS). However, even in a hospital setting with a high volume of ACS P, the diagnosis of FH frequently goes undetected. The aim of this study was to evaluate the application of the Dutch Lipid Clinic Network (DLCN) Criteria in P admitted for ACS and analyse ACS recurrence, hospitalization and mortality in a 30-day follow-up. Methods Retrospective evaluation of P with ACS admitted to a tertiary center from 2005 to 2019. Data from the digital files including family history and laboratory tests was analysed and P were followed up for 30 days for hospitalization, recurrent ACS, all cause mortality and cardiovascular (CV) death. Evaluation of tendinous xanthomata, arcus cornealis and genetic analysis was not undertaken. Results 3811 P were evaluated, mean age 63 ± 13 years, 28% female gender, 1497 P (39%) with active or previous smoking habits, 847 P (22%) with diabetes mellitus, 419 P (11%) with family history of coronary disease, 1340 P (35%) with premature CAD, 53 P (1.4%) with premature cerebral or peripheral vascular disease and 522 (14%) with previous ACS. The mean LDL cholesterol level was 125 ± 43 mg/dL, the mean high-density lipoprotein (HDL) cholesterol level was 40 ± 16 mg/dL and the mean triglyceride level was 132 ± 89 mg/dL. The diagnosis at hospital admission was unstable angina (UA) in 189 P (5%), non-ST-segment elevation myocardial infarction (NSTEMI) in 1024 P (27%) and ST-segment elevation MI (STEMI) in 2598 P (68%). The hospital mortality rate was 4.3% (163P). Applying the DLCN criteria, 3089 P (81%) had a score of &lt;3 ("unlikely FH"), 675 P (17.7%) a score of 3 to 5 ("possible FH"), 41 P (1.1%) a score of 6 to 8 ("probable FH") and 1 P (0.03%) a score of &gt;8 ("definite FH"). Stratifying according to ACS type: among UA, 31 P (16%) had "possible FH" and 4 P (2.1%) had "probable FH". Among NSTEMI, 145 P (14.2%) had "possible FH", 9 P (0.9%) "probable FH" and 1 P (0.03%) had "definite FH". Finally, among STEMI P, 497 P (19.1%) had "possible FH" and 28 P (1.1%) had "probable FH". In a 30-day follow-up, there was an all cause mortality of 2% (78 P) and a CV death of 1.3% (49P), while the all cause hospitalization rate was 3.5% (134P) and the admission rate for recurrent ACS was 1.7% (65P). The DLCN criteria score was significantly correlated with CV death (OR 1.25, CI 95% 1.04-1.50, p = 0.020) and admission for recurrent ACS (OR 1.19, CI 95% 1.04-1.36, p = 0.04). Conclusion Application of the DLCN criteria in P admitted for ACS revealed 675 P (17.7%) with "possible FH" and 41 P (1.1%) with "probable FH" as well as show significant correlation with CV death and recurrent ACS. Routine assessment of these criteria can be an accessible tool to stratify likelihood of FH and proceed accordingly to genetic testing.

Pitavastatin Combined with Ezetimibe Treatment was an Effective Approach to Non-IRA Lesion of ST-segment Elevation Myocardial Infarc-tion Patients with Primary Percutaneous Coronary Intervention

2020 ◽  
Vol 21 ◽  
Author(s):  
Bo Zhao ◽  
Guang Ping Li ◽  
Jian Jun Peng ◽  
Li Hui Ren ◽  
Li Cheng Lei ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Primary Pci ◽  
Gensini Score ◽  
St Segment Elevation ◽  
St Segment ◽  
Percutaneous Coronary ◽  
One Year

Objective: ST-segment elevation myocardial infarction (STEMI) patients with the multivessel disease have distinctive plaque characteristics in non-IRA lesions. Intensive statin therapy was a potential approach to treat STEMI patients with the non-IRA disease. However, there is still poor evidence about the therapeutic effect. In this study, we have evaluated the detailed therapeutic effect of statin plus ezetimibe intensive therapy. Method: For STEMI patients with non-IRA disease undergoing primary percutaneous coronary intervention (PCI), 183 control STEMI patients without non-IRA disease undergoing primary PCI, and 200 STEMI patients with non-IRA disease undergoing primary PCI were introduced into this study. 200 STEMI patients with non-IRA disease undergoing primary PCI were divided into Normal group, Intensive group, Normal & Combined group, and Intensive & Combined group. The baseline information for each participant was recorded. Meanwhile, the physiological and biochemical indicators of each member with different treatments were collected after one-year follow-up. Result: For STEMI patients with non-IRA disease undergoing primary PCI, no differences could be detected in multiple indexes such as OCT examination results, age, stroke, etc. However, diabetes mellitus, smoking, and coronary Gensini score were different between different groups (P<0.05). After one year follow-up, cholesterol, low-density lipoprotein, coronary Gensini score, thin-cap fibroatheroma, length of non-infarcted arterial lesions, non-infarct artery lesion range, myocardial infarction again, and revascularization again were significantly different between different groups (P<0.05). Conclusion: The results mentioned above suggested that pitavastatin combined with ezetimibe was an effective approach to STEMI patients with non-IRA disease undergoing primary PCI. The results obtained in this study have provided a novel way for the treatment of STEMI patients with non-IRA disease undergoing primary PCI.

Geriatric nutritional risk index is a predictor of recurrent percutaneous coronary intervention in patients with non-ST segment elevation myocardial infarction

Kardiologiia ◽  
2021 ◽  
Vol 61 (8) ◽  
pp. 60-67
Author(s):  
Mehmet Kaplan ◽  
Ertan Vuruskan ◽  
Gökhan Altunbas ◽  
Fethi Yavuz ◽  
Gizem Ilgın Kaplan ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Risk Group ◽  
Coronary Intervention ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Percutaneous Coronary ◽  
All Cause Mortality

Aim To investigate the relationship between malnutrition and follow-up cardiovascular (CV) events in non-ST-segment elevation myocardial infarction (NSTEMI).Material and methods A retrospective study was performed on 298 patients with NSTEMI. The baseline geriatric nutritionalrisk index (GNRI) was calculated at the first visit. The patients were divided into three groups accordingto the GNRI: >98, no-risk; 92 to ≤98, low risk; 82 to <92, moderate to high (MTH) risk. The studyendpoint was a composite of follow-up CV events, including all-cause mortality, non-valvular atrialfibrillation (NVAF), hospitalizations, and need for repeat percutaneous coronary intervention (PCI).Results Follow-up data showed that MTH risk group had significantly higher incidence of repeat PCI and all-cause mortality compared to other groups (p<0.001). However, follow-up hospitalizations and NVAFwere similar between groups (p>0.05). The mean GNRI was 84.6 in patients needing repeat PCI and99.8 in patients who did not require repeat PCI (p<0.001). Kaplan Meier survival analysis showed thatpatients with MTH risk had significantly poorer survival (p<0.001). According to multivariate Coxregression analysis, theMTH risk group (hazard ratio=5.372) was associated with increased mortality.Conclusion GNRI value may have a potential role for the prediction of repeat PCI in patients with NSTEMI.

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