scholarly journals Association between body mass index and outcomes after percutaneous coronary intervention in multiethnic South East Asian population: a retrospective analysis of the Malaysian National Cardiovascular Disease Database—Percutaneous Coronary Intervention (NCVD-PCI) registry

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e017794 ◽  
Author(s):  
Zaid Azhari ◽  
Muhammad Dzafir Ismail ◽  
Ahmad Syadi Mahmood Zuhdi ◽  
Norashikin Md Sari ◽  
Imran Zainal Abidin ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Lower Risk ◽  
East Asian ◽  
Vascular Complications ◽  
Asian Population ◽  
Coronary Intervention ◽  
Hospital Death ◽  
Percutaneous Coronary ◽  
Overweight Group ◽  
National Cardiovascular

ObjectiveTo examine the relationship between body mass index (BMI) and outcomes after percutaneous coronary intervention (PCI) in a multiethnic South East Asian population.SettingFifteen participating cardiology centres contributed to the Malaysian National Cardiovascular Disease Database—Percutaneous Coronary Intervention (NCVD-PCI) registry.Participants28 742 patients from the NCVD-PCI registry who had their first PCI between January 2007 and December 2014 were included. Those without their BMI recorded or BMI <11 kg/m2or >70 kg/m2were excluded.Main outcome measuresIn-hospital death, major adverse cardiovascular events (MACEs), vascular complications between different BMI groups were examined. Multivariable-adjusted HRs for 1-year mortality after PCI among the BMI groups were also calculated.ResultsThe patients were divided into four groups; underweight (BMI <18.5 kg/m2), normal BMI (BMI 18.5 to <23 kg/m2), overweight (BMI 23 to <27.5 kg/m2) and obese (BMI ≥27.5 kg/m2). Comparison of their baseline characteristics showed that the obese group was younger, had lower prevalence of smoking but higher prevalence of diabetes, hypertension and dyslipidemia. There was no difference found in terms of in-hospital death, MACE and vascular complications after PCI. Multivariable Cox proportional hazard regression analysis showed that compared with normal BMI group the underweight group had a non-significant difference (HR 1.02, p=0.952), while the overweight group had significantly lower risk of 1-year mortality (HR 0.71, p=0.005). The obese group also showed lower HR but this was non-significant (HR 0.78, p=0.056).ConclusionsUsing Asian-specific BMI cut-off points, the overweight group in our study population was independently associated with lower risk of 1-year mortality after PCI compared with the normal BMI group.

scholarly journals Radial versus femoral access percutaneous coronary intervention in patients with acute myocardial infarction: Experience from a Southeast Asian country PCI registry

2020 ◽  
Author(s):  
Muhammad Dzafir Ismail ◽  
Mohd Al-Baqlish Mohd Firdaus ◽  
Mohd Firdaus Hadi ◽  
Zaid Azhari ◽  
Muhammad Imran Abdul Hafidz ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Vascular Complications ◽  
Asian Population ◽  
Coronary Intervention ◽  
Southeast Asian ◽  
Radial Approach ◽  
Femoral Approach ◽  
Southeast Asian Population ◽  
Percutaneous Coronary

Abstract IntroductionBleeding complications adversely affect patient’s outcomes following percutaneous coronary intervention (PCI). Radial approach PCI was advocated to overcome this complication. The information regarding the safety and feasibility of radial approach PCI in acute myocardial infarction (AMI) in the Southeast Asian population was limited. Hence, we sought to examine the outcome of radial versus femoral approach in this particular cohort.Materials and MethodsThis is an observational retrospective analysis of the Malaysian National Cardiovascular Disease Database-Percutaneous Coronary Intervention (NCVD – PCI) registry, recruiting patients with AMI from 2007 – 2014. Patients were stratified into radial and femoral groups depending on the PCI access route. The patient's baseline characteristics, lesion, and procedural data, complications, and outcomes are assessed accordingly.ResultsA total of 11,555 (4895 radial and 6660 femoral) cases were included in the analysis. In the radial group, there were predominantly more males (89.2%) with the younger patient (mean age 55.2 ± 10.5 years) as compared to the femoral group. They also had a higher body mass index (BMI) and taller. However, femoral group patients had significantly more premorbid conditions, namely diabetes mellitus, hypertension, previous stroke, heart failure, and chronic kidney disease. Complex lesions were similar in both groups with no difference in fluoroscopy time, although higher contrast load recorded in the femoral group. The adjusted odds ratio of developing in-hospital complications after femoral approach PCI compared to radial approach for death, MACE and vascular complications were OR: 8.21 95% CI 5.38 – 12.54, OR: 3.39 95% CI 2.51 – 4.58, OR: 1.79 95% CI 1.01 – 3.16 respectively. ConclusionPCI via the trans-radial approach has resulted in a significantly lower risk of vascular complications, MACE and death compared to the trans-femoral approach. Our study confirmed the superiority of the trans-radial approach in the setting of primary PCI in the Southeast Asian population and underscores the importance of trans-radial interventions to reduce bleeding complication rates.

Abstract 11324: Immediate Percutaneous Coronary Intervention in Patients with Refractory Out of Hospital Cardiac Arrest

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Daniel Rob ◽  
Jana Smalcova ◽  
Tomas Kovarnik ◽  
David Zemanek ◽  
Ales Kral ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Cardiac Arrest ◽  
Lower Risk ◽  
Coronary Intervention ◽  
Post Hoc Analysis ◽  
Risk Of Death ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
Post Hoc ◽  
Hospital Cardiac Arrest

Background: An increasing number of cardiac centres are using immediate percutaneous coronary intervention (PCI) and extracorporeal cardiopulmonary resuscitation (ECPR) in patients with refractory out of hospital cardiac arrest (r-OHCA). Published evidence regarding PCI in OHCA has been mainly reporting to patients with early return of spontaneous circulation and the influence of PCI and ECPR on survival in the population of patients with r-OHCA and acute coronary syndrome (ACS) remains unclear. Methods: In this post hoc analysis of the randomized r-OHCA trial, all patients with ACS as a cause of r-OHCA were included. The effect of successful PCI and ECPR on 180-days survival was examined using Kaplan-Meier estimates and multivariable Cox regression. Results: In total, 256 patients were evaluated in Prague OHCA study and 127 (49.6 %) had ACS as the cause of r-OHCA constituting current study population. The mean age was 58 years (46.3-64) and duration of resuscitation was 52.5 minutes (36.5-68). ECPR was used in 51 (40.2 %) of patients. Immediate PCI was performed in 86 (67.7%) patients and TIMI flow 2 or 3 was achieved in 75 (87.2%) patients. The overall 180-days survival of patients with successful PCI was 40 % compared to 7.7 % with no or failed immediate PCI (log-rank p < 0.001). After adjustment for confounders, successful PCI was associated with a lower risk of death (HR 0.47, CI 0.24-0.93, p = 0.031). Likewise, ECPR was associated with a lower risk of death (HR 0.11, CI 0.05-0.24, p< 0.001). Conclusion: In this post hoc analysis of the randomized r-OHCA trial, successful immediate PCI as well as ECPR were associated with improved 180-days survival in patients with r-OHCA due to ACS.

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