scholarly journals Associations of myeloperoxidase, interleukin-17A and heparin-binding EGF-like growth factor levels with in-stent restenosis after percutaneous coronary intervention: a single-centre case–control study in China

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e039405
Author(s):  
Hua Jiang ◽  
Hongmei Zhang ◽  
Ying Yang ◽  
Xuezhou Yang
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Growth Factor ◽  
Case Control Study ◽  
Coronary Intervention ◽  
Case Control ◽  
Heparin Binding ◽  
Stent Restenosis ◽  
Percutaneous Coronary ◽  
Control Study ◽  
In Stent Restenosis

ObjectivesTo investigate the changes in serum myeloperoxidase (MPO), interleukin (IL)-17A and heparin-binding EGF-like growth factor (HB-EGF) levels before and after percutaneous coronary intervention (PCI), and to evaluate the associations of MPO, IL-17A and HB-EGF levels with the 1-year restenosis rate.DesignCase–control study.SettingsXiangyang Central Hospital between January 2012 and December 2017.ParticipantsPatients with coronary heart disease who underwent PCI.InterventionsNot applicable.Primary and secondary outcome measuresNot applicable.ResultsFinally, 407 and 132 patients were included in the control and in-stent restenosis (ISR) groups, respectively. The general clinical characteristics of the patients were not significantly different between the two groups. The MPO, IL-17A and HB-EGF levels were not significantly different between the two groups at baseline but significantly increased after PCI. The ISR group showed higher levels of MPO, IL-17A and HB-EGF compared with the control group at all postoperative time points. Multivariable analysis showed that MPO, IL-17A and HB-EGF were associated with increased ISR [MPO (OR=1.003; 95% CI: 1.001 to 1.005; p=0.002), IL-17A (OR=1.015; 95% CI: 1.009 to 1.020; p<0.0001) and HB-EGF (OR=2.256; 95% CI: 1.103 to 4.009; p=0.002)]. All three factors had sensitivity and specificity ≥68% for ISR.ConclusionsHB-EGF could be used for the detection of ISR after PCI and could be of use for the prediction of ISR, but the value of MPO and IL-17A might be more limited. This will have to be validated in future studies.

scholarly journals Cardiovascular and renal outcomes following percutaneous coronary intervention in a population with renal disease: a case-control study

QJM ◽  
2019 ◽  
Vol 112 (9) ◽  
pp. 669-674
Author(s):  
L A Allen ◽  
R D Pyart ◽  
J Holmes ◽  
K L Donovan ◽  
R A Anderson ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Calcium Phosphate ◽  
Serum Creatinine ◽  
Case Control Study ◽  
Coronary Intervention ◽  
Case Control ◽  
Percutaneous Coronary ◽  
Phosphate Product ◽  
Poor Outcomes ◽  
Control Study

Abstract Background Patients with renal disease are less likely to undergo percutaneous coronary intervention (PCI) due to concerns about poor outcomes. Aim We describe outcomes following PCI in individuals with chronic kidney disease (CKD), as compared with matched controls with comparable CKD who did not undergo PCI. We also identified factors predictive of poor outcomes following PCI amongst patients with CKD. Design Retrospective observational case-control study. Methods Cases were individuals with CKD (stages 1–5) undergoing PCI between 2008 and 2014. Controls were age, gender and creatinine-matched individuals not requiring PCI. We compared mortality between groups using Kaplan–Meier curves and Cox regression modelling. We assessed changes in serum creatinine using Wilcoxon Rank testing. We explored the relationship between biochemical and haematological measures (baseline creatinine, calcium, phosphate, calcium-phosphate product, parathyroid hormone, white cell count, haemoglobin, platelet count, c-reactive protein and total cholesterol) and post-PCI mortality, using logistic regression. Results We identified 144 cases and 144 controls. Mortality was significantly lower amongst cases compared with controls [hazard ratio 0.46 (95% confidence intervals 0.31, 0.69)]. PCI did not result in a significant change in renal function (P=0.52). Amongst cases, serum creatinine and calcium-phosphate product were predictors of mortality following PCI. Conclusion Cases undergoing PCI had lower mortality, and PCI was not associated with accelerated CKD progression. On this data, PCI should not be deferred as a treatment option in patients with CKD. Serum creatinine and calcium-phosphate product predict mortality following PCI in this cohort, and may be useful in risk-stratifying patients with CKD being considered for PCI.

scholarly journals No-reflow phenomenon and comparison to the normal-flow population postprimary percutaneous coronary intervention for ST elevation myocardial infarction: case–control study (NORM PPCI)

Open Heart ◽  
2020 ◽  
Vol 7 (2) ◽  
pp. e001215
Author(s):  
Jennifer Ann Rossington ◽  
Eirini Sol ◽  
Konstantina Masoura ◽  
Konstantinos Aznaouridis ◽  
Raj Chelliah ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Risk Score ◽  
Systolic Hypertension ◽  
Case Control Study ◽  
Coronary Intervention ◽  
Case Control ◽  
Percutaneous Coronary ◽  
St Elevation ◽  
Control Study

IntroductionNo-reflow (NR) phenomenon is characterised by the failure of myocardial reperfusion despite the absence of mechanical coronary obstruction. NR negatively affects patient outcomes, emphasising the importance of prediction and management. The objective was to evaluate the incidence and independent predictors of NR in patients presenting with ST-elevation myocardial infarction (STEMI).MethodsThis was a single-centre prospective case–control study. Cases were subjects who suffered NR, and the control comparators were those who did not. Clinical outcomes were documented. Salient variables relating to the patients and their presentation, history and angiographical findings were compared using one-way analysis of variance or χ2 test. Multiple regression determined the independent predictors, and a risk score was established based on the β coefficient.ResultsOf 173 consecutive patients, 24 (13.9%) suffered from NR, with 46% occurring post stent implantation. Patients with NR had increased risk of in-hospital death (OR 7.0, 95% CI 1.3 to 36.7, p=0.022). From baseline variables available prior to percutaneous coronary intervention, the independent predictors of NR were increased lesion complexity, admission systolic hypertension, weight of <78 kg and history of hypertension. Continuous data were transformed into best-fit binary variables, and a risk score was defined. Significant difference was demonstrated between the risk score of patients with NR (4.1±1) compared with controls (2.6±1) (p<0.001), and the risk score was considered a good test (area under the curve=0.823). A score of ≥4 had 75% sensitivity and 76.5% specificity.ConclusionPatients with NR have a higher rate of mortality following STEMI. Predictors of NR include lesion complexity, systolic hypertension and low weight. Further validation of this risk model is required.

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