scholarly journals e0522 Dual antiplatelet plus tirofiban therapy have a beneficial effect on acute coronary syndrome in diabetic patients undergoing percutaneous coronary intervention

Heart ◽  
2010 ◽  
Vol 96 (Suppl 3) ◽  
pp. A162-A162
Author(s):  
S. Hua ◽  
Z. Yujie ◽  
L. Yuyang ◽  
Y. Shiwei ◽  
G. Fei ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Beneficial Effect ◽  
Coronary Intervention ◽  
Diabetic Patients ◽  
Coronary Syndrome ◽  
Percutaneous Coronary

scholarly journals Safety and efficacy of bivalirudin in diabetic acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI)

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A Golam Mostofa ◽  
T Parvin ◽  
R Masum Mandal ◽  
S Ali Ahsan ◽  
R Afrin
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Major Bleeding ◽  
Guide Wire ◽  
Coronary Intervention ◽  
Diabetic Patients ◽  
Safety And Efficacy ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
Hemorrhagic Complications

Abstract Background Prevention of hemorrhagic complications has emerged as a priority in patients undergoing Percutaneous Coronary Intervention (PCI) in addition to suppressing thrombotic complications. This goal is challenging to achieve in diabetic Acute Coronary Syndrome (ACS) patients as Diabetes Mellitus (DM) itself is a prothrombotic state with more pronounced vascular injury response and have a worse outcome after PCI compared with non-diabetic patients. In patients with ACS, Bivalirudin has been shown to result in similar rates of composite ischemia as Heparin plus GPI (GP IIb /IIIa inhibitor), while significantly reducing major bleeding and has received class I recommendation for PCI by American College of Cardiology (ACC 2013). Whether Bivalirudin is safe and effective specially in diabetic ACS patients undergoing PCI, as compared with Heparin (UFH) monotherapy, is unknown. Purpose To determine and compare the incidence of in-hospital and 30-day hemorrhagic complications and major adverse cardiac events (MACEs) as evidence of safety and efficacy using Bivalirudin versus Heparin in diabetic ACS patients undergoing PCI. Methods 218 diabetic ACS patients (age>18 years and ≤75 years) who underwent PCI from May 2018 to April 2019 at University Cardiac Centre, BSM Medical University, Dhaka, Bangladesh were randomly assigned to have UFH or Bivalirudin. Before the guide wire crossed the lesion, 111 patients in the UFH group received a bolus of 70–100 U/kg (targeted activated clotting time, ACT: 200–250 s). 107 patients in the Bivalirudin group received a loading dose of 0.75 mg/kg, followed by an infusion of 1.75 mg/kg/h for up to 4 hours. Dual antiplatelet (DAPT) loading as Aspirin 300 mg plus P2Y12 inhibitors (Clopidogrel 600 mg or Prasugrel 60 mg or Ticagrelor 180 mg) was given in all patients before the procedure. The maintenance dose of DAPT was continued for at least one month and patients were followed telephonically up to 30 days. The outcome measures were in-hospital and 30-day hemorrhagic complications and MACEs [death, MI, target vessel revascularization (TVR) and stroke]. Results Patients treated with Bivalirudin compared with Heparin had a significantly lower in-hospital incidence of QMI (0% vs. 6%; p=0.03) and major bleeding (0% vs. 7%; p=0.02). However, the incidence of cardiac death, stent thrombosis, TVR were no differences between two groups (p>0.05). There was only one NQMI in the Bivalirudin group as opposed to 8% in the Heparin group in 30 days following stenting (p=0.04). Conclusion In diabetic ACS patients undergoing PCI, Bivalirudin is safe and effective as it reduces immediate and short-term hemorrhagic complications as well as MACEs as compared with Heparin. FUNDunding Acknowledgement Type of funding sources: None.

Abstract 14068: One-year Outcomes of Dpp-4 Inhibitor Treatment in Diabetic Patients After Contemporary Percutaneous Coronary Intervention - Ps Matching From Data of Multicenter Registry -

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Takehiro Hata ◽  
Kentaro Jujo
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Diabetic Patients ◽  
Ventricular Ejection Fraction ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
Dipeptidyl Peptidase 4 Inhibitors

Introduction: Clinical prognosis in diabetic patients comorbid with coronary artery disease (CAD) remained poor, even in the current drug-eluting stent (DES) era. However, there has been a limited evidence about the prognosis in diabetic patients with CAD who were treated with dipeptidyl peptidase-4 inhibitors (DPP4i). Methods: This study is a subanalysis from the TWINCRE registry that is a multicentral prospective cohort including patients who underwent percutaneous coronary intervention (PCI) at 12 hospitals in Japan between 2017 and 2019. Among 1,905 registered patients who were followed up, we ultimately evaluated 615 diabetic patients. They were divided into two groups depending on the prescription of DPP4i at the hospital discharge after the index PCI; DPP4i group (n=287) and Non-DPP4i group (n=328). For the two groups, we performed propensity-score (PS) matching using variables as follows: age, sex, acute coronary syndrome, left ventricular ejection fraction, serum creatinine, insulin use, prescriptions of statin, beta blocker, aspirin, and ACE inhibitor/ARB. The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE) including death, acute coronary syndrome, stent thrombosis, hospitalization due to heart failure and ischemic stroke. Results: Overall MACCE was observed in 70 patients (11.4%) during 364 days of median observation period. In unmatched patients, Kaplan-Meier analysis showed that patients in the DPP4i group showed a significantly lower MACCE rate than those in the Non-DPP4i group (Log-rank test, p=0.009, Figure A). In 284 PS-matched patients, patients in the DPP4i group still had lower MACCE rate than those in the non-DPP4i group (hazard ratio 0.39, 95% confidence interval 0.16-0.96, p=0.034, Figure B). Conclusion: Propensity-matching analysis showed that hyperglycemia control by DPP4i was associated with better 1-year clinical outcomes in diabetic patients after PCI in the contemporary DES era.

Antiplatelet treatment in diabetic patients with acute coronary syndrome undergoing percutaneous coronary intervention

2018 ◽  
Vol 29 (1) ◽  
pp. 53-59 ◽  
Author(s):  
Michalis Hamilos ◽  
Stylianos Petousis ◽  
Ioanna Xanthopoulou ◽  
John Goudevenos ◽  
John Kanakakis ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Coronary Intervention ◽  
Diabetic Patients ◽  
Antiplatelet Treatment ◽  
Coronary Syndrome ◽  
Percutaneous Coronary

scholarly journals Correlation Between Diabetes Mellitus and Clinical Outcome of Patients with Acute Coronary Syndrome Underwent Percutaneus Coronary Intervention Therapy in Dr Soetomo Surabaya Hospital

2020 ◽  
Vol 1 (2) ◽  
pp. 36-41
Author(s):  
Alanna Sari Pratikto ◽  
I Gde Rurus Suryawan ◽  
Andrianto Andrianto ◽  
Purwo Sri Rejeki
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Mortality Rate ◽  
Clinical Outcome ◽  
Significant Relationship ◽  
Coronary Intervention ◽  
Diabetic Patients ◽  
Coronary Syndrome ◽  
Diabetic Status ◽  
Percutaneous Coronary

Introduction: Coronary heart diseases continue to be the rising cause of mortality amongst Indonesian population, alongside with the increasing number of diabetic patients. The first line management of ACS is percutaneous coronary intervention (PCI), however previous have shown that diabetic patients have worse outcomes after therapy compared to non-diabetic patients. This study aims to compare the clinical outcomes between acute coronary syndrome (ACS) patients with diabetes and those without diabetes following percutaneus coronary intervention therapy. Methods: This study used cross sectional observational approach collecting records of ACS patients that underwent percutaneous coronary intervention in RSUD Dr Soetomo Surabaya from January 2018 to December 2019. Data regarding a patient’s age, gender, diabetic status, location of lesion, revascularization status, and clinical outcome were collected. Those with missing or incomplete data were excluded from the study. A total of 55 patients were included and analyzed, Results: amongst 55 patients that underwent PCI observed, 23 were diabetic and 32 were non-diabetic. Study has shown that diabetic patients have higher mortality rate compared to those without diabetes (6 patients vs. 1 patient, p=0,072) however based on the result analysis the p value of >0,05 showed no significant relationship between patients’ diabetic status and the clinical outcome following PCI therapy. Study has also shown that diabetic patients are more likely to undergo staged PCI (56,5%), than total revascularization PCI. Conclusion: Study has found that diabetic ACS has a higher mortality rate compared to those without diabetes, however analitycal studies found no significant relationship between the two variables. Further studies should be performed with higher number of patients to accurately investigate the relationship between diabetes melitus and PCI outcomes.

Abstract 311: One-year Outcomes of DPP-4 Inhibitor Treatment in Diabetic Patients After Contemporary Percutaneous Coronary Intervention - Ps Matching from Data of Multicenter Registry -

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_4) ◽  
Author(s):  
Takehiro Hata ◽  
Nobuhisa Hagiwara ◽  
Kentaro Jujo
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Diabetic Patients ◽  
Ventricular Ejection Fraction ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
Dipeptidyl Peptidase 4 Inhibitors

Introduction: Clinical prognosis in diabetic patients comorbid with coronary artery disease (CAD) remained poor, even in the current drug-eluting stent (DES) era. However, there has been a limited evidence about the prognosis in diabetic patients with CAD who were treated with dipeptidyl peptidase-4 inhibitors (DPP4i). Methods: This study is a subanalysis from the TWINCRE registry that is a multicentral prospective cohort including patients who underwent percutaneous coronary intervention (PCI) at 12 hospitals in Japan between 2017 and 2019. Among 1,905 registered patients who were followed up, we ultimately evaluated 615 diabetic patients. They were divided into two groups depending on the prescription of DPP4i at the hospital discharge after the index PCI; DPP4i group (n=287) and Non-DPP4i group (n=328). For the two groups, we performed propensity-score (PS) matching using variables as follows: age, sex, acute coronary syndrome, left ventricular ejection fraction, serum creatinine, insulin use, prescriptions of statin, beta blocker, aspirin, and ACE inhibitor/ARB. The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE) including death, acute coronary syndrome, stent thrombosis, hospitalization due to heart failure and ischemic stroke. Results: Overall MACCE was observed in 70 patients (11.4%) during 364 days of median observation period. In unmatched patients, Kaplan-Meier analysis showed that patients in the DPP4i group showed a significantly lower MACCE rate than those in the Non-DPP4i group (Log-rank test, p=0.009, Figure A). In 284 PS-matched patients, patients in the DPP4i group still had lower MACCE rate than those in the non-DPP4i group (hazard ratio 0.39, 95% confidence interval 0.16-0.96, p=0.034, Figure B). Conclusion: Propensity-matching analysis showed that hyperglycemia control by DPP4i was associated with better 1-year clinical outcomes in diabetic patients after PCI in the contemporary DES era.

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