scholarly journals Colchicine for symptomatic coronary artery disease after percutaneous coronary intervention

Open Heart ◽  
2022 ◽  
Vol 9 (1) ◽  
pp. e001887
Author(s):  
Kah Long Aw ◽  
Amanda Koh ◽  
Han Lin Lee ◽  
Aurimas Kudzinskas ◽  
Rodney De Palma
Keyword(s):  
Coronary Artery Disease ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Stent Thrombosis ◽  
Coronary Intervention ◽  
Control Group ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
Symptomatic Coronary Artery Disease ◽  
Artery Disease

BackgroundPercutaneous coronary intervention (PCI), the preferred coronary reperfusion strategy, induces endothelial trauma which may mount an inflammatory response. This has been shown to increase the likelihood of further major adverse cardiovascular events (MACE). Colchicine, a cheap and widely used anti-inflammatory has shown promise in improving cardiovascular outcomes. We aimed to perform a systematic review and meta-analysis to study the effects of colchicine in patients with symptomatic coronary artery disease (CAD) who have undergone PCI.MethodWe systematically reviewed and meta-analysed 7 randomised controlled trials including a total of 6660 patients (colchicine group: 3347, control group: 3313; mean age=60.9±10). Six studies included participants who had a ≤13.5-day history of acute coronary syndrome (ACS). One study included patients with both ACS and chronic coronary syndrome. The follow-up of studies ranged from 3 days to 22.6 months.ResultsThe use of colchicine in patients who underwent PCI significantly reduced MACE outcomes (risk ratio 0.73 (95% CI 0.61 to 0.87); p=0.0003) with minimal heterogeneity across the analysis (I2=6%; P for Cochran Q=0.38). These results were driven mainly by the reduction in repeat vessel revascularisation, stroke and stent thrombosis. The number needed to treat to prevent one occurrence of MACE was 41.ConclusionColchicine significantly reduced the risk of MACE in patients with CAD who underwent PCI, mostly in the reduction of repeat vessel revascularisation, stroke and stent thrombosis. The efficacy of colchicine should be further studied by distinguishing its use alongside different stent types and dosing regimens.PROSPERO registration numberCRD42021245699.

scholarly journals The Association of Baseline N-terminal Pro-B-type Natriuretic Peptide With Short and Long-term Prognosis Following Percutaneous Coronary Intervention in Non-ST Segment Elevation Acute Coronary Syndrome With Multivessel Coronary Artery Disease: a Retrospective Cohort Study

2020 ◽  
Author(s):  
Wen-fei He ◽  
Lei Jiang ◽  
Yi-yue Chen ◽  
Yuan-hui Liu ◽  
Peng-yuan Chen ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Coronary Intervention ◽  
Multivessel Coronary Artery Disease ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
Artery Disease

Abstract Background: Although several studies have shown that N-terminal pro-B-type natriuretic peptide (NT-proBNP) is strongly correlated with coronary artery lesion complexity as well as prognosis in non-ST segment elevation acute coronary syndrome (NSTE-ACS) patients, the prognostic value of NT-proBNP in patients with NSTE-ACS and multivessel coronary artery disease undergoing PCI remains unclear. This study aimed to reveal the relationship between NT-proBNP levels and prognosis among NSTE-ACS patients with multivessel coronary artery disease undergoing successfully percutaneous coronary intervention.Methods: We consecutively enrolled 1022 patients from January 2010 to December 2014. Patients with a diagnosis of NSTE-ACS with multivessel coronary artery disease and NT-proBNP levels were included. The primary outcome was in-hospital all-cause death. The 3-year follow-up all-cause death was also ascertained.Results: A total of 12 (1.2%) deaths occurred during hospitalization. The 4th quartile group of NT-proBNP (>1287 pg/ml) had the highest rate of in-hospital all-cause death (4.3%) (P<0.001). Logistic analyses revealed that increasing NT-proBNP was robustly associated with a higher risk of in-hospital all-cause death (adjusted OR: 2.86, 95% CI=1.16-7.03, P=0.022). NT-proBNP had a good ability to predict in-hospital all-cause death (AUC=0.888, 95% CI=0.834-0.941, P<0.001; cutoff: 1568pg/ml). The cumulative event analyses exhibited a statistically significant relationship between a higher level of NT-proBNP and a higher rate of the long-term all-cause death compared with a lower level of NT-proBNP (P< 0.0001).Conclusions: Increasing NT-proBNP is significant associated with a high risk of in-hospital and long-term all-cause death in NSTE-ACS patients with multivessel coronary artery disease who received percutaneous coronary intervention. NT-proBNP > 1568pg/ml was associated with all-cause, in-hospital death.

scholarly journals Modern strategy of antithrombotic therapy in patients with coronary artery disease and atrial fibrillation after percutaneous coronary intervention

2019 ◽  
pp. 137-147
Author(s):  
Yu. A. Karpov
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery Disease ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Antithrombotic Therapy ◽  
Oral Anticoagulants ◽  
Coronary Intervention ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
Artery Disease

Reducing of cardiovascular risk, morbidity and mortality is considered as one of the main aims of modern cardiology, which should help increase life expectancy. Oral anticoagulants are the basis for the cardioembolic stroke prevention in patients with atrial fibrillation, which is common in patients with coronary artery disease. According to statistics, about a quarter of patients with atrial fibrillation have to perform percutaneous coronary intervention at some point in their life. This is due to stable angina or acute coronary syndrome, which is accompanied by difficulties with antithrombotic therapy. This article discusses the main clinical data and recommendations on the optimal use of combination antithrombotic therapy in patients after percutaneous coronary intervention.

scholarly journals Predictors of adverse cardiovascular events in patients with coronary artery disease after percutaneous coronary intervention

2020 ◽  
Vol 25 (6) ◽  
pp. 3938
Author(s):  
A. V. Svarovskaya ◽  
E. A. Kuzheleva ◽  
A. A. Arzhanik ◽  
V. A. Fediunina ◽  
V. A. Aleksandrenko ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Cardiovascular Events ◽  
Coronary Intervention ◽  
Endothelin 1 ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
Artery Disease

Aim. To identify predictors of major adverse cardiovascular events (MACE) in patients with coronary artery disease (CAD) after percutaneous coronary intervention (PCI).Material and methods. This prospective single-center study included 225 patients with stable CAD requiring drug-eluting stent implantation. The average follow-up period for patients was 14,5 (6;23) months. Levels of glycated hemoglobin (HbA1c), insulin, tumor necrosis factor (TNF)-α, interleukin-6 (IL-6), interleukin-10 (IL-10), endothelin-1 (ET-1) and the serum lipid profile were evaluated. Insulin resistance was assessed by the HOMA-IR index. The patients were divided into 2 groups: group 1 (n=98) — patients with MACE, group 2 (n=127) — patients without MACE over the follow-up period.Results. During the follow-up period, MACE were recorded in 43,5% of patients, of which: fatal outcome in 3 (3,1%) patients, acute coronary syndrome (ACS) — 14 (14,3%), decompensated heart failure (HF) — 8 (8,2%), non-fatal myocardial infarc tion (MI) — 4 (4,1%), stroke — 3 (3,1%), in-stent restenosis — 18 (18,4%), target vessel revascularization due to progression of atherosclerosis — 25 (25,4%), lifethreatening arrhythmias — 18 (18,4%), implantation of a cardiac resynchronization therapy defibrillator — 5 (5%). To determine critical levels for quantitative predictors, ROC curves were created with threshold values that increase the likelihood of MACE.Conclusion. As a result of the study, we found that the waist-to-hip ratio >1,0495, the HOMA-IR index >3,13 and the endothelin-1 >0,75 mmol/L are independent predictors of unfavorable prognosis in patients with CAD after PCI.

scholarly journals The relationship between IL-6 levels and the angiographic severity of coronary artery disease following percutaneous coronary intervention in acute coronary syndrome patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yang Ling ◽  
Hairong Weng ◽  
Shengxing Tang
Keyword(s):  
Coronary Artery Disease ◽  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Area Under The Curve ◽  
Coronary Intervention ◽  
Syntax Score ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
Artery Disease

Abstract Background The present investigation was developed for the exploration of the association between IL-6 levels and acute coronary syndrome (ACS) findings upon angiographic evaluation. Methods A retrospective review of 346 patients suffering from chest discomfort that underwent coronary angiography was performed. The SYNergy between Percutaneous Coronary Intervention with TAXus and cardiac surgery (SYNTAX) score (SS) and SS II were used to gauge ACS severity, with ACS patients being stratified into two groups based on an SS value of 22 and the median SS II value. Associations between IL-6 levels and SS or SS II values were assessed through Spearman's correlation analyses, and independent predictors of intermediate-high SS or high SS II were identified via a multivariate logistic regression approach. A receiver operating characteristic (ROC) curve was employed to explore of the predictive value of IL-6 levels. Results IL-6 was positively correlated with both SS (r = 0.479, P < 0.001) and SS II (r = 0.305, P < 0.001). Moreover, IL-6 levels were independently predictive of intermediate-high SS and high SS II values. ROC curves further demonstrated that IL-6 was able to predict intermediate-high SS and high SS II, with area under the curve (AUC) values of 0.806 and 0.624, respectively. Conclusion IL-6 levels are closely linked to the extent of coronary artery disease in ACS patients undergoing percutaneous coronary intervention. IL-6 levels may thus serve as a valuable and non-invasive biomarker of high-risk ACS patients.

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