scholarly journals Baseline Serum sLOX-1 Concentrations Are Associated with 2-Year Major Adverse Cardiovascular and Cerebrovascular Events in Patients after Percutaneous Coronary Intervention

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Zi-wen Zhao ◽  
Yi-wei Xu ◽  
Shu-mei Li ◽  
Jin-jian Guo ◽  
Jian-min Sun ◽  
...  
Keyword(s):  
Risk Factors ◽  
Percutaneous Coronary Intervention ◽  
Prognostic Value ◽  
Cox Regression ◽  
Coronary Intervention ◽  
Enzyme Linked Immunosorbent Assay ◽  
Baseline Serum ◽  
Kaplan Meier ◽  
Cerebrovascular Events ◽  
Percutaneous Coronary

Background. Soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1) may be a potential biomarker of coronary artery disease (CAD) and stroke. Objective. We aimed to investigate the association and prognostic value of elevated sLOX-1 concentrations with regard to long-term major adverse cardiovascular and cerebrovascular events (MACCEs) in patients with CAD undergoing primary percutaneous coronary intervention (PCI). Methods. A total of 1011 patients were enrolled. Serum sLOX-1 concentrations were detected by the enzyme-linked immunosorbent assay (ELISA). Patients were followed for 2 years. Multivariate Cox regression and Kaplan-Meier survival curve were explored to assess the association between sLOX-1 and MACCEs. A receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of sLOX-1. Results. Two-year MACCEs were associated with serum sLOX-1 concentrations (HR 1.278, 95% CI 1.019-1.604, P=0.034), left main disease (HR 2.938, 95% CI 1.246-6.925, P=0.014), small-caliber stents used (HR 2.207, 95% CI 1.189-4.095, P=0.012), and total stent length (HR 1.057, 95% CI 1.005-1.112, P=0.030). Serum sLOX-1 concentration≥1.10 ng/ml had maximum sensitivity and specificity in predicting the occurrence of 2-year MACCEs (P<0.001). Patients with higher serum sLOX-1 concentrations showed a significantly higher incidence of MACCEs in the Kaplan-Meier curve (P<0.001). The combination of any of the risk factors identified in multiple Cox regression was associated with a stepwise increase in MACCE rate (P<0.001). Conclusions. High baseline serum sLOX-1 concentration predicts 2-year MACCEs and shows an additional prognostic value to conventional risk factors in patients after primary PCI. sLOX-1 determination might play a complementary role in the risk stratification of patients with CAD treated with PCI.

scholarly journals The Prognostic Value of a Derived Neutrophil-Lymphocyte Ratio in Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

2021 ◽  
Vol 27 ◽  
pp. 107602962110345
Author(s):  
Wenjun Fan ◽  
Ying Zhang ◽  
Xiuxin Gao ◽  
Yixiang Liu ◽  
Fei Shi ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Cardiovascular Events ◽  
Regression Models ◽  
Prognostic Value ◽  
Cox Regression ◽  
Coronary Intervention ◽  
Neutrophil Lymphocyte Ratio ◽  
Coronary Syndrome ◽  
Kaplan Meier ◽  
Percutaneous Coronary

The systemic immune-inflammatory index (SII) and derived neutrophil-lymphocyte ratio (dNLR) are novel indexes that simultaneously reflect the host inflammatory and immune status and have prognostic value in some cancers. SII was associated with major cardiovascular events in coronary artery disease patients who received percutaneous coronary intervention (PCI). However, dNLR correlations with clinical outcomes in acute coronary syndrome (ACS) patients undergoing PCI remain unclear. This study aimed to elucidate the predictive values of SII and dNLR on the long-term prognosis of patients with ACS undergoing PCI. In total, 1,553 ACS patients undergoing PCI were consecutively enrolled from January 2016 to December 2018. The subjects were divided into high and low SII and dNLR groups for comparison (high vs. low). The SII and dNLR cutoff values for predicting major adverse cardiovascular events (MACE) were calculated using receiver operating characteristic curves, and Kaplan-Meier curves and Cox regression models were used for survival analyses. The endpoint was a MACE, which included all-cause mortality and rehospitalization for severe heart failure during follow-up. The Kaplan-Meier curves showed that a higher SII or dNLR value was associated with a higher risk of MACE (all P < 0.001). Multivariate Cox regression models showed that SII (hazard ratio [HR]: 2.545; 95% confidence interval [CI]: 1.416-4.574; P = 0.002) and dNLR (HR: 2.610, 95% CI: 1.454-4.685, P = 0.001) were independent predictors for MACE. dNLR may be a suitable laboratory marker to identify high-risk ACS patients after PCI.

scholarly journals Prognostic Value of D-dimer in patients with acute coronary syndrome treated by percutaneous coronary intervention: a retrospective cohort study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Runzhen Chen ◽  
Chen Liu ◽  
Peng Zhou ◽  
Yu Tan ◽  
Zhaoxue Sheng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Percutaneous Coronary Intervention ◽  
Prognostic Value ◽  
Coronary Intervention ◽  
Risk Scores ◽  
Risk Of Death ◽  
Clinical Risk ◽  
Percutaneous Coronary ◽  
D Dimer

Abstract Background Associations between D-dimer and outcomes of patients with acute coronary syndromes (ACS) remain controversial. This study aimed to investigate the prognostic value of D-dimer in ACS patients treated by percutaneous coronary intervention (PCI). Methods In this observational study, 3972 consecutive patients with ACS treated by PCI were retrospectively recruited. The X-tile program was used to determine the optimal D-dimer thresholds for risk stratifications. Cox regression with multiple adjustments was used for outcome analysis. Restricted cubic spline (RCS) analysis was performed to assess the dose-response association between D-dimer and outcomes. The C-index was calculated to evaluate the additional prognostic value of D-dimer when added to clinical risk factors and commonly used clinical risk scores, with internal validations using bootstrapping methods. The primary outcome was all-cause death. Results During a median follow-up of 720 days, 225 deaths occurred. Based on the thresholds generated by X-tile, ACS-PCI patients with median (420–1150 ng/mL, hazard ratio [HR]: 1.58, 95 % confidence interval [CI]: 1.14–2.20, P = 0.007) and high (≥ 1150 ng/mL, HR: 1.98, 95 % CI: 1.36–2.89, P < 0.001) levels of D-dimer showed substantially higher risk of death compared to those with low D-dimer (< 420 ng/mL). RCS analysis depicted a constant relation between D-dimer and various outcomes. The addition of D-dimer levels significantly improved risk predictions for all-cause death when combined with the fully adjusted models (C-index: 0.853 vs. 0.845, P difference = 0.021), the GRACE score (C-index: 0.826 vs. 0.814, P difference = 0.027), and the TIMI score (C-index: 0.804 vs. 0.776, P difference < 0.001). The predicted mortality at the median follow-up (two years) was 1.7 %, 5.2 %, and 10.9 % for patients with low, median, and high D-dimer, respectively, which was well matched with the observed mortality (low D-dimer group: 1.2 %, median D-dimer group: 5.2 %, and high D-dimer group: 12.6 %). Conclusions For ACS patients treated by PCI, D-dimer level was an independent predictor for adverse outcomes, and provided additional prognostic value when combined with clinical risk factors and risk scores. Risk stratifications based on D-dimer was plausible to differentiate ACS-PCI patients with higher risk of death.

scholarly journals Monocyte-to-albumin Ratio as a Novel Predictor of Long-term Adverse Outcomes in Patients after Percutaneous Coronary Intervention

2021 ◽  
Author(s):  
Zeng-Lei Zhang ◽  
Qian-Qian Guo ◽  
Jun-Nan Tang ◽  
Jian-Chao Zhang ◽  
Meng-Die Cheng ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Cox Regression ◽  
Coronary Intervention ◽  
Adverse Outcomes ◽  
Major Adverse Cardiovascular Events ◽  
Monocyte Count ◽  
Albumin Ratio ◽  
Kaplan Meier ◽  
Percutaneous Coronary

Background: Monocyte count and serum albumin (Alb) have been proven to be involved in the process of systemic inflammation. Therefore, we investigated the prognostic value of monocyte-to-albumin ratio (MAR) in patients who underwent percutaneous coronary intervention (PCI). Methods：We enrolled a total of 3561 patients in this study from January 2013 to December 2017. They were divided into two groups according to MAR cutoff value (MAR &lt; 0.014, n = 2220; and MAR ≥ 0.014, n = 1119) as evaluated by receiver operating characteristic (ROC) curve. The average follow-up time was 37.59 ± 22.24 months. Results: The two groups differed significantly in the incidences of all-cause mortality (ACM; P &lt; 0.001), cardiac mortality (CM; P &lt; 0.001), major adverse cardiovascular events (MACEs; P = 0.038), and major adverse cardiovascular and cerebrovascular events (MACCEs; P = 0.037). Multivariate Cox regression analyses revealed MAR as an independent prognostic factor for ACM and CM. The incidence of ACM increased 56.5% (hazard ratio [HR] = 1.565; 95% confidence interval [CI], 1.086–2.256; P = 0.016) and that of CM increased 76.3% (HR = 1.763; 95% CI, 1.106–2.810; P = 0.017) in patients in the higher-MAR group. Kaplan–Meier survival analysis suggested that patients with higher MAR tended to have an increased accumulated risk of ACM ( Log rank P &lt; 0.001) and CM (Log rank P &lt; 0.001). Conclusion: The findings of the present study suggested that MAR was a novel independent predictor of long-term mortality in patients who underwent PCI.

Clinical Implications of the SYNTAX Study

2009 ◽  
Vol 4 (1) ◽  
pp. 48 ◽  
Author(s):  
Patrick Serruys ◽  
Scot Garg ◽  
◽  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
De Novo ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Coronary Intervention ◽  
Syntax Score ◽  
Cerebrovascular Events ◽  
Percutaneous Coronary ◽  
Syntax Study ◽  
Better Than

Recent years have seen an ongoing debate as to whether coronary artery bypass graft (CABG) surgery or percutaneous coronary intervention (PCI) is the most appropriate revascularisation strategy for patients with coronary heart disease (CAD). The Synergy between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery (SYNTAX) study was conducted with the intention of defining the specific roles of each therapy in the management of de novo three-vessel disease or left main CAD. Interim results after 12 months show that PCI leads to significantly higher rates of major adverse cardiac or cerebrovascular events compared with CABG (17.8 versus 12.4; p=0.002), largely owing to increased rates of repeat revascularisation. However, CABG was much more likely to lead to stroke. Interestingly, categorisation of patients by severity of CAD complexity according to the SYNTAX score has shown that there are certain patients in whom PCI can yield results that are comparable to, if not better than, those achieved with CABG. Careful clinical evaluation and comprehensive assessment of CAD severity, alongside application of the SYNTAX score, can aid practitioners in selecting the most suitable therapy for each individual CAD patient.

Risk factors of coronary microvascular obstruction (Preprint)

2020 ◽  
Author(s):  
Yong Li ◽  
Shuzheng Lyu
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Logistic Regression ◽  
Microvascular Obstruction ◽  
Coronary Intervention ◽  
St Elevation Myocardial Infarction ◽  
Neutrophil Percentage ◽  
Percutaneous Coronary ◽  
St Elevation

BACKGROUND Coronary microvascular obstruction /no-reflow(CMVO/NR) is a predictor of long-term mortality in survivors of ST elevation myocardial infarction (STEMI) underwent primary percutaneous coronary intervention (PPCI). OBJECTIVE To identify risk factors of CMVO/NR. METHODS Totally 2384 STEMI patients treated with PPCI were divided into two groups according to thrombolysis in myocardial infarction(TIMI) flow grade:CMVO/NR group(246cases,TIMI 0-2 grade) and control group(2138 cases,TIMI 3 grade). We used univariable and multivariable logistic regression to identify risk factors of CMVO/NR. RESULTS A frequency of CMVO/NR was 10.3%(246/2384). Logistic regression analysis showed that the differences between the two groups in age(unadjusted odds ratios [OR] 1.032; 95% CI, 1.02 to 1.045; adjusted OR 1.032; 95% CI, 1.02 to 1.046 ; P <0.001), periprocedural bradycardia (unadjusted OR 2.357 ; 95% CI, 1.752 to 3.171; adjusted OR1.818; 95% CI, 1.338 to 2.471 ; P <0.001),using thrombus aspirationdevices during operation (unadjusted OR 2.489 ; 95% CI, 1.815 to 3.414; adjusted OR1.835; 95% CI, 1.291 to 2.606 ; P =0.001),neutrophil percentage (unadjusted OR 1.028 ; 95% CI, 1.014 to 1.042; adjusted OR1.022; 95% CI, 1.008 to 1.036 ; P =0.002) , and completely block of culprit vessel (unadjusted OR 2.626; 95% CI, 1.85 to 3.728; adjusted-OR 1.656;95% CI, 1.119 to 2.45; P =0.012) were statistically significant ( P <0. 05). The area under the receiver operating characteristic curve was 0.6896 . CONCLUSIONS Age , periprocedural bradycardia, using thrombus aspirationdevices during operation, neutrophil percentage ,and completely block of culprit vessel may be independent risk factors for predicting CMVO/NR. We registered this study with WHO International Clinical Trials Registry Platform (ICTRP) (registration number: ChiCTR1900023213; registered date: 16 May 2019).http://www.chictr.org.cn/edit.aspx?pid=39057&htm=4. Key Words: Coronary disease ST elevation myocardial infarction No-reflow phenomenon Percutaneous coronary intervention

scholarly journals Prasugrel versus ticagrelor in patients with myocardial infarction undergoing percutaneous coronary intervention

Heart ◽  
2021 ◽  
pp. heartjnl-2020-318694
Author(s):  
Dimitrios Venetsanos ◽  
Erik Träff ◽  
David Erlinge ◽  
Emil Hagström ◽  
Johan Nilsson ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Similar Efficacy ◽  
Efficacy And Safety ◽  
Adjusted Risk ◽  
Cerebrovascular Events ◽  
Percutaneous Coronary ◽  
Significant Difference ◽  
Evidence Based Care

ObjectiveThe comparative efficacy and safety of prasugrel and ticagrelor in patients with myocardial infarction (MI) treated with percutaneous coronary intervention (PCI) remain unclear. We aimed to investigate the association of treatment with clinical outcomes.MethodsIn the SWEDEHEART (Swedish Web-system for enhancement and development of evidence-based care in heart disease evaluated according to recommended therapies) registry, all patients with MI treated with PCI and discharged on prasugrel or ticagrelor from 2010 to 2016 were included. Outcomes were 1-year major adverse cardiac and cerebrovascular events (MACCE, death, MI or stroke), individual components and bleeding. Multivariable adjustment, inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) were used to adjust for confounders.ResultsWe included 37 990 patients, 2073 in the prasugrel group and 35 917 in the ticagrelor group. Patients in the prasugrel group were younger, more often admitted with ST elevation MI and more likely to have diabetes. Six to twelve months after discharge, 20% of patients in each group discontinued the P2Y12 receptor inhibitor they received at discharge. The risk for MACCE did not significantly differ between prasugrel-treated and ticagrelor-treated patients (adjusted HR 1.03, 95% CI 0.86 to 1.24). We found no significant difference in the adjusted risk for death, recurrent MI or stroke alone between the two treatments. There was no significant difference in the risk for bleeding with prasugrel versus ticagrelor (2.5% vs 3.2%, adjusted HR 0.92, 95% CI 0.69 to 1.22). IPTW and PSM analyses confirmed the results.ConclusionIn patients with MI treated with PCI, prasugrel and ticagrelor were associated with similar efficacy and safety during 1-year follow-up.

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