Abstract 1691: Stages of Chronic Kidney Disease Correlate with Major Adverse Cardiac Events as well as Late Lumen Loss Following the Sirolimus Eluting Coronary Stent

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Yota Kawamura ◽  
Yoshihiro Morino ◽  
Masakazu Nagaoka ◽  
Takashi Matsukage ◽  
Naoki Masuda ◽  
...  

Background: Chronic Kidney Disease (CKD) is considered as a risk factor for development of cardiovascular disease. However, it is unclear whether CKD has association with prognosis following the drug eluting stent implantation. Methods and Results : The Cypher coronary stents were implanted to 302 lesions in 249 patients who underwent elective PCI between January 2005 and April 2006. Average age was 66.3 ± 9.7 and male gender was 80.3%. Diabetes was found in 47% of the patients including 16% of insulin treatment. Stages of CKD are shown in the table 1 and 2 . AHA/ACC lesion type B2/C was 62%. Cypher stents were implanted at maximum pressure at 17.3 ± 3.0 atm. Intravascular ultrasound was used in 92% of the procedure. Clinical follow-up data were available in 89.9 % at 1 year although angiographic follow-up was performed in 73.1% at 8 months. Major adverse cardiac events were frequently observed in association with stages of CKD as shown in the table 1 . Stages of CKD have correlation with late lumen loss at 8 months (Table 2 ). Furthermore, in-stent late lumen loss inversely correlated with glomerular filtration rate (GFR) (R = −0.18, p = 0.0097). Conclusion : Stages of CKD have correlation with major adverse cardiac events as well as late lumen loss following the sirolimus eluting stent implantation. Clinical follow-up at 1 year of study stratified by stages of CKD Angiographic data of study stratified by stages of CKD

2012 ◽  
Vol 26 (1) ◽  
pp. 111-118 ◽  
Author(s):  
Chao-Ping Wang ◽  
Li-Fen Lu ◽  
Teng-Hung Yu ◽  
Wei-Chin Hung ◽  
Cheng-An Chiu ◽  
...  

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Celestino Sardu ◽  
Nunzia D’Onofrio ◽  
Michele Torella ◽  
Michele Portoghese ◽  
Francesco Loreni ◽  
...  

Abstract Background/objectives Pericoronary adipose tissue inflammation might lead to the development and destabilization of coronary plaques in prediabetic patients. Here, we evaluated inflammation and leptin to adiponectin ratio in pericoronary fat from patients subjected to coronary artery bypass grafting (CABG) for acute myocardial infarction (AMI). Furthermore, we compared the 12-month prognosis of prediabetic patients compared to normoglycemic patients (NG). Finally, the effect of metformin therapy on pericoronary fat inflammation and 12-months prognosis in AMI-prediabetic patients was also evaluated. Methods An observational prospective study was conducted on patients with first AMI referred for CABG. Participants were divided in prediabetic and NG-patients. Prediabetic patients were divided in two groups; never-metformin-users and current-metformin-users receiving metformin therapy for almost 6 months before CABG. During the by-pass procedure on epicardial coronary portion, the pericoronary fat was removed from the surrounding stenosis area. The primary endpoints were the assessments of Major-Adverse-Cardiac-Events (MACE) at 12-month follow-up. Moreover, inflammatory tone was evaluated by measuring pericoronary fat levels of tumor necrosis factor-α (TNF-α), sirtuin 6 (SIRT6), and leptin to adiponectin ratio. Finally, inflammatory tone was correlated to the MACE during the 12-months follow-up. Results The MACE was 9.1% in all prediabetic patients and 3% in NG-patients. In prediabetic patients, current-metformin-users presented a significantly lower rate of MACE compared to prediabetic patients never-metformin-users. In addition, prediabetic patients showed higher inflammatory tone and leptin to adiponectin ratio in pericoronary fat compared to NG-patients (P < 0.001). Prediabetic never-metformin-users showed higher inflammatory tone and leptin to adiponectin ratio in pericoronary fat compared to current-metformin-users (P < 0.001). Remarkably, inflammatory tone and leptin to adiponectin ratio was significantly related to the MACE during the 12-months follow-up. Conclusion Prediabetes increase inflammatory burden in pericoronary adipose tissue. Metformin by reducing inflammatory tone and leptin to adiponectin ratio in pericoronary fat may improve prognosis in prediabetic patients with AMI. Trial registration Clinical Trial NCT03360981, Retrospectively Registered 7 January 2018


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