Abstract 15439: Lesion Complexity and Long-term Outcomes According to Mean Observed Blood Pressure After Percutaneous Coronary Intervention

Background: The guideline recommended strict blood pressure (BP) control for the patients treated with percutaneous coronary intervention (PCI). We aimed to evaluate the relationship between mean observed BP and long-term outcomes for patients with or without lesion complexity. Methods: A total of 1,470 patients who underwent PCI were investigated. We categorized the study population into four groups based on mean observed BP and lesion complexity (left main & three-vessel disease, chronic total occlusion, total stent length ≥60mm, or bifurcation two stenting): Group A (non-complex & systolic BP ≤120mmHg, n=310), Group B (non-complex & systolic BP >120mmHg, n=674), Group C (complex & systolic BP ≤120mmHg, n=131), and Group D (complex & systolic BP >120mmHg, n=355). We evaluated major adverse cardiovascular and cerebrovascular events (MACCEs), defined as cardiac death, myocardial infarction (MI), repeat target vessel revascularization, or stroke. Results: Well-controlled BP group (Group A&C) showed significantly lower systolic BP than uncontrolled BP group (Group B&D) (114.3±6.1mmHg vs. 130.7±7.6mmHg, p<0.001). MACCEs occurred less frequently in Group A (18.9%) than Group B (23.6%), Group C (22.7%), and Group D (33.6%) (p=0.001) at 8 years. After multivariate analysis, with Group A as a reference, the adjusted hazard ratio (HR) for MACCEs was 1.382 (95% confidence interval [CI] 0.978-1.954, p=0.067) for Group B, 1.559 (95% CI 0.957-2.540, p=0.075) for Group C, and 1.872 (95% CI 1.296-2.705, p=0.001) for Group D. In Cox regression model, although lesion complexity was not associated with MACCE, systolic BP≤120mmHg was an independent predictor for reduced rate of MACCE (HR 0.667, 95% CI 0.485-0.918, p=0.013). Conclusions: Mean observed systolic BP ≤120mmHg after PCI was independent predictor for reduced MACCEs regardless of lesion complexity. Key Words: Blood Pressure; Percutaneous Coronary Intervention; Lesion Complexity; Treatment Outcome

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Abstract 14199: Long-term Impact of Baseline Anemia and Dual Antiplatelet Therapy Duration After Percutaneous Coronary Intervention

Circulation ◽

10.1161/circ.142.suppl_3.14199 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Huntae Kim ◽

Jong-Il Park ◽

Byung-Jun Kim ◽

Jung-hee Lee ◽

Ung Kim ◽

...

Keyword(s):

Percutaneous Coronary Intervention ◽

Antiplatelet Therapy ◽

Major Bleeding ◽

Dual Antiplatelet Therapy ◽

Coronary Intervention ◽

Target Vessel Revascularization ◽

Percutaneous Coronary ◽

Group A ◽

Group B ◽

Group D

Background: Anemia is a known risk factor for future ischemic events and bleeding for patients with ischemic heart disease. However, there are little data about dual antiplatelet therapy (DAPT) duration for patients with anemia after percutaneous coronary intervention (PCI). Methods: From 2010 to 2013, a total of 1,470 patients who underwent PCI were investigated. We categorized the study population into four groups based on the DAPT duration and anemia (Hemoglobin <13g/dL for men and <12g/dL for women): Group A (non-anemia & ≤12m DAPT, n=521), Group B (non-anemia & >12m DAPT, n=501), Group C (anemia & ≤12m DAPT, n=226), and Group D (anemia & >12m DAPT, n=222). We evaluated major adverse cardiovascular and cerebrovascular events (MACCEs), defined as cardiac death, myocardial infarction, repeat target vessel revascularization, or stroke, and bleeding complication. Results: Even though anemic patients had more severe angiographic findings, such as three-vessel disease or diffuse long lesion, the DAPT duration was similar between anemia and non-anemia group. MACCEs occurred less frequently in Group B (16.9%) than Group A (24.7%), Group C (34.6%), and Group D (35.1%) (p<0.001) at 8 years. After multivariate analysis, with Group A as a reference, the adjusted hazard ratio for MACCEs was 0.711 (95% confidence interval [CI] 0.526-0.961, p=0.027) for Group B, 1.126 (95% CI 0.802-1.581, p=0.494) for Group C, and 0.995 (95% CI 0.706-1.405, p=0.980) for Group D. However, major bleeding occurred more frequently occurred in Group D (13.0%) than Group A (5.7%), Group B (7.5%), and Group C (11.2%) (p=0.035) at 8 years. Conclusions: Although extended DAPT showed reduced rate of MACCEs for non-anemic patients, it can be related with increased of major bleeding for anemic patients.

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Impact of Pre-Procedural Blood Pressure on Long-Term Outcomes Following Percutaneous Coronary Intervention

Heart Lung and Circulation ◽

10.1016/j.hlc.2017.06.084 ◽

2017 ◽

Vol 26 ◽

pp. S80

Author(s):

J. Warren ◽

S. Nanyakkara ◽

N. Andrianopulos ◽

A. Brennan ◽

C. Reid ◽

...

Keyword(s):

Blood Pressure ◽

Percutaneous Coronary Intervention ◽

Coronary Intervention ◽

Long Term Outcomes ◽

Percutaneous Coronary

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Association of Preprocedural Hyperglycemia With Contrast-Induced Acute Kidney Injury and Poor Outcomes After Emergency Percutaneous Coronary Intervention

Angiology ◽

10.1177/0003319718758140 ◽

2018 ◽

Vol 69 (9) ◽

pp. 770-778 ◽

Cited By ~ 6

Author(s):

Kai-Yang Lin ◽

Xiu-Ling Shang ◽

Yan-Song Guo ◽

Peng-Li Zhu ◽

Zhi-Yong Wu ◽

...

Keyword(s):

Acute Kidney Injury ◽

Percutaneous Coronary Intervention ◽

Independent Predictor ◽

Kidney Injury ◽

Coronary Intervention ◽

Long Term Outcomes ◽

Coronary Syndrome ◽

Percutaneous Coronary ◽

Emergency Percutaneous Coronary Intervention

We investigated whether preprocedural hyperglycemia was associated with contrast-induced acute kidney injury (CI-AKI) and long-term outcomes in patients with acute coronary syndrome (ACS) who underwent emergency percutaneous coronary intervention (PCI). Patients (n = 558) with ACS who underwent emergency PCI were consecutively enrolled. Preprocedural hyperglycemia was defined as glucose levels >198 mg/dL (11 mmol/L). The primary outcome was CI-AKI (≥0.3 mg/dL absolute or ≥50% relative serum creatinine increase 48 hours after contrast medium exposure). Overall, 103 (18.5%) patients had preprocedural hyperglycemia and 89 (15.9%) patients developed CI-AKI. The incidence of CI-AKI was significantly higher in patients with hyperglycemia than without (28.2% vs 13.2%; P < .01). Multivariate analysis indicated that preprocedural hyperglycemia was an independent predictor of CI-AKI (odds ratio = 1.971, 95% confidence interval [CI]: 1.129-3.441; P < .05). In addition, preprocedural hyperglycemia was associated with an increased risk of all-cause mortality during the 2-year follow-up (hazard ratio = 2.440, 95% CI: 1.394-4.273; P = .002). Preprocedural hyperglycemia is a significant and independent predictor of CI-AKI and long-term outcomes.

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