Abstract 16599: Impact of Race and Ethnicity on Long Term Outcomes Post Percutaneous Coronary Intervention With Drug Eluting Stents

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Anastasios Roumeliotis ◽  
Bimmer E Claessen ◽  
Samantha Sartori ◽  
Davide Cao ◽  
Won-Joon Koh ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
African American ◽  
African Americans ◽  
Private Insurance ◽  
Coronary Intervention ◽  
Drug Eluting Stent ◽  
P Value ◽  
Percutaneous Coronary ◽  
Drug Eluting ◽  
Race Ethnicity

Introduction: Cardiovascular disease is the leading cause of mortality worldwide, irrespective of race/ethnicity. Previous studies reported that minority patients with ACS have distinct clinical, genetic and socioeconomic backgrounds that may affect clinical outcomes. Hypothesis: To investigate post percutaneous coronary intervention (PCI) outcomes according to race/ethnicity in a contemporary ACS population. Methods: We included consecutive patients undergoing drug-eluting stent implantation for STEMI, non-STEMI or unstable angina (UA) between 2012-2017. The study population was stratified into Caucasian, African American, Hispanic and Asian. The primary endpoint was major adverse cardiac and cerebrovascular events (MACCE) defined as a composite of death, spontaneous myocardial infarction or stroke at 1 year. Results: Of the 6800 patients included, 3377 (49.7%) were Caucasian, 1408 (20.7%) Hispanic, 1156 (17.0%) Asian and 859 (12.6%) African American. Caucasians were the oldest, Hispanics and Asians had the highest prevalence of diabetes mellitus (DM) and African Americans had more insulin dependent DM and chronic kidney disease. Hispanics and African Americans had the highest STEMI rate, while Asians were more likely to present with UA, have private insurance and be discharged on aspirin and clopidogrel. Compared to Caucasians, Asians had a lower rate of MACCE at 1 year (3.9% vs. 7.1%; p<0.01) whereas Hispanics (6.2% vs. 7.1%; p-value=0.17) and African Americans (8.0% vs. 7.1%; p-value=0.38) had comparable outcomes. Differences were driven by fewer deaths in the Hispanic (2.1% vs. 4.2%; p<0.01) and Asian (1.7% vs. 4.2%; p<0.01) subgroups. Findings remained unchanged after adjusting for potential confounders [Figure]. Conclusions: Among patients undergoing PCI for ACS, Asian race is associated with favorable cardiovascular outcomes compared to Caucasian. No significant differences were observed for Hispanics and African Americans.

Unprotected Left Main Coronary Artery Percutaneous Coronary Intervention-Our Experiences at a Tertiary Hospital

2014 ◽  
Vol 6 (2) ◽  
pp. 107-111
Author(s):  
S Munwar ◽  
AHMW Islam ◽  
S Talukder ◽  
AQM Reza ◽  
T Ahmed ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Left Main Coronary Artery ◽  
Coronary Intervention ◽  
Drug Eluting Stent ◽  
Bare Metal ◽  
Coronary Artery Diseases ◽  
Left Main ◽  
Percutaneous Coronary ◽  
Drug Eluting

Background: Aim of the study was to evaluate the primary procedural success of percutaneous coronary intervention of unprotected left main coronary artery stenosis using either Bare-metal stents or drug eluting stent. Methods: Total 33 patients were enrolled in this very preliminary non-randomized prospective cohort study. Among them, Male: 25 and Female: 8. Total 35 stents were deployed. Mean age were for Male: 59 yrs, for Female: 62 yrs. Associated coronary artery diseases risk factors were dyslipidemia, High Blood pressure, Diabetes Mellitus, Positive family history for coronary artery diseases and smoking. Results: Among the study group; 26 (78%) were Dyslipidemic, 24(70%) were hypertensive; 17 (51.5%) patients were Diabetic, 11(33%) were smoker and 7(21%) patients had family history of Ischaemic heart disease. Female patients were more obese (BMI M 26: F 27) and developed coronary artery diseases in advance age. Common stented territory were left main: 20 (60%), Left main to left anterior descending artery 7 (22%) and Left main to left circumflex artery 6 (18%). Average length and diameter of stent was 3.5 and 18 mm respectively. Stent used: Bare Metal Stent 5 (15%), Drug Eluting Stent: 28 (85%). Among the different Drug Eluting Stents, Everolimus eluting stents were 11 (39.3%), Sirolimus eluting 10(35.7%), Paclitaxel eluting 3 (10.7%), Biolimus eluting 3 (10.7%) and Zotarolimus eluting1 (3.6%). In the present study, overall survival outcome was 94% (31 patient), mortality of cardiac cause 3% (1 patient) and 1 patient (3%) died of hepatocellular carcinoma. Conclusion: Our study has shown that percutaneous coronary intervention of the unprotected left main is a safe and effective alternative to Coronary Artery Bypass Graft (CABG). DOI: http://dx.doi.org/10.3329/cardio.v6i2.18349 Cardiovasc. j. 2014; 6(2): 107-111

scholarly journals Percutaneous Coronary Intervention and Drug-Eluting Stent Use Among Patients ≥85 Years of Age in the United States

2012 ◽  
Vol 59 (2) ◽  
pp. 105-112 ◽  
Author(s):  
Tracy Y. Wang ◽  
Frederick A. Masoudi ◽  
John C. Messenger ◽  
Kendrick A. Shunk ◽  
Andrew Boyle ◽  
...  
Keyword(s):  
United States ◽  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
The United States ◽  
Drug Eluting Stent ◽  
Percutaneous Coronary ◽  
Drug Eluting

Risk reduction strategies: coronary revascularization before non-cardiac surgery

ESC CardioMed ◽  
2018 ◽  
pp. 2659-2663
Author(s):  
Fabio Rigamonti ◽  
Marco Roffi
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Cardiac Surgery ◽  
Myocardial Revascularization ◽  
Bare Metal Stents ◽  
Coronary Intervention ◽  
Drug Eluting Stent ◽  
Metal Stents ◽  
Percutaneous Coronary ◽  
Reduction Strategies ◽  
Drug Eluting

An individualized, stepwise patient evaluation based on the degree of urgency of non-cardiac surgery, functional capacity, clinical presentation, and estimated cardiovascular stress related to surgery is recommended in order to assess the perioperative cardiovascular risk and optimize management. Myocardial ischaemia in the context of non-cardiac surgery may be related to acute coronary syndromes secondary to coronary plaque rupture or prolonged myocardial oxygen supply–demand imbalance. Randomized controlled trials have failed to show a benefit of routine preoperative prophylactic myocardial revascularization. Preoperative coronary angiography and, if appropriate, myocardial revascularization may be considered before high-risk surgery depending on symptom status and extent of ischaemia on non-invasive imaging. In patients requiring percutaneous coronary intervention, guidelines recommend new-generation drug-eluting stents over bare-metal stents, though randomized data are absent. While the minimal delay for a safe surgery following drug-eluting stent implantation remains to be defined, a time window of 5–6 weeks between percutaneous coronary intervention and surgery appears to be adequate in patients who cannot wait longer.

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