Abstract P222: Percutaneous Coronary Intervention in Hospitals Without Surgery on Site: One Year Follow-Up From a Longitudinal Registry

2011 ◽  
Vol 4 (suppl_1) ◽  
Author(s):  
Jorge Gonzalez ◽  
Ankur Gupta ◽  
Mohamad Alkhouli ◽  
Abdul Kashem ◽  
Kristy Scheiring ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Carotid Artery Disease ◽  
Bare Metal Stents ◽  
Coronary Intervention ◽  
Metal Stents ◽  
Time Interval ◽  
Elective Percutaneous Coronary Intervention ◽  
Percutaneous Coronary ◽  
One Year

Background: The safety of performing elective percutaneous coronary intervention (PCI) in hospitals without surgery on site (SOS) has been questioned. We assessed the safety of this practice in a one year follow up study. Methods: 485 patients underwent elective (PCI) in two network hospitals without (SOS) were followed for one-year in a longitudinal registry. Baseline demographics, hemodynamics, and renal function were recorded for each patient before and after PCI. Clinical data were obtained at 6 weeks, 3, 6, 9, and 12 months. Results: Baseline demographics: Mean age was 68±12 years, 67% were male, BMI: 28.9±5.3. Comorbidities included heart failure-8.4%, carotid artery disease-7%, hypertension-80%, IDDM-9%, NIDDM-20%, PAD-6%, smoking-22%, prior PCI-31%. Systolic BP: 146±24 mmHg, diastolic BP: 79±15 mmHg, creatinine: 1.1±0.7mg/dl, Total Cholesterol: 157±40 mg/dl, EF: 52±14%. Total number of stents used was 558 (28% Bare-metal stents and 72% Drug eluted stents). Death, all cause readmissions, repeat PCI, CABG, and angina symptoms were recorded at each time interval (See table1 ). At one year 95% were taking aspirin and 89% were taking clopidogrel. No correlation was noted between clopidrogel use and repeat PCI. Conclusions: One year follow up after PCI in hospitals without SOS demonstrates acceptable rates of immediate complications and long term outcomes. The data suggest that elective PCI can be performed safely in hospitals without surgery on site. Time Interval Death Readmit Repeat PCI CABG Angina Symptoms 6 weeks 1% 7% 1.2% 1% 6.4% 3 months 0.4% 5% 0.6% 1% 6.9% 6 months 0.8% 7% 1.1% 0% 9.4% 9 months 0.4% 4% 9.3% 1% 10.4% 12 months 0.4% 3% 6.8% 0% 7.4%

Abstract 1685: Clinical and Angiographic Outcomes following Percutaneous Coronary Intervention with Sirolimus-Eluting Stents vs. Bare Metal Stents in Hemodialysis Patients

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Sen Yachi ◽  
Kengo Tanabe ◽  
Hirosada Yamamoto ◽  
Shuji Otsuki ◽  
Atsuhiko Yagishita ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Bare Metal Stents ◽  
Coronary Intervention ◽  
Hemodialysis Patients ◽  
Metal Stents ◽  
Control Group ◽  
Bare Metal ◽  
Percutaneous Coronary ◽  
Significant Difference

Background Percutaneous coronary intervention in hemodialysis patients has been hampered by high rate of major adverse cardiac events (MACE). It remains uncertain whether sirolimus-eluting stent (SES) improves clinical outcomes in hemodialysis patients compared to bare metal stent (BMS). Methods The present study consisted of consecutive 46 hemodialysis patients with 57 lesions treated with SES from August 2004 to April 2006. For comparison, the control group was composed of 67 hemodialysis patients with 70 lesions who were treated with BMS in three years before the introduction of SES. Clinical and angiographic follow-up were performed after 8 months. MACE included all-cause death, myocardial infarction and repeat target vessel revascularization. Results Baseline characteristics were comparable between the 2 groups except for lesion length. Clinical follow-up was available in all patients. Angiographic follow-up was obtained in 39 patients (84.8%) in the SES group and 49 patients (73.1%) in the BMS group. There was no difference in MACE between the 2 groups (SES;28.3%, BMS;40.3%, p=0.19). As shown in the table , quantitative angiographic analysis revealed a significant difference in late lumen loss (SES;0.66±0.80mm, BMS;1.07±0.75mm, p=0.01), however, the rate of binary restenosis was identical (SES;31.9%, BMS;40.4%, p=0.38). Of the angiographic restenosis lesions analyzed, focal restenosis pattern was frequently observed in the SES group than the BMS group(SES;93.3%, BMS;23.8%, p<0.0001), whereas diffuse restenosis pattern was dominant in the BMS group. Conclusion Angiographic parameters favored inhibition of neointimal hyperplasia by SES. However, the inhibitory effect of sirolimus was not translated into clinical superiority over BMS in hemodialysis patients. Table. Serial QCA data

Percutaneous Coronary Intervention in Patients with Diabetes and Multivessel or Left Main Disease – a Review

2012 ◽  
Vol 7 (1) ◽  
pp. 37
Author(s):  
Donald E Cutlip ◽  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Statistical Significance ◽  
Bare Metal Stents ◽  
Coronary Intervention ◽  
Metal Stents ◽  
Increased Risk ◽  
Percutaneous Coronary ◽  
Patients With Diabetes ◽  
The Impact

Coronary artery disease in patients with diabetes is frequently a diffuse process with multivessel involvement and is associated with increased risk for myocardial infarction and death. The role of percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG) in patients with diabetes and multivessel disease who require revascularisation has been debated and remains uncertain. The debate has been continued mainly because of the question to what degree an increased risk for in-stent restenosis among patients with diabetes contributes to other late adverse outcomes. This article reviews outcomes from early trials of balloon angioplasty versus CABG through later trials of bare-metal stents versus CABG and more recent data with drug-eluting stents as the comparator. Although not all studies have been powered to show statistical significance, the results have been generally consistent with a mortality benefit for CABG versus PCI, despite differential risks for restenosis with the various PCI approaches. The review also considers the impact of mammary artery grafting of the left anterior descending artery and individual case selection on these results, and proposes an algorithm for selection of patients in whom PCI remains a reasonable strategy.

scholarly journals Cost-effectiveness of drug-eluting stents versus bare-metal stents in patients undergoing percutaneous coronary intervention

Open Heart ◽  
2016 ◽  
Vol 3 (2) ◽  
pp. e000445 ◽  
Author(s):  
Louise Baschet ◽  
Sandrine Bourguignon ◽  
Sébastien Marque ◽  
Isabelle Durand-Zaleski ◽  
Emmanuel Teiger ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Cost Effectiveness ◽  
Bare Metal Stents ◽  
Coronary Intervention ◽  
Drug Eluting Stents ◽  
Metal Stents ◽  
Bare Metal ◽  
Percutaneous Coronary ◽  
Drug Eluting

scholarly journals Growth differentiation factor 15 and the risk of cardiovascular events in patients with atrial fibrillation after elective percutaneous coronary intervention

2021 ◽  
Vol 26 (7) ◽  
pp. 4457
Author(s):  
E. N. Krivosheeva ◽  
E. S. Kropacheva ◽  
A. B. Dobrovolsky ◽  
E. V. Titaeva ◽  
E. P. Panchenko
Keyword(s):  
Atrial Fibrillation ◽  
Percutaneous Coronary Intervention ◽  
Cardiovascular Events ◽  
Coronary Intervention ◽  
Growth Differentiation Factor 15 ◽  
Elective Percutaneous Coronary Intervention ◽  
Percutaneous Coronary ◽  
D Dimer

Aim. To study the predictive value of growth differentiation factor 15 (GDF-15) in patients with atrial fibrillation (AF) after elective percutaneous coronary intervention (PCI).Material and methods. The study included 150 patients (men, 69,3%) with AF receiving direct oral anticoagulants in combination with two (89,3%) or one antiplatelet agent (10,7%) after elective PCI. Median age was 71,0 [interquartile range, 66,0; 77,0] years. The median follow-up was 11,5 months [interquartile range, 8,0; 12,0]. The efficacy endpoint was the sum of cardiovascular events (CVEs), including cardiovascular death, ischemic stroke, venous thromboembolism, peripheral arterial thrombosis, acute coronary syndrome, and the need for emergency PCI. The safety endpoint was considered to be BARC type 2-5 bleeding. Prior to PCI, blood plasma samples were taken from patients to determine GDF-15 and D-dimer by enzyme immunoassay.Results. The incidence of CVEs was 16%. The incidence of BARC type 2-5 bleeding was 24,7%. The median GDF-15 level was 1270,0 pg/ml [953,0; 1778,0]. According to multiple regression, the GDF-15 level is associated with D-dimer (t=3,20; p=0,0018), diabetes (t=3,97; p=0,0001) and SYNTAX score II (t=4,77; p<0,0001). In patients with single-vessel coronary artery disease, the GDF-15 level was significantly lower than in patients with three-vessel disease (p=0,0119). According to the ROC analysis, a GDF-15 >1191 pg/ml (p=0,0076) increases the likelihood of CVE (area under the curve, 0,647; confidence interval (CI), 0,5650,723). According to Kaplan-Meier survival curves, significant differences were found in terms of absence of CVEs during the follow-up period between the groups of patients with a GDF-15 >1191 and those with GDF-15 <1191 pg/ml (76% vs 94%, p=0,0032; relative risk, 4,36; CI 1,50-7,48). The relationship of GDF-15 level with BARC type 2-5 bleeding was not revealed.Conclusion. GDF-15 is a novel marker of CVE in AF patients after elective PCI.

Sign in / Sign up

Export Citation Format

Share Document