Abstract 111: Assessing Statin Therapy and Lipid Profile Goals 6 Months After Percutaneous Coronary Intervention at a Veterans Hospital

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Dmitry Blumenkrants ◽  
Saifullah M Siddiqui ◽  
Karthik Challa ◽  
Amit Ladani ◽  
Adhir Shroff
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Statin Therapy ◽  
Coronary Intervention ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Percutaneous Coronary ◽  
Core Measure ◽  
Study Population ◽  
Artery Disease

Background: Patients undergoing percutaneous coronary intervention (PCI) represent a high-risk cohort for cardiovascular events. Lipid lowering therapy is an established core measure of secondary prevention in coronary artery disease management. The NCEP-ATPIII advises a minimum LDL level < 100 mg/dL in patients with coronary heart disease (CHD). However, further research suggests that an LDL < 70 is more desirable in this population to further reduce adverse CHD endpoints. Methods: We conducted a retrospective, observational study on all patients undergoing PCI at an urban Veterans Hospital from September 2004 to December 2011. Statin use and lipid profiles at 6 months post-PCI were compared to pre-PCI values. Results: A total of 1052 unique patients had PCI during the study period. Approximately 70% of patients were on statins at baseline, which improved to 88% at 6 months post-PCI (p < 0.0001). LDL levels improved significantly when compared to pre-PCI levels, from a mean of 97.2 to 85.1 (p < 0.0001). With regards to NCEP-ATPIII guidelines, the proportion of the study population that met minimum LDL goals (<100) post-PCI increased from 59% to 76% (p < 0.0001). The percentage of patients meeting ideal goals for LDL (<70) increased from 23% to 33% (p < 0.0001). Conclusion: In patients who have undergone PCI, there was significant improvement in LDL levels. At six months, there was an increase in usage of statin therapy. Furthermore there was a statistically significant increase in adherence to NCEP-ATIII guidelines at both the minimum and ideal LDL levels on follow-up after PCI.

Abstract 436: Assessing Statin Therapy and Lipid Profile Goals 6 Months After Percutaneous Coronary Intervention at a Veterans Hospital

2012 ◽  
Vol 32 (suppl_1) ◽  
Author(s):  
Amit Ladani ◽  
Karthik Challa ◽  
Sloane McGraw ◽  
Anupama Shivaraju ◽  
Adhir Shroff
Keyword(s):  
Total Cholesterol ◽  
Statin Therapy ◽  
Coronary Intervention ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Percutaneous Coronary ◽  
Risk Patients ◽  
Core Measure ◽  
The Mean ◽  
Artery Disease

Background: Lipid lowering therapy is an established core measure of secondary prevention in coronary artery disease (CAD) management. The National Cholesterol Education Program - Adult treatment panel III (NCEP-ATP III) advises a minimum LDL level less than 100 mg/dL in patients with CAD and a recommended LDL less than 70 mg/dL for high risk patients. Statins remain the preferred agent for LDL reduction. Methods: We conducted a retrospective, observational study on all patients undergoing PCI at an urban Veterans Hospital from September 2004 to January 2011. Statin use and lipid profiles at 6 months post-PCI were compared to pre-PCI values. Results: A total of 933 unique patients had PCI during the study period. The mean total cholesterol decreased 18 mg/dL and the mean LDL decreased 15 mg/dL during 6 months follow-up (p< 0.001) (refer to table). The mean HDL did not differ significantly. The percent of patients at NCEP-ATP III guideline’s goal of LDL < 100 mg/dL increased from 58% pre-PCI to 74% post-PCI. Goal LDL < 70 mg/dL increased from 22 to 31% at 6 months. The use of statins increased from 69% to 89%. Conclusion: There were significant improvements in total cholesterol and LDL values at six months post-PCI, as well as the percentage of patients who met the NCEP-ATP III recommended goal of LDL cholesterol less than 100 mg/dL and the suggested goal of 70 mg/dL. At six months, there was an increase usage of statin therapy.

scholarly journals Impact of a stent-less percutaneous coronary intervention strategy using directional coronary atherectomy and a drug coated balloon for left main and ostial lesions

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Nakamura ◽  
T Rokutanda ◽  
H Kurokawa ◽  
Y Onoue
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Balloon Angioplasty ◽  
Chronic Phase ◽  
Coronary Intervention ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Left Main ◽  
Percutaneous Coronary ◽  
Directional Coronary Atherectomy

Abstract Background With the advent of drug eluting stents (DESs), the restenosis rate has markedly decreased. However, even with DESs, problems remain unsolved for bifurcated lesions including left main trunk (LMT) and right coronary artery (RCA) ostial lesions. In the era of directional coronary atherectomy (DCA) alone, an optimal DCA provides a significantly lower residual stenosis and lower angiographic restenosis than conventional balloon angioplasty, despite failing to reach a statistical significance for reducing late clinical events as compared to balloon angioplasty (Circulation 1998; 97:322–31.). Purpose This study aimed to examine the safety and effectiveness of stent-less percutaneous coronary intervention (PCI) using DCA and drug coated balloons (DCBs). Methods From November 2017 to June 2019, a stent-less PCI for LMT and ostial lesions was performed in 32 consecutive cases (male 24/female 8; mean age 70.9±9.8). A stent-less PCI was performed using SeQuent Please™ DCB after an ATHEROCUT™ DCA, and procedural success was obtained in all cases (6 cases with LMT, 18 with left anterior descending ostial, 6 with left circumflex ostial, and 2 with RCA ostial lesions). Results The percent plaque area (%PA) decreased from 70.0±7.7% at baseline to 51.6±8.1% after the DCA and to 46.1±9.0% after the DCBs. All patients completed a follow up coronary angiography after 6 months and no restenosis was observed. No major adverse cardiac events occurred in any cases including target lesion revascularizations. In 29 cases that the lumen was confirmed with IVUS at 6 months of follow-up, the lumen area (LA) had expanded significantly from 8.0±2.3 mm2 at baseline (post DCBs) to 8.9±2.7 mm2 at 6 months (P=0.023, Figure 1A). Local paclitaxel may induce late lumen enlargement (LLE) after a DCA/DCB. The group in which the LA increased during the chronic phase was defined as the Increased group and the group in which the LA decreased during the chronic phase was defined as the Decreased group. When comparing the LDL-Cho level pre DCA between the two groups, the LDL-Cho level in the Increased group was significantly low (74.0±25.8 mg/dl vs. 101.0±33.6 mg/dl, P=0.050, Figure 1B). Conclusions Stent-less PCI using DCA and DCBs for bifurcated lesions including LMT and RCA ostial lesions was effective, safe, and useful. Furthermore, a chronic LLE effect by DCBs is expected. In addition, intensive lipid-lowering therapy may also contribute to the chronic outcome after DCA/DCBs. Funding Acknowledgement Type of funding source: None

Association between the rs342293 polymorphism and adverse cardiac events in patients undergoing percutaneous coronary intervention

2014 ◽  
Vol 111 (06) ◽  
pp. 1060-1066 ◽  
Author(s):  
Iciar Arbesu ◽  
Bernd Jilma ◽  
Gerald Maurer ◽  
Irene M. Lang ◽  
Christine Mannhalter ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Adverse Events ◽  
Coronary Intervention ◽  
Cardiovascular Outcome ◽  
Cardiac Events ◽  
Adverse Cardiac Events ◽  
Percutaneous Coronary ◽  
Artery Disease ◽  
Cardiac Adverse Events

SummaryThe single nucleotide polymorphism (SNP) rs342293 has been shown to influence platelet number and mean platelet volume (MPV). We investigated the association between the rs342293 polymorphism and cardiovascular outcome in a prospective cohort study. The rs342293 polymorphism was analysed in 404 patients with coronary artery disease undergoing percutaneous coronary intervention. The rates of cardiac adverse events were recorded during two years of follow-up. The polymorphism was associated with MPV (median 10.1 fL, interquartile range [IQR]: 9.6 to 10.6 in patients with the CC-allele vs 10.4 fL, IQR: 9.9 to 11.1 in G>C SNP carriers; p<0.001), but not with platelet count. Survival analysis indicated that carriers of the rs342293 G variant had a substantially higher risk to develop cardiac adverse events compared with wild type carriers during two years of follow-up (33% vs 22%; adjusted hazard ratio = 1.63, 95% confidence interval = 1.06–2.52, p=0.027). The rs342293 SNP could explain 2.9% of the variability in MPV (p=0.01). In conclusion, patients undergoing coronary stenting who carry the G-variant of the rs342293 SNP which is associated with larger MPV are at higher risk for adverse cardiovascular outcome.

Differential Impact of Cigarette Smoking on Prognosis in Women and Men Undergoing Percutaneous Coronary Intervention

Angiology ◽  
2019 ◽  
Vol 71 (3) ◽  
pp. 281-287
Author(s):  
Li Xia Yang ◽  
Zhi Jian Wang ◽  
Dong Mei Shi ◽  
Meng Chai ◽  
Lin Zhang ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Cigarette Smoking ◽  
Smoking Status ◽  
Coronary Intervention ◽  
Major Adverse Cardiovascular Events ◽  
Target Vessel Revascularization ◽  
Percutaneous Coronary ◽  
Artery Disease

We sought to compare the effects of smoking on clinical outcomes in women and men with coronary artery disease undergoing percutaneous coronary intervention (PCI). We prospectively followed up 10 369 patients undergoing elective PCI. All patients were stratified according to smoking status and sex. The impacts of smoking on long-term major adverse cardiovascular events (MACEs, the composite of all-cause death, myocardial infarction, or target vessel revascularization) were assessed. Among 7773 men and 2596 women undergoing PCI, the prevalence of cigarette smoking was 66.7% (n = 5185) and 11.0% (n = 286; P < .001). During the 3 years of follow-up (median: 20.6 months), smoking increased MACE in both men and women (men 10.8% vs 8.1%, P < .001; women 23.2% vs 6.4%; P < .001). After adjusting for baseline characteristics, smoking had a greater effect on MACE in women (hazard ratio [HR]: 3.68, 95% confidence interval [CI]: 1.86-7.28; P < .001) compared with men (HR: 1.35, 95% CI: 1.03-1.77; P = .005, interaction P = .026). There was a lower prevalence of smoking in women compared to men among patients undergoing PCI. However, smoking confers a higher excess risk for MACE among women compared with men.

Angiographic profile and outcomes of Pakistani women with ST elevation myocardial infarction

2020 ◽  
pp. 1-13
Author(s):  
Sobia Masood ◽  
Kanwal Fatima Aamir ◽  
Khalid Naseeb ◽  
Quratulain Shaikh ◽  
Tahir Saghir ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Acute Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Female Patients ◽  
Vessel Disease ◽  
Percutaneous Coronary ◽  
Artery Disease

Abstract Objective: To evaluate the angiographic profile and outcome of primary percutaneous coronary intervention in female patients with acute myocardial infarction. Method: The cross-sectional study was conducted at the National Institute of Cardiovascular Diseases, Karachi, from July 1, 2017, to March 31, 2018, and comprised female patients presenting with acute myocardial infarction who underwent primary percutaneous coronary intervention and got enrolled in the National Cardiovascular Data Registry. Follow-up calls were made 1 year post-intervention and outcomes were noted. Data was analysed using SPSS 21. Results: Of the 522 female patients with a mean age of 57.41±11.14 years, 334(64%) were hypertensive, 202(38.7%) diabetic, 16(3.1%) had a family history of coronary artery disease, and 9(1.7%) were smokers. Single-vessel disease was observed in 183(35.1%) patients, and three-vessel disease in 144(27.6%). Post-procedure thrombolysis in myocardial infarction flow (0-II) was observed in 29(5.6%) patients, bleeding in 2(0.4%), and in-hospital mortality was in 22(4.2%). Telephonic follow-up was successfully conducted in 436(87.5%) of the discharged patients, and, of them 15(3.4%) had expired and recurrence was reported by 10(2.3%) patients and 8(80%) of them underwent re-intervention. Conclusion: More than half the female patients had multi-vessel disease and bifurcation lesion was observed in more than three-fourth of the sample. Key Words: Coronary artery disease, Women, Percutaneous coronary intervention, Acute myocardial infarction, Angiography, Pakistan. Continuous...

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