Impact of Diabetes Mellitus on the Pharmacodynamic Effects of Ticagrelor Versus Clopidogrel in Troponin‐Negative Acute Coronary Syndrome Patients Undergoing Ad Hoc Percutaneous Coronary Intervention

Objective To evaluate the safety and cost of early discharge compared with ordinary discharge in patients with diabetes mellitus (DM) following percutaneous coronary intervention (PCI) for acute coronary syndrome. Methods We performed a retrospective analysis of prospectively collected data from 474 patients with DM who were discharged from hospital following PCI at a regional center between 2012 and 2015. Results A total of 192 patients (40.5%) were included in the early discharge group and 282 patients (59.5%) were included in the ordinary group. Mortality and morbidity after PCI were recorded. Kaplan–Meier analysis showed similar prognosis between the two groups at 30 days and at 1 year after discharge. However, hospitalization expenses for the regular discharge group were significantly higher than those of the early discharge group (RMB65,750 vs. RMB50,983). Conclusion Our findings demonstrate that early discharge of patients with DM following PCI for acute coronary syndrome is safe compared with ordinary discharge, and may reduce hospitalization costs.

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Feasibility and safety of non-contrast percutaneous coronary intervention in patients with complicated acute coronary syndrome

European Heart Journal ◽

10.1093/ehjci/ehaa946.1751 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

S Higuchi ◽

Y Kabeya ◽

Y Nishina ◽

Y Miura ◽

H Yoshino

Keyword(s):

Percutaneous Coronary Intervention ◽

Acute Coronary Syndrome ◽

Renal Function ◽

Serum Creatinine ◽

Contrast Medium ◽

Ad Hoc ◽

Kidney Injury ◽

Coronary Intervention ◽

Coronary Syndrome ◽

Percutaneous Coronary

Abstract Background Contrast-induced acute kidney injury (CI-AKI) occurs in 10% to 20% of acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI), resulting in a poor short- and long-term prognosis. Reducing the amount of contrast medium can prevent CI-AKI. Objectives This study aimed to examine the feasibility and safety of non-contrast PCI in patients with ACS. Methods The study was a prospective and single-center registry. Successful non-contrast PCI was confirmed when contrast medium was not injected from the guiding catheter engagement to wire removal in ad-hoc PCI. Coronary angiography after the PCI procedure was permitted once. CI-AKI was defined as an increase in the serum creatinine of ≥0.5 mg/dL from or ≥1.25 times the baseline within 72 hours after PCI. Worsening renal function (WRF) was defined as an increase in the serum creatinine of ≥0.3 mg/dL from baseline after the PCI. Results The present study included 106 lesions from 81 patients. Forty-eight lesions were (45%) type C lesions. Successful non-contrast PCI was performed in 95 lesions (90%). CI-AKI was observed in 4 (5%); coronary perforation, 0; no/slow flow, 9 (11%); periprocedural death, 0. The follow-up period was 348 (190–492) days. Successful non-contrast PCI was not associated with the incidence of CI-AKI. However, WRF at 6-month was observed in 18 individuals (22%). Successful non-contrast PCI was inversely associated with WRF (hazard ratio, 0.28; 95% confidence interval, 0.09–0.90) after adjustment for renal function. Conclusions The present study suggests that non-contrast PCI is feasible and safe in ACS patients with complex lesions. Funding Acknowledgement Type of funding source: None

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