Evaluation of the risk factors on time to phlebitis- and nonphlebitis-related failure when peripheral venous catheters were replaced as clinically indicated

Background: This study aimed to determine the frequency of peripheral venous catheter–related complications and the risk factors that have an impact on the time of peripheral venous catheter failure when they were replaced as clinically indicated. Methods: This was a prospective observational study. The demographic and clinical characteristics of the patients, as well as the catheter specifications, were recorded. All the catheters were followed-up at 12-h intervals for the development of complications. Two different peripheral venous catheters were used in the study. The catheter dwell times were estimated using Kaplan–Meier analysis. The logrank test was utilized to investigate the catheter dwell times by univariate analyses. Variables with a significance level of less than 0.20 were taken into Cox regression analysis. Results: Our results revealed that phlebitis and nonphlebitis complications occurred more frequently within the first 96 h. No significant difference was observed in the occurrence time of phlebitis, nonphlebitis, and composite failures. The use of a locally manufactured catheter, unsuccessful first attempt, poor skin integrity, after-hours’ insertion, the use of sterile gauze dressing were all associated with shorter catheter survival rates. Conclusion: We observed no difference on the time to phlebitis or nonphlebitis symptoms with clinically indicated replacement of peripheral venous catheters. We found a significant difference in survival rates between locally manufactured and imported peripheral venous catheters. Our identified risk factors should be taken into account to reduce peripheral venous catheter–related complications and to increase dwell time.

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Surgical Resection Significantly Promotes the Overall Survival of Patients with Hepatocellular Carcinoma: A Propensity Score Matching Analysis

10.21203/rs.3.rs-148506/v1 ◽

2021 ◽

Author(s):

Pei-Min Hsieh ◽

Hung-Yu Lin ◽

Chao-Ming Hung ◽

Gin-Ho Lo ◽

I-Cheng Lu ◽

...

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Overall Survival ◽

Propensity Score ◽

Propensity Score Matching ◽

Surgical Resection ◽

Cox Regression ◽

Survival Rates ◽

Hbv Infection ◽

Cox Regression Analysis

Abstract Background: The benefits of surgical resection (SR) for various Barcelona Clinic Liver Cancer (BCLC) stages of hepatocellular carcinoma (HCC) remain unclear. We investigated the risk factors of overall survival (OS) and survival benefits of SR over nonsurgical treatments in patients with HCC of various BCLC stages.Methods: Overall, 2316 HCC patients were included, and their clinicopathological data and OS were recorded. OS was analyzed by the Kaplan-Meier method and Cox regression analysis. Propensity score matching (PSM) analysis was performed.Results: In total, 66 (2.8%), 865 (37.4%), 575 (24.8%) and 870 (35.0%) patients had BCLC stage 0, A, B, and C disease, respectively. Furthermore, 1302 (56.2%) of all patients, and 37 (56.9%), 472 (54.6%), 313 (54.4%) and 480 (59.3%) of patients with BCLC stage 0, A, B, and C disease, respectively, died. The median follow-up duration time was 20 (range 0-96) months for the total cohort and was subdivided into 52 (8-96), 32 (1-96), 19 (0-84), and 12 (0-79) months for BCLC stages 0, A, B, and C cohorts, respectively. The risk factors for OS were 1) SR and cirrhosis; 2) SR, cirrhosis, and Child-Pugh (C-P) class; 3) SR, hepatitis B virus (HBV) infection, and C-P class; and 4) SR, HBV infection, and C-P class for the BCLC stage 0, A, B, and C cohorts, respectively. Compared to non-SR treatment, SR resulted in significantly higher survival rates in all cohorts. The 5-year OS rates for SR vs non-SR were 44.0% vs 28.7%, 72.2% vs 42.6%, 42.6% vs 36.2, 44.6% vs 23.5%, and 41.4% vs 15.3% (all p-values<0.05) in the total and BCLC stage 0, A, B, and C cohorts, respectively. After PSM, SR resulted in significantly higher survival rates compared to non-SR treatment in various BCLC stages.Conclusion: SR conferred significant survival benefits to patients with HCC of various BCLC stages and should be considered a recommended treatment for select HCC patients, especially patients with BCLC stage B and C disease.

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NUTRITIONAL INDICATORS OF MALNUTRITION IN HOSPITALIZED PATIENTS

Arquivos de Gastroenterologia ◽

10.1590/s0004-2803.201900000-74 ◽

2019 ◽

Vol 56 (4) ◽

pp. 447-450 ◽

Cited By ~ 3

Author(s):

Vânia Aparecida LEANDRO-MERHI ◽

Caroline Lobo COSTA ◽

Laiz SARAGIOTTO ◽

José Luiz Braga de AQUINO

Keyword(s):

Lymphocyte Count ◽

Cox Regression ◽

Nutritional Assessment ◽

Mini Nutritional Assessment ◽

Hospitalized Patients ◽

Nutritional Risk ◽

Calf Circumference ◽

Significance Level ◽

Cox Regression Analysis ◽

Significant Difference

ABSTRACT BACKGROUND: Malnutrition is associated with clinical factors, including longer hospital stay, increased morbidity and mortality and hospital costs. OBJECTIVE: To investigate the prevalence of malnutrition using different nutritional indicators and to identify factors that contribute to malnutrition in hospitalized patients. METHODS: We investigated anthropometric, laboratory standards, nutritional risk screening (NRS), subjective global assessment (SGA), mini nutritional assessment and habitual energy consumption (HEC). Chi-square, Fisher’s exact test, Mann-Whitney test and univariate and multiple Cox regression analysis were used, at 5% significance level. RESULTS: It was found 21.01% of malnourished individuals by ASG; a total of 34.78% with nutritional risk according to NRS and 11.59% with low weight (BMI). There was no statistically significant difference in the prevalence of malnutrition by ASG (P=0.3344) and nutritional risk by NRS (P=0.2286), among the types of disorders. Patients with nutritional risk were of higher median age (64.5 vs 58.0 years; P=0.0246) and had lower median values of HEC (1362.1 kcal vs 1525 kcal, P=0.0030), of calf circumference (32.0 cm vs 33.5 cm, P=0.0405) of lymphocyte count (1176.5 cell/mm3 vs 1760.5 cell/ mm3, P=0.0095); and higher percentage of low body weight according to the BMI (22.9% vs 5.6%; P=0.0096). Lymphocyte count was associated with nutritional risk (P=0.0414; HR= 1.000; IC95%= 0.999; 1.000). CONCLUSION: NRS was more sensitive than other indicators in the diagnosis of malnutrition. Patients at risk were older and had lower HEC values, calf circumference, BMI and lymphocyte count. Low lymphocyte count was considered a factor associated with nutritional risk by the NRS.

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Early and Midterm Outcome of TEVAR for Thoracic Aortic Pseudoaneurysm

10.21203/rs.3.rs-659146/v1 ◽

2021 ◽

Author(s):

Hui Wang ◽

Tun Wang ◽

Hao He ◽

Xin Li ◽

Yuan Peng ◽

...

Keyword(s):

Risk Factors ◽

Clinical Outcome ◽

Cardiac Disease ◽

Cox Regression ◽

Cox Regression Analysis ◽

Aortic Pseudoaneurysm ◽

Significant Difference ◽

Independent Risk Factors ◽

The Mean

Abstract Backgrounds: The prognosis of thoracic aortic pseudoaneurysm (TAP) after thoracic endovascular aortic repair (TEVAR) remains unclear. This study investigates the early and midterm clinical outcome as well as relevant risk factors of TAP patients following TEVAR therapy.Methods: From July 2010 to July 2020, 37 eligible TAP patients who underwent TEVAR were selected into our research. We retrospectively explored their baseline, perioperative and follow-up data. Fisher exact test and Kaplan-Meier method were applied for comparing difference between groups. Risk factors of late survival were discerned using Cox regression analysis.Results: There were 29 men and 12 women, with the mean age as 59.5±13.0 years (range, 30-82). The mean follow-up time was 30.7±28.3 months (range, 1-89). For early result, early mortality (≦30days) happened in 3(8.1%) zone 3 TAP patients versus 0 in zone 4 (p= 0.028); acute arterial embolism of lower extremity and type II endoleak respectively occurred in 1(2.7%) case. For midterm result, survival at 3 months, 1 year and 5 years was 88.8±5.3%, 75.9±7.5% and 68.3±9.9%, which showed significant difference between zone 2/3 versus zone 4 group (56.3±14.8% versus 72.9±13.2%, p= 0.013) and emergent versus elective TEVAR groups (0.0±0.0% versus 80.1±8.0%, p= 0.049). On multivariate Cox regression, lesions at zone 2/3 (HR 4.605, 95%CI 1.095-19.359), concomitant cardiac disease (HR 4.932, 95%CI 1.086-22.403) and emergent TEVAR (HR 4.196, 95%CI 1.042-16.891) were significant independent risk factors for worse late clinical outcome. Conclusions: TEVAR therapy is effective and safe with satisfactory early and midterm clinical outcome for TAP patients. Lesions at zone 2/3, concomitant cardiac disease and emergent TEVAR were independent risk factors for midterm survival outcome.

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Cardiotoxicity and related risk factors in long-term trastuzumab (T) administration for metastatic breast cancer (MBC): A retrospective analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e11616 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e11616-e11616

Author(s):

Barbara Pistilli ◽

Andrea Marcellusi ◽

Michele Valeri ◽

Umberto Torresi ◽

Dania Nacciarriti ◽

...

Keyword(s):

Risk Factors ◽

Regression Analysis ◽

Cardiac Disease ◽

Cox Regression ◽

Significant Risk ◽

Concomitant Chemotherapy ◽

Cox Regression Analysis ◽

Significant Difference ◽

History Of

e11616 Background: Continuing T beyond progression has become a common strategy in the treatment of human epidermal growth receptor 2- overexpressing (HER2) MBC. However, T administered for several years with concomitant chemotherapy elicits concern about cardiac safety especially in patients (pts) with risk factors. Methods: Cardiac events (CEs) and survival of HER2 MBC pts treated with T +/- chemotherapy at our institution from Dec 2003 to Jun 2012 were evaluated. CEs were graded by NCI-CTCAE v 3.0. Risk factors assessed for cardiotoxicity were: age, body mass index, antihypertensive therapy, history of cardiac disease, diabetes, hypothyroidism, smoking, prior radiotherapy on the chest wall, prior cumulative dose of anthracycline(A), interval between last A dose and first T dose, baseline LVEF, continued/interrupted T exposure, concomitant chemotherapy. Chi-square test was used to compare distribution of CEs over different times of T exposure (p≤ 0.05). Univariate and multivariate Cox regression analysis were used to assess the effect of risk predictors. Results: Sixty-two pts assessable. Median age 52 years (range, 29 to 76), median cumulative time receiving T 29.5 months (range, 3 to 99 months); 40 pts (64.5%) received T without interruption and 19 pts (30.6%) were treated for more than 36 months. CEs occurred in 11 out of all pts (17.7%): grade 1 in 3 pts (4.8%), grade 2 in 5 (8.1%) and grade 3 in 3 (4.8%). The rate of CEs showed no statistically significant difference in pts receiving T for up to 36 months and over: 7/43 (16.3%) and 4/19 (21%), respectively, (p =0.724). In univariate Cox regression analysis significant risk factors were: history of cardiac disease (HR 6,814, 95% CI: 1,384-33,542) and smoking (HR 5,228, 95% CI: 1,403-19,491). In multivariate analysis smoking was the only independent predictor (HR 5,886, 95% CI: 1,479-23,247). Median survival from MBC diagnosis was 50 months (range, 6 to 101 months). Conclusions: Despite the limited sample size, our analysis suggests that cardiotoxicity does not hamper a long-term use of T, since the rate of CEs did not increase in pts treated over 36 months. Moreover, smoking appears to be a predictive factor of T cardiotoxicity.

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Clinical Outcomes of Myocardial Bridging versus No Myocardial Bridging in Patients with Apical Hypertrophic Cardiomyopathy

Cardiology ◽

10.1159/000486276 ◽

2018 ◽

Vol 139 (3) ◽

pp. 161-168 ◽

Cited By ~ 4

Author(s):

Shan-Shan Zhai ◽

Chao-Mei Fan ◽

Shuo-Yan An ◽

Fei Hang ◽

Yin-Jian Yang ◽

...

Keyword(s):

Risk Factors ◽

Hypertrophic Cardiomyopathy ◽

Cox Regression ◽

Survival Rates ◽

Clinical Effects ◽

Class Iii ◽

Myocardial Bridging ◽

Cox Regression Analysis ◽

Apical Hypertrophic Cardiomyopathy ◽

St Segment Elevation

Objective: To determine the prevalence and clinical effects of myocardial bridging (MB) in patients with apical hypertrophic cardiomyopathy (AHCM). Methods: Angiograms from 212 AHCM patients were reviewed to identify MB. The patients were classified into 2 groups: AHCM with and AHCM without MB. We reviewed patient records on cardiovascular (CV) risk factors, symptoms, CV events, and CV mortality. Results: In all, 60 patients with MB and 100 without MB were included. Rates of angina (61.7 vs. 40%; p = 0.008), mimicking non-ST-segment elevation myocardial infarction (15 vs. 3%, p = 0.013), and Canadian Cardiovascular Society class III/IV angina (18.3 vs. 4%; p = 0.003) were higher in patients with MB than in those without. Mean follow-up periods (65.5 ± 50.5 vs. 64.4 ± 43.6 months, p = 0.378) and CV mortality (3.3 vs. 1%; p = 0.652) were similar in the 2 groups. Kaplan-Meier estimates demonstrated that CV event-free survival rates were lower in patients with MB than in those without (71.7 vs. 88%; p = 0.022). MB, late gadolinium enhancement, and female sex were independent risk factors for CV events in a multivariate Cox regression analysis adjusted for other risk factors. Conclusion: More serious symptoms and a higher risk of CV events were observed in AHCM patients with MB than in those without MB. CV mortality was similar in these 2 groups.

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Risk Factors for Primary Arteriovenous Fistula Dysfunction in Hemodialysis Patients: A Retrospective Survival Analysis in Multiple Medical Centers

Blood Purification ◽

10.1159/000500045 ◽

2019 ◽

Vol 48 (3) ◽

pp. 276-282 ◽

Cited By ~ 4

Author(s):

Maowan Wen ◽

Zheng Li ◽

Jun Li ◽

Wen Zhou ◽

Yu Liu ◽

...

Keyword(s):

Risk Factors ◽

Blood Flow ◽

Survival Analysis ◽

Arteriovenous Fistula ◽

Cox Regression ◽

Autoimmune Disorder ◽

Major Barrier ◽

Cox Regression Analysis ◽

Medical Centers ◽

Significant Difference

Background: Arteriovenous fistula (AVF) is the preferred vascular access for hemodialysis (HD). However, primary AVF dysfunction represents a major barrier to the long-term success of HD therapy. This study aims to analyze the variables that influence the incidence of first AVF failure in HD patients. Methods: From January 2012 to October 2016, a total of 100 HD subjects from 43 medical centers were enrolled for a retrospective survival analysis of AVF dysfunction. To diminish the potential influence of surgeon experiences, the same operation group in Second Xiangya Hospital performed all studied AVF placements. This study focuses on a Chinese population of idiopathic glomerular disease to avoid the secondary influence of other systemic diseases, including diabetes, hypertension, and autoimmune disorder. AVF dysfunction was defined as lower blood flow during dialysis (≤200 mL/min) or insufficiency of HD treatment caused by reduced blood flow. Results: Among all enrolled subjects, the incidence of AVF dysfunction due to impatency was 27% (n = 27) with a cumulative survival of 84.0, 73.1, and 71.6% in 6, 12, and 24 months of post-placement. AVF survival analysis revealed a higher incidence of AVF failure in females (p= 0.025) and elderly (p = 0.031) patients. Importantly, AVF dysfunction markedly increased in subjects with higher levels of platelets (PLTs; p = 0.024), severe anemia (p = 0.014), and extended temporary catheter retention (p = 0.020). Further multivariate Cox regression analysis confirmed these variables as independent risk factors for first AVF dysfunction. Meanwhile, no significant difference could be observed according to the levels of body mass index, serum albumin, serum calcium, serum phosphorus, prothrombin time, and activated partial thromboplastin time. Lastly, anti-coagulant treatments seemed to barely influence the outcomes of AVF survival in this study. Conclusion: These findings suggest that primary AVF dysfunction in HD patients is associated with gender, ageing, PLT counting number, hemoglobin level, and retention time of temporary catheter.

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Treatment of colorectal cancer in Armenia: A retrospective hospital-based study from a developing world.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e16099 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e16099-e16099

Author(s):

Samvel Bardakhchyan ◽

Sergo Mkhitaryan ◽

Davit Zohrabyan ◽

Liana Safaryan ◽

Armen Avagyan ◽

...

Keyword(s):

Colorectal Cancer ◽

Adjuvant Chemotherapy ◽

Median Survival ◽

Cox Regression ◽

Survival Rates ◽

Disease Free Survival ◽

Rectum Cancer ◽

Cox Regression Analysis ◽

Stage 4 ◽

Significant Difference

e16099 Background: In Armenia colorectal cancer (CRC) is on the third place by incidence. Every year around 700 new cases are diagnosed with 60% diagnosed in 3rd and 4th stages. Methods: For this retrospective hospital-based study we have collected data from two main oncology centers in Armenia: National Oncology Center and Muratsan Hospital Complex of Yerevan state medical university. The information about patients with CRC who were treated at these two centers during 01/01/2010 - 07/01/2018 period was collected from the medical records. Results: 602 patients with CRC treated during mentioned period in these two hospitals were involved in final analysis. From them 51.8% were female. Median age at diagnosis was 58. Median follow up time was 37 months (range 3-207). 26.1% had right sided, 30.9% left sided and 43.0% rectum cancer. 8.6% of patients had stage 1, 32.9% stage 2, 38.0% stage 3, 17.6% stage 4 CRC and for 2.7% patients stage was unknown. The median survival was not reached for the entire cohort ( > 37 months). Median survival was > 66.5 months for 1st, > 48.5 months for 2nd, > 35 months for 3rd and 19 months for 4th stages. Tumor stage, grade and histology were the main independent prognostic factors by univariate and multivariate Cox regression analysis. For stage 2 CRC patients (198) we found significant difference regarding overall survival (OS) (p = 0.024) and disease free survival (DFS) (p = 0.006) for those who received adjuvant chemotherapy after surgery compared to those who didn’t receive adjuvant chemotherapy. For stage 2 and 3 rectum cancer patients, our study failed to show OS (2nd stage: p = 0.961; 3rd stage: p = 0.348) or DFS (2nd stage: p = 0.719; 3rd stage: p = 0.983) advantage for those who received radiotherapy (RT) compared with those who didn’t receive RT. In our study population 28.3% of stage 4 patients received chemotherapy combined with Bevacizumab while 70% were treated with chemotherapy only. Median OS between these two groups wasn’t significantly different (21 months in Chemo+Bevacizumab group and 18.5 months in chemo only group (p = 0.382)). 3 and 5-year survival rates were 62.9% and 51.8% for all stages combined and 79.7% and 68.5% for stages 1-2, 62.5% and 48.4% for stage 3, 24.4% and 17% for stage 4 respectively. Conclusions: As seen from our results our survival rates are inferior compared to that of developed world. The reasons for that could be compromise in surgery and RT, poor pathological assessment, unavailability of some molecular markers, poor availability of new targeted drugs and absence of national treatment guidelines.

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Comparison of clinical characteristics and outcomes of infective endocarditis between haemodialysis and non-haemodialysis patients in China

Journal of International Medical Research ◽

10.1177/0300060520940435 ◽

2020 ◽

Vol 48 (7) ◽

pp. 030006052094043

Author(s):

Wei Zhang ◽

Ping Ju ◽

Xuemei Liu ◽

Haiyan Zhou ◽

Feng Xue

Keyword(s):

Infective Endocarditis ◽

Antibiotic Therapy ◽

Clinical Characteristics ◽

Heart Surgery ◽

Cox Regression ◽

Survival Rates ◽

Venous Catheter ◽

Cox Regression Analysis ◽

Long Term Prognosis

Objective To clarify differences in clinical characteristics and outcomes between patients with infective endocarditis (IE) receiving long-term haemodialysis (HD group) and those not receiving haemodialysis (non-HD group). Methods Medical records of patients with IE, admitted to hospital between January 2010 and December 2017, were retrospectively studied. Clinical characteristics and outcomes were compared between HD and non-HD groups. Risk factors for IE were assessed by COX regression. Results Twenty-one HD and 143 non-HD patients were included. Predisposing heart conditions were more frequently observed in the non-HD versus HD group (90.9% versus 19.0%). Inappropriate antibiotic therapy rate before admission and proportion of methicillin-resistant Staphylococcus aureus and Enterococcus-associated IE was higher in the HD versus non-HD group. In the HD group, fewer patients underwent heart surgery (9.5% versus 51.7%), all-cause in-hospital mortality was higher (52.4% versus 21%), and survival rate was lower versus the non-HD group. COX regression analysis revealed that haemodialysis, use of central venous catheter (CVC) and inappropriate antibiotic therapy before admission increased IE mortality, while surgery improved long-term prognosis. Conclusions Haemodialysis patients with IE may have higher mortality and lower survival rates than patients with IE not receiving haemodialysis. Haemodialysis, use of CVC and inappropriate antibiotic therapy before admission may increase IE mortality. Surgery may improve long-term prognosis.

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Surgical resection significantly promotes the overall survival of patients with hepatocellular carcinoma: a propensity score matching analysis

BMC Gastroenterology ◽

10.1186/s12876-021-01807-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yaw-Sen Chen ◽

Pei-Min Hsieh ◽

Hung-Yu Lin ◽

Chao-Ming Hung ◽

Gin-Ho Lo ◽

...

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Overall Survival ◽

Propensity Score ◽

Propensity Score Matching ◽

Surgical Resection ◽

Cox Regression ◽

Survival Rates ◽

Hbv Infection ◽

Cox Regression Analysis

Abstract Background The benefits of surgical resection (SR) for various Barcelona Clinic Liver Cancer (BCLC) stages of hepatocellular carcinoma (HCC) remain unclear. We investigated the risk factors of overall survival (OS) and survival benefits of SR over nonsurgical treatments in patients with HCC of various BCLC stages. Methods Overall, 2316 HCC patients were included, and their clinicopathological data and OS were recorded. OS was analyzed by the Kaplan-Meier method and Cox regression analysis. Propensity score matching (PSM) analysis was performed. Results In total, 66 (2.8%), 865 (37.4%), 575 (24.8%) and 870 (35.0%) patients had BCLC stage 0, A, B, and C disease, respectively. Furthermore, 1302 (56.2%) of all patients, and 37 (56.9%), 472 (54.6%), 313 (54.4%) and 480 (59.3%) of patients with BCLC stage 0, A, B, and C disease, respectively, died. The median follow-up duration time was 20 (range 0–96) months for the total cohort and was subdivided into 52 (8–96), 32 (1–96), 19 (0–84), and 12 (0–79) months for BCLC stages 0, A, B, and C cohorts, respectively. The risk factors for OS were (1) SR and cirrhosis; (2) SR, cirrhosis, and Child–Pugh (C–P) class; (3) SR, hepatitis B virus (HBV) infection, and C–P class; and (4) SR, HBV infection, and C–P class for the BCLC stage 0, A, B, and C cohorts, respectively. Compared to non-SR treatment, SR resulted in significantly higher survival rates in all cohorts. The 5-year OS rates for SR vs. non-SR were 44.0% versus 28.7%, 72.2% versus 42.6%, 42.6% versus 36.2, 44.6% versus 23.5%, and 41.4% versus 15.3% (all P values < 0.05) in the total and BCLC stage 0, A, B, and C cohorts, respectively. After PSM, SR resulted in significantly higher survival rates compared to non-SR treatment in various BCLC stages. Conclusions SR conferred significant survival benefits to patients with HCC of various BCLC stages and should be considered a recommended treatment for select HCC patients, especially patients with BCLC stage B and C disease.

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Independent Risk Factor Analysis for Major Cardiovascular Adverse Events in Patients with Mild Coronary Stenosis

10.21203/rs.2.14615/v1 ◽

2019 ◽

Author(s):

Wei Luo ◽

Ru Zhao ◽

YanQiu Song ◽

Hui Zhao ◽

WeiJun Ma ◽

...

Keyword(s):

Risk Factors ◽

High Risk ◽

Coronary Stenosis ◽

Cox Regression ◽

Risk Group ◽

Adverse Cardiovascular Event ◽

Cox Regression Analysis ◽

Significant Difference ◽

Independent Risk Factors ◽

Hs Crp

Abstract Background: Independent risk factors for major adverse cardiovascular event (MACE) in patients with mild coronary stenosis are uncertain. This study aims to predict high-risk plaques detected by coronary computed tomographic angiography (CCTA) associated with indicative biomarkers.Methods: Totally 381 patients with mild coronary stenosis were included and MACE incidences were recorded through a 24-month follow-up. Totally 91 high-risk plaques are detected by CCTA, dividing into three plaque groups: high-risk group (HR), intermediate-risk group (IR) and low-risk group (LR). Specific blood biomarker measurements of hs-CRP, MMP-9, and MPO were taken simultaneously.Results: The mean age, levels of hs-CRP and MPO in HR and IR group were significantly higher than LR group. A considerably higher level of MMP-9 showed in HR group compared to LR group. The incidence rates of MACE were remarkably higher in HR group than LR group and IR group. Kaplan—Meier survival analysis demonstrated that the cumulative event—free survival rate of HR was significantly higher than that in LR and IR group and there were no significant difference between LR and IR group. The univariate COX regression analysis indicated that the age of patients, hs-CRP, MPO, and high-risk plaque scores≥2 were independent risk factors for MACE. Conclusion: Age, levels of hs-CRP and MPO, and high-risk plaque features informed by CCTA independently predicted MACE in patients with mild coronary stenosis. These results may improve the risk stratification in patients with mild coronary stenosis and suggest strategies for the individualized prevention programs.

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