Predictors of In - Hospital and Short Term Endpoints of Primary Percutaneous Coronary Intervention in Ain Shams University Hospital

2013 ◽  
Vol 64 (10-12) ◽  
pp. 821-831
Author(s):  
Adel M. El Etriby ◽  
Yasser G. Elkashlan ◽  
Wael M. El Kilany ◽  
Adham A. Abdel Tawab
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Primary Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
University Hospital ◽  
Short Term ◽  
Percutaneous Coronary

Development and External Validation of Diagnostic Model for Intra-Procedural Hypotension during Primary Percutaneous Coronary Intervention: Algorithm Development and Validation (Preprint)

2020 ◽  
Author(s):  
Yong Li
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Primary Percutaneous Coronary Intervention ◽  
External Validation ◽  
Model Development ◽  
Coronary Intervention ◽  
University Hospital ◽  
Diagnostic Model ◽  
Validation Data ◽  
Acute Stemi ◽  
Percutaneous Coronary

BACKGROUND Intra-procedural hypotension weaken the benefit of primary percutaneous coronary intervention (PPCI) and worsens the prognosis of acute ST elevation myocardial infarction ( STEMI ) patients. OBJECTIVE The objective of our study was to develop and externally validate a diagnostic model of intra-procedural hypotension. METHODS Design:Multivariable logistic regression of a cohort of acute STEMI patients. Setting: Emergency department ward of a university hospital. Participants: Diagno The objective of our study was to develop and externally validate a diagnostic model of intra-procedural hypotension. stic model development: A total of 1239 acute STEMI patients who were consecutively treated with PPCI from November 2007 to December 2013. External validation: A total of 1294 acute STEMI patients who were treated with PPCI from January 2014 to June 2018. Outcomes: Intra-procedural hypotension. Intra-procedural hypotension was defined as pre-procedural systolic blood pressure (SBP) was > 90mmHg, intra-procedural SBP less than or equal to 90 mmHg persistent or transient. RESULTS Intra-procedural hypotension occurred in121 out of 1,239 participants (9.8%) in the development data set.The strongest predictors of intra-procedural hypotension were no-reflow(odds ratios (OR) 1.911; 95% confidence interval(CI), 1.177～3.102 ; P =.009), the culprit vessel was left anterior descending(OR.488;95% CI, .326～.732 ; P =.001), complete occlusion of culprit vessel(OR4.351;95% CI, 2.076～9.12 ; P<.001), using thrombus aspiration devices during operation(OR 1.793;95% CI, 1.058～3.039 ; P =.03) ,and history of diabetes (OR .589;95% CI, .353~.983 ; P =.042). We developed a diagnostic model of intra-procedural hypotension. The area under the receiver operating characteristic (ROC) curve (AUC)was .685 ± .022, 95% CI= .641 ~ .729 in the development set. We constructed a nomogram using the development database based on predictors of intra-procedural hypotension. Intra-procedural hypotension occurred in 123 out of 1,294 participants (9.5%)patients in the validation data set.The AUC was .718 ±.022, 95% CI= .674 ~ .761 in the validation set . Discrimination, calibration, and decision curve analysis were satisfactory. Date of approved by ethic committee: 2 September 2019. Date of data collection start: 10 September 2019. Numbers recruited as of submission of the manuscript:2,533. CONCLUSIONS We developed and externally validated a diagnostic model of intra-procedural hypotension during PPCI . We can use the formula or nomogram to predict intra-procedural hypotension. CLINICALTRIAL This study was registered with WHO International Clinical Trials Registry Platform (ICTRP) on 6 September 2019 (registration number:ChiCTR1900025706). http://www.chictr.org.cn/edit.aspx?pid=42913&htm=4.

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