scholarly journals Changes in non-culprit lesion severity on follow-up coronary angiography after primary percutaneous coronary ıntervention

2021 ◽  
Author(s):  
Fuat CANER ◽  
Selahattin TUREN ◽  
Aydın YILDIRIM
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Angiography ◽  
Primary Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Culprit Lesion ◽  
Percutaneous Coronary ◽  
Lesion Severity

scholarly journals Longitudinal Evaluation of Mitral Valve Leaflet Remodeling After Acute Myocardial Infarction

2020 ◽  
Vol 13 (12) ◽  
Author(s):  
Shun Nishino ◽  
Nozomi Watanabe ◽  
Toshihiro Gi ◽  
Nehiro Kuriyama ◽  
Yoshisato Shibata ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Mitral Valve ◽  
Primary Percutaneous Coronary Intervention ◽  
Complex Geometry ◽  
Coronary Intervention ◽  
Mitral Valve Leaflet ◽  
Percutaneous Coronary

Background: Recent animal studies have suggested that mitral valve (MV) leaflet remodeling can occur even without significant tethering force and that the postinfarct biological reaction would contribute to the histopathologic changes of the leaflet. We serially evaluated the MV remodeling in patients with anterior and inferior acute myocardial infarction (MI), by using 2- and 3-dimensional transthoracic echocardiography. Additional histopathologic examinations were performed to assess the leaflet pathology. Methods: Sixty consecutive first-onset acute MI (anterior MI, n=30; inferior MI, n=30) patients who underwent successful primary percutaneous coronary intervention were examined (1) before primary percutaneous coronary intervention, (2) at 6-month follow-up, and (3) at follow-up 1 year or later after onset. MV complex geometry including MV leaflet area and thickness was analyzed using dedicated software. Additional histopathologic study compared 18 valves harvested during surgery for ischemic mitral regurgitation (MR). Results: MV area and thickness incrementally increased during the follow-up period. MV leaflet area significantly increased (anterior MI: 5.59 [5.28–5.98] to 6.54 [6.20–7.26] cm 2 /m 2 , P <0.001; inferior MI: 5.60 [4.76–6.08] to 6.32 [5.90–6.90] cm 2 /m 2 , P <0.001), and leaflet thickness also increased (anterior MI: 1.09 [0.92–1.24] to 1.45 [1.28–1.60] mm/m 2 , P <0.001; inferior MI: 1.15 [1.03–1.25] to 1.44 [1.27–1.59] mm/m 2 , P <0.001); data represent onset versus ≥1 year. Larger annuls, larger tenting, and a reduced leaflet area/annular ratio with smaller coaptation index were observed in patients with persistent ischemic MR compared with those without significant ischemic MR. Histopathologic examinations revealed that MV thickness was significantly greater in chronic ischemic MR compared with acute ischemic MR (1432.6±490.5 versus 628.7±278.7 μm; P =0.001), with increased smooth muscle cells and fibrotic materials. Conclusions: MV leaflet remodeling progressed both in area and thickness after MI. This is the first clinical study to record the longitudinal course of MV leaflet remodeling by serial echocardiography.

scholarly journals Relationship between White Blood Count to Mean Platelet Volume Ratio and Clinical Outcomes and Severity of Coronary Artery Disease in Patients Undergoing Primary Percutaneous Coronary Intervention

2020 ◽  
Vol 2020 ◽  
pp. 1-13
Author(s):  
Altekin Refik Emre ◽  
Kilinc Ali Yasar ◽  
Yanikoglu Atakan ◽  
Cicekcibasi Orhan ◽  
Kucuk Murathan
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Primary Percutaneous Coronary Intervention ◽  
Mean Platelet Volume ◽  
Cardiac Death ◽  
Volume Ratio ◽  
Coronary Intervention ◽  
White Blood Count ◽  
Platelet Volume ◽  
Percutaneous Coronary

Background. The white blood cell count to mean platelet volume ratio (WMR) is an indicator of inflammation in patients with atherosclerotic disease. Residual SYNTAX Score (RSS) is an objective measure of degree and complexity of residual stenosis after percutaneous coronary intervention (PCI). We investigated the relationship between WMR and clinical prognosis and RSS in patients undergoing primary percutaneous coronary intervention (P-PCI). Method. Between June 2015 and December 2018, 537 patients who underwent primary PCI were evaluated for in-hospital events, and 477 patients were evaluated for clinical events during follow-up after discharge. The endpoint of our study is major adverse cardiac events (MACEs) seen in the in-hospital and follow-up periods. Results. In our study, 537 patients were stratified into two groups according to admission median WMR. There were 268 patients in the low WMR group (WMR<1286) and 269 patients in the high WMR group (WMR≥1286). RSS (p=0.01) value of the high WMR group was higher than that of the low WMR group. The rates of in-hospital MACE (p=0.001), cardiac death (p<0.001), decompansated heart failure (0.007), and ventricular tachycardia/fibrillation (p=0.003) were higher in the high WMR group than in the low WMR group. The follow-up MACEs (p=0.043), cardiac death (p=0.026), and reinfarction (p=0.031) ratio were higher in the high WMR group. In ROC analysis, cut-off values of in-hospital and follow-up MACEs were >1064 (sensitivity: 83.12%, and specificity: 36.29%) and >1130 (sensitivity: 69.15%, and specificity: 44.91%), respectively. The Kaplan-Meier analysis showed that the high WMR group had the significantly lowest MACE-free survival rate (log-rank test, p=0.006). A moderate correlation was observed between WMR and RSS (r: 456, p=0.002). Conclusion. A higher WMR value on admission was associated with worse outcomes in patients with P-PCI and independently predicted for follow-up MACEs. The WMR provides both a rapid and an easily obtainable parameter to identify reliably high-risk patients who underwent primary percutaneous coronary intervention due to STEMI.

scholarly journals The Clinical Prediction Factors for Non-Culprit Lesion Progression in Patients with Acute ST Elevation Myocardial Infarction After Primary Percutaneous Coronary Intervention

2021 ◽  
Author(s):  
jian wang ◽  
Cheng-ying Yan
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Confidence Interval ◽  
Primary Percutaneous Coronary Intervention ◽  
Odds Ratio ◽  
Coronary Intervention ◽  
Control Group ◽  
Percutaneous Coronary ◽  
St Elevation

Abstract Background To investigate the relationship between the clinical features and progression of non-culprit lesions in patients with ST-elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (PPCI). Methods A total of 480 patients (57.1 ± 9.2 y) with STEMI who underwent PPCI between January 2016 and December 2017 in Beijing Anzhen Hospital were enrolled in this study. All patients underwent PPCI as a treatment for culprit lesions. Clinical and angiographic follow-up were performed for 12 months. All patients were divided into a non-culprit lesions (NCL) progression group (205 cases) and a control group (275 cases) based on angiographic follow-up outcomes at 12 months. The clinical and angiographic features were analyzed. Results Body mass index (BMI), serum creatinine (Scr), fasting blood glucose (FBG), glycated serum albumin, glycated hemoglobin and homocysteine levels in the NCL progression group were significantly higher than those in the control group (P < 0.05). A logistic regression analysis showed that FBG (odds ratio = 1.274, 95% confidence interval: 1.077–1.505, P = 0.005) and Scr (odds ratio = 1.020, 95% confidence interval: 1.002–1.038, P = 0.027) were independent predictors of NCL progression. A partial correlation analysis showed that FBG was positively correlated with NCL progression (r = 0.231, P = 0.001). A receiver operating characteristic curve showed that the boundary point of FBG to predict NCL progression was 5.715 mmol/L, and the sensitivity was 74.4% and the specificity was 46.4%. Conclusions FBG is a valuable predictor for NCL progression in patients with STEMI after PPCI.

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