scholarly journals Prognostic Value of Chronic Kidney Disease in Acute Coronary Syndrome Patients Treated with Percutaneous Coronary Intervention

2016 ◽  
Vol 8 ◽  
Author(s):  
Hanan Ibrahim Radwan ◽  
Abdelhakem Selem ◽  
Yaser Ammar ◽  
Kamel Ghazal
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Renal Impairment ◽  
Severe Renal Impairment ◽  
Coronary Intervention ◽  
Lower Grade ◽  
Long Term Outcome ◽  
Stenotic Lesion ◽  
Coronary Syndrome ◽  
Percutaneous Coronary

<p><strong>Objective:</strong>Impact of renal impairment (RI) on short&amp;long term outcome of percutaneous coronary intervention (PCI) in patients with ACS.</p><p><strong>Methods:</strong> 427 patients with ACS, treated with PCI .They were classified into 4 groups (normal , mild, moderate and severe renal impairment) based on creatinine clearance (eCrCl).MACE including death, new myocardial infarction (MI) and target vessel revascularization (TVR) were recorded during early (30 days) and late for average 49months.</p><p><strong>Results:</strong>Patients with severe RI had   higher number of vessels affected (p 0.023), lower grade of  TIMI flow(p0.029), lower percent dilatation of culprit lesion( p&lt;0.001), less frequent use of GPIIb/IIIa inhibitors(p0.002) and more frequent need for TVR(p0.03). eCrCl had  positive correlation with EF and percent dilatation of  stenotic lesion (p,0.001)and   negative correlation with number of vessels &amp; late MACE(p0.001).Patients with severe RI had increase in frequency of lateMACE compared to other groups(p0.001).TypeC lesions were more common in patients with advanced RI(p0.03).MACE free survival showed significant decline matching the decline in eCrCl among study groups.</p><p><strong>Conclusion:</strong> PCI outcome in patients with severe RI was suboptimal.They had increased riskof TVR within one month and increased riskof MI,death and total MACE on the long term.</p>

P1745Clinical characteristics and long-term outcome in patients with helicopter-transported acute coronary syndrome after primary percutaneous coronary intervention

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
N Takahashi ◽  
M Ogita ◽  
S Tsuboi ◽  
R Nishio ◽  
K Yasuda ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Primary Pci ◽  
Long Term Outcome ◽  
Cox Regression Analysis ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
Long Term Mortality

Abstract Background Reducing delay to percutaneous coronary intervention improves functional outcome and reduces long-term mortality. Transportation by helicopter is often quicker than ground transport and thus may improve overall prognosis through reduced ischemic injury and infarction size. Our hospital is located on the medically-depopulated peninsula surrounded by mountain. The journey from the southern tip of the peninsula to the critical care medical center of our hospital take 1.5 hour by a ground ambulance but only 15 minutes by helicopter. We compared the clinical characteristics and long-term mortality between air and ground transport of ACS patients for primary PCI. Methods We conducted an observational cohort study evaluating 2324 patients (mean age 68.5±12.0, male 75.2%) with ACS underwent primary PCI between April 2004 and December 2017 at our hospital. We divided into three groups according to transportation system type (air, ground, walk-in). The primary outcome was defined as all-cause death during the long-term follow-up. Results Among the entire cohort, 577 patients (24.8%) were transported by air. 1326 (57.1%) patients by ambulance, 421 (18.1%) patients by walk. Baseline characteristics were comparable, but patients by air had a higher prevalence of ST-elevation myocardial infarction. The rate of long-term mortality was comparable during the median follow up of 6 years (air, 21.1% vs. ground, 21.4% vs. walk-in, 21.1%, respectively, log-rank p=0.72). Multivariate Cox regression analysis showed no significant association between air transportation and long-term mortality (Adjusted HR [vs ground] 1.05, 95% CI 0.60–1.78, p=0.85 and [vs walk-in] 0.94, 95% CI 0.62–1.43, respectively, p=0.77). Kaplan-Meier curve Conclusions The rate of long-term mortality in patients with ACS transported by air was comparable with those transported by ground.

scholarly journals Predictors of long-term outcome of percutaneous coronary intervention in octogenarians with acute coronary syndrome

2014 ◽  
Vol 4 ◽  
pp. 138-144 ◽  
Author(s):  
Salim Bary Barywani ◽  
Maria Lindh ◽  
Josefin Ekelund ◽  
Max Petzold ◽  
Per Albertsson ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Coronary Intervention ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Coronary Syndrome ◽  
Percutaneous Coronary

scholarly journals Additive Effect of Anemia and Renal Impairment on Long-Term Outcome after Percutaneous Coronary Intervention

PLoS ONE ◽  
2014 ◽  
Vol 9 (12) ◽  
pp. e114846 ◽  
Author(s):  
Thomas Pilgrim ◽  
Martina Rothenbühler ◽  
Bindu Kalesan ◽  
Cédric Pulver ◽  
Giulio G. Stefanini ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Renal Impairment ◽  
Coronary Intervention ◽  
Additive Effect ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Percutaneous Coronary

scholarly journals Differing effects of beta-blockers on long-term clinical outcomes following percutaneous coronary intervention between patients with mid-range and reduced left ventricular ejection fraction

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jun Shitara ◽  
Ryo Naito ◽  
Takatoshi Kasai ◽  
Hirohisa Endo ◽  
Hideki Wada ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Ejection Fraction ◽  
Clinical Outcomes ◽  
Beta Blockers ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Coronary Syndrome ◽  
Percutaneous Coronary

Abstract Background The aim of this study was to determine the difference in effects of beta-blockers on long-term clinical outcomes between ischemic heart disease (IHD) patients with mid-range ejection fraction (mrEF) and those with reduced ejection fraction (rEF). Methods Data were assessed of 3508 consecutive IHD patients who underwent percutaneous coronary intervention (PCI) between 1997 and 2011. Among them, 316 patients with mrEF (EF = 40–49%) and 201 patients with rEF (EF < 40%) were identified. They were assigned to groups according to users and non-users of beta-blockers and effects of beta-blockers were assessed between mrEF and rEF patients, separately. The primary outcome was a composite of all-cause death and non-fatal acute coronary syndrome. Results The median follow-up period was 5.5 years in mrEF patients and 4.3 years in rEF patients. Cumulative event-free survival was significantly lower in the group with beta-blockers than in the group without beta-blockers in rEF (p = 0.003), whereas no difference was observed in mrEF (p = 0.137) between those with and without beta-blockers. In the multivariate analysis, use of beta-blockers was associated with reduction in clinical outcomes in patients with rEF (hazard ratio (HR), 0.59; 95% confidence interval (CI), 0.36–0.97; p = 0.036), whereas no association was observed among those with mrEF (HR 0.74; 95% CI 0.49–1.10; p = 0.137). Conclusions Our observational study showed that use of beta-blockers was not associated with long-term clinical outcomes in IHD patients with mrEF, whereas a significant association was observed in those with rEF.

scholarly journals Does Baseline On-treatment Platelet Reactivity Impact Long-term Prognosis in Patients with Acute Coronary Syndrome and Thrombocytopenia Who Underwent Percutaneous Coronary Intervention?

2021 ◽  
Author(s):  
Ru Liu ◽  
Tianyu Li ◽  
Deshan Yuan ◽  
Yan Chen ◽  
Xiaofang Tang ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Real World ◽  
Cox Regression ◽  
Platelet Reactivity ◽  
Coronary Intervention ◽  
The Real ◽  
Coronary Syndrome ◽  
Percutaneous Coronary

Abstract Objectives: This study analyzed the association between on-treatment platelet reactivity and long-term outcomes of patients with acute coronary syndrome (ACS) and thrombocytopenia (TP) in the real world. Methods: A total of 10724 consecutive cases with coronary artery disease who underwent percutaneous coronary intervention (PCI) were collected from January to December 2013. Cases with ACS and TP under dual anti-platelet therapy were enrolled from the total cohort. 5-year clinical outcomes were evaluated among cases with high on-treatment platelet reactivity (HTPR), low on-treatment platelet reactivity (LTPR) and normal on-treatment platelet reactivity (NTPR), tested by thromboelastogram (TEG) at baseline. Results: Cases with HTPR, LTPR and NTPR accounted for 26.2%, 34.4% and 39.5%, respectively. Cases with HTPR were presented with the most male sex, lowest hemoglobin level, highest erythrocyte sedimentation rate and most LM or three-vessel disease, compared with the other two groups. The rates of 5-year all-cause death, major adverse cardiovascular and cerebrovascular events (MACCE), cardiac death, myocardial infarction (MI), revascularization, stroke and bleeding were all not significantly different among three groups. Multivariable Cox regression indicated that, compared with cases with NTPR, cases with HTPR were not independently associated with all endpoints, as well as cases with LTPR (all P>0.05). Conclusions: In patients with ACS and TP undergoing PCI, 5-year all-cause death, MACCE, MI, revascularization, stroke and bleeding risk were all similar between cases with HTPR and cases with NTPR, tested by TEG at baseline, in the real world. The comparison result was the same between cases with LTPR and NTPR.

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