scholarly journals Integrative Chinese and Western Medicine for patients after Percutaneous Coronary Intervention (ICWM-PCI): A Prospective Observational Real-World Cohort Study

2021 ◽  
Author(s):  
Siyu YAN ◽  
Wei-Xian Yang ◽  
Pei-Pei Lu ◽  
Xuan-Tong Guo ◽  
Cai-Xia Guo ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Cohort Study ◽  
Real World ◽  
Western Medicine ◽  
Cox Regression ◽  
Cumulative Risk ◽  
Coronary Intervention ◽  
Adverse Cardiovascular Event ◽  
Cox Regression Analysis ◽  
Percutaneous Coronary

Abstract Background Integrative Chinese and Western Medicine (ICWM) is widely used in coronary artery disease (CAD) patients after percutaneous coronary intervention (PCI) in China. However, the evidence-based on the long-term prognosis and large sample on this topic are weak. The purpose of this study is to evaluate the correlation between the therapeutic effect of ICWM and the prognosis of patients after PCI.Methods This study is a prospective observational real-world cohort study that was conducted from September 2016 to August 2019 in Fuwai Hospital. The study was reviewed and approved by the Ethics Review Committee of Fuwai Hospital, Chinese Academy of Medical Sciences. We consecutively screened 6000 patients after PCI and they were followed up for 2 years. ICWM were related to prognostic outcomes using unadjusted (Kaplan-Meier curves) and risk-adjusted (multivariable Cox regression) analyses. The primary endpoint was a composite of all-cause death, revascularization, and myocardial infarction.Results A total of 5942 patients after PCI were enrolled in this study, 5453 patients were included in the final analysis (4189[76.8%] were male; mean [SD] age, 61.91[9.91] years). There were 2932 patients (53.8%) in western medicine group (WMG) and 2521 patients (46.2%) in integrated medicine group (IMG). Cox regression analysis showed that IMG had a 27% lower cumulative risk of the major adverse cardiovascular event (MACE) than WMG (hazard ratio [HR], 0.73; 95% CI, 0.63-0.85; P＜0.0001), especially in all-cause mortality and revascularization.Conclusions Among patients after PCI, ICWM compared with conventional western medicine was correlated with a lower risk of 2-year MACE. Further research is needed to provide higher levels of evidence.

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.

scholarly journals Residual Dyslipidemia Leads to Unfavorable Outcomes in Patients with Acute Coronary Syndrome after Percutaneous Coronary Intervention

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Bin Que ◽  
Chunmei Wang ◽  
Hui Ai ◽  
Xinyong Zhang ◽  
Mei Wang ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Cox Regression ◽  
Plasma Concentrations ◽  
Coronary Intervention ◽  
High Rate ◽  
Cox Regression Analysis ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
Low Hdl

Background. The present study aimed to evaluate the prevalence and prognosis of residual lipid abnormalities in statin-treated acute coronary syndrome (ACS) patients after percutaneous coronary intervention (PCI).Subjects and Methods. A total of 3,047 ACS patients who underwent PCI and received statin therapy were included. Plasma concentrations of LDL-C, HDL-C, and TG were measured. For the follow-up study, major adverse cardiovascular cerebrovascular events (MACCE; including total death, cardiovascular death, myocardial infarction, and revascularization) were documented.Results. A total of 93.14% of all individuals were followed up for 18.1 months (range, 0–29.3 months). Of all 3,047 patients, those with a suboptimal goal were 67.75%, 85.85%, and 33.64% for LDL-C, HDL-C, and TG levels, respectively. Multiple Cox regression analysis revealed there were significant increases in cumulative MACCE of 41% (HR = 1.41, 95% CI [1.09–1.82],p=0.008), and revascularization of 48% (HR = 1.48, 95% CI [1.10–1.99],p=0.01) in low HDL-C patients with ACS after PCI, but not the high TG group at the end of study.Conclusions. Our results showed there is high rate of dyslipidemia in Chinese ACS patients after PCI. Importantly, low HDL-C but not high TG levels are associated with higher MACCE and revascularization rates in ACS patients after PCI.

scholarly journals Evaluation of two classical contrast-induced nephropathy definitions for predicting long-term mortality in patients undergoing elective percutaneous coronary intervention

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Lin ◽  
Z You ◽  
H Chen ◽  
C He ◽  
X Chen ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Cox Regression ◽  
Interaction Analysis ◽  
Kidney Injury ◽  
Coronary Intervention ◽  
Contrast Induced Nephropathy ◽  
Cox Regression Analysis ◽  
Percutaneous Coronary ◽  
Long Term Mortality

Abstract Background Contrast-induced nephropathy (CIN) is a frequent complication after percutaneous coronary intervention (PCI), and is associated with poor outcome. However, the optimal definition of CIN has been debated because of its different incidence and influence on prognosis. At present, there are limited data regarding th impact of different CIN definitions on long-term mortality in patients undergoing elective PCI. Purpose To explore the influence of two classical CIN definitions on long-term mortality and identify which definition was more suitable for predicting long-term mortality in patients undergoing elective PCI.. Methods We prospectively observed 5600 consenting patients undergoing PCI from January 2012 to December 2018. Two classical CIN definitions include those defined by ESUR[Contrast-media-induced nephrotoxicity (CMN)] and AKIN[contrast induced acute kidney injury (CI-AKI)]. CMN was defined as an increase in serum creatinine (SCr) ≥25% or 0.5 mg/dLabove thebaseline level within 3 days,while CI-AKI wasdefined as an increase in SCr ≥50% or 0.3 mg/dL within 48hs after contrast medium exposure.The association of CIN with long-term mortality was investigated by Cox regression analysis.Interaction analyses were performed for long-term mortality across subgroups. Results The incidence of CIN according to ESUR (CMN) and AKIN (CI-AKI) definition were18.3% (n=1023) and 6.1% (n=342), respectively. During a median follow-up of 2 years, after adjusting other potential risk factors, multivariable cox regression analysis revealed CIN was a risk factor for long-term mortality [hazard ratio (HR): 2.021, 95% confidence interval (CI): 1.389–2.938, P<0.0001] according to AKIN definition, but not for ESUR definition (HR: 1.344, 95% CI: 0.982–1.838, P>0.05). Further interaction analysis showed that there was a significant interaction between age >75ys and CMN for long-term mortality (P=0.042) while no such association was observed between age >75ys and CI-AKI (P=0.806). Conclusions CIN defined by AKIN may be more suitable for predicting long-term mortality in patients undergoing elective PCI. However, in elderly patients, CIN defined by ESUR could also be used for predicting long-term mortality. Association Between CIN and mortality Funding Acknowledgement Type of funding source: None

scholarly journals A real-world comparison of outcomes between fractional flow reserve-guided versus angiography-guided percutaneous coronary intervention

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0259662
Author(s):  
Christopher C. Y. Wong ◽  
Austin C. C. Ng ◽  
Cuneyt Ada ◽  
Vincent Chow ◽  
William F. Fearon ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Fractional Flow Reserve ◽  
Real World ◽  
Primary Outcome ◽  
Coronary Intervention ◽  
Fractional Flow ◽  
Cox Regression Analysis ◽  
Flow Reserve ◽  
Percutaneous Coronary ◽  
Secondary Outcomes

Background Fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) has been shown to be superior to angiography-guided PCI in randomized controlled studies. However, real-world data on the use and outcomes of FFR-guided PCI remain limited. Thus, we investigated the outcomes of patients undergoing FFR-guided PCI compared to angiography-guided PCI in a large, state-wide unselected cohort. Methods and results All patients undergoing PCI between June 2017 and June 2018 in New South Wales, Australia, were included. The cohort was stratified into the FFR-guided group when concomitant FFR was performed, and the angiography-guided group when no FFR was performed. The primary outcome was a combined endpoint of death or myocardial infarction (MI). Secondary outcomes included all-cause death, cardiovascular (CVS) death, and MI. The cohort comprised 10,304 patients, of which 542 (5%) underwent FFR-guided PCI. During a mean follow-up of 12±4 months, the FFR-guided PCI group had reduced occurrence of the primary outcome (hazard ratio [HR] 0.34, 95% confidence intervals [CI] 0.20–0.56, P<0.001), all-cause death (HR 0.18, 95% CI 0.07–0.47, P = 0.001), CVS death (HR 0.21, 95% CI 0.07–0.66, P = 0.01), and MI (HR 0.46, 95% CI 0.25–0.84, P = 0.01) compared to the angiography-guided PCI group. Multivariable Cox regression analysis showed FFR-guidance to be an independent predictor of the primary outcome (HR 0.45, 95% CI 0.27–0.75, P = 0.002), all-cause death (HR 0.22, 95% CI 0.08–0.59, P = 0.003), and CVS death (HR 0.27, 95% CI 0.09–0.83, P = 0.02). Conclusions In this real-world study of patients undergoing PCI, FFR-guidance was associated with lower rates of the primary outcome of death or MI, as well as the secondary outcomes of all-cause death and CVS death.

scholarly journals Ticagrelor versus Prasugrel in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention - analysis from the Acute Coronary Syndrome Israeli Survey (ACSIS)

Cardiology ◽  
2021 ◽  
Author(s):  
Ran Eliaz ◽  
Bethlehem Mengesha ◽  
Tal Ovdat ◽  
Zaza Iakobishvili ◽  
David Hasdai ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Cox Regression ◽  
Coronary Intervention ◽  
Complication Rates ◽  
Cox Regression Analysis ◽  
Entire Cohort ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
St Elevation

Introduction: We aimed to compare the outcomes of ACS (acute coronary syndrome) patients undergoing in-hospital PCI (percutaneous coronary intervention) treated with prasugrel versus ticagrelor. Methods: Among 7,233 patients enrolled to the ACSIS (Acute Coronary Syndrome Israeli Survey) between 2010 and 2018, we identified 1126 eligible patients treated with prasugrel and 817 with ticagrelor. Comparison between the groups was preformed separately in ST-elevation myocardial infarction (STEMI) patients, propensity score matched (PSM) STEMI patients, and non-ST-elevation ACS (NSTE-ACS) patients. Results: In-hospital complication rates, including rates of stent thrombosis, were not significantly different between groups. In PSM STEMI patients, 30-day re-hospitalization rate (p <0.05), 30-day MACE (the composite of death, MI, stroke and urgent revascularization; p=0.006), and 1-year mortality rates (p = 0.08) were higher in the ticagrelor group compared to the prasugrel group; In NSTE-ACS patients, outcomes were not associated with drug choice. In cox regression analysis applied on the entire cohort, prasugrel was associated with lower 1-year mortality in STEMI patient but not in NSTE-ACS patients (p for interaction 0.03). Conclusions: Compared to ticagrelor, prasugrel was associated with superior clinical outcomes in STEMI patients, but not in NSTE-ACS patients.

scholarly journals Relationship between lncRNA-Ang362 and prognosis of patients with coronary heart disease after percutaneous coronary intervention

2020 ◽  
Vol 40 (7) ◽  
Author(s):  
Hui Wang ◽  
Huichao Gong ◽  
Yingwu Liu ◽  
Limin Feng
Keyword(s):  
Coronary Heart Disease ◽  
Percutaneous Coronary Intervention ◽  
Heart Disease ◽  
Cardiovascular Events ◽  
Cox Regression ◽  
Quantitative Polymerase Chain Reaction ◽  
Coronary Intervention ◽  
Cox Regression Analysis ◽  
Percutaneous Coronary

Abstract The severity and complexity evaluation of coronary artery disease in patients with coronary heart disease (CHD) require objective and accurate prognosis indexes. We assessed the relationship between lncRNA-Ang362 and prognosis of CHD patients after percutaneous coronary intervention (PCI). Clinical follow-up data of CHD patients were prospectively collected. LncRNA-Ang362 levels were detected by real-time quantitative polymerase chain reaction. Survival rate was calculated by the Kaplan–Meier method, and risk ratios and 95% confidence intervals were computed using univariate and multivariate COX proportional hazard models. Finally, 434 patients were included in the follow-up cohort. The median follow-up time was 24.8 months (6.7–40). The incidence of adverse cardiovascular events was 13.6%. The high expression group significantly tended to be smoker and higher body mass index, low-density lipoprotein cholesterol, high-sensitivity C-reactive protein, creatinine, and uric acid levels compared with the low expression group. According to the SYNTAX grade, the high-risk and medium-risk groups had significantly higher lncRNA expression levels than the low-risk group. The univariate COX regression analysis indicated that high lncRAN-Ang362 expression significantly increased the risk of adverse cardiovascular events in CHD patients after PCI (hazard risk (HR) = 3.19, 95% confidence interval (CI): 1.29–7.92). Multivariate analysis found high lncRNA-Ang362 expression was independently related to worse prognosis in CHD patients after PCI (HR = 2.83, 95%CI: 1.34–6.02). Plasma lncRNA-Ang362 may be a prognosis factor in CHD patients after PCI. The patients with higher lncRNA-Ang362 expression usually have poor prognosis.

Design and Rationale of the National Tunisian Registry of Percutaneous coronary Intervention: Protocol for a Prospective, Multicenter Trial (Preprint)

2020 ◽  
Author(s):  
Rania Hammami ◽  
Slim Boudiche ◽  
Rami Tlili ◽  
Nejeh Ben Hlima ◽  
Ahmed Jamel ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Clinical Epidemiology ◽  
Artery Bypass ◽  
Coronary Intervention ◽  
Long Term Results ◽  
Adverse Cardiovascular Event ◽  
Chronic Occlusion ◽  
Percutaneous Coronary ◽  
Intervention Protocol

BACKGROUND Coronary diseases remain the first cause of death in the world; the management of this condition has improved, thanks to new technical tools and multicentric registries. Recently in Tunisia, the number of intervention procedures has markedly increased, giving the explosion of cardiovascular risk factors among Tunisian people. OBJECTIVE The aim of the study was to investigate the in-hospital and one-year clinical outcome of patients treated with percutaneous coronary intervention (PCI) in Tunisia. METHODS We will conduct a prospective, multicentric, observational study including patients > 18 year-old who underwent a PCI between 31January and 30 June 2020. The primary end point are the occurrence of a major adverse cardiovascular event , defined as cardiovascular death, myocardial infarction, cerebrovascular accident, and target vessel revascularization with either repeat PCI or coronary artery bypass surgery (CABG). Secondary end-points consist in procedural success rate, stent thrombosis, and the rate of redo-PCI/CABG for in-stent restenosis. RESULTS Results will be available at the end of the study as well as the demographic profile and general risk profile of Tunisian patients undergoing PCI. The complexity level of procedures, as left main, bifurcation, chronic occlusion PCI will be analyzed and immediate as well as long term results will be determined. NATURE-PCI will be the first national multicentric registry of angioplasty in Africa. CONCLUSIONS This study would add data and provide a valuable opportunity for real-world clinical epidemiology and practice in the field of interventional cardiology in Tunisia with insights into the uptake of contemporary coronary artery disease in this developing region. CLINICALTRIAL clinicaltrials.gov

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