scholarly journals Monocyte-to-serum albumin Ratio as a Novel Predictor of Long-Term Adverse Outcomes in Patients after Undergoing Percutaneous Coronary Intervention: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Ying-Ying Zheng ◽  
Zeng-Lei Zhang ◽  
Qian-Qian Guo ◽  
Jun-Nan Tang ◽  
Xu-Ming Yang ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Serum Albumin ◽  
Cox Regression ◽  
Independent Predictor ◽  
Coronary Intervention ◽  
Adverse Outcomes ◽  
Major Adverse Cardiovascular Events ◽  
Albumin Ratio ◽  
Percutaneous Coronary

Abstract Background: Inflammation plays a significant role in the initiation and progression of atherosclerosis. Monocyte and serum albumin have been proved to be involved in the process of systemic inflammation. Therefore, we investigated the prognostic value of monocyte-to-serum albumin ratio (MAR) in patients who underwent percutaneous coronary intervention (PCI).Methods：A total of 3,561 patients enrolled in this study from January 2013 to December 2017, who were divided into two groups according to the cut-off value of MAR (MAR<0.014, n=2220 and MAR≥0.014, n=1119). The average follow-up time was 37.59±22.24 months.Results: There were significant differences between the two groups in the incidences of all-cause mortality (ACM) (P<0.001), cardiac mortality (CM) (P<0.001), major adverse cardiovascular events (MACEs, P=0.038) and major adverse cardiovascular and cerebrovascular events (MACCEs, P=0.037). Kaplan–Meier survival analysis suggested that patients with higher MAR value tended to have an increased accumulated risk of ACM and CM (Log rank P<0.001 and Log rank P<0.001, respectively). And multivariate Cox regression analyses showed MAR was an independent predictor for ACM (hazard ratio [HR]=1.461, 95% confidence interval [CI]:1.009–2.115, P=0.045) and CM (HR=1.695, 95% CI:1.056-2.721, P=0.029).Conclusion: The present study suggests that MAR is a novel independent predictor of long-term mortality in patients who underwent PCI.Trial registration: ChiCTR, ChiCTR1800019699. Registered 24 November 2018, http://www.chictr.org.cn/showproj.aspx?proj=33249

scholarly journals Monocyte-to-albumin Ratio as a Novel Predictor of Long-term Adverse Outcomes in Patients after Percutaneous Coronary Intervention

2021 ◽  
Author(s):  
Zeng-Lei Zhang ◽  
Qian-Qian Guo ◽  
Jun-Nan Tang ◽  
Jian-Chao Zhang ◽  
Meng-Die Cheng ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Cox Regression ◽  
Coronary Intervention ◽  
Adverse Outcomes ◽  
Major Adverse Cardiovascular Events ◽  
Monocyte Count ◽  
Albumin Ratio ◽  
Kaplan Meier ◽  
Percutaneous Coronary

Background: Monocyte count and serum albumin (Alb) have been proven to be involved in the process of systemic inflammation. Therefore, we investigated the prognostic value of monocyte-to-albumin ratio (MAR) in patients who underwent percutaneous coronary intervention (PCI). Methods：We enrolled a total of 3561 patients in this study from January 2013 to December 2017. They were divided into two groups according to MAR cutoff value (MAR &lt; 0.014, n = 2220; and MAR ≥ 0.014, n = 1119) as evaluated by receiver operating characteristic (ROC) curve. The average follow-up time was 37.59 ± 22.24 months. Results: The two groups differed significantly in the incidences of all-cause mortality (ACM; P &lt; 0.001), cardiac mortality (CM; P &lt; 0.001), major adverse cardiovascular events (MACEs; P = 0.038), and major adverse cardiovascular and cerebrovascular events (MACCEs; P = 0.037). Multivariate Cox regression analyses revealed MAR as an independent prognostic factor for ACM and CM. The incidence of ACM increased 56.5% (hazard ratio [HR] = 1.565; 95% confidence interval [CI], 1.086–2.256; P = 0.016) and that of CM increased 76.3% (HR = 1.763; 95% CI, 1.106–2.810; P = 0.017) in patients in the higher-MAR group. Kaplan–Meier survival analysis suggested that patients with higher MAR tended to have an increased accumulated risk of ACM ( Log rank P &lt; 0.001) and CM (Log rank P &lt; 0.001). Conclusion: The findings of the present study suggested that MAR was a novel independent predictor of long-term mortality in patients who underwent PCI.

Gamma-Glutamyl Transferase-to-Platelet Ratio as a Novel Predictor of Long-Term Adverse Outcomes in Patients after Undergoing Percutaneous Coronary Intervention: A Retrospective Cohort Study

2019 ◽  
Vol 119 (06) ◽  
pp. 1021-1030 ◽  
Author(s):  
Ying-Ying Zheng ◽  
Ting-Ting Wu ◽  
You Chen ◽  
Xian-Geng Hou ◽  
Yi Yang ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Retrospective Cohort ◽  
Independent Predictor ◽  
Coronary Intervention ◽  
Adverse Outcomes ◽  
Gamma Glutamyl Transferase ◽  
Bleeding Events ◽  
Percutaneous Coronary ◽  
Glutamyl Transferase

Background Gamma-glutamyl transferase (GGT) has been shown to be involved in the pathogenesis of both coronary artery disease (CAD) and liver disease, and it has been reported that the GGT-to-platelet ratio (GPR) is an independent predictor for adverse outcomes from liver fibrosis and hepatic carcinoma. However, the relation between the GPR and adverse outcomes in CAD patients after percutaneous coronary intervention (PCI) has not been investigated. Methods A total of 5,636 patients enrolled in Clinical Outcomes and Risk Factors of Patients with Coronary Heart Disease after PCI, a retrospective cohort study, from January 2008 to December 2016, were divided into two groups according to GPR (GPR < 0.12, n = 2,769 and GPR ≥ 0.12, n = 2,867). The primary outcome was long-term mortality including all-cause mortality (ACM) and cardiac mortality (CM) after PCI. The average follow-up time was 35.9 ± 22.6 months. Results We found that there were significant differences between the two groups in the incidences of ACM (p = 0.011), CM (p = 0.001), major adverse cardiovascular events (MACEs, p < 0.024), major adverse cardiovascular and cerebrovascular events (MACCEs, p = 0.014) and bleeding events (p = 0.003). Multivariate Cox regression analyses showed that GPR was an independent predictor for ACM (hazard ratio [HR]: 1.536 [95% confidence interval [CI]:1.162–2.032], p = 0.003), CM (HR: 1.763 [95% CI: 1.283–2.424], p < 0.001), MACCEs (HR: 1.269 [95% CI: 1.066–1.511], p = 0.007) and MACEs (HR: 1.308 [95% CI: 1.089–1.570], p = 0.004) in stable CAD patients but that it was an independent predictor for only the incidence of bleeding events (HR: 3.104 [95% CI: 1.680–5.736], p < 0.001) in acute coronary syndrome (ACS) patients. Conclusion This study indicates that GPR is an independent and novel predictor of adverse long-term outcomes in CAD patients who underwent PCI.

scholarly journals Plasma Trimethylamine-N-Oxide Is an Independent Predictor of Long-Term Cardiovascular Mortality in Patients Undergoing Percutaneous Coronary Intervention for Acute Coronary Syndrome

2021 ◽  
Vol 8 ◽  
Author(s):  
Ceren Eyileten ◽  
Joanna Jarosz-Popek ◽  
Daniel Jakubik ◽  
Aleksandra Gasecka ◽  
Marta Wolska ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Predictive Value ◽  
Cox Regression ◽  
Independent Predictor ◽  
Coronary Intervention ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
All Cause Mortality

To investigate the association of liver metabolite trimethylamine N-oxide (TMAO) with cardiovascular disease (CV)-related and all-cause mortality in patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention. Our prospective observational study enrolled 292 patients with ACS. Plasma concentrations of TMAO were measured during the hospitalization for ACS. Observation period lasted seven yr in median. Adjusted Cox-regression analysis was used for prediction of mortality. ROC curve analysis revealed that increasing concentrations of TMAO levels assessed at the time point of ACS significantly predicted the risk of CV mortality (c-index=0.78, p &lt; 0.001). The cut-off value of &gt;4 μmol/L, labeled as high TMAO level (23% of study population), provided the greatest sum of sensitivity (85%) and specificity (80%) for the prediction of CV mortality and was associated with a positive predictive value of 16% and a negative predictive value of 99%. A multivariate Cox regression model revealed that high TMAO level was a strong and independent predictor of CV death (HR = 11.62, 95% CI: 2.26–59.67; p = 0.003). High TMAO levels as compared with low TMAO levels were associated with the highest risk of CV death in a subpopulation of patients with diabetes mellitus (27.3 vs. 2.6%; p = 0.004). Although increasing TMAO levels were also significantly associated with all-cause mortality, their estimates for diagnostic accuracy were low. High TMAO level is a strong and independent predictor of long-term CV mortality among patients presenting with ACS.

scholarly journals Long term outcomes of patients with chronic inflammatory diseases after percutaneous coronary intervention

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
E Marcusohn ◽  
R Zukermann ◽  
A Roguin ◽  
O Kobo
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Cox Regression ◽  
Inflammatory Diseases ◽  
Tertiary Care ◽  
Coronary Intervention ◽  
Long Term Outcomes ◽  
Chronic Inflammatory Diseases ◽  
Increased Risk ◽  
Percutaneous Coronary

Abstract Introduction Patients with chronic inflammatory diseases are at increased risk for coronary artery disease. Aim We aimed to assess the long-term outcomes of patients with chronic inflammatory diseases who underwent percutaneous coronary intervention. Methods A Retrospective cohort study of all adult (&gt;18 years) patients who underwent PCI in a large [1000 bed] tertiary care centerfrom January 2002 to August 2020. Results A total of 12,951 patients underwent PCI during the study period and were included in the cohort. The population of chronic inflammatory diseases includes 247/12,951 [1.9%]; 70 with IBD and 173 with AIRD. The composite endpoint of mortality, ACS or CHF admission was more frequent in the inflammatory disease group (77.5% in AIRD group, 72.9% in the IBD group and 59.6% in the non-inflammatory group, p&lt;0.001). The adjusted cox regression model found a statistically significant increased risk of the composite primary endpoints of around 40% for patients both with AIRD and IBD. The increased risk for ACS was 61% for AIRD patients and 37% for IBD patients. Patients with inflammatory diseases were found to have a significant increased risk CHF admission, while both IBD and AIED patients had a non-significant increased risk for mortality. Conclusion Patients with AIRD and IBD are at higher risk for cardiovascular events also in long term follow up once diagnosed with CAD and treated with PCI. FUNDunding Acknowledgement Type of funding sources: None.

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.

Abstract 15439: Lesion Complexity and Long-term Outcomes According to Mean Observed Blood Pressure After Percutaneous Coronary Intervention

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Jong Il Park ◽  
Byung Jun Kim ◽  
Hun Tae Kim ◽  
Jung Hee Lee ◽  
Ung Kim ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Percutaneous Coronary Intervention ◽  
Independent Predictor ◽  
Coronary Intervention ◽  
Long Term Outcomes ◽  
Percutaneous Coronary ◽  
Group A ◽  
Group B ◽  
Group D

Background: The guideline recommended strict blood pressure (BP) control for the patients treated with percutaneous coronary intervention (PCI). We aimed to evaluate the relationship between mean observed BP and long-term outcomes for patients with or without lesion complexity. Methods: A total of 1,470 patients who underwent PCI were investigated. We categorized the study population into four groups based on mean observed BP and lesion complexity (left main & three-vessel disease, chronic total occlusion, total stent length ≥60mm, or bifurcation two stenting): Group A (non-complex & systolic BP ≤120mmHg, n=310), Group B (non-complex & systolic BP >120mmHg, n=674), Group C (complex & systolic BP ≤120mmHg, n=131), and Group D (complex & systolic BP >120mmHg, n=355). We evaluated major adverse cardiovascular and cerebrovascular events (MACCEs), defined as cardiac death, myocardial infarction (MI), repeat target vessel revascularization, or stroke. Results: Well-controlled BP group (Group A&C) showed significantly lower systolic BP than uncontrolled BP group (Group B&D) (114.3±6.1mmHg vs. 130.7±7.6mmHg, p<0.001). MACCEs occurred less frequently in Group A (18.9%) than Group B (23.6%), Group C (22.7%), and Group D (33.6%) (p=0.001) at 8 years. After multivariate analysis, with Group A as a reference, the adjusted hazard ratio (HR) for MACCEs was 1.382 (95% confidence interval [CI] 0.978-1.954, p=0.067) for Group B, 1.559 (95% CI 0.957-2.540, p=0.075) for Group C, and 1.872 (95% CI 1.296-2.705, p=0.001) for Group D. In Cox regression model, although lesion complexity was not associated with MACCE, systolic BP≤120mmHg was an independent predictor for reduced rate of MACCE (HR 0.667, 95% CI 0.485-0.918, p=0.013). Conclusions: Mean observed systolic BP ≤120mmHg after PCI was independent predictor for reduced MACCEs regardless of lesion complexity. Key Words: Blood Pressure; Percutaneous Coronary Intervention; Lesion Complexity; Treatment Outcome

scholarly journals Comparison among Different Scoring Systems in Predicting Procedural Success and Long-Term Outcomes after Percutaneous Coronary Intervention in Patients with Chronic Total Coronary Artery Occlusions

Medicina ◽  
2019 ◽  
Vol 55 (8) ◽  
pp. 494
Author(s):  
Kalnins ◽  
Strele ◽  
Lejnieks
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Cox Regression ◽  
Scoring Systems ◽  
Coronary Intervention ◽  
Long Term Outcome ◽  
Risk Of Death ◽  
Percutaneous Coronary ◽  
Procedural Success

Background and objectives: Different scoring systems are used to stratify patients with chronic total coronary artery occlusions (CTO) according to disease complexity to predict the success of the percutaneous coronary intervention (PCI). Comparison among different CTO scoring systems and long-term outcome for patients with CTO after PCI has not been well established. The objectives of the study were to assess the ability of different disease severity scoring systems to predict, first, procedural success and, second, overall survival in patients with a successful procedure. Materials and Methods: A total of 551 patients who underwent elective CTO PCI in Riga East University hospital from January 2007 to December 2016 were included in the study. Four scoring systems (J CTO, PROGRESS CTO, CL, and CASTLE) were calculated. ROC curves were used to assess the association between scores and procedural success, and the Kaplan–Meier method and Cox regression were used to estimate the association with death from any cause after a successful procedure, Results: 454 of 551cases were successful. With increasing disease complexity, the procedural success rate was significantly reduced in all scoring systems (p < 0.001): Area under the curve was 0.714 for J CTO score, 0.605 for PROGRESS CTO, 0.624 for CL and 0.641 for CASTLE scores. During the median 6.8 years of follow-up time, survival was better in the successful procedure group (p = 0.041). Among patients with procedural success, only PROGRESS and CASTLE scores showed an association with all-cause risk of death. After adjustment for baseline characteristics, patients having high PROGRESS score had almost twice higher risk of death (HR 1.81(95% CI 1.19–2.75)), and those with high and intermediate CASTLE score experienced almost four (HR 3.68(95% CI 1.50–9.05)) and two (HR 2.15, (95% CI 1.42–3.23)) times higher risk of death than the low score patients, respectively. Conclusions: All four CTO scoring systems had moderate ability to predict procedural success. More complex CTO PCI patients, assessed by PROGRESS and CASTLE scores, has worse all-cause survival in six to seven years after a successful procedure; whereas J CTO and CL scores had no association with survival.

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