scholarly journals Cardiac Strain as a Predictor of Adverse Events and Ventricular Remodeling: A Cohort Study

2020 ◽  
Author(s):  
Yanjun Gong ◽  
Yuan Lu ◽  
Jessica C. Huo ◽  
Zhi Wang ◽  
Fan Yang ◽  
...  

Abstract Background: It remains controversial whether cardiac strain accurately predicts adverse events after acute ST-segment elevation myocardial infarction (STEMI). The aim of the present study was to evaluate the effects of cardiac strain revealed on cardiac magnetic resonance (CMR) imaging on cardiac events and adverse left ventricular (LV) remodeling.Methods: Between February 2015 and September 2016, we conducted a prospective two-center cohort study of patients with STEMI treated with primary percutaneous coronary intervention comprising stent implantation. All included patients underwent CMR imaging before discharge. Major adverse cardiac events (MACE) and LV remodeling were assessed during 6 months of follow-up.Results: Seventy-six patients were available for the final analysis. The MACE rate was 23.7%, using cardiac death, reinfarction, unplanned revascularization, and heart failure as combined events during 6 months of follow-up. The global longitudinal strain (GLS) was an independent predictor of MACE (OR=1.21 (1.07–1.36), P=0.002) and LV remodeling (OR=2.06 (1.14–3.73), P=0.017).Conclusion: In patients with STEMI treated with primary percutaneous coronary intervention, the GLS determined on CMR imaging performed before discharge is a predictor of MACE and adverse LV remodeling during 6 months of follow-up.

2020 ◽  
Author(s):  
yanjun GONG ◽  
Yuan Lu ◽  
Jessica C. Huo ◽  
Zhi Wang ◽  
Fan Yang ◽  
...  

Abstract Background: It remains controversial whether cardiac strain accurately predicts adverse events after acute ST-segment elevation myocardial infarction (STEMI). The aim of the present study was to evaluate the effects of cardiac strain revealed on cardiac magnetic resonance (CMR) imaging on cardiac events and adverse left ventricular (LV) remodeling.Methods: Between February 2015 and September 2016, we conducted a prospective two-center cohort study of patients with STEMI treated with primary percutaneous coronary intervention comprising stent implantation. All included patients underwent CMR imaging before discharge. Major adverse cardiac events (MACE) and LV remodeling were assessed during 6 months of follow-up.Results: Seventy-six patients were available for the final analysis. The MACE rate was 23.7%, using cardiac death, reinfarction, unplanned revascularization, and heart failure as combined events during 6 months of follow-up. The global longitudinal strain (GLS) was an independent predictor of MACE (OR=1.21 (1.07–1.36), P=0.002) and LV remodeling (OR=2.06 (1.14–3.73), P=0.017).Conclusion: In patients with STEMI treated with primary percutaneous coronary intervention, the GLS determined on CMR imaging performed before discharge is a predictor of MACE and adverse LV remodeling during 6 months of follow-up.


2014 ◽  
Vol 111 (06) ◽  
pp. 1060-1066 ◽  
Author(s):  
Iciar Arbesu ◽  
Bernd Jilma ◽  
Gerald Maurer ◽  
Irene M. Lang ◽  
Christine Mannhalter ◽  
...  

SummaryThe single nucleotide polymorphism (SNP) rs342293 has been shown to influence platelet number and mean platelet volume (MPV). We investigated the association between the rs342293 polymorphism and cardiovascular outcome in a prospective cohort study. The rs342293 polymorphism was analysed in 404 patients with coronary artery disease undergoing percutaneous coronary intervention. The rates of cardiac adverse events were recorded during two years of follow-up. The polymorphism was associated with MPV (median 10.1 fL, interquartile range [IQR]: 9.6 to 10.6 in patients with the CC-allele vs 10.4 fL, IQR: 9.9 to 11.1 in G>C SNP carriers; p<0.001), but not with platelet count. Survival analysis indicated that carriers of the rs342293 G variant had a substantially higher risk to develop cardiac adverse events compared with wild type carriers during two years of follow-up (33% vs 22%; adjusted hazard ratio = 1.63, 95% confidence interval = 1.06–2.52, p=0.027). The rs342293 SNP could explain 2.9% of the variability in MPV (p=0.01). In conclusion, patients undergoing coronary stenting who carry the G-variant of the rs342293 SNP which is associated with larger MPV are at higher risk for adverse cardiovascular outcome.


Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Seung Woon Rha ◽  
Byoung Geol Choi ◽  
Se Yeon Choi ◽  
Jae Kyeong Byun ◽  
Jin Oh Na ◽  
...  

Background: It is unclear whether the routine follow up (FU) coronary angiography (CAG) regardless of patient’s symptoms after successful percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) in patients (pts) with dyslipidemia is beneficial or not. Methods: The study population consisted of 554 consecutive dyslipidemia pts underwent PCI with unrestricted utilization of DESs from January 2004 to May 2011. Routine FU CAG was performed between 6 to 9 months following index PCI and was decided by individual physician’s discretion. Rests of the pts were clinically followed and ischemic driven events were captured. Clinical events including mortality, myocardial infarction and clinically driven PCI before 9 months were excluded in both groups. Cumulative clinical outcomes up to 3 years were compared between the Routine CAG group (n=329 pts) and the Clinical FU group (n= 225 pts). To adjust potential confounders, a propensity score matched (PSM) analysis was performed using the logistic regression model. Results: After PSM analysis, 2 propensity-matched groups (165 pairs, n = 330 pts, C-statistic=0.718) were generated and, the baseline characteristics of the two groups were balanced. At 3 years, the incidence of repeat revascularization and major adverse cardiac events (MACEs) was higher in the Routine CAG group than the control group (Table). Conclusions: Despite the expected beneficial effects, routine FU CAG following index PCI with DESs in dyslipidemia pts was associated with higher incidence of repeat PCI and MACE up to 3 years.


BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e039096
Author(s):  
Natsuko Kanazawa ◽  
Hiroaki Iijima ◽  
Kiyohide Fushimi

ObjectivesTo verify the associations between participation in an in-hospital cardiac rehabilitation (CR) programme and clinical outcomes among patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI).DesignA retrospective cohort study using the Japanese administrative claims database.SettingJapanese acute-care hospitals.ParticipantsPatients aged ≥18 years who underwent PCI due to AMI and survived to discharge.Primary and secondary outcome measureThe primary outcomes were revascularisation, all-cause readmission and cardiac readmission (median follow-up period: 324 days, 236 days and 263 days, respectively). The secondary outcomes were all-cause mortality and cardiac mortality (median follow-up period: both were 460 days).ResultThe data of 13 697 patients were extracted from the database, and 65.4% of them participated in an in-hospital CR. The risks of revascularisation, all-cause readmission and cardiac readmission among CR participants were compared with those of non-participants using two statistical techniques: matched-pair analysis based on propensity score and a 30-day landmark analysis. The results of those analysis were consistent and showed that the CR participants had lower risk of revascularisation (adjusted HR: 0.74; 95% CI: 0.65 to 0.84), all-cause readmission (HR: 0.81; 95% CI: 0.74 to 0.88) and cardiac readmission (HR: 0.77; 95% CI: 0.70 to 0.85). However, all-cause mortality and cardiac mortality were not associated with participation in the CR.ConclusionsIt was suggested that in-hospital CR participation may reduce the risk of revascularisation, all-cause readmission and cardiac readmission among patients with AMI after PCI. In-hospital CR may expand the potential benefits of CR in addition to outpatient CR.


2020 ◽  
Vol 5 (01) ◽  
pp. 18-24
Author(s):  
A. Siva Ramakrishna ◽  
V. Satish Kumar Rao ◽  
Garre Indrani

Abstract Background We aimed to recognize the predictors of long-term major adverse cardiac events (MACE) in the elderly candidates for elective percutaneous coronary intervention (PCI) in relation to gender at our center. Methods In this retrospective cohort study, we reviewed the data of the elderly patients (age ≥70 years) who underwent elective PCI who met our study criteria in our institution during 2008 and 2018. Demographical data, clinical history, angiographic details, PCI procedure, and follow-up data of the patients enrolled in the study were studied by using the angiographic and PCI procedure details. Patients were characterized in the study group as those with or without MACE, which were then compared and analyzed using the statistical analysis in a univariable and binary linear regression analysis. Results A total of 355 elderly patients (older than 70 years) undergoing elective PCI were selected who fulfilled the inclusion criteria; 277 patients were men and had more comorbidities, including hypertension, diabetes mellitus (DM), chronic obstructive pulmonary disease, history of heart failure, previous coronary artery bypass graft, and presentation with acute coronary syndrome. MACE occurred in 24 events patients of whom 20 were suffering from DM. Binary logistic regression showed that the only determinant for the 1-year follow-up outcome is diabetes (p = 0.000). Even in univariate analysis, DM (0.01) is the determinant. DM is a strong predictor for death in univariate analysis (p = 0.00). Conclusion PCI is a safe and effective method of coronary revascularization in elderly patients, and some risk factors can predict long-term MACE in this group of patients.


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