Prognostic Impact of Red Cell Distribution Width on the Development of Contrast Induced Nephropathy, Major Adverse Cardiac Events, and Mortality in Coronary Artery Disease Patients Undergoing Percutaneous Coronary Intervention.

2021 ◽  
Vol 17 ◽  
Author(s):  
Azka Latif ◽  
Muhammad Junaid Ahsan ◽  
Noman Lateef ◽  
Vikas Kapoor ◽  
Hafiz Muhammad Fazeel ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Intervention ◽  
Cardiac Events ◽  
Distribution Width ◽  
Adverse Cardiac Events ◽  
Percutaneous Coronary ◽  
All Cause Mortality ◽  
Artery Disease

: Red cell distribution width (RDW) serves as an independent predictor towards the prognosis of coronary artery disease (CAD) in patients undergoing percutaneous coronary intervention (PCI). A systematic search of databases such as PubMed, Embase, Web of Science, and Cochrane library was performed on October 10th, 2019 to elaborate the relationship between RDW and in hospital and long term follow up all-cause and cardiovascular mortality, major adverse cardiac events (MACE) and development of contrast-induced nephropathy (CIN) in patients with CAD undergoing PCI. Twenty-one studies qualified this strict selection criteria (number of patients = 56,425): one study was prospective, and the rest were retrospective cohorts. Our analysis showed that patients undergoing PCI with high RDW had a significantly higher risk of in-hospital all-cause mortality (OR 2.41), long-term all-cause mortality (OR 2.44), cardiac mortality (OR 2.65), MACE (OR: 2.16) and odds of developing CIN (OR: 1.42) when compared to the patients with low RDW. Therefore, incorporating RDW in the predictive models for the development of CIN, MACE, and mortality can help in triage to improve the outcomes in coronary artery disease patients who undergo PCI.

Sex differences in clinical outcomes of patients with stable coronary artery disease after percutaneous coronary intervention

2021 ◽  
Vol 27 ◽  
Author(s):  
Emmanuel P. Vardas ◽  
Evangelos Oikonomou ◽  
Gerasimos Siasos ◽  
Panagiotis Theofilis ◽  
Polychronis Dilaveris ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Risk Factor ◽  
Coronary Artery ◽  
Independent Risk Factor ◽  
Stable Coronary Artery Disease ◽  
Coronary Intervention ◽  
Female Sex ◽  
Percutaneous Coronary ◽  
Artery Disease

: Potential sex-related differences in the periprocedural and long-term postprocedural outcomes of coronary angioplasty in patients with stable coronary artery disease have been studied thoroughly over the last few decades, to determine whether female sex should be regarded as an independent risk factor that affects clinical outcomes. Based on a significant number of observational studies and meta-analyses, sex has not yet emerged as an independent risk factor for either mortality or major cardiac and cerebrovascular events, despite the fact that in the early 1980s, for several reasons, female sex was associated with unfavourable outcomes. Therefore, it remains debatable whether female sex should be considered as an independent risk factor for periprocedural and long-term bleeding events. The pharmacological and technological advancements that support current coronary angioplasty procedures, as well as the non-delayed treatment of coronary artery disease in females have certainly lessened the outcome differences between the two sexes. However, females show fluctuations in blood coagulability through their lifetime and higher prevalence of bleeding episodes associated with the antithrombotic treatment, following transcatheter coronary reperfusion interventions. In conclusion, the clinical results of percutaneous coronary intervention in patients with stable coronary artery disease, during the periprocedural and long-term postprocedural periods, appear to show no significant differences between the two sexes, except for bleeding rates, which seem to be higher in females, a difference that mandates further systematic research.

Abstract 15071: Effect of Percutaneous Coronary Intervention on Death and Myocardial Infarction in Patients Withstable Coronary Artery Disease and Inducible Ischemia

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Qais Radaideh ◽  
Mohammed Osman ◽  
Babikir Kheiri ◽  
Ahmad Al-Abdouh ◽  
mahmoud Barbarawi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Stress Testing ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
All Cause Mortality ◽  
Artery Disease ◽  
Severe Ischemia

Introduction: There has been a continuous debate about the survival benefit of percutaneous coronary intervention (PCI) for the management of patients with stable coronary artery disease (CAD) and moderate to severe ischemia. To address this, we performed a meta-analysis of RCTs comparing PCI plus MT vs. MT alone in stable CAD patients to evaluate endpoints of all-cause mortality, cardiovascular (CV) mortality, and MI in a larger cohort of patients with objective evidence of myocardial ischemia. Methods: An electronic database search was conducted for RCTs that compared PCI on top of MT versus MT alone. A random effects model was used to calculate relative risk (RR) and 95% confidence intervals (CIs). Results: A total of 7 RCTs with 10,043 patients with a mean age of 62.54 ± 1.56 years and a median follow up of 3.9 years were identified. Among patients with (CAD) and moderate to severe ischemia by stress testing, PCI didn’t show any benefit for the primary outcome of all-cause mortality compared to MT(RR = 0.85; 95% CI 0.646-1.12; p= 0.639). There was also no benefit in cardiovascular (CV) death (RR = 0.88 ; 95% CI 0.71-1.09; p =0.18) or myocardial infarction (MI) (RR = 0.271 ; 95% CI 0.782-1.087; P =0.327) in the PCI group as compared to MT. Conclusions: Among patients with (CAD) and evidence of moderate to severe ischemia by stress testing, PCI on top of MT appears to add no mortality benefit as compared to with MT alone.

Impact of Pre-Existing Depression in Patients With Coronary Artery Disease Undergoing Percutaneous Coronary Intervention; A Nationwide Cohort Study

2020 ◽  
Author(s):  
Jangho Park ◽  
Sangwoo Park ◽  
Yong-Giun Kim ◽  
Soe Hee Ann ◽  
Hyun Woo Park ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
All Cause Mortality ◽  
Artery Disease ◽  
The Impact

Abstract The impact of pre-existing depression on mortality in individuals with established coronary artery disease (CAD) remains unclear. We evaluate the clinical implications of pre-existing depression in patients who underwent percutaneous coronary intervention (PCI). Based on National Health Insurance claims data in Korea, patients without a known history of CAD who underwent PCI between 2013 and 2017 were enrolled. The study population was divided into patients with angina (n=50,256) or acute myocardial infarction (AMI; n=40,049). The primary endpoint, defined as all-cause death, was compared between the non-depression and depression groups using propensity score matching analysis. After propensity score matching, there were 4,262 and 2,346 matched pairs of patients with angina and AMI, respectively. During the follow-up period, there was no significant difference in the incidence of all-cause death in the angina (hazard ratio [HR] of depression, 1.013; 95% confidence interval [CI]: 0.893-1.151) and AMI (HR, 0.991; 95% CI: 0.865-1.136) groups. However, angina patients less than 65 years of age with depression had higher all-cause mortality (HR, 1.769; 95% CI: 1.240-2.525). In Korean patients undergoing PCI, pre-existing depression is not associated with poorer clinical outcomes. However, in younger patients with angina, depression is associated with higher all-cause mortality.

Real-world referral pattern and outcomes of diabetic patients who undergo revascularization: data from the prospective Multi-vessel Coronary Artery Disease (MULTICAD) Israeli Registry†

2019 ◽  
Vol 56 (2) ◽  
pp. 328-334 ◽  
Author(s):  
Eilon Ram ◽  
Ilan Goldenberg ◽  
Leonid Sternik ◽  
Yael Peled ◽  
Amit Segev ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Intervention ◽  
Diabetic Patients ◽  
Term Survival ◽  
Percutaneous Coronary ◽  
Artery Disease ◽  
Percutaneous Revascularization ◽  
Vessel Coronary Artery

Abstract OBJECTIVES Diabetes mellitus patients with multivessel coronary artery disease present with a poor prognosis. We aimed to explore real-life clinical outcomes of diabetic patients who were referred for coronary revascularization. METHODS We used data from the Multi-vessel Coronary Artery Disease (MULTICAD) Israeli Registry. Using descriptive statistics, Kaplan–Meier, Cox and logistic regression, we described a revascularization referral pattern, short-term outcomes and long-term survival among 475 diabetic patients with multivessel and/or left main disease, 48% of whom underwent surgical and 52% percutaneous revascularization. RESULTS Factors independently associated with referral for surgery included the presence of left main stenosis [odds ratio (OR) 1.89; P = 0.030] and a higher Syntax score (OR 1.15 per point increment; P < 0.001), whereas an older age (OR 1.03 per 1-year increment in age; P = 0.019), prior percutaneous coronary intervention (OR 1.83; P = 0.009) and the presence of renal impairment (OR 2; P = 0.026) were associated with percutaneous coronary intervention referral. At 7 months of follow-up, multivariable analysis did not reveal any difference in mortality risk between the surgical and percutaneous revascularization groups [hazard ratio (HR) 1.23, 95% confidence interval (CI) 0.5–3.04; P = 0.649], whereas after 7 months, surgical revascularization was associated with a significant survival benefit (HR 2.24, 95% CI 1.03–4.87; P = 0.042). CONCLUSIONS Our observation suggests that in a real-world setting, only approximately one-half of diabetic patients with multivessel disease are referred to surgical revascularization despite guideline indications. Surgical compared to percutaneous revascularization in this population was associated with improved long-term survival that became evident 7 months after the revascularization procedure.

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