HEMORRAGIC COMPLICATIONS IN PATIENTS WITH ISCHEMIC HEART DISEASE AFTER PLANNED PERCUTANEOUS CORONARY INTERVENTIONS

2018 ◽  
Author(s):  
Е.В. Гуськова ◽  
А.Л. Комаров ◽  
А.Н. Самко ◽  
Е.П. Панченко
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Antiplatelet Therapy ◽  
Coronary Intervention ◽  
Ischemic Heart ◽  
Percutaneous Coronary Interventions ◽  
Bleeding Events ◽  
Percutaneous Coronary

Введение. Антитромбоцитарная терапия является основой медикаментозного лечения больных с различными проявлениями атеротромбоза. Совместный прием аспирина и блокатора P2Y12-рецепторов способствует более сильному ингибированию функции тромбоцитов и снижению риска тромботических осложнений по сравнению с монотерапией, но неизбежно ведет к увеличению числа различных кровотечений. Цель исследования: изучение распространенности и клинических факторов риска кровотечений (по классификации BARC) у больных стабильной ишемической болезнью сердца (ИБС) после плановых чрескожных коронарных вмешательств (ЧКВ). Материалы и методы. Обследовано 188 больных (средний возраст 61,4 ± 10,7 лет) со стабильной ИБС, подвергнутых плановому ЧКВ. Все больные получали стандартную антитромботическую, гиполипидемическую, антиангинальную и гипотензивную терапию и наблюдались в течение всего периода приема двойной антитромбоцитарной терапии (ДАТТ) – в среднем 1,1 ± 0,3 года. Результаты. Показано, что малые (BARC 1) кровотечения возникают у половины пациентов, длительно получающих двойную антитромбоцитарную терапию, и не связаны с появлением больших (BARC 3-5) кровотечений. Заключение. У больных с малыми (BARC 1) кровотечениями не было отмечено ни одного тромбоза стента, что может отражать эффективно проводимую антитромбоцитарную терапию. The aim: to study the incidence and clinical risk factors of bleeding events (according to BARC classification) in patients with ischemic heart disease (IHD) after planned percutaneous coronary intervention (PCI). Materials and methods. We examined 188 patients (mean age 61,4 ± 10,7 years) with IHD undergoing planned PCI. All patients received standard antithrombotic, hypolipidemic, antianginal and antihypertensive therapy and were monitored during the entire period of double antiplatelet therapy (DAPT) – an average of 1,1 ± 0,3 years. Results. It was shown that small (BARC 1) bleedings occurred in half of patients under long-term antiplatelet therapy and were not associated with the occurrence of large (BARC 3-5) bleedings. Conclusion. In patients with small (BARC 1) bleedings no cases of stent thrombosis were noted that can prove the effectiveness of DAPT.

scholarly journals Regulation of risk factors in patients with ischemic heart disease treated with percutaneous coronary intervention

2011 ◽  
Vol 30 (4) ◽  
pp. 257-263
Author(s):  
Marina Ličina ◽  
Tatjana Potpara ◽  
Marija Polovina ◽  
Mladen Ostojić ◽  
Nataša Milić ◽  
...  
Keyword(s):  
Risk Factors ◽  
Percutaneous Coronary Intervention ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Coronary Intervention ◽  
Ischemic Heart ◽  
Percutaneous Coronary

scholarly journals Unique referral system contributes to long-term net clinical benefits in patients undergoing secondary prevention therapy after percutaneous coronary intervention

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242707
Author(s):  
Shigetaka Kageyama ◽  
Koichiro Murata ◽  
Ryuzo Nawada ◽  
Tomoya Onodera ◽  
Yuichiro Maekawa
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Heart Disease ◽  
Secondary Prevention ◽  
Ischemic Heart Disease ◽  
Coronary Intervention ◽  
Ischemic Heart ◽  
Referral System ◽  
Clinical Events ◽  
Percutaneous Coronary ◽  
Clinical Benefits

Cardiovascular disease, including ischemic heart disease, is a leading cause of death worldwide. Improvement of the secondary prevention of ischemic heart disease is necessary. We established a unique referral system to connect hospitals and outpatient clinics to coordinate care between general practitioners and cardiologists. Here, we evaluated the impact and long-term benefits of our system for ischemic heart disease patients undergoing secondary prevention therapy after percutaneous coronary intervention. This single-center retrospective observational study included 3658 consecutive patients who underwent percutaneous coronary intervention at Shizuoka City Hospital between 2010 and 2019. After percutaneous coronary intervention, patients were considered conventional outpatients (conventional follow-up group) or subjected to our unique referral system (referral system group) at the attending cardiologist’s discretion. To audit compliance of the treatment with the latest Japanese guidelines, we adopted a circulation-type referral system, whereby general practitioners needed to refer registered patients at least once a year, even if no cardiac events occurred. Clinical events in each patient were evaluated. Net adverse clinical events were defined as a combination of major adverse cardiac, cerebrovascular, and major bleeding events. There were 2241 and 1417 patients in the conventional follow-up and referral system groups, with mean follow-ups of 1255 and 1548 days and cumulative net adverse clinical event incidences of 27.6% and 21.5%, respectively. Kaplan–Meier analysis showed that the occurrence of net adverse clinical events was significantly lower in the referral system group than in the conventional follow-up group (log-rank: P<0.001). Univariate and multivariate analyses revealed that the unique referral system was a significant predictor of the net clinical benefits (hazard ratio: 0.56, 95% confidence interval: 0.37–0.83, P = 0.004). This result was consistent after propensity-score matching. In summary, our unique referral system contributed to long-term net clinical benefits for the secondary prevention of ischemic heart disease after percutaneous coronary intervention.

scholarly journals Model for End-Stage Liver Disease Score Predicts the Mortality of Patients with Coronary Heart Disease Who Underwent Percutaneous Coronary Intervention

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
You Chen ◽  
Min Han ◽  
Ying-Ying Zheng ◽  
Feng Zhu ◽  
Aikebai Aisan ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Liver Disease ◽  
Coronary Intervention ◽  
Meld Score ◽  
Bleeding Events ◽  
Percutaneous Coronary ◽  
End Stage ◽  
Long Term Mortality

Background. Coronary heart disease (CHD) is caused by the blockage or spasm of coronary arteries. Evidence shows that liver disease is related to CHD. However, the correlation between the Model for End-Stage Liver Disease (MELD) score and outcomes in patients after percutaneous coronary intervention (PCI) was unclear. Method. A retrospective cohort study involved 5373 patients with coronary heart disease after PCI was conducted from January 2008 to December 2016. Participants were classified to four groups according to the MELD score by quartiles. The primary endpoint was long-term mortality including all-case mortality (ACM) and cardiac mortality (CM). Secondary endpoints included bleeding events, readmission, major adverse cardiovascular events (MACE), major adverse cardiovascular, and cerebrovascular events (MACCE). The longest follow-up time was almost 10 years. Results. There were significant differences in the incidences of ACM ( p = 0.038 ) and CM ( p = 0.027 ) among the four MELD groups, but there was no significant difference in MACEs ( p = 0.496 ), MACCEs ( p = 0.234 ), readmission ( p = 0.684 ), and bleeding events ( p = 0.232 ). After adjusting the age, gender, smoking, drinking status, and diabetes by a multivariable Cox regression analysis, MELD remains independently associated with ACM (HR:1.57, 95%CI 1.052–2.354, p = 0.027 ) and CM (HR:1.434, 95% CI 1.003–2.050, p = 0.048 ). Conclusion. This study indicated that the MELD score had a strong prediction for long-term mortality in CHD patients who underwent PCI.

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