scholarly journals Vascular Complications from Coronary Angiography/Percutaneous Coronary Intervention: Comparing Day Case Patients and Inpatients in a Tertiary Hospital in Thailand: A Retrospective Cohort Stud

2020 ◽  
Author(s):  
Chantana Charoensin ◽  
Ratchanee Srichai ◽  
Thammasin Ingviya
Keyword(s):  
Risk Factors ◽  
Percutaneous Coronary Intervention ◽  
Coronary Angiography ◽  
Retrospective Cohort ◽  
Vascular Complications ◽  
Coronary Intervention ◽  
Closure Device ◽  
Day Case ◽  
Vascular Closure Devices ◽  
Percutaneous Coronary

Objective: To compare the incidence along with risk factors of vascular complications between patients having undergone Coronary angiography/Percutaneous Coronary Interventions (CAG/PCIs); as day cases and those as inpatients. Material and Methods: Our study is a retrospective cohort study. We performed a retrospective chart review of the patients, visiting a heart center of the hospital from October, 2014 to September, 2018. We included patients of a minimum 18 years of age, who had undergone CAG/PCIs. Excluded patients were those who had been referred from other hospitals. The main outcomes were vascular complications defined as: (1) bleeding with significant blood loss during the procedure. (2) Hematoma within 1 month after the procedure. Wilcoxon’s rank sum and chi-squared test were used to assess the risk factors. Results: Of all 784 patients having undergone CAG/PCI, 387 were day cases and 397 were inpatients. Only 12 cases developed vascular complications. The incidence of vascular complications was not significantly different between either day case; whose incidence was 1.3% (95% confidence interval (CI), 0.72-1.87), and inpatients; whose incidence was 1.8% (95% CI, 1.10-2.42). We found that the risk factors of vascular complications were percutaneous coronary intervention, and using a vascular closure device to remove the introducer sheath. Conclusion: Performing CAG/PCI as day cases did not increase the risks of complications post-procedure, as compare to the inpatients. However, due to the small numbers of patients with complications future studies with more patients are needed to ensure the safety of day case CAG/PCI. Patients undergoing PCI, or patients with vascular closure devices used should be closely observed before discharge.

scholarly journals Reintroduction of elective cardiac interventions in the era of COVID-19: the Barts experience

Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001446
Author(s):  
Stephen Hamshere ◽  
Katrina Comer ◽  
Fizzah Choudhry ◽  
Krishna Rathod ◽  
Gordon Mills ◽  
...  
Keyword(s):  
Risk Factors ◽  
Percutaneous Coronary Intervention ◽  
Aortic Valve ◽  
Coronary Angiography ◽  
Coronary Intervention ◽  
Multidisciplinary Teams ◽  
Transcatheter Aortic Valve ◽  
Percutaneous Coronary ◽  
Procedural Complications

BackgroundThe response to COVID-19 has required cancellation of all but the most urgent procedures; there is therefore a need for the reintroduction of a safe elective pathway.MethodsThis was a study of a pilot pathway performed at Barts Heart Centre for the admission of patients requiring elective coronary and structural procedures during the COVID-19 pandemic (April–June 2020). All patients on coronary and structural waiting lists were screened for procedural indications, urgency and adverse features for COVID-19 prognosis and discussed at dedicated multidisciplinary teams. Dedicated admission pathways involving preadmission isolation, additional consent, COVID-19 PCR testing and dedicated clean areas were used.Results143 patients (101 coronary and 42 structural) underwent procedures (coronary angiography, percutaneous coronary intervention, transcatheter aortic valve intervention and MitralClip) during the study period. The average age was 68.2; 74% were male; and over 93% had one or more moderate COVID-19 risk factors. All patients were COVID-19 PCR negative on admission with (8.1%) COVID-19 antibody positive (swab negative). All procedures were performed successfully with low rates of procedural complications (9.8%). At 2-week follow-up, no patients had symptoms or confirmed COVID-19 infection with significant improvements in quality if life and symptoms.ConclusionWe demonstrated that patients undergoing coronary and structural procedures can be safely admitted during the COVID-19 pandemic, with no patients contracting COVID-19 during their admission. Reassuringly, patients reflective of typical practice, that is, those at moderate or higher risk, were treated successfully. This pilot provides important information applicable to other settings, specialties and areas to reintroduce services safely.

scholarly journals Coronary Artery Disease (CAD) - risk factors and causes: In Libyan patients.

2021 ◽  
Author(s):  
Osama Bheleel ◽  
Alaa Abdulhamid ◽  
Ibtisam Alhadi Naas ◽  
Hanaa Grash ◽  
Hajer M almuaket ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Intervention ◽  
University Hospital ◽  
Contributing Factors ◽  
Percutaneous Coronary ◽  
Artery Disease

Aims Coronary artery disease (CAD) is the leading cause of death worldwide in both men and women. Accordingly, we retrospectively reviewed the effects of various risk factors on coronary angiographic outcomes. Methods and Results Data were collected from the catheter lab through Tripoli university hospital records, whereas the team reviewed clinical data and coronary artery diagrams for one year from 01/04/2019 to 31/03/2020. In our study, the total number of cases was 666; 401 male and 265 female, ranging in age between 27 and 91 years. Considering the data, a significantly increased incidence of coronary artery disease (CAD) among the male who smokes, and who were less than 60 years of age. Furthermore, in the present study, the total number of normal patients was predominantly female. The most common risk factors for women were diabetes mellitus (DM), hypertension (HTN) (12%,13% respectively). While the men share the significant effects of smoking on coronary angiography (C. Angio) findings (40.52%), and most of them underwent a percutaneous coronary intervention (PCI). Conclusions In our study, there was evidence that CAD is a prevalent disease among the middle-aged populations with male gender preference. The risk factors including diabetes, hypertension, and smoking are the most contributing factors for the developing CAD in Libya. Keywords: coronary artery disease; percutaneous coronary intervention; risk factors; coronary angiography; Libya

Management of Haemostasis with Combined Use of Vascular Closure Devices and Bivalirudin – A Review

2011 ◽  
Vol 6 (2) ◽  
pp. 177
Author(s):  
Emanuela de Cillis ◽  
Giuseppe Massimo Sangiorgi ◽  
Alessandro Santo Bortone ◽  
◽  
◽  
...  
Keyword(s):  
High Risk ◽  
Vascular Complications ◽  
Coronary Intervention ◽  
Closure Device ◽  
Vascular Closure Device ◽  
High Risk Patients ◽  
Vascular Closure Devices ◽  
Combined Use ◽  
Percutaneous Coronary ◽  
Risk Patients

Bleeding and vascular complications related to invasive cardiovascular procedures are associated with significant morbidity and mortality. The aim of this article is to evaluate the literature to determine haemostasis strategies in percutaneous coronary intervention when using bivalirudin with or without a vascular closure device. The literature data seem to underline that the combination of vascular closure devices and bivalirudin was associated with significantly lower bleeding rates. However, these strategies were less often used among high-risk patients. We recommend that prospective clinical studies are undertaken to determine the potential disadvantages of using vascular closure devices and bivalirudin in combination in high-risk patients.

scholarly journals Development and Validation of Risk Prediction Model for New-Onset Diabetes After Percutaneous Coronary Intervention (NODAP): A Study Protocol for a Retrospective, Multicenter Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Yiwen Li ◽  
Jing Cui ◽  
Yanfei Liu ◽  
Keji Chen ◽  
Luqi Huang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Percutaneous Coronary Intervention ◽  
Cohort Study ◽  
Cardiovascular Diseases ◽  
Prediction Model ◽  
Retrospective Cohort ◽  
Coronary Intervention ◽  
Onset Diabetes ◽  
Percutaneous Coronary ◽  
New Onset

Background: Type 2 Diabetes mellitus (T2DM) is a major risk factor for cardiovascular diseases and increase mortality. Clinical outcomes of patients after percutaneous coronary intervention (PCI) were worse in T2DM patients than those without T2DM. New-onset diabetes after PCI (NODAP) is often observed during long-term follow-up and this further aggravates cardiovascular diseases. Several studies had focused on patients after PCI with known T2DM. Previous studies showed that impaired glucose tolerance and aging are risk factors that promote NODAP. Considering the unique characteristics of patients after PCI, we will further study relevant risk factors. We sought to investigate the potential predictors of acute coronary syndrome patients with NODAP by a multicenter retrospective cohort study.Methods: This is a multicenter retrospective cohort study including patients after PCI. Clinical medical records of these patients were collected from four hospitals in different areas in China, from 2010 to 2021. Patients' demographic information, medical history, diagnostic testing, PCI-related information, medication situation will be summarized using descriptive statistics, and correlation analysis was performed on the development of new-onset diabetes. Variation will be described and evaluated using χ2 test or Kreskas-Wallis test. The prediction model will be verified by a validation set.Discussion: A novel diabetes prediction model for patients after PCI is established, and this study can achieve advanced intervention for the occurrence of NODAP. Owing to its retrospective nature, this study has some limitations, but it will be further studied through supplement data collection or prospective study. The study has been registered for clinical trials by the Chinese Clinical Trial Registry (ChiCTR2100047241).

scholarly journals Analysis of the risk factors for contrast-induced nephropathy in over-aged patients receiving coronary intervention

2018 ◽  
Vol 243 (12) ◽  
pp. 970-975 ◽  
Author(s):  
Hui-Chao Pan ◽  
Xian-Hao Wu ◽  
Qian-Li Wan ◽  
Bao-Hong Liu and ◽  
Xu-Sheng Wu
Keyword(s):  
Risk Factors ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Artery Stenosis ◽  
Coronary Intervention ◽  
Artery Stenosis ◽  
Contrast Induced Nephropathy ◽  
Aged Patients ◽  
Percutaneous Coronary

Contrast-induced nephropathy has been the common cause of hospital-acquired acute kidney injury in the elderly patients. This study aimed to analyze the risk factors for contrast-induced nephropathy in over-aged patients undergoing coronary angiography or percutaneous coronary intervention. A total of 470 over-aged patients (≥80 years old) were judged as the contrast-induced nephropathy group ( n = 46) and non-contrast-induced nephropathy group ( n = 424) according to the postoperative 48-h serum creatinine levels. The patients’ clinical information such as hypertension grade, number and degree of coronary artery stenosis, and death rate was compared. The risk factors for contrast-induced nephropathy were also analyzed. The hypertension grade in the contrast-induced nephropathy group was significantly higher than that in the non-contrast-induced nephropathy group ( P = 0.004). The degree of coronary artery stenosis was significantly more in the contrast-induced nephropathy group compared with the non-contrast-induced nephropathy group ( P = 0.003). The death rate of the contrast-induced nephropathy group (15.8%) was significantly higher than that of the non-contrast-induced nephropathy group (0.6%; P = 0.000). The percentage of patients with abnormal urine microalbumin was significantly bigger in the contrast-induced nephropathy group (62.5%) when comparing to the non-contrast-induced nephropathy group (23.6%; P = 0.00). Besides, there was also significant difference in the emergency/selective operation between the contrast-induced nephropathy group and non-contrast-induced nephropathy group ( P = 0.001). Further, hypertension grade ( P = 0.019), emergency/selective operation ( P = 0.025), degree of coronary artery stenosis ( P = 0.038), eGFR ( P = 0.034), and urine microalbumin ( P = 0.005) were the risk factors for contrast-induced nephropathy. Hypertension grade, emergency/selective operation, degree of coronary artery stenosis, eGFR, and urine microalbumin were the risk factors for contrast-induced nephropathy in over-aged patients receiving coronary angiography and percutaneous coronary intervention, providing guidance for the clinical prevention of contrast-induced nephropathy. Impact statement In this work, we evaluated the risk factors for contrast-induced nephropathy (CIN) in over-aged patients receiving coronary angiography (CAG) and percutaneous coronary intervention (PCI). We found that hypertension grade, emergency/selective operation, degree of coronary artery stenosis, eGFR, and urine microalbumin were the risk factors for CIN in over-aged patients receiving CAG and PCI. This study provides guidance for the clinical prevention of CIN in over-aged patients undergoing coronary intervention, highlighting that a perioperative comprehensive management strategy is needed to improve the prognosis.

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