scholarly journals Post PCI with stenting Follow-Up in Women for 7 Years in Public Sector Tertiary Care Cardiac Unit. Retrospective Study

2020 ◽  
Vol 5 (2) ◽  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Menopausal Status ◽  
Major Adverse Cardiac Events ◽  
Hormonal Contraceptives ◽  
Cardiac Events ◽  
Adverse Cardiac Events ◽  
Long Term Follow Up

Introduction: Despite of the fact that there is continual improvement in diagnostic and therapeutic procedures in catherization Lab introduction of better catheter techniques and new-generation stents and with the acquisition of knowledge from largescale clinical trials Still women appear to have a higher in-hospital mortality after PCI with stenting and during long term follow up specially in developing countries of South Asia the, Reason could be multi-factorial in women. The objectives: The goals of treatment in PCI with stenting in Women is to improve quality of life, to prevent CHD from becoming symptomatic, prevent myocardial infarction, cardiac death and heart failure, the approaches to achieve these goals at the societal or individual level in this regards differ among various countries, the data that have been published are often limited due to the relatively small number of western women. It is important to collect data in under developed countries on outcomes of long term follow up of women with AMI after PCI with stenting to change the global perception of treatment of women with myocardial infarction. Material and Method: Out of 3300 patients, underwent successful PCI with stenting during 2010 to 2016 in Cath Lab of cardiology department of Dow University of Health and Sciences Karachi Pakistan , 577 patients with Sciences Karachi Pakistan, 577 patients with Myocardial infarction within 7 days were included in study and they constitute the present followup population. Additional data regarding noncardiac comorbid diseases and Risk factors were obtained along with crucial aspects of women’s health, such as menopausal status, use of hormonal contraceptives, Follow-up was planned after 1 month and then with annualy for 7 years. The primary end point of study were the long-term rate of major adverse cardiac events (i.e. death, Infarction, and repeat revascularization). The secondary end points were the individual components of the major adverse cardiac events and stent thrombosis. Result: This observational study was conducted by reviewing the record of cases performed and getting information on follow up visits of patients for 7 years from June 2010 to June 2016, out of total 3300 procedure 577 patients were included in the study who underwent PCI with stenting with in the 7 day of Myocardial infarction consisting of 346 patient from urban and 237 people from Rural areas of Sindh Balochistan Provinice of Pakistan Revascularization with stenting was performed in 313 patients 40-50 years of age followed by 219 patients 56-70 years of age in comparison to 23 in older group > 70 years and 22 in younger age < 40 years ,In 528 (91.5%)patients PCI with BMS, in 28 (4.8%)patients DES alone and in 21 (3.6%)patients with BMS and DES performed The odds of short-term mortality were significantly higher among older post - menopausal group compared to premenopausal patients <55. I3 patients (5 patients during hospitalization) and 8 patients died within 30 days after PCI. Total 57((9.8%) patient died during7 years follow up, 31 (58.5%) cases due to comorbid conditions, and remaining 27 patients death was due to myocardial infarction in 13 (39.4%). Arrhythmias in 5 (9.4%) and worsening of heart Failure in 8 (42.1%) elderly patients. Patient had complete Closure of Target Vessel, 28 (4.8%) had Re PCI on 7 years follow up and CABG was performed in 13 (2.2%). Patients main reason could be noncompliance of therapy in 71 (12.3%) in patients.

scholarly journals Circulating Platelet-Derived Microparticles Associated with Postdischarge Major Adverse Cardiac Events in ST-Elevation Acute Myocardial Infarction

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Anggoro Budi Hartopo ◽  
Dyah Samti Mayasari ◽  
Ira Puspitawati ◽  
Hasanah Mumpuni
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Major Adverse Cardiac Events ◽  
Cardiac Events ◽  
Prognostic Implication ◽  
Adverse Cardiac Events ◽  
St Elevation ◽  
Elevation Acute Myocardial Infarction

Introduction. Platelet-derived microparticles (PDMPs) measurement adds prognostic implication for ST-elevation acute myocardial infarction (STEMI). The long-term implication of PDMPs in STEMI needs to be corroborated. Methods. The research design was a cohort study. Subjects were STEMI patients and were enrolled consecutively. The PDMPs were defined as microparticles bearing CD41(+) and CD62P(+) markers detected with flow cytometry. The PDMPs were measured on hospital admission and 30 days after discharge. The outcomes were major adverse cardiac events (MACE), i.e., a composite of cardiac death, heart failure, cardiogenic shock, reinfarction, and resuscitated ventricular arrhythmia, occurring from hospitalization until 1 year after discharge. Results. We enrolled 101 subjects with STEMI. During hospitalization, 17 subjects (16.8%) developed MACE. The PDMPs were not different between subjects with MACE and those without (median (IQR): 3305.0/μL (2370.0–14690.5/μL) vs. 4452.0/μL (2024.3–14396.8/μL), p=0.874). Forty-five subjects had increased PDMPs in 30 days after discharge as compared with on-admission measurement. Subjects with increased PDMPs had significantly higher 30-day MACE as compared to subjects with decreased PDMPs 17 (37.8%) vs. 6 (16.7%, p=0.036). There was a trend toward higher MACE in subjects with increased PDMPs as compared to those with decreased PDMPs in 90 days after discharge (48.9% vs. 30.6%, p=0.095) and 1 year after discharge (48.9% vs. 36.1%, p=0.249). Conclusion. The PDMPs level was increased from the day of admission to 30 days after discharge in patients with STEMI. The persistent increase in the PDMPs level in 30 days after the STEMI event was associated with the 30-day postdischarge MACE and trended toward increased MACE during the 90-day and 1-year follow-up.

scholarly journals Pericoronary fat inflammation and Major Adverse Cardiac Events (MACE) in prediabetic patients with acute myocardial infarction: effects of metformin

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Celestino Sardu ◽  
Nunzia D’Onofrio ◽  
Michele Torella ◽  
Michele Portoghese ◽  
Francesco Loreni ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Adipose Tissue ◽  
Artery Bypass ◽  
Major Adverse Cardiac Events ◽  
Cardiac Events ◽  
Metformin Therapy ◽  
Adverse Cardiac Events ◽  
Factor Α

Abstract Background/objectives Pericoronary adipose tissue inflammation might lead to the development and destabilization of coronary plaques in prediabetic patients. Here, we evaluated inflammation and leptin to adiponectin ratio in pericoronary fat from patients subjected to coronary artery bypass grafting (CABG) for acute myocardial infarction (AMI). Furthermore, we compared the 12-month prognosis of prediabetic patients compared to normoglycemic patients (NG). Finally, the effect of metformin therapy on pericoronary fat inflammation and 12-months prognosis in AMI-prediabetic patients was also evaluated. Methods An observational prospective study was conducted on patients with first AMI referred for CABG. Participants were divided in prediabetic and NG-patients. Prediabetic patients were divided in two groups; never-metformin-users and current-metformin-users receiving metformin therapy for almost 6 months before CABG. During the by-pass procedure on epicardial coronary portion, the pericoronary fat was removed from the surrounding stenosis area. The primary endpoints were the assessments of Major-Adverse-Cardiac-Events (MACE) at 12-month follow-up. Moreover, inflammatory tone was evaluated by measuring pericoronary fat levels of tumor necrosis factor-α (TNF-α), sirtuin 6 (SIRT6), and leptin to adiponectin ratio. Finally, inflammatory tone was correlated to the MACE during the 12-months follow-up. Results The MACE was 9.1% in all prediabetic patients and 3% in NG-patients. In prediabetic patients, current-metformin-users presented a significantly lower rate of MACE compared to prediabetic patients never-metformin-users. In addition, prediabetic patients showed higher inflammatory tone and leptin to adiponectin ratio in pericoronary fat compared to NG-patients (P < 0.001). Prediabetic never-metformin-users showed higher inflammatory tone and leptin to adiponectin ratio in pericoronary fat compared to current-metformin-users (P < 0.001). Remarkably, inflammatory tone and leptin to adiponectin ratio was significantly related to the MACE during the 12-months follow-up. Conclusion Prediabetes increase inflammatory burden in pericoronary adipose tissue. Metformin by reducing inflammatory tone and leptin to adiponectin ratio in pericoronary fat may improve prognosis in prediabetic patients with AMI. Trial registration Clinical Trial NCT03360981, Retrospectively Registered 7 January 2018

Abstract 4910: Integrated Approach By Using Coronary Flow Velocity Reserve And Coronary Flow Velocity Patterns In Predicting Long-term Adverse Cardiac Events In Acute Myocardial Infarction

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Myeong Ho Yoon ◽  
Seung-Jea Tahk ◽  
Hong-Seok Lim ◽  
Jin-Sun Park ◽  
Hyeong-Mo Yang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Flow Velocity ◽  
Coronary Flow ◽  
Integrated Approach ◽  
Left Ventricular ◽  
Cardiac Events ◽  
Coronary Flow Velocity ◽  
Adverse Cardiac Events

Background: The microvascular function was known to be an useful predictor of left ventricular functional changes and clinical outcomes in ST-segment elevation myocardial infarction (STEMI). We evaluated the usefulness of integrated approach by using coronary flow velocity reserve (CFR) and diastolic deceleration time (DDT) in the prediction of long-term major adverse cardiac events in STEMI. Methods and Results: Using an intracoronary Doppler wire, CFR, DDT and hyperemic microvascular resistance index (MVRI) were evaluated in 202 patients with first STEMI received reperfusion therapy within 24 hours after onset of symptoms. Major adverse cardiac events were the composite of cardiac death, recurrent myocardial infarction, congestive heart failure and stroke during an average follow-up period of 60 ± 39 months. Follow-up echocardiography was performed at 12 ± 9 months. CFR, DDT and MVRI had significant correlations with left ventricular regional wall motion score index at follow-up echocardiography (r =−0.441, p<0.001; r = 0.413, p<0.001; r =−0.485, p<0.001, respectively). Using receiver-operating characteristics analysis, CFR ≤1.3 (sensitivity: 51%, specificity: 78%), DDT ≤577 ms (sensitivity: 72%, specificity: 62%) and MVRI >2.7 (sensitivity: 68%, specificity: 67%) were the best cutoff values in the prediction of occurring the adverse cardiac events. In patients with CFR ≤1.3, DDT ≤577 ms, cardiac events were occurred in 18 patients (40.0 %) of 45 patients, whereas cardiac events were occurred in 12 patients (20.3%) of 59 patients with CFR >1.3 and DDT ≤577 ms or CFR ≤1.3 and DDT >577 ms (p= 0.048), 9 patients (9.1%) of 99 patients with CFR>1.3 and DDT >577 ms (p<0.001). Ejection fraction at admission (p=0.009), MVRI (p =0.002) and DDT (p=0.023) were independent predictors in the prediction of long-term adverse cardiac outcomes during follow-up. Conclusions: Integrated approach by using CFR and DDT was useful in the prediction of long-term adverse cardiac events. MVRI and DDT were strong independent predictors of long-term adverse cardiac events in STEMI patients.

scholarly journals Incidence of postoperative, major, adverse cardiac events in patients undergoing carotid endarterectomy: A single-center, retrospective study

2022 ◽  
Vol 10 ◽  
pp. 205031212110703
Author(s):  
Aphichat Suphathamwit ◽  
Chutima Leewatchararoongjaroen ◽  
Pongprueth Rujirachun ◽  
Kittipatr Poopong ◽  
Apichaya Leesakul ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Congestive Heart Failure ◽  
Retrospective Study ◽  
Confidence Interval ◽  
Carotid Endarterectomy ◽  
Major Adverse Cardiac Events ◽  
Single Center ◽  
Cardiac Events ◽  
Adverse Cardiac Events

Objective: This study aimed to determine the incidence of postoperative major adverse cardiac events for patients undergoing carotid endarterectomy. Methods: This single-center, retrospective study recruited 171 carotid endarterectomy patients between January 1999 and June 2018. Patients who received a carotid endarterectomy in conjunction with other surgery were excluded. The primary outcomes were the incidences of major adverse cardiac events (comprising myocardial infarction, significant arrhythmias, congestive heart failure, and cardiac death) within 7 days, 7–30 days, and > 30 days–1 year, postoperatively. The secondary outcomes were the factors related to major adverse cardiac events and the incidence of postoperative stroke. The patients’ charts were reviewed, and direct contact was made with them to obtain information on their status post discharge. Results: The incidences of major adverse cardiac events within 7 days, 7–30 days, and >30 days–1 year of the carotid endarterectomy were 3.5% of patients (95% confidence interval: 0.008–0.063), 1.2% (95% confidence interval: 0.004–0.028), and 1.8% (95% confidence interval: 0.002–0.037), respectively. The major adverse cardiac events occurring within 7 days were arrhythmia (2.3% of patients), cardiac arrest (1.8%), myocardial infarction (1.2%), and congestive heart failure (1.2%), while the corresponding postoperative stroke rate was 4.7%. Conclusion: The 7-day incidence of major adverse cardiac events after the carotid endarterectomy was 3.5%. The most common major adverse cardiac event during that period was cardiac arrhythmia.

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