scholarly journals Impact of SYNTAX Score on In-hospital Outcome after Primary Percutaneous Coronary Intervention

2018 ◽  
Vol 33 (2) ◽  
pp. 121-125
Author(s):  
Md Shariful Islam ◽  
Md Afzalur Rahman ◽  
Abdul Wadud Chowdhury ◽  
Sayed Nasir Uddin ◽  
Nupur Kar ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Syntax Score ◽  
Primary Pci ◽  
Culprit Lesion ◽  
Acute Stemi ◽  
Hospital Outcome ◽  
Group I ◽  
Percutaneous Coronary ◽  
Group Ii

Background: Limited contemporary data exist regarding the impact of SYNTAX score on in-hospital outcomes undergoing primary percutaneous coronary intervention(PCI) in acute STEMI patients. Objectives: To evaluate the significance of the SYNTAX score for predicting in- hospital outcome after primary PCI in patient with acute STEMI. Methods: This cohort study was conducted in the department of cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh from September, 2015 to September, 2016. 42 patients with acute STEMI who underwent primary PCI were considered for the study. But 2 patients were excluded from the study due to failure of primary PCI. The patients were divided into two groups: Group I (low SYNTAX score d”22) and Group II (high Syntax score > 22). The Syntax score of all patients were calculated from an initial coronary angiogram before primary PCI. In-hospital outcome was observed in between two groups. Results: Among traditional cardiovascular risk factors diabetes was significantly more prevalent in the Group II than Group I ( 82.4% vs 34.8%, p  0.003). Angiographic profile revealed maximum (69.6% vs 17.6%) culprit lesion in LAD artery in Group I and maximum culprit lesion (64.7% vs 21.7%) in RCA in Group II, these were the statistically significant between Group I and Group II (P<0.05). The high SYNTAX score group had lower TIMI 3 (76.47% vs 91.3%, p  0.03) compared to the low SYNTAX score group. But there were no significant difference in complications as arrhythmia (2.5% vs 0%), cardiogenic shock (2.5% vs 0%), heart failure (5% vs 2.5%) and mortality (5%vs 0%) between high and low SYNTAX score. Multivariate logistic regression analysis revealed SYNTAX score (OR = 5.95, p  0.001) was an independent predictor of in-hospital outcome in patients under going primary PCI. Performance test of SYNTEX score in the setting of Primary PCI outcome showed positive predictive value 83%. Conclusions: SYNTAX score was an independent variable that can predict in-hospital outcomes of patients with acute STEMI undergoing primary PCI. Bangladesh Heart Journal 2018; 33(2) : 121-125

scholarly journals SYNTAX Score on Procedural Outcome among Patient Undergoing Primary Percutaneous Coronary Intervention

2019 ◽  
Vol 34 (1) ◽  
pp. 5-10
Author(s):  
Md Shariful Islam ◽  
Md Afzalur Rahman ◽  
Abdul Wadud Chowdhury ◽  
Mohsin Ahmed ◽  
Kajal Kumar Karmakar ◽  
...  
Keyword(s):  
Coronary Intervention ◽  
Syntax Score ◽  
Primary Pci ◽  
Culprit Lesion ◽  
Acute Stemi ◽  
Group I ◽  
Percutaneous Coronary ◽  
Group Ii ◽  
Procedural Outcomes ◽  
Procedural Outcome

Background: Limited contemporary data exist regarding the impact of SYNTAX score on procedural outcomes undergoing primary percutaneous coronary intervention(PCI) in acute STEMI patients. Objectives: To evaluate the significance of the SYNTAX score for predicting procedural outcome after primary PCI in patient with acute STEMI. Methods: This perspective observational study was conducted in the department of cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh from September, 2015 to September, 2016. 42 patients with acute STEMI who underwent primary PCI were considered for the study. But 2 patients were excluded from the study due to failure of primary PCI. The patients were divided into two groups: Group I (low Syntax score d”22) and Group II (high Syntax score > 22). The Syntax score of all patients were calculated from an initial coronary angiogram before primary PCI. Procedural outcome was observed in between two groups. Results: Among study patients 57.5% were in SYNTAX score d”22 (Group I) and 42.5% were in SYNTAX score >22 (Group II). Among traditional cardiovascular risk factors diabetes was significantly more prevalent in the Group II than Group I ( 82.4% vs 34.8%, p  0.003). Angiographic profile revealed maximum (69.6% vs 17.6%) culprit lesion in LAD artery in Group I and maximum culprit lesion (64.7% vs 21.7%) in RCA in Group II, these were the statistically significant between Group I and Group II (P<0.05). The high SYNTAX score group had lower ejection fraction (47.8±5.1 vs. 54.4±4.3, p= 0.04), lower TIMI flow 3 rate (76.47% vs 91.3%, p= 0.03 ) greater rate of MACE (29.4% vs. 4.3%, p=0.041), lower procedural success rate ( 76.47 vs. 91.3%, p= 0.046) compared to the low SYNTAX score group. ROC curve showed 77% sensitivity and 32% specificity for SYNTAX score when cut off value was 22 Performance test of SYNTEX score in the setting of Primary PCI outcome showed positive predictive value 83%. Conclusions: SYNTAX score was an independent variable that can predict procedural outcomes Bangladesh Heart Journal 2019; 34(1) : 5-10

scholarly journals In-hospital Outcome of Use of Low Molecular Weight Heparin in Patients Undergoing Percutaneous Coronary Intervention

2018 ◽  
Vol 33 (1) ◽  
pp. 22-27
Author(s):  
Tariq Ahmed Chowdhury ◽  
Mustafizul Aziz ◽  
Iftekhar Alam ◽  
Abuduz Zaher ◽  
Sayed Azizul Haque ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Percutaneous Coronary Intervention ◽  
Low Molecular Weight Heparin ◽  
Coronary Intervention ◽  
Low Molecular Weight ◽  
Hospital Outcome ◽  
Group I ◽  
Percutaneous Coronary ◽  
Myocardial Infraction ◽  
Group Ii

This prospective observational study was carried out in the Department of Cardiology of national institute of cardiovascular diseases (NICVD), Dhaka to assess the safety of low molecular weight heparin (LMWH) in patients undergoing percutaneous coronary intervention (PCI). Safety of low molecular weight heparin in comparison to unfractionated heparin (UFH) was observed in this study. In total data from 100 patients undergoing elective PCI was evaluated. Among them 50 patients in group I received I mg/kg intra-arterial LMWH and rest in group II received UFH. Demographic profile of individuals in both groups was almost similar. There was no significant difference in major coronary risk factors between the two groups. Patients were monitored during their stay in hospital for any complications like bleeding, haematoma, myocardial infraction and death. No death was observed in any group. Minor bleeding in group I and II (6% vs 105), Major bleeding (2% vs4%) and haematoma (6% vs 10%). Myocardial infraction no incidence in group I and 4% in group II. So complications was more prevalent in group II who were treated with UFH, but those were not statistically significant. The intra-arterial administration of LMWH in patients undergoing PCI is safe. The risk of acute and sub-acute coronary events and bleeding complications are similar in both groups and in hospital outcome there is less complication with LMWH used during PCI.Bangladesh Heart Journal 2018; 33(1) : 22-27

scholarly journals In-Hospital Outcome of Compromised Small Side Branch after Percutaneous Coronary Intervention

2014 ◽  
Vol 7 (1) ◽  
pp. 11-16
Author(s):  
MM Alam ◽  
M Ali ◽  
MSR Patwary ◽  
SMA Romel ◽  
MS Kabir ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Side Branch ◽  
St Elevation Myocardial Infarction ◽  
Hospital Outcome ◽  
Group I ◽  
Percutaneous Coronary ◽  
St Elevation ◽  
Group Ii

Background: Side branch occlusion is a well known complication of percutaneous coronary intervention. Although occlusion of small side branches is well tolerated, occlusion of larger side branches may cause more serious complications. After PCI the incidence of complications in patients with compromised side branches smaller than 2 mm is small. Compromising side branches larger than 2 mm can be accompanied by clinical outcomes as non Q-wave MI. This study was undertaken to assess the in-hospital outcomes of compromised small (<2mm) side branch after percutaneous coronary intervention. Methods: This cross sectional analytical study was carried out in the department of cardiology, National Institute of Cardiovascular Diseases, Dhaka during the period of September 2011 to June 2012. A total of 100 consecutive patients with coronary artery disease who underwent elective PCI were included in the study. Study patients were divided into two groups on the basis of presence of compromised small (< 2 mm) side branch. In Group- I, small (< 2 mm) side branch were compromised after PCI and in Group- II, side branches were patent after PCI, with 50 patients in each group. In-hospital outcome were evaluated in both groups. Result: There were no significant differences of the baseline clinical demographics between two groups. Post PCI angina was higher in group I than group II (10.0% vs. 9.0%). Non ST elevation myocardial infarction and significant arrhythmia was identical in both groups (2.0% vs. 2.0%) but hypotension was more in group II than group I (4.0% vs. 2.0%). The findings were statistically insignificant between the study groups. There was no mortality, emergency CABG within 24 hours, ST elevation myocardial infarction, cardiogenic shock or acute left ventricular failure during their hospital course in either group. Conclusion: The present study concluded that compromised small (<2mm) side branch after percutaneous coronary intervention was not associated with adverse in-hospital outcome. DOI: http://dx.doi.org/10.3329/cardio.v7i1.20795 Cardiovasc. j. 2014; 7(1): 11-16

scholarly journals Association of Pre-procedural High Sensitivity C-Reactive Protein with In-hospital Outcome of Patients Undergoing Percutaneous Coronary Intervention

2017 ◽  
Vol 42 (1) ◽  
pp. 01-07
Author(s):  
Sufia Jannat ◽  
MD Abdul Kader Akanda ◽  
Md Khalequzzaman ◽  
Mohammad Ullah ◽  
Md Monirujjaman ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
High Sensitivity ◽  
Coronary Intervention ◽  
C Reactive Protein ◽  
Hospital Outcome ◽  
Reactive Protein ◽  
Inflammatory Status ◽  
Group I ◽  
Percutaneous Coronary

Emerging evidence links an elevated baseline inflammatory status to adverse outcome among patients undergoing percutaneous coronary intervention (PCI). Baseline inflammation measured by high sensitivity C-reactive protein hsCRP may prove useful for identification of high risk patients requiring adjunctive therapies. This prospective study was carried out in the department of cardiology, National Institute of Cardiovascular Diseases, Dhaka, during October 2012 to September 2013.Two hundred consecutive patients with CSA and UA undergoing PCI were included in the study. Study patients were divided into two groups on the basis of hsCRP levels. In Group I hsCRP levels were elevated, that is ?3 mg/L and in Group II hsCRP levels were normal, that is < 3 mg/L, with 100 patients in each group. Fol-lowing the procedure in-hospital outcome of study patients were observed. Increased inci-dence (44%) of adverse in-hospital outcome was found in Group I (44% Vs. 11%). Higher incidence of post procedural angina (17%), peri-procedural myocardial infarction (6%) and peri-procedural myocardial injury (10%) was observed in this group. Nonsignificant rate of acute myocardial infarction, significant arrhythmia, acute LVF, cardiogenic shock and death were found in elevated hsCRP Group. Overall Major Adverse Cardiac Events (6% Vs. 0%) were found in pre-procedural elevated hsCRP group. High sensitivity C-reactive protein remained independently predictive of adverse in-hospital outcome, with 95% CI of RR 1.4 – 4.4 and p<001. The present study concludes that the hsCRP is an important and independent predictor of adverse in hospital outcome.

scholarly journals Pre-Procedural C-Reactive Protein Level Predicts In-Hospital Outcome in Percutaneous Coronary Intervention

1970 ◽  
Vol 4 (1) ◽  
pp. 32-41 ◽  
Author(s):  
MM Haque ◽  
M Ullah ◽  
MS Alam ◽  
SU Ulabbi ◽  
R Uddin
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Spasm ◽  
Coronary Intervention ◽  
Side Branch ◽  
Major Adverse Cardiovascular Events ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Group I ◽  
Percutaneous Coronary ◽  
Group Ii

Background:To accurately stratify patients undergoing PCI, according to their risk of future adverse events, a quest for risk predictors is ongoing worldwide. But only a few powerful and independent predictors of early and late major adverse cardiovascular events have been found. These include traditional risk factors, such as acute coronary instability, diabetes mellitus, reference vessel diameter, and lesion and/or stent length. This study was undertaken to find out the relationship between pre-procedural CRP level with in-hospital (both procedural and before discharge) complications. Materials & methods: This prospective study was carried out in National Institute of Cardiovascular Diseases (NICVD), Dhaka during the period of June,2006 to May,2007. After fulfilling the exclusion criteria, 100 consecutive patients were selected as sample those underwent percutaneous coronary intervention. C-Reactive protein (CRP) was measured in all patients before the procedure. Those having pre-procedural CRP level <.3 mg/dl was labeled as group-I and those with CRP level e”.3 mg/dl was labeled as group-II. In hospital outcomes were compared between two groups after percutaneous coronary intervention. Results: During the procedure, higher rate of complications (10.0% vs 26.0%) were noted in group- II, which was statistically significant. Among many complications abrupt occlusion, threatened (dissection and new thrombus) and residual stenosis were significantly high in group-II. Other complications like coronary spasm, arrhythmia, side branch occlusion, heart failure, shock and no reflow were also high in higher level of CRP level patients but statistically not significant. Inhospital complications were also significantly high (10.0% vs 28.0%) in patients with higher level of CRP ie. Group-II. Among other complications recurrence of ischemia and myocardial infarction developed at significantly higher rate in group-II. Post procedural CK-MB rose significantly (18.0% vs 36.0%) in patients with higher level of CRP (group-II) in comparison to normal level of CRP patients (group-I). When the in-hospital complications were distributed among three tertiles of CRP, it was observed that complications were proportionately high with increasing level of CRP. Conclusions: Many studies, conducted abroad, have suggested that factors like gender, extreme age, diabetes, multi-vessel disease and lesion characteristics adversely influence PCI outcome. But in this study, multivariate regression analysis has shown that elevated level of CRP is even stronger independent predictor of PCI outcome. Keywords: C-Reactive Protein; In hosital outcome; PCI. DOI: http://dx.doi.org/10.3329/cardio.v4i1.9387 Cardiovasc. J. 2011; 4(1): 32-41

scholarly journals The safety of Ramadan Fasting following Percutaneous Coronary Intervention

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Osama A. Amin ◽  
Ahmed Alaarag
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Major Adverse Cardiac Events ◽  
Cardiac Events ◽  
Ramadan Fasting ◽  
Group I ◽  
Adverse Cardiac Events ◽  
Percutaneous Coronary ◽  
Significant Difference ◽  
Group Ii

Abstract Background This work aimed to assess the safety of Ramadan Fasting following the Percutaneous Coronary Intervention. Methods In our two centers’ Prospective Cohort Study, We included 303 patients who had successful Percutaneous Coronary Intervention before the first day of Ramadan. We advised the patients that recent Percutaneous Coronary Intervention could be a valid excuse for not fulfilling Ramadan Fasting. However, many patients intended to fast the following Ramadan, and we included them in the fasting Group I. We added the patients who decided not to fast the following Ramadan as a control Group II. We followed all the patients during Ramadan and for 6 months after Ramadan. Results The demographic data of both groups and the complexity of the coronary anatomy showed no statistically significant difference. Group I (n = 153) showed a statistically significant difference in the incidence of Major Adverse Cardiac Events compared to Group II with a P value (0.005). The logistic multivariate regression analysis showed that the duration from index PCI till the start of RF, SYNTAX score > 22, and Complex procedure were independent predictors of Major Adverse Cardiac Events in the fasting Group I with {P = 0.001, OR (2.302), P = 0.026, OR (2.419), and P = 0.032 OR (1.952)}, respectively. Major Adverse Cardiac Events in Group I occurred mainly during Ramadan Fasting, with 19 patients having Major Adverse Cardiac Events during Ramadan and four patients during the remaining of the follow-up period. The Receiver Operating Characteristic curve analysis showed the decline of the incidence of Major Adverse Cardiac Events after 90 days from Percutaneous Coronary Intervention till the start of Ramadan Fasting with Sensitivity and specificity (90% and 65%), respectively. Conclusions We suggest that low-risk patients with a normal systolic function who underwent Percutaneous Coronary Intervention may safely fast Ramadan. At the same time, Ramadan Fasting during the first 3 months following the Percutaneous Coronary Intervention may not be safe.

scholarly journals The Safeness of Ramadan Fasting Among Patients Who Have Undergone Primary Percutaneous Coronary Intervention: a Cross-sectional Descriptive Study

2021 ◽  
Author(s):  
Shwan O. Amen ◽  
Banan Q. Rasool ◽  
Alaa Rashid ◽  
Sara S. Shakir ◽  
Parez M. Qadr ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Primary Percutaneous Coronary Intervention ◽  
Recovery Period ◽  
Coronary Intervention ◽  
P Value ◽  
Class Iii ◽  
Ramadan Fasting ◽  
Group I ◽  
Percutaneous Coronary ◽  
Group Ii

Abstract Background: The rise of Primary Percutaneous Coronary Intervention (PPCI) procedure as an option for treating Coronary Artery Diseases demands addressing a variety of concerns in the recovery period and afterward including fasting the Ramadan month in the countries with the prevailing Muslim population. Therefore this study aims to assess the ability and the safety of fasting among patients who underwent PPCI within two specified periods.Method: This study was a prospective observational study with a sample size of 200 consecutive patients that have been divided into two groups based on the duration of their last PCI for an attack of Acute Myocardial Infarction (AMI). The patients were admitted to the Causality Department of the Surgical Specialty Hospital-Cardiac Center, Erbil/Iraq. The studied data have been analyzed using the Statistical Package for Social Science version 25 (SPSS), and a P-value of ≤0.05 was considered statistically significant.Results: The proportion of fasting and non-fasting patients showed a significant association with the duration of their last PCI procedure with a P-value of 0.001 as 14% in Group I (patients with less than 6 weeks duration post-PCI) successfully fasted the month while it was 54% in Group II (Patients with more than 6 weeks duration post PCI). Among our findings, there were significant associations with P-values of 0.001 between post-PCI symptoms and Ramadan fasting. In regards to NYHA classifications assessment, Group I had a higher proportion of patients classified as Class III and Class IV compared to Group II with a significant P-value of 0.001 with proportions of class III classification in Group I of 14.3% among fasting, 17.1% among non-fasting, and 58.3% among those who could not continue their fasting while in Group II, the proportions showed 3.7% among fasting, 6.7% among non-fasting, and 0% among those who could not continue their fasting.Conclusion: We discourage fasting among patients who have undergone Percutaneous Coronary Intervention within the first 6 weeks, as well as patients who have NYHA class III and above as they are highly liable for deterioration and can not continue their fasting.

Impact of coronary plaque characteristics on periprocedural myocardial injury after elective percutaneous coronary intervention -MDCT and CMR analysis-

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Usami ◽  
H Watabe ◽  
M Otani ◽  
S Maruta ◽  
D Hiraya ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Predictive Value ◽  
Myocardial Injury ◽  
Troponin T ◽  
Coronary Intervention ◽  
Coronary Plaque ◽  
Group I ◽  
Percutaneous Coronary ◽  
Group Ii ◽  
Periprocedural Myocardial Injury

Abstract Background Percutaneous coronary intervention (PCI) is often complicated by periprocedural myocardial injury (PMI) manifested by elevated cardiac biomarkers. The occurrence of PMI has been shown to be associated with worse clinical outcome over short- and long-term. Purpose We performed multidetector computed tomography (MDCT) and cardiac magnetic resonance imaging (CMR) to evaluate the relationship between culprit plaque characteristics and PMI. Methods A total of 90 patients who underwent elective PCI were underwent CMR and multidetector coronary tomography before PCI. The high intensity plaque (HIP) on CMR was defined as a coronary plaque to myocardium signal intensity ratio (PMR) of &gt;1.4. The plaque characteristics and the presence of napkin-ring sign (NRS) were analyzed on MDCT. PMI was defined as an increase in cardiac Troponin T levels to more than 5 times the upper limit of normal at 24 h after PCI. Patients were divided into 2 groups according to the presence (Group I, n=26) or absence (Group II, n=64) of PMI. Results Spotty calcification, positive remodeling, low attenuation plaque and NRS on MDCT were significantly more observed in Group I than in Group II. HIP on CMR was significantly more observed in Group I than in Group II. In the multivariable logistic regression analysis, the presence of NRS and HIP were significantly independent predictors of PMI (odds ratio (OR) 4.82, 95% confidence interval 1.13–20.60, P=0.034 and OR 3.66, 95% CI 1.09–12.30, P=0.036, respectively). Moreover, for prediction of PMI, NRS and HIP showed a high positive predictive value of 81%, and their absence showed a high negative predictive value of 91%. Conclusions MDCT and CMR may play an important role in detecting which lesions are high risks for myocardial necrosis after PCI in elective coronary stenting. Funding Acknowledgement Type of funding source: None

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