scholarly journals Colchicine for the Prevention of Myocardial Injury Following Elective PCI: A Randomized Clinical Trial

2021 ◽  
Author(s):  
Naser Aslanabadi ◽  
Sajad Khiali ◽  
Saeid Joudi ◽  
Milad Mamdouhi ◽  
Taher Entezari-Maleki
Keyword(s):  
Clinical Trial ◽  
Myocardial Injury ◽  
Randomized Clinical Trials ◽  
Troponin I ◽  
Intervention Group ◽  
Myocardial Damage ◽  
Coronary Intervention ◽  
Elective Percutaneous Coronary Intervention ◽  
Mean Differences ◽  
The Impact

Purpose: Considering the potential benefits of colchicine in coronary artery diseases, we aimed to carry out the present study to assess the impact of colchicine in the prevention of myocardial injury following elective percutaneous coronary intervention (PCI). Methods: A randomized, single-blinded, clinical trial was carried out on 102 patients undergoing elective PCI. All patients received the standard treatment prior to performing PCI. Moreover, the intervention group received 1, 0.5, 0.5 mg colchicine 12 to 18 hours before, 30-60 min before, and 12 hours after PCI, respectively. Serum concentrations of cardiac troponin I (cTnI) were measured before, 8, and 24 hours after the procedure to assess myocardial damage during PCI. Results: There were no significant differences in cTnI levels at baseline (P = 0.839), 8 (P = 0.729), and 24 hours (P = 0.398) after PCI between the intervention and the control groups. Likewise, no significant differences were seen regarding the mean differences of cTnI at baseline and 8 hours (P =0.190), at baseline and 24 hours (P = 0.780), and 8 and 24 hours after PCI (P = 0.680) in both groups. Conclusion: The study did not support the potential benefit of colchicine in the prevention of myocardial injury following elective PCI. Conducting well-designed randomized clinical trials with adequate sample size is recommended.

scholarly journals Effect of Showing Angiograms to Patients After Elective Percutaneous Coronary Intervention on Anxiety and Illness Perception: A Randomized, Blinded, Controlled Clinical Trial

2019 ◽  
Vol 8 ◽  
Author(s):  
Babak Geraiely ◽  
Roya Sattarzadeh Badkoubeh ◽  
Maryam Jalalsafari ◽  
Nazila Shahmansouri ◽  
Anahita Tavousi ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Percutaneous Coronary Intervention ◽  
Illness Perception ◽  
Intervention Group ◽  
Coronary Intervention ◽  
Anxiety Score ◽  
Control Group ◽  
Elective Percutaneous Coronary Intervention ◽  
Percutaneous Coronary ◽  
Before And After

Background: As an invasive modality, a coronary angioplasty may cause a great deal of anxiety in patients and affect their mental health and general well-being. Accordingly, we sought to assess whether showing patients the video of their elective percutaneous coronary intervention (angiogram) could affect their illness perception and anxiety level. Materials and Methods: In this randomized clinical trial, the patients undergoing angioplasty, were randomly divided into two groups of 30 patients. Angiograms were shown only to the intervention group postprocedurally. A checklist comprising demographic data and clinical presentations as well as the Beck anxiety questionnaire and the Brief Illness Perception Questionnaire (BIPQ) was completed for each patient immediately after the intervention and one month later. The differences in the patients’ anxiety level and illness perception were analyzed. Results: In the intervention group, the mean anxiety score before and after watching the angiograms was 34.26 ± 8.1 and 24.4 ± 8.56, respectively. While in the control group, the score before and after angioplasty was 34.46 ± 9.34 and 26.6 ± 9.44, respectively. Thus, watching angiograms led to a significant decrease in the anxiety score in the intervention group, whereas there was no such difference in the control group. There was also a considerable difference in the anxiety score between the two groups. Further, there was a significant decrease in the BIPQ score of the intervention group after watching the angioplasty videos. Conclusion: Educating cardiovascular patients about diagnostic and therapeutic procedures may confer such good outcomes as alleviated anxiety, enhanced satisfaction, and ultimately, fewer anxiety-related complications. [GMJ.2019;8:e1556]

scholarly journals Remote ischaemic conditioning for myocardial infarction or elective PCI: systematic review and meta-analyses of randomised trials

2018 ◽  
Vol 9 (1_suppl) ◽  
pp. 82-92 ◽  
Author(s):  
Paul M Haller ◽  
Kris G Vargas ◽  
Maria C Haller ◽  
Edita Piackova ◽  
Johann Wojta ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Myocardial Injury ◽  
Myocardial Damage ◽  
Coronary Intervention ◽  
Mean Difference ◽  
Elective Percutaneous Coronary Intervention ◽  
Percutaneous Coronary ◽  
Remote Ischaemic Conditioning ◽  
Ischaemic Conditioning

Background: The efficacy of remote ischaemic conditioning in clinical trials of ST-segment elevation myocardial infarction (STEMI) or elective percutaneous coronary intervention is controversial. We aimed to systematically review and meta-analyse whether remote ischaemic conditioning reduces myocardial damage in those patients. Methods: We searched PubMed, Embase and Web of Science from inception until December 2017 for randomised clinical trials evaluating remote ischaemic conditioning versus a control group. Two independent reviewers extracted data of 23 trials (2118 patients with STEMI; 2048 patients undergoing elective percutaneous coronary intervention) which were meta-analysed using random-effects models. Results: Remote ischaemic conditioning reduced infarct size in STEMI patients when assessed by imaging (mean difference of infarct size as percentage of left ventricle −2.43, 95% confidence interval (CI) –4.37 to −0.48; P=0.01; I2=44%; n=925) or biomarkers related to myocardial injury (peak values of cardiac biomarker release reported as standardised mean difference −0.19, 95% CI −0.37 to −0.02; P=0.03; I2=58%; n=1483) and increased myocardial salvage index (mean difference 0.07, 95% CI 0.01 to 0.13; P=0.02; I2=49%; n= 636). Left ventricular ejection fraction was increased when assessed during the first days after STEMI (mean difference 1.53, 95% CI 0.23 to 2.83; P=0.02; I2=28%; n=1192). Remote ischaemic conditioning had no influence on biomarker values after elective percutaneous coronary intervention (standardised mean difference 0.06, 95% CI −0.17 to 0.30; P=0.59). Conclusions: Despite a statistically significant reduction of myocardial damage in STEMI patients, the magnitude of the reduction was small and a significant impact on clinical events is unlikely. With respect to elective percutaneous coronary intervention, remote ischaemic conditioning had no influence on myocardial injury and its use is not supported by our analysis.

scholarly journals Effectiveness of Ranolazine to Prevent Myocardial Injury During Elective Percutaneous Coronary Intervention

2019 ◽  
Vol 10 (1) ◽  
pp. 43-49
Author(s):  
SM Mamun Iqbal ◽  
Syed Ali Ahsan ◽  
Kasekh Akhtar Jahan ◽  
Sohely Nazneen Eva
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Myocardial Injury ◽  
Troponin I ◽  
Chronic Stable Angina ◽  
Coronary Intervention ◽  
Control Group ◽  
Interventional Study ◽  
Elective Percutaneous Coronary Intervention ◽  
Percutaneous Coronary ◽  
Periprocedural Myocardial Injury

Background: Ranolazine is a novel antianginal drug that reduces intracellular accumulation of calcium ion in ischemic myocardium. A pilot randomized study (n=70) has shown that pretreatment with ranolazine 1000mg twice daily for 7days significantly reduced periprocedural myocardial injury (PMI) in elective Percutaneous coronary intervention (PCI). Our objective was to detect whether similar effect could be obtained by ranolazine pretreatment through an interventional study. Materials & Methods: 110 patients with chronic stable angina scheduled for elective PCI were enrolled in an interventional study. For 7 days before the procedure, 55 patients were allocated to receive ranolazine 1000 mg twice daily (ranolazine group) and 55 patients didn't receive ranolazine (control group). Serum creatinine kinase-MB (CK-MB) and Troponin I levels were measured at baseline and 24 hours post procedure. Results: Periprocedural myocardial injury [i.e. an elevation of serum biomarkers (preferably cardiac troponins) above the 99th percentile of upper reference limit (URL)] was detected less commonly after PCI in ranolazine than in control group (11% vs. 27%, p=0.0001). Also, PCI-related myocardial infarction [i.e., post procedural increase in CK-MB>3 times above the URL] tended to be lower in the ranolazine versus placebo group: 1.8% versus 5.45%, P=0.0002. 24 hours post procedural levels of cardiac markers were also significantly lower in the ranolazine versus control group (CK-MB: 2.42±2.05 versus 7.02±9 ng/ml, P=0.001; Troponin 1: 0.447±0.74 versus 1.18±1.6 ng/ml, P=0.004). No significant adverse effect of the drug was reported. Conclusion: So, we have concluded that ranolazine was effective in significantly reducing the periprocedural myocardial injury in elective PCI. Anwer Khan Modern Medical College Journal Vol. 10, No. 1: Jan 2019, P 43-49

scholarly journals Cardiac procedural myocardial injury, infarction, and mortality in patients undergoing elective percutaneous coronary intervention: a pooled analysis of patient-level data

2020 ◽  
Author(s):  
Johanne Silvain ◽  
Michel Zeitouni ◽  
Valeria Paradies ◽  
Huili L Zheng ◽  
Gjin Ndrepepa ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Myocardial Injury ◽  
High Sensitivity ◽  
Fold Increase ◽  
Coronary Intervention ◽  
Reference Limit ◽  
Coronary Syndrome ◽  
Elective Percutaneous Coronary Intervention ◽  
Percutaneous Coronary ◽  
The Impact

Abstract Aims The prognostic importance of cardiac procedural myocardial injury and myocardial infarction (MI) in chronic coronary syndrome (CCS) patients undergoing elective percutaneous coronary intervention (PCI) is still debated. Methods and results We analysed individual data of 9081 patients undergoing elective PCI with normal pre-PCI baseline cardiac troponin (cTn) levels. Multivariate models evaluated the association between post-PCI elevations in cTn and 1-year mortality, while an interval analysis evaluated the impact of the size of the myocardial injury on mortality. Our analysis was performed in the overall population and also according to the type of cTn used [52.0% had high-sensitivity cTn (hs-cTn)]. Procedural myocardial injury, as defined by the Fourth Universal Definition of MI (UDMI) [post-PCI cTn elevation ≥1 × 99th percentile upper reference limit (URL)], occurred in 52.8% of patients and was not associated with 1-year mortality [adj odds ratio (OR), 1.35, 95% confidence interval (CI) (0.84–1.77), P = 0.21]. The association between post-PCI cTn elevation and 1-year mortality was significant starting ≥3 × 99th percentile URL. Major myocardial injury defined by post-PCI ≥5 × 99th percentile URL occurred in 18.2% of patients and was associated with a two-fold increase in the adjusted odds of 1-year mortality [2.29, 95% CI (1.32–3.97), P = 0.004]. In the subset of patients for whom periprocedural evidence of ischaemia was collected (n = 2316), Type 4a MI defined by the Fourth UDMI occurred in 12.7% of patients and was strongly associated with 1-year mortality [adj OR 3.21, 95% CI (1.42–7.27), P = 0.005]. We also present our results according to the type of troponin used (hs-cTn or conventional troponin). Conclusion Our analysis has demonstrated that in CCS patients with normal baseline cTn levels, the post-PCI cTn elevation of ≥5 × 99th percentile URL used to define Type 4a MI is associated with 1-year mortality and could be used to detect ‘major’ procedural myocardial injury in the absence of procedural complications or evidence of new myocardial ischaemia.

scholarly journals Effect of allopurinol in the prevention of contrast-induced nephropathy in patients undergoing angioplasty: randomized clinical trial

2019 ◽  
Vol 7 (4) ◽  
pp. 118-121
Author(s):  
Haleh Bodagh ◽  
Zahra Esfahani ◽  
Naser Aslanabadi ◽  
Bita Amiri ◽  
Ali Heidari Sarvestani
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Ischemia Reperfusion ◽  
Intervention Group ◽  
Coronary Intervention ◽  
Control Group ◽  
Contrast Induced Nephropathy ◽  
Elective Percutaneous Coronary Intervention ◽  
Percutaneous Coronary ◽  
And Control

Introduction : Allopurinol could decrease the undesirable effects of free radicals and then prevent contrast induced nephropathy (CIN). Therefore, it may be useful for reducing the ischemia-reperfusion induced nephropathy and inhibiting nitric oxide synthesis produced in CIN. This study was performed aimeing to determine the effect of allopurinol in the prevention of CIN in patients undergoing angioplasty. Methods: In this randomized clinical trial, 100 patients (50 cases as the intervention group receiving allopurinol 300 mg one day and one hour before angiography and 50 cases as the control group) were evaluated. CIN was considered if the serum creatinine (SCr) value was increased 25% in relation to its basic value. Additionally, the prevalence of CIN was evaluated. Results: The case and control groups had CIN 38% and 12%, respectively (P = 0.003). Hyperuricemia was significant indicator of higher CIN rate in the control group (37.5% versus 7.1%) (P = 0.044). Conclusion: Finally, the administration of allopurinol before procedure might prevent CIN following elective percutaneous coronary intervention (PCI) and decrease the rate of CIN.

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