RETROSPECTIVE STUDY OF CLINICAL & EPIDEMIOLOGICAL PARAMETERS OF PATIENTS UNDERGOING PERCUTANEOUS CORONARY INTERVENTION WITH THEIR FOLLOW-UP

2021 ◽  
pp. 38-40
Author(s):  
Sunil Washimkar ◽  
Rohan Parikh ◽  
Atul Singh Rajput ◽  
Pradeep Deshmukh

Aim:To study clinical and epidemiological parameters of patients undergoing percutaneous coronary intervention (PCI) and to follow them up for understanding outcomes of procedure. Materials & methods:This is retrospective data analysis of 862 patients who underwent PCI from January 2016 to November 2017 Results: Out of 862 patients, 611 (70.88%) were male & 251 (29.12%) were female, with mean age being 55. 243 (28.19%) were diabetic, 470 (54.52%) were hypertensive, 158 (18.32%) patients were tobacco chewer, 215 (24.92%) were smokers & 111 (12.87%) were alcoholic. 636 (73.78%) patients had STEMI, 153 (17.74%) had NSTE-ACS, 61 (7.07%) had CSA.578 (67.05%) were SVD, 262 (30.39%) were DVD & 19 (2.20%) were TVD. Out of SVD, 350 (60.55%) patients had LAD involvement and among DVD patients, LAD & RCA were most commonly involved in 107 (40.83%) patients. On follow-up of mean 604.42 days (minimum 236 days, maximum 909 days), 2 (0.23%) episodes of subacute stent thrombosis occurred & 11 (1.27%) patients had ISR but no mortality was reported. Summary: The study shows affection of young population predominately and gender inequality suggesting primarily male disease. PCI is often sought in ACS and CSAis predominately treated medically. Thrombolysis still remains the rst treatment received by STEMI patients. SVD is the most common angiographic diagnosis with LAD predominately affected vessel. This real world-data on clopidogrel with aspirin as dual antiplatelet therapy and second generation stent shows negligible event of stent thrombosis & ISR. Limitation: Due to non-invasive follow-up, exact amount of stent restenosis can not be calculated. Impact on daily practice: This real world-data on clopidogrel with aspirin as dual anti-platelet therapy and second generation stent shows negligible event of stent thrombosis & ISR. This can help reduce cost burden on society and help better distribution of health budget.

2019 ◽  
Vol 7 (21) ◽  
pp. 3603-3607
Author(s):  
Rohan P. Parikh ◽  
Sunil Washimkar ◽  
Pradeep Deshmukh ◽  
Mukund Deshpande ◽  
Amey Beedkar ◽  
...  

AIM: To study clinical and epidemiological parameters of patients undergoing percutaneous coronary intervention (PCI) and to follow them up for understanding the outcomes of the procedure. MATERIAL AND METHODS: This is a retrospective data analysis of 862 patients who underwent PCI from January 2016 to November 2017 RESULTS: Out of 862 patients, 611 (70.88%) were male & 251 (29.12%) were female, with the mean age being 55. 243 (28.19%) were diabetic, 470 (54.52%) were hypertensive, 158 (18.32%) patients were tobacco chewer, 215 (24.92%) were smokers and 111 (12.87%) were alcoholic. 636 (73.78%) patients had STEMI, 153 (17.74%) had NSTE-ACS, 61 (7.07%) had CSA.578 (67.05%) were SVD, 262 (30.39%) were DVD and 19 (2.20%) were TVD. Out of SVD, 350 (60.55%) patients had LAD involvement and among DVD patients, LAD and RCA were most commonly involved in 107 (40.83%) patients. On follow-up of mean 604.42 days (minimum 236 days, maximum 909 days), 2 (0.23%) episodes of subacute stent thrombosis occurred and 11 (1.27%) patients had ISR but no mortality was reported. CONCLUSION: The study shows affection of young population predominately and genders inequality, suggesting primarily male disease. PCI is often sought in ACS and CSA is predominately treated medically. Thrombolysis remains the first treatment received by STEMI patients. SVD is the most common angiographic diagnosis with LAD predominately affected vessel. This real world-data on clopidogrel with aspirin as dual antiplatelet therapy and second-generation stent shows negligible event of stent thrombosis and ISR. LIMITATION: Due to non-invasive follow-up, the exact amount of stent restenosis cannot be calculated. IMPACT ON DAILY PRACTICE: This real world-data on clopidogrel with aspirin as dual antiplatelet therapy and second-generation stent shows negligible event of stent thrombosis and ISR. This can help reduce the cost burden on society and help better distribution of health budget.


Author(s):  
Anitha Rajamanickam ◽  
YuanYuan Zhang ◽  
Abhishek Rao ◽  
Ruth Aguiar ◽  
Elizabeth Bradley ◽  
...  

Background: Secondary prevention with statin therapy in Coronary artery disease (CAD) decreases future major cardiovascular events and mortality and improves outcomes. Current guidelines recommend a LDL goal of at least ≤ 100 and preferably ≤ 70 . Statins have also shown to have beneficial effects independent of LDL levels. We hypothesized that is the real world statin use and LDL goal in CAD patients who need a subsequent percutaneous coronary intervention (PCI) is inadequate in spite of strong recommendations and guidelines Methods: A query of electronic medical records (EMR) in our 1100 bed academic community hospital retrieved 8586 PCIs from 10/1/2006 to 2/14/2012. Of these 1641 patients had definite CAD (defined by either a prior PCI or CABG) and only 1315 had lipid levels drawn within three months prior to PCI and patient (pts) data was retrieved from our PCI database and EMR. Results: Only 573 (44%) patients were on statins on arrival for PCI .However, 1187(90%) patients were prescribed statins on discharge from the cardiac catheterization lab and this was independent of the experience of the interventional cardiologists. Only 26% (346) patients had LDL≤ 70 and only 55% (727 ) patients had LDL ≤ 100. Patients with LDL not at goal were less likely to be on statins or any lipid lowering medications. Patients with renal failure were less likely to be on stains. However there was no significant difference in comorbidities(except hypertension)like alcohol abuse, liver failure, arthritis, obesity or depression in patients whether on or not on therapy with statins. Conclusions: Real world data shows that we fail at adequate usage of statins or getting lipids to target goals. Interestingly around 90% of patients are prescribed statins on discharge from the cardiac catheterization lab. In practice statins are discontinued or higher doses to achieve target LDLs are avoided as they are generally less well tolerated due to side effects (muscle and liver toxicity). In this subset of patients, referral to lipid specialists and specialty centers and advent of newer lipid lowering drugs may prove to be beneficial.


2016 ◽  
Vol 7 (2) ◽  
pp. 85-95 ◽  
Author(s):  
Wojciech Wańha ◽  
Damian Kawecki ◽  
Tomasz Roleder ◽  
Aleksandra Pluta ◽  
Kamil Marcinkiewicz ◽  
...  

Background: The following registry (Katowice-Zabrze retrospective registry) aimed to assess the influence of a chronic kidney disease (CKD) on long-term clinical outcomes in patients undergoing percutaneous coronary intervention (PCI) using either first-generation (DES-I) or second-generation (DES-II) drug-eluting stents. Methods: The study group consisted of 1,908 consecutive patients, of whom 331 (17.3%) had CKD. CKD was defined as an estimated glomerular filtration rate of <60 mL/min/m2. We evaluated the major adverse cardiac and cerebral events (MACCE), i.e., the composite of death, myocardial infarction (MI), stroke, and target vessel revascularization at the 12-month follow-up. Results: CKD patients had a lower left ventricular ejection fraction and more often a history of MI and PCI. Coronary angiography revealed that multivessel coronary artery disease, intracoronary thrombus, and extensive calcifications were more frequent in patients with CKD. However, the SYNTAX score did not vary between patients with or without CKD. There was a higher rate of in-hospital bleedings requiring blood transfusion in patients with CKD. At the 1-year follow-up, MACCE (17.8 vs. 12.6%, HR = 1.46 [95% CI 1.05-2.03], p = 0.009) and death (8.4 vs. 2.3%, HR = 3.9 [95% CI 2.0-7.5], p < 0.001) were more often observed in CKD patients. Multivariable Cox analysis revealed that CKD was an independent risk predictor of death after PCI at the 1-year follow-up (HR = 2.1 [95% CI 1.2-3.6], p = 0.004). In comparison to DES-I, the use of DES-II did not decrease the adverse effect of CKD on MACCE. Conclusion: CKD patients had an increased risk of in-hospital bleeding requiring blood transfusion and a higher risk of MACCE and death at the 12-month follow-up. The use of second-generation DES did not improve clinical outcomes in patients with CKD at the 12-month follow-up.


2015 ◽  
Vol 9 (1) ◽  
pp. 127-132 ◽  
Author(s):  
Khalid Bin Thani ◽  
Fajer Al-Moosa ◽  
Eman Murad ◽  
Aisha Al-Moosa ◽  
Mohamed E. Alalawi ◽  
...  

Main Problem:To determine the incidence of coronary stent thrombosis (ST) in patients with acute ST segment elevation myocardial infarction (STEMI) after rescue percutaneous coronary intervention (PCI). Methods:An observational study looking at the incidence of ST in a middle-eastern population. A total of 510 consecutive patients presented with ST-segment elevation myocardial infarction (STEMI) were enrolled and underwent thrombolytic therapy with a total follow-up period of 2 years. Study outcomes were ST, death, re-infarction or acute coronary syndrome requiring coronary angiography and PCI. Results:A total of 510 patients enrolled, all diagnosed with STEMI and underwent thrombolytic therapy. Only 100 subjects underwent rescue PCI with intra-coronary stenting, including 54 patients with drug-eluting stent (DES) and 46 patients with bare metal stent (BMS). During the study period and follow-up, the overall rate of ST was 13.7%, definite ST occurred in 6 patients (5.5%), probable ST in 8 patients (7.3%), and possible ST in one patient (0.9%), including 0.9% acute ST, 0.9% sub-acute ST, 2.8% late ST and 8.3% very late ST. Patients with ST were likely to have prior PCI (p=0.001), prior coronary artery bypass grafting (CABG) (p=0.002) and history of heart failure (p=0.04). Conclusion:ST is infrequent event with major consequences in patients presenting with STEMI in the first 2 years after stent implantation.


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