scholarly journals Retrospective Study of Clinical and Epidemiological Parameters of Patients Undergoing Percutaneous Coronary Intervention with Their Follow-Up

2019 ◽  
Vol 7 (21) ◽  
pp. 3603-3607
Author(s):  
Rohan P. Parikh ◽  
Sunil Washimkar ◽  
Pradeep Deshmukh ◽  
Mukund Deshpande ◽  
Amey Beedkar ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Antiplatelet Therapy ◽  
Stent Thrombosis ◽  
Real World ◽  
Dual Antiplatelet Therapy ◽  
Coronary Intervention ◽  
Real World Data ◽  
Percutaneous Coronary ◽  
Epidemiological Parameters

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.

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
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Stent Thrombosis ◽  
Real World ◽  
Second Generation ◽  
Coronary Intervention ◽  
Real World Data ◽  
World Data ◽  
Percutaneous Coronary ◽  
Epidemiological Parameters

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.

Abstract 15223: Comparison of Net Clinical Benefit Between Clopidogrel-based and Ticagrelor-based Dual Antiplatelet Therapy in Acute Coronary Syndrome Patients Undergoing Percutaneous Coronary Intervention in China

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
yundai chen ◽  
Daowen Wang ◽  
Dandan Li ◽  
Yang Sun ◽  
Xiaoran Ye ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Antiplatelet Therapy ◽  
Real World ◽  
Lower Risk ◽  
Dual Antiplatelet Therapy ◽  
Coronary Intervention ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
The Difference

Introduction: Dual antiplatelet therapy (DAPT) increases the bleeding risk, which might outweigh the benefits of reduction in ischemic events in acute coronary syndrome (ACS) patients after percutaneous coronary intervention (PCI). This study aimed to evaluate the difference in net clinical benefits of clopidogrel-based DAPT compared with ticagrelor-based DAPT in ACS patients undergoing PCI in a real-world setting in China. Method: This study was conducted on three pre-existing PCI patient databases, two were from nation-wide studies with similar prospective designs and time-span: the BRIC-ACS(I) study and the COSTIC study, and other was from a tertiary hospital-maintained PCI patient database. The primary endpoint was net adverse clinical and cerebral event (NACCE), which was a composite of all-cause death, non-fatal myocardial infarction (MI), non-fatal stroke and BARC ≥ 2 (excluding BARC 4) bleeding within 12 months after discharge. The efficacy outcome, major adverse cardiovascular events (MACE), was defined as a composite of all-cause death, non-fatal MI, and non-fatal stroke. The safety outcome was defined as BARC ≥ 2 (excluding BARC 4) bleeding. Kaplan-Meier survival curves, and Cox regression were applied to analyze the difference between the two groups after propensity score matching (PSM). Results: A total of 7,236 adult ACS patients who underwent PCI in the period of Jan 2014 to Oct 2017 were analyzed. Of them, 4,330 patients were included in post-PSM analyses. Patients prescribed clopidogrel and aspirin had a significant lower risk of NACCE within 12 months after discharge relative to those prescribed ticagrelor and aspirin [5.4% vs. 8.3%, hazard ratio (HR) = 0.63, 95% CI: 0.50 - 0.80]. While the two groups did not vary significantly in the risk of MACE (2.9% vs. 3.1%, HR = 0.91, 95% CI: 0.64 - 1.28), clopidogrel-based DAPT was associated with a significant lower risk of BARC ≥ 2 (excluding BARC 4) bleeding (2.9% vs. 5.5%, HR = 0.50, 95% CI: 0.37 - 0.68) compared to ticagrelor-based DAPT. Conclusion: In this real-world study, post-PCI ACS patients prescribed clopidogrel-based DAPT were associated with a reduction in NACCE and bleeding events without significant difference in MACE, compared to patients treated with ticagrelor-based DAPT.

scholarly journals Efficiency and safety of various dual antiplatelet therapy strategies in patients undergoing percutaneous coronary intervention due to myocardial infarction

2021 ◽  
Vol 26 (7) ◽  
pp. 4525
Author(s):  
S. B. Aksentiev ◽  
A. V. Solovieva ◽  
D. S. Yunevich
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Antiplatelet Therapy ◽  
Dual Antiplatelet Therapy ◽  
Coronary Intervention ◽  
Efficacy And Safety ◽  
Reperfusion Arrhythmias ◽  
Percutaneous Coronary ◽  
Secondary Endpoints

Aim. To compare the efficacy and safety of prasugrel, ticagrelor, or clopidogrel as part of dual antiplatelet therapy (DAPT) in patients undergoing percutaneous coronary intervention (PCI) due to myocardial infarction (MI).Material and methods. The observational study included 74 patients who underwent PCI due to MI within the first 24 hours after the onset. The patients were devided into 3 groups: group 1 — patients who received ticagrelor as part of DAPT; group 2 — clopidogrel, group 3 — prasugrel. The follow-up period was 28 days. To assess the efficacy and safety of therapy, a composite endpoint was assessed (death + nonfatal recurrent MI (and/or stent rethrombosis) + nonfatal ischemic stroke (IS). Additional secondary endpoints were any moderate and severe (major) bleeding according to the GUSTO and/or TIMI scales. We assessed the incidence of reperfusion arrhythmias, an opening of an infarct-related coronary artery (IRCA), and non-ST elevation myocardial infarction (non-STEMI).Results. The analysis showed no significant differences in the cumulative incidence of adverse outcomes in the study groups within 28 days. The prevalence of secondary endpoints over a 28-day follow-up period was 3,1% in the ticagrelor group and 5,9% in the clopidogrel group, while no moderate and life-threatening bleeding was recorded in the prasugrel group during. There were no significant differences in the incidence of reperfusion arrhythmias, opening of an IRCA, and non-STEMI between the groups.Conclusion. The obtained results suggest the comparable efficacy and safety profiles of prasugrel, ticagrelor and clopidogrel as a part of DAPT in patients undergoing PCI due to MI. There were no significant differences in endpoint event rates. In particular, prasugrel has been shown to be as effective and safe as ticagrelor.

Abstract 16929: Propensity-matched Analysis of Triple Oral Antithrombotic Therapy versus Dual Antiplatelet Therapy Following Percutaneous Coronary Intervention

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Daniel B Spoon ◽  
Ryan J Lennon ◽  
Joshua P Slusser ◽  
David R Holmes ◽  
Kent R Bailey ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Antiplatelet Therapy ◽  
Primary Endpoint ◽  
Antithrombotic Therapy ◽  
Dual Antiplatelet Therapy ◽  
Coronary Intervention ◽  
Minor Bleeding ◽  
Bleeding Events ◽  
Percutaneous Coronary

Introduction: Triple oral antithrombotic therapy (TOAT) (aspirin, clopidogrel, and warfarin) is associated with an increased risk of bleeding. Despite this, the optimal management of patients with indications for warfarin following percutaneous coronary intervention (PCI) has not been established. We sought to compare long-term clinical outcomes between patients receiving TOAT with those receiving dual antiplatelet therapy (DAPT) (aspirin and clopidogrel) after PCI. Hypothesis: Patients with clinical indications for warfarin have higher baseline risk which is largely responsible for the observed differences in outcomes between patients receiving TOAT vs. DAPT. Methods: Retrospective analysis of prospectively collected data from 9,009 patients. The primary outcome was a composite of all-cause mortality, ischemic or embolic events (myocardial infarction or stroke), or bleeding. Secondary outcomes were death plus ischemic or embolic events, death plus bleeding, death, MI, stroke, and bleeding. A 2:1 propensity matched analysis was also performed. Results: In 9,009 patients, 812 received TOAT and 8,197 received DAPT. Median follow-up was 61 months. The primary end point occurred in 2,749 patients. At 1 year, 22% of patients treated with TOAT had the primary endpoint versus 11% of DAPT patients (p<0.001). At 1 year, secondary end points of death or ischemic or embolic events (19% vs. 10%, p<0.001), and death or bleeding events (15% vs. 5%, p<0.001) also occurred with a higher frequency with TOAT. After propensity matched analysis the above differences were no longer significant with 1 year primary endpoint rates of 19% vs. 17% respectively (HR 1.95%, CI 0.88, 1.47; p = 0.33). Following propensity matching the only significant difference between TOAT and DAPT groups was minor bleeding (5% vs. 2%; HR 2.65, 95% CI 1.39, 5.03; p=0.003). Conclusions: In a large single center registry with comprehensive follow up, patients treated with TOAT had higher rates of ischemic and bleeding events. However, when baseline risks are accounted for event rates are similar, other than minor bleeding, indicating patient risk characteristics are largely responsible for the observed differences in outcomes.

scholarly journals Benefit and Risk of Prolonged Dual Antiplatelet Therapy After Percutaneous Coronary Intervention With Drug-Eluting Stents in Patients With Elevated Lipoprotein(a) Concentrations

2021 ◽  
Vol 8 ◽  
Author(s):  
Kongyong Cui ◽  
Hao-Yu Wang ◽  
Dong Yin ◽  
Chenggang Zhu ◽  
Weihua Song ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Antiplatelet Therapy ◽  
Stent Thrombosis ◽  
Cardiovascular Events ◽  
Dual Antiplatelet Therapy ◽  
Coronary Intervention ◽  
Cerebrovascular Event ◽  
Lipoprotein A ◽  
Percutaneous Coronary ◽  
All Cause Mortality

Background: Lipoprotein(a) is positively related to cardiovascular events in patients with coronary artery disease (CAD). Given that lipoprotein(a) has a prothrombotic effect, prolonged dual antiplatelet therapy (DAPT) might have a beneficial effect on reducing ischemic events in patients with elevated lipoprotein(a) levels after percutaneous coronary intervention (PCI). We performed this study to assess the efficacy and safety of prolonged DAPT (&gt;1 year) in this population.Methods: We evaluated a total of 3,025 CAD patients with elevated lipoprotein(a) levels who were event-free at 1 year after PCI from the prospective Fuwai PCI Registry, of which 913 received DAPT ≤ 1 year and 2,112 received DAPT&gt;1 year. The primary endpoint was major adverse cardiovascular and cerebrovascular event (MACCE), defined as a composite of all-cause death, myocardial infarction or stroke.Results: After a median follow-up of 2.4 years, patients who received DAPT&gt;1 year were associated with lower risks of MACCE compared with DAPT ≤ 1 year (1.6 vs. 3.8%; hazard ratio [HR] 0.383, 95% confidence interval [CI] 0.238–0.616), which was primarily driven by the lower all-cause mortality (0.2 vs. 2.3%; HR 0.078, 95% CI 0.027–0.227). In addition, DAPT&gt;1 year was also associated with lower risks of cardiac death, and definite/probable stent thrombosis than those who received DAPT ≤ 1 year (P &lt; 0.05). Conversely, no difference was found between the two groups in terms of clinically relevant bleeding. Similar results were observed in multivariate Cox regression analysis and inverse probability of treatment weighting analysis.Conclusions: In patients with elevated lipoprotein(a) concentrations after PCI, prolonged DAPT (&gt;1 year) reduced ischemic cardiovascular events, including MACCE, all-cause mortality, cardiac mortality, and definite/probable stent thrombosis, without increase in clinically relevant bleeding risk compared with ≤ 1-year DAPT. Lipoprotein(a) levels might be a new important consideration when deciding the duration of DAPT after PCI.

Sign in / Sign up

Export Citation Format

Share Document