scholarly journals The PR Interval Predicted Major Adverse Cardiovascular Events in Patients with Acute Coronary Syndrome Who Underwent Percutaneous Coronary Intervention: 3 Years Follow-up Results

2021 ◽  
Vol 11 (3) ◽  
pp. 241-248
Author(s):  
Ahmet Seyda Yılmaz ◽  
Göksel Çinier ◽  
Fatih Kahraman ◽  
Mustafa Çetin ◽  
Ömer Faruk Çırakoğlu
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Cardiovascular Events ◽  
Coronary Intervention ◽  
Major Adverse Cardiovascular Events ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
Pr Interval

scholarly journals Effect of Loading Dose of Atorvastatin Prior to Planned Percutaneous Coronary Intervention on Major Adverse Cardiovascular Events in Acute Coronary Syndrome

JAMA ◽  
2018 ◽  
Vol 319 (13) ◽  
pp. 1331 ◽  
Author(s):  
Otavio Berwanger ◽  
Eliana Vieira Santucci ◽  
Pedro Gabriel Melo de Barros e Silva ◽  
Isabella de Andrade Jesuíno ◽  
Lucas Petri Damiani ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Cardiovascular Events ◽  
Coronary Intervention ◽  
Major Adverse Cardiovascular Events ◽  
Loading Dose ◽  
Coronary Syndrome ◽  
Percutaneous Coronary

Abstract 3740: Prognostic Significance of Plasma Osteopontin Levels in Patients Undergoing Percutaneous Coronary Intervention

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Yukihiko Momiyama ◽  
Nobukiyo Tanaka ◽  
Reiko Ohmori ◽  
Ryuichi Kato ◽  
Hiroaki Taniguchi ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Multivariate Analysis ◽  
Cardiovascular Events ◽  
Prognostic Significance ◽  
Coronary Intervention ◽  
Major Adverse Cardiovascular Events ◽  
Neointimal Formation ◽  
Coronary Syndrome ◽  
Percutaneous Coronary

Osteopontin (OPN) mRNA was shown to be highly expressed in atherosclerotic plaques. We reported plasma OPN levels to be high in patients (pts) with coronary artery disease. Moreover, OPN levels were recently shown to be high in acute coronary syndrome. Increased OPN mRNA expression was also shown in rat arteries after balloon injury. OPN transgenic mice showed markedly increased neointimal formation after arterial injury. OPN may play a role in the development of restenosis after percutaneous coronary intervention (PCI). Methods: We investigated the prognostic value of pre-procedural plasma OPN levels by ELISA on restenosis and clinical outcome in 130 pts undergoing PCI, of whom 89 (68%) had bare metal stent. Pts with AMI were excluded. Restenosis was defined as >50% diameter stenosis at follow-up angiography. Pts were followed up for 3 years for major adverse cardiovascular events (MACE) (death, MI, unstable angina, stroke). Results: At 7±3 months after PCI, re-angiography was performed in 91 (70%) pts, of whom 40 had restenosis. Between 40 pts with restenosis and 51 without it, plasma OPN (492±200 vs 482±224 ng/ml) and C-reactive protein (CRP) (median 0.78 vs 0.70 mg/l) levels did not differ. In multivariate analysis, reference diameter and smoking were independent predictors for angiographic restenosis, but OPN or CRP levels were not. During the 3-year follow-up, MACE occurred in 21 pts. Compared with 109 pts without MACE, 21 with it had higher OPN (586±230 vs 438±195 ng/ml, P<0.005) and CRP (1.30 vs 0.70 mg/l, P<0.002) levels. Pts with MACE more often had OPN level >500 ng/ml (62% vs 35%) and CRP >3.0 mg/l (33% vs 12%) than without it (P<0.05). OPN did not correlate with CRP levels. To clarify the association between MACE and OPN, pts were divided into 2 groups by OPN levels. Kaplan Meier analysis showed a lower event-free survival rate in pts with OPN level >500 ng/ml than those without it (P<0.05). In multivariate analysis, both OPN and CRP levels were independent predictors for MACE. Hazard ratios for MACE were 2.9 (95%CI=1.3–5.5) for OPN >500 ng/ml and 4.3 (1.3–14.0) for CRP >3.0 mg/l. Conclusion: Plasma levels of OPN as well as CRP were found to be independent predictors for cardiovascular events in pts undergoing PCI, but they were not predictors for restenosis.

scholarly journals Pooled Analysis of Bleeding, Major Adverse Cardiovascular Events, and All‐Cause Mortality in Clinical Trials of Time‐Constrained Dual‐Antiplatelet Therapy After Percutaneous Coronary Intervention

2020 ◽  
Vol 9 (16) ◽  
Author(s):  
John D. McClure ◽  
Jennifer C. Ramsay ◽  
Colin Berry
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Cardiovascular Events ◽  
Dual Antiplatelet Therapy ◽  
Coronary Intervention ◽  
Major Adverse Cardiovascular Events ◽  
P2y12 Inhibitor ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
All Cause Mortality

Background The net clinical benefit of dual antiplatelet therapy (DAPT) reflects the paradoxical effects of an increased risk of bleeding and a reduced risk of major adverse cardiovascular events. A time‐constrained approach to DAPT has been recently investigated in 5 multicenter trials including GLOBAL LEADERS, STOPDAPT2 (Short and Optimal Duration of Dual Antiplatelet Therapy After Everolimus‐Eluting Cobalt‐Chromium Stent‐2), SMART‐CHOICE, TWILIGHT (Ticagrelor With Aspirin or Alone in High‐Risk Patients After Coronary Intervention), and TICO (Ticagrelor Monotherapy After 3 Months in the Patients Treated With New Generation Sirolimus Stent for Acute Coronary Syndrome). Methods and Results We undertook a pooled analysis of these trials to assess the overall associations between time‐constrained P2Y12 inhibitor monotherapy (aspirin‐free regimen) for bleeding events, major adverse cardiovascular events, and all‐cause mortality as compared to standard care with DAPT for at least 12 months post‐percutaneous coronary intervention. We implemented a DerSimonian and Laird random effects meta‐analysis using the metafor package in R. 32 361 randomized trial participants, including 16 898 (52.2%) who had a history of acute coronary syndrome, underwent percutaneous coronary intervention, and had outcome data available. P2Y12 inhibitor monotherapy from 1 to 3 months was associated with a reduced risk for bleeding (hazard ratio [HR] 0.60; 95% CI, 0.45‐0.81), including in the acute coronary syndrome group in which the magnitude of risk reduction was greatest (HR 0.50; 95% CI, 0.41‐0.61). The estimates of the effect of P2Y12 inhibitor monotherapy on the HR were also favorable for major adverse cardiovascular events (0.88; 95% CI, 0.77‐1.02) and all‐cause mortality (0.85; 95% CI, 0.71‐1.03). Conclusions Compared with DAPT for 12 months post‐percutaneous coronary intervention, P2Y12 inhibitor monotherapy from 1 to 3 months substantially reduces the risk of major and fatal bleeding and, in addition, confers potentially protective effects, for major adverse cardiovascular events and all‐cause mortality. Considering patient safety, the results support a strategy of DAPT for 1 to 3 months followed by aspirin‐free P2Y12 inhibitor monotherapy.

scholarly journals A prognostic nomogram for long-term major adverse cardiovascular events in patients with acute coronary syndrome after percutaneous coronary intervention

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shuting Kong ◽  
Changxi Chen ◽  
Gaoshu Zheng ◽  
Hui Yao ◽  
Junfeng Li ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Lactate Level ◽  
Cardiovascular Events ◽  
Coronary Intervention ◽  
Major Adverse Cardiovascular Events ◽  
Training Set ◽  
Coronary Syndrome ◽  
Calibration Curves ◽  
Percutaneous Coronary

Abstract Background Accurate prediction of major adverse cardiovascular events (MACEs) is very important for the management of acute coronary syndrome (ACS) patients. We aimed to construct an effective prognostic nomogram for individualized risk estimates of MACEs for patients with ACS after percutaneous coronary intervention (PCI). Methods This was a prospective study of patients with ACS after PCI from January 2013 to July 2019 (n = 2465). After removing patients with incomplete clinical information, a total of 1986 patients were randomly divided into evaluation (n = 1324) and validation (n = 662) groups. Predictors included in the nomogram were determined by a multivariate Cox proportional hazards regression model based on the training set. Receiver operating characteristic (ROC) curves and calibration curves were used to assess the discrimination and predictive accuracy of the nomogram, which were then compared with those of the classic models. The clinical utility of the nomogram was assessed by X-tile analysis and Kaplan–Meier curve analysis. Results Independent prognostic factors, including lactate level, age, left anterior descending branch stenosis, right coronary artery stenosis, brain natriuretic peptide level, and left ventricular ejection fraction, were determined and contained in the nomogram. The nomogram achieved good areas under the ROC curve of 0.712–0.762 in the training set and 0.724–0.818 in the validation set and well-fitted calibration curves. In addition, participants could be divided into two risk groups (low and high) according to this model. Conclusions A simple-to-use nomogram incorporating lactate level effectively predicted 6-month, 1-year, and 4-year MACE incidence among patients with ACS after PCI.

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