scholarly journals Endothelial function as predictor in patients with coronary syndrome treated by percutaneous coronary intervention

2018 ◽  
Vol 38 (5) ◽  
Author(s):  
Xiaofeng Cheng ◽  
Yun He ◽  
Huaping Fan ◽  
Ting Liu ◽  
Wenxu Pan ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Endothelial Function ◽  
Reactive Hyperemia ◽  
Coronary Intervention ◽  
Rank Test ◽  
Syntax Score ◽  
Coronary Syndrome ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Percutaneous Coronary

We aimed at identifying the predictive role of endothelial function assessed by the RH-PAT index (RHI) for future major cardiovascular events (MACEs) in acute coronary syndrome (ACS) patients treated with percutaneous coronary intervention (PCI). We measured RHI in 308 subjects with ACS, and they were divided into the normal endothelial function (NEF) group and the endothelial dysfunction (DEF) group according to the RHI. The subjects were followed up for a mean of 16 months (interquartile range [IQR]: 14–20 months) after PCI treatment, and their MACEs were also recorded. Cumulative incidence curves were constructed for time-to-event variables with Kaplan–Meier estimates and compared using the log-rank test. The overall incidence of MACEs was 25.39% in the DEF group and 15.96% in the NEF group (P<0.05). Kaplan–Meier analysis also demonstrated a significantly higher probability of MACEs in the DEF group than in the NEF group (log-rank test: P<0.05). Multivariate Cox hazard analysis identified RHI (Model 2, adjusted by blood pressure, hazard ratio [HR]: 0.425; 95% confidence interval [CI]: 0.198–0.914; P=0.029) and SYNTAX score (HR: 1.043; 95% CI: 1.019–1.067; P<0.001) as independent predictors of future MACEs after PCI treatment in ACS patients. Endothelial function measured by reactive hyperemia-peripheral arterial tonometry (RH-PAT) is impaired in ACS subjects treated with PCI. The RHI was an independent predictor of MACEs, suggesting that RHI may be useful as a candidate biomarker in the risk stratification of patients with ACS after PCI treatment.

scholarly journals Improving Quality of Life with Percutaneous Coronary Intervention in Chronic Coronary Syndrome Patients with SYNTAX Score of More than 22

2021 ◽  
Vol 2 (2) ◽  
pp. 15-20
Author(s):  
Wella Karolina ◽  
Mohammad Saifur Rohman ◽  
Pawik Supriadi ◽  
Djanggan Sargowo ◽  
Wira Kimahesa Anggoro ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Percutaneous Coronary Intervention ◽  
Daily Living ◽  
Coronary Intervention ◽  
Syntax Score ◽  
Seattle Angina Questionnaire ◽  
Physical Limitation ◽  
Coronary Syndrome ◽  
Percutaneous Coronary

Background : The benefit of PCI to improve quality of life (QoL) in chronic coronary syndrome (CCS) is still unclear. Objectives : This study aimed to assess the benefit of percutaneous coronary intervention (PCI) in improving QoL among CCS patients receiving OMT. Methods : We conducted a retrospective cohort study. CCS patients who underwent coronary angiography (CAG) and/or PCI were grouped into OMT plus PCI and OMT groups. The SYNTAX score was used to assess the complexity and severity of coronary artery lesions. The outcome measured was QoL assessed using Seattle Angina Questionnaire (SAQ) and rehospitalization. Results: A total of 57 patients in the OMT plus PCI group and 49 patients in the OMT group were included. The percentage of patients with good QoL was higher in the OMT plus PCI group than OMT only group (64.5% vs. 35.5%; p = 0.007). The OMT plus PCI group revealed a better activities of daily living (85.11 ± 12.46 vs. 12.46 ± 21.87; p = 0.014) and angina stability (84.32 ± 23.63 vs. 71.81 ± 27.89; p = 0.014) than OMT group. Among patients with SYNTAX scores of more than 22, achievement of good QoL was greater in the OMT plus PCI group than the OMT group (80.8% vs. 45.5%; p = 0.025). Conclusion: PCI improved the QoL in CCS patients treated with OMT. Second, OMT plus PCI improves physical limitation and angina stability. For patients with a SYNTAX score of more than 22, OMT plus PCI was correlated with good QoL achievement.

Abstract 15442: Low Serum Levels of Insulin-like Growth Factor-1 Are Associated With Long-term Risk of Adverse Cardiovascular Events in Diabetic Patients Following Percutaneous Coronary Intervention

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Yuichi Chikata ◽  
Hiroshi Iwata ◽  
Takehiro Funamizu ◽  
Katsutoshi Miyosawa ◽  
Shinichiro Doi ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Growth Factor ◽  
Coronary Intervention ◽  
Serum Levels ◽  
Rank Test ◽  
Diabetic Patients ◽  
Insulin Like Growth Factor ◽  
Coronary Syndrome ◽  
Increased Risk ◽  
Percutaneous Coronary

Background: Insulin-like growth factor-1 (IGF-1) is a protein which plays protective roles against cardiovascular disorders, including the endothelial dysfunction and the instability of atherosclerotic plaque. However, prognostic implication of serum IGF-1 level has been rarely evaluated in diabetic patients with established coronary artery disease. Methods: This single center observational study involved consecutive 819 diabetic patients underwent percutaneous coronary intervention (PCI) since 2008 to 2018. In frozen-stocked (-80°C) serum, IGF-1 was measured by ELISA assay. Endpoints were set as cardiovascular (CV) death and the composite of CV death, myocardial infarction and ischemic stroke (3-point MACE). The median and the range of follow-up period was 4.0 and 0-10.4 years, respectively. Results: Participants were divided by the median of IGF-1 (75 ng/ml) (low (n=412) and high IGF-1 group (n=407)). Unadjusted Kaplan-Meier analyses with log-rank test showed the significantly higher incidences of CV death and 3P-MACE in low IGF-1 group ( Figures ). Moreover, multivariate Cox proportional hazard analysis adjusted by covariates including age, sex, PCI for acute coronary syndrome, multivessel disease, renal function (eGFR, ml/min/1.73m 2 ) and glycated hemoglobin (HbA1c, %) demonstrated that low IGF-1≤75 ng/ml was associated with substantially increased risk of CV death (Hazard Ratio (HR): 1.9, 95% confidence interval (95%CI): 1.1-3.6, p=0.03) and 3P-MACE (HR 1.7, 95%CI:1.0-2.7, p=0.04), respectively. Conclusion: Findings in this study suggest that serum IGF-1 levels are a useful and independent prognostic indicator in diabetic patients following PCI.

scholarly journals Development of one-year major adverse cardiac events risk index in patients with acute coronary syndrome and diabetes mellitus who underwent percutaneous coronary intervention

2020 ◽  
Vol 77 (11) ◽  
pp. 1192-1200
Author(s):  
Marija Mirkovic ◽  
Milan Nedeljkovic ◽  
Dusan Ruzicic ◽  
Mira Vukovic
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Percutaneous Coronary Intervention ◽  
Risk Index ◽  
Coronary Intervention ◽  
Syntax Score ◽  
Coronary Syndrome ◽  
C Statistic ◽  
Percutaneous Coronary ◽  
One Year

Background/Aim. Patients with acute coronary syndrome (ACS) and diabetes mellitus (DM) have an increased risk of major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI), which is not estimated sufficiently-multidimensionally in terms of type and severity of the ACS and/or DM and angiographic findings. The study was intended to validate and develop an index of metabolic, angiographic, anatomic and clinical risk factors for one-year MACE after conducted PCI in patients with ACS and DM. Methods. A prospective cross-sectional study was performed in patients with DM and ACS. In the PCI period the following risk factors were recorded: 1) age and metabolic variables ? glycosylated hemoglobin (HbA1c), total cholesterol, and triglycerides levels in the blood; 2) endocrinological variables ? DM therapy and type of DM; 3) ACS modality; 4) radiological/anatomical variable ? SYNTAX score, and 5) clinical variables in modified age, creatinine, ejection fraction (ACEF) score. One-year MACE were recorded. Results. From a total of 136 consecutive patients, 55 of them developed at least one MACE in one-year follow-up. A high predictive risk index was evaluated that assessed particular or associated risks for one-year MACE (c statistic = 0.879) in the study population, defined by: SYNTAX score > 21, modified ACEF score > 1.38, HbA1c ? 8%, triglyceridemia ? 2.3 mmol/L in patients with insulin therapy, and ACS modality ? unstable angina pectoris. The constructed risk index for one-year MACE (MACERI) had better predictive characteristics than SYNTAX score (c statistic = 0.798), as well as ACF score (c statistic = 0.744). Conclusion. MACERI can potentially have great application in future risk factors studies for one-year MACE in patients with DM and ACS who underwent PCI, because with it the effects of these factors are measured multidimensionally at valid and accurate manner.

scholarly journals The relationship between IL-6 levels and the angiographic severity of coronary artery disease following percutaneous coronary intervention in acute coronary syndrome patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yang Ling ◽  
Hairong Weng ◽  
Shengxing Tang
Keyword(s):  
Coronary Artery Disease ◽  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Area Under The Curve ◽  
Coronary Intervention ◽  
Syntax Score ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
Artery Disease

Abstract Background The present investigation was developed for the exploration of the association between IL-6 levels and acute coronary syndrome (ACS) findings upon angiographic evaluation. Methods A retrospective review of 346 patients suffering from chest discomfort that underwent coronary angiography was performed. The SYNergy between Percutaneous Coronary Intervention with TAXus and cardiac surgery (SYNTAX) score (SS) and SS II were used to gauge ACS severity, with ACS patients being stratified into two groups based on an SS value of 22 and the median SS II value. Associations between IL-6 levels and SS or SS II values were assessed through Spearman's correlation analyses, and independent predictors of intermediate-high SS or high SS II were identified via a multivariate logistic regression approach. A receiver operating characteristic (ROC) curve was employed to explore of the predictive value of IL-6 levels. Results IL-6 was positively correlated with both SS (r = 0.479, P < 0.001) and SS II (r = 0.305, P < 0.001). Moreover, IL-6 levels were independently predictive of intermediate-high SS and high SS II values. ROC curves further demonstrated that IL-6 was able to predict intermediate-high SS and high SS II, with area under the curve (AUC) values of 0.806 and 0.624, respectively. Conclusion IL-6 levels are closely linked to the extent of coronary artery disease in ACS patients undergoing percutaneous coronary intervention. IL-6 levels may thus serve as a valuable and non-invasive biomarker of high-risk ACS patients.

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