scholarly journals Prognostic Value of VEGF in Patients Submitted to Percutaneous Coronary Intervention

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Catarina Ramos ◽  
Patrícia Napoleão ◽  
Mafalda Selas ◽  
Cláudia Freixo ◽  
Ana Maria Viegas Crespo ◽  
...  

We examined the longitudinal changes of VEGF levels after percutaneous coronary intervention for predicting major adverse cardiac events (MACE) in coronary artery disease (CAD) patients. VEGF was measured in 94 CAD patients’ serum before revascularization, 1-month and 1-year after. Independently of clinical presentation, patients had lower VEGF concentration than a cohort of healthy subjects (median, IQ: 15.9, 9.0–264 pg/mL versus 419, 212–758 pg/mL;P<0.001) at baseline. VEGF increased to 1-month (median, IQ: 276, 167–498 pg/mL;P<0.001) and remained steady to 1-year (median, IQ: 320, 173–497 pg/mL;P<0.001) approaching control levels. Drug eluting stent apposition and previous medication intake produced a less steep VEGF evolution after intervention (P<0.05). Baseline VEGF concentration <40.8 pg/mL conveyed increased risk for MACE in a 5-year follow-up. Results reflect a positive role of VEGF in recovery and support its importance in CAD prognosis.

2020 ◽  
Vol 72 (1) ◽  
Author(s):  
Sidhi Laksono ◽  
Budhi Setianto ◽  
Steven Philip Surya

Abstract Background Coronary artery disease is one of the major issues in the medical world around the globe. The prevalence tends to increase. The use of coronary intervention is one of the ways often used in the management of coronary artery disease due to its satisfying result from earlier studies. Nowadays, there are several different techniques in coronary intervention: balloon vs stent. Main body The stent-based vascular interventions are increasingly being used over balloon-based coronary intervention. However, revascularization intervention using stent often have undesirable long-term effects compared to balloon. Besides, stent-based interventions are also considered more expensive, use more complicated techniques, and use more drug regimens. On the other hand, percutaneous coronary intervention techniques using balloons coated by anti-proliferation drugs have begun to be glimpsed by many interventionists. Studies have found many benefits that cannot be given by stent-based intervention therapy. Conclusions Angioplasty using percutaneous coronary intervention techniques reveals satisfying result compared to conservative medical treatment. The indication and technique of percutaneous coronary intervention is still evolving until now. Currently, percutaneous coronary intervention using stent, either bare-metal stent or drug-eluting stent, is preferred by interventionist. Nevertheless, recent clinical trial favors the using of drug-eluting balloon for percutaneous coronary intervention in terms of both clinical outcome and complication in several scenarios.


Angiology ◽  
2017 ◽  
Vol 68 (10) ◽  
pp. 884-892 ◽  
Author(s):  
Naoto Hashizume ◽  
Takashi Miura ◽  
Yusuke Miyashita ◽  
Hirohiko Motoki ◽  
Soichiro Ebisawa ◽  
...  

Concomitant coronary and peripheral artery disease is associated with higher periprocedural and long-term percutaneous coronary intervention (PCI) complication rates. We evaluated in-hospital and 1-year clinical outcomes of patients with low or borderline ankle–brachial indexes (ABIs) undergoing PCIs in the drug-eluting stent era. We divided 1370 SHINANO registry patients into 3 groups—low (ABI ≤ 0.9), borderline (0.9 < ABI ≤ 1.0), and normal (1.0 ≤ ABI < 1.4). During the 1-year follow-up, more PCI-related complications occurred in the low and borderline ABI groups than in the normal ABI group (7.7% vs 8.8% vs 4.0%, respectively). Low ABI patients were more likely to experience adverse clinical events (6.3% vs 3.6% vs 3.0%, respectively; log-rank P = .020 for low vs normal ABI), with a hazard ratio of 2.27 (95% confidence interval, 1.12-4.61; P = .023), compared with patients with normal ABIs. Patients with abnormal ABIs had a significantly higher incidence of PCI-related complications and a less favorable 1-year prognosis. Routine ABI measurement before PCI may help predict PCI-related complication incidence and 1-year prognosis.


2008 ◽  
Vol 109 (4) ◽  
pp. 596-604 ◽  
Author(s):  
Jennifer A. Rabbitts ◽  
Gregory A. Nuttall ◽  
Michael J. Brown ◽  
Andrew C. Hanson ◽  
William C. Oliver ◽  
...  

Background The American College of Cardiology released a scientific advisory that included a recommendation to delay elective of noncardiac surgery (NCS) for 1 yr after percutaneous coronary intervention (PCI) with a drug-eluting stent (DES). Methods This single-center, retrospective study examined the risk for complications of NCS performed within 2 yr after DES placement and examined whether this risk changed based on the time between procedures. The primary endpoint was major adverse cardiac events (MACEs) during the hospitalization for NCS. Bleeding events were analyzed as a secondary endpoint. Results From April 22, 2003, to December 31, 2006, a total of 520 patients underwent NCS within 2 yr after PCI with a DES at Mayo Clinic. The majority, 84%, of the DES placed were Cypher stents. The frequency of MACE was not found to be significantly associated with the time between PCI and NCS (rate of MACEs 6.4, 5.7, 5.9, and 3.3% at 0-90, 91-180, 181-365, and 366-730 days after PCI with DES, respectively; P = 0.727 for comparison across groups). Characteristics found to be associated with MACEs in univariate analysis were advanced age (P = 0.031), emergent NCS (P = 0.006), shock at time of PCI (P = 0.035), previous history of myocardial infarction (P = 0.046), and continuation of a thienopyridine (ticlopidine or clopidogrel) into the preoperative period (P = 0.040). The rate of transfusion did not seem to be associated with antiplatelet therapy use. Conclusions The risk of MACEs with NCS after DES placement was not significantly associated with time from stenting to surgery, but observed rates of MACEs were lowest after 1 yr.


2014 ◽  
Vol 6 (2) ◽  
pp. 107-111
Author(s):  
S Munwar ◽  
AHMW Islam ◽  
S Talukder ◽  
AQM Reza ◽  
T Ahmed ◽  
...  

Background: Aim of the study was to evaluate the primary procedural success of percutaneous coronary intervention of unprotected left main coronary artery stenosis using either Bare-metal stents or drug eluting stent. Methods: Total 33 patients were enrolled in this very preliminary non-randomized prospective cohort study. Among them, Male: 25 and Female: 8. Total 35 stents were deployed. Mean age were for Male: 59 yrs, for Female: 62 yrs. Associated coronary artery diseases risk factors were dyslipidemia, High Blood pressure, Diabetes Mellitus, Positive family history for coronary artery diseases and smoking. Results: Among the study group; 26 (78%) were Dyslipidemic, 24(70%) were hypertensive; 17 (51.5%) patients were Diabetic, 11(33%) were smoker and 7(21%) patients had family history of Ischaemic heart disease. Female patients were more obese (BMI M 26: F 27) and developed coronary artery diseases in advance age. Common stented territory were left main: 20 (60%), Left main to left anterior descending artery 7 (22%) and Left main to left circumflex artery 6 (18%). Average length and diameter of stent was 3.5 and 18 mm respectively. Stent used: Bare Metal Stent 5 (15%), Drug Eluting Stent: 28 (85%). Among the different Drug Eluting Stents, Everolimus eluting stents were 11 (39.3%), Sirolimus eluting 10(35.7%), Paclitaxel eluting 3 (10.7%), Biolimus eluting 3 (10.7%) and Zotarolimus eluting1 (3.6%). In the present study, overall survival outcome was 94% (31 patient), mortality of cardiac cause 3% (1 patient) and 1 patient (3%) died of hepatocellular carcinoma. Conclusion: Our study has shown that percutaneous coronary intervention of the unprotected left main is a safe and effective alternative to Coronary Artery Bypass Graft (CABG). DOI: http://dx.doi.org/10.3329/cardio.v6i2.18349 Cardiovasc. j. 2014; 6(2): 107-111


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