scholarly journals Deep Learning-Based Assessment of Adverse Cardiovascular Events in Elderly Patients with Coronary Heart Disease after Percutaneous Coronary Intervention Using Intravascular Ultrasound Images

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Shu Wang
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Deep Learning ◽  
Cardiovascular Events ◽  
Learning Algorithm ◽  
Density Lipoprotein ◽  
Coronary Intervention ◽  
Deep Learning Algorithm ◽  
Percutaneous Coronary ◽  
Sensitivity Specificity

This study aimed to analyze the risk factors of adverse cardiovascular events (ACVEs) in elderly patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI) using the intravascular ultrasound (IVUS) images based on the deep learning of convolutional neural networks (CNNs). This study included 90 patients with coronary heart disease as the research object. All the patients were randomly divided into a control group (group C) and an experimental group (group E), and all were treated with PCI. The patients in group C were diagnosed by angiography, and patients in group E underwent IVUS examination under deep learning. The levels of blood lipids and inflammatory factors between the two groups before and after PCI were compared, and the sensitivity, specificity, and positive predictive value (PPV) were recorded. Compared with angiography diagnosis, ultrasound diagnosis based on deep learning algorithm had higher sensitivity (92.3% vs. 81.4%), specificity (90.1% vs. 88.6%), and PPV (94.8% vs. 75.3%) ( P < 0.05 ). Compared with group C, patients in group E had a higher narrowest lesion diameter (2.54 ± 0.18 mm vs. 2.21 ± 0.19 mm) and detection rate of eccentric plaques (80.1% vs. 45.3%) ( P < 0.05 ). High-density lipoprotein cholesterol (HDL-C) after PCI in the two groups was significantly higher than that before surgery, while low-density lipoprotein cholesterol (LDL-C), tumor necrosis factor (TNF), and C-reactive protein (CRP) were significantly lower than those before surgery, and the difference was statistically significant ( P < 0.05 ). In short, the ultrasonic detection method based on deep learning algorithm has high sensitivity, specificity, and accuracy for CHD detection; PCI can improve the patient’s blood lipid level, relieve the patient’s inflammation, and reduce the occurrence of ACVEs in the patient.

scholarly journals EFFECTIVENESS OF TICAGRELOR COMPARED TO CLOPIDOGREL IN REDUCING THE RISK OF MAJOR ADVERSE CARDIOVASCULAR EVENTS IN PATIENTS WITH CORONARY HEART DISEASE AFTER PERCUTANEOUS CORONARY INTERVENTION

2017 ◽  
Vol 9 (9) ◽  
pp. 178 ◽  
Author(s):  
Hendra Wana Nur’amin ◽  
Iwan Dwiprahasto ◽  
Erna Kristin
Keyword(s):  
Myocardial Infarction ◽  
Coronary Heart Disease ◽  
Percutaneous Coronary Intervention ◽  
Heart Disease ◽  
Cardiovascular Events ◽  
Coronary Intervention ◽  
Population Based ◽  
Major Adverse Cardiovascular Events ◽  
Repeat Revascularization ◽  
Percutaneous Coronary

Objective: Antiplatelet therapy is recommended in patients with coronary heart disease (CHD) who had the percutaneous coronary intervention (PCI) procedure to reduce major adverse cardiovascular events (MACE). There has been a lack of population-based studies that showed the superior effectiveness of ticagrelor over clopidogrel and similar studies have not been conducted in Indonesia yet. The aim of the study was to investigate the effectiveness of ticagrelor compared to clopidogrel in reducing the risk of MACE in patients with CHD after PCI.Methods: A retrospective cohort study with 1-year follow-up was conducted. 361 patients consisted of 111 patients with ticagrelor exposure and 250 patients with clopidogrel exposure. The primary outcome was MACE, defined as a composite of repeat revascularization, myocardial infarction, or all-cause death. The association between antiplatelet exposure and the MACE was analyzed with Cox proportional hazard regression, adjusted for sex, age, comorbid, PCI procedures and concomitant therapy.Results: MACE occurred in 22.7% of the subjects. Clopidogrel had a significantly higher risk of MACE compared with ticagrelor (28.8%, vs 9.0%, hazard ratio (HR): 1.96 (95% CI 1.01 to 3.81, p=0.047). There were no significant differences in risk of repeat revascularization (20.40% vs 5.40%, HR: 2.32, 95% CI 0.99 to 5.42, p = 0.05), myocardial infarction (11.60% vs 3.60%, HR: 2.08, 95% CI, 0.73 to 5.93, p = 0.17), and death (1.60% vs 1.80%, HR: 0.77, 95% CI, 0.14 to 4.25, p = 0.77).Conclusion: Clopidogrel had a higher risk of MACE compared to clopidogrel in patients with CHD after PCI, but there were no significant differences in the risk of repeat revascularization, myocardial infarction, and all-cause death. 

scholarly journals Association between epicardial adipose tissue and adverse outcomes in coronary heart disease patients with percutaneous coronary intervention

2019 ◽  
Vol 39 (5) ◽  
Author(s):  
Changqing Lu ◽  
Helei Jia ◽  
Zhentao Wang
Keyword(s):  
Computed Tomography ◽  
Coronary Heart Disease ◽  
Adipose Tissue ◽  
Cardiovascular Events ◽  
Epicardial Adipose Tissue ◽  
Density Lipoprotein ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
The Relationship

Abstract We assessed the relationship between the volume of epicardial adipose tissue and long-term outcomes in patients with coronary heart disease (CHD) undergoing percutaneous coronary intervention (PCI). The patients with CHD were followed for at least 2 years after PCI. The epicardial adipose tissue volume (EATV) was measured using multi-slice computed tomography. Cox regression analysis was used to examine the relationship between EATV and clinical outcome. In this study, 500 patients were enrolled and followed up for a median of 25.2 months. The incidence of adverse cardiovascular events was 12.4%. No significant differences were observed in age, sex, proportion of patients with hypertension or diabetes, smoking, drinking, total cholesterol, triglyceride, high-density lipoprotein, or unstable angina pectoris among different EATV quartiles (P>0.05). The EATV was associated with body mass index (P<0.0001), low-density lipoprotein level (P=0.039), high-sensitivity C-reactive protein level (P<0.001), uric acid level (P=0.004), adiponectin level (P<0.001), and left ventricular ejection fraction (P<0.001). Kaplan–Meier analysis indicated a significant difference in survival rate of patients in EATV quartile 1 versus 4 (P=0.019). After adjusting for confounding factors, EATV quartile 4 (>216.15 cm3) was still associated with adverse cardiovascular outcomes (HR = 1.98, 95% CI: 1.15–4.47, P=0.023) compared with quartile 1 (<101.58 cm3). Our data suggest that EATV is an independent predictor of long-term major adverse cardiovascular events in CHD patients after PCI. Therefore, assessment of EATV using multi-slice computed tomography may contribute to risk stratification in these patients.

scholarly journals Relationship between lncRNA-Ang362 and prognosis of patients with coronary heart disease after percutaneous coronary intervention

2020 ◽  
Vol 40 (7) ◽  
Author(s):  
Hui Wang ◽  
Huichao Gong ◽  
Yingwu Liu ◽  
Limin Feng
Keyword(s):  
Coronary Heart Disease ◽  
Percutaneous Coronary Intervention ◽  
Heart Disease ◽  
Cardiovascular Events ◽  
Cox Regression ◽  
Quantitative Polymerase Chain Reaction ◽  
Coronary Intervention ◽  
Cox Regression Analysis ◽  
Percutaneous Coronary

Abstract The severity and complexity evaluation of coronary artery disease in patients with coronary heart disease (CHD) require objective and accurate prognosis indexes. We assessed the relationship between lncRNA-Ang362 and prognosis of CHD patients after percutaneous coronary intervention (PCI). Clinical follow-up data of CHD patients were prospectively collected. LncRNA-Ang362 levels were detected by real-time quantitative polymerase chain reaction. Survival rate was calculated by the Kaplan–Meier method, and risk ratios and 95% confidence intervals were computed using univariate and multivariate COX proportional hazard models. Finally, 434 patients were included in the follow-up cohort. The median follow-up time was 24.8 months (6.7–40). The incidence of adverse cardiovascular events was 13.6%. The high expression group significantly tended to be smoker and higher body mass index, low-density lipoprotein cholesterol, high-sensitivity C-reactive protein, creatinine, and uric acid levels compared with the low expression group. According to the SYNTAX grade, the high-risk and medium-risk groups had significantly higher lncRNA expression levels than the low-risk group. The univariate COX regression analysis indicated that high lncRAN-Ang362 expression significantly increased the risk of adverse cardiovascular events in CHD patients after PCI (hazard risk (HR) = 3.19, 95% confidence interval (CI): 1.29–7.92). Multivariate analysis found high lncRNA-Ang362 expression was independently related to worse prognosis in CHD patients after PCI (HR = 2.83, 95%CI: 1.34–6.02). Plasma lncRNA-Ang362 may be a prognosis factor in CHD patients after PCI. The patients with higher lncRNA-Ang362 expression usually have poor prognosis.

scholarly journals Proton Pump Inhibitor and Clopidogrel Use After Percutaneous Coronary Intervention and Risk of Major Cardiovascular Events

2021 ◽  
Author(s):  
John Maret-Ouda ◽  
Giola Santoni ◽  
Shaohua Xie ◽  
Annika Rosengren ◽  
Jesper Lagergren
Keyword(s):  
Coronary Heart Disease ◽  
Percutaneous Coronary Intervention ◽  
Heart Disease ◽  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Cardiovascular Events ◽  
Coronary Intervention ◽  
Primary Pci ◽  
Major Cardiovascular Events ◽  
Percutaneous Coronary

Abstract Purpose Due to shared hepatic metabolism, concomitant medication with a proton pump inhibitor (PPI) and clopidogrel might reduce the effectiveness of clopidogrel in the prevention of cardiovascular events after percutaneous coronary intervention (PCI). We aimed to examine the risk of major cardiovascular events after PCI comparing patients who used clopidogrel together with PPI with those who used clopidogrel alone. Methods This Swedish nationwide cohort study included patients who received clopidogrel after primary PCI in 2005–2019. Patients were followed for up to 12 months after PCI. Data were retrieved from the Swedish Prescribed Drug Registry, Patient Registry, Cancer Registry, and Cause of Death Registry. Multivariable Cox regression provided hazard ratios (HRs) with 95% confidence intervals (CIs) for cardiovascular events comparing PPI users (exposed) with non-users of PPI (non-exposed). The HRs were adjusted for sex, age, comorbidity, calendar period, obesity, diabetes, anti-diabetic medication, tobacco-related diseases, hypertension, and congestive heart failure. Results The cohort included 99,836 patients who received clopidogrel after primary PCI. Among these, 35,772 (35.8%) received concomitant PPI. Compared to non-users, PPI users had increased adjusted HRs of all study outcomes, i.e., the main outcome myocardial infarction (HR = 1.23, 95% CI 1.15–1.32) and the secondary outcomes coronary heart disease (HR = 1.28, 95% CI 1.24–1.33), stroke (HR = 1.21, 95% CI 1.05–1.40), and death due to coronary heart disease (HR = 1.52, 95% CI 1.37–1.69). The results were similar in analyses including both primary and secondary PCIs. Conclusions In patients who receive clopidogrel after PCI, concomitant use of PPI seems to increase the risk of major cardiovascular events.

The Preventive Effect of Alprostadil on the Contrast-Induced Nephropathy of Coronary Heart Disease Treated by Percutaneous Coronary Intervention in Moderate and High-Risk Population Stratified by Mehran Score

Angiology ◽  
2021 ◽  
pp. 000331972110155
Author(s):  
Xiaogang Liu ◽  
Peng Zhang ◽  
Jing Zhang ◽  
Xue Zhang ◽  
Shicheng Yang ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Percutaneous Coronary Intervention ◽  
Heart Disease ◽  
High Risk ◽  
Risk Groups ◽  
Coronary Intervention ◽  
Preventive Effect ◽  
Moderate Risk ◽  
Contrast Induced Nephropathy ◽  
Percutaneous Coronary

The Mehran risk score (MRS) was used to classify patients with coronary heart disease and evaluate the preventive effect of alprostadil on contrast-induced nephropathy (CIN) after percutaneous coronary intervention. The patients (n = 1146) were randomized into an alprostadil and control group and then divided into 3 groups on the basis of the MRS: low-risk, moderate-risk, and high-risk groups. The primary end point was the occurrence of CIN (alprostadil + hydration vs simple hydration treatment); secondary end points included serum creatinine, blood urea nitrogen, creatinine clearance rate, cystatin C, interleukin-6, C-reactive protein, proteinuria, and differences in the incidence of major adverse events. In the low-risk, moderate-risk, and high-risk groups, the incidence of CIN in the control and alprostadil group was 2.9 versus 2.6% ( P = .832), 11.4 versus 4.9% ( P = .030), 19.1 versus 7.7% ( P = .041), respectively. Multivariate logistic regression analysis showed that alprostadil treatment was a favorable protective factor for moderate-risk and high-risk CIN patients (OR = 0.343, 95% CI: 0.124-0.951, P = .040). Alprostadil can be used as a preventive treatment for moderate- and high-risk CIN patients classified by the MRS. The reduction of CIN by alprostadil may be related to an anti-inflammatory effect.

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