scholarly journals Evaluation of the Prognostic Role of the Wall Motion Score Index and the SYNTAX Score II in Patients with Acute Coronary Syndrome Following Percutaneous Coronary Intervention by Evaluation of Major Adverse Cardiovascular Events at 12-Month Follow-Up

2021 ◽  
Vol 27 ◽  
Author(s):  
Fanyang Kong ◽  
Li Xiang ◽  
Yanni Wu ◽  
Guangming Tong
Keyword(s):  
Coronary Intervention ◽  
Major Adverse Cardiovascular Events ◽  
Syntax Score ◽  
Wall Motion Score Index ◽  
Coronary Syndrome ◽  
Syntax Score Ii ◽  
Percutaneous Coronary ◽  
Score Index

scholarly journals New Predictors of Early and Late Outcomes after Primary Percutaneous Coronary Intervention in Patients with ST-Segment Elevation Myocardial Infarction and Unprotected Left Main Coronary Artery Culprit Lesion

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Cãlin Homorodean ◽  
Adrian Corneliu Iancu ◽  
Daniel Leucuţa ◽  
Şerban Bãlãnescu ◽  
Ioana Mihaela Dregoesc ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Cardiogenic Shock ◽  
Coronary Intervention ◽  
Syntax Score ◽  
Syntax Score Ii ◽  
Percutaneous Coronary ◽  
Artery Disease ◽  
Residual Syntax Score

Objectives. The study evaluated the correlation between baseline SYNTAX Score, Residual SYNTAX Score, and SYNTAX Revascularization Index and long-term outcomes in ST-elevation myocardial infarction (STEMI) patients with primary percutaneous coronary intervention (PCI) on an unprotected left main coronary artery lesion (UPLMCA). Background. Previous studies on primary PCI in UPLMCA have identified cardiogenic shock, TIMI 0/1 flow, and cardiac arrest, as prognostic factors of an unfavourable outcome, but the complexity of coronary artery disease and the extent of revascularization have not been thoroughly investigated in these high-risk patients. Methods. 30-day, 1-year, and long-term outcomes were analyzed in a cohort of retrospectively selected, 81 consecutive patients with STEMI, and primary PCI on UPLMCA. Results. Cardiogenic shock (p=0.001), age (p=0.008), baseline SYNTAX Score II (p=0.006), and SYNTAX Revascularization Index (p=0.046) were independent mortality predictors at one-year follow-up. Besides cardiogenic shock (HR 3.28, p<0.001), TIMI 0/1 flow (HR 2.17, p=0.021) and age (HR 1.03, p=0.006), baseline SYNTAX Score II (HR 1.06, p=0.006), residual SYNTAX Score (HR 1.03, p=0.041), and SYNTAX Revascularization Index (HR 0.9, p=0.011) were independent predictors of mortality at three years of follow-up. In patients with TIMI 0/1 flow, the presence of Rentrop collaterals was an independent predictor for long-term survival (HR 0.24; p=0.049). Conclusions. In this study, the complexity of coronary artery disease and the extent of revascularization represent independent mortality predictors at long-term follow-up.

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.

IMMEDIATE AND 4-YEAR OUTCOME OF PATIENTS WITH ACUTE CORONARY SYNDROME UNDERGOING PERCUTANEOUS CORONARY INTERVENTION FOR LEFT MAIN CORONARY ARTERY DISEASE

2021 ◽  
pp. 8-11
Author(s):  
Saroj Mandal ◽  
Sidnath Singh ◽  
Kaushik Banerjee ◽  
Aditya Verma ◽  
Vignesh R.
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Ejection Fraction ◽  
Coronary Intervention ◽  
Left Ventricular Ejection ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
The Mean

Background: The treatment of LMCAD has shifted from coronary artery bypass grafting (CABG) to Percutaneous coronary intervention (PCI). However, data on long-term outcomes of PCI for LMCA disease, especially in patients with acute coronary syndrome (ACS) remains limited and conicting. This study aims to nd the association of the immediate and 4-year mortality in ACS patients with LMCA disease treated by PCI based on ejection fractions at admission. Methods: A retrospective analytical study was conducted. Patients were divided at admission into those with reduced left ventricular ejection fraction and those with preserved ejection fraction. Results: Forty (58.8%) of the patients presented with preserved EF. The mean age of the patients was 71.6±7.1 years. The mean LVEF of the preserved group was 61.6±4.3% and signicantly higher than that of the reduced group. Age and cardiovascular risk factor prole was similar between the two groups. Patients with reduced ejection fraction had signicantly higher levels of serum creatinine and signicantly lower levels of Hb and HDL. Mean hospital stay was signicantly longer for patients with preserved EF. In-hospital deaths were also similar between the two groups. The reduced EF group had a signicantly higher allcause mortality in the 4-year follow-up period. The mean years of follow-up for all participants was 4.2±1.3 years. Conclusion: It was seen that in patients presenting with ACS and undergoing PCI due to LMCAD, LVEF at admission, singly and in in multivariate regression is an important predictor of in hospital and 4-year mortality

Abstract 16231: Long-term Outcomes of Coronary Artery Bypass Grafting versus Percutaneous Coronary Intervention in Patients With Non-st Elevation Acute Coronary Syndrome

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Kiro Barssoum ◽  
Ashish Kumar ◽  
Devesh Rai ◽  
Adnan Kharsa ◽  
Medhat Chowdhury ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Meta Analysis ◽  
Artery Bypass ◽  
Coronary Intervention ◽  
Long Term Outcomes ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
St Elevation

Background: Long term outcomes of culprit multi-vessel and left main patients who presented with Non-ST Elevation Acute Coronary Syndrome (NSTE-ACS) and underwent either coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) are not well defined. Randomized trials comparing the two modalities constituted mainly of patients with stable coronary artery disease (SCAD). We performed a meta-analysis of studies that compared the long term outcomes of CABG vs. PCI in NSTE-ACS. Methods: Medline, EmCare, CINAHL, Cochrane databases were queried for relevant articles. Studies that included patients with SCAD and ST-elevation myocardial infarction were excluded. Our primary outcome was major adverse cardiac events (MACE) at 3-5 years, defined as a composite of all-cause mortality, stroke, re-infarction and repeat revascularization. The secondary outcome was re-infarction at 3 to 5 years. We used the Paule-Mandel method with Hartung-Knapp-Sidik-Jonkman adjustment to estimate risk ratio (RR) with 95% confidence interval (CI). Heterogeneity was assessed using Higgin’s I 2 statistics. All statistical analysis was carried out using R version 3.6.2 Results: Four observational studies met our inclusion criteria with a total number of 6695 patients. At 3 to 5 years, the PCI group was associated with a higher risk of MACE as compared to CABG, (RR): 1.52, 95% CI: 1.28 to 1.81, I 2 =0% (PANEL A). The PCI group also had a higher risk of re-infarctions during the period of follow up, RR: 1.88, 95% CI 1.49 to 2.38, I 2 =0% (PANEL B). Conclusion: In this meta-analysis, CABG was associated with a lower risk of MACE and re-infarctions as compared to PCI during 3 to 5 years follow up period.

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