scholarly journals Impact of Postdilation on Intervention Success and Long-Term Major Adverse Cardiovascular Events (MACE) among Patients with Acute Coronary Syndromes

2020 ◽  
Vol 4 (3) ◽  
pp. 185-193
Author(s):  
Turan Erdoğan ◽  
Hakan Duman ◽  
Mustafa Çetin ◽  
Savaş Özer ◽  
Göksel Çinier ◽  
...  
Keyword(s):  
Acute Coronary Syndromes ◽  
Cardiovascular Events ◽  
Major Adverse Cardiovascular Events ◽  
Drug Eluting Stent ◽  
Timi Flow Grade ◽  
Coronary Interventions ◽  
Coronary Syndromes ◽  
The Impact ◽  
Myocardial Blush Grade

Postdilation is frequently used during coronary interventions to prevent stent malapposition. Currently there are contradictory findings regarding the benefits of postdilation for both intraprocedural and long-term outcomes. We evaluated the impact of postdilation among patients who presented with acute coronary syndromes (ACS) and underwent percutaneous coronary interventions (PCI). A total of 258 consecutive patients who presented with ACS and underwent PCI were included in the study. The patients were followed up for 25±1.7 months for the occurrence of major adverse cardiovascular events (MACE). During follow-up, 65 patients (25.2%) had MACE. Among patients without MACE, intracoronary nitrate infusion was less frequently used (P=0.005), myocardial blush grade was higher (P<0.001), and a drug-eluting stent was more frequently used (P=0.005). No significant differences were noted between groups regarding the predilation, recurrent dilation, postdilation, and other angiographic characteristics. In multivariate analysis, female sex (P=0.047), myocardial blush grade (P=0.038), previous coronary artery disease (P=0.030), and peak troponin level (P=0.002) were found to be predictors of MACE. In patients who were treated with PCI for ACS, performing postdilation did not predict final Thrombolysis in Myocardial Infarction (TIMI) flow grade, corrected TIMI frame count, myocardial blush grade, or MACE.

scholarly journals The Impact of Aspirin Resistance on the Long-term Cardiovascular Mortality in Patients with Non-ST Segment Elevation Acute Coronary Syndromes

2009 ◽  
Vol 32 (3) ◽  
pp. 142-147 ◽  
Author(s):  
Stefanos G. Foussas ◽  
Michael N. Zairis ◽  
Vasilios G. Tsirimpis ◽  
Stamatis S. Makrygiannis ◽  
Nikolaos G. Patsourakos ◽  
...  
Keyword(s):  
Cardiovascular Mortality ◽  
Acute Coronary Syndromes ◽  
Aspirin Resistance ◽  
St Segment Elevation ◽  
St Segment ◽  
Coronary Syndromes ◽  
The Impact

scholarly journals High Residual Platelet Reactivity After Clopidogrel Loading and Long-term Cardiovascular Events Among Patients With Acute Coronary Syndromes Undergoing PCI

JAMA ◽  
2011 ◽  
Vol 306 (11) ◽  
pp. 1215 ◽  
Author(s):  
Guido Parodi ◽  
Rossella Marcucci ◽  
Renato Valenti ◽  
Anna Maria Gori ◽  
Angela Migliorini ◽  
...  
Keyword(s):  
Acute Coronary Syndromes ◽  
Cardiovascular Events ◽  
Platelet Reactivity ◽  
Coronary Syndromes

scholarly journals Is percutaneous coronary intervention safe during uninterrupted direct oral anticoagulant therapy in patients with atrial fibrillation and acute coronary syndromes?

Open Heart ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. e001677
Author(s):  
Leonardo De Luca ◽  
Andrea Rubboli ◽  
Leonardo Bolognese ◽  
Massimo Uguccioni ◽  
Donata Lucci ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndromes ◽  
Multivariable Analysis ◽  
Coronary Intervention ◽  
Major Adverse Cardiovascular Events ◽  
Safe Procedure ◽  
Percutaneous Coronary ◽  
Coronary Syndromes

ObjectivesNo data on optimal management of patients with acute coronary syndromes (ACS) on long-term direct oral anticoagulants (DOACs) undergoing percutaneous coronary intervention (PCI) are available. Using the data of the Management of Antithrombotic TherApy in Patients with Chronic or DevelOping AtRial Fibrillation During Hospitalization for PCI study, we sought to compare the outcome of patients with ACS and atrial fibrillation (AF) who underwent PCI during uninterrupted DOAC (UDOAC group) and those who interrupted DOAC before PCI (IDOAC group).MethodsThe primary outcomes of our analysis were the incidence of major adverse cardiovascular events (MACEs), a composite of death, cerebrovascular events, recurrent myocardial infarction or revascularisation and net adverse clinical events (NACEs), including major bleeding, at 6 months.ResultsAmong the 132 patients on long-term DOAC, 72 (54.6%) underwent PCI during UDOAC and 60 (45.4%) after IDOAC. The mean CHA2DS2-VASc score was 3.8±1.7 and 3.9±1.3 (p=0.89), while the HAS-BLED score was 2.5±1.0 and 2.5±0.9 (p=0.96), in UDOAC and IDOAC groups, respectively. The median time from hospital admission to PCI was 9.5 (IQR: 2.0–31.5) hours in UDOAC and 45.5 (IQR: 22-5–92.0) hours in IDOAC group (p<0.0001). A radial approach was used in 92%, and a drug-eluting stent was implanted in 98% of patients. At 6 months, the rates of MACE (13.9% vs 16.7%) and NACE (20.8% vs 21.7%) did not differ between UDOAC and IDOAC groups. At multivariable analysis, increasing CHA2DS2-VASc score (HR: 1.39; 95% CIs 1.05 to 1.83; p=0.02) resulted as the only independent predictor of NACE.ConclusionsOur study shows that PCI is a safe procedure during UDOAC in patients with concomitant ACS and AF.

The impact of subclinical hyperthyroidism on cardiovascular prognosis in patients undergoing PCI

2021 ◽  
Author(s):  
Jie Yang ◽  
Yitian Zheng ◽  
Chen Li ◽  
Yu Peng Liu ◽  
Qing Zhou ◽  
...  
Keyword(s):  
Primary Endpoint ◽  
Cardiovascular Events ◽  
Cox Regression ◽  
Coronary Intervention ◽  
Major Adverse Cardiovascular Events ◽  
Drug Eluting Stent ◽  
Cox Regression Analysis ◽  
Target Vessel Revascularization ◽  
Significant Difference ◽  
The Impact

Abstract Background Limited studies have focused on the impact of SHyper on poor prognosis in patients with known coronary artery disease (CAD). Hence, we implemented the present study to explore the association between SHyper and adverse cardiovascular events in CAD patients who underwent drug-eluting stent (DES) implantation. Methods We consecutively recruited 8,283 CAD patients undergoing percutaneous coronary intervention (PCI). All subjects were divided into 2 groups according to their thyroid function: group 1 (euthyroidism group, n = 7,942) and group 2 (SHyper group, n = 341). After 1:4 propensity score (PS) matching, 1,603 patients (332 SHyper group and 1,271 euthyroidism group) were selected. The primary endpoint was major adverse cardiovascular events (MACE), a composite of cardiac mortality, nonfatal myocardial infarction (MI), and target vessel revascularization (TVR). Results Kaplan-Meier (K-M) survival analyses suggested that there was no significant difference in the primary endpoint and secondary endpoints (MACE: 11.4% vs. 8.8%, log-rank P = 0.124; cardiac death: 1.2% vs. 0.9%, log-rank P = 0.540; nonfatal MI: 5.7% vs. 4%, log-rank P = 0.177; and TVR: 6% vs. 4.7%, log-rank P = 0.303) in the PS-matched population. Besides, Cox regression analysis indicated that SHyper was not an independent risk factor for MACE (HR: 1.33, 95% CI, 0.92–1.92, P = 0.127). Conclusion SHyper is not independently associated with adverse cardiovascular events in CAD patients undergoing PCI. More studies should be implemented in the future to assess the long-term predictive value of SHyper with thyrotropin (TSH) levels &lt; 0.1 mIU/L for CAD patients undergoing PCI.

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