Clinical Impact of Angiographic Restenosis After Bare-Metal Stent Implantation on Long-Term Outcomes in Patients With Coronary Artery Disease

Ogita, Manabu; Miyauchi, Katsumi; Kurata, Takeshi; Yokoyama, Ken; Dohi, Tomotaka; Tuboi, Shuta; Miyazaki, Tadashi; Nishino, Ayako; Yokoyama, Takayuki; Daida, Hiroyuki

doi:10.1253/circj.cj-11-0469

Cited by 12 publications

(7 citation statements)

References 29 publications

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“…15 It was shown that ISR with BMS is significantly associated with long-term adverse clinical outcomes. [2][3][4] Therefore, ISR is considered the Achilles heel of interventional cardiology. The development of ISR following BMS implantation has been linked to several clinical, lesion, and procedural factors and, most importantly, patient-related factors.…”

Section: Discussionmentioning

confidence: 99%

“…1 Bare-metal ISR is not a benign entity and has been associated with both poor survival and acute coronary syndromes (ACSs). [2][3][4] The development of ISR has been linked to several specific clinical, laboratory, and angiographic variables. The CHA2DS2-VASc score (congestive heart failure [CHF]; hypertension; age !75 years [doubled]; type 2 diabetes; previous stroke or transient ischemic attack [doubled]; vascular disease; age 65-74 years; and sex [female] category) has been initially recommended for the assessment of thromboembolic risk in patients with atrial fibrillation (AF).…”

Section: Introductionmentioning

confidence: 99%

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Usefulness of the CHA2DS2-VASc Score in Predicting In-Stent Restenosis Among Patients Undergoing Revascularization With Bare-Metal Stents

Kurtul¹

2017

Clin Appl Thromb Hemost

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In-stent restenosis (ISR) is a limitation of percutaneous coronary intervention and has been linked to specific clinical and angiographic variables. The aim of the present study was to investigate the predictive value of preprocedural CHA2DS2-VASc score on ISR in patients undergoing revascularization with bare-metal stent (BMS) implantation for stable coronary artery disease or acute coronary syndrome. In the years 2012 to 2014, a total of 358 consecutive patients (mean age: 62.36 + 11.28 years and 62.2% men) who had undergone successful BMS implantation were included in the study. All patients underwent stent implantation at admission to our center and had another coronary angiography performed due to recurrence of the symptoms consistent with myocardial ischemia and/or a stress test indicating ischemia. The patients were divided into 2 groups-ISR (n ¼ 166) and non-ISR (n ¼ 192). Angiographic ISR was defined as narrowing !50% in the stented coronary artery segment at follow-up angiography. The mean CHA2DS2-VASc score was 3.42 + 1.35 (range 1-7). The CHA2DS2-VASc scores and high-sensitivity Creactive protein (hs-CRP) levels were higher in the ISR group compared to the non-ISR group. At multivariable analysis, CHA2DS2-VASc score (odds ratio [OR]: 2.004, 95% confidence interval: 1.361-2.949, P < .001), total stent length (OR: 1.093, P ¼ .001), stent diameter (OR: 0.129, P < .001), and hs-CRP (OR: 1.224, P < .001) emerged as independent risk factors for ISR. In conclusion, preprocedural CHA2DS2-VASc is an easily calculated score that provides an additional level of risk stratification beyond that provided by conventional risk factors. Thus, this score can be used as a simple and effective tool to predict ISR in patients undergoing BMS implantation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Usefulness of the CHA2DS2-VASc Score in Predicting In-Stent Restenosis Among Patients Undergoing Revascularization With Bare-Metal Stents

Kurtul¹

2017

Clin Appl Thromb Hemost

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“…These results are similar to that of the REACH registry 5 and other Japanese studies. 26, 27 Fourth, there were no data on DAPT continuation at 2-year follow-up, or on medication such as cilostazol and sarpogrelate at baseline. Within these limitations, we conclude that the incidence of MACE is significantly increased by polyVD in patients undergoing PCI and is further increased in those with a greater number of arterial beds.…”

Section: Limitations and Conclusionmentioning

confidence: 99%

Prevalence and Clinical Outcome of Polyvascular Atherosclerotic Disease in Patients Undergoing Coronary Intervention

Miura

Soga

Doijiri

et al. 2013

Circ J

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“…Some investigators found that smoking increases the risk of MACEs, while others did not. [35][36][37][38] Another explanation of the increased rate of restenosis and in -stent thrombosis could be inadequate cardiac therapy due to poor compliance, as well as pulmonary therapy due to underdiagnosis resulting in hypoxia and further consequences leading to progression of atherosclerosis. Enriquez et al 25 demonstrated that patients with COPD were significantly less likely to receive β -blockers, aspirin, and statins at discharge after PCI.…”

Section: Discussionmentioning

confidence: 99%

Chronic obstructive pulmonary disease affects the angiographic presentation and outcomes of patients with coronary artery disease treated with percutaneous coronary interventions

Januszek¹,

Siudak²,

Dziewierz³

et al. 2017

Polish Archives of Internal Medicine

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INTRODUCTION The incidence of chronic obstructive pulmonary disease (COPD) in patients treated with percutaneous coronary intervention (PCI) is underestimated, and the effect of COPD on atherosclerosis and the outcomes of PCI is not fully understood. OBJECTIVES The aim of this study was to assess the impact of COPD on periprocedural outcomes of PCI, as well as its relationship with clinical presentation and the type of coronary artery lesions. PATIENTS AND METHODS Data were prospectively collected using a national electronic registry of PCI procedures performed in Poland between January 2015 and December 2016. Out of the 221 187 PCIs, 5594 patients had been diagnosed with COPD before the intervention. RESULTS Patients with COPD were older than those without COPD (mean [SD] age, 70.3 [9.9] years vs 67 [10.8] years; P <0.001) and more often were males (72.3% vs 67.8%; P <0.001). Non-ST‑segment elevation myocardial infarction (NSTEMI) was a more common clinical presentation of coronary artery disease (CAD) in the COPD group, while ST‑segment elevation myocardial infarction (STEMI) occurred more frequently in the non‑COPD group. Multivessel disease (MVD) with or without left main coronary artery (LMCA) involvement and separate LMCA was diagnosed more often in the COPD group. At baseline, the culprit lesion was more often restenosis and in‑stent thrombosis in the COPD group, whereas de‑novo lesion-in the non‑COPD group. The rates of periprocedural mortality and myocardial infarction did not differ between the groups with and without COPD (0.13% vs 0.12%, P = 0.88 and 0.53% vs 0.45%, P = 0.39, respectively). COPD was found to be an independent predictor of restenosis assessed before PCI in patients with a history of PCI (P = 0.006). CONCLUSIONS Patients with COPD diagnosed before PCI are at an increased risk of MVD with or without LMCA involvement and NSTEMI. Restenosis and in‑stent thrombosis occur more often in patients with COPD before PCI.

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Clinical Impact of Angiographic Restenosis After Bare-Metal Stent Implantation on Long-Term Outcomes in Patients With Coronary Artery Disease

Cited by 12 publications

References 29 publications

Usefulness of the CHA2DS2-VASc Score in Predicting In-Stent Restenosis Among Patients Undergoing Revascularization With Bare-Metal Stents

Usefulness of the CHA2DS2-VASc Score in Predicting In-Stent Restenosis Among Patients Undergoing Revascularization With Bare-Metal Stents

Prevalence and Clinical Outcome of Polyvascular Atherosclerotic Disease in Patients Undergoing Coronary Intervention

Chronic obstructive pulmonary disease affects the angiographic presentation and outcomes of patients with coronary artery disease treated with percutaneous coronary interventions

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