Clinical impact of complete revascularization in elderly patients with multi-vessel coronary artery disease undergoing percutaneous coronary intervention: A sub-analysis of the SHINANO registry

Harada, Mikiko; Miura, Takashi; Kobayashi, Takahiro; Kobayashi, Hideki; Kobayashi, Masanori; Nakajima, Hiroyuki; Kimura, Hironobu; Akanuma, Hiroshi; Mawatari, Eiichiro; Sato, Toshio; Hotta, Shoji; Kamiyoshi, Yuichi; Maruyama, Takuya; Watanabe, Noboru; Eisawa, Takayuki; Hashizume, Naoto; Ebisawa, Soichiro; Miyashita, Yusuke; Ikeda, Uichi

doi:10.1016/j.ijcard.2016.12.093

Cited by 21 publications

(21 citation statements)

References 18 publications

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“…Besides, we also found that the patients with left main lesions had signi cantly older age than those patients without left main lesions. The results of Harada et al [17] showed that coronary artery disease with multivessel disease was prone to occur in elderly patients. With the gradual aging of China in these years, the number of patients with multivessel disease of coronary heart disease is increasing year by year, which deserves clinical attention [18][19][20][21][22][23][24] .…”

Section: Discussionmentioning

confidence: 99%

Clinical study of patients with coronary artery disease combined multivessel disease

Zhu

Wen

Liu³

et al. 2021

Preprint

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Background: To investigate the clinical prognosis of patients with coronary artery disease combined multivessel disease. Methods: The patients who were diagnosed with multivessel disease by coronary angiography were selected in this study. The clinical datas about the clinical prognosis and the incidence of adverse cardiovascular events within five-year follow-up were analyzed. Results: A total of 230 participants were included in this study, includeing 129 male (56.09%) and 101 female (43.91%), the average age was 69.73 ± 10.93. The outcomes showed that the patients with three-vessel lesions had significantly higher rate of diabetes history (51.32% vs. 34.62%, P=0.018), unstable angina pectoris history ( 73.03% vs. 55.13%, P=0.008), and significantly higher risk of cardiogenic mortality (7.24% vs. 1.28%, P=0.045) when compared with patients who had two-vessel lesions. The patients with CTO had significantly higher rate of diabetes history (58.54% vs. 42.86%, P=0.049), unstable angina pectoris history ( 80.49% vs. 64.02%, P=0.029), MI history ( 48.78% vs. 25.40%, P=0.003), significantly lower LVEF (58.73±11.30 vs. 64.23±9.49, P=0.001) and significantly higher risk of recurrent myocardial infarction (12.20% vs. 3.2%, P=0.043) when compared with those patients without CTO. The patients with left main lesions had significantly older age (73.61±9.95 vs. 69.02±10.98, P=0.018) and significantly higher risk of cardiogenic mortality (13.89% vs. 3.61%, P=0.025) when compared with those patients without left main lesions. Conclusions: Among patients with coronary artery disease combined multivessel disease, patients with CTO had significantly lower LVEF and higher risk of recurrent myocardial infarction than patients without CTO. The patients with left main lesions had significantly higher risk of cardiogenic mortality than patients without left main lesions. The patients with three-vessel lesions had higher risk of cardiogenic mortality than patients with two-vessel lesions.

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Section: Discussionmentioning

confidence: 99%

Clinical study of patients with coronary artery disease combined multivessel disease

Zhu

Wen

Liu³

et al. 2021

Preprint

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“…Specifically, 20%–30% of MACE in the ICR group and 5%–10% of MACE in the CR group (ie, HR ICR/CR =3.3). 26 27 In addition, dropout rates of 10%–20% have been reported in prospective studies evaluating ischaemic heart disease. 28 …”

Section: Methods and Analysismentioning

confidence: 99%

“…Previous studies in older patients with MVCAD have revealed significant differences between CR and ICR groups in the primary outcome measures after a 12-month follow-up. Specifically, 20%–30% of MACE in the ICR group and 5%–10% of MACE in the CR group (ie, HR ICR/CR =3.3) 26 27. In addition, dropout rates of 10%–20% have been reported in prospective studies evaluating ischaemic heart disease 28…”

Section: Methods and Analysismentioning

confidence: 99%

Prognostic stratification of older patients with multivessel coronary artery disease treated with percutaneous transluminal coronary angioplasty based on clinical and biochemical measures: protocol for a prospective cohort study

et al. 2022

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IntroductionThe incidence of acute coronary syndrome is rising in step with the growth of life expectancy. An increase in the age of patients with coronary artery disease has been related to in-hospital mortality, which has seen an upsurge over a short period of time. However, there is no consensus about the percutaneous coronary angioplasty strategy to follow for older patients with multivessel coronary artery disease (MVCAD). Complete revascularisation (CR) or incomplete revascularisation (ICR) strategy depends on prognosis but this has not yet been accurately described because of geriatric conditions and comorbidities. The aim of this study is to evaluate changes of clinical and biochemical parameters in older patients with MVCAD undergoing revascularisation and to establish a prognostic stratification model for CR and ICR.Methods and analysisThis observational, longitudinal, prospective study will include 150 patients with MVCAD and subsequent revascularisation who attend the Hospital Universitario Virgen de la Victoria (Málaga, Spain). Because of the dropout rates, 180 patients will be recruited at the beginning. Sociodemographic characteristics, clinical and angiographic parameters, and biochemical variables, such as cardiovascular, metabolic, inflammatory, stress oxidative biomarkers, will be collected in the admission for coronary revascularisation and three follow-ups at 6, 12 and 18 months. Statistical analyses will be conducted with these data using CR and ICR as the primary exposure variable. Relevant explanatory variables will be selected from a predictive model for their inclusion in a prognostic stratification model. The primary outcome measures will be major adverse cardiovascular events.Ethics and disseminationProtocols and patient information have been approved by the regional research ethics committee (CEIm Provincial de Málaga-PEIBA (PI0131/2020). The results will be disseminated in international peer-reviewed journals, presented at conferences in Cardiology and Gerontology, and sent to participants, medical and health service managers, clinicians and other researchers.

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“…Agra-Bermejo et al observed in a propensity-score analysis of an observational cohort a long-term benefit in terms of mortality of complete vs. culprit-only revascularization in older patients with NSTEMI [39]. However, other studies showed controversial results [40,41]. Further randomized evidence is warranted to clarify the better strategy regarding complete revascularization in the older patient.…”

Section: Non-stemi (Nstemi) Patients: Invasive Versus Conservative Treatment?mentioning

confidence: 99%

Acute Coronary Syndrome in the Older Patient

García‐Blas

Cordero

Díez‐Villanueva

et al. 2021

JCM

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Coronary artery disease is one of the leading causes of morbidity and mortality, and its prevalence increases with age. The growing number of older patients and their differential characteristics make its management a challenge in clinical practice. The aim of this review is to summarize the state-of-the-art in diagnosis and treatment of acute coronary syndromes in this subgroup of patients. This comprises peculiarities of ST-segment elevation myocardial infarction (STEMI) management, updated evidence of non-STEMI therapeutic strategies, individualization of antiplatelet treatment (weighting ischemic and hemorrhagic risks), as well as assessment of geriatric conditions and ethical issues in decision making.

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Clinical impact of complete revascularization in elderly patients with multi-vessel coronary artery disease undergoing percutaneous coronary intervention: A sub-analysis of the SHINANO registry

Cited by 21 publications

References 18 publications

Clinical study of patients with coronary artery disease combined multivessel disease

Clinical study of patients with coronary artery disease combined multivessel disease

Prognostic stratification of older patients with multivessel coronary artery disease treated with percutaneous transluminal coronary angioplasty based on clinical and biochemical measures: protocol for a prospective cohort study

Acute Coronary Syndrome in the Older Patient

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