Clinical prognosis of optimal medical therapy after percutaneous coronary intervention in patients with coronary heart disease

Hao, Jing-Yan; Zhang, Jian; Jiang, Rui; Liu, Jingjing; Di, Chengye; Lu, Yan-qing; Gao, Peng; Wang, Yajie; Yang, Rui-Fei; Lin, Wenhua

doi:10.1097/cm9.0000000000001720

Cited by 4 publications

(3 citation statements)

References 8 publications

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“…Clinical trial and registry data have demonstrated a 31–39% and 21–32% prevalence of two-vessel and three-vessel diseases, respectively, in patients undergoing revascularization. [ 1 2 3 ] Multi-vessel coronary artery disease (CAD) occurs in 40–50% of patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PCI). [ 4 5 6 ] Previous studies have shown that complete revascularization is associated with lower rates of long-term adverse events when compared with incomplete revascularization.…”

Section: Introductionmentioning

confidence: 99%

Residual coronary artery tree description and lesion EvaluaTion (CatLet) score, clinical variables, and their associations with outcome predictions in patients with acute myocardial infarction

Wang

Zhang

et al. 2023

Chinese Medical Journal

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Background: We have recently developed a new Coronary Artery Tree description and Lesion EvaluaTion (CatLet) angiographic scoring system. Our preliminary studies have demonstrated its superiority over the the Synergy between percutaneous coronary intervention (PCI) with Taxus and Cardiac Surgery (SYNTAX) score with respect to outcome predictions for acute myocardial infarction (AMI) patients. The current study hypothesized that the residual CatLet (rCatLet) score predicts clinical outcomes for AMI patients and that a combination with the three clinical variables (CVs)—age, creatinine, and ejection fraction, will enhance its predicting values. Methods: The rCatLet score was calculated retrospectively in 308 consecutively enrolled patients with AMI. Primary endpoint, major adverse cardiac or cerebrovascular events (MACCE) including all-cause mortality, non-fatal AMI, transient ischemic attack/stroke, and ischemia-driven repeat revascularization, was stratified according to rCatLet score tertiles: rCatLet_low ≤3, rCatLet_mid 4–11, and rCatLet_top ≥12, respectively. Cross-validation confirmed a reasonably good agreement between the observed and predicted risks. Results: Of 308 patients analyzed, the rates of MACCE, all-cause death, and cardiac death were 20.8%, 18.2%, and 15.3%, respectively. Kaplan–Meier curves for all endpoints showed increasing outcome events with the increasing tertiles of the rCatLet score, with P values <0.001 on trend test. For MACCE, all-cause death, and cardiac death, the area under the curves (AUCs) of the rCatLet score were 0.70 (95% confidence intervals [CI]: 0.63–0.78), 0.69 (95% CI: 0.61–0.77), and 0.71 (95% CI: 0.63–0.79), respectively; the AUCs of the CVs-adjusted rCatLet score models were 0.83 (95% CI: 0.78–0.89), 0.87 (95% CI: 0.82–0.92), and 0.89 (95% CI: 0.84–0.94), respectively. The performance of CVs-adjusted rCatLet score was significantly better than the stand-alone rCatLet score in terms of outcome predictions. Conclusion: The rCatLet score has a predicting value for clinical outcomes for AMI patients and the incorporation of the three CVs into the rCatLet score will enhance its predicting ability. Trial Registration: http://www.chictr.org.cn, ChiCTR-POC-17013536.

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Section: Introductionmentioning

confidence: 99%

Residual coronary artery tree description and lesion EvaluaTion (CatLet) score, clinical variables, and their associations with outcome predictions in patients with acute myocardial infarction

Wang

Zhang

et al. 2023

Chinese Medical Journal

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“…At present, optimal medical therapy (OMT) [ 1 ] and timely coronary revascularization [ 2 ] continue to improve the prognosis of coronary heart disease (CHD) patients. However, angina pectoris, myocardial infarction, malignant arrhythmia, heart failure, and mortality remain high due to coronary artery stenosis or occlusion.…”

Section: Introductionmentioning

confidence: 99%

Effects of monitoring exercise rehabilitation with target intensity on the patient with twice PCI: A case report

Liu

Chen

et al. 2023

Medicine

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Rationale: As the core of cardiac rehabilitation (CR), early exercise rehabilitation is beneficial for patients with coronary heart disease (CHD), and center-based CR with target intensity is superior to home-based CR. However, there was no research to observe the effects of exercise rehabilitation on cardiopulmonary exercise capacity, oxygen uptake efficiency slope, endothelial function evaluated as flow-mediated vasodilation (FMD), and blood plasma lipoprotein-associated phospholipase A2 (Lp-PLA2) in CHD patients undergone percutaneous coronary intervention (PCI) for 3 months. Patient concerns: A 57-year-old woman had been identified with triple vessel disease and undergone twice PCI for complete revascularization, however, there was no improvement in Lp-PLA2, FMD, and related indicators of cardiopulmonary exercise testing. Diagnosis: Coronary angiography showed an 85% stenosis in the middle left anterior descending artery, an 85% stenosis in the proximity of a thick first-diagonal branch, a long 75 to 85% stenosis in the middle left circumflex artery, and a 90 to 95% stenosis in the proximal. The case was diagnosed as CHD. Interventions: The patient obtained optimal medical therapy comprising therapeutic lifestyle changes, and began monitoring exercise rehabilitation with target intensity 3 months after the second PCI in the CR center. Outcomes: There were changes in cardiopulmonary exercise capacity, oxygen uptake efficiency slope, FMD, and Lp-PLA2 in the patient with 3 apparent stenotic coronary arteries who was done PCI twice, without or with postoperative exercise rehabilitation, respectively. Lessons: We proved that monitoring exercise rehabilitation training with target intensity could improve the prognosis of chronic coronary syndrome patients, and it was never too late to do regular exercise rehabilitation.

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“…Coronary artery bypass grafting (CABG) is one of the most effective treatments for coronary artery disease (CAD) patients. [1][2][3][4][5] CABG patients remain at a high risk for experiencing long-term events, with reported 10-year rates for major cardiovascular events ranging from 26.1% to 47.6%. [6][7][8][9][10][11] While several preoperative cross-tools are available that help physicians to evaluate surgical efficacy and tailor treatment over time.…”

Section: Introductionmentioning

confidence: 99%

Identifying coronary artery bypass grafting patients at high risk for adverse long-term prognosis using serial health-related quality of life assessments

Wang,

Liu,

Yue

et al. 2023

Chinese Medical Journal

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Background: Patients who undergo coronary artery bypass grafting (CABG) are known to be at a significant risk of experiencing long-term adverse events, emphasizing the importance of regular assessments. Evaluating health-related quality of life (HRQoL) serves as a direct method to gauge prognosis. Our objective is to ascertain the prognostic significance of consecutive HRQoL assessments using the Physical Component Summary (PCS) and Mental Component Summary (MCS) derived from the Short-Form 36 (SF-36) health survey in CABG patients. Methods: The study population consisted of 433 patients who underwent isolated elective CABG at Fuwai Hospital between 2012 and 2013. SF-36 assessments were conducted during both the hospitalization period and follow-up. The primary endpoint of the study was all-cause mortality, while the secondary outcome was a composite measure including death, myocardial infarction, stroke, and repeat revascularization. We assessed the relationships between the PCS and MCS at baseline, as well as their changes during the first 6 months after the surgery (referred to as ΔPCS and ΔMCS, respectively), and the observed outcomes. Results: The patients were followed for an average of 6.28 years, during which 35 individuals (35/433, 8.1%) died. After adjusting for clinical variables, it was observed that baseline MCS scores (hazard ratio [HR] for a 1-standard deviation [SD] decrease, 1.57; 95% confidence interval [CI], 1.07–2.30) and ΔMCS (HR for a 1-SD decrease, 1.67; 95% CI, 1.09–2.56) were associated with all-cause mortality. However, baseline PCS scores and ΔPCS did not exhibit a significant relationship with all-cause mortality. Notably, there was a dose-response relationship observed between ΔMCS and the likelihood of all-cause mortality (HRs for the 2nd, 3rd and 4th quartiles compared to the 1st quartile, 0.33, 0.45 and 0.11, respectively). Conclusions: Baseline MCS and changes in MCS were independent predictors for long-term mortality of CABG. Better mental health status and recovery indicated better prognosis.

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Clinical prognosis of optimal medical therapy after percutaneous coronary intervention in patients with coronary heart disease

Cited by 4 publications

References 8 publications

Residual coronary artery tree description and lesion EvaluaTion (CatLet) score, clinical variables, and their associations with outcome predictions in patients with acute myocardial infarction

Residual coronary artery tree description and lesion EvaluaTion (CatLet) score, clinical variables, and their associations with outcome predictions in patients with acute myocardial infarction

Effects of monitoring exercise rehabilitation with target intensity on the patient with twice PCI: A case report

Identifying coronary artery bypass grafting patients at high risk for adverse long-term prognosis using serial health-related quality of life assessments

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