Feasibility of management of hemodynamically stable patients with acute myocardial infarction following primary percutaneous coronary intervention in the general ward settings

Tateishi, Kazuya; Nakagomi, Atsushi; Saito, Yuichi; Kitahara, Hideki; Kanda, Masato; Shiko, Yuki; Kawasaki, Yohei; Kuwabara, Hiroyo; Kobayashi, Yoshio; Inoue, Takahiro

doi:10.1371/journal.pone.0240364

Cited by 6 publications

(3 citation statements)

References 24 publications

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“…The present study used the DPC database, which consists of administrative claim data regularly collected from participating hospitals under the DPC system. 11 The DPC database includes inpatient information such as disease diagnosis, comorbidities, Killip class on admission, the use of mechanical support (intra‐aortic balloon pumping and extracorporeal membrane oxygenation), and medications. Diseases were identified with the International Classification of Disease, Tenth Revision ( ICD‐10 ) codes.…”

Section: Methodsmentioning

confidence: 99%

Volume‐Outcome Relationships for Percutaneous Coronary Intervention in Acute Myocardial Infarction

Saito

Tateishi

Kanda

et al. 2022

JAHA

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Background Lower primary percutaneous coronary intervention (PCI) volume is known to be associated with worse outcomes in patients with acute myocardial infarction (MI) at hospital level. The present study aimed to evaluate the relations of primary, elective, and total PCI volume and primary/total PCI volume ratio per hospital to in‐hospital mortality in patients with acute MI undergoing primary PCI. Methods and Results Using a large nationwide administrative database, we included a total of 83 076 patients from 154 hospitals in Japan undergoing PCI for either acute MI or elective cases. Relations of annual procedural volumes for primary, elective, and total PCI to in‐hospital mortality after acute MI at hospital level were evaluated. The ratio of primary to total PCI volume per hospital was also assessed. The primary end point was the ratio of observed to predicted mortality. Of 83 076 patients, 26 913 (32.4%) underwent primary PCI for acute MI, among whom 1561 (5.8%) died during hospitalization. Overall, observed in‐hospital mortality after acute MI and observed/predicted mortality ratio were higher in hospitals with lower primary, elective, and total PCI volumes. Observed/predicted in‐hospital mortality ratio was higher in hospitals with low primary/total PCI volume ratio, even in those with high total PCI volume. Conclusions Primary, elective, and total PCI volume at hospitals were inversely associated with in‐hospital mortality in patients with acute MI undergoing primary PCI. Lower ratio of primary to total PCI volume were related to higher in‐hospital mortality, suggesting primary/total PCI volume ratio as an institutional indicator of quality of care for acute MI.

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Section: Methodsmentioning

confidence: 99%

Volume‐Outcome Relationships for Percutaneous Coronary Intervention in Acute Myocardial Infarction

Saito

Tateishi

Kanda

et al. 2022

JAHA

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“…Drug-eluting stents (DES) have a higher e cacy and safety pro le than bare metal stents (BMS), and international guidelines recommend their use as rst-line treatment [20]. Although stent technology has made great progress in recent years, the incidence of ISR has not improved signi cantly and has become one of the major clinical challenges in the treatment of CAD [21]. Chronic in ammation and/or endothelial dysfunction may induce late de novo neoatherosclerosis inside.…”

Section: Discussionmentioning

confidence: 99%

Gensini Score as a Predictor for in-Stent Restenosis in Patients with Coronary Artery Disease (CAD)

Shi-qi

Gai

Wang

et al. 2021

Preprint

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Background: Despite Drug-eluting stent (DES) have considerably reduced the rates of in-stent restenosis (ISR). ISR is still the most common limitation of percutaneous coronary intervention（PCI). The aim of this study was to investigate potential predictors on ISR in patients with DES implantation for Coronary heart disease (CAD).Methods: A retrospective case-control study was conducted. A total of 916 patients who underwented DESs implantations and angiography follow-up within one year at the First Affiliated hospital of Xinjiang medical University, between September, 2013, and September, 2016, were included. The subjects were divided into 2 groups, ISR (n=315) and non-ISR (n=601), ISR was defined as a diameter stenosis of ≥50% located within a coronary stent or up to 5 mm beyond the stent edges. Clinical data and angiographic characteristics were collected. CAD severity was evaluated by calculating the Gensini score. The logistic regression and ROC analysis were pereformed to screen out efficient predictors.Results: Comparation between the ISR group and the non-ISR group, Gensini Score, diastolic pressure, waist, blood glucose, left ventricular end diastolic diameter (LVED), left ventricular end systolic diameter (LVES) levels were higher in ISR group, and ApoA1, ejection fraction (EF%), and accidence of myocardial infarction (MI) were lower in the ISR group. Comparation of angiographic characteristics between the groups, the results showed the occurrence of stenosis in vessels of left main coronary artery (LM), left anterior descending artery(LAD), or right coronary artery (RCA) have more vulnerability to ISR. Patients in the ISR group have been implanted more stents. In univariate regression analysis, diastolic pressure, waist, history of MI, ApoA1, number of implanted stents, and Gensini Score were associated with ISR. After multiple logistic regression analysis, Gensini score was screen out to be an independent risk factor of ISR. Receiver operating characteristic curve analysis identified that the Gensini score was a reliable predictor for ISR, area under curve (AUC): 0.80 (0.78-0.83), Sensitivity and specificity were 73.33% and 72.33%, respectively.Conclusions: Gensini score was independently associated with ISR, and was a good predictor for ISR in patients with DES implantaion.

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“…Routine lidocaine is gone, but there is increasing resort to assisted circulation, such as that provided by the Impella device (11). Progress in mechanically assisted circulatory support will increasingly improve survival of severe MI and might increase consideration of lesserstaffed recovery units for relatively robust patients (12)(13)(14)(15).…”

mentioning

confidence: 99%

After a Heart Attack, Who Should Care?*

Yasuhara

Alston

2022

Critical Care Medicine

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Feasibility of management of hemodynamically stable patients with acute myocardial infarction following primary percutaneous coronary intervention in the general ward settings

Cited by 6 publications

References 24 publications

Volume‐Outcome Relationships for Percutaneous Coronary Intervention in Acute Myocardial Infarction

Volume‐Outcome Relationships for Percutaneous Coronary Intervention in Acute Myocardial Infarction

Gensini Score as a Predictor for in-Stent Restenosis in Patients with Coronary Artery Disease (CAD)

After a Heart Attack, Who Should Care?*

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