Long-term Outcomes of Elective Percutaneous Coronary Interventions

Вершинина, Е. О.; Repin, A. N.

doi:10.18087/cardio.2018.7.10137

Cited by 3 publications

(2 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Simultaneously with the possibility of reliable decrease in perioperative MI, application of statins has nephroprotective effect. Usage of 40mg/12hrs rosuvastatin is associated with reliably less pronounce increase of serum creatinine and cystatin C within the fi rst day after the contrast X-ray intervention [34][35][36]. Understanding of cardiorenal interactions makes it possible to conclude that the function of kidneysor, to be precise, their dysfunction -could be considered as a free-standing factor of cardiovascular risk.…”

Section: Modifi Able Risks Before Elective Pci: Prognostic Signifi Camentioning

confidence: 99%

Preparation of Patients for Elective Percutaneous Coronary Intervention: Management of Risk Factors as an Approach to Increase in Intervention Efficacy

et al. 2019

View full text Add to dashboard Cite

The article is a topical literature review of the place of percutaneous coronary interventions in the structure of elective revascularisation procedures, preoperative preparation of patients with stable ischaemic heart disease before percutaneous coronary intervention, the prospects of the technique, taking into account the latest advances in intervention cardiology (intravascular methods for assessing the hemodynamic significance of stenosis, drug eluting stents). Modern data of the early and long-term results of percutaneous coronary intervention are presented, the predictable potentially modifiable risks of adverse events are described, and ways to correct them are discussed. The results of randomised studies comparing the effectiveness of different approaches for managing patients with stable coronary heart disease (medical therapy, percutaneous coronary intervention) are presented, and prospects for using new drugs to improve the early and late outcomes of endovascular revascularisation are discussed.

show abstract

Section: Modifi Able Risks Before Elective Pci: Prognostic Signifi Camentioning

confidence: 99%

Preparation of Patients for Elective Percutaneous Coronary Intervention: Management of Risk Factors as an Approach to Increase in Intervention Efficacy

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Чрескожные коронарные вмешательства (ЧКВ) широко используются для плановой реваскуляризации миокарда. Острые осложнения процедуры, такие как острое повреждение миокарда (ОПМ) и перипроцедурное острое повреждение почек (ОПП), связаны с последующим прогнозом пациентов и остаются достаточно частыми, несмотря на активное медикаментозное сопровождение ЧКВ и постоянное техническое усовершенствование используемых устройств [1,2].…”

unclassified

Association of ACE gene polymorphisms with cardiovascular events in patients after elective percutaneous coronary interventions

et al. 2022

Self Cite

View full text Add to dashboard Cite

Aim. To reveal the association of the INS/DEL polymorphism of the angiotensinconverting enzyme (ACE) gene with acute and long-term complications of elective percutaneous coronary interventions (PCI).Material and methods. This prospective study included 286 patients with chronic coronary artery disease who underwent elective endovascular myocardial revascularization in accordance with current guidelines. The ACE gene INS/DEL (I/D) polymorphism was determined in patients using polymerase chain reaction. Acute periprocedural complications were recorded. Acute myocardial injury (AMI) was detected in 30,4% of patients. Type 4a acute myocardial infarction developed in 3,1% of patients. A significant decrease in the glomerular filtration rate by more than 30% due to periprocedural acute kidney injury (AKI) was diagnosed in 6,5% of patients. Outcomes of elective PCIs were assessed after 4 years via telephone interviews. Cardiovascular and any-cause mortality was 3,6% and 5,1%, respectively. Acute coronary syndrome during the follow-up period developed in 15,2%, while cerebrovascular accident — in 5,4% of patients. Any-stent thrombosis was detected in 10%, and restenosis ≥30% — in 21,8% of patients. Statistical analysis was carried out using the STATISTICA 10. The odds ratio (OR) was calculated with a 95% confidence interval.Results. Analysis of the association of ACE gene I/D polymorphism with acute and long-term complications of the PCI revealed that the presence of I allele is associated with the risk of periprocedural AKI (p=0,017; OR, 2,627 (1,161- 5,947)), as well as long-term cardiovascular events, vascular complications such as acute coronary syndrome (p=0,045; OR, 1,610 (1,007-2,573)) and stent thrombosis (p=0,01; OR, 2,073 (1,178-3,650)). The presence of genotype II further increases the risk of AKI (p=0,029; OR, 5,138 (1,022-25,824)), any acute clinical complications of PCI (p=0,041; OR, 1,996 (1,024-3,980)), and stent thrombosis (p=0,018, OR, 3,498 (1,178-10,392)).Conclusion. In patients with chronic coronary artery disease, the carriage of allele I and genotype II of the ACE gene I/D polymorphism is associated with the risk of acute clinical complications of elective PCI, periprocedural AKI, as well as the risk of stent thrombosis and acute coronary syndrome within 4-year follow-up period after PCI.

show abstract

Frequency and Prognostic Value of Acute Periprocedural Myocardial Injury in Elective Percutaneous Coronary Interventions

Nalesnik,

Repin

2024

Arhivʺ vnutrennej mediciny

Self Cite

View full text Add to dashboard Cite

Background. Periprocedural myocardial injury (PMI) is an acute complication of percutaneous coronary interventions (PCI) in patients with stable coronary artery disease. Its frequency and relationship with the prognosis of the disease are especially important in elective interventions due to the low risk of ischemic events in this cohort of patients. However, according to the literature, there are significant differences in the criteria for PMI and type 4a myocardial infarction (MI), and, accordingly, their frequency and their prognostic value. Aim. To study the frequency and magnitude of PMI during elective PCI in terms of the level of periprocedural increase in cardiospecific biomarkers, as well as to determine the relationship of PMI with long-term adverse events in patients with chronic coronary artery disease. Materials and methods. A single-center open retrospective cohort study was conducted, which included 435 patients (367/84.4 % men, mean age 58.3±8.6 years) from the elective PCI registry. PMI was diagnosed with an increase in the level of creatine phosphokinase MB fraction (CK-MB) or or cardiac troponin I (cTn I) >1×99 percentile URL (Upper Reference Limit), while the level of increase in biomarkers >1, 2, 3, 4 or >5×99 percentile URL was recorded. An increase in biomarkers >5x99 URL percentile was assessed as a large PMI, and in the presence of clinical and imaging evidence of new loss of viable myocardium, as periprocedural MI type 4a. Depending on the level of periprocedural increase in biomarkers, the relative risk (RR) of developing long-term (within 5 years after index PCI) adverse cardiovascular events, death, as well as clinically significant bleeding and newly diagnosed malignant oncological diseases was calculated. In addition, the correlation between PMI and the above endpoints was summarized using Kaplan-Meier analysis. Results. The frequency of periprocedural PMI diagnosed by increased biomarkers >1×99 percentile URL was 40.2 %, >2×99 percentile URL — 9.7 %, >3×99 percentile URL — 6.7 %, >4×99 percentile URL — 4.8 %, >5×99 percentile URL — 3.5 %, type 4a MI — in 2 patients (0.46 %). An association of “major” PMI (>5x99 percentile URL) with cardiovascular complications within 3 years after elective PCI, including fatal ones, was revealed: for acute myocardial infarction (AMI), RR — 6.516, confidence interval (CI) [2.375-17.881]; for death from cardiovascular causes RR — 6.538, CI [1.695-25.227]. An association of “moderate” PMI (>3, but <5 ×99 URL percentile) with acute ischemic events within 3 years after elective PCI was shown: for AMI, RR was 4.073, CI [1.598 — 10.378]. An association of “minor” AKI (>1, but <5 ×99 URL percentile) with acute ischemic events within 3 years after elective PCI was shown: for AMI, RR was 4.073, CI [1.598 — 10.378]. An association of “minor” AKI (>1, but <3 ×99 URL percentile) with newly diagnosed malignant oncological diseases within 5 years after index PCI was revealed: RR 2.319; CI [1.248- 4.310]. An association of late thrombotic events, such as stent thrombosis (index and re-interventions), stent occlusion (index and non-index) as a reason for re-intervention within 5 years after index PCI, was found with most PMI subgroups. Kaplan-Meier analysis of the dependence of clinically significant bleeding within 5 years after index PCI on the development of “moderate” PMI (p=0.003), as well as the association of non-cardiovascular death within 5 years after index PCI with “minor” PMI (p= 0.007). Conclusion. Registration of periprocedural increase in cardiac biomarkers should be carried out during planned PCI not only for the purpose of diagnosing and predicting acute and late ischemic events, but also for assessing the risk of developing stent occlusion, clinically significant bleeding and prognostically important comorbidities in the long-term (5-year) period in order to identification of groups of patients requiring active monitoring, additional examination and selection of an optimal treatment regimen at the outpatient stage of rehabilitation.

show abstract

Long-term Outcomes of Elective Percutaneous Coronary Interventions

Cited by 3 publications

References 26 publications

Preparation of Patients for Elective Percutaneous Coronary Intervention: Management of Risk Factors as an Approach to Increase in Intervention Efficacy

Preparation of Patients for Elective Percutaneous Coronary Intervention: Management of Risk Factors as an Approach to Increase in Intervention Efficacy

Association of ACE gene polymorphisms with cardiovascular events in patients after elective percutaneous coronary interventions

Frequency and Prognostic Value of Acute Periprocedural Myocardial Injury in Elective Percutaneous Coronary Interventions

Contact Info

Product

Resources

About