Clinical impact of complex percutaneous coronary intervention in patients with coronary artery disease

Endo, Hirohisa; Dohi, Tomotaka; Miyauchi, Katsumi; Takahashi, Daigo; Funamizu, Takehiro; Shitara, Jun; Wada, Hideki; Kato, Yoshiteru; Okai, Iwao; Iwata, Hiroshi; Okazaki, Shinya; Isoda, Kikuo; Daida, Hiroyuki

doi:10.1007/s12928-019-00608-7

Cited by 14 publications

(11 citation statements)

References 25 publications

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“…Pakistan and Brazilian studies had presented a higher prevalence as compared to this nding and were found to be 22.9% and 22.3% respectively (21,22). whereas nearly equal with the study done in the USA which is 19.4% (23). However, another multicenter study in the USA reported low prevalence as compared to this study which is 0.95% (24).…”

Section: Discussioncontrasting

confidence: 46%

Outcome of Percutaneous coronary intervention and associated factors among patients with coronary artery disease in selected public hospital Addis Ababa, Ethiopia, 2022; A cross-sectional study

Amdestion¹,

Fetensa

Wondimu

et al. 2022

Preprint

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Background Percutaneous coronary intervention is a non-surgical, invasive revascularization procedure of relieving the narrowing or occlusion of the coronary artery and improving blood supply to the ischemic tissue. However, in Ethiopia, limited numbers of research regarding outcomes of percutaneous coronary intervention, and most of them lack representativeness. Objectives The aim of this study is to assess the outcome of percutaneous coronary intervention and associated factors among patients with coronary artery disease in selected public hospitals in Addis Ababa. Methods Institutional-based cross-sectional study was conducted from January 2017 up to September 2021 GC in the coronary unit of the selected public and private hospitals. Records of patients from the coronary cardiac unit (n = 408) were reviewed and the sample size was allocated proportionally and subjects were selected by using a simple random sampling technique. The data were abstracted using a checklist and entered into Epi Data manager version 4.6 and statistical analyses were performed using the SPSS version 25. The strength of association was assessed using odds ratio and Variables that had a value of P ≤ 0.25 on bivariable analysis were directly forward to be analyzed by multivariable analysis then having P-values < 0.05 is considered as statistically significant. Result Out of 422 charts,408 were reviewed with a response rate of 96%, prevalence of procedure-related complications was 18.4%. Being male (AOR = 6.5295%CI:2.41–17.66), diabetes mellites patients (AOR = 2.1795%CI:1.17–4.03), being chronic kidney disease patient (AOR = 3.53, 95%CI:1.37–9.08), having a history of smoking (AOR = 3.69 95%CI:1.77–7.68), radial access (AOR = 0.38,95%CI:0.15–0.99), having ejection fraction of < 30%(AOR = 3.8595%CI:1.47–10.08), from31-40%(AOR = 3.68,95%CI:1.56–8.69) respectively were significantly associated with the outcome of percutaneous coronary intervention. Conclusion This study shows that percutaneous coronary intervention in spite of a low mortality rate, complications remain a concern. It is crucial to conduct further studies to identify other keys to determine percutaneous coronary intervention that might be better to conduct a prospective study with better investigation tools.

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Section: Discussioncontrasting

confidence: 46%

Outcome of Percutaneous coronary intervention and associated factors among patients with coronary artery disease in selected public hospital Addis Ababa, Ethiopia, 2022; A cross-sectional study

Amdestion¹,

Fetensa

Wondimu

et al. 2022

Preprint

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“…Randomized evidence on the differential clinical performances of newest‐generation DESs among patients undergoing complex versus noncomplex PCI is limited to large‐scale retrospective contemporary registries 4,5,17,18 and small‐sized post hoc subgroup 2 or pooled analyses 6 from randomized controlled trials that predominately included all‐comer PCI patients. These studies yielded conflicting results with respect to the ability of newer‐generation DESs to prevent repeat revascularization in patients with complex, compared with noncomplex, coronary lesions 2,4,5,17,18 .…”

Section: Discussionmentioning

confidence: 99%

Complex primary percutaneous coronary intervention with ultrathin‐strut biodegradable versus thin‐strut durable polymer drug‐eluting stents in patients with ST‐segment elevation myocardial infarction: A subgroup analysis from the BIOSTEMI randomized trial

Iglesias

Müller

Losdat

et al. 2023

Cathet Cardio Intervent

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Background: Ultrathin-strut biodegradable polymer sirolimus-eluting stents (BP-SES) are superior to thin-strut durable polymer everolimus-eluting stents (DP-EES) with respect to target lesion failure (TLF) at 2 years among patients with ST-segment elevation myocardial infarction (STEMI). We sought to determine the impact of primary percutaneous coronary intervention (pPCI) complexity on long-term clinical outcomes with BP-SES versus DP-EES in STEMI patients.Methods: We performed a post hoc subgroup analysis from the BIOSTEMI (NCT02579031) randomized trial, which included individual data from 407 STEMI patients enrolled in the BIOSCIENCE trial (NCT01443104). STEMI patients were randomly assigned to treatment with ultrathin-strut BP-SES or thin-strut DP-EES, and further categorized into those undergoing complex versus noncomplex pPCI.Complex pPCI was defined by the presence of ≥1 of the following criteria: 3 vessel treatment, ≥3 stents implanted, ≥3 lesions treated, bifurcation lesion with ≥2 stents implanted, total stent length ≥60 mm, and/or chronic total occlusion treatment. The primary endpoint was TLF, a composite of cardiac death, target-vessel myocardial reinfarction, or clinically indicated target lesion revascularization, within 2 years.Results: Among a total of 1707 STEMI patients, 421 (24.7%) underwent complex pPCI. Baseline characteristics were similar between groups. At 2 years, TLF occurred in 14 patients (7.1%) treated with BP-SES and 25 patients (11.6%) treated with

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“…Eight components of complex intervention procedures, with the left main as the target vessel, bifurcation PCI with two stents, multivessel PCI, >60 mm long stent implantation, restenosis, CTO lesion, ≥3 lesions treated and ≥3 stents implanted, were independently associated with poor major ischemic events. Some studies have addressed the association between each complex PCI component and hard clinical endpoints, such as cardiovascular mortality or myocardial infarction; however, data from the AMI population are scarce [ 2 , 27 ]. In our study, the presence of procedural complexity significantly affected poor prognosis in AMI patients successfully revascularized with coronary stents (second-generation drug-eluting stent usage: 65.8%).…”

Section: Discussionmentioning

confidence: 99%

Independent Clinical Impacts of Procedural Complexity on Ischemic and Bleeding Events in Patients with Acute Myocardial Infarction: Long-Term Clinical Study

Lee

Hwang

Lim

et al. 2022

JCM

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This study aimed to investigate the relationship between a complex percutaneous coronary intervention (C-PCI) and long-term clinical outcomes in the AMI cohort. A total of 10,329 patients were categorized into the C-PCI and non-C-PCI groups. The primary ischemic endpoint was a composite of major adverse cardiac events (MACEs, cardiac death, myocardial infarction, stent thrombosis and revascularization). The primary bleeding endpoint was the risk of overt bleeding (BARC 2, 3 or 5). The median follow-up duration was 4.9 (2.97, 7.16) years. The risks of MACEs and bleeding were significantly higher in the C-PCI group (hazard ratio (HR): 1.72; 95% confidence interval (CI): 1.60 to 1.85; p < 0.001; and HR: 1.32; 95% CI: 1.17 to 1.50; p < 0.001, respectively). After propensity score matching, compared to the non-C-PCI group, the adjusted MACE rate in C-PCI remained significantly higher (p < 0.001), but no significant interaction (p = 0.273) was observed for bleeding. Significant differences in overt bleeding were observed only within the first three months (p = 0.024). The MACEs were consistently higher in the C-PCI group with or without severe comorbid conditions (p < 0.001 for both). Patients with AMI who undergo C-PCI experience worse long-term ischemic outcomes after successful PCI, regardless of the presence of severe comorbidities.

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Clinical impact of complex percutaneous coronary intervention in patients with coronary artery disease

Cited by 14 publications

References 25 publications

Outcome of Percutaneous coronary intervention and associated factors among patients with coronary artery disease in selected public hospital Addis Ababa, Ethiopia, 2022; A cross-sectional study

Outcome of Percutaneous coronary intervention and associated factors among patients with coronary artery disease in selected public hospital Addis Ababa, Ethiopia, 2022; A cross-sectional study

Complex primary percutaneous coronary intervention with ultrathin‐strut biodegradable versus thin‐strut durable polymer drug‐eluting stents in patients with ST‐segment elevation myocardial infarction: A subgroup analysis from the BIOSTEMI randomized trial

Independent Clinical Impacts of Procedural Complexity on Ischemic and Bleeding Events in Patients with Acute Myocardial Infarction: Long-Term Clinical Study

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