Guidelines for percutaneous transluminal coronary angioplasty. A report of the American College of Cardiology/American Heart Association Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures (Subcommittee on Percutaneous Transluminal Coronary Angioplasty).

Ryan, Thomas J.; Faxon, David P.; Gunnar, R M; Kennedy, J. Ward; King, Spencer B.; Loop, Floyd D.; Peterson, Kirk L.; Reeves, Tim; Williams, David O.; Winters, William L.

doi:10.1161/01.cir.78.2.486

Cited by 1,165 publications

(448 citation statements)

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“…Angiographic lesion morphology before coronary angioplasty was categorized according to the scheme of the American College of Cardiology/American Heart Association Task Force classification. 5) Minimal luminal diameter, percent of diameter stenosis, acute gain, and balloon/vessel ratios were assessed by computerized quantitative angiography. Procedural angiograms were also analyzed for Thrombolysis in Myocardial Infarction (TIMI) flow grade, 6) coronary angioplasty was considered successful if the final percent diameter stenosis was less than 30% with TIMI 3 flow in the absence of death, recurrent ischemia, MI (creatine kinase increase to more than twice the upper limit of normal with or without evidence of new Q waves), or urgent coronary artery bypass graft (CABG) during the hospital period.…”

Section: Methodsmentioning

confidence: 99%

The Prognostic Value of IL-8 for Cardiac Events and Restenosis in Patients with Coronary Heart Diseases After Percutaneous Coronary Intervention

Qi¹,

Li²,

Li³

2003

Jpn Heart J

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SUMMARYThe objective of the present study was to investigate the prognostic value of plasma interleukin-8 (IL-8) for adverse cardiac events and restenosis in patients with percutaneous coronary intervention (PCI). The pre-and post-procedural peak plasma levels of IL-8 and serum C-reactive protein (CRP) were examined by immunoassay, while adverse cardiac events and restenosis within one year follow-up were observed in 134 consecutive patients who underwent PCI. Angiography revealed that 23.88% (32/134) of the patients had adverse cardiac events and 29.41% (35/119) of the patients had restenosis. Preprocedural levels of IL-8 and CRP and post-procedural peak levels of IL-8 in patients with adverse cardiac events were higher than those without adverse cardiac events (all P < 0.05). The incidence of adverse cardiac events increased from 6.67% in the bottom tertile to 31.82% in the top tertile of IL-8 levels (P = 0.001); a similar trend was observed for restenosis from 10% in low tertile to 51.28% in high tertile of IL-8 levels to 51.8% (P = 0.012). The preprocedural levels of IL-8 (RR = 5.539, CI = 1.720-17.887, P = 0.001) and CRP (RR= 2.031, CI = 1.132-2.049, P = 0.003) were the only independent predictors of adverse cardiac events. The post-procedure peak level of IL-8 (RR = 3.766, CI = 2.990-5.904, P = 0.002) and stent length (RR = 1.468, CI = 1.161-2.022, P = 0.021) were the independent predictors of restenosis. The results demonstrate that the release of IL-8 after PCI is a powerful prognostic factor for cardiac events and restenosis. The higher the peak level of post-procedure IL-8, the lower the event-free survival observed. (Jpn Heart J 2003; 44: 623-632) Key words: PCI, IL-8, Cardiac events, Restenosis PERCUTANEOUS coronary intervention (PCI) is an established myocardial revascularization procedure. However, the high initial success rate is compromised by the risk of cardiac events and restenosis ranges from 30% to 60%. Recent experimental and clinical studies have shown that inflammatory cytokines and inflammatory responses can be provoked following PCI in patients with coronary heart disease, and there are accumulations of inflammatory cells around the From

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Section: Methodsmentioning

confidence: 99%

The Prognostic Value of IL-8 for Cardiac Events and Restenosis in Patients with Coronary Heart Diseases After Percutaneous Coronary Intervention

Qi¹,

Li²,

Li³

2003

Jpn Heart J

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“…In our study we divided the optimum window of routine early intervention post thrombolysis into two groups, a very early group who performed the post thrombolysis intervention [3][4][5][6][7][8][9][10][11][12] hours and an early group who performed the intervention 12-24 hours. Since no other studies were designed to lay bare the assumption that very early revascularization might be superior compared to the early one, within the first 24 hours.…”

Section: Discussionmentioning

confidence: 99%

“…Angiographic data: Coronary angiography and subsequent needed intervention for the culprit vessel was done for each patient according to the index time of each study group with the following data obtained: Culprit and other vessel affection, site of the lesion, type of the lesion according to AHA/ACC classification system into 3 types A, B and C, [12] the degree of stenosis, thrombus burden, [13] TIMI flow, [14] and myocardial blush grade (MBG) [15] were assessed. N.B.…”

Section: Ecgmentioning

confidence: 99%

Very Early versus Early Invasive Strategy after Successful Thrombolysis in Patients with ST Segment Elevation Myocardial Infarction

2016

JCCR

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Background: Till this time even with superiority of primary percutaneous coronary intervention (pPCI) in the management of ST segment elevation myocardial infarction (STEMI), most of patients present to hospitals without pPCI facilities receive fibrinolytic therapy. The current recommendations support routine early invasive strategy within 24 hours.Objectives: we aimed at evaluating the best timing of invasive strategy within the first 24 hours. Methods:The study was conducted on 60 STEMI patients who were referred to our center after successful thrombolysis. Patients were randomized into 2 groups: Very early invasive group (n=30): subjected to very early invasive strategy within 3 to 12 hours post thrombolysis. Early invasive group (n=30): subjected to early invasive strategy within 12 to 24 hours. The primary endpoints were the composite endpoints of major adverse cardiac events (MACEs). Secondary endpoints were achievement of TIMI III flow with MBG II or III. Safety endpoints were bleeding complications.Results: Both groups were homogenous regarding the demographic, clinical, and angiographic data before invasive strategy. TIMI III flow and MBG II or III were achieved in 83.3% of patients in the very early invasive group vs. 86.6% in the early group (P = 0.955). There was no difference between both groups regarding the composite endpoints MACEs (P= 0.667) or bleeding complications (P=0.528). Conclusion:The study did not demonstrate a correlation between magnitude of benefit and timing of early PCI post successful thrombolysis in patients with STEMI. Thus, early invasive strategy could be scheduled depending on the logistics of the reference catheterization laboratory within 24 hours post thrombolysis.

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“…The type of angiographic lesion was determined according to ACC/AHA criteria. 10) Procedural success was defined as residual stenosis < 30% in the worse of two orthogonal views, as assessed by quantitative analysis and normal runoff of the contrast medium in the stented vessel, and absence of death, myocardial infarction, and the need for further revascularization procedures during the hospital stay. Statistical analysis: Data are presented as the mean ± SD.…”

Section: Methodsmentioning

confidence: 99%

C-Reactive Protein and Immunoglobulin-E Response to Coronary Artery Stenting in Patients with Stable Angina

et al. 2003

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SUMMARYRecent reports indicate that inflammatory mechanisms play a crucial role in the pathogenesis of atherosclerosis and neointimal proliferation as well as coronary restenosis. To provide baseline data for further studies regarding stenting, restenosis and inflammatory response, we prospectively conducted a clinical study to investigate the time related response of plasma levels of immunoglobulin-E (IgE) and C-reactive protein (CRP) which are two different inflammatory markers mediated by different cytokines in stable patients who underwent elective coronary artery stenting. Thirteen consecutive stable patients who underwent coronary artery stenting were included in the study. Levels of IgE and CRP were determined pre-and poststent implantation on four consecutive days and at the end of the first as well as third month. Levels of these two markers were gradually elevated on postprocedure days while reaching peak values on the second and third days for IgE (initial 278 ± 335 IU/mL vs peak 350 ± 489 IU/mL, P = 0.01) and CRP (initial 0.5 ± 0 mg/dL vs peak 2.7 ± 3 mg/dL, P = 0.002), respectively. High levels gradually returned to baseline values determined at the end of the first and even third months after stent implantation implying an acute inflammatory reaction. Stent implantation seems not to cause any persistent and ongoing inflammatory response in the long term. (Jpn Heart J 2003; 44: 593-600)

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Guidelines for percutaneous transluminal coronary angioplasty. A report of the American College of Cardiology/American Heart Association Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures (Subcommittee on Percutaneous Transluminal Coronary Angioplasty).

Cited by 1,165 publications

References 76 publications

The Prognostic Value of IL-8 for Cardiac Events and Restenosis in Patients with Coronary Heart Diseases After Percutaneous Coronary Intervention

The Prognostic Value of IL-8 for Cardiac Events and Restenosis in Patients with Coronary Heart Diseases After Percutaneous Coronary Intervention

Very Early versus Early Invasive Strategy after Successful Thrombolysis in Patients with ST Segment Elevation Myocardial Infarction

C-Reactive Protein and Immunoglobulin-E Response to Coronary Artery Stenting in Patients with Stable Angina

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