Showing 6 results for Coronary Intervention
Nouzari Y, Faghihi Sh, Poorhoseini Hr,
Volume 64, Issue 12 (11-2006)
Abstract
Background: Despite recent improvement in coronary intervention, there are many controversies about it’s results in diabetic patients. The goal of this study is comparison of in hospital outcome of diabetics after coronary intervention with nondiabetics.
Methods: In this study 115 diabetic and 115non diabetic patients who admitted for coronary intervention in our center during 1383&84 were entered in an analytic study of Cohort type. Datas about clinical, aniographic, procedural and post procedural (24hours) characteristics were entered in each patient’s form. Independent T test,chi-square and Fisher’s exact test were used for analyzing datas.
Results: The Diabetic Patients were most often older men, and they had higher angina class, more co-risk factors and lower ejection fractions. Diabetic’s lesions were longer and more located in proximal portion of vessels. But success rate, major complication (death, revascularization, Q Wave MI and CVA), and minor complications (coronary/peripheral arteries complication, pulmonary edema, ischemic ECG) had no significant differences between two groups.
Conclusion: Diabetes mellitus does not affect short outcomes of coronary intervention as an independent factor. So intervention could be done in these patients with considering favorable outcomes.
Nozari Y, Gaemian A, Safir Mardanloo A,
Volume 65, Issue 3 (6-2007)
Abstract
Background: Percutaneous Coronary Intervention (PCI) for bifurcated lesions is associated with a low rate of success and high rate of complications compared to such treatment of lesions of most other morphologies. Symptoms occurring at the time of procedure caused by PCI may require additional angiography with or without stenting through stent struts, which subsequently increases risks of restenosis and stent thrombosis. The purpose of this study was to evaluate the incidence of major side branch (>1mm) complications during PCI and their clinical, angiographic, and interventional predictors.
Methods: Of 104 consecutive patients, we evaluated 50 lesions with ostial stenosis (group 1) and 54 lesions without ostial stenosis (group 2) as a control group. Age, sex, major coronary artery disease risk factors, and left ventricular ejection fraction (LVEF), were compared between groups. Morphology, location, type of lesion, length of lesion, main and side branch diameters, interventional approach, and clinical and interventional outcomes were the main variables studied during this trial.
Results: Side Branch Compromise (SBC) occurred in 41 (39.4%) of the total number of cases: 52% in group 1 and 27.8% in group 2 (p=0.01). More than 80% of SBC occurred in main branches with stenosis (p=0.02). SBC did not correlate with clinical characteristics, bifurcation location, LVEF, or stent number. Chest pain was reported in 18% of the cases during or after PCI. Three non Q wave myocardial infarctions (MI) occurred after SBC, each with >2 mm branch diameters (p=0.02). SBC was not associated with adverse clinical outcomes.
Conclusion: The risk of MI after losing the side branch of a bifurcation lesion is not usually as high as it is after losing the main branch. Furthermore, it may not be a serious problem as one of the problems of the bifurcation lesion is the high rate of post procedural non Q wave MI associated with SBC. These findings demonstrate that side branch ostial stenosis >50%, and main branch stenosis >80% were important predictors of SBC. Protection of side branches >2mm is highly recommended during coronary intervention.
Pedarzadeh A, Kassaian S.e, Esfahanian F, Goudarzinejad H.r, Payedari N, Salarifar M, Hajizeinali A.m, Alidoosti M, Boroumand M.a,
Volume 65, Issue 8 (11-2007)
Abstract
Background: Several randomized controlled trials have demonstrated the safety and efficacy of drug eluting stents (DES) in selected groups of patients with less complicated diabetes. We conducted this study to determine how an unselected group of diabetic patients in Iran fare following DES implantation.
Methods: Data were collected on 147 consecutive diabetic patients who underwent percutaneous coronary intervention (PCI) with the implantation of at least one DES at the Tehran Heart Center from June 2003 to September 2005. Clinical follow-up was performed by timely scheduled visits at one, four and nine months following DES implantation. Nine months of follow-up was completed for 94.5% of the patients. The primary endpoint was the occurrence of major adverse cardiac events (MACE), which include cardiac death, myocardial infarction and target vessel revascularization (TVR). In-hospital complications were the secondary endpoint.
Results: A total of 158 coronary artery lesions were treated with DES in 147 diabetic patients (mean age = 56.4±8.92 years, 57.1% were men). During the nine-month follow-up, MACE occurred in 3.4% of patients, with a myocardial infarction rate of 1.4% and TVR rate of 1.4%. Considering one patient who underwent TVR due to acute stent thrombosis following angioplasty (during hospitalization) the total number of TVR reached 3 (2%). Only one patient (0.7%) died of cardiac death, which occurred after the procedure and before discharge. In-hospital complications occurred in six patients (4.1%) five patients suffered from myocardial infarction.
Conclusions: PCI with DES seems to be safe and effective in diabetic patients. However, more studies with larger study populations and longer follow-up are required to confirm this issue.
Rahmani R, Nafasi L, Salary A, Meisami A, Abdollahi A,
Volume 70, Issue 11 (2-2013)
Abstract
Background: Percutaneous coronary intervention (PCI) may been associated with high-er risk of cardiac events during this procedure. The goal of this study was to compare high dose atorvastatin therapy with low dose atorvastatin therapy 24 hours before PCI to a reduction in Peri- percutaneous coronary intervention myocardial infarction.
Methods: One hundred ninety patients with stable angina were enrolled in a randomiz-ed controlled clinical trial study. All patients received low dose atorvastatin. The patients scheduled for elective PCI were randomized to atorvastatin (80 mg/d, n=95) or placebo (n=95) within 24 hours before the procedure. Creatine kinase-MB, troponin I, and high sensitive C- reactive protein levels were measured at baseline and at 6 and 12 hours after the procedure. PCI related myocardial infarction was defined as increasing of Creatine kinase-MB or troponin I three times compared with values before procedure.
Results: Myocardial infarction was detected after coronary intervention in 4.2% of patients in the atorvastatin group and in 13.7% of those in the placebo group (P=0.022). Mean of changed levels of Creatine kinase-MB (0.7±0.5 versus 3.3±1.9 ng/mL, P<0.001), troponin I (0.1±0.2 versus 0.4±0.7 ng/mL, P=0.052) and hs-CRP (0.1±0.5 versus 1±0.9 ng/mL, P<0.001) were significantly lower in the statin than in the placebo group.
Conclusion: Pretreatment with high dose atorvastatin within 24 hours before elective percutaneous coronary intervention significantly reduces procedural myocardial infarct-tion in elective coronary intervention.
Khalilullah Moonikh, Majid Kashef , Khalil Mahmoudi, Mojtaba Salehpour,
Volume 78, Issue 5 (8-2020)
Abstract
Background: Hypertension induces cardiac hypertrophy. Oxidative stress plays an important role in the pathogenesis of hypertension induced cardiac hypertrophy. Exercise and Quercetin (as activators of Sirtuins) reduce oxidative stress. The aim of this study was to investigate the effect of high-intensity interval training (HIIT) with Quercetin supplement on oxidative stress and level of concentric pathologic hypertrophy in patients with hypertension and coronary heart disease after angioplasty.
Methods: The present study was conducted experimentally randomized, placebo-controlled and double‑blind on 24 men with hypertension and coronary heart disease after angioplasty aged 40-60 since years May to August 2019 at the Exercise Physiology department of Sport Sciences Faculty, Shahid Rajaee Teacher Training University, Tehran, Iran. The subjects were randomly divided into two groups of HIIT+quercetin (n=12) and HIIT+placebo (n=12) and were followed during 8 weeks of high-intensity interval training (30 seconds of activity and 30 seconds of rest) and quercetin consumption (250 mgr of quercetin supplement or placebo pills daily). Echocardiography was used to investigate morphological factors such as posterior wall dimension (PWd) and left ventricular end diastolic diameter (LVEDd). Plasma total antioxidant capacity (TAC) and malondialdehyde (MDA) were measured by colorimetric method.
|
Results: The results showed that MDA and The relative wall thickness (RWT) decreased after 8 weeks in HIIT+ supplement and HIIT+placebo groups and TAC level and LVEDd increased significantly (P<0.05). PWd decreased significantly only in the exercise+supplement group (P<0.05). No significant difference between groups in any other variables was detected (P>0.05).
Conclusion: Eight weeks of high-intensity interval training alone or with quercetin by reducing oxidative stress(increasing total antioxidant capacity (TAC) and reducing malondialdehyde (MDA) reduces level of concentric pathologic hypertrophy in men with hypertension and coronary heart disease after angioplasty. So that high-intensity interval training with quercetin supplementation has relatively more effects.
|
Ahmadreza Assareh, Maryam Jozaei, Hoda Mombeini , Nehzat Akiash ,
Volume 79, Issue 10 (1-2022)
Abstract
Background: In patients with ST-segment elevation myocardial infarction (STEMI), Primary percutaneous coronary intervention (PCI) is the preferred reperfusion therapy. Timely primary PCI is essential in improving the clinical outcomes of these patients. The aim of this study was to evaluate the factors affecting balloon delay in STEMI treated patients by primary PCI and its relationship with major adverse cardiac events (MACE).
Methods: This prospective observational study was conducted on 143 cases of STEMI patients, who had the inclusion criteria and were treated by primary PCI, after obtaining written consent in Imam Khomeini hospital in Ahvaz, between May 2019 to May 2020. All-time components from symptom onset to PCI treatment include symptom-to-balloon time or ischemic time, symptom-to-door time and door-to-balloon time calculated. The incidence of major adverse cardiovascular events (MACE) including decompensated heart failure (DHF), acute coronary syndrome (ACS), sudden cardiac death (SCD) and cerebrovascular accident (CVA) was evaluated during 12 months follow up after primary PCI. left ventricular ejection fraction (LVEF) changes were evaluated 3 months after primary PCI.
Results: The median symptom-to-door time was 200.5 minutes (IQR: 90-438.75 min), the median ischemic time was 406 minutes (IQR: 231-671 min), and most patients had an ischemic time ≥120 minutes (92.4%) and door-to-device time ≥90 minutes (64.3%). The most common delay for treatment was in the symptom-to-door time (76.9%) and then the decision for primary PCI to transfer to the cat lab (17.5%). Overall, 59 (41.3%) of the patients experienced MACE during 1-year of follow-up, including ACS (13.3%), DHF (22.4%), cardiac death (9.8%) and CVA (2.1%). The patients age (OR: 0.96, P=0.020), LVEF changes (OR: 1.123, P=0.005) and STEMI type (OR: 0.705; P=0.039) predicted in-hospital MACE, while the symptom-to-balloon time (P=0.607) and door-to-balloon time (P=0.347) were not associated with MACE.
Conclusion: None of the time intervals were associated with the occurrence of MACE in one-year follow-up, and most STEMI patients were admitted to the hospital with a long delay. Therefore, efforts to shorten the time of hospitalization admission can help improve the MACE in STEMI patients under primary PCI in our medical centers. |
