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Glasgow prognostic score can be a prognostic indicator after percutaneous coronary intervention: a two-center study in Japan. Heart Vessels 2021; 37:903-910. [PMID: 34807279 DOI: 10.1007/s00380-021-01986-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 11/05/2021] [Indexed: 10/19/2022]
Abstract
Glasgow prognostic score (GPS) has been used to evaluate inflammatory response and nutritional status. This study aimed to investigate the impact of nutritional status on cardiac prognosis by using GPS in patients after undergoing percutaneous coronary intervention (PCI). We included 862 patients who underwent PCI for stable angina pectoris between 2015 and 2018. We used the original cutoff values, which were an albumin (Alb) level of 3.5 g/dl and a C-reactive protein (CRP) level of 0.3 mg/dl. We categorized them into the three groups: originally defined GPS (od-GPS) 0 (high Alb and low CRP), 1 (low Alb or high CRP), and 2 (low Alb and high CRP). Major adverse clinical events (MACEs) included all-cause death, nonfatal myocardial infarction, revascularization, and hospitalization for heart failure. The median follow-up period was 398.5 days. During the follow-up, MACEs occurred in 136 patients. Od-GPS 2 had higher prevalence rates in terms of chronic kidney disease (CKD; 31.7% [229/722] vs. 44.9% [53/118] vs. 63.6% [14/22], p < 0.001), hemodialysis (6.4% [46/722] vs. 14.4% [17/118] vs. 31.8% [7/22], p < 0.001), and heart failure cases (HF; 9.1% [66/722] vs. 14.4% [17/118] vs. 27.3% [6/22], p = 0.007), with higher creatinine (1.17 ± 1.37 mg/dl vs. 1.89 ± 2.60 mg/dl vs. 3.49 ± 4.01 mg/dl, p < 0.001) and brain natriuretic peptide levels (104.1 ± 304.6 pg/ml vs. 242.4 ± 565.9 pg/ml vs. 668.1 ± 872.2 pg/ml, p < 0.001) and lower low-density lipoprotein cholesterol (101.5 ± 32.9 mg/dl vs. 98.2 ± 28.8 mg/dl vs. 77.1 ± 24.3 mg/dl, p = 0.002) than od-GPS 0 and 1.Od-GPS 2 (HR 2.42; 95% CI 1.16-5.02; p = 0.018), od-GPS 1 (HR 2.09; 95% CI 1.40-3.13; p < 0.001), diabetes (HR 1.41; 95% CI 1.00-1.99; p = 0.048), CKD (HR 2.10; 95% CI 1.49-2.96; p < 0.001), and HF (HR 1.64; 95% CI 1.05-2.56; p = 0.029) were independent predictors of MACEs. A scoring system using CRP and Alb levels with a milder definition than GPS suitably predicted the risk of MACEs in the patients who underwent PCI.
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Murata N, Fukamachi D, Matsumoto N, Tachibana E, Oiwa K, Matsumoto M, Kojima T, Ichikawa M, Nomoto K, Arima K, Okumura Y. Clinical outcomes for intracoronary imaging strategies at different medical facilities in Japanese patients with coronary artery disease: the SAKURA imaging PCI Registry. Heart Vessels 2021; 37:12-21. [PMID: 34363517 DOI: 10.1007/s00380-021-01896-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 06/25/2021] [Indexed: 11/27/2022]
Abstract
The relationships between intracoronary imaging modalities and outcomes among Japanese patients with coronary artery disease (CAD) based on the type of medical facility providing outpatient care remain unclear. In this multicenter prospective study (SAKURA PCI Registry), we aimed to investigate the clinical outcomes of patients with CAD who underwent percutaneous coronary intervention (PCI) between April 2015 and December 2018. In this registry, we investigated differences in patient characteristics, intracoronary imaging modalities, and clinical outcomes between two types of medical facilities. Of the 414 patients enrolled in this registry, 196 were treated at two university hospitals, and 218 were treated at five community hospitals (median follow-up 11.0 months). The primary endpoint was clinically relevant events (CREs), including a composite of all-cause death, non-fatal myocardial infarction, clinically driven target lesion revascularization, stent thrombosis, stroke, and major bleeding. Patients treated at university hospitals had higher rates of diabetes (50% vs. 38%, p = 0.015) and malignant tumors (12% vs. 6%, p = 0.015) and more frequent use of multiple intracoronary imaging modalities than patients treated at community hospitals (21% vs. 0.5%, p < 0.001). The Kaplan-Meier incidence of CREs at 1 year was comparable between university hospitals and community hospitals (8.8% vs. 7.3%, p = 0.527, log-rank test). Despite the relatively higher risk among patients in university hospitals with frequent use of multi-intracoronary imaging modalities, adverse clinical events appeared to be comparable between patients with CAD treated at university and community hospitals in Japan.
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Affiliation(s)
- Nobuhiro Murata
- Department of Medicine, Division of Cardiology, Nihon University Itabashi Hospital, Nihon University School of Medicine, Ohyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Daisuke Fukamachi
- Department of Medicine, Division of Cardiology, Nihon University Itabashi Hospital, Nihon University School of Medicine, Ohyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Naoya Matsumoto
- Department of Cardiology, Nihon University Hospital, Tokyo, Japan
| | | | - Koji Oiwa
- Yokohama Chuo Hospital, Kanagawa, Japan
| | | | | | | | | | - Ken Arima
- Kasukabe Municipal Hospital, Saitama, Japan
| | - Yasuo Okumura
- Department of Medicine, Division of Cardiology, Nihon University Itabashi Hospital, Nihon University School of Medicine, Ohyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610, Japan.
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Vu HTT, Pham HM, Nguyen HTT, Nguyen QN, Do LD, Pham NM, Norman R, Huxley RR, Lee CMY, Reid CM. Novel insights into clinical characteristics and in-hospital outcomes of patients undergoing percutaneous coronary intervention in Vietnam. IJC HEART & VASCULATURE 2020; 31:100626. [PMID: 32944609 PMCID: PMC7481132 DOI: 10.1016/j.ijcha.2020.100626] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 08/17/2020] [Accepted: 08/21/2020] [Indexed: 11/09/2022]
Abstract
Data on percutaneous coronary intervention (PCI) in Vietnam is scarce. This study reported patient characteristics and in-hospital outcomes following PCI. These novel results contribute to benchmarking PCI practices in Vietnam.
Background Little is known about percutaneous coronary intervention (PCI) practices and outcomes in low-and middle-income nations, despite its rapid uptake across Asia. For the first time, we report on clinical characteristics and in-hospital outcomes for patients undergoing PCI at a leading cardiac centre in Vietnam. Methods Information on characteristics, treatments, and outcomes of patients undergoing PCI was collected into the first PCI registry through direct interviews using a standardised form, medical record abstraction, and reading PCI imaging data on secured disks. Subgroup analysis was also conducted to explore gender differences. Results Between September 2017 and May 2018, 1022 patients undergoing PCI were recruited from a total of 1041 procedures. The mean age was 68.3 years and two thirds were male. While 54.4% of patients presented with acute coronary syndromes, the rate of ST-elevation myocardial infarction was 14.5%. The majority of lesions were classified as type B2 and C and the radial artery was the most common access location for PCI (79.2%). The use of drug-eluting stents was universal and the angiographic success rate was 99.4%. Cardiac complications following PCI were rare with the exception of major bleeding (2.0%). Female patients were older with relatively more comorbidities and a higher incidence of major bleeding than males (p < 0.05). Conclusions Findings of this study provide an opportunity to benchmark current PCI practices in Vietnam, identify possible care gaps and potentially inform the adoption of treatment guidelines as well as use of prevention strategies.
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Key Words
- ACC/AHA, American College of Cardiology/American Heart Association
- ACS, Acute coronary syndrome
- APAC, Asia-Pacific
- CABG, Coronary artery bypass grafts
- CHD, Coronary heart disease
- Clinical characteristic
- DAPT, Dual-anti platelet therapy
- DES, Drug eluting stent
- ECG, Electrocardiogram
- GRACE, Global Registry of Acute Coronary Events
- MI, Myocardial infarction
- NSTEMI, Non-ST-elevation myocardial infraction
- Outcomes, Vietnam
- PCI, Percutaneous coronary intervention
- Percutaneous coronary intervention
- STEMI, ST-elevation myocardial infraction
- UA, Unstable angina
- VNHI, Vietnam National Heart Institute
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Affiliation(s)
- Hoa T T Vu
- School of Public Health, Curtin University, Perth, Australia.,Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Viet Nam
| | - Hung M Pham
- Vietnam National Heart Institute, Hanoi, Viet Nam
| | | | | | - Loi D Do
- Vietnam National Heart Institute, Hanoi, Viet Nam
| | - Ngoc M Pham
- School of Public Health, Curtin University, Perth, Australia.,Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Viet Nam.,Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Richard Norman
- School of Public Health, Curtin University, Perth, Australia
| | - Rachel R Huxley
- School of Public Health, Curtin University, Perth, Australia.,College of Science, Health and Engineering, La Trobe University, Melbourne, Australia.,The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Crystal M Y Lee
- School of Public Health, Curtin University, Perth, Australia.,School of Psychology and Public Health, La Trobe University, Melbourne, Australia.,Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, University of Sydney, Sydney, Australia
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