1
|
Węgiel M, Wojtasik-Bakalarz J, Malinowski K, Surmiak M, Dziewierz A, Sorysz D, Tokarek T, Dudek D, Bartuś S, Surdacki A, Rakowski T. Mid-regional pro-adrenomedullin and lactate dehydrogenase as predictors of left ventricular remodeling in patients with myocardial infarction treated with percutaneous coronary intervention. Pol Arch Intern Med 2021; 132. [PMID: 34846110 DOI: 10.20452/pamw.16150] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND The main impact of myocardial infarction (MI) is shifting from acute mortality to adverse remodeling, chronic left ventricle (LV) dysfunction and heart failure. OBJECTIVES The aim of this study was to assess relationships between levels of circulating biomarkers and function of LV after MI. PATIENTS AND METHODS Prospective study of 80 patients with MI treated with percutaneous coronary interventions (PCI). Novel biomarkers including mid-regional pro-adrenomedullin (MR-proADM), Notch-1, syndecan-4, myeloperoxidase, S-100 protein, soluble ST-2, as well as markers of inflammatory response and tissue injury: galectin-3, C-reactive protein (CRP), lactate dihydrogenase (LDH) and interleukin-6 (IL-6) were assessed in the acute phase of MI. Echocardiography was performed at baseline and 6 months. RESULTS Adverse remodeling, defined as >20% increase in LV end-diastolic volume occurred in 26% of patients. Reverse remodeling (>10% reduction in LV end-systolic volume) was observed in 52% of patients. In a univariable analysis higher levels of MR-proADM and LDH were predictors of adverse remodeling and higher levels of MR-proADM, LDH, CRP and Il-6 were negative predictors of reverse remodeling. In a multivariable model LDH remained an independent predictor of adverse remodeling (OR: 3.13; 95%CI: 1.42-8.18; P=0.003) and negative predictor of reverse remodeling (OR: 0.37; 95%CI: 0.17-0.8; P=0.005). CONCLUSIONS LDH and MR-proADM seem to be promising biomarkers of adverse remodeling. On the other hand, higher levels of these biomarkers were associated with reduced chance of occurrence of favorable reverse remodeling in MI patients. However, further studies on larger groups of patients are necessary to confirm this data.
Collapse
Affiliation(s)
- Michał Węgiel
- Second Department of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | | | - Krzysztof Malinowski
- Second Department of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Marcin Surmiak
- Department of Internal Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Artur Dziewierz
- Second Department of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Danuta Sorysz
- Department of Cardiology and Cardiovascular Interventions, University Hospital in Krakow, Kraków, Poland
| | - Tomasz Tokarek
- Department of Cardiology and Cardiovascular Interventions, University Hospital in Krakow, Kraków, Poland
- Center for Intensive Care and Perioperative Medicine, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Dariusz Dudek
- Department of Cardiology and Cardiovascular Interventions, University Hospital in Krakow, Kraków, Poland
| | - Stanisław Bartuś
- Second Department of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Andrzej Surdacki
- Second Department of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Tomasz Rakowski
- Second Department of Cardiology, Jagiellonian University Medical College, Kraków, Poland.
| |
Collapse
|
2
|
Kleczynski P, Dziewierz A, Socha S, Rakowski T, Daniec M, Zawislak B, Arif S, Wojtasik-Bakalarz J, Dudek D, Rzeszutko L. Direct Rapid Left Ventricular Wire Pacing during Balloon Aortic Valvuloplasty. J Clin Med 2020; 9:jcm9041017. [PMID: 32260289 PMCID: PMC7230545 DOI: 10.3390/jcm9041017] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 03/27/2020] [Accepted: 03/31/2020] [Indexed: 11/16/2022] Open
Abstract
Background: Rapid ventricular pacing is mandatory for optimal balloon positioning during aortic valvuloplasty (BAV) in patients with severe aortic stenosis. We aimed to assess the safety and efficacy of direct left ventricular (LV) guidewire pacing in comparison with regular pacing induced by temporary pacemaker (PM) placement in the right ventricle. Methods: Direct rapid LV pacing was provided with a 0.035″ guidewire. Baseline clinical characteristics, echocardiographic and procedural data, as well as complication rates, were compared between the two groups. Results: A total of 202 patients undergoing BAV were enrolled (49.5% with direct LV guidewire pacing). The pacing success rate was 100%. In the direct LV guidewire pacing group, we found a lower radiation dose, shorter fluoroscopy and overall procedural time (0.16 vs. 0.28 Gy, p = 0.02; 5.4 vs. 10.3 min, p = 0.01; 17 vs. 25 min, p = 0.01; respectively). In addition, the complication rate was lower in that group (cardiac tamponades, vascular access site complications, blood transfusions rate, and in-hospital mortality: 0% vs. 3.9%; 4.0% vs. 15.7%; 2.0% vs. 12.7%; 2.0% vs. 9.8%, p = 0.01 for all, respectively). Conclusions: Direct rapid LV guidewire pacing is a simple, safe and effective option for BAV with a reduced complication rate compared to a temporary PM placed in the right ventricle.
Collapse
Affiliation(s)
- Pawel Kleczynski
- Department of Interventional Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Pradnicka 80 Street, 31-202 Krakow, Poland
- 2nd Department of Cardiology, Jagiellonian University Medical College, University Hospital, Jakubowskiego 2 Street, 30-688 Krakow, Poland; (A.D.); (T.R.); (B.Z.); (D.D.)
- Correspondence:
| | - Artur Dziewierz
- 2nd Department of Cardiology, Jagiellonian University Medical College, University Hospital, Jakubowskiego 2 Street, 30-688 Krakow, Poland; (A.D.); (T.R.); (B.Z.); (D.D.)
| | - Sylwia Socha
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Jakubowskiego 2 Street, 30-688 Krakow, Poland; (S.S.); (M.D.); (S.A.); (J.W.-B.); (L.R.)
| | - Tomasz Rakowski
- 2nd Department of Cardiology, Jagiellonian University Medical College, University Hospital, Jakubowskiego 2 Street, 30-688 Krakow, Poland; (A.D.); (T.R.); (B.Z.); (D.D.)
| | - Marzena Daniec
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Jakubowskiego 2 Street, 30-688 Krakow, Poland; (S.S.); (M.D.); (S.A.); (J.W.-B.); (L.R.)
| | - Barbara Zawislak
- 2nd Department of Cardiology, Jagiellonian University Medical College, University Hospital, Jakubowskiego 2 Street, 30-688 Krakow, Poland; (A.D.); (T.R.); (B.Z.); (D.D.)
- Intensive Cardiac Care Unit, University Hospital, Jakubowskiego 2 Street, 30-688 Krakow, Poland
| | - Saleh Arif
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Jakubowskiego 2 Street, 30-688 Krakow, Poland; (S.S.); (M.D.); (S.A.); (J.W.-B.); (L.R.)
| | - Joanna Wojtasik-Bakalarz
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Jakubowskiego 2 Street, 30-688 Krakow, Poland; (S.S.); (M.D.); (S.A.); (J.W.-B.); (L.R.)
| | - Dariusz Dudek
- 2nd Department of Cardiology, Jagiellonian University Medical College, University Hospital, Jakubowskiego 2 Street, 30-688 Krakow, Poland; (A.D.); (T.R.); (B.Z.); (D.D.)
| | - Lukasz Rzeszutko
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Jakubowskiego 2 Street, 30-688 Krakow, Poland; (S.S.); (M.D.); (S.A.); (J.W.-B.); (L.R.)
| |
Collapse
|
3
|
Pawlik A, Januszek R, Ruzsa Z, Óriás V, Kleczyński P, Wojtasik-Bakalarz J, Arif S, Nyerges A, Chyrchel M, Stanek A, Dudek D, Bartuś S. Gender differences and long-term clinical outcomes in patients with chronic total occlusions of infrainguinal lower limb arteries treated from retrograde access with peripheral vascular interventions. Adv Med Sci 2020; 65:197-201. [PMID: 32014808 DOI: 10.1016/j.advms.2020.01.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 09/10/2019] [Accepted: 01/21/2020] [Indexed: 11/19/2022]
Abstract
PURPOSE We sought to investigate gender-related differences in clinical outcomes after peripheral vascular interventions (PVIs) from retrograde access in patients with chronic total occlusions (CTOs) of the infrainguinal arteries. PATIENTS AND METHODS A total of 939 consecutive patients undergoing PVI were enrolled in the study. Patients with peripheral artery diseases (PAD) and CTOs were treated with PVI from retrograde access according to the local protocol. The participants were divided according to gender. Retrograde access included distal puncturing to reach the CTO. The mean follow-up lasted 1,144.9 ± 664.3 days. Baseline characteristics, procedural and long-term outcomes were compared according to gender. RESULTS Women represented 37.4% of the study population, and more frequently suffered from hypertension (92% vs. 86%, p = 0.001) and diabetes (54% vs. 46%, p = 0.02). Males more often presented with chronic obstructive pulmonary disease (14.8% vs. 6.8%, p = 0.0003), coronary artery disease (45.4% vs. 32.7%, p = 0.0001), smoking (60.4% vs. 45%, p = 0.007) and prior PVI (25% vs. 17%, p = 0.005). The Kaplan-Meier survival curves at 5 years did not reveal gender-related differences in mortality (p = 0.8), whereas men were at a significantly higher risk of re-PVI during the follow-up period (p = 0.047). Male gender was an independent predictor of re-PVI (Hazard ratio: 1.276; 95% confidence interval: 1.015-1.614, p = 0.03). CONCLUSION Males are at increased risk of re-PVI compared to females with PAD and CTOs of infrainguinal arteries treated with PVI from retrograde access.
Collapse
Affiliation(s)
- Artur Pawlik
- 2nd Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
| | - Rafał Januszek
- 2nd Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland; University of Physical Education, Department of Clinical Rehabilitation, Krakow, Poland.
| | - Zoltan Ruzsa
- Semmelweis University of Budapest, Cardiac and Vascular Center, Budapest, Hungary; Bács-Kiskun County Hospital, Invasive Cardiology Department, Teaching Hospital of the Szent-Györgyi Albert Medical University, Kecskemét, Hungary
| | - Viktor Óriás
- Semmelweis University of Budapest, Cardiac and Vascular Center, Budapest, Hungary
| | - Paweł Kleczyński
- 2nd Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
| | - Joanna Wojtasik-Bakalarz
- 2nd Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
| | - Saleh Arif
- 2nd Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
| | - Andras Nyerges
- Bács-Kiskun County Hospital, Invasive Cardiology Department, Teaching Hospital of the Szent-Györgyi Albert Medical University, Kecskemét, Hungary
| | - Michał Chyrchel
- 2nd Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
| | - Agata Stanek
- School of Medicine with the Division of Dentistry in Zabrze, Department of Internal Medicine, Angiology and Physical Medicine, Medical University of Silesia, Bytom, Poland
| | - Dariusz Dudek
- 2nd Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland; 2nd Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Stanisław Bartuś
- 2nd Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland; 2nd Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| |
Collapse
|
4
|
Ruzsa Z, Januszek R, Óriás V, Chyrchel M, Wojtasik-Bakalarz J, Bartuś J, Arif S, Kleczyński P, Tokarek T, Nyerges A, Stanek A, Dudek D, Bartuś S. Mortality and chronic obstructive pulmonary disease in patients treated with endovascular revascularization of the infra-inguinal lower limb arteries from retrograde access. Ann Transl Med 2020; 8:206. [PMID: 32309353 PMCID: PMC7154487 DOI: 10.21037/atm.2020.01.57] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background In this trial, our objective was to evaluate the relationship between long-term clinical outcomes in patients with peripheral arterial disease (PAD) treated with retrograde endovascular recanalization (ER) of chronic total occlusions (CTOs) regarding the infra-inguinal lower limb arteries and chronic obstructive pulmonary disease (COPD). Methods A total of 834 consecutive subjects were enrolled in the study. The mean age was 67.8±10.6 years (62.6% males). COPD was diagnosed in 98 patients (11.7%). The infra-inguinal location included the deep, superficial and common femoral artery, popliteal artery or below the knee arteries. During follow-up, we evaluated major adverse cardiac and cerebrovascular events (MACCE) and major adverse limb events (MALE). MACCE was considered as death, stroke/transient ischemic attack, myocardial infarction, percutaneous coronary intervention or coronary artery bypass grafting operation, while MALE regarded amputation, target lesion re-intervention, target vessel re-intervention and surgical action. Results The mean follow-up was 1,144.9±664.3 days and the interquartile range was 1,110.5 (504.5–1,734.7). Data were collected between 2006 and 2016. We noticed significant differences in death rates among the COPD and non-COPD groups. The cumulative number of events (deaths) was 12.2%, 17.3%, 18.4%, 22.4%, 23.5%, 23.5% and 23.5% in the COPD group and 6.1%, 7.5%, 10.5%, 11.3%, 11.4% 11.5% and 11.5% in the non-COPD group after 1, 2, 3, 4, 5, 6 and 7 years of follow-up, and was notably greater for COPD (P=0.0007). Conclusions Patients with COPD and PAD treated with the ER and retrograde approach due to CTOs are related to higher mortality than non-COPD patients.
Collapse
Affiliation(s)
- Zoltan Ruzsa
- Semmelweis University of Budapest, Cardiac and Vascular Center, Budapest, Hungary.,Bács-Kiskun County Hospital, Invasive Cardiology Department, Teaching Hospital of the Szent-Györgyi Albert Medical University, Kecskemét, Hungary
| | - Rafał Januszek
- University of Physical Education, Department of Clinical Rehabilitation, Kraków, Poland.,2nd Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
| | - Viktor Óriás
- Semmelweis University of Budapest, Cardiac and Vascular Center, Budapest, Hungary
| | - Michał Chyrchel
- 2nd Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
| | - Joanna Wojtasik-Bakalarz
- 2nd Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
| | - Jerzy Bartuś
- Jagiellonian University Medical College, Krakow, Poland
| | - Saleh Arif
- 2nd Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
| | - Paweł Kleczyński
- 2nd Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
| | - Tomasz Tokarek
- 2nd Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
| | - Andras Nyerges
- Bács-Kiskun County Hospital, Invasive Cardiology Department, Teaching Hospital of the Szent-Györgyi Albert Medical University, Kecskemét, Hungary
| | - Agata Stanek
- School of Medicine with the Division of Dentistry in Zabrze, Department of Internal Medicine, Angiology and Physical Medicine, Medical University of Silesia, Bytom, Poland
| | - Dariusz Dudek
- 2nd Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland.,2nd Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Stanisław Bartuś
- 2nd Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland.,2nd Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| |
Collapse
|
5
|
Januszek R, Ruzsa Z, Nyerges A, Óriás V, Kleczyński P, Wojtasik-Bakalarz J, Pawlik A, Arif S, Dudek D, Bartuś S. Body mass index and long-term outcomes in patients with chronic total occlusions undergoing retrograde endovascular revascularization of the infra-inguinal lower limb arteries. Cardiol J 2019; 28:509-518. [PMID: 31642053 DOI: 10.5603/cj.a2019.0097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 08/27/2019] [Accepted: 09/29/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The aim of the present study is to assess the relationship between body mass index (BMI) and long-term clinical outcomes in retrograde endovascular recanalization (ER) regarding chronic total occlusions (CTOs) of the infra-inguinal lower limb arteries. METHODS The study included patients who underwent retrograde ER of CTOs localized in superficial, popliteal or below-the-knee arteries. During follow-up, major adverse cardiac and cerebrovascular and major adverse lower limb events (MALE) were evaluated. MALE was defined as amputation, target lesion re-intervention, target vessel re-intervention and surgical treatment. RESULTS The study included 405 patients at the mean age of 67.2 ± 10.4. The authors divided the overall group of patients according to BMI into < 25 (n = 156, 38.5%) and ≥ 25 kg/m2 (n = 249, 61.5%), and then into < 30 (n = 302, 75.8%) and ≥ 30 kg/m2 (n = 103, 24.2%). During the average follow-up 1,144.9 ± 664.3 days, the mortality rate was higher in the group of patients with BMI < 25 kg/m2 (10.5% vs. 5.3%, p = 0.051), and in the group of patients with BMI < 30 kg/m2 (8.7% vs. 2.9%, p = 0.048). The comparison of Kaplan-Meier curves revealed borderline differences when assessing months to death for the BMI < 25 kg/m2 (p = 0.057) and BMI < 30 kg/m2 (p = 0.056) grouping variables. CONCLUSIONS Obese and overweight patients undergoing CTO ER of the lower limb arteries from retrograde access are related to lower death rates during long-term follow-up.
Collapse
Affiliation(s)
- Rafał Januszek
- 2nd Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland. .,Department of Clinical Rehabilitation, University of Physical Education, Krakow, Poland.
| | - Zoltan Ruzsa
- Semmelweis University, Heart and Vascular Center, Cardiology Department, Budapest, Hungary.,Bács-Kiskun County Hospital, Invasive Cardiology Department, Teaching Hospital of Szent-Györgyi Albert Medical University, Kecskemét, Hungary
| | - Andras Nyerges
- Bács-Kiskun County Hospital, Invasive Cardiology Department, Teaching Hospital of Szent-Györgyi Albert Medical University, Kecskemét, Hungary
| | - Victor Óriás
- Semmelweis University, Heart and Vascular Center, Cardiology Department, Budapest, Hungary
| | - Paweł Kleczyński
- 2nd Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
| | - Joanna Wojtasik-Bakalarz
- 2nd Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
| | - Artur Pawlik
- 2nd Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
| | - Salech Arif
- 2nd Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
| | - Dariusz Dudek
- 2nd Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland.,2nd Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Stanisław Bartuś
- 2nd Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland.,2nd Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| |
Collapse
|
6
|
Januszek R, Pawlik A, Ruzsa Z, Nyerges A, Wojtasik-Bakalarz J, Rakowski T, Kleczynski P, Dudek D, Bartus S. P4706Sex-related differences in clinical outcomes after percutaneous transluminal angioplasty in patients with peripheral artery disease. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.1087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Aim
There are inconsistent data on the sex-related differences in clinical outcomes after percutaneous transluminal angioplasty (PTA) in patients with peripheral artery disease (PAD). We aimed to investigate sex-related differences in clinical outcomes after PTA.
Methods
A total of 939 consecutive patients undergoing PTA were enrolled in two large volume centers. Patients were stratified by gender. Baseline characteristics, procedural and long-term clinical outcomes were compared between women and men.
Results
Women represented 37.4% of the study population. Women, compared to men, had more often hypertension (92% vs 86%, p=0.001) and diabetes (54% vs 46%, p=0.02). However, men presented more often with chronic obstructive pulmonary disease (14.8% vs 6.8%, p=0.0003), coronary artery disease (45.4% vs 32.7%, p=0.0001), smoking (60.4% vs 45%, p=0.007) and previous PTA (25% vs 17%, p=0.005). There were no differences in 120-month all-cause mortality between groups (women vs. men: 29% vs. 21%, p=0.6). Men were at higher risk of re-PTA at 5-year follow-up (40% vs. 49%; p=0.03). Moreover, male sex was an independent predictor of re-PTA (age-adjusted odds ratio (OR) (95% CI): 1.276 (1.015–1.614), p=0.03). In multivariable Cox regression analysis, a superficial femoral artery chronic total occlusion (SFA-CTO) (hazard ratio [HR]) (95% confidence interval [CI]): 1.68 (1.12–2.5), body mass index (BMI) (hazard ratio (HR)) (95% CI): 0.93 (0.87–0.99), baseline creatinine level hazard ratio (HR)) (95% CI): 0.95 (0.88–0.99) were identified as independent factors of re-PTA in women.
Figure 1. Months to re-PTA for grouping variable male.
Conclusion
Male sex was identified as an independent predictor of re-PTA. SFA-CTO, BMI and baseline creatinine level were associated with re-PTA in women.
Collapse
Affiliation(s)
- R Januszek
- The University Hospital, 2nd Department of Cardiology and Cardiovascular Interventions, Cracow, Poland
| | - A Pawlik
- The University Hospital, 2nd Department of Cardiology and Cardiovascular Interventions, Cracow, Poland
| | - Z Ruzsa
- Semmelweis University Heart Center, Heart and Vascular Center, Budapest, Hungary
| | - A Nyerges
- Fejér County Szent György Hospital, Invasive Cardiology Department, Kecskemet, Hungary
| | - J Wojtasik-Bakalarz
- The University Hospital, 2nd Department of Cardiology and Cardiovascular Interventions, Cracow, Poland
| | - T Rakowski
- The University Hospital, 2nd Department of Cardiology and Cardiovascular Interventions, Cracow, Poland
| | - P Kleczynski
- The University Hospital, 2nd Department of Cardiology and Cardiovascular Interventions, Cracow, Poland
| | - D Dudek
- The University Hospital, 2nd Department of Cardiology and Cardiovascular Interventions, Cracow, Poland
| | - S Bartus
- The University Hospital, 2nd Department of Cardiology and Cardiovascular Interventions, Cracow, Poland
| |
Collapse
|
7
|
Zeymer U, Ludman P, Danchin N, Kala P, Maggioni AP, Weidinger F, Gale CP, Beleslin B, Budaj A, Chioncel O, Dagres N, Danchin N, Emberson J, Erlinge D, Glikson M, Gray A, Kayikcioglu M, Maggioni AP, Nagy VK, Nedoshivin A, Petronio AS, Roos-Hesselink J, Wallentin L, Zeymer U, Weidinger F, Zeymer U, Danchin N, Ludman P, Sinnaeve P, Kala P, Ferrari R, Maggioni AP, Goda A, Zelveian P, Weidinger F, Karamfilov K, Motovska Z, Zeymer U, Raungaard B, Marandi T, Shaheen SM, Lidon RM, Karjalainen PP, Kereselidze Z, Alexopoulos D, Becker D, Quinn M, Iakobishvili Z, Al-Farhan H, Sadeghi M, Caporale R, Romeo F, Mirrakhimov E, Serpytis P, Erglis A, Kedev S, Balbi MM, Moore AM, Dudek D, Legutko J, Mimoso J, Tatu-Chitoiu G, Stojkovic S, Shlyakhto E, AlHabib KF, Bunc M, Studencan M, Mourali MS, Bajraktari G, Konte M, Larras F, Lefrancq EF, Mekhaldi S, Laroche C, Maggioni AP, Goda A, Shuka N, Pavli E, Tafaj E, Gishto T, Dibra A, Duka A, Gjana A, Kristo A, Knuti G, Demiraj A, Dado E, Hasimi E, Simoni L, Siqeca M, Sisakian H, Hayrapetyan H, Markosyan S, Galustyan L, Arustamyan N, Kzhdryan H, Pepoyan S, Zirkik A, Von Lewinski D, Paetzold S, Kienzl I, Matyas K, Neunteufl T, Nikfardjam M, Neuhold U, Mihalcz A, Glaser F, Steinwender C, Reiter C, Grund M, Hrncic D, Hoppe U, Hammerer M, Hinterbuchner L, Hengstenberg C, Delle Karth G, Lang I, Weidinger F, Winkler W, Hasun M, Kastner J, Havel C, Derntl M, Oberegger G, Hajos J, Adlbrecht C, Publig T, Leitgeb MC, Wilfing R, Jirak P, Ho CY, Puskas L, Schrutka L, Spinar J, Parenica J, Hlinomaz O, Fendrychova V, Semenka J, Sikora J, Sitar J, Groch L, Rezek M, Novak M, Kramarikova P, Stasek J, Dusek J, Zdrahal P, Polasek R, Karasek J, Seiner J, Sukova N, Varvarovsky I, Lazarák T, Novotny V, Matejka J, Rokyta R, Volovar S, Belohlavek J, Motovska Z, Siranec M, Kamenik M, Kralik R, Raungaard B, Ravkilde J, Jensen SE, Villadsen A, Villefrance K, Schmidt Skov C, Maeng M, Moeller K, Hasan-Ali H, Ahmed TA, Hassan M, ElGuindy A, Farouk Ismail M, Ibrahim Abd El-Aal A, El-sayed Gaafar A, Magdy Hassan H, Ahmed Shafie M, Nabil El-khouly M, Bendary A, Darwish M, Ahmed Y, Amin O, AbdElHakim A, Abosaif K, Kandil H, Galal MAG, El Hefny EE, El Sayed M, Aly K, Mokarrab M, Osman M, Abdelhamid M, Mantawy S, Ali MR, Kaky SD, Khalil VA, Saraya MEA, Talaat A, Nabil M, Mounir WM, Mahmoud K, Aransa A, Kazamel G, Anwar S, Al-Habbaa A, Abd el Monem M, Ismael A, Amin Abu-Sheaishaa M, Abd Rabou MM, Hammouda TMA, Moaaz M, Elkhashab K, Ragab T, Rashwan A, Rmdan A, AbdelRazek G, Ebeid H, Soliman Ghareeb H, Farag N, Zaki M, Seleem M, Torki A, Youssef M, AlLah Nasser NA, Rafaat A, Selim H, Makram MM, Khayyal M, Malasi K, Madkour A, Kolib M, Alkady H, Nagah H, Yossef M, Wafa A, Mahfouz E, Faheem G, Magdy Moris M, Ragab A, Ghazal M, Mabrouk A, Hassan M, El-Masry M, Naseem M, Samir S, Marandi T, Reinmets J, Allvee M, Saar A, Ainla T, Vaide A, Kisseljova M, Pakosta U, Eha J, Lotamois K, Sia J, Myllymaki J, Pinola T, Karjalainen PP, Paana T, Mikkelsson J, Ampio M, Tsivilasvili J, Zurab P, Kereselidze Z, Agladze R, Melia A, Gogoberidze D, Khubua N, Totladze L, Metreveli I, Chikovani A, Eitel I, Pöss J, Werner M, Constantz A, Ahrens C, Zeymer U, Tolksdorf H, Klinger S, Sack S, Heer T, Lekakis J, Kanakakis I, Xenogiannis I, Ermidou K, Makris N, Ntalianis A, Katsaros F, Revi E, Kafkala K, Mihelakis E, Diakakis G, Grammatikopoulos K, Voutsinos D, Alexopoulos D, Xanthopoulou I, Mplani V, Foussas S, Papakonstantinou N, Patsourakos N, Dimopoulos A, Derventzis A, Athanasiou K, Vassilikos VP, Papadopoulos C, Tzikas S, Vogiatzis I, Datsios A, Galitsianos I, Koutsampasopoulos K, Grigoriadis S, Douras A, Baka N, Spathis S, Kyrlidis T, Hatzinikolaou H, Kiss RG, Becker D, Nowotta F, Tóth K, Szabó S, Lakatos C, Jambrik Z, Ruzsa J, Ruzsa Z, Róna S, Toth J, Vargane Kosik A, Toth KSB, Nagy GG, Ondrejkó Z, Körömi Z, Botos B, Pourmoghadas M, Salehi A, Massoumi G, Sadeghi M, Soleimani A, Sarrafzadegan N, Roohafza H, Azarm M, Mirmohammadsadeghi A, Rajabi D, Rahmani Y, Siabani S, Najafi F, Hamzeh B, Karim H, Siabani H, Saleh N, Charehjoo H, Zamzam L, Al-Temimi G, Al-Farhan H, Al-Yassin A, Mohammad A, Ridha A, Al-Saedi G, Atabi N, Sabbar O, Mahmood S, Dakhil Z, Yaseen IF, Almyahi M, Alkenzawi H, Alkinani T, Alyacopy A, Kearney P, Twomey K, Iakobishvili Z, Shlomo N, Beigel R, Caldarola P, Rutigliano D, Sublimi Saponetti L, Locuratolo N, Palumbo V, Scherillo M, Formigli D, Canova P, Musumeci G, Roncali F, Metra M, Lombardi C, Visco E, Rossi L, Meloni L, Montisci R, Pippia V, Marchetti MF, Congia M, Cacace C, Luca G, Boscarelli G, Indolfi C, Ambrosio G, Mongiardo A, Spaccarotella C, De Rosa S, Canino G, Critelli C, Caporale R, Chiappetta D, Battista F, Gabrielli D, Marziali A, Bernabò P, Navazio A, Guerri E, Manca F, Gobbi M, Oreto G, Andò G, Carerj S, Saporito F, Cimmino M, Rigo F, Zuin G, Tuccillo B, Scotto di Uccio F, Irace L, Lorenzoni G, Meloni I, Merella P, Polizzi GM, Pino R, Marzilli M, Morrone D, Caravelli P, Orsini E, Mosa S, Piovaccari G, Santarelli A, Cavazza C, Romeo F, Fedele F, Mancone M, Straito M, Salvi N, Scarparo P, Severino P, Razzini C, Massaro G, Cinque A, Gaudio C, Barillà F, Torromeo C, Porco L, Mei M, Iorio R, Nassiacos D, Barco B, Sinagra G, Falco L, Priolo L, Perkan A, Strana M, Bajraktari G, Percuku L, Berisha G, Mziu B, Beishenkulov M, Abdurashidova T, Toktosunova A, Kaliev K, Serpytis P, Serpytis R, Butkute E, Lizaitis M, Broslavskyte M, Xuereb RG, Moore AM, Mercieca Balbi M, Paris E, Buttigieg L, Musial W, Dobrzycki S, Dubicki A, Kazimierczyk E, Tycinska A, Wojakowski W, Kalanska-Lukasik B, Ochala A, Wanha W, Dworowy S, Sielski J, Janion M, Janion-Sadowska A, Dudek D, Wojtasik-Bakalarz J, Bryniarski L, Peruga JZ, Jonczyk M, Jankowski L, Klecha A, Legutko J, Michalowska J, Brzezinski M, Kozmik T, Kowalczyk T, Adamczuk J, Maliszewski M, Kuziemka P, Plaza P, Jaros A, Pawelec A, Sledz J, Bartus S, Zmuda W, Bogusz M, Wisnicki M, Szastak G, Adamczyk M, Suska M, Czunko P, Opolski G, Kochman J, Tomaniak M, Miernik S, Paczwa K, Witkowski A, Opolski MP, Staruch AD, Kalarus Z, Honisz G, Mencel G, Swierad M, Podolecki T, Marques J, Azevedo P, Pereira MA, Gaspar A, Monteiro S, Goncalves F, Leite L, Mimoso J, Manuel Lopes dos Santos W, Amado J, Pereira D, Silva B, Caires G, Neto M, Rodrigues R, Correia A, Freitas D, Lourenco A, Ferreira F, Sousa F, Portugues J, Calvo L, Almeida F, Alves M, Silva A, Caria R, Seixo F, Militaru C, Ionica E, Tatu-Chitoiu G, Istratoaie O, Florescu M, Lipnitckaia E, Osipova O, Konstantinov S, Bukatov V, Vinokur T, Egorova E, Nefedova E, Levashov S, Gorbunova A, Redkina M, Karaulovskaya N, Bijieva F, Babich N, Smirnova O, Filyanin R, Eseva S, Kutluev A, Chlopenova A, Shtanko A, Kuppar E, Shaekhmurzina E, Ibragimova M, Mullahmetova M, Chepisova M, Kuzminykh M, Betkaraeva M, Namitokov A, Khasanov N, Baleeva L, Galeeva Z, Magamedkerimova F, Ivantsov E, Tavlueva E, Kochergina A, Sedykh D, Kosmachova E, Skibitskiy V, Porodenko N, Namitokov A, Litovka K, Ulbasheva E, Niculina S, Petrova M, Harkov E, Tsybulskaya N, Lobanova A, Chernova A, Kuskaeva A, Kuskaev A, Ruda M, Zateyshchikov D, Gilarov M, Konstantinova E, Koroleva O, Averkova A, Zhukova N, Kalimullin D, Borovkova N, Tokareva A, Buyanova M, Khaisheva L, Pirozhenko A, Novikova T, Yakovlev A, Tyurina T, Lapshin K, Moroshkina N, Kiseleva M, Fedorova S, Krylova L, Duplyakov D, Semenova Y, Rusina A, Ryabov V, Syrkina A, Demianov S, Reitblat O, Artemchuk A, Efremova E, Makeeva E, Menzorov M, Shutov A, Klimova N, Shevchenko I, Elistratova O, Kostyuckova O, Islamov R, Budyak V, Ponomareva E, Ullah Jan U, Alshehri AM, Sedky E, Alsihati Z, Mimish L, Selem A, Malik A, Majeed O, Altnji I, AlShehri M, Aref A, AlHabib K, AlDosary M, Tayel S, Abd AlRahman M, Asfina KN, Abdin Hussein G, Butt M, Markovic Nikolic N, Obradovic S, Djenic N, Brajovic M, Davidovic A, Romanovic R, Novakovic V, Dekleva M, Spasic M, Dzudovic B, Jovic Z, Cvijanovic D, Veljkovic S, Ivanov I, Cankovic M, Jarakovic M, Kovacevic M, Trajkovic M, Mitov V, Jovic A, Hudec M, Gombasky M, Sumbal J, Bohm A, Baranova E, Kovar F, Samos M, Podoba J, Kurray P, Obona T, Remenarikova A, Kollarik B, Verebova D, Kardosova G, Studencan M, Alusik D, Macakova J, Kozlej M, Bayes-Genis A, Sionis A, Garcia Garcia C, Lidon RM, Duran Cambra A, Labata Salvador C, Rueda Sobella F, Sans Rosello J, Vila Perales M, Oliveras Vila T, Ferrer Massot M, Bañeras J, Lekuona I, Zugazabeitia G, Fernandez-Ortiz A, Viana Tejedor A, Ferrera C, Alvarez V, Diaz-Castro O, Agra-Bermejo RM, Gonzalez-Cambeiro C, Gonzalez-Babarro E, Domingo-Del Valle J, Royuela N, Burgos V, Canteli A, Castrillo C, Cobo M, Ruiz M, Abu-Assi E, Garcia Acuna JM. The ESC ACCA EAPCI EORP acute coronary syndrome ST-elevation myocardial infarction registry. European Heart Journal - Quality of Care and Clinical Outcomes 2019; 6:100-104. [DOI: 10.1093/ehjqcco/qcz042] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Accepted: 07/24/2019] [Indexed: 12/20/2022]
Abstract
Abstract
Aims
The Acute Cardiac Care Association (ACCA)–European Association of Percutaneous Coronary Intervention (EAPCI) Registry on ST-elevation myocardial infarction (STEMI) of the EurObservational programme (EORP) of the European Society of Cardiology (ESC) registry aimed to determine the current state of the use of reperfusion therapy in ESC member and ESC affiliated countries and the adherence to ESC STEMI guidelines in patients with STEMI.
Methods and results
Between 1 January 2015 and 31 March 2018, a total of 11 462 patients admitted with an initial diagnosis of STEMI according to the 2012 ESC STEMI guidelines were enrolled. Individual patient data were collected across 196 centres and 29 countries. Among the centres, there were 136 percutaneous coronary intervention centres and 91 with cardiac surgery on-site. The majority of centres (129/196) were part of a STEMI network. The main objective of this study was to describe the demographic, clinical, and angiographic characteristics of patients with STEMI. Other objectives include to assess management patterns and in particular the current use of reperfusion therapies and to evaluate how recommendations of most recent STEMI European guidelines regarding reperfusion therapies and adjunctive pharmacological and non-pharmacological treatments are adopted in clinical practice and how their application can impact on patients’ outcomes. Patients will be followed for 1 year after admission.
Conclusion
The ESC ACCA-EAPCI EORP ACS STEMI registry is an international registry of care and outcomes of patients hospitalized with STEMI. It will provide insights into the contemporary patient profile, management patterns, and 1-year outcome of patients with STEMI.
Collapse
Affiliation(s)
- Uwe Zeymer
- Hospital of the City of Ludwigshafen, Medical Clinic B and Institute of Heart Attack Research, Ludwigshafen on the Rhine, Germany
| | - Peter Ludman
- Institute of Cardiovascular Sciences, Birmingham University, Birmingham, UK
| | - Nicolas Danchin
- Cardiology Department, Georges Pompidou European Hospital, Paris, France
| | - Petr Kala
- Internal Cardiology Department, University Hospital Brno, Czech Republic
| | - Aldo P Maggioni
- EURObservational Research Programme, ESC, Sophia Antipolis, France
- ANMCO Research Center, Florence, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Wojtasik-Bakalarz J, Kleczyński P, Zasada W, Rakowski T, Arif S, Bartuś K, Dudek D, Bartuś S. Safety of bivalirudin versus unfractionated heparin in endovascular revascularization of peripheral arteries in short- and long-term follow-up. Postepy Kardiol Interwencyjnej 2019; 15:91-97. [PMID: 31043990 PMCID: PMC6488834 DOI: 10.5114/aic.2019.81757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Accepted: 11/04/2018] [Indexed: 06/09/2023] Open
Abstract
INTRODUCTION Patients with peripheral artery disease (PAD) are considered as a high-risk group for hemorrhagic events. AIM To assess the safety of bivalirudin vs. unfractionated heparin (UFH) in percutaneous peripheral interventions (PPI) in short- and long-term follow-up. MATERIAL AND METHODS The retrospective single-center, observational study included 160 patients, undergoing PPI. Patients were divided into 2 groups based on the use of anticoagulation - unfractionated heparin (UFH group) or bivalirudin (Biv. group) - and observed up to 5 years. RESULTS The UFH group consisted of 101 patients and the Biv. group consisted of 59. We registered the following end points during in-hospital observation: 1 death (0.63% Biv, p = 0.18), 12 hematomas at puncture site (0.63% Biv. vs. 7.05% UFH, p = 0.04), 2 pseudoaneurysms (1.27% UFH, p = 0.29), thrombosis (0.63% UFH, p = 0.45), 1 bleeding from puncture site (0.63% UFH, p = 0.45). The total number of hemorrhagic complications was 1.24% in the Biv. group and 8.07% in the UFH group (p = 0.04). During long-term follow-up of 65.7 ±36.4 months the all-cause mortality rate was higher in the Biv. group (8.59% Biv vs. 0% in UFH group, p = 0.009). Regression analysis showed that bivalirudin administration is a risk factor for increased mortality risk (p = 0.003, OR = 15, 95% CI: 3.3-107.8). CONCLUSIONS Usage of UFH was associated with a higher number of hemorrhagic complications, especially hematomas at the puncture site in comparison to patients receiving bivalirudin.
Collapse
Affiliation(s)
| | - Paweł Kleczyński
- 2 Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Wojciech Zasada
- 2 Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Tomasz Rakowski
- 2 Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Salech Arif
- 2 Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Krzysztof Bartuś
- 2 Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Dariusz Dudek
- 2 Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Stanisław Bartuś
- 2 Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| |
Collapse
|
9
|
Wojtasik-Bakalarz J, Ruzsa Z, Rakowski T, Nyerges A, Bartuś K, Stanek A, Dudek D, Surdacki A, Kleczyński P, Bartuś S. Impact of Coronary Artery Disease and Diabetes Mellitus on the Long-Term Follow-Up in Patients after Retrograde Recanalization of the Femoropopliteal Arterial Region. J Diabetes Res 2019; 2019:6036359. [PMID: 31049356 PMCID: PMC6462337 DOI: 10.1155/2019/6036359] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 12/10/2018] [Accepted: 12/25/2018] [Indexed: 11/24/2022] Open
Abstract
The most relevant comorbidities in patients with peripheral artery disease (PAD) are coronary artery disease (CAD) and diabetes mellitus (DM). However, data of long-term follow-up of patients with chronic total occlusion (CTO) are scarce. The aim of the study was to assess the impact of CAD and DM on long-term follow-up patients after superficial femoral artery (SFA) CTO retrograde recanalization. In this study, eighty-six patients with PAD with diagnosed CTO in the femoropopliteal region and at least one unsuccessful attempt of antegrade recanalization were enrolled in 2 clinical centers. Mean time of follow-up in all patients was 47.5 months (±40 months). Patients were divided into two groups depending on the presence of CAD (CAD group: n = 45 vs. non-CAD group: n = 41) and DM (DM group: n = 50 vs. non-DM group: n = 36). In long-term follow-up, major adverse peripheral events (MAPE) occurred in 66.6% of patients with CAD vs. 36.5% of patients without CAD and in 50% of patients with DM vs. 55% of non-DM subjects. There were no statistical differences in peripheral endpoints in both groups. However, there was a statistically significant difference in all-cause mortality: in the DM group, there were 6 deaths (12%) (P value = 0.038). To conclude, patients after retrograde recanalization, with coexisting CTO and DM, are at higher risk of death in long-term follow-up.
Collapse
Affiliation(s)
| | - Zoltan Ruzsa
- Semmelweis University, Heart and Vascular Center, Cardiology Department, Hungary
- Bács-Kiskun County Hospital, Invasive Cardiology Department, Teaching Hospital of Szent-Györgyi Albert Medical University, Kecskemét, Hungary
| | - Tomasz Rakowski
- 2nd Department of Cardiology, Jagiellonian University Collegium Medicum, Krakow, Poland
| | - Andreas Nyerges
- Semmelweis University, Heart and Vascular Center, Cardiology Department, Hungary
| | - Krzysztof Bartuś
- 2nd Department of Cardiology, Jagiellonian University Collegium Medicum, Krakow, Poland
| | - Agata Stanek
- Department of Internal Medicine, Angiology and Physical Medicine, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Bytom, Poland
| | - Dariusz Dudek
- 2nd Department of Cardiology, Jagiellonian University Collegium Medicum, Krakow, Poland
| | - Andrzej Surdacki
- 2nd Department of Cardiology, Jagiellonian University Collegium Medicum, Krakow, Poland
| | - Paweł Kleczyński
- 2nd Department of Cardiology, Jagiellonian University Collegium Medicum, Krakow, Poland
| | - Stanisław Bartuś
- 2nd Department of Cardiology, Jagiellonian University Collegium Medicum, Krakow, Poland
| |
Collapse
|
10
|
Ruzsa Z, Wojtasik-Bakalarz J, Nyerges A, Rakowski T, Kleczynski P, Bartus S. Long-Term Follow-up After Retrograde Recanalization of Superficial Femoral Artery Chronic Total Occlusion. J Invasive Cardiol 2017; 29:336-339. [PMID: 28974660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVES The aim of this study was to assess the safety of the retrograde procedure with long-term follow-up of 86 patients after retrograde recanalization of the superficial femoral artery (SFA). BACKGROUND Chronic total occlusion (CTO) of SFAs occurs in >50% of the patient population with peripheral artery disease. The retrograde technique is an option for patients with unsuccessful antegrade percutaneous interventions, but data from long-term follow-up after retrograde recanalization are still limited. METHODS The study included 86 patients (67% males), who underwent percutaneous retrograde recanalization. Major adverse cardiovascular or cerebrovascular events and major adverse peripheral events were assessed from long-term (47.5 ± 40 months) follow-up data. RESULTS Mean patient age was 64 ± 9 years. Retrograde puncture was successful in all cases. Procedural success rate was 93%. In-hospital observation showed vascular perforation/bleeding in 4.7%, proximal hematoma in 9.3%, distal hematoma in 4.7%, pseudoaneurysm in 1.2%, thrombosis in 1.2%, puncture-site bleeding in 3.5%, and local inflammation in 1.2%. Mortality rate was 6.98%. Target-vessel reintervention was needed in 20.9% of cases, and percutaneous transluminal angioplasty of another artery was done in 27% of cases. Amputation rate was 4.7%. CONCLUSIONS Long-term follow-up shows that retrograde recanalization is connected with a high rate of technical success and low percentage of reinterventions. Retrograde technique is safe and related to low complication rates; most complications were localized in nature.
Collapse
Affiliation(s)
| | | | | | | | | | - Stanislaw Bartus
- II Dept. of Cardiology, Jagiellonian University, Krakow, Poland.
| |
Collapse
|