Long-Term Clinical Outcomes for Non-ST Elevation Acute Coronary Syndrome Patients with High-Risk Angiographic Findings Undergoing Percutaneous Coronary Intervention
Objective. We aim to evaluate the long-term prognosis of non-ST elevation acute coronary syndrome (NSTE-ACS) patients with high-risk coronary anatomy (HRCA). Background. Coronary disease severity is important for therapeutic decision-making and prognostication among patients presenting with NSTE-ACS...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Journal of Interventional Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2020/2139617 |
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| author | Sida Jia Ce Zhang Yue Liu Deshan Yuan Xueyan Zhao Runlin Gao Yuejin Yang Bo Xu Zhan Gao Jinqing Yuan |
| author_facet | Sida Jia Ce Zhang Yue Liu Deshan Yuan Xueyan Zhao Runlin Gao Yuejin Yang Bo Xu Zhan Gao Jinqing Yuan |
| author_sort | Sida Jia |
| collection | DOAJ |
| description | Objective. We aim to evaluate the long-term prognosis of non-ST elevation acute coronary syndrome (NSTE-ACS) patients with high-risk coronary anatomy (HRCA). Background. Coronary disease severity is important for therapeutic decision-making and prognostication among patients presenting with NSTE-ACS. However, long-term outcome in patients undergoing percutaneous coronary intervention (PCI) with HRCA is still unknown. Method. NSTE-ACS patients undergoing PCI in Fuwai Hospital in 2013 were prospectively enrolled and subsequently divided into HRCA and low-risk coronary anatomy (LRCA) groups according to whether angiography complies with the HRCA definition. HRCA was defined as left main disease >50%, proximal LAD lesion >70%, or 2- to 3- vessel disease involving the LAD. Prognosis impact on 2-year and 5-year major adverse cardiovascular and cerebrovascular events (MACCE) is analyzed. Results. Out of 4,984 enrolled patients with NSTE-ACS, 3,752 patients belonged to the HRCA group, while 1,232 patients belonged to the LRCA group. Compared with the LRCA group, patients in the HRCA group had worse baseline characteristics including higher age, more comorbidities, and worse angiographic findings. Patients in the HRCA group had higher incidence of unplanned revascularization (2 years: 9.7% vs. 5.1%, p<0.001; 5 years: 15.4% vs. 10.3%, p<0.001), 2-year MACCE (13.1% vs. 8.8%, p<0.001), and 5-year death/MI/revascularization/stroke (23.0% vs. 18.4%, p=0.001). Kaplan–Meier survival analysis showed similar results. After adjusting for confounding factors, HRCA is independently associated with higher risk of revascularization (2 years: HR = 1.636, 95% CI: 1.225–2.186; 5 years: HR = 1.460, 95% CI: 1.186–1.798), 2-year MACCE (HR = 1.275, 95% CI = 1.019–1.596) and 5-year death/MI/revascularization/stroke (HR = 1.183, 95% CI: 1.010–1.385). Conclusion. In our large cohort of Chinese patients, HRCA is an independent risk factor for long-term unplanned revascularization and MACCE. |
| format | Article |
| id | doaj-art-6a687bd0e30340babc292850428b0958 |
| institution | Kabale University |
| issn | 0896-4327 1540-8183 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Interventional Cardiology |
| spelling | doaj-art-6a687bd0e30340babc292850428b09582025-02-03T05:53:56ZengWileyJournal of Interventional Cardiology0896-43271540-81832020-01-01202010.1155/2020/21396172139617Long-Term Clinical Outcomes for Non-ST Elevation Acute Coronary Syndrome Patients with High-Risk Angiographic Findings Undergoing Percutaneous Coronary InterventionSida Jia0Ce Zhang1Yue Liu2Deshan Yuan3Xueyan Zhao4Runlin Gao5Yuejin Yang6Bo Xu7Zhan Gao8Jinqing Yuan9Fu Wai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, ChinaFu Wai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, ChinaFu Wai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, ChinaFu Wai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, ChinaFu Wai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, ChinaFu Wai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, ChinaFu Wai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, ChinaFu Wai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, ChinaFu Wai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, ChinaFu Wai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, ChinaObjective. We aim to evaluate the long-term prognosis of non-ST elevation acute coronary syndrome (NSTE-ACS) patients with high-risk coronary anatomy (HRCA). Background. Coronary disease severity is important for therapeutic decision-making and prognostication among patients presenting with NSTE-ACS. However, long-term outcome in patients undergoing percutaneous coronary intervention (PCI) with HRCA is still unknown. Method. NSTE-ACS patients undergoing PCI in Fuwai Hospital in 2013 were prospectively enrolled and subsequently divided into HRCA and low-risk coronary anatomy (LRCA) groups according to whether angiography complies with the HRCA definition. HRCA was defined as left main disease >50%, proximal LAD lesion >70%, or 2- to 3- vessel disease involving the LAD. Prognosis impact on 2-year and 5-year major adverse cardiovascular and cerebrovascular events (MACCE) is analyzed. Results. Out of 4,984 enrolled patients with NSTE-ACS, 3,752 patients belonged to the HRCA group, while 1,232 patients belonged to the LRCA group. Compared with the LRCA group, patients in the HRCA group had worse baseline characteristics including higher age, more comorbidities, and worse angiographic findings. Patients in the HRCA group had higher incidence of unplanned revascularization (2 years: 9.7% vs. 5.1%, p<0.001; 5 years: 15.4% vs. 10.3%, p<0.001), 2-year MACCE (13.1% vs. 8.8%, p<0.001), and 5-year death/MI/revascularization/stroke (23.0% vs. 18.4%, p=0.001). Kaplan–Meier survival analysis showed similar results. After adjusting for confounding factors, HRCA is independently associated with higher risk of revascularization (2 years: HR = 1.636, 95% CI: 1.225–2.186; 5 years: HR = 1.460, 95% CI: 1.186–1.798), 2-year MACCE (HR = 1.275, 95% CI = 1.019–1.596) and 5-year death/MI/revascularization/stroke (HR = 1.183, 95% CI: 1.010–1.385). Conclusion. In our large cohort of Chinese patients, HRCA is an independent risk factor for long-term unplanned revascularization and MACCE.http://dx.doi.org/10.1155/2020/2139617 |
| spellingShingle | Sida Jia Ce Zhang Yue Liu Deshan Yuan Xueyan Zhao Runlin Gao Yuejin Yang Bo Xu Zhan Gao Jinqing Yuan Long-Term Clinical Outcomes for Non-ST Elevation Acute Coronary Syndrome Patients with High-Risk Angiographic Findings Undergoing Percutaneous Coronary Intervention Journal of Interventional Cardiology |
| title | Long-Term Clinical Outcomes for Non-ST Elevation Acute Coronary Syndrome Patients with High-Risk Angiographic Findings Undergoing Percutaneous Coronary Intervention |
| title_full | Long-Term Clinical Outcomes for Non-ST Elevation Acute Coronary Syndrome Patients with High-Risk Angiographic Findings Undergoing Percutaneous Coronary Intervention |
| title_fullStr | Long-Term Clinical Outcomes for Non-ST Elevation Acute Coronary Syndrome Patients with High-Risk Angiographic Findings Undergoing Percutaneous Coronary Intervention |
| title_full_unstemmed | Long-Term Clinical Outcomes for Non-ST Elevation Acute Coronary Syndrome Patients with High-Risk Angiographic Findings Undergoing Percutaneous Coronary Intervention |
| title_short | Long-Term Clinical Outcomes for Non-ST Elevation Acute Coronary Syndrome Patients with High-Risk Angiographic Findings Undergoing Percutaneous Coronary Intervention |
| title_sort | long term clinical outcomes for non st elevation acute coronary syndrome patients with high risk angiographic findings undergoing percutaneous coronary intervention |
| url | http://dx.doi.org/10.1155/2020/2139617 |
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