Postepy W Kardiologii Interwencyjnej最新文献

{"title":"Dicrotic notch index in pulmonary hypertension: correlation with hemodynamic, echocardiographic and clinical parameters.","authors":"Mustafa Oguz, İrem Yılmaz, Almina Erdem, Gürkan Imre, Nilufer D Eksi, Mehmet Uzun","doi":"10.5114/aic.2024.144977","DOIUrl":"10.5114/aic.2024.144977","url":null,"abstract":"<p><strong>Introduction: </strong>Pulmonary hypertension (PH) is characterized by increased pulmonary artery pressure (PAP) and pulmonary vascular resistance (PVR) due to loss of arterial elasticity and vascular obstruction. The dicrotic notch index (DNI) represents reflected wave characteristics and vascular elasticity, potentially serving as an important marker in PH assessment.</p><p><strong>Aim: </strong>This study evaluates the relationship between DNI and PVR, PAPs, and other hemodynamic and clinical parameters in PH patients.</p><p><strong>Material and methods: </strong>A retrospective analysis was conducted on 76 patients diagnosed with pulmonary arterial hypertension (PAH), chronic thromboembolic pulmonary hypertension (CTEPH), or normal PAPs who underwent right heart catheterization (RHC). PAP waveforms were analyzed to determine DNI. Correlations between DNI and hemodynamic, clinical, and echocardiographic parameters were assessed using Pearson's correlation coefficient. Logistic regression and ROC analysis were performed to evaluate the DNI's predictive value.</p><p><strong>Results: </strong>DNI showed significant positive correlations with systolic PAP (sPAP) (<i>r</i> = 0.972, <i>p</i> < 0.001), diastolic PAP (dPAP) (<i>r</i> = 0.876, <i>p</i> < 0.001), mean PAP (mPAP) (<i>r</i> = 0.987, <i>p</i> < 0.001), right atrial (RA) pressure (<i>r</i> = 0.741, <i>p</i> = 0.018), and PVR (<i>r</i> = 0.814, <i>p</i> < 0.001). Significant negative correlations were observed with cardiac index (CI) (<i>r</i> = -0.573, <i>p</i> = 0.012) and pSO₂ (<i>r</i> = -0.516, <i>p</i> = 0.043). Univariable logistic regression identified DNI as a significant predictor of PH (O<i>R</i> = 1.100, 95% CI: 1.048-1.155, <i>p</i> < 0.001). ROC analysis showed an AUC of 0.922 for DNI, indicating excellent predictive value.</p><p><strong>Conclusions: </strong>DNI is correlated with key hemodynamic parameters such as PVR and mPAP, underscoring its potential as a crucial marker in the assessment of PAH and CTEPH patients. Additionally, DNI exhibited significant correlations with echocardiographic measurements and clinical indicators, suggesting its utility in evaluating pulmonary arterial stiffness and resistance. Further research is needed to validate these findings in larger cohorts and to establish standardized protocols for DNI measurement in clinical practice.</p>","PeriodicalId":49678,"journal":{"name":"Postepy W Kardiologii Interwencyjnej","volume":"20 4","pages":"449-454"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased epicardial adipose tissue volume may adversely affect outcomes in patients undergoing transcatheter aortic valve implantation.","authors":"Kerem Özbek, Mustafa Dağlı, Ahmet Balun, Murat M Yigitbasi, Zehra G Çetin, Bekir Demirtaş, Eren Çamur, Mustafa Çetin, Hülya Çiçekçioğlu","doi":"10.5114/aic.2024.142574","DOIUrl":"10.5114/aic.2024.142574","url":null,"abstract":"<p><strong>Introduction: </strong>Epicardial adipose tissue (EAT) influences the development of cardiovascular diseases through the secretion of inflammatory cytokines. Transcatheter aortic valve implantation (TAVI) is one of the most commonly used methods for treating severe aortic stenosis in adults.</p><p><strong>Aim: </strong>Given the role of inflammatory cytokines in the progression of aortic stenosis, we investigated the impact of EAT on the outcomes of patients undergoing TAVI.</p><p><strong>Material and methods: </strong>The medical records of 334 patients who underwent TAVI for symptomatic severe aortic stenosis between March 2018 and December 2022 were evaluated after applying the exclusion criteria. Major adverse cardiac and cerebrovascular endpoints (MACCE) were defined according to the Valvular Academic Research Consortium criteria. The patients were divided into two groups: those with and without MACCE.</p><p><strong>Results: </strong>Mean EAT volume was higher in patients with MACCE than those without MACCE (120.7 ±43.9 vs. 96.1 ±39.8, <i>p</i> < 0.001). Univariate Cox proportional-risk analysis revealed that creatinine and albumin levels, mean systolic pulmonary artery pressure, and EAT volume were significantly associated with MACCE. Multivariate Cox proportional-hazard analysis showed that EAT volume (hazard ratio (HR) = 1.012; 95% confidence interval (CI): 1.006-1.018; <i>p</i> < 0.001) and albumin level (HR = 0.925; 95% CI: 0.866-0.987; <i>p</i> = 0.018) were significantly independently associated with MACCE.</p><p><strong>Conclusions: </strong>The EAT volume and 1-year outcomes may be related in patients undergoing TAVI for severe aortic stenosis.</p>","PeriodicalId":49678,"journal":{"name":"Postepy W Kardiologii Interwencyjnej","volume":"20 4","pages":"420-427"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The possible modulatory impact of high-dose statin therapy on carotid intima-media thickness: a preliminary study.","authors":"Tomasz K Urbanowicz, Katarzyna Gabriel, Ievgen Spasenenko, Aleksandra Krasińska-Płachta, Marta Banaszkiewicz, Krzysztof J Filipiak, Zbigniew Krasiński, Beata Krasińska, Andrzej Tykarski","doi":"10.5114/aic.2024.145183","DOIUrl":"10.5114/aic.2024.145183","url":null,"abstract":"<p><strong>Introduction: </strong>Morbidity related to cardiovascular disease (CVD) is a leading epidemiological problem. Carotid intima-media thickness (CIMT) can be regarded as a surrogate marker for cardiovascular disease. Lipid-lowering agents such as statins have proven to reduce future risk and promote regression of atherosclerotic plaques.</p><p><strong>Aim: </strong>To relate long-term high-dose statin therapy to CIMT in a retrospective analysis of patients presenting with preserved ejection fraction heart failure (HFpEF).</p><p><strong>Material and methods: </strong>There were 77 (47 female and 30 male) consecutive patients with a median age of 69 (62-75) years admitted to the Hypertension and Internal Medicine Department presenting with preserved ejection fraction heart failure symptoms in NYHA class 2.0 (0.5) for clinical evaluation in 2024. Laboratory tests, echocardiography, carotid ultrasound, and cine angiography were performed. The possible relation between CIMT and patients' characteristics was evaluated.</p><p><strong>Results: </strong>The multivariable model indicated possible relations between CIMT above 0.8 mm and obesity (BMI > 30 kg/m²) (OR = 11.86, 95% CI: 2.5-54.02, <i>p</i> = 0.001), and high-statin therapy (OR = 0.18, 95% CI: 0.04-0.08, <i>p</i> = 0.024). The receiver operator curve (ROC) was characterized by an area under the curve (AUC) of 0.794 with an F-measure of 0.417, yielding a sensitivity of 35.7% and specificity of 91.8%.</p><p><strong>Conclusions: </strong>The results from the retrospective single-measurement analysis on long-term statin therapy may indicate the relation between CIMT and rosuvastatin (at least 20 mg/day) or atorvastatin (at least 40 mg/day) administration. Long-term statin therapy is associated with a reduced likelihood of having CIMT above 0.8 mm, although the presented results are statin-type and dosage-dependent.</p>","PeriodicalId":49678,"journal":{"name":"Postepy W Kardiologii Interwencyjnej","volume":"20 4","pages":"413-419"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Propranolol palliation after right ventricular outflow tract stenting reduces the reintervention rate until complete repair of Fallot tetralogy and variants.","authors":"Tugcin Bora Polat","doi":"10.5114/aic.2024.144978","DOIUrl":"10.5114/aic.2024.144978","url":null,"abstract":"<p><strong>Introduction: </strong>Stenting of the right ventricular outflow tract (RVOT) is a reasonable palliation in symptomatic infants with tetralogy of Fallot (ToF) and variants. However, this procedure needs reintervention until corrective surgery.</p><p><strong>Aim: </strong>To compare RVOT stenting followed with or without propranolol medication until complete repair of ToF and variants.</p><p><strong>Material and methods: </strong>Twenty-five cyanotic infants under 6 months of age with ToF and variants underwent RVOT stenting between March 2017 and May 2024 including the first 11 followed without propranolol medication and the next 14 followed with propranolol medication.</p><p><strong>Results: </strong>Median age at initial RVOT stent implantation was 92 days and similar in both groups. At the time of this writing, total correction of ToF has been performed in 23 patients including 11 followed without propranolol medication and 12 followed with propranolol medication. Median age at the time of surgery was 258 days and similar in both groups. The rate of reintervention before complete repair was 8/25 (32%) during follow-up for recurrence of cyanosis, including 6/11 (54%) patients followed without propranolol medication and 2/14 (14%) in patients with propranolol medication (<i>p</i> = 0.041). The remaining 2 patients followed with propranolol medication required reintervention 150 and 170 days after initial intervention.</p><p><strong>Conclusions: </strong>Long-term treatment with propranolol given after RVOT stenting in ToF and variants, particularly under 3 months of age, may reduce the need for further interventions prior to complete repair.</p>","PeriodicalId":49678,"journal":{"name":"Postepy W Kardiologii Interwencyjnej","volume":"20 4","pages":"455-460"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of parameters predicting in-hospital mortality and septic embolisms in patients with infective endocarditis.","authors":"Tuba Tatlı Kış, Mehmet Kış, Tuncay Güzel, Çiğdem Mermutluoğlu","doi":"10.5114/aic.2024.145171","DOIUrl":"10.5114/aic.2024.145171","url":null,"abstract":"<p><strong>Introduction: </strong>Infective endocarditis (IE) is the infection of the cardiac endothelium and heart valves. The incidence of IE has recently increased due to the widespread use of cardiac device therapies and prosthetic heart valves. Despite modern medical and surgical treatment methods, morbidity and mortality are still high, and it leads to serious complications. Evaluation of predictive factors leading to septic embolism, which is one of the most important complications in terms of mortality and morbidity, is important for improving outcomes in infective endocarditis.</p><p><strong>Aim: </strong>In this study, we aimed to determine the predictive parameters of in-hospital mortality and septic embolism in patients with IE.</p><p><strong>Material and methods: </strong>This was a retrospective cohort study. The patients were divided into two groups: group 1 (septic embolism or mortality +, 21 patients) and group 2 (septic embolism or mortality -, 43 patients). ROC analysis was performed to determine the cut-off value of the predictive parameters. Univariable and multivariable regression analysis was performed to identify parameters significantly associated with in-hospital mortality/septic embolism in infective endocarditis.</p><p><strong>Results: </strong>A total of 64 patients diagnosed with IE were included in the study. In the multivariable regression analysis, the parameters vegetation size (OR = 1.227; 95% CI: 1.019-1.477, <i>p</i> = 0.031), aortic valve vegetation (OR = 0.088; 95% CI: 0.009-0.820, <i>p =</i> 0.033), mitral valve vegetation (OR = 0.082; 95% CI: 0.009-0.760, <i>p =</i> 0.028), albumin (OR = 0.185; 95% CI: 0.039-0.889, <i>p =</i> 0.035) and D-dimer (OR = 1.004; 95% CI: 1.000-1.009, <i>p =</i> 0.045) were found to be independent predictors for septic embolism and mortality in IE patients.</p><p><strong>Conclusions: </strong>Vegetation size, high D-dimer and low serum albumin levels are predictors of in-hospital mortality and septic embolism in patients with IE.</p>","PeriodicalId":49678,"journal":{"name":"Postepy W Kardiologii Interwencyjnej","volume":"20 4","pages":"480-486"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interventional cardiology in Poland in 2023. Annual summary report of the Association of Cardiovascular Interventions of the Polish Cardiac Society (AISN PTK) and Jagiellonian University Medical College.","authors":"Zbigniew Siudak, Marek Grygier, Mariusz Tomaniak, Marta Kałużna-Oleksy, Paweł Kleczyński, Krzysztof Milewski, Maksymilian P Opolski, Grzegorz Smolka, Robert Sabiniewicz, Krzysztof P Malinowski, Dariusz Dudek, Zenon Huczek, Michał Hawranek","doi":"10.5114/aic.2024.144970","DOIUrl":"10.5114/aic.2024.144970","url":null,"abstract":"","PeriodicalId":49678,"journal":{"name":"Postepy W Kardiologii Interwencyjnej","volume":"20 4","pages":"379-381"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between uric acid to HDL ratio and extent and severity of coronary artery disease.","authors":"Mehmet Yaman, Ali Y Kilinc, Fatih Öztürk, Mehmet Coşkun, Ramazan Duz, Yılmaz Gunes","doi":"10.5114/aic.2024.145034","DOIUrl":"10.5114/aic.2024.145034","url":null,"abstract":"<p><strong>Introduction: </strong>Coronary artery disease (CAD) is common worldwide and is a significant cause of morbidity and mortality. CAD is a chronic and inflammatory disease mainly caused by atherosclerosis. SYNTAX and Gensini scoring systems are used to evaluate CAD extent and severity. Uric acid to high-density lipoprotein (HDL) ratio (UHR) increases in inflammatory conditions.</p><p><strong>Aim: </strong>To investigate the relationship between UHR and the extent and severity of CAD and its correlation with SYNTAX and Gensini scoring systems.</p><p><strong>Material and methods: </strong>894 patients who underwent angiography were included in the study. 612 participants with critical coronary stenosis were designated as the patient group, and 282 participants without stenosis were designated as the control group. Characteristic features and laboratory parameters of the groups were compared. The relationship between the SYNTAX and Gensini scores of the patient group and UHR was analyzed.</p><p><strong>Results: </strong>Baseline characteristics and laboratory parameters were similar in both groups, except for uric acid and UHR levels. Both uric acid levels (7.58 ±2.55 mg/dl vs. 5.71 ±1.46 mg/dl, <i>p</i> < 0.01) and UHR (0.2016 ±0.094 vs. 0.1461 ±0.05, <i>p</i> < 0.01) were significantly higher in the patient group. UHR levels were found to be correlated significantly with both scoring systems. In the ROC curve analysis the UHR cut-off value of 0.1567 was able to predict CAD moderately (AUC = 0.669 (0.634-0.704), sensitivity 61.1%, specificity 38.7%).</p><p><strong>Conclusions: </strong>UHR is an easy-to-use parameter that can be used before invasive evaluation to predict the presence, severity, and extent of CAD.</p>","PeriodicalId":49678,"journal":{"name":"Postepy W Kardiologii Interwencyjnej","volume":"20 4","pages":"401-405"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of anemia on clinical outcomes in patients with multivessel coronary artery disease treated with percutaneous coronary intervention.","authors":"Szymon Jonik, Alicja Skrobucha, Zenon Huczek, Janusz Kochman, Grzegorz Opolski, Marcin Grabowski, Tomasz Mazurek","doi":"10.5114/aic.2024.144778","DOIUrl":"10.5114/aic.2024.144778","url":null,"abstract":"<p><strong>Introduction: </strong>Coronary artery disease (CAD) remains one of the major problems of contemporary medicine. Hematological disorders seem to play an important role in progression and severity of CAD. The aging of the population results in an increase in the number of patients with both CAD and anemia.</p><p><strong>Aim: </strong>To assess the impact of anemia on clinical outcomes in patients with multivessel CAD who underwent percutaneous coronary intervention (PCI) in long-term follow-up.</p><p><strong>Material and methods: </strong>In this retrospective study we examined 6-year outcomes of 679 individuals with multivessel CAD treated with PCI based on the hemoglobin (HGB) value before the interventional procedure. We classified the participants into two groups: anemia and non-anemia. The primary endpoint was overall mortality. Secondary endpoints were major adverse cardiac or cerebrovascular events (MACCE) (i.e. overall mortality, stroke, myocardial infarction (MI), or repeat revascularization (RR)) and separate components of MACCE.</p><p><strong>Results: </strong>We found that 35.4% (240 out of 679) of the patients were anemic. The occurrence of the primary endpoint significantly differed between anemia and non-anemia-groups (48/240 (20.0%) vs. 51/439 (11.6%), <i>p</i> = 0.003). The co-existence of anemia was associated with increased rates of MACCE, MI and in-hospital mortality (177/240 (73.8%) vs. 211/439 (48.1%); 51/240 (21.3%) vs. 44/439 (10.0%) and 21/240 (8.8%) vs. 4/439 (0.9%) for non-anemia, <i>p</i> < 0.001 for all, respectively).</p><p><strong>Conclusions: </strong>Our research identified an important risk factor for stratifying PCI patients. Given the high incidence of anemia in CAD patients undergoing PCI, HGB levels should be assessed upon admission and factored into risk stratification.</p>","PeriodicalId":49678,"journal":{"name":"Postepy W Kardiologii Interwencyjnej","volume":"20 4","pages":"393-400"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wide-awake local anesthesia during insertion of cardiac implantable electronic devices: a randomized study.","authors":"Ersin Doğanözü, Burcu U Ilgın","doi":"10.5114/aic.2024.145170","DOIUrl":"10.5114/aic.2024.145170","url":null,"abstract":"<p><strong>Introduction: </strong>Wide-awake local anesthesia (WALA) with epinephrine has been demonstrated to be effective in orthopedics and hand surgery, as it offers adequate local anesthesia and obviates the requirement for patient sedation and even the use of a tourniquet to block the blood supply to the proximal extremity.</p><p><strong>Aim: </strong>To evaluate the effect of wide-awake local anesthesia on pain and bleeding levels in patients who received cardiac implantable electronic device implantation.</p><p><strong>Material and methods: </strong>The patients were randomly assigned to two groups: Group 1, consisting of 21 patients, referred to as the WALA group; and Group 2, consisting of 21 patients, which served as the control group and received local anesthesia. After surgery, the primary operator assigned a bleeding score ranging from 1 to 10 to each patient. The Visual Analog Scale was employed to assess pain.</p><p><strong>Results: </strong>The control group had a significantly higher median bleeding score compared to the WALA group (5 vs. 2, <i>p</i> < 0.001). The median intra-procedural and post-procedural pain scores were significantly lower in the WALA group compared to the control group (2 vs. 4, <i>p</i> < 0.001, and 1 vs. 3, <i>p</i> < 0.001, respectively). No surgical revision was necessary for any pocket hematoma.</p><p><strong>Conclusions: </strong>WALA anesthesia significantly reduces intra- and post-procedural bleeding and pain. The potential benefits of the technique, such as preventing the formation of pocket hematoma, shortening the duration of the procedure, and accelerating the recovery period, must be demonstrated in randomized trials conducted on a larger number of patients.</p>","PeriodicalId":49678,"journal":{"name":"Postepy W Kardiologii Interwencyjnej","volume":"20 4","pages":"461-467"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of different revascularization strategies in patients with non-ST-segment elevation myocardial infarction with multivessel disease: a systematic review and network meta-analysis.","authors":"Tingting Chen, Chen Lu, Jingli Mo, Ting Wang, Xiang Li, Ying Yang","doi":"10.5114/aic.2024.144666","DOIUrl":"10.5114/aic.2024.144666","url":null,"abstract":"<p><strong>Introduction: </strong>The optimal timing of revascularization in non-ST-segment elevation myocardial infarction (NSTEMI) with multivessel disease (MVD) remains controversial.</p><p><strong>Aim: </strong>We investigated the impact of different revascularization strategies on clinical outcomes to assess the optimal revascularization strategy for these patients.</p><p><strong>Methods: </strong>We performed a network meta-analysis of cohort studies comparing revascularization strategies in NSTEMI with MVD. Effect sizes were calculated as odds ratios (ORs) using a random-effects model. The primary efficacy outcome was all-cause mortality and the primary safety outcome was recurrent myocardial infarction.</p><p><strong>Results: </strong>Eight eligible studies involving 34,151 patients receiving four revascularization strategies were analyzed. Compared to conventional culprit-only revascularization (COR), planned complete multi-vessel percutaneous coronary intervention during a second hospitalization (MV-PCI) reduced the risk of major adverse cardiovascular events (MACEs) (MV-PCI vs. COR: OR = 0.53; 95% CI: 0.38-0.74) and decreased all-cause mortality (MV-PCI vs. COR: OR = 0.53; 95% CI: 0.30-0.93) and the likelihood of repeat revascularization (MV-PCI vs. COR: OR = 0.55; 95% CI: 0.37-0.82). However, compared to COR, immediate complete revascularization (ICR) but not MV-PCI was associated with reduced risk of recurrent MI (COR vs. ICR: OR = 1.39; 95% CI: 1.07-1.81; MV-PCI vs. COR: OR = 0.64; 95% CI: 0.40-1.01). Compared to MV-PCI: COR and staged complete revascularization during index PCI (SCR) increased the risk of cardiovascular mortality (MV-PCI vs. COR: OR = 0.48; 95% CI: 0.34-0.70; MV-PCI vs. SCR: OR = 0.62; 95% CI: 0.40-0.96). COR also had significantly higher cardiovascular mortality compared to ICR (COR vs. ICR: OR = 1.38; 95% CI: 1.02-1.85).</p><p><strong>Conclusions: </strong>Complete revascularization is more effective compared to culprit-only revascularization for most follow-ups.</p>","PeriodicalId":49678,"journal":{"name":"Postepy W Kardiologii Interwencyjnej","volume":"20 4","pages":"382-392"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}