Coronary Angioplasty In Patients Research Articles

The microvascular bed of the skin of lower limbs in patients with intermittent lameness and coronary heart disease as a possible model of their myocardial microcirculation

Purpose: to assess possibility to extrapolate findings of skin microvascular bed examination in lower extremities with laser Doppler flowmetry in patients with obliterating atherosclerosis as a model of their myocardial microcirculation in coronary heart disease.Material and methods. Males with angiographically confirmed coronary heart disease (n = 70) and obliterating atherosclerosis in lower limbarteries (n = 74) were taken in the study. Microcirculation of the skin in the left forearm in the Zakharyin – Head zone in patients with coronaryheart disease and skin microcirculation in the foot of affected limb in patients with obliterating atherosclerosis of arteries of lower extremities were examined with laser Doppler flowmetry. The basal blood flow, amplitude-frequency spectrum of its oscillations, myogenic, neurogenic vascular tone and occlusion parameters were assessed as well. Comparison groups included 50 practically healthy males for the patients with coronary heart disease and 20 males – for the patients with obliterating atherosclerosis of arteries of lower extremities. Patients were examinedat the initial stage and in 2–3 weeks after endovascular restoration of blood flow in the myocardium and lower limbs.Results and discussion. At the initial research stage, the microcirculation picture in patients with coronary heart disease and obliterating ath-erosclerosis in lower extremities differed from that of healthy individuals by shifts covering all links of the microvascular bed and characterizedby constriction of the precapillary segment, a statistically significant decrease in median values of capillary blood flow by 17.5 and 43.1 %,microvascular blood flow reserve – by 11.2 and 31.0 %, as well as by the increase in arteriolovenular blood bypass – by 10.3 and 70.8 %,respectively. After the restoration of blood flow in lower extremities in patients with obliterating atherosclerosis, muscular pain disappeared,and the ankle-shoulder index got normalized. At the same time, one could observe a statistically significant increase in the capillary blood flow(+13.6 %), the increase of reserve potential in microvascular bed (+20.6 %) with the simultaneous decrease of vascular tone in the precapillarysegment (–15.1 %) and of the blood bypass index (–25.0 %). Better clinical picture after coronary angioplasty in patients with coronary heart disease was accompanied with a similar and unidirectional tendency to positive changes in the microvascular bed.Conclusion. As far as etiopathogenetic mechanisms and clinical manifestations of coronary heart disease and obliterating atherosclerosis in arteries of lower extremities have much in common and microcirculatory shifts in forearm and foot skin in these patients before and after angioplasty are unidirectional, all these allow to suggest that one can see similar changes in the myocardium microcirculatory system in patients with coronary heart disease. Thus, it opens possibilities to have a targeted medicamentous impact at the microvascular level.

A Study to Assess the Knowledge and Attitude Regarding Care After Coronary Angioplasty and its Importance Among Care Givers of Coronary Angioplasty Patients at Mamata Super Specialty Hospital, Khammam, Telangana, India

after coronary angioplasty and its importance among care givers of coronary angioplasty patients at Mamata super specialty hospital, Khammam, Telangana”. The objectives were to describe the socio demographic variables of care givers, to assess the levels of knowledge and attitude regarding care after coronary angioplasty and its importance among care givers, to find out the association between the levels of knowledge and attitude scores of care givers with their selected socio demographic variables, to develop and distribute an information booklet regarding care after coronary angioplasty and its importance. Methodology: The study was conducted with a survey research approach for a sample of 50 care givers of coronary angioplasty patients at Mamata super specialty hospital, Khammam, Telangana. Sample was selected by Nonprobability Convenience Sampling technique. The data was collected by Structured Interview schedule. The collected data is analyzed by using descriptive and inferential statistics. Results: The study results revealed that levels of knowledge of care givers regarding care after coronary angioplasty and its importance among 50, majority of care givers 33 (66%) had moderately adequate knowledge 14(28%) had inadequate knowledge and 3(6%) adequate knowledge. Regarding attitude scores among 50, Majority of care givers 28 (56%) had favorable attitude and 22(44%) had moderately favorable attitude. Conclusion: The study concluded that the majority of the care givers had moderately adequate knowledge and favorable attitude. So, it is indicated that there is a need to increase the knowledge of care givers regarding care after coronary angioplasty and its importance.

ROLE OF SHORT SIX WEEKS HOME BASED AEROBIC EXERCISES IN PATIENTS WITH POST PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY (PTCA)

To examine the cardiovascular adaptations and functional capacity (6 min walk test, rate of perceived exertion, resting heart rate, maximal heart rate, systolic and diastolic blood pressure, mean arterial blood pressure) by giving Aerobic Exercises in Post Percutaneous Transluminal Coronary Angioplasty patients. The need for the study is to know the efficiency of aerobic exercises in post percutaneous transluminal coronary angioplasty (PTCA). To evaluate whether the patient can perform the aerobic exercises with -out any difficulty. To evaluate the effects of aerobic exercises on an individual with post PTCA and lead a better life after post PTCA. Key Words: Percutaneous Transluminal Coronary Angioplasty (PTCA); Resting Heart Rate (RHR); Maximal Heart Rate (MHR); Blood Pressure (BP); Systolic Blood Pressure (SBP); Diastolic Blood Pressure (DBP); Mean Arterial Blood Pressure (MRBP) cardiovascular diseases (CVD); Coronary heart diseases (CHD).

Clinical Outcome of Revascularization Deferral With Instantaneous Wave-Free Ratio and Fractional Flow Reserve: A 5-Year Follow-Up Substudy From the iFR-SWEDEHEART Trial.

Background Although physiology-based assessment of coronary artery stenosis using instantaneous wave-free ratio (iFR) and fractional flow reserve (FFR) are established methods of guiding coronary revascularization, its clinical outcome in long-term deferral needs further evaluation, especially with acute coronary syndrome as a clinical presentation. The aim was to evaluate the long-term clinical outcome of deferral of revascularization based on iFR or FFR. Methods and Results This is a substudy of the iFR-SWEDEHEART (Instantaneous Wave-Free Ratio Versus Fractional Flow Reserve in Patients With Stable Angina Pectoris or Acute Coronary Syndrome) randomized clinical trial, where patients deferred from revascularization from each study arm were selected. Nine hundred eight patients deferred from coronary revascularization with iFR (n=473) and FFR (n=435) were followed for 5 years. The national quality registry, SWEDEHEART (Swedish Web-System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies), was used for patient data collection and clinical follow-up. The end point was major adverse cardiac events and their individual components all-cause death, cardiovascular death, noncardiovascular death, nonfatal myocardial infarction, and unplanned revascularization. No significant difference was found in major adverse cardiac events (iFR 18.6% versus FFR 16.8%; adjusted hazard ratio, 1.08 [95% CI, 0.79-1.48]; P=0.63) or their individual components. Conclusions No differences in clinical outcomes after 5-year follow-up were noted when comparing iFR versus FFR as methods for deferral of coronary revascularization in patients presenting with stable angina pectoris and acute coronary syndrome. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT02166736.

Percutaneous Coronary Angioplasty in Patients with Cancer: Clinical Challenges and Management Strategies.

The number of cancer survivors in the United States is projected to increase by 31% by 2030. With advances in early screening, diagnosis and therapeutic strategies, a steadily increasing number of patients are surviving cancer. Coronary artery disease (CAD) is now one of the leading causes of death amongst cancer survivors, with the latter group of patients having a higher risk of CAD compared to the general population. Our review covers a range of specific challenges faced by doctors when considering percutaneous coronary interventions (PCI) in cancer patients; clinical outcomes in cancer patients undergoing PCI, as well as some important technical considerations to be made when making decisions regarding the management strategy in this special population of patients.

Profile of Coronary Angioplasty Patients in a Rural Care Setting in India- Real World Study of 5830 Patients Over 15 Years

Profile of Coronary Angioplasty Patients in a Rural Care Setting in India- Real World Study of 5830 Patients Over 15 Years

Використання екстракорпоральної мембранної оксигенації при реваскуляризації міокарда у пацієнтів з ішемічною хворобою серця на фоні кардіогенного шоку

Актуальність. Використання екстракорпоральної мембранної оксигенації (ЕКМО) стало ефективною методикою в лікуванні дорослих і дітей із тяжкою серцевою і легеневою дисфункцією, резистентною до традиційної терапії. Метою даної роботи було узагальнення досвіду використання ЕКМО при кардіальній дисфункції, що розвивається у пацієнтів з ішемічною хворобою серця при проведенні рентген-ендоваскулярної реваскуляризації міокарда. Матеріали та методи. У дослідженні проведено ретроспективний одноцентровий аналіз 23 пацієнтів з ішемічною хворобою серця (19 чоловіків і 4 жінки, середній вік — 65,7 ± 12,3 року), яким в ДУ «Інститут серця МОЗ України» в період з березня 2014 по червень 2018 р. при проведенні черезшкірної транслюмінальної коронарної ангіопластики (ЧТКА) використовувалася методика ЕКМО. Результати. 13 (56,52 %) пацієнтів, яким проводили ЕКМО при ЧТКА, померли безпосередньо в стаціонарі або через 30 днів після виписки, серед них переважали особи чоловічої статі (92,30 %). Незалежними предикторами фатальних наслідків виступали цукровий діабет (ВШ = 17,58; 95% ДI = 6,47–47,48; р = 0,00125), хронічна ниркова недостатність (ВШ = 20,81; 95% ДI = 5,95–72,21; р = 0,00014), ішемія міокарда в басейні правої коронарної артерії (ВШ = 25,51; 95% ДI = 8,27–79,12; р = 0,00013). Процедура тромбоекстракції та феномен «no reflow» на 18,5 і на 13,1 % частіше реєструвались у пацієнтів, які померли. Перераховані вище обставини зумовили і менший процедуральний успіх у пацієнтів, що померли (TIMI потік після ЧТКА становив 1,50 ± 0,48), тоді як у тих, що вижили, TIMI становив 2,40 ± 0,37 (р = 0,00138). Підключення ЕКМО до виникнення кардіологічних подій достовірно частіше виявлялося в групі пацієнтів, які вижили (90 % випадків), порівняно з померлими (0 %) (р = 0,0000001). Висновки. Цукровий діабет, ниркова недостатність, ураження правої коронарної артерії є незалежними предикторами летальності при проведенні рентгенендоваскулярної реканалізації у пацієнтів з ішемічною хворобою серця. Планове використання ЕКМО у пацієнтів групи високого ризику при черезшкірній реваскуляризації міокарда є позитивним прогностичним фактором виживання пацієнтів.

Sex Differences in Clinical Outcomes of Patients with Stable Coronary Artery Disease after Percutaneous Coronary Intervention

Potential sex-related differences in the periprocedural and long-term postprocedural outcomes of coronary angioplasty in patients with stable coronary artery disease have been studied thoroughly over the last few decades, to determine whether female sex should be regarded as an independent risk factor that affects clinical outcomes. Based on a significant number of observational studies and meta-analyses, sex has not yet emerged as an independent risk factor for either mortality or major cardiac and cerebrovascular events, despite the fact that in the early 1980s, for several reasons, female sex was associated with unfavourable outcomes. Therefore, it remains debatable whether female sex should be considered as an independent risk factor for periprocedural and long-term bleeding events. The pharmacological and technological advancements that support current coronary angioplasty procedures, as well as the non-delayed treatment of coronary artery disease in females have certainly lessened the outcome differences between the two sexes. However, females show fluctuations in blood coagulability through their lifetime and higher prevalence of bleeding episodes associated with the antithrombotic treatment, following transcatheter coronary reperfusion interventions. In conclusion, the clinical results of percutaneous coronary intervention in patients with stable coronary artery disease, during the periprocedural and long-term postprocedural periods, appear to show no significant differences between the two sexes, except for bleeding rates, which seem to be higher in females, a difference that mandates further systematic research.

One year follow-up of post percutaneous transluminal coronary angioplasty in patients with coronary heart disease

Background: Globally, the Cardiovascular Diseases (CVDs) has become the number one cause of death. Antithrombotic therapy along with Percutaneous Coronary Intervention (PCI) is the most common preferred approach to improve clinical outcomes. Aims: To know the clinical end points of Myocardial infarction like unstable angina, congestive cardiac failure and death in post Percutaneous Transluminal Coronary Angioplasty (PTCA). Methodology: This study was designed as prospective observational study, carried out on myocardial infarction patients who have underwent PTCA surgery. These patients were subjected to detailed clinical examination with observation on signs of unstable angina, reinfarction and mortality. All the patients were called for follow up at 3, 6, and 12 months and they underwent clinical examination, ECG and 2D echo. The collected data was entered into excel chart and analysed using SPSS V.23. The Chi-square test was used and p-value less than 0.05 was considered as statistically significant. Results: A total of 240 patients were included with mean age of 56.7 ± 9.6 years with a range and gender ratio of 3.1:1. Around half of the patients had anterior wall Myocardial Infarction (MI), 31.2% had inferior wall MI and 13.8% had lateral wall MI. Nine (3.8%) patients had global ischemia. All patients had undergone PTCA surgery. At 12 months follow-up, 8.33% had angina, 5.8% had reinfarction and 3.3% died during the study period. Conclusion: Angioplasty in myocardial infarction cases is able to achieve good long-term results.

Extracorporeal Membrane Oxygenation during Percutaneous Coronary Intervention in Patients with Coronary Heart Disease

Extracorporeal membrane oxygenation (ECMO) has become an effective method in the treatment of adults and children with severe cardiac and pulmonary dysfunction that is resistant to conventional therapy. The aim of this article was to summarize an experience of ECMO usage for cardiac dysfunction, which develops in patients with coronary heart disease (CHD) during percutaneous transluminal coronary angioplasty. The study comprised a retrospective, single-center analysis of 23 patients with CHD (19 men and four women, average age 65.7 ± 12.3 years), who undertook the ECMO technique during percutaneous transluminal coronary angioplasty. A total of 13 (56.52%) patients died directly in the hospital, or 30 days after a discharge. Independent predictors of fatal outcomes were diabetes mellitus (odds ratio [OR] = 17.58; 95% confidence interval [CI] = 6.47–47.48; p = .00125), chronic renal failure (CRF) (OR = 20.81; 95% CI = 5.95–72.21; p = .00014), and damage to the right coronary artery (RCA) (OR = 25.51; 95% CI = 8.27–79.12; p = .00013). For deceased patients, the “no reflow” phenomenon was indicated in a larger percentage of cases (23.1% in the group of deceased, vs. 10% in the group of survivors). A routine connection to ECMO before the occurrence of cardiac events was significantly more often used in the group of survived patients (90% of cases) than in the deceased (p = .0000001). Diabetes mellitus, CRF, and damage to the RCA were independent predictors of mortality during percutaneous transluminal coronary angioplasty in patients with CHD. The routine use of ECMO in high-risk patients with percutaneous transluminal coronary angioplasty was a positive prognostic factor of patient survival.

Extracorporeal Membrane Oxygenation during Percutaneous Coronary Intervention in Patients with Coronary Heart Disease.

Extracorporeal membrane oxygenation (ECMO) has become an effective method in the treatment of adults and children with severe cardiac and pulmonary dysfunction that is resistant to conventional therapy. The aim of this article was to summarize an experience of ECMO usage for cardiac dysfunction, which develops in patients with coronary heart disease (CHD) during percutaneous transluminal coronary angioplasty. The study comprised a retrospective, single-center analysis of 23 patients with CHD (19 men and four women, average age 65.7 ± 12.3 years), who undertook the ECMO technique during percutaneous transluminal coronary angioplasty. A total of 13 (56.52%) patients died directly in the hospital, or 30 days after a discharge. Independent predictors of fatal outcomes were diabetes mellitus (odds ratio [OR] = 17.58; 95% confidence interval [CI] = 6.47-47.48; p = .00125), chronic renal failure (CRF) (OR = 20.81; 95% CI = 5.95-72.21; p = .00014), and damage to the right coronary artery (RCA) (OR = 25.51; 95% CI = 8.27-79.12; p = .00013). For deceased patients, the "no reflow" phenomenon was indicated in a larger percentage of cases (23.1% in the group of deceased, vs. 10% in the group of survivors). A routine connection to ECMO before the occurrence of cardiac events was significantly more often used in the group of survived patients (90% of cases) than in the deceased (p = .0000001). Diabetes mellitus, CRF, and damage to the RCA were independent predictors of mortality during percutaneous transluminal coronary angioplasty in patients with CHD. The routine use of ECMO in high-risk patients with percutaneous transluminal coronary angioplasty was a positive prognostic factor of patient survival.

Effect of Video Assisted Teaching on Knowledge and Practice in Prevention of Recurrence of Myocardial Infarction among Post Coronary Angioplasty Patients

Effect of Video Assisted Teaching on Knowledge and Practice in Prevention of Recurrence of Myocardial Infarction among Post Coronary Angioplasty Patients

Insights into the Role of Fractional Flow Reserve in Clinical Practice

The early trials of fractional flow reserve (FFR), such as the Deferral versus Performance of Percutaneous Transluminal Coronary Angioplasty in Patients Without Documented Ischaemia, FFR versus angiography for multivessel evaluation (FAME), and FAME 2 trials, established the role of FFR in the practice of interventional cardiology. These trials led proponents of FFR to propose making FFR a routine procedure before percutaneous coronary intervention (PCI) and to give preference to PCI over optimal medical therapy (OMT) in those with FFR-positive coronary stenoses. Follow-up results of these trials have given more insights. Some of the benefits of FFR-guided strategy over angiography-guided strategy disappeared over time, and beyond revascularization, the FFR strategy did not show benefit over OMT when considering death and myocardial infarction as endpoints. The FUnctional Testing Underlying Coronary REvascularization trial did not demonstrate the superiority of the FFR-guided strategy over angiography-guided strategy. The ORBITA and the ISHEMIA trials gave strength to the lifestyle modification and OMT approach in stable ischemic heart disease patients with moderate-to-severe ischemia. The role of FFR has to be defined in light of the evolving clinical advances in medicine and new evidence. An in-depth review of all current evidence provides no compelling evidence for the routine use of FFR in cardiac interventions. However, FFR can play a role in coronary stenoses where there is uncertainty in the hemodynamic impact of the lesions.

P6384Thrombotic-hemorrhagic balance evaluation in STEMI patients with or without associated cardiac arrest: an observational study

Abstract Background Data is scarce on hemorrhagic and thrombotic complications in patients with ST-elevation myocardial infarction (STEMI) associated with out-of-hospital cardiac arrest (OHCA). Purpose We sought to evaluate the difference in the thrombotic-hemorrhagic balance in STEMI patients with or without associated cardiac arrest. Methods This is a monocentric, retrospective study conducted from January 2012 to December 2017. Over the study period, all consecutive patients who were treated for STEMI with our without OHCA were included. Baseline characteristics, treatments, haemorrhagic and thrombotic events were compared between STEMI patients associated or not with OHCA. Univariate and multivariate analysis were performed to identify predictors of 30-day mortality, occurrence of major bleeding, defined by BARC score ≥3 and early stent thrombosis. Results A total of 549 patients treated for STEMI and 146 patients for STEMI associated with OHCA were included. The incidence of stent thrombosis and major bleeding after coronary angioplasty in patients treated for STEMI was significantly higher when associated with OHCA (2.7% vs. 12.3%, p=0.04 and 3.3% vs. 19.2%, p<0.001, respectively). Independent predictors of major bleeding in OHCA patients were effective anticoagulation (HR=3.11, 95% CI [1.22–7.98], p=0.02) and the use of glycoprotein IIb/IIIa inhibitors (HR=4.16, 95% CI [1.61–10.79], p=0.003). Independent predictors of mortality in STEMI associated with OHCA were age (HR=1.05, 95% CI [1.02–1.09], p=0.004) and stent thrombosis (HR=5.62, 95% CI [1.61–19.65], p=0.007, with a protective effect of new anti-P2Y12 treatments (HR=0.20, 95% CI [0.08–0.46], p<0.001). Clinical outcomes at 30 days follow-up Conclusion Patients treated for STEMI associated with OHCA are at higher-risk of stent thrombosis and bleeding than those who did not experience cardiac arrest. The use of effective anticoagulation and glycoprotein IIb/IIIa inhibitors contributes to increase bleeding complications. In this subset of patients, prospective studies are needed to better evaluate thrombotic and haemorrhagic balance.

241-OR: Restenosis after Percutaneous Transluminal Coronary Angioplasty in Patients with Different Categories of Glucose Tolerance: A 2-Year Follow-Up Study

Patients with diabetes (DM) are at high risk for restenosis after coronary stenting. Information relating the outcome of percutaneous transluminal coronary angioplasty (PTCA) to prediabetes is, however, limited. The study objective was to investigate the relationship between restenosis after PTCA and baseline glucose categories. We retrospectively analyzed data of 1003 patients (mean age 58.5±4.2 years, 61.5% of men, mean history of coronary heart disease 9.5±1.1 years) who undertook PTCA at Emergency Department between Jan 2008 and Dec 2011. Baseline measures included blood pressure (BP), fasting plasma glucose, lipid profile, HbA1c, C-reactive protein (C-RP), and 2-hour capillary glucose. All patients had follow-up coronary angiography 2 year after PTCA. Restenosis was defined as ≧ 50% stenosis in stent or within 5 mm adjacent to stent. The rate of restenosis was compared among patients with normal glucose tolerance (NGT, n=436), impaired glucose regulation (IGR, n=275), and DM (n=292) according to their baseline glucose levels or prior history of DM. Patients with DM had highest levels of body mass index (BMI), BP, triglycerides (TG), and C-RP, followed by those with IGR and NGT (P<0.01).The number of lesion was 1.6, 1.8, and 2.5 in patients with NGT, IGR, and DM, respectively (p<0.05). At year 2, the rate of restenosis were 4.2%, 5.3%, and 12.0% in patients with NGT, IGT, and DM, respectively (P<0.05). Among DM subgroup, compared with patients with A1c<8%, those with A1c>8% had increased rate of restenosis (14.6% vs. 11.2%, P<0.05). In the logistic regression model, the odd ratio (OR) of having restenosis was 1.46 (95% CI: 1.05-1.87) for DM and 1.10 (95% CI: 1.01-1.25) for IGR, after adjusting for age, history of coronary heart disease, BMI, BP, LDL-C, TG, and C-RP. Restenosis is more frequent in patients with compared those without DM. Prediabetes is associated with increased risk of restenosis after PTCA. Disclosure L. Zhang: None. Y. Gu: None. X. Yin: None. J. Wang: None. N. Wang: None. Y. Yang: None. Y. Dong: None.

100.34 Multivessel Coronary Angioplasty in Patients With Acute Myocardial Infarction and Cardiogenic Shock: Does the Clinical or Revascularization Strategy Matter?

Complete coronary revascularization is associated with a better cardiovascular prognosis and overall survival. However, the current guidelines recommend primary coronary angioplasty of multiple vessels in the same session only in cases of ongoing objective ischemia. It has recently been reported

ADD-ON GRADE-RANKING SCALE FOR ASSESSING THROMBOTIC RISK IN PATIENTS WITH ISCHEMIC HEART DISEASE AND PERCUTANEOUS CORONARY ANGIOPLASTY

Introduction: The anticipation of the development of thrombotic complications in coronary angioplasty patients helps to prevent this dangerous complication. Development of the available informative scales on the basis of mathematical methods taking into account the main clinical and biochemical parameters significantly simplifies the classification of patients in terms of thrombotic risk. The aim of the paper is to concentrate information on the state of hemostasis in the studied category of patients using the method of the main components and to obtain a matrix with minimal loss of information, which is convenient for analysis and the creation of a grade-ranking scale. Materials and methods: Data of 70 patients with coronary heart disease and percutaneous coronary angioplasty were analyzed. The level of soluble fibrin, fibrinogen, D-dimer, protein C, and ratios rf/dd×100 were determined, and also the presence of diabetes mellitus and restenosis in the history was considered. Results: As a result of a stepwise study using the method of the main components, in the first stage two most singular matrices were obtained that describe 70% of the entire data variance (one of them is the component rf+dd, and the second one is fg+pc), which led to the first indicator of the level of thrombotic risk. At the second stage, the level of thrombotic risk was clarified, taking into consideration the presence of diabetes and history of restenosis, and it is recommended to use a second indicator for its determination (rf/dd×100). Conclusions: The presented grade-ranking scale scale allows the anticipation of the development of thrombotic complications in the studied category of patients with high probability.

The world's first 2 coronary angioplasty patients.

The world's first 2 coronary angioplasty patients.

Effect of age on cardiac output after coronary angioplasty in patients of acute myocardial infarction

Background: Although most of the acute coronary syndrome (ACS) patients are elderly, less data available on the effect of age on outcome after percutaneous coronary interventions (PCI) and major adverse cardiovascular events. In this study, we evaluated the effect of age on clinical outcomes in patients with ACS undergoing PCI because it is a well-known fact that the ages of patients influence clinical outcomes in ACS. Aims and Objectives: The aim of the study was to find out the effect of age on outcome of angioplasty in acute myocardial infarction (AMI) patients. Materials and Methods: It is a cross-sectional, self-control, interventional study. In this study, cardiac output (CO) of 52 patients of AMI was measured by echocardiography before and after angioplasty. CO is calculated with the help of end diastolic volume, end systolic volume, and left ventricular outflow tract diameter. Statistical software IBM SPSS version 16 was used for analysis of data. Results: A negative and statistically significant coefficient of correlation (r = −0.384 and P = 0.005) was found between age of patients and the value of CO after coronary angioplasty. Linear regression analysis was also done taking CO after coronary angioplasty as dependent variable and age of the patient as the independent variable. It can be hypothesized that as the age advances, CO after angioplasty deteriorates. Conclusion: Advancing age is associated with deterioration in outcome after coronary angioplasty in AMI patients.

Iso-osmolar contrast media and adverse renal and cardiac events after percutaneous cardiovascular intervention.

To assess the relationship between type of contrast media (CM), iso-osmolar contrast media (IOCM) or low-osmolar contrast media (LOCM), and major adverse renal and cardiovascular events (MARCE). Coronary or peripheral angioplasty visits were stratified into CM cohorts: IOCM or LOCM. Multivariable regression analysis used hospital fixed effects to assess the relationship between MARCE events and type of CM. Among 333,533 visits (357 hospitals), the incidence of MARCE was 7.41%. After controlling for observable and unobservable time invariant within-hospital characteristics, administration of IOCM versus LOCM was associated with a 0.69% absolute and 9.32% relative risk reduction in MARCE rate. Our study indicates that as compared with LOCM, IOCM may be associated with reduction of MARCE events in coronary or peripheral angioplasty patients.