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Staged versus “one-time” multivessel intervention in elderly patients with non-ST-elevation acute coronary syndrome
OBJECTIVE: To evaluate the clinical outcomes of “one-time” versus staged multivessel stenting in elderly (≥ 60 years) patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) and multivessel disease (MVD). METHODS: We analyzed data of consecutive NSTE-ACS patients with multivessel percutane...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Science Press
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5122501/ https://www.ncbi.nlm.nih.gov/pubmed/27899940 http://dx.doi.org/10.11909/j.issn.1671-5411.2016.09.004 |
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author | Yu, Xiao-Fan Li, Yi Wang, Qian-Cheng Wang, Xiao-Zeng Liang, Ming Zhao, Xin Xu, Kai Han, Ya-Ling |
author_facet | Yu, Xiao-Fan Li, Yi Wang, Qian-Cheng Wang, Xiao-Zeng Liang, Ming Zhao, Xin Xu, Kai Han, Ya-Ling |
author_sort | Yu, Xiao-Fan |
collection | PubMed |
description | OBJECTIVE: To evaluate the clinical outcomes of “one-time” versus staged multivessel stenting in elderly (≥ 60 years) patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) and multivessel disease (MVD). METHODS: We analyzed data of consecutive NSTE-ACS patients with multivessel percutaneous coronary intervention (PCI) who were enrolled in General Hospital of Shenyang Military Region between 2008 and 2012. A total of 1090 eligible patients aged ≥ 60 were further categorized into “one-time” group (n = 623) and staged PCI group (n = 467) according to intervention strategy. The primary endpoint was composite outcome of myocardial infarction (MI) or cardiac death during 3-year follow-up. RESULTS: The estimated 3-year composite rate of cardiac death or MI was 7.0% in the staged PCI group and 9.5% in the “one-time” group (P = 0.110). Multivariate analysis confirmed the benefit of staged PCI on the primary events in the elderly (HR: 0.638, 95% CI: 0.408–0.998, P = 0.049). In a propensity score matched cohort, staged PCI was associated with lower rates of primary events (6.1% vs. 10.4%, P = 0.046) and MI (3.4% vs. 7.4%, P = 0.037) at three years. In addition, there were reduced trends in the stent thrombosis at 30 days (0.3% vs. 1.4%, P = 0.177) and at three years (1.1% vs. 2.4%, P = 0.199) in the staged PCI group. There was no significant difference in the 3-year target vessel revascularization (15.5% vs. 14.4%, P = 0.746). CONCLUSIONS: In elderly NSTE-ACS patients with MVD, staged PCI might be an optimal strategy associated with reduced long-term cardiac death or MI compared with “one-time” PCI strategy, which needs further confirmation. |
format | Online Article Text |
id | pubmed-5122501 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Science Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-51225012016-11-29 Staged versus “one-time” multivessel intervention in elderly patients with non-ST-elevation acute coronary syndrome Yu, Xiao-Fan Li, Yi Wang, Qian-Cheng Wang, Xiao-Zeng Liang, Ming Zhao, Xin Xu, Kai Han, Ya-Ling J Geriatr Cardiol Research Article OBJECTIVE: To evaluate the clinical outcomes of “one-time” versus staged multivessel stenting in elderly (≥ 60 years) patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) and multivessel disease (MVD). METHODS: We analyzed data of consecutive NSTE-ACS patients with multivessel percutaneous coronary intervention (PCI) who were enrolled in General Hospital of Shenyang Military Region between 2008 and 2012. A total of 1090 eligible patients aged ≥ 60 were further categorized into “one-time” group (n = 623) and staged PCI group (n = 467) according to intervention strategy. The primary endpoint was composite outcome of myocardial infarction (MI) or cardiac death during 3-year follow-up. RESULTS: The estimated 3-year composite rate of cardiac death or MI was 7.0% in the staged PCI group and 9.5% in the “one-time” group (P = 0.110). Multivariate analysis confirmed the benefit of staged PCI on the primary events in the elderly (HR: 0.638, 95% CI: 0.408–0.998, P = 0.049). In a propensity score matched cohort, staged PCI was associated with lower rates of primary events (6.1% vs. 10.4%, P = 0.046) and MI (3.4% vs. 7.4%, P = 0.037) at three years. In addition, there were reduced trends in the stent thrombosis at 30 days (0.3% vs. 1.4%, P = 0.177) and at three years (1.1% vs. 2.4%, P = 0.199) in the staged PCI group. There was no significant difference in the 3-year target vessel revascularization (15.5% vs. 14.4%, P = 0.746). CONCLUSIONS: In elderly NSTE-ACS patients with MVD, staged PCI might be an optimal strategy associated with reduced long-term cardiac death or MI compared with “one-time” PCI strategy, which needs further confirmation. Science Press 2016-09 /pmc/articles/PMC5122501/ /pubmed/27899940 http://dx.doi.org/10.11909/j.issn.1671-5411.2016.09.004 Text en Institute of Geriatric Cardiology http://creativecommons.org/licenses/by-nc-sa/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported License, which allows readers to alter, transform, or build upon the article and then distribute the resulting work under the same or similar license to this one. The work must be attributed back to the original author and commercial use is not permitted without specific permission. |
spellingShingle | Research Article Yu, Xiao-Fan Li, Yi Wang, Qian-Cheng Wang, Xiao-Zeng Liang, Ming Zhao, Xin Xu, Kai Han, Ya-Ling Staged versus “one-time” multivessel intervention in elderly patients with non-ST-elevation acute coronary syndrome |
title | Staged versus “one-time” multivessel intervention in elderly patients with non-ST-elevation acute coronary syndrome |
title_full | Staged versus “one-time” multivessel intervention in elderly patients with non-ST-elevation acute coronary syndrome |
title_fullStr | Staged versus “one-time” multivessel intervention in elderly patients with non-ST-elevation acute coronary syndrome |
title_full_unstemmed | Staged versus “one-time” multivessel intervention in elderly patients with non-ST-elevation acute coronary syndrome |
title_short | Staged versus “one-time” multivessel intervention in elderly patients with non-ST-elevation acute coronary syndrome |
title_sort | staged versus “one-time” multivessel intervention in elderly patients with non-st-elevation acute coronary syndrome |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5122501/ https://www.ncbi.nlm.nih.gov/pubmed/27899940 http://dx.doi.org/10.11909/j.issn.1671-5411.2016.09.004 |
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