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Novel predictors of outcome after coronary angioplasty with rotational atherectomy. Not only low ejection fraction and clinical parameters matter
INTRODUCTION: Most established risk factors after rotational atherectomy (RA) of heavily fibro-calcified lesions are associated with patients’ general risk and clinical related factors and are not specific for either coronary and culprit lesion anatomy or the RA procedure. AIM: To assess novel predi...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Termedia Publishing House
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5939544/ https://www.ncbi.nlm.nih.gov/pubmed/29743903 http://dx.doi.org/10.5114/aic.2018.74354 |
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author | Kübler, Piotr Zimoch, Wojciech Kosowski, Michał Tomasiewicz, Brunon Rakotoarison, Oscar Telichowski, Artur Reczuch, Krzysztof |
author_facet | Kübler, Piotr Zimoch, Wojciech Kosowski, Michał Tomasiewicz, Brunon Rakotoarison, Oscar Telichowski, Artur Reczuch, Krzysztof |
author_sort | Kübler, Piotr |
collection | PubMed |
description | INTRODUCTION: Most established risk factors after rotational atherectomy (RA) of heavily fibro-calcified lesions are associated with patients’ general risk and clinical related factors and are not specific for either coronary and culprit lesion anatomy or the RA procedure. AIM: To assess novel predictors of poor outcome after percutaneous coronary intervention using RA in an all-comers population. MATERIAL AND METHODS: A total of 207 consecutive patients after RA were included in a single-center observational study. Primary endpoints were 1-year mortality and 1-year major adverse cardiac events (MACE). Secondary endpoints were angiographic and procedural success and in-hospital complications. RESULTS: Procedural complications occurred in 19 (8%) patients. In-hospital mortality was 1%, peri-procedural myocardial infarction (MI) was 9%, and acute stroke occurred in one patient. The 1-year MACE rate was 20% with all-cause mortality 10%, MI 10% and stroke 1%. Multivariable analysis revealed heart failure with left ventricle ejection fraction (LVEF) ≤ 35% (p = 0.02) and uncrossable lesion, as compared to undilatable lesion (p = 0.01), as independent predictors of 1-year mortality and residual SYNTAX score ≤ 8 as an independent predictor of favorable outcome (p = 0.04). Heart failure with LVEF ≤ 35% (p < 0.01) and uncrossable lesion (p = 0.04) were independent predictors of 1-year MACE. CONCLUSIONS: The presence of a novel factor, uncrossable lesion, as compared to undilatable lesion, is associated with poor outcome, and low residual SYNTAX score ≤ 8 is associated with favorable outcome in 1-year follow-up after the RA procedure and can help in risk stratification of patients undergoing complex coronary intervention with RA. |
format | Online Article Text |
id | pubmed-5939544 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Termedia Publishing House |
record_format | MEDLINE/PubMed |
spelling | pubmed-59395442018-05-09 Novel predictors of outcome after coronary angioplasty with rotational atherectomy. Not only low ejection fraction and clinical parameters matter Kübler, Piotr Zimoch, Wojciech Kosowski, Michał Tomasiewicz, Brunon Rakotoarison, Oscar Telichowski, Artur Reczuch, Krzysztof Postepy Kardiol Interwencyjnej Original Paper INTRODUCTION: Most established risk factors after rotational atherectomy (RA) of heavily fibro-calcified lesions are associated with patients’ general risk and clinical related factors and are not specific for either coronary and culprit lesion anatomy or the RA procedure. AIM: To assess novel predictors of poor outcome after percutaneous coronary intervention using RA in an all-comers population. MATERIAL AND METHODS: A total of 207 consecutive patients after RA were included in a single-center observational study. Primary endpoints were 1-year mortality and 1-year major adverse cardiac events (MACE). Secondary endpoints were angiographic and procedural success and in-hospital complications. RESULTS: Procedural complications occurred in 19 (8%) patients. In-hospital mortality was 1%, peri-procedural myocardial infarction (MI) was 9%, and acute stroke occurred in one patient. The 1-year MACE rate was 20% with all-cause mortality 10%, MI 10% and stroke 1%. Multivariable analysis revealed heart failure with left ventricle ejection fraction (LVEF) ≤ 35% (p = 0.02) and uncrossable lesion, as compared to undilatable lesion (p = 0.01), as independent predictors of 1-year mortality and residual SYNTAX score ≤ 8 as an independent predictor of favorable outcome (p = 0.04). Heart failure with LVEF ≤ 35% (p < 0.01) and uncrossable lesion (p = 0.04) were independent predictors of 1-year MACE. CONCLUSIONS: The presence of a novel factor, uncrossable lesion, as compared to undilatable lesion, is associated with poor outcome, and low residual SYNTAX score ≤ 8 is associated with favorable outcome in 1-year follow-up after the RA procedure and can help in risk stratification of patients undergoing complex coronary intervention with RA. Termedia Publishing House 2018-03-22 2018 /pmc/articles/PMC5939544/ /pubmed/29743903 http://dx.doi.org/10.5114/aic.2018.74354 Text en Copyright: © 2018 Termedia Sp. z o. o. http://creativecommons.org/licenses/by-nc-sa/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license. |
spellingShingle | Original Paper Kübler, Piotr Zimoch, Wojciech Kosowski, Michał Tomasiewicz, Brunon Rakotoarison, Oscar Telichowski, Artur Reczuch, Krzysztof Novel predictors of outcome after coronary angioplasty with rotational atherectomy. Not only low ejection fraction and clinical parameters matter |
title | Novel predictors of outcome after coronary angioplasty with rotational atherectomy. Not only low ejection fraction and clinical parameters matter |
title_full | Novel predictors of outcome after coronary angioplasty with rotational atherectomy. Not only low ejection fraction and clinical parameters matter |
title_fullStr | Novel predictors of outcome after coronary angioplasty with rotational atherectomy. Not only low ejection fraction and clinical parameters matter |
title_full_unstemmed | Novel predictors of outcome after coronary angioplasty with rotational atherectomy. Not only low ejection fraction and clinical parameters matter |
title_short | Novel predictors of outcome after coronary angioplasty with rotational atherectomy. Not only low ejection fraction and clinical parameters matter |
title_sort | novel predictors of outcome after coronary angioplasty with rotational atherectomy. not only low ejection fraction and clinical parameters matter |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5939544/ https://www.ncbi.nlm.nih.gov/pubmed/29743903 http://dx.doi.org/10.5114/aic.2018.74354 |
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