Cargando…
Impact of drug-eluting stent-associated coronary artery spasm on 3-year clinical outcomes: A propensity score matching analysis
BACKGROUND: It has been reported that significant endothelial dysfunction or clinically evident vasospasm can be associated with drug-eluting stents (DESs). However, the impact of DES associated coronary artery spasm (CAS) on long-term clinical outcomes has not been fully elucidated as compared with...
Autores principales: | , , , , , , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9243619/ https://www.ncbi.nlm.nih.gov/pubmed/35576993 http://dx.doi.org/10.1016/j.ihj.2022.05.002 |
_version_ | 1784738356511375360 |
---|---|
author | Ali, Jabar Rha, Seung-Woon Choi, Byoung Geol Byun, Jae Kyeong Choi, Se Yeon Cha, Jin Ah Park, Soohyung Lee, Kyuho Back, Seungmin Lee, Jieun Kang, Dong Oh Choi, Jah Yeon Roh, Seung-Young Na, Jin Oh Choi, Cheol Ung Kim, Jin-Won Kim, Eung Ju Park, Chang Gyu Seo, Hong Seog Wasim, Mohammad Hassan, Zair |
author_facet | Ali, Jabar Rha, Seung-Woon Choi, Byoung Geol Byun, Jae Kyeong Choi, Se Yeon Cha, Jin Ah Park, Soohyung Lee, Kyuho Back, Seungmin Lee, Jieun Kang, Dong Oh Choi, Jah Yeon Roh, Seung-Young Na, Jin Oh Choi, Cheol Ung Kim, Jin-Won Kim, Eung Ju Park, Chang Gyu Seo, Hong Seog Wasim, Mohammad Hassan, Zair |
author_sort | Ali, Jabar |
collection | PubMed |
description | BACKGROUND: It has been reported that significant endothelial dysfunction or clinically evident vasospasm can be associated with drug-eluting stents (DESs). However, the impact of DES associated coronary artery spasm (CAS) on long-term clinical outcomes has not been fully elucidated as compared with those of patients with vasospastic angina. METHODS: A total of 2797 consecutive patients without significant coronary artery lesion (<70%), who underwent the Acetylcholine (Ach) provocation test, were enrolled between Nov 2004 and Oct 2010. DES-associated spasm was defined as significant CAS in proximal or distal to previously implanted DES site at follow-up angiography with Ach test. Patients were divided into two groups (DES-CAS; n = 108, CAS; n = 1878). For adjustment, propensity score matching (PSM) was done (C-statistics = 0.766, DES-CAS; n = 102, CAS; n = 102). SPSS 20 (Inc., Chicago, Illinois) was used to analyze this data. RESULTS: Baseline characteristics were worse in the DES-CAS group. After PSM, both baseline characteristics and the Ach test results were balanced except higher incidence of diffuse CAS and ECG change in the DES-CAS group. During Ach test, the incidence of diffuse spasm (93.1% vs. 81.3%, p = 0.012) and ST-T change (10.7% vs. 1.9%, p = 0.010) were higher in the DES-CAS group. At 3-year, before and after adjustment, the DES-CAS group showed a higher incidence of coronary revascularization (9.8% vs. 0.0%, p = 0.001), recurrent chest pain requiring follow up coronary angiography (CAG, 24.5% vs. 7.8%, p = 0.001) and major adverse cardiac events (MACEs, 9.8% vs. 0.9%, p < 0.005). CONCLUSION: In this study, DES associated CAS was associated with higher incidence of diffuse spasm, ST-T change and adverse 3-year clinical outcomes. Special caution should be exercised in this particular subset of patients. |
format | Online Article Text |
id | pubmed-9243619 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-92436192022-07-01 Impact of drug-eluting stent-associated coronary artery spasm on 3-year clinical outcomes: A propensity score matching analysis Ali, Jabar Rha, Seung-Woon Choi, Byoung Geol Byun, Jae Kyeong Choi, Se Yeon Cha, Jin Ah Park, Soohyung Lee, Kyuho Back, Seungmin Lee, Jieun Kang, Dong Oh Choi, Jah Yeon Roh, Seung-Young Na, Jin Oh Choi, Cheol Ung Kim, Jin-Won Kim, Eung Ju Park, Chang Gyu Seo, Hong Seog Wasim, Mohammad Hassan, Zair Indian Heart J Original Article BACKGROUND: It has been reported that significant endothelial dysfunction or clinically evident vasospasm can be associated with drug-eluting stents (DESs). However, the impact of DES associated coronary artery spasm (CAS) on long-term clinical outcomes has not been fully elucidated as compared with those of patients with vasospastic angina. METHODS: A total of 2797 consecutive patients without significant coronary artery lesion (<70%), who underwent the Acetylcholine (Ach) provocation test, were enrolled between Nov 2004 and Oct 2010. DES-associated spasm was defined as significant CAS in proximal or distal to previously implanted DES site at follow-up angiography with Ach test. Patients were divided into two groups (DES-CAS; n = 108, CAS; n = 1878). For adjustment, propensity score matching (PSM) was done (C-statistics = 0.766, DES-CAS; n = 102, CAS; n = 102). SPSS 20 (Inc., Chicago, Illinois) was used to analyze this data. RESULTS: Baseline characteristics were worse in the DES-CAS group. After PSM, both baseline characteristics and the Ach test results were balanced except higher incidence of diffuse CAS and ECG change in the DES-CAS group. During Ach test, the incidence of diffuse spasm (93.1% vs. 81.3%, p = 0.012) and ST-T change (10.7% vs. 1.9%, p = 0.010) were higher in the DES-CAS group. At 3-year, before and after adjustment, the DES-CAS group showed a higher incidence of coronary revascularization (9.8% vs. 0.0%, p = 0.001), recurrent chest pain requiring follow up coronary angiography (CAG, 24.5% vs. 7.8%, p = 0.001) and major adverse cardiac events (MACEs, 9.8% vs. 0.9%, p < 0.005). CONCLUSION: In this study, DES associated CAS was associated with higher incidence of diffuse spasm, ST-T change and adverse 3-year clinical outcomes. Special caution should be exercised in this particular subset of patients. Elsevier 2022 2022-05-13 /pmc/articles/PMC9243619/ /pubmed/35576993 http://dx.doi.org/10.1016/j.ihj.2022.05.002 Text en © 2022 Published by Elsevier, a division of RELX India, Pvt. Ltd on behalf of Cardiological Society of India. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Article Ali, Jabar Rha, Seung-Woon Choi, Byoung Geol Byun, Jae Kyeong Choi, Se Yeon Cha, Jin Ah Park, Soohyung Lee, Kyuho Back, Seungmin Lee, Jieun Kang, Dong Oh Choi, Jah Yeon Roh, Seung-Young Na, Jin Oh Choi, Cheol Ung Kim, Jin-Won Kim, Eung Ju Park, Chang Gyu Seo, Hong Seog Wasim, Mohammad Hassan, Zair Impact of drug-eluting stent-associated coronary artery spasm on 3-year clinical outcomes: A propensity score matching analysis |
title | Impact of drug-eluting stent-associated coronary artery spasm on 3-year clinical outcomes: A propensity score matching analysis |
title_full | Impact of drug-eluting stent-associated coronary artery spasm on 3-year clinical outcomes: A propensity score matching analysis |
title_fullStr | Impact of drug-eluting stent-associated coronary artery spasm on 3-year clinical outcomes: A propensity score matching analysis |
title_full_unstemmed | Impact of drug-eluting stent-associated coronary artery spasm on 3-year clinical outcomes: A propensity score matching analysis |
title_short | Impact of drug-eluting stent-associated coronary artery spasm on 3-year clinical outcomes: A propensity score matching analysis |
title_sort | impact of drug-eluting stent-associated coronary artery spasm on 3-year clinical outcomes: a propensity score matching analysis |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9243619/ https://www.ncbi.nlm.nih.gov/pubmed/35576993 http://dx.doi.org/10.1016/j.ihj.2022.05.002 |
work_keys_str_mv | AT alijabar impactofdrugelutingstentassociatedcoronaryarteryspasmon3yearclinicaloutcomesapropensityscorematchinganalysis AT rhaseungwoon impactofdrugelutingstentassociatedcoronaryarteryspasmon3yearclinicaloutcomesapropensityscorematchinganalysis AT choibyounggeol impactofdrugelutingstentassociatedcoronaryarteryspasmon3yearclinicaloutcomesapropensityscorematchinganalysis AT byunjaekyeong impactofdrugelutingstentassociatedcoronaryarteryspasmon3yearclinicaloutcomesapropensityscorematchinganalysis AT choiseyeon impactofdrugelutingstentassociatedcoronaryarteryspasmon3yearclinicaloutcomesapropensityscorematchinganalysis AT chajinah impactofdrugelutingstentassociatedcoronaryarteryspasmon3yearclinicaloutcomesapropensityscorematchinganalysis AT parksoohyung impactofdrugelutingstentassociatedcoronaryarteryspasmon3yearclinicaloutcomesapropensityscorematchinganalysis AT leekyuho impactofdrugelutingstentassociatedcoronaryarteryspasmon3yearclinicaloutcomesapropensityscorematchinganalysis AT backseungmin impactofdrugelutingstentassociatedcoronaryarteryspasmon3yearclinicaloutcomesapropensityscorematchinganalysis AT leejieun impactofdrugelutingstentassociatedcoronaryarteryspasmon3yearclinicaloutcomesapropensityscorematchinganalysis AT kangdongoh impactofdrugelutingstentassociatedcoronaryarteryspasmon3yearclinicaloutcomesapropensityscorematchinganalysis AT choijahyeon impactofdrugelutingstentassociatedcoronaryarteryspasmon3yearclinicaloutcomesapropensityscorematchinganalysis AT rohseungyoung impactofdrugelutingstentassociatedcoronaryarteryspasmon3yearclinicaloutcomesapropensityscorematchinganalysis AT najinoh impactofdrugelutingstentassociatedcoronaryarteryspasmon3yearclinicaloutcomesapropensityscorematchinganalysis AT choicheolung impactofdrugelutingstentassociatedcoronaryarteryspasmon3yearclinicaloutcomesapropensityscorematchinganalysis AT kimjinwon impactofdrugelutingstentassociatedcoronaryarteryspasmon3yearclinicaloutcomesapropensityscorematchinganalysis AT kimeungju impactofdrugelutingstentassociatedcoronaryarteryspasmon3yearclinicaloutcomesapropensityscorematchinganalysis AT parkchanggyu impactofdrugelutingstentassociatedcoronaryarteryspasmon3yearclinicaloutcomesapropensityscorematchinganalysis AT seohongseog impactofdrugelutingstentassociatedcoronaryarteryspasmon3yearclinicaloutcomesapropensityscorematchinganalysis AT wasimmohammad impactofdrugelutingstentassociatedcoronaryarteryspasmon3yearclinicaloutcomesapropensityscorematchinganalysis AT hassanzair impactofdrugelutingstentassociatedcoronaryarteryspasmon3yearclinicaloutcomesapropensityscorematchinganalysis |