Background The hybrid procedure for coronary heart disease combines minimally invasive coronary artery bypass grafting （CABG） and percutaneous coronary intervention （PCI） and is an alternative to revascularization...Background The hybrid procedure for coronary heart disease combines minimally invasive coronary artery bypass grafting （CABG） and percutaneous coronary intervention （PCI） and is an alternative to revascularization treatment. We sought to assess the predictive value of four risk-stratification models for risk assessment of major adverse cardiac and cerebrovascular events （MACCE） in patients with multivessel disease undergoing hybrid coronary revascularization. Methods The data of 120 patients were retrospectively collected and the SYNTAX score, EuroSCORE, SinoSCORE and the Global Risk Classification （GRC） calculated for each patient. The outcomes of interest were 2.7-year incidences of MACCE, including death, myocardial infarction, stroke, and any-vessel revascularization. Results During a mean of 2.7-year follow-up, actuarial survival was 99.17%, and no myocardial infarctions occurred. The discriminatory power （area under curve （AUC）） of the SYNTAX score, EuroSCORE, SinoSCORE and GRC for 2.7-year MACCE was 0.60 （95% confidence interval 0.42-0.77）, 0.65 （0.47-0.82）, 0.57 （0.39-0.75） and 0.65 （0.46-0.83）, respectively. The calibration characteristics of the SYNTAX score, EuroSCORE, SinoSCORE and GRC were 3.92 （P=0.86）, 5.39 （P=0.37）, 13.81 （P=0.32） and 0.02 （P=0.89）, respectively. Conclusions In patients with multivessel disease undergoing a hybrid procedure, the SYNTAX score, EuroSCORE, SinoSCORE and GRC were inaccurate in predicting MACCE. Modifying risk-stratification models to improve the predictive value for a hybrid procedure is needed.展开更多
Coronary artery spasm is typically a transient and marked narrowing of a single coronary artery lumen that induces myocardial ischemia.In general,patients with coronary spastic angina have a good prognosis.Herein,we d...Coronary artery spasm is typically a transient and marked narrowing of a single coronary artery lumen that induces myocardial ischemia.In general,patients with coronary spastic angina have a good prognosis.Herein,we described a case of recurrent diffuse multivessel coronary artery spasm presented as myocardial infarction,which was a very rare form of coronary heart disease.Although several similar ones have been reported worldwide,this is the first case rechecked by coronary angiography （CAG） in the follow-up period.展开更多
Background Contrast-induced nephropathy（CIN） occurs frequently in patients undergoing primary percutaneous coronary intervention（PCI） for ST-segment elevation myocardial infarction（STEMI） and is associated with ...Background Contrast-induced nephropathy（CIN） occurs frequently in patients undergoing primary percutaneous coronary intervention（PCI） for ST-segment elevation myocardial infarction（STEMI） and is associated with poor outcomes. Multivessel coronary artery disease（MVCAD） is considered to be a potentially important risk factor for CIN. There are still no data on CIN in patients undergoing staged PCI for STEMI and MVCAD. Therefore, we explored the incidence, risk factors, in-hospital and follow-up outcomes of CIN in this special population. Methods From 2011 to 2018, we enrolled 103 consecutive patients with STEMI who underwent staged PCI for MVCAD. CIN was defined as a relative increase of 〉 25% or an absolute increase of ≥ 0.5 mg/dL in SCr from the baseline value 72 h after exposure to the contrast medium. The incidence, risk factors, in-hospital and follow-up outcomes of CIN in this special population were studied. Results We found1） the incidence of CIN after primary PCI and staged PCI was 16.50% and 25.20%, respectively. 2） patients with CIN had worse in-hospital and follow-up outcomes. 3） in multivariate logistic analysis, independent risk factors for CIN included：（1） lower creatinine clearance at baseline;（2） atrioventricular block requiring temporary cardiac pacemaker implantation;（3） use of IABP at baseline;（4） total contrast volume administered（ primary PCI ＋staged PCI）;（5） shorter time interval between primary PCI and staged PCI. Conclusions CIN is a frequent complication in patients with STEMI and MVCAD undergoing staged PCI. The development of CIN is associated with worse in-hospital and follow-up outcomes.展开更多
文摘Background The hybrid procedure for coronary heart disease combines minimally invasive coronary artery bypass grafting （CABG） and percutaneous coronary intervention （PCI） and is an alternative to revascularization treatment. We sought to assess the predictive value of four risk-stratification models for risk assessment of major adverse cardiac and cerebrovascular events （MACCE） in patients with multivessel disease undergoing hybrid coronary revascularization. Methods The data of 120 patients were retrospectively collected and the SYNTAX score, EuroSCORE, SinoSCORE and the Global Risk Classification （GRC） calculated for each patient. The outcomes of interest were 2.7-year incidences of MACCE, including death, myocardial infarction, stroke, and any-vessel revascularization. Results During a mean of 2.7-year follow-up, actuarial survival was 99.17%, and no myocardial infarctions occurred. The discriminatory power （area under curve （AUC）） of the SYNTAX score, EuroSCORE, SinoSCORE and GRC for 2.7-year MACCE was 0.60 （95% confidence interval 0.42-0.77）, 0.65 （0.47-0.82）, 0.57 （0.39-0.75） and 0.65 （0.46-0.83）, respectively. The calibration characteristics of the SYNTAX score, EuroSCORE, SinoSCORE and GRC were 3.92 （P=0.86）, 5.39 （P=0.37）, 13.81 （P=0.32） and 0.02 （P=0.89）, respectively. Conclusions In patients with multivessel disease undergoing a hybrid procedure, the SYNTAX score, EuroSCORE, SinoSCORE and GRC were inaccurate in predicting MACCE. Modifying risk-stratification models to improve the predictive value for a hybrid procedure is needed.
文摘Coronary artery spasm is typically a transient and marked narrowing of a single coronary artery lumen that induces myocardial ischemia.In general,patients with coronary spastic angina have a good prognosis.Herein,we described a case of recurrent diffuse multivessel coronary artery spasm presented as myocardial infarction,which was a very rare form of coronary heart disease.Although several similar ones have been reported worldwide,this is the first case rechecked by coronary angiography （CAG） in the follow-up period.
文摘Background Contrast-induced nephropathy（CIN） occurs frequently in patients undergoing primary percutaneous coronary intervention（PCI） for ST-segment elevation myocardial infarction（STEMI） and is associated with poor outcomes. Multivessel coronary artery disease（MVCAD） is considered to be a potentially important risk factor for CIN. There are still no data on CIN in patients undergoing staged PCI for STEMI and MVCAD. Therefore, we explored the incidence, risk factors, in-hospital and follow-up outcomes of CIN in this special population. Methods From 2011 to 2018, we enrolled 103 consecutive patients with STEMI who underwent staged PCI for MVCAD. CIN was defined as a relative increase of 〉 25% or an absolute increase of ≥ 0.5 mg/dL in SCr from the baseline value 72 h after exposure to the contrast medium. The incidence, risk factors, in-hospital and follow-up outcomes of CIN in this special population were studied. Results We found1） the incidence of CIN after primary PCI and staged PCI was 16.50% and 25.20%, respectively. 2） patients with CIN had worse in-hospital and follow-up outcomes. 3） in multivariate logistic analysis, independent risk factors for CIN included：（1） lower creatinine clearance at baseline;（2） atrioventricular block requiring temporary cardiac pacemaker implantation;（3） use of IABP at baseline;（4） total contrast volume administered（ primary PCI ＋staged PCI）;（5） shorter time interval between primary PCI and staged PCI. Conclusions CIN is a frequent complication in patients with STEMI and MVCAD undergoing staged PCI. The development of CIN is associated with worse in-hospital and follow-up outcomes.
