Background Rotational atherectomy （RA） could facilitate the percutaneous coronary intervention （PCI） in heavily coronary calcified patients. The effectiveness and safety of this technique needs to be further evalu...Background Rotational atherectomy （RA） could facilitate the percutaneous coronary intervention （PCI） in heavily coronary calcified patients. The effectiveness and safety of this technique needs to be further evaluated. Methods ＆ Results Eighty patients who underwent RA in our center from September 2011 to June 2014 were enrolled. The mean age was 72.4 ± 10.4 years. The left ventricular ejection frac- tion （LVEF） was average 52.3% ± 8.48% and the estimated glomerular filtration rate was 73.2 ± 3.20 mL/min per 1.73 m2. The coronary lesions were complex, with Syntax score 29.5 ± 9.86. The diameter of reference vessel was 3.4 ± 0.45 mm and the average diameter stenosis of target vessels was 80% ~ 10%. All the patients were deployed with drug eluting stents （DES） successfully aiter RA. The patients were followed up for 12-18 months. Kaplan-Meier plots estimated the survival rate was 93.4% and the cumulative incidence of major adverse cardiac and cerebral events （MACCE） was 25.4%. Bleeding and procedural-related complications were quite low. COX proportional hazards model for multivariate analysis demonstrated that diabetes, LVEF and maximum pressure of postdilatation were the predictors of MACCE. Conclusions RA followed by implantation of DES was effective and safe for heavily coronary calcified patients. Diabetes, LVEF and maximum pressure ofpostdilatation were predictive for MACCE.展开更多
Background There are limited data on long-term （〉 5 years） outcomes of drug-eluting stent （DES） implantation compared with coro- nary artery bypass grafting （CABG） for ostial/rnidshaft left main coronary artery...Background There are limited data on long-term （〉 5 years） outcomes of drug-eluting stent （DES） implantation compared with coro- nary artery bypass grafting （CABG） for ostial/rnidshaft left main coronary artery （LMCA） lesions. Methods Of the 259 consecutive pa- tients in Beijing Anzhen Hospital with ostial/midshaff LMCA lesions, 149 were treated with percutaneous coronary intervention （PCI） with DES and 110 were with CABG. The endpoints of the study were death, repeat revascularization, myocardial infarction （MI）, stroke, the composite of cardiac death, and major adverse cardiac and cerebrovascular events （MACCE, the composite of cardiac death, MI, stroke or repeat revascularization）.The duration of follow-up is 7.1 years （interquartile range 5.3 to 8.2 years）. Results There is no significant differ- ence between the PCI and CABG group during the median follow-up of 7.1 years （interquartile range： 5.3-8.2 years） in the occurrence of death （HR： 0.727, 95% CI： 0.335-1.578; P = 0.421）, the composite endpoint of cardiac death, MI or stroke （HR： 0.730, 95% CI： 0.375-1.421; P = 0.354）, MACCE （HR： 1.066, 95% CI： 0.648-1.753; P = 0.801）, MI （HR： 1.112, 95% CI： 0.414-2.987; P = 0.833）, stroke （HR： 1.875, 95% CI： 0.528-6.659; P = 0.331）, and repeat revascularization （HR： 1.590, 95% CI： 0.800-3.161; P = 0.186）. These results remained after multivariable adjusting. Conclusion During a follow-up up to 8.2 years, we found that DES implantation had similar endpoint outcomes compared with CABG.展开更多
Objectives To explore the effectiveness of the mobile app-based multidisciplinary exercise management on patients who receive percutaneous coronary intervention(PCI).Methods From January to October 2020,54 patients af...Objectives To explore the effectiveness of the mobile app-based multidisciplinary exercise management on patients who receive percutaneous coronary intervention(PCI).Methods From January to October 2020,54 patients after PCI were randomly assigned to the intervention group(n=27)and the control group(n=27).The intervention group received the mobile app-based multidisciplinary exercise management,whereas the control group received routine care.The patients after PCI began to take intervention one month after the operation,and the intervention lasted for two months.Before and after the intervention,6-Minute Walking Distance was used to evaluate the patient’s exercise tolerance,and the patient’s exercise compliance was evaluated according to the patient’s exercise status recorded by the mobile app.The cognitive questionnaire on knowledge about PCI treatment for Coronary Heart Disease,the Self-efficacy for Chronic Disease Scale and the Perceived Social Support Scale were used to evaluate patients’disease-related cognition,self-efficacy and perception of social support.This study was registered on Clinical Trials.gov with registration number ChiCTR2000028930.Results Totally 51 patients after PCI who completed this study(25 patients in the intervention group and 26 patients in the control group)were included in the analysis.After 2 months of intervention,the exercise compliance of patients in the intervention group was better than that in the control group.And 6-Minute Walking Distance(469.36±57.48 vs.432.81±67.09),and the scores of knowledge of PCI treatment for coronary heart disease(52.64±9.82 vs.42.42±8.54),Self-efficacy for Chronic Disease Scale(42.40±8.04 vs.36.88±7.73)and Perceived Social Support Scale(74.04±5.73 vs.66.69±6.86)in the intervention group were higher than those in the control group with statistical significance(P<0.05).Conclusions The multidisciplinary exercise management based on the mobile app can effectively improve exercise tolerance,exercise compliance,disease-related cognition,self-efficacy,and perception of social support during exercise training for patients after PCI.展开更多
Objectives To evaluate the very long-term safety and effectiveness of drug-eluting stents （DES） compared to bare-metal stents （BMS） for patients with large coronary vessels. Methods From April 2004 to October 2006...Objectives To evaluate the very long-term safety and effectiveness of drug-eluting stents （DES） compared to bare-metal stents （BMS） for patients with large coronary vessels. Methods From April 2004 to October 2006, 2407 consecutive patients undergoing de novo lesion percutaneous coronary intervention with reference vessel diameter greater than or equal to 3.5 mm at Fu Wai Hospital in Beijing, China, were prospectively enrolled into this study. We obtained 9-year clinical outcomes including death, myocardial infarction （MI）, thrombosis, target lesion revascularization （TLR）, target vessel revascularization （TVR）, and major adverse cardiac events （MACE, the composite of death, MI, and TVR）. We performed Cox＇s proportional-hazards models to assess relative risks of all the outcome measures after propensity match. Results After propensity scoring, 514 DES-treated patients were matched to 514 BMS-treated patients. The patients treated with BMS were associated with higher risk ofTLR （HR： 2.55, 95%CI： 1.520-4.277, P = 0.0004） and TVR （HR： 1.889, 95%CI： 1.185-3.011, P = 0.0075）, but the rates of death/MI and MACE were not statistically different. All Academic Research Consortium definition stent thrombosis at 9-year were comparable in the two groups. Conclusions During long-term follow-up through nine years, use of DES in patients with large coronary arteries was still associated with significant reductions in the risks of TLR and TVR.展开更多
Background Although radial access for drug-eluting stent （DES） combined with rotational atherectomy （RA） in patients with calcified coronary lesions may be associated with a lower risk of major bleeding complicati...Background Although radial access for drug-eluting stent （DES） combined with rotational atherectomy （RA） in patients with calcified coronary lesions may be associated with a lower risk of major bleeding complications and obtain favorable clinical results compared with femoral access, the long-term outcome data of this approach were limited in contemporary DES era. Methods ＆ Results This retrospective study sought to compare in-hospital and long-term outcomes for patients undergoing RA via the transradial （TR） and transfemoral （TF） route in 126 consecutive patients （59 radial, 67 femoral） from 2009 to 2014. TR RA procedures were performed in 44/62 （71%） by the three TR operators, compared with 15/64 （23%） by the four TF operators in the present study. Significantly smaller diameter guide catheters and burrs （1.39 ± 0.16 mm vs. 1.53 ± 0.24 mm, P = 0.001） were used in the TR group. Procedural success rates were similar in both TR and TF groups. There was a significantly less major access site bleeding complications in favor of radial artery access （2% vs. 16%, P = 0.012）. The incidence of in-hospital death or myocardial infarction was low in both groups. Although a trend of lower adverse event rate was demonstrated in the TR group compared with the TF one, no statistical significance （21% vs. 27%, P = 0.135） was detected. Conclusions Radial access, a useful alternative to femoral access for RA and DES, can be safely and successfully performed on up to 71% of the patients with heavily calcified coronary lesions needing RA by experienced TR operators.展开更多
OBJECTIVE: To assess the immediate- and long-term outcomes of stent supported coronary angioplasty in patients with severe left ventricular dysfunction. METHODS: Seventy-four consecutive patients with angiographic lef...OBJECTIVE: To assess the immediate- and long-term outcomes of stent supported coronary angioplasty in patients with severe left ventricular dysfunction. METHODS: Seventy-four consecutive patients with angiographic left ventricular ejection fractions or = 1 was seen in 29 (73%) of 40 successfully treated congestive heart failure patients at 6 months after the procedure. During long-term follow-up, 58 (87.9%) of 66 patients with clinical success were alive, including 44 (68.6%) free from cardiac events. CONCLUSIONS: Patients with severe left ventricular dysfunction treated with stent supported PTCA experience a high rate of success, low procedure related mortality and satisfactory long-term survival.展开更多
文摘Background Rotational atherectomy （RA） could facilitate the percutaneous coronary intervention （PCI） in heavily coronary calcified patients. The effectiveness and safety of this technique needs to be further evaluated. Methods ＆ Results Eighty patients who underwent RA in our center from September 2011 to June 2014 were enrolled. The mean age was 72.4 ± 10.4 years. The left ventricular ejection frac- tion （LVEF） was average 52.3% ± 8.48% and the estimated glomerular filtration rate was 73.2 ± 3.20 mL/min per 1.73 m2. The coronary lesions were complex, with Syntax score 29.5 ± 9.86. The diameter of reference vessel was 3.4 ± 0.45 mm and the average diameter stenosis of target vessels was 80% ~ 10%. All the patients were deployed with drug eluting stents （DES） successfully aiter RA. The patients were followed up for 12-18 months. Kaplan-Meier plots estimated the survival rate was 93.4% and the cumulative incidence of major adverse cardiac and cerebral events （MACCE） was 25.4%. Bleeding and procedural-related complications were quite low. COX proportional hazards model for multivariate analysis demonstrated that diabetes, LVEF and maximum pressure of postdilatation were the predictors of MACCE. Conclusions RA followed by implantation of DES was effective and safe for heavily coronary calcified patients. Diabetes, LVEF and maximum pressure ofpostdilatation were predictive for MACCE.
文摘Background There are limited data on long-term （〉 5 years） outcomes of drug-eluting stent （DES） implantation compared with coro- nary artery bypass grafting （CABG） for ostial/rnidshaft left main coronary artery （LMCA） lesions. Methods Of the 259 consecutive pa- tients in Beijing Anzhen Hospital with ostial/midshaff LMCA lesions, 149 were treated with percutaneous coronary intervention （PCI） with DES and 110 were with CABG. The endpoints of the study were death, repeat revascularization, myocardial infarction （MI）, stroke, the composite of cardiac death, and major adverse cardiac and cerebrovascular events （MACCE, the composite of cardiac death, MI, stroke or repeat revascularization）.The duration of follow-up is 7.1 years （interquartile range 5.3 to 8.2 years）. Results There is no significant differ- ence between the PCI and CABG group during the median follow-up of 7.1 years （interquartile range： 5.3-8.2 years） in the occurrence of death （HR： 0.727, 95% CI： 0.335-1.578; P = 0.421）, the composite endpoint of cardiac death, MI or stroke （HR： 0.730, 95% CI： 0.375-1.421; P = 0.354）, MACCE （HR： 1.066, 95% CI： 0.648-1.753; P = 0.801）, MI （HR： 1.112, 95% CI： 0.414-2.987; P = 0.833）, stroke （HR： 1.875, 95% CI： 0.528-6.659; P = 0.331）, and repeat revascularization （HR： 1.590, 95% CI： 0.800-3.161; P = 0.186）. These results remained after multivariable adjusting. Conclusion During a follow-up up to 8.2 years, we found that DES implantation had similar endpoint outcomes compared with CABG.
基金This study was provided by The Scientific Reuter Foundation of Liaoning Provincial Education Department,China(grant no.LZ2020039).
文摘Objectives To explore the effectiveness of the mobile app-based multidisciplinary exercise management on patients who receive percutaneous coronary intervention(PCI).Methods From January to October 2020,54 patients after PCI were randomly assigned to the intervention group(n=27)and the control group(n=27).The intervention group received the mobile app-based multidisciplinary exercise management,whereas the control group received routine care.The patients after PCI began to take intervention one month after the operation,and the intervention lasted for two months.Before and after the intervention,6-Minute Walking Distance was used to evaluate the patient’s exercise tolerance,and the patient’s exercise compliance was evaluated according to the patient’s exercise status recorded by the mobile app.The cognitive questionnaire on knowledge about PCI treatment for Coronary Heart Disease,the Self-efficacy for Chronic Disease Scale and the Perceived Social Support Scale were used to evaluate patients’disease-related cognition,self-efficacy and perception of social support.This study was registered on Clinical Trials.gov with registration number ChiCTR2000028930.Results Totally 51 patients after PCI who completed this study(25 patients in the intervention group and 26 patients in the control group)were included in the analysis.After 2 months of intervention,the exercise compliance of patients in the intervention group was better than that in the control group.And 6-Minute Walking Distance(469.36±57.48 vs.432.81±67.09),and the scores of knowledge of PCI treatment for coronary heart disease(52.64±9.82 vs.42.42±8.54),Self-efficacy for Chronic Disease Scale(42.40±8.04 vs.36.88±7.73)and Perceived Social Support Scale(74.04±5.73 vs.66.69±6.86)in the intervention group were higher than those in the control group with statistical significance(P<0.05).Conclusions The multidisciplinary exercise management based on the mobile app can effectively improve exercise tolerance,exercise compliance,disease-related cognition,self-efficacy,and perception of social support during exercise training for patients after PCI.
文摘Objectives To evaluate the very long-term safety and effectiveness of drug-eluting stents （DES） compared to bare-metal stents （BMS） for patients with large coronary vessels. Methods From April 2004 to October 2006, 2407 consecutive patients undergoing de novo lesion percutaneous coronary intervention with reference vessel diameter greater than or equal to 3.5 mm at Fu Wai Hospital in Beijing, China, were prospectively enrolled into this study. We obtained 9-year clinical outcomes including death, myocardial infarction （MI）, thrombosis, target lesion revascularization （TLR）, target vessel revascularization （TVR）, and major adverse cardiac events （MACE, the composite of death, MI, and TVR）. We performed Cox＇s proportional-hazards models to assess relative risks of all the outcome measures after propensity match. Results After propensity scoring, 514 DES-treated patients were matched to 514 BMS-treated patients. The patients treated with BMS were associated with higher risk ofTLR （HR： 2.55, 95%CI： 1.520-4.277, P = 0.0004） and TVR （HR： 1.889, 95%CI： 1.185-3.011, P = 0.0075）, but the rates of death/MI and MACE were not statistically different. All Academic Research Consortium definition stent thrombosis at 9-year were comparable in the two groups. Conclusions During long-term follow-up through nine years, use of DES in patients with large coronary arteries was still associated with significant reductions in the risks of TLR and TVR.
文摘Background Although radial access for drug-eluting stent （DES） combined with rotational atherectomy （RA） in patients with calcified coronary lesions may be associated with a lower risk of major bleeding complications and obtain favorable clinical results compared with femoral access, the long-term outcome data of this approach were limited in contemporary DES era. Methods ＆ Results This retrospective study sought to compare in-hospital and long-term outcomes for patients undergoing RA via the transradial （TR） and transfemoral （TF） route in 126 consecutive patients （59 radial, 67 femoral） from 2009 to 2014. TR RA procedures were performed in 44/62 （71%） by the three TR operators, compared with 15/64 （23%） by the four TF operators in the present study. Significantly smaller diameter guide catheters and burrs （1.39 ± 0.16 mm vs. 1.53 ± 0.24 mm, P = 0.001） were used in the TR group. Procedural success rates were similar in both TR and TF groups. There was a significantly less major access site bleeding complications in favor of radial artery access （2% vs. 16%, P = 0.012）. The incidence of in-hospital death or myocardial infarction was low in both groups. Although a trend of lower adverse event rate was demonstrated in the TR group compared with the TF one, no statistical significance （21% vs. 27%, P = 0.135） was detected. Conclusions Radial access, a useful alternative to femoral access for RA and DES, can be safely and successfully performed on up to 71% of the patients with heavily calcified coronary lesions needing RA by experienced TR operators.
文摘OBJECTIVE: To assess the immediate- and long-term outcomes of stent supported coronary angioplasty in patients with severe left ventricular dysfunction. METHODS: Seventy-four consecutive patients with angiographic left ventricular ejection fractions or = 1 was seen in 29 (73%) of 40 successfully treated congestive heart failure patients at 6 months after the procedure. During long-term follow-up, 58 (87.9%) of 66 patients with clinical success were alive, including 44 (68.6%) free from cardiac events. CONCLUSIONS: Patients with severe left ventricular dysfunction treated with stent supported PTCA experience a high rate of success, low procedure related mortality and satisfactory long-term survival.
