Background Studies have shown that staged percutaneous coronary intervention （PCI） for non-culprit lesions is beneficial for prog- nosis of ST-segment elevation myocardial infarction （STEMI） patients with multives...Background Studies have shown that staged percutaneous coronary intervention （PCI） for non-culprit lesions is beneficial for prog- nosis of ST-segment elevation myocardial infarction （STEMI） patients with multivessel disease. However, the optimal timing of staged re- vascularization is still controversial. This study aimed to find the optimal timing of staged revascularization. Methods A total of 428 STEMI patients with multivessel disease who underwent primary PCI and staged PCI were included. According to the time interval between primary and staged PCI, patients were divided into three groups （〈 1 week, 1- weeks, and 2-12 weeks after primary PCI）. The primary endpoint was major adverse cardiovascular events （MACE）, a composite of all-cause death, non-fatal re-infarction, repeat revascularization, and stroke. Cox regression model was used to assess the association between staged PCI timing and risk of MACE. Results During the follow-up, 119 participants had MACEs. There was statistical difference in MACE incidence among the three groups （〈 1 week： 23.0%; 1-2 weeks： 33.0%; 2-12 weeks： 40.0%; P = 0.001）. In the multivariable adjustment model, the timing interval of staged PCI ≤ 1 week and l-2 weeks were both significantly associated with a lower risk of MACE [hazard ratio （HR）： 0.40, 95% confidence intervals （CI）： 0.24-4）.65; HR： 0.54, 95% CI： 0.3 lq3.93, respectively], mainly attributed to a lower risk of repeat revascularization （HR： 0.41, 95% CI： 0.24-0.70; HR： 0.36, 95% CI： 0.18-0.7）, compared with a strategy of 2-12 weeks later of primary PCI. Conclusions The optimal timing of staged PCI for non-culprit vessels should be within two weeks after primary PCI for STEMI patients.展开更多
This paper employs the SCAD-penalized least squares method to simultaneously select variables and estimate the coefficients for high-dimensional covariate adjusted linear regression models.The distorted variables are ...This paper employs the SCAD-penalized least squares method to simultaneously select variables and estimate the coefficients for high-dimensional covariate adjusted linear regression models.The distorted variables are assumed to be contaminated with a multiplicative factor that is determined by the value of an unknown function of an observable covariate.The authors show that under some appropriate conditions,the SCAD-penalized least squares estimator has the so called "oracle property".In addition,the authors also suggest a BIC criterion to select the tuning parameter,and show that BIC criterion is able to identify the true model consistently for the covariate adjusted linear regression models.Simulation studies and a real data are used to illustrate the efficiency of the proposed estimation algorithm.展开更多
文摘Background Studies have shown that staged percutaneous coronary intervention （PCI） for non-culprit lesions is beneficial for prog- nosis of ST-segment elevation myocardial infarction （STEMI） patients with multivessel disease. However, the optimal timing of staged re- vascularization is still controversial. This study aimed to find the optimal timing of staged revascularization. Methods A total of 428 STEMI patients with multivessel disease who underwent primary PCI and staged PCI were included. According to the time interval between primary and staged PCI, patients were divided into three groups （〈 1 week, 1- weeks, and 2-12 weeks after primary PCI）. The primary endpoint was major adverse cardiovascular events （MACE）, a composite of all-cause death, non-fatal re-infarction, repeat revascularization, and stroke. Cox regression model was used to assess the association between staged PCI timing and risk of MACE. Results During the follow-up, 119 participants had MACEs. There was statistical difference in MACE incidence among the three groups （〈 1 week： 23.0%; 1-2 weeks： 33.0%; 2-12 weeks： 40.0%; P = 0.001）. In the multivariable adjustment model, the timing interval of staged PCI ≤ 1 week and l-2 weeks were both significantly associated with a lower risk of MACE [hazard ratio （HR）： 0.40, 95% confidence intervals （CI）： 0.24-4）.65; HR： 0.54, 95% CI： 0.3 lq3.93, respectively], mainly attributed to a lower risk of repeat revascularization （HR： 0.41, 95% CI： 0.24-0.70; HR： 0.36, 95% CI： 0.18-0.7）, compared with a strategy of 2-12 weeks later of primary PCI. Conclusions The optimal timing of staged PCI for non-culprit vessels should be within two weeks after primary PCI for STEMI patients.
基金supported by the National Natural Science Foundation of China under Grant Nos.11471029,11101014,61273221 and 11171010the Beijing Natural Science Foundation under Grant Nos.1142002 and 1112001+1 种基金the Science and Technology Project of Beijing Municipal Education Commission under Grant No.KM201410005010the Research Fund for the Doctoral Program of Beijing University of Technology under Grant No.006000543114550
文摘This paper employs the SCAD-penalized least squares method to simultaneously select variables and estimate the coefficients for high-dimensional covariate adjusted linear regression models.The distorted variables are assumed to be contaminated with a multiplicative factor that is determined by the value of an unknown function of an observable covariate.The authors show that under some appropriate conditions,the SCAD-penalized least squares estimator has the so called "oracle property".In addition,the authors also suggest a BIC criterion to select the tuning parameter,and show that BIC criterion is able to identify the true model consistently for the covariate adjusted linear regression models.Simulation studies and a real data are used to illustrate the efficiency of the proposed estimation algorithm.
