Aghajani Hassan, Alkamel Abdolhakim, Shafiee Akbar, Jalali Arash, Nozari Younes, Pourhosseini Hamidreza, Kassaian Seyed Ebrahim, Salarifar Mojtaba, Hajizeinali Alimohammad, Amirzadegan Alireza, Alidoosti Mohammad, Masoudkabir Farzad, Nematipour Ebrahim
Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
Indian Heart J. 2018 Jan-Feb;70(1):20-23. doi: 10.1016/j.ihj.2017.06.011. Epub 2017 Jun 19.
Diameter of the affected coronary artery is an important predictor of restenosis and need for revascularization. In the present study, we investigated the frequency and potential risk factors for major adverse cardiac events following elective percutaneous coronary intervention (PCI) and stenting of large coronary arteries.
We reviewed the data of elective candidates of PCI on a large coronary artery who presented to our center. Demographic, clinical, angiographic and follow-up data of the eligible patients were retrieved from our databank. The study characteristics were then compared between the patients with and without MACE in order to find out the probable risk factors for MACE in patients with large stent diameter.
Data of 3043 patients who underwent single vessel elective PCI with a stent diameter of ≥3.5mm was reviewed. During a median follow up period of 14 months, 64 (2.1%) patients had MACE. TVR was the most common type of MACE that was observed in 29 patients, while 5 patients had cardiac death. Higher serum levels of creatinine, history of cerebrovascular accident (CVA), and use of a drug eluting stent (DES) were significantly associated with MACE. In the multivariate model, history of CVA (odds ratio=5.23, P=0.030) and use of DES (odds ratio=0.048, P=0.011) were the independent predictors of MACE in patients underwent large coronary artery stenting.
This study showed that prior CVA and the use of BMS were the potential risk factors for MACE in patients who were stented on their large coronary arteries.
病变冠状动脉的直径是再狭窄和血管重建需求的重要预测指标。在本研究中，我们调查了选择性经皮冠状动脉介入治疗（PCI）和大冠状动脉支架置入术后主要不良心脏事件的发生频率及潜在危险因素。
我们回顾了前来本中心就诊的大冠状动脉PCI择期候选者的数据。从我们的数据库中检索符合条件患者的人口统计学、临床、血管造影和随访数据。然后比较有和没有发生主要不良心脏事件（MACE）患者的研究特征，以找出大支架直径患者发生MACE的可能危险因素。
回顾了3043例接受单支血管选择性PCI且支架直径≥3.5mm患者的数据。在中位随访期14个月期间，64例（2.1%）患者发生了MACE。靶血管重建（TVR）是最常见的MACE类型，有29例患者出现，5例患者发生心源性死亡。血清肌酐水平升高、脑血管意外（CVA）病史和使用药物洗脱支架（DES）与MACE显著相关。在多变量模型中，CVA病史（比值比=5.23，P=0.030）和使用DES（比值比=0.048，P=0.011）是接受大冠状动脉支架置入术患者发生MACE的独立预测因素。
本研究表明，既往CVA病史和使用裸金属支架（BMS）是大冠状动脉支架置入术患者发生MACE的潜在危险因素。
