- Email: [email protected]
Acute Coronary Syndrome and Acute Myocardial Infarction I (oral abstracts 1-2)
http://www.aievolution.com/tct0701/
SATURDAY, OCTOBER 20, 2007, 12:00 PM - 6:43 PM
Acute Coronary Syndrome and Acute Myocardial Infarction I Room 151B Saturday, October 20, 2007, 12:00 noon - 6:43 pm (Abstract Nos. 1-2) TCT-1 Complete versus Culprit Vessel Percutaneous Revascularization in Patients with Non ST Segment Elevation Acute Coronary Syndromes Anibal A Damonte, Gerardo Zapata, Leandro Lasave, Sabrina Carbo, Alejandro Meiriño, Maximiliano Rossi, Fernando Kozak, Eduardo Picabea Instituto Cardiovascular De Rosario, Rosario, Argentina
Table 1
Background: Coronary angioplasty is an established revascularization strategy in patients with non ST segment elevation acute coronary syndromes (NSTEACS), as well as an alternative to surgery in multivessel coronary disease. However it is not known wether complete revascularization (CR) is superior to an strategy of only culprit vessel revascularization (CVR) in NSTEACS. Objectives: To compare the in hospital outcomes, and at 1 year followup of a strategy of CR vs. CVR in NSTEACS with multivessel disease. Methods: 612 consecutive patients with NSTEACS and multivessel disease were included from the institutional coronary angioplasty database. According to a clinical decision CR was performed in 206 patients (Group 1) and CVR was performed in 406 patients (Group 2). This decision was based on: 1)hemodynamic stability, 2) possibility to identify culprit vessel, 3) technical feasibility of CR, 4) refering physician preference. We compared the baseline characteristics in both groups and death, non fatal myocardial infarction (NFMI), and a composite end point of death, NFMI, and repeat revascularization during hospitalization and at 1 year followup. Results: The two groups were similar regarding baseline characteristics. 7KHUHZHUHQRWVLJQL¿FDQWGLIIHUHQFHVEHWZHHQJURXSVLQWHUPVRILQKRVSLWDO outcomes. At 1 year followup the composite end point (death, NFMI, repeat revascularization) was 9,4% in group 1 vs 16,7% in group 2 (p 0,012). There ZHUHQRWVLJQL¿FDQWGLIIHUHQFHVLQGHDWK LQJURXSYVLQJURXS (p 0,78) and NFMI 0,5% in group 1 vs 1,2% in group 2 (p 0,37) Conclusion: CR with angioplasty in patients with NSTEACS and multivessel FRURQDU\GLVHDVHLVDVVRFLDWHGZLWKDVLJQL¿FDQWGHFUHDVHLQWKHFRPSRVLWH end point at 1 year, driven by a lower repeat revascularization rate, compared to a strategy of only CVR. However there were no differences between groups in death or NFMI using this strategy of revascularization based on a clinical decision.
Marker
R
sig.
IL-1
0.62
<0.001
IL-6
0.51
<0.001
TNF
0.61
<0.001
VEGF
-0.09
NS
FGF
0.08
NS
MMP-9
0.24
NS
TIMP-1
-0.13
NS
TCT-2 Biochemical Assessment Of The Atherosclerotic Plaque Necrotic Core Content In Patients With Coronary Artery Disease Adam Rdzanek1, Janusz Kochman1, Arkadiusz Pietrasik1, Ewa Warnawin2, Anna Radzikowska2, Ewa Kondracka3, Joanna Wilczynska1, Grzegorz Opolski1 1 1st Chair and Department of Cardiology, Warsaw, Poland2Department of Immunology; Institue of Rheumatology, Warsaw, Poland3Department of Endocrinology, Warsaw, Poland Background: High necrotic core (NC) content is a risk factors of plaque YXOQHUDELOLW\9LUWXDO+LVWRORJ\ ,9869+ HQDEOHVLQYLYRLGHQWL¿FDWLRQRI NC. Invasive character of the IVUS-VH precludes its widespread use as a screening tool in large population. Therefore it is reasonable to search for the biochemical surrogates of IVUS-VH derived NC content.
The American Journal of Cardiology® |
October 20-25, 2007
|
TCT Abstracts/ORAL
1L
O R A L A B S T R AC T S
Methods: The study group comprised of 60 patients in whom 83 coronary DWKHURVFOHURWLF OHVLRQV ZHUH LGHQWL¿HG 7KH 1& FRQWHQW ZDV VWXGLHG ZLWK IVUS-VH in the in the entire lesion as a volume of NC tissue. Before the examination blood was sampled from all the patients for the assessment of the biochemical markers. Results: We examined the plasma concentration of several markers: interleukins 1 (IL-1) and 6 (IL-6), tumor necrosis factor A (TNF); vascular HQGRWKHOLDO JURZWK IDFWRU 9(*) ¿EUREODVW JURZWK IDFWRU )*) PDWUL[ metalloproteinase 9 (MMP-9) and tissue inhibitor of matrix metalloproteinase 7,03 &RUUHODWLRQ FRHI¿FLHQWV EHWZHHQ 1& DQG VWXGLHG PDUNHUV DUH given in table 1. In the multiple regression analysis IL-1 occurred to be the strongest risk factor of the high NC volume. Conclusion: :H KDYH LGHQWL¿HG VHYHUDO ELRFKHPLFDO PDUNHUV WKDW FDQ EH applied as indirect indicators of NC content. Out of the studied markers IL-1 appears to be the best independent predictor of the high NC volume. Further studies are needed to establish whether this biochemical correlation can be translated into patients’ clinical outcome.
SATURDAY, OCTOBER 20, 2007, 12:00 PM - 6:43 PM
Acute Coronary Syndrome and Acute Myocardial Infarction I Room 151B Saturday, October 20, 2007, 12:00 noon - 6:43 pm (Abstract Nos. 1-2) TCT-1 Complete versus Culprit Vessel Percutaneous Revascularization in Patients with Non ST Segment Elevation Acute Coronary Syndromes Anibal A Damonte, Gerardo Zapata, Leandro Lasave, Sabrina Carbo, Alejandro Meiriño, Maximiliano Rossi, Fernando Kozak, Eduardo Picabea Instituto Cardiovascular De Rosario, Rosario, Argentina
Table 1
Background: Coronary angioplasty is an established revascularization strategy in patients with non ST segment elevation acute coronary syndromes (NSTEACS), as well as an alternative to surgery in multivessel coronary disease. However it is not known wether complete revascularization (CR) is superior to an strategy of only culprit vessel revascularization (CVR) in NSTEACS. Objectives: To compare the in hospital outcomes, and at 1 year followup of a strategy of CR vs. CVR in NSTEACS with multivessel disease. Methods: 612 consecutive patients with NSTEACS and multivessel disease were included from the institutional coronary angioplasty database. According to a clinical decision CR was performed in 206 patients (Group 1) and CVR was performed in 406 patients (Group 2). This decision was based on: 1)hemodynamic stability, 2) possibility to identify culprit vessel, 3) technical feasibility of CR, 4) refering physician preference. We compared the baseline characteristics in both groups and death, non fatal myocardial infarction (NFMI), and a composite end point of death, NFMI, and repeat revascularization during hospitalization and at 1 year followup. Results: The two groups were similar regarding baseline characteristics. 7KHUHZHUHQRWVLJQL¿FDQWGLIIHUHQFHVEHWZHHQJURXSVLQWHUPVRILQKRVSLWDO outcomes. At 1 year followup the composite end point (death, NFMI, repeat revascularization) was 9,4% in group 1 vs 16,7% in group 2 (p 0,012). There ZHUHQRWVLJQL¿FDQWGLIIHUHQFHVLQGHDWK LQJURXSYVLQJURXS (p 0,78) and NFMI 0,5% in group 1 vs 1,2% in group 2 (p 0,37) Conclusion: CR with angioplasty in patients with NSTEACS and multivessel FRURQDU\GLVHDVHLVDVVRFLDWHGZLWKDVLJQL¿FDQWGHFUHDVHLQWKHFRPSRVLWH end point at 1 year, driven by a lower repeat revascularization rate, compared to a strategy of only CVR. However there were no differences between groups in death or NFMI using this strategy of revascularization based on a clinical decision.
Marker
R
sig.
IL-1
0.62
<0.001
IL-6
0.51
<0.001
TNF
0.61
<0.001
VEGF
-0.09
NS
FGF
0.08
NS
MMP-9
0.24
NS
TIMP-1
-0.13
NS
TCT-2 Biochemical Assessment Of The Atherosclerotic Plaque Necrotic Core Content In Patients With Coronary Artery Disease Adam Rdzanek1, Janusz Kochman1, Arkadiusz Pietrasik1, Ewa Warnawin2, Anna Radzikowska2, Ewa Kondracka3, Joanna Wilczynska1, Grzegorz Opolski1 1 1st Chair and Department of Cardiology, Warsaw, Poland2Department of Immunology; Institue of Rheumatology, Warsaw, Poland3Department of Endocrinology, Warsaw, Poland Background: High necrotic core (NC) content is a risk factors of plaque YXOQHUDELOLW\9LUWXDO+LVWRORJ\ ,9869+ HQDEOHVLQYLYRLGHQWL¿FDWLRQRI NC. Invasive character of the IVUS-VH precludes its widespread use as a screening tool in large population. Therefore it is reasonable to search for the biochemical surrogates of IVUS-VH derived NC content.
The American Journal of Cardiology® |
October 20-25, 2007
|
TCT Abstracts/ORAL
1L
O R A L A B S T R AC T S
Methods: The study group comprised of 60 patients in whom 83 coronary DWKHURVFOHURWLF OHVLRQV ZHUH LGHQWL¿HG 7KH 1& FRQWHQW ZDV VWXGLHG ZLWK IVUS-VH in the in the entire lesion as a volume of NC tissue. Before the examination blood was sampled from all the patients for the assessment of the biochemical markers. Results: We examined the plasma concentration of several markers: interleukins 1 (IL-1) and 6 (IL-6), tumor necrosis factor A (TNF); vascular HQGRWKHOLDO JURZWK IDFWRU 9(*) ¿EUREODVW JURZWK IDFWRU )*) PDWUL[ metalloproteinase 9 (MMP-9) and tissue inhibitor of matrix metalloproteinase 7,03 &RUUHODWLRQ FRHI¿FLHQWV EHWZHHQ 1& DQG VWXGLHG PDUNHUV DUH given in table 1. In the multiple regression analysis IL-1 occurred to be the strongest risk factor of the high NC volume. Conclusion: :H KDYH LGHQWL¿HG VHYHUDO ELRFKHPLFDO PDUNHUV WKDW FDQ EH applied as indirect indicators of NC content. Out of the studied markers IL-1 appears to be the best independent predictor of the high NC volume. Further studies are needed to establish whether this biochemical correlation can be translated into patients’ clinical outcome.