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Heart Rate as a Predictor of Outcome Following Percutaneous Coronary Intervention
Abstracts CSANZ 2012 Abstracts
S157
P = 0.001) and glycoprotein 2b3a inhibitors (34.7% vs 46.6%, P = 0.002) were less in the female cohort. There was no difference in door to balloon times (79 min vs 78 min, P = 0.60) or in-patient mortality (females 6.7%, males 5.1%, P = 0.64). Conclusions: Demographic and procedural differences are evident between the genders. These do not appear to impact on outcome, in particular no effect on D2BT or inpatient mortality was noted.
however, it was an independent predictor of 30-day MACE (OR 1.21 per quintile; 95% CI: 1.06–1.39, p = 0.004). Conclusions: HR immediately prior to PCI is an independent predictor of adverse 30-day cardiovascular outcomes.
http://dx.doi.org/10.1016/j.hlc.2012.05.392
How Well do We Manage STEMI in Australian Private Hospitals? Results from a National Multi-centre Registry
382 Heart Rate as a Predictor of Outcome Following Percutaneous Coronary Intervention J. O’Brien 1,∗ , C. Reid 2,3 , N. Andrianopoulos 3,4 , A. Ajani 5 , D. Clark 6 , H. Krum 2 , P. Loane 2,3 , D. Stub 1 , G. New 7 , M. Sebastian 8 , A. Brennan 2,3 , A. Dart 1 , S. Duffy 1 1 Heart
Centre, Alfred Hospital, Melbourne, Australia of Cardiovascular Research & Education in Therapeutics (CCRE), Monash University, Melbourne, Australia 3 Department of Epidemiology and Preventive Medicine (DEPM), Monash University, Melbourne, Australia 4 Centre of Research Excellence in Patient Safety (CREPS), Monash University, Melbourne, Australia 5 Coronary Care Unit, Royal Melbourne Hospital, Melbourne, Australia 6 Department of Cardiology, Austin Hospital, Heidelberg, Australia 7 Department of Medicine, Box Hill Hospital, Box Hill, Australia 8 Department of Cardiology, Geelong Hospital, Geelong, Australia 2 Centre
Background: Data from previous studies of patients with heart failure and coronary artery disease suggest that patients with higher resting heart rates (HR) have worse cardiovascular outcomes. We sought to evaluate whether HR immediately prior to percutaneous coronary intervention (PCI) is an independent predictor for 30-day outcome. Methods and results: We analysed the outcome of 3720 patients who had HR recorded prior to PCI from the Melbourne Interventional Group registry. HR and outcomes were analysed by quintiles. Patients with cardiogenic shock, intra-aortic balloon pump or inotropic support, and out-of-hospital arrest were excluded. The mean HR was 70.9 ± 14.7 b.p.m. HR by quintile was 55 ± 5, 64 ± 2, 70 ± 1, 77 ± 3 and 93 ± 13 b.p.m., respectively. Patients with higher HR were more likely to be female, current smokers, have higher systolic and diastolic blood pressure, atrial fibrillation, recent heart failure, lower ejection fraction, and ST-elevation myocardial infarction (MI) as the indication for the PCI (all p ≤ 0.002). However, rates of hypertension, multivessel disease, previous MI, PCI and coronary bypass surgery were lower (all p ≤ 0.004). Increased HR was associated with higher 30-day mortality (p for trend = 0.04), target vessel revascularisation (p for trend = 0.003) and 30day MACE (p for trend = 0.004). In a multivariable analysis, HR did not remain an independent predictor of 30-day mortality (OR 1.24 per quintile; 95% CI: 0.94–1.64, p = 0.13),
http://dx.doi.org/10.1016/j.hlc.2012.05.393 383
D. Eccleston 1,∗ , T. Rafter 2 , P. Sage 3 , D. Latchem 4 , M. Horrigan 1 1 Warringal
Private Hospital, Australia Private Hospital, Australia 3 Wakefield Hospital Adelaide, Australia 4 Mount Hospital Perth, Australia 2 Wesley
Background: Several large registries have reported outcomes after percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) in the USA, however few Australian data exist. We aimed to report short and long-term outcomes after PCI for STEMI using the Heart Care Group Registry. Methods: We prospectively collected data on 244 consecutive STEMI patients undergoing primary PCI in private hospitals from November 2009 to February 2011 and compared outcomes to NCDR results. Results: Australians STEMI patients compared to US were older (66 ± 13 years vs 60 ± 11 years), and smoked less (19.5% vs 37%, p < 0.01). 12 month MACE (death, MI, PCI, CABG, CVA) was similar in both STEMI 6/240 (2.4%) and elective 163/2890 (5.3%) PCI patients in Australia (p = 0.05). Outcome
NCDR
HCG
p
Prior MI % Prior PCI % NYHA Class III/IV % Cardiogenic shock on admit % B2/C class lesion % DES use % Lesion success % In-hospital mortality %
19 20 46 7 52 61 93 4.83
10.8 8.7 37.5 1.7 47.9 48 97 0.7
0.001 0.004 0.02 0.001 0.21 <0.001 0.008 0.001
Conclusion: The results of STEMI PCI in Australian private hospitals are comparable to international reports. Long-term outcomes after STEMI PCI remain satisfactory. http://dx.doi.org/10.1016/j.hlc.2012.05.394
ABSTRACTS
Heart, Lung and Circulation 2012;21:S143–S316
S157
P = 0.001) and glycoprotein 2b3a inhibitors (34.7% vs 46.6%, P = 0.002) were less in the female cohort. There was no difference in door to balloon times (79 min vs 78 min, P = 0.60) or in-patient mortality (females 6.7%, males 5.1%, P = 0.64). Conclusions: Demographic and procedural differences are evident between the genders. These do not appear to impact on outcome, in particular no effect on D2BT or inpatient mortality was noted.
however, it was an independent predictor of 30-day MACE (OR 1.21 per quintile; 95% CI: 1.06–1.39, p = 0.004). Conclusions: HR immediately prior to PCI is an independent predictor of adverse 30-day cardiovascular outcomes.
http://dx.doi.org/10.1016/j.hlc.2012.05.392
How Well do We Manage STEMI in Australian Private Hospitals? Results from a National Multi-centre Registry
382 Heart Rate as a Predictor of Outcome Following Percutaneous Coronary Intervention J. O’Brien 1,∗ , C. Reid 2,3 , N. Andrianopoulos 3,4 , A. Ajani 5 , D. Clark 6 , H. Krum 2 , P. Loane 2,3 , D. Stub 1 , G. New 7 , M. Sebastian 8 , A. Brennan 2,3 , A. Dart 1 , S. Duffy 1 1 Heart
Centre, Alfred Hospital, Melbourne, Australia of Cardiovascular Research & Education in Therapeutics (CCRE), Monash University, Melbourne, Australia 3 Department of Epidemiology and Preventive Medicine (DEPM), Monash University, Melbourne, Australia 4 Centre of Research Excellence in Patient Safety (CREPS), Monash University, Melbourne, Australia 5 Coronary Care Unit, Royal Melbourne Hospital, Melbourne, Australia 6 Department of Cardiology, Austin Hospital, Heidelberg, Australia 7 Department of Medicine, Box Hill Hospital, Box Hill, Australia 8 Department of Cardiology, Geelong Hospital, Geelong, Australia 2 Centre
Background: Data from previous studies of patients with heart failure and coronary artery disease suggest that patients with higher resting heart rates (HR) have worse cardiovascular outcomes. We sought to evaluate whether HR immediately prior to percutaneous coronary intervention (PCI) is an independent predictor for 30-day outcome. Methods and results: We analysed the outcome of 3720 patients who had HR recorded prior to PCI from the Melbourne Interventional Group registry. HR and outcomes were analysed by quintiles. Patients with cardiogenic shock, intra-aortic balloon pump or inotropic support, and out-of-hospital arrest were excluded. The mean HR was 70.9 ± 14.7 b.p.m. HR by quintile was 55 ± 5, 64 ± 2, 70 ± 1, 77 ± 3 and 93 ± 13 b.p.m., respectively. Patients with higher HR were more likely to be female, current smokers, have higher systolic and diastolic blood pressure, atrial fibrillation, recent heart failure, lower ejection fraction, and ST-elevation myocardial infarction (MI) as the indication for the PCI (all p ≤ 0.002). However, rates of hypertension, multivessel disease, previous MI, PCI and coronary bypass surgery were lower (all p ≤ 0.004). Increased HR was associated with higher 30-day mortality (p for trend = 0.04), target vessel revascularisation (p for trend = 0.003) and 30day MACE (p for trend = 0.004). In a multivariable analysis, HR did not remain an independent predictor of 30-day mortality (OR 1.24 per quintile; 95% CI: 0.94–1.64, p = 0.13),
http://dx.doi.org/10.1016/j.hlc.2012.05.393 383
D. Eccleston 1,∗ , T. Rafter 2 , P. Sage 3 , D. Latchem 4 , M. Horrigan 1 1 Warringal
Private Hospital, Australia Private Hospital, Australia 3 Wakefield Hospital Adelaide, Australia 4 Mount Hospital Perth, Australia 2 Wesley
Background: Several large registries have reported outcomes after percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) in the USA, however few Australian data exist. We aimed to report short and long-term outcomes after PCI for STEMI using the Heart Care Group Registry. Methods: We prospectively collected data on 244 consecutive STEMI patients undergoing primary PCI in private hospitals from November 2009 to February 2011 and compared outcomes to NCDR results. Results: Australians STEMI patients compared to US were older (66 ± 13 years vs 60 ± 11 years), and smoked less (19.5% vs 37%, p < 0.01). 12 month MACE (death, MI, PCI, CABG, CVA) was similar in both STEMI 6/240 (2.4%) and elective 163/2890 (5.3%) PCI patients in Australia (p = 0.05). Outcome
NCDR
HCG
p
Prior MI % Prior PCI % NYHA Class III/IV % Cardiogenic shock on admit % B2/C class lesion % DES use % Lesion success % In-hospital mortality %
19 20 46 7 52 61 93 4.83
10.8 8.7 37.5 1.7 47.9 48 97 0.7
0.001 0.004 0.02 0.001 0.21 <0.001 0.008 0.001
Conclusion: The results of STEMI PCI in Australian private hospitals are comparable to international reports. Long-term outcomes after STEMI PCI remain satisfactory. http://dx.doi.org/10.1016/j.hlc.2012.05.394
ABSTRACTS
Heart, Lung and Circulation 2012;21:S143–S316