- Email: [email protected]
OP-003 The Impact of Intravascular Ultrasound Guidance During Drug Eluting Stent Implantation on Angiographic Outcomes
MARCH 13e16, 2014
Coronary Interventions: Safety and Outcomes Thursday, March 13, 2014 12:00 PM w 1:30 PM, Hall 6 (Abstract nos. OP-001 w OP-008) - OP-001 Comparison of Primary Angioplasty Results with and without Cardiac Surgery Backup in a Single Center. C. Mansuro glu, E. Örnek, M. Çetin, E. Kızıltunç, H. Kundi, A. Balun, M. Gök, S. Hüseynova, B. U gurlu, F.V. Ulusoy. Ankara Numune Research and Education Hospital.
infarction. Door- to- balloon time was 38 19 minutes. Thrombosis aspiration was 12% and intra-aortic pump use was 5%. Procedure success rate was 92%.In- hospital mortality was 4. 5%, vascular access complications were 1. 5 %. A stent was slipped off in one patient but taken from the artery and primary percutaneous procedure completed succsesfully. Stroke and emergent cardiac surgery were not needed in any patient. Result: Our primary angioplasty results were comperable with onsite card,iac surgery hospitals.Teses results support the theory primary angioplasty cane be effective and safe at off- site cardiac surgery.
- OP-003 The Impact of Intravascular Ultrasound Guidance During Drug Eluting Stent Implantation on Angiographic Outcomes. H.U. Yazıcı1, M. Agamalıyev1, C. Ovalı2, U. S¸enol1, Y. Aydar3, A. Ünalır1. 1Department of Cardiology, Medical School of Eskisehir Osmangazi University, Eskis¸ehir, Turkey; 2Department of Cardiovascular Surgery, Medical School of Eskisehir Osmangazi University, Eskis¸ehir, Turkey; 3Department of Anatomy, Medical School of Eskisehir Osmangazi University, Eskis¸ehir, Turkey. Results of angiographies pertaining to the patients prior to and after the intervention, and at ninth month follow-up
Objectives: To investigate the safety and efficacy of primary percutaneous transluminal coronary angioplasty (PPTCA) in patients with acute myocardial infarction (AMI) at a off- site cardiac surgery hospital. Background: Though randomized studies indicate that PPTCA in AMI result in superior outcomes compared with fibrinolytic therapy, the performance of PPTCA at hospitals without cardiac surgery is debated. Methods: Eighth eight consecutive PPTCA procedures were performed at a community hospital when cardiac surgery was not built. After cardiac surgery facilities were available, results of 156 consecutive PPTCA procedures were included to the study. Characteristics and in- hospital results of PPTCA of off- site cardiac and on- site cardiac surgery were compared. Results: PPTCA was performed for all available patients with AMI referred to emergency department. Baseline clinical and angiographic data of the patients as well as adjunctive medical therapies were nearly similar among groups. Time from chest pain to presentation was 261 12 min. in on- site group and 287 23 min. in off- site group p¼0.42. In hospital motality rate was 4. 54% in on- site cardiac surgery and 5. 12% in off- site cardiac surgery p¼ 0.18. PPTCA procedure success rate was 94. 45% and 94. 23% relatively. No patients developed stroke, referred for urgent surgery or repeated angioplasty during follow-up. All other patients were major cardiac event-free during the overall follow-up time. Conclusions: PPTCA results with or without on-site surgery were similar. Immediate coronary angiography with PPTCA in AMI can be performed safely and effectively in community hospitals without onsite cardiac surgery when rigorous program criteria are established.
- OP-002 Outcomes of Primary Angioplasty Procedure of a Tertiary Center without on- site Cardiac Surgery. C. Mansuroglu, E. Örnek, M. Çetin, H. Kundi, A. Balun, M. Gök, B. Ugurlu, F.V. Ulusoy. Ankara Numune Research and Education Hospital. Aim: Argues continue about primary angioplasty procedures at hospitals without on- site cardiac surgery. We aim to present and compare with the litreature the results of our center without on- site cardiac surgery of primary angioplasty procedures. Methods: 45 consecutive acute ST- elevation myocardial infarction patients were performed primary angioplasty between January and May 2012 at our hospital. Average age was 62 7 years ( limits 40- 85 years, 34( 76% ) were male and, 11( 24% ) were female. 12( 27%) patients were acute anterior myocardial infarction and 33(73%) were acute inferior myocardial The American Journal of Cardiologyâ MARCH 13e16, 2014 10th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Oral
S1
O R A L A B S T R A C T S
MARCH 13e16, 2014
O R A L A B S T R A C T S
Objectives: The aim of the present study was to investigate the effect of intravascular ultrasound (IVUS)-guided stenting on angiographic results for drug eluting stent (DES) implantation. Material-Methods: For the present study, we included 30 patients who received DES with IVUS-guided stenting (Group A) and 30 patients receiving the DES without IVUS-guided stenting (Group B). The patients were evaluated for their ninth month control angiographies and were followed during two years for the development of relevant clinical events after the DES implantations. The angiographic and clinical results were compared between the groups. Results: After the percutaneous intervention, the minimal luminal diameter and net acute gain were significantly increased in Group A in respect to Group B (3.30.34 vs. 2.80.33, p <0.01). By contrast, stent restenosis rates were similar between the groups (p >0.3). Conclusions: The present results indicate that the use of IVUS for the implantation of DES can increase the success rate of the intervention. We think that the IVUS guidance during DES implantation can be complementary percutaneous intervention, in particularly by detecting the situations that need for post-dilatation.
- OP-004 The Impact of Post Dilatation on Angiographic Outcomes after Drug Eluting Stent Implantation. H.U. Yazıcı1, C. Ovalı2, M. A gamalıyev1, Y. Aydar3, B. Morrad1, U. S¸enol1, A. Ünalır1. 1 Department of Cardiology, Medical School of Eskisehir Osmangazi University, Eskis¸ehir, Turkey; 2Department of Cardiovascular Surgery, Medical School of Eskisehir Osmangazi University, Eskis¸ehir, Turkey; 3 Department of Anatomy, Medical School of Eskisehir Osmangazi University, Eskis¸ehir, Turkey. Background: Major limitation for the use of stent in the treatment of coronary artery disease are development of stent restenosis and stent thrombosis. The impact of post dilatation on angiographic outcomes after drug eluting stent implantation presently not yet well established. Objectives: The aim of the present study was to investigate the effect of post dilatation on angiographic results for drug eluting stent (DES) implantation. Study Design: For the present study, we included 31 patients who performed post dilatation and 29 patients without performing post dilatation. Coronary angiographies of the patients were evaluated before, after stent implantation and at ninth month. The angiographic and clinical results were compared between the groups. Effect of post-dilatation procedure on the angiographic results
Stent Restenosis(n, %)
Total (n=60)
Postdilatation (-) (n=29)
Postdilatation (+) (n=31)
P Value
7 (11.7)
6 (20.7)
1 (3.2)
0.042
1 (3.4)
0 (0)
0.48
Stent 1 (1.7) Thrombosis(n, %) Acute Gain (mm)
2.55±0.52 2.32±0.52
2.77±0.43
0.001
In-stent minimal luminal diameter (mm)
2.8±0.36
2.62±0.37
2.92±0.29
0.001
Late Lumen Loss (mm)
0.59±0.76 0.71±0.85
0.47±0.65
0.23
Dissection (n, %)
4 (6.7)
4 (12.9)
0.065
S2
0 (0)
Results: Stent restenosis and stent thrombosis rates were similar between the groups (p >0.05). Acute gain and in-stent minimal luminal diameter after drug eluting stent implantation were significantly increased in post dilatation (þ) in respect to post dilatation (-) (p <0.05). Late Lumen Loss and rate of dissection after stent implantation were similar between two groups (p >0.05). (Table 1) Conclusions: The present results indicate that the performing of post dilatation after implantation of DES can increase the success rate of the intervention. The post dilatation after drug eluting stent implantation doesn’t increase angiographic complications.
- OP-005 Relation Between Platelet/Lymphocyte Ratio and Coronary Flow in Patients With ST-Segment Elevation Acute Myocardial Infarction Undergoing Primary Coronary Intervention. C. Toprak, G. Acar, A. Avci, M.M. Tabakci, M.E. Kalkan, G. Kahveci, L. Ocal, S.H. Akpınar, R. Kargın, A.M. Esen. Kosuyolu Kartal Heart Education and Research Hospital. Objectives: Platelet/lymphocyte ratio (PLR) has been shown as an inflammatory biomarkers for coronary heart disease, but data regarding the association of PLR with coronary blood flow in ST-segment elevation myocardial infarction (STEMI) are lacking. We aimed to investigate the relationship between the PLR and no-reflow in patient with STEMI. Methods: In present study, we included 360 consecutive patients suffering from STEMI who underwent primary percutaneous coronary intervention (p-PCI), reperfused within 12 h of symptom onset. Patients were divided into 2 groups based on Thrombolysis In Myocardial Infarction (TIMI) flow Grade and Myocardial blush grade (MBG). Noreflow after p-PCI was defined as a coronary TIMI flow grade <¼ 2 after vessel re-canalized or TIMI flow grade 3 together with a final MBG < 2. Results: The PLR values were significantly higher in patients with no-reflow than in those without no-reflow (283.7 96.6 vs 251.8 75.6 p <0.001). In regression analysis, PLR [odds ratio 1.18, 95% confidence interval (CI) 1.05-1.39; P <0.001]. In receiver operator characteristic curve analysis, optimal cut-off value of PLR to predict noreflow was found as 162, with 70% sensitivity and 61% specificity. Furthermore, we found that a significant correlation between the PLR both the TIMI thrombus grade scale and C-reactive protein (r ¼ 42, p <0.001 and r ¼ 33, p <0.001, respectively). Conclusion: PLR on admission is a strong and independent predictor of poor coronary blood flow following p-PCI in patient with STEMI. This simple and readily avaible parameter may be a useful biomarker for stratification of risk in patients with STEMI.
- OP-006 Electroencephalographic Evaluation Of Lohexol’s Impact On Early and Late Stage Brain Functions In Patients Who Undervent Coronary Angiopraphy. S. Kahraman1, O. Gölgeli2. 1Department of Cardiology, Private Erciyes Kartal Hospital; 2Department of Neurology, Private Erciyes Kartal Hospital. Objective: Coronary angiography (CAG) is the gold standart technique in diagnosing coronary artery disease (CAD). However contrast agents used for coronary angiography may lead to some contrast induced complications. In this study we aimed to compare electroencephalographies of patients before and after angiography. Methods: Fifty patients who were referred to rutine coronary angiography for suspected CAD were included in this study. Electroencephalography (EEG) was performed to each patient before CAG and 30 minutes and 12 hours after CAG. Contrast dose was recorded for
The American Journal of Cardiologyâ MARCH 13e16, 2014 10th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Oral
Coronary Interventions: Safety and Outcomes Thursday, March 13, 2014 12:00 PM w 1:30 PM, Hall 6 (Abstract nos. OP-001 w OP-008) - OP-001 Comparison of Primary Angioplasty Results with and without Cardiac Surgery Backup in a Single Center. C. Mansuro glu, E. Örnek, M. Çetin, E. Kızıltunç, H. Kundi, A. Balun, M. Gök, S. Hüseynova, B. U gurlu, F.V. Ulusoy. Ankara Numune Research and Education Hospital.
infarction. Door- to- balloon time was 38 19 minutes. Thrombosis aspiration was 12% and intra-aortic pump use was 5%. Procedure success rate was 92%.In- hospital mortality was 4. 5%, vascular access complications were 1. 5 %. A stent was slipped off in one patient but taken from the artery and primary percutaneous procedure completed succsesfully. Stroke and emergent cardiac surgery were not needed in any patient. Result: Our primary angioplasty results were comperable with onsite card,iac surgery hospitals.Teses results support the theory primary angioplasty cane be effective and safe at off- site cardiac surgery.
- OP-003 The Impact of Intravascular Ultrasound Guidance During Drug Eluting Stent Implantation on Angiographic Outcomes. H.U. Yazıcı1, M. Agamalıyev1, C. Ovalı2, U. S¸enol1, Y. Aydar3, A. Ünalır1. 1Department of Cardiology, Medical School of Eskisehir Osmangazi University, Eskis¸ehir, Turkey; 2Department of Cardiovascular Surgery, Medical School of Eskisehir Osmangazi University, Eskis¸ehir, Turkey; 3Department of Anatomy, Medical School of Eskisehir Osmangazi University, Eskis¸ehir, Turkey. Results of angiographies pertaining to the patients prior to and after the intervention, and at ninth month follow-up
Objectives: To investigate the safety and efficacy of primary percutaneous transluminal coronary angioplasty (PPTCA) in patients with acute myocardial infarction (AMI) at a off- site cardiac surgery hospital. Background: Though randomized studies indicate that PPTCA in AMI result in superior outcomes compared with fibrinolytic therapy, the performance of PPTCA at hospitals without cardiac surgery is debated. Methods: Eighth eight consecutive PPTCA procedures were performed at a community hospital when cardiac surgery was not built. After cardiac surgery facilities were available, results of 156 consecutive PPTCA procedures were included to the study. Characteristics and in- hospital results of PPTCA of off- site cardiac and on- site cardiac surgery were compared. Results: PPTCA was performed for all available patients with AMI referred to emergency department. Baseline clinical and angiographic data of the patients as well as adjunctive medical therapies were nearly similar among groups. Time from chest pain to presentation was 261 12 min. in on- site group and 287 23 min. in off- site group p¼0.42. In hospital motality rate was 4. 54% in on- site cardiac surgery and 5. 12% in off- site cardiac surgery p¼ 0.18. PPTCA procedure success rate was 94. 45% and 94. 23% relatively. No patients developed stroke, referred for urgent surgery or repeated angioplasty during follow-up. All other patients were major cardiac event-free during the overall follow-up time. Conclusions: PPTCA results with or without on-site surgery were similar. Immediate coronary angiography with PPTCA in AMI can be performed safely and effectively in community hospitals without onsite cardiac surgery when rigorous program criteria are established.
- OP-002 Outcomes of Primary Angioplasty Procedure of a Tertiary Center without on- site Cardiac Surgery. C. Mansuroglu, E. Örnek, M. Çetin, H. Kundi, A. Balun, M. Gök, B. Ugurlu, F.V. Ulusoy. Ankara Numune Research and Education Hospital. Aim: Argues continue about primary angioplasty procedures at hospitals without on- site cardiac surgery. We aim to present and compare with the litreature the results of our center without on- site cardiac surgery of primary angioplasty procedures. Methods: 45 consecutive acute ST- elevation myocardial infarction patients were performed primary angioplasty between January and May 2012 at our hospital. Average age was 62 7 years ( limits 40- 85 years, 34( 76% ) were male and, 11( 24% ) were female. 12( 27%) patients were acute anterior myocardial infarction and 33(73%) were acute inferior myocardial The American Journal of Cardiologyâ MARCH 13e16, 2014 10th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Oral
S1
O R A L A B S T R A C T S
MARCH 13e16, 2014
O R A L A B S T R A C T S
Objectives: The aim of the present study was to investigate the effect of intravascular ultrasound (IVUS)-guided stenting on angiographic results for drug eluting stent (DES) implantation. Material-Methods: For the present study, we included 30 patients who received DES with IVUS-guided stenting (Group A) and 30 patients receiving the DES without IVUS-guided stenting (Group B). The patients were evaluated for their ninth month control angiographies and were followed during two years for the development of relevant clinical events after the DES implantations. The angiographic and clinical results were compared between the groups. Results: After the percutaneous intervention, the minimal luminal diameter and net acute gain were significantly increased in Group A in respect to Group B (3.30.34 vs. 2.80.33, p <0.01). By contrast, stent restenosis rates were similar between the groups (p >0.3). Conclusions: The present results indicate that the use of IVUS for the implantation of DES can increase the success rate of the intervention. We think that the IVUS guidance during DES implantation can be complementary percutaneous intervention, in particularly by detecting the situations that need for post-dilatation.
- OP-004 The Impact of Post Dilatation on Angiographic Outcomes after Drug Eluting Stent Implantation. H.U. Yazıcı1, C. Ovalı2, M. A gamalıyev1, Y. Aydar3, B. Morrad1, U. S¸enol1, A. Ünalır1. 1 Department of Cardiology, Medical School of Eskisehir Osmangazi University, Eskis¸ehir, Turkey; 2Department of Cardiovascular Surgery, Medical School of Eskisehir Osmangazi University, Eskis¸ehir, Turkey; 3 Department of Anatomy, Medical School of Eskisehir Osmangazi University, Eskis¸ehir, Turkey. Background: Major limitation for the use of stent in the treatment of coronary artery disease are development of stent restenosis and stent thrombosis. The impact of post dilatation on angiographic outcomes after drug eluting stent implantation presently not yet well established. Objectives: The aim of the present study was to investigate the effect of post dilatation on angiographic results for drug eluting stent (DES) implantation. Study Design: For the present study, we included 31 patients who performed post dilatation and 29 patients without performing post dilatation. Coronary angiographies of the patients were evaluated before, after stent implantation and at ninth month. The angiographic and clinical results were compared between the groups. Effect of post-dilatation procedure on the angiographic results
Stent Restenosis(n, %)
Total (n=60)
Postdilatation (-) (n=29)
Postdilatation (+) (n=31)
P Value
7 (11.7)
6 (20.7)
1 (3.2)
0.042
1 (3.4)
0 (0)
0.48
Stent 1 (1.7) Thrombosis(n, %) Acute Gain (mm)
2.55±0.52 2.32±0.52
2.77±0.43
0.001
In-stent minimal luminal diameter (mm)
2.8±0.36
2.62±0.37
2.92±0.29
0.001
Late Lumen Loss (mm)
0.59±0.76 0.71±0.85
0.47±0.65
0.23
Dissection (n, %)
4 (6.7)
4 (12.9)
0.065
S2
0 (0)
Results: Stent restenosis and stent thrombosis rates were similar between the groups (p >0.05). Acute gain and in-stent minimal luminal diameter after drug eluting stent implantation were significantly increased in post dilatation (þ) in respect to post dilatation (-) (p <0.05). Late Lumen Loss and rate of dissection after stent implantation were similar between two groups (p >0.05). (Table 1) Conclusions: The present results indicate that the performing of post dilatation after implantation of DES can increase the success rate of the intervention. The post dilatation after drug eluting stent implantation doesn’t increase angiographic complications.
- OP-005 Relation Between Platelet/Lymphocyte Ratio and Coronary Flow in Patients With ST-Segment Elevation Acute Myocardial Infarction Undergoing Primary Coronary Intervention. C. Toprak, G. Acar, A. Avci, M.M. Tabakci, M.E. Kalkan, G. Kahveci, L. Ocal, S.H. Akpınar, R. Kargın, A.M. Esen. Kosuyolu Kartal Heart Education and Research Hospital. Objectives: Platelet/lymphocyte ratio (PLR) has been shown as an inflammatory biomarkers for coronary heart disease, but data regarding the association of PLR with coronary blood flow in ST-segment elevation myocardial infarction (STEMI) are lacking. We aimed to investigate the relationship between the PLR and no-reflow in patient with STEMI. Methods: In present study, we included 360 consecutive patients suffering from STEMI who underwent primary percutaneous coronary intervention (p-PCI), reperfused within 12 h of symptom onset. Patients were divided into 2 groups based on Thrombolysis In Myocardial Infarction (TIMI) flow Grade and Myocardial blush grade (MBG). Noreflow after p-PCI was defined as a coronary TIMI flow grade <¼ 2 after vessel re-canalized or TIMI flow grade 3 together with a final MBG < 2. Results: The PLR values were significantly higher in patients with no-reflow than in those without no-reflow (283.7 96.6 vs 251.8 75.6 p <0.001). In regression analysis, PLR [odds ratio 1.18, 95% confidence interval (CI) 1.05-1.39; P <0.001]. In receiver operator characteristic curve analysis, optimal cut-off value of PLR to predict noreflow was found as 162, with 70% sensitivity and 61% specificity. Furthermore, we found that a significant correlation between the PLR both the TIMI thrombus grade scale and C-reactive protein (r ¼ 42, p <0.001 and r ¼ 33, p <0.001, respectively). Conclusion: PLR on admission is a strong and independent predictor of poor coronary blood flow following p-PCI in patient with STEMI. This simple and readily avaible parameter may be a useful biomarker for stratification of risk in patients with STEMI.
- OP-006 Electroencephalographic Evaluation Of Lohexol’s Impact On Early and Late Stage Brain Functions In Patients Who Undervent Coronary Angiopraphy. S. Kahraman1, O. Gölgeli2. 1Department of Cardiology, Private Erciyes Kartal Hospital; 2Department of Neurology, Private Erciyes Kartal Hospital. Objective: Coronary angiography (CAG) is the gold standart technique in diagnosing coronary artery disease (CAD). However contrast agents used for coronary angiography may lead to some contrast induced complications. In this study we aimed to compare electroencephalographies of patients before and after angiography. Methods: Fifty patients who were referred to rutine coronary angiography for suspected CAD were included in this study. Electroencephalography (EEG) was performed to each patient before CAG and 30 minutes and 12 hours after CAG. Contrast dose was recorded for
The American Journal of Cardiologyâ MARCH 13e16, 2014 10th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Oral