PMID- 32489330
OWN - NLM
STAT- MEDLINE
DCOM- 20201116
LR  - 20220414
IS  - 1540-8183 (Electronic)
IS  - 0896-4327 (Print)
IS  - 0896-4327 (Linking)
VI  - 2020
DP  - 2020
TI  - Long-Term Clinical Outcomes for Non-ST Elevation Acute Coronary Syndrome Patients 
      with High-Risk Angiographic Findings Undergoing Percutaneous Coronary 
      Intervention.
PG  - 2139617
LID - 10.1155/2020/2139617 [doi]
LID - 2139617
AB  - OBJECTIVE: We aim to evaluate the long-term prognosis of non-ST elevation acute 
      coronary syndrome (NSTE-ACS) patients with high-risk coronary anatomy (HRCA). 
      BACKGROUND: Coronary disease severity is important for therapeutic 
      decision-making and prognostication among patients presenting with NSTE-ACS. 
      However, long-term outcome in patients undergoing percutaneous coronary 
      intervention (PCI) with HRCA is still unknown. METHOD: NSTE-ACS patients 
      undergoing PCI in Fuwai Hospital in 2013 were prospectively enrolled and 
      subsequently divided into HRCA and low-risk coronary anatomy (LRCA) groups 
      according to whether angiography complies with the HRCA definition. HRCA was 
      defined as left main disease >50%, proximal LAD lesion >70%, or 2- to 3- vessel 
      disease involving the LAD. Prognosis impact on 2-year and 5-year major adverse 
      cardiovascular and cerebrovascular events (MACCE) is analyzed. RESULTS: Out of 
      4,984 enrolled patients with NSTE-ACS, 3,752 patients belonged to the HRCA group, 
      while 1,232 patients belonged to the LRCA group. Compared with the LRCA group, 
      patients in the HRCA group had worse baseline characteristics including higher 
      age, more comorbidities, and worse angiographic findings. Patients in the HRCA 
      group had higher incidence of unplanned revascularization (2 years: 9.7% vs. 
      5.1%, p < 0.001; 5 years: 15.4% vs. 10.3%, p < 0.001), 2-year MACCE (13.1% vs. 
      8.8%, p < 0.001), and 5-year death/MI/revascularization/stroke (23.0% vs. 18.4%, 
      p = 0.001). Kaplan-Meier survival analysis showed similar results. After 
      adjusting for confounding factors, HRCA is independently associated with higher 
      risk of revascularization (2 years: HR = 1.636, 95% CI: 1.225-2.186; 5 years: 
      HR = 1.460, 95% CI: 1.186-1.798), 2-year MACCE (HR = 1.275, 95% CI = 1.019-1.596) 
      and 5-year death/MI/revascularization/stroke (HR = 1.183, 95% CI: 1.010-1.385). 
      CONCLUSION: In our large cohort of Chinese patients, HRCA is an independent risk 
      factor for long-term unplanned revascularization and MACCE.
CI  - Copyright (c) 2020 Sida Jia et al.
FAU - Jia, Sida
AU  - Jia S
AD  - Fu Wai Hospital, National Center for Cardiovascular Diseases, Peking Union 
      Medical College & Chinese Academy of Medical Sciences, Beijing, China.
FAU - Zhang, Ce
AU  - Zhang C
AD  - Fu Wai Hospital, National Center for Cardiovascular Diseases, Peking Union 
      Medical College & Chinese Academy of Medical Sciences, Beijing, China.
FAU - Liu, Yue
AU  - Liu Y
AD  - Fu Wai Hospital, National Center for Cardiovascular Diseases, Peking Union 
      Medical College & Chinese Academy of Medical Sciences, Beijing, China.
FAU - Yuan, Deshan
AU  - Yuan D
AUID- ORCID: 0000-0002-6413-3545
AD  - Fu Wai Hospital, National Center for Cardiovascular Diseases, Peking Union 
      Medical College & Chinese Academy of Medical Sciences, Beijing, China.
FAU - Zhao, Xueyan
AU  - Zhao X
AD  - Fu Wai Hospital, National Center for Cardiovascular Diseases, Peking Union 
      Medical College & Chinese Academy of Medical Sciences, Beijing, China.
FAU - Gao, Runlin
AU  - Gao R
AD  - Fu Wai Hospital, National Center for Cardiovascular Diseases, Peking Union 
      Medical College & Chinese Academy of Medical Sciences, Beijing, China.
FAU - Yang, Yuejin
AU  - Yang Y
AD  - Fu Wai Hospital, National Center for Cardiovascular Diseases, Peking Union 
      Medical College & Chinese Academy of Medical Sciences, Beijing, China.
FAU - Xu, Bo
AU  - Xu B
AUID- ORCID: 0000-0002-1165-7302
AD  - Fu Wai Hospital, National Center for Cardiovascular Diseases, Peking Union 
      Medical College & Chinese Academy of Medical Sciences, Beijing, China.
FAU - Gao, Zhan
AU  - Gao Z
AD  - Fu Wai Hospital, National Center for Cardiovascular Diseases, Peking Union 
      Medical College & Chinese Academy of Medical Sciences, Beijing, China.
FAU - Yuan, Jinqing
AU  - Yuan J
AUID- ORCID: 0000-0002-3740-5103
AD  - Fu Wai Hospital, National Center for Cardiovascular Diseases, Peking Union 
      Medical College & Chinese Academy of Medical Sciences, Beijing, China.
LA  - eng
PT  - Journal Article
DEP - 20200507
PL  - United States
TA  - J Interv Cardiol
JT  - Journal of interventional cardiology
JID - 8907826
SB  - IM
MH  - *Acute Coronary Syndrome/diagnosis/epidemiology/surgery
MH  - China/epidemiology
MH  - Coronary Angiography/*methods
MH  - Electrocardiography/methods
MH  - Female
MH  - Humans
MH  - *Long Term Adverse Effects/diagnosis/etiology/mortality
MH  - Male
MH  - Middle Aged
MH  - Outcome and Process Assessment, Health Care
MH  - *Percutaneous Coronary Intervention/adverse effects/methods/mortality
MH  - Prognosis
MH  - Reoperation/methods/statistics & numerical data
MH  - Risk Assessment
MH  - Risk Factors
MH  - Severity of Illness Index
PMC - PMC7229566
COIS- The authors have no conflicts of interest to declare.
EDAT- 2020/06/04 06:00
MHDA- 2020/11/18 06:00
PMCR- 2020/05/07
CRDT- 2020/06/04 06:00
PHST- 2019/11/10 00:00 [received]
PHST- 2020/03/20 00:00 [revised]
PHST- 2020/03/25 00:00 [accepted]
PHST- 2020/06/04 06:00 [entrez]
PHST- 2020/06/04 06:00 [pubmed]
PHST- 2020/11/18 06:00 [medline]
PHST- 2020/05/07 00:00 [pmc-release]
AID - 10.1155/2020/2139617 [doi]
PST - epublish
SO  - J Interv Cardiol. 2020 May 7;2020:2139617. doi: 10.1155/2020/2139617. eCollection 
      2020.