Impact of Atherothrombotic risk stratification in patients with heavily calcified lesions following rotational Atherectomy
Patients who undergo percutaneous coronary intervention (PCI) with rotational atherectomy (RA) are at high risk of adverse clinical outcomes, and there are few clinical risk stratification tools for these patients. We conducted a study with 196 patients who underwent PCI with RA out of 7391 patients...
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| Veröffentlicht in: | Journal of cardiology 2024-01, Vol.83 (1), p.37-43 |
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| creator | Yoshizaki, Toru Nakamura, Takamitsu Horikoshi, Takeo Watanabe, Yosuke Kobayashi, Tsuyoshi Saito, Yukio Obata, Jun-ei Sawanobori, Takao Takano, Hajime Umetani, Ken Asakawa, Tetsuya Sato, Akira |
| description | Patients who undergo percutaneous coronary intervention (PCI) with rotational atherectomy (RA) are at high risk of adverse clinical outcomes, and there are few clinical risk stratification tools for these patients.
We conducted a study with 196 patients who underwent PCI with RA out of 7391 patients who underwent PCI using a multicenter, prospective cohort registry. Patients were divided into three groups according to the tertiles of the Thrombolysis in Myocardial Infarction (TIMI) Risk Score for Secondary Prevention (TRS 2°P): 65 patients in the T1 group (TRS 2°P 3). The primary endpoint was the cumulative 2-year incidence of major adverse cardiovascular and cerebrovascular events (MACCE), defined as a composite of cardiac death, acute coronary syndrome, and ischemic stroke.
Cumulative 2-year MACCE occurred in 41 patients (24 %) during the follow-up period. The cumulative incidence of MACCE was significantly higher in the T3 group than in the T1 group (log-rank test, p = 0.02). Multivariate Cox analyses revealed that the T3 group was associated with an increased risk of MACCE compared to that of the T1 group (adjusted hazard ratio, 2.66; 95 % confidence interval, 1.04–6.77; p = 0.04). The addition of TRS 2°P to conventional risk factors, including male sex, number of diseased vessels, and low-density lipoprotein cholesterol levels, improved the net reclassification improvement (NRI) and integrated discrimination improvement (IDI) (NRI 0.39, p = 0.027; IDI 0.072, p |
| doi_str_mv | 10.1016/j.jjcc.2023.07.013 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2844680309</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0914508723001788</els_id><sourcerecordid>2844680309</sourcerecordid><originalsourceid>FETCH-LOGICAL-c380t-d4c5c77b107fb7221c08a0098eb6bdb05910a3f40b591e25bc3ca23c380982213</originalsourceid><addsrcrecordid>eNp9kMFu1DAQhi0EokvhBTggH7kkjO0kTiQuVQW0UiUucLbsicM6OPFie1stT4_TLRy5eObw_b81HyFvGdQMWPdhrucZsebARQ2yBiaekR3rZVc1UvTPyQ4G1lQt9PKCvEppBuhg6LuX5ELIljcCYEd-3y4HjZmGiV7lvY0h72NYTMgOaXTpJ0056uwmh-UNK3UrPZTNrjnRB5f3dG_1vfMnitpjwexIvU2FTHQK3ocHt_6gpfUxrf35E4s5LKfX5MWkfbJvnuYl-f7507frm-ru65fb66u7CkUPuRobbFFKw0BORnLOEHoN5RBrOjMaaAcGWkwNmLJZ3hoUqLnYwkNfcHFJ3p97DzH8OtqU1eISWu_1asMxKd43TdeDgKGg_IxiDClFO6lDdIuOJ8VAbc7VrDbnanOuQKrivITePfUfzWLHf5G_kgvw8QzYcuW9s1ElLAbRjm5Tocbg_tf_Bw5OlUk</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2844680309</pqid></control><display><type>article</type><title>Impact of Atherothrombotic risk stratification in patients with heavily calcified lesions following rotational Atherectomy</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Yoshizaki, Toru ; Nakamura, Takamitsu ; Horikoshi, Takeo ; Watanabe, Yosuke ; Kobayashi, Tsuyoshi ; Saito, Yukio ; Obata, Jun-ei ; Sawanobori, Takao ; Takano, Hajime ; Umetani, Ken ; Asakawa, Tetsuya ; Sato, Akira</creator><creatorcontrib>Yoshizaki, Toru ; Nakamura, Takamitsu ; Horikoshi, Takeo ; Watanabe, Yosuke ; Kobayashi, Tsuyoshi ; Saito, Yukio ; Obata, Jun-ei ; Sawanobori, Takao ; Takano, Hajime ; Umetani, Ken ; Asakawa, Tetsuya ; Sato, Akira</creatorcontrib><description>Patients who undergo percutaneous coronary intervention (PCI) with rotational atherectomy (RA) are at high risk of adverse clinical outcomes, and there are few clinical risk stratification tools for these patients.
We conducted a study with 196 patients who underwent PCI with RA out of 7391 patients who underwent PCI using a multicenter, prospective cohort registry. Patients were divided into three groups according to the tertiles of the Thrombolysis in Myocardial Infarction (TIMI) Risk Score for Secondary Prevention (TRS 2°P): 65 patients in the T1 group (TRS 2°P < 3), 66 patients in the T2 group (TRS 2°P = 3), and 65 patients in the T3 group (TRS 2°P > 3). The primary endpoint was the cumulative 2-year incidence of major adverse cardiovascular and cerebrovascular events (MACCE), defined as a composite of cardiac death, acute coronary syndrome, and ischemic stroke.
Cumulative 2-year MACCE occurred in 41 patients (24 %) during the follow-up period. The cumulative incidence of MACCE was significantly higher in the T3 group than in the T1 group (log-rank test, p = 0.02). Multivariate Cox analyses revealed that the T3 group was associated with an increased risk of MACCE compared to that of the T1 group (adjusted hazard ratio, 2.66; 95 % confidence interval, 1.04–6.77; p = 0.04). The addition of TRS 2°P to conventional risk factors, including male sex, number of diseased vessels, and low-density lipoprotein cholesterol levels, improved the net reclassification improvement (NRI) and integrated discrimination improvement (IDI) (NRI 0.39, p = 0.027; IDI 0.072, p < 0.001).
Atherothrombotic risk stratification using TRS 2°P was useful in identifying high-risk patients with heavily calcified lesions following RA.
[Display omitted]
•Patients undergoing percutaneous coronary intervention (PCI) with rotational atherectomy (RA) are at high risk of major adverse cardiac and cerebrovascular events (MACCE).•There are few risk stratification tools for these patients.•TIMI Risk Score for Secondary Prevention (TRS 2°P) is a simple risk stratification.•High-TRS 2°P was associated with risk of MACCE in patients undergoing PCI with RA.•TRS 2°P was useful for identifying high-risk patients undergoing PCI with RA.</description><identifier>ISSN: 0914-5087</identifier><identifier>EISSN: 1876-4738</identifier><identifier>DOI: 10.1016/j.jjcc.2023.07.013</identifier><identifier>PMID: 37524300</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Atherectomy, Coronary - adverse effects ; Coronary Artery Disease - etiology ; Humans ; Male ; Percutaneous coronary intervention ; Percutaneous Coronary Intervention - adverse effects ; Prospective Studies ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Rotational atherectomy ; Thrombolysis in myocardial infarction risk score for secondary prevention ; Treatment Outcome</subject><ispartof>Journal of cardiology, 2024-01, Vol.83 (1), p.37-43</ispartof><rights>2023</rights><rights>Copyright © 2023 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c380t-d4c5c77b107fb7221c08a0098eb6bdb05910a3f40b591e25bc3ca23c380982213</citedby><cites>FETCH-LOGICAL-c380t-d4c5c77b107fb7221c08a0098eb6bdb05910a3f40b591e25bc3ca23c380982213</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0914508723001788$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37524300$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yoshizaki, Toru</creatorcontrib><creatorcontrib>Nakamura, Takamitsu</creatorcontrib><creatorcontrib>Horikoshi, Takeo</creatorcontrib><creatorcontrib>Watanabe, Yosuke</creatorcontrib><creatorcontrib>Kobayashi, Tsuyoshi</creatorcontrib><creatorcontrib>Saito, Yukio</creatorcontrib><creatorcontrib>Obata, Jun-ei</creatorcontrib><creatorcontrib>Sawanobori, Takao</creatorcontrib><creatorcontrib>Takano, Hajime</creatorcontrib><creatorcontrib>Umetani, Ken</creatorcontrib><creatorcontrib>Asakawa, Tetsuya</creatorcontrib><creatorcontrib>Sato, Akira</creatorcontrib><title>Impact of Atherothrombotic risk stratification in patients with heavily calcified lesions following rotational Atherectomy</title><title>Journal of cardiology</title><addtitle>J Cardiol</addtitle><description>Patients who undergo percutaneous coronary intervention (PCI) with rotational atherectomy (RA) are at high risk of adverse clinical outcomes, and there are few clinical risk stratification tools for these patients.
We conducted a study with 196 patients who underwent PCI with RA out of 7391 patients who underwent PCI using a multicenter, prospective cohort registry. Patients were divided into three groups according to the tertiles of the Thrombolysis in Myocardial Infarction (TIMI) Risk Score for Secondary Prevention (TRS 2°P): 65 patients in the T1 group (TRS 2°P < 3), 66 patients in the T2 group (TRS 2°P = 3), and 65 patients in the T3 group (TRS 2°P > 3). The primary endpoint was the cumulative 2-year incidence of major adverse cardiovascular and cerebrovascular events (MACCE), defined as a composite of cardiac death, acute coronary syndrome, and ischemic stroke.
Cumulative 2-year MACCE occurred in 41 patients (24 %) during the follow-up period. The cumulative incidence of MACCE was significantly higher in the T3 group than in the T1 group (log-rank test, p = 0.02). Multivariate Cox analyses revealed that the T3 group was associated with an increased risk of MACCE compared to that of the T1 group (adjusted hazard ratio, 2.66; 95 % confidence interval, 1.04–6.77; p = 0.04). The addition of TRS 2°P to conventional risk factors, including male sex, number of diseased vessels, and low-density lipoprotein cholesterol levels, improved the net reclassification improvement (NRI) and integrated discrimination improvement (IDI) (NRI 0.39, p = 0.027; IDI 0.072, p < 0.001).
Atherothrombotic risk stratification using TRS 2°P was useful in identifying high-risk patients with heavily calcified lesions following RA.
[Display omitted]
•Patients undergoing percutaneous coronary intervention (PCI) with rotational atherectomy (RA) are at high risk of major adverse cardiac and cerebrovascular events (MACCE).•There are few risk stratification tools for these patients.•TIMI Risk Score for Secondary Prevention (TRS 2°P) is a simple risk stratification.•High-TRS 2°P was associated with risk of MACCE in patients undergoing PCI with RA.•TRS 2°P was useful for identifying high-risk patients undergoing PCI with RA.</description><subject>Atherectomy, Coronary - adverse effects</subject><subject>Coronary Artery Disease - etiology</subject><subject>Humans</subject><subject>Male</subject><subject>Percutaneous coronary intervention</subject><subject>Percutaneous Coronary Intervention - adverse effects</subject><subject>Prospective Studies</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Rotational atherectomy</subject><subject>Thrombolysis in myocardial infarction risk score for secondary prevention</subject><subject>Treatment Outcome</subject><issn>0914-5087</issn><issn>1876-4738</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMFu1DAQhi0EokvhBTggH7kkjO0kTiQuVQW0UiUucLbsicM6OPFie1stT4_TLRy5eObw_b81HyFvGdQMWPdhrucZsebARQ2yBiaekR3rZVc1UvTPyQ4G1lQt9PKCvEppBuhg6LuX5ELIljcCYEd-3y4HjZmGiV7lvY0h72NYTMgOaXTpJ0056uwmh-UNK3UrPZTNrjnRB5f3dG_1vfMnitpjwexIvU2FTHQK3ocHt_6gpfUxrf35E4s5LKfX5MWkfbJvnuYl-f7507frm-ru65fb66u7CkUPuRobbFFKw0BORnLOEHoN5RBrOjMaaAcGWkwNmLJZ3hoUqLnYwkNfcHFJ3p97DzH8OtqU1eISWu_1asMxKd43TdeDgKGg_IxiDClFO6lDdIuOJ8VAbc7VrDbnanOuQKrivITePfUfzWLHf5G_kgvw8QzYcuW9s1ElLAbRjm5Tocbg_tf_Bw5OlUk</recordid><startdate>20240101</startdate><enddate>20240101</enddate><creator>Yoshizaki, Toru</creator><creator>Nakamura, Takamitsu</creator><creator>Horikoshi, Takeo</creator><creator>Watanabe, Yosuke</creator><creator>Kobayashi, Tsuyoshi</creator><creator>Saito, Yukio</creator><creator>Obata, Jun-ei</creator><creator>Sawanobori, Takao</creator><creator>Takano, Hajime</creator><creator>Umetani, Ken</creator><creator>Asakawa, Tetsuya</creator><creator>Sato, Akira</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20240101</creationdate><title>Impact of Atherothrombotic risk stratification in patients with heavily calcified lesions following rotational Atherectomy</title><author>Yoshizaki, Toru ; Nakamura, Takamitsu ; Horikoshi, Takeo ; Watanabe, Yosuke ; Kobayashi, Tsuyoshi ; Saito, Yukio ; Obata, Jun-ei ; Sawanobori, Takao ; Takano, Hajime ; Umetani, Ken ; Asakawa, Tetsuya ; Sato, Akira</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c380t-d4c5c77b107fb7221c08a0098eb6bdb05910a3f40b591e25bc3ca23c380982213</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Atherectomy, Coronary - adverse effects</topic><topic>Coronary Artery Disease - etiology</topic><topic>Humans</topic><topic>Male</topic><topic>Percutaneous coronary intervention</topic><topic>Percutaneous Coronary Intervention - adverse effects</topic><topic>Prospective Studies</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Rotational atherectomy</topic><topic>Thrombolysis in myocardial infarction risk score for secondary prevention</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yoshizaki, Toru</creatorcontrib><creatorcontrib>Nakamura, Takamitsu</creatorcontrib><creatorcontrib>Horikoshi, Takeo</creatorcontrib><creatorcontrib>Watanabe, Yosuke</creatorcontrib><creatorcontrib>Kobayashi, Tsuyoshi</creatorcontrib><creatorcontrib>Saito, Yukio</creatorcontrib><creatorcontrib>Obata, Jun-ei</creatorcontrib><creatorcontrib>Sawanobori, Takao</creatorcontrib><creatorcontrib>Takano, Hajime</creatorcontrib><creatorcontrib>Umetani, Ken</creatorcontrib><creatorcontrib>Asakawa, Tetsuya</creatorcontrib><creatorcontrib>Sato, Akira</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yoshizaki, Toru</au><au>Nakamura, Takamitsu</au><au>Horikoshi, Takeo</au><au>Watanabe, Yosuke</au><au>Kobayashi, Tsuyoshi</au><au>Saito, Yukio</au><au>Obata, Jun-ei</au><au>Sawanobori, Takao</au><au>Takano, Hajime</au><au>Umetani, Ken</au><au>Asakawa, Tetsuya</au><au>Sato, Akira</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of Atherothrombotic risk stratification in patients with heavily calcified lesions following rotational Atherectomy</atitle><jtitle>Journal of cardiology</jtitle><addtitle>J Cardiol</addtitle><date>2024-01-01</date><risdate>2024</risdate><volume>83</volume><issue>1</issue><spage>37</spage><epage>43</epage><pages>37-43</pages><issn>0914-5087</issn><eissn>1876-4738</eissn><abstract>Patients who undergo percutaneous coronary intervention (PCI) with rotational atherectomy (RA) are at high risk of adverse clinical outcomes, and there are few clinical risk stratification tools for these patients.
We conducted a study with 196 patients who underwent PCI with RA out of 7391 patients who underwent PCI using a multicenter, prospective cohort registry. Patients were divided into three groups according to the tertiles of the Thrombolysis in Myocardial Infarction (TIMI) Risk Score for Secondary Prevention (TRS 2°P): 65 patients in the T1 group (TRS 2°P < 3), 66 patients in the T2 group (TRS 2°P = 3), and 65 patients in the T3 group (TRS 2°P > 3). The primary endpoint was the cumulative 2-year incidence of major adverse cardiovascular and cerebrovascular events (MACCE), defined as a composite of cardiac death, acute coronary syndrome, and ischemic stroke.
Cumulative 2-year MACCE occurred in 41 patients (24 %) during the follow-up period. The cumulative incidence of MACCE was significantly higher in the T3 group than in the T1 group (log-rank test, p = 0.02). Multivariate Cox analyses revealed that the T3 group was associated with an increased risk of MACCE compared to that of the T1 group (adjusted hazard ratio, 2.66; 95 % confidence interval, 1.04–6.77; p = 0.04). The addition of TRS 2°P to conventional risk factors, including male sex, number of diseased vessels, and low-density lipoprotein cholesterol levels, improved the net reclassification improvement (NRI) and integrated discrimination improvement (IDI) (NRI 0.39, p = 0.027; IDI 0.072, p < 0.001).
Atherothrombotic risk stratification using TRS 2°P was useful in identifying high-risk patients with heavily calcified lesions following RA.
[Display omitted]
•Patients undergoing percutaneous coronary intervention (PCI) with rotational atherectomy (RA) are at high risk of major adverse cardiac and cerebrovascular events (MACCE).•There are few risk stratification tools for these patients.•TIMI Risk Score for Secondary Prevention (TRS 2°P) is a simple risk stratification.•High-TRS 2°P was associated with risk of MACCE in patients undergoing PCI with RA.•TRS 2°P was useful for identifying high-risk patients undergoing PCI with RA.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>37524300</pmid><doi>10.1016/j.jjcc.2023.07.013</doi><tpages>7</tpages></addata></record> |
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| source | MEDLINE; Elsevier ScienceDirect Journals; EZB-FREE-00999 freely available EZB journals |
| subjects | Atherectomy, Coronary - adverse effects Coronary Artery Disease - etiology Humans Male Percutaneous coronary intervention Percutaneous Coronary Intervention - adverse effects Prospective Studies Retrospective Studies Risk Assessment Risk Factors Rotational atherectomy Thrombolysis in myocardial infarction risk score for secondary prevention Treatment Outcome |
| title | Impact of Atherothrombotic risk stratification in patients with heavily calcified lesions following rotational Atherectomy |
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