Background: Stent placement remains a challenge for coronary bifurcation lesions. While both simple and complex stenting strategies are available, it is unclear which one results in better clinical outcomes. This meta-analysis aims to explore the long-term prognosis following treatment with the 2 stenting strategies.
Method: Randomized controlled trials found from searches of the PubMed, EMBASE, and Cochrane Central Register of Controlled Trials were included in this meta-analysis. The complex stent placement strategy was identified as the control group, and the simple stent placement strategy was identified as the experimental group. Data were synthesized with a random effects model. The quality of the randomized controlled trials was assessed by Jadad scale scores. The clinical endpoints at 6 months, 1 year, and 5 years were analyzed.
Results: A total of 11 randomized controlled trials met the inclusion criteria. A total of 2494 patients were included in this meta-analysis. The odds ratio [OR] of the major adverse cardiac events (MACEs) at 6 months was 0.85 (95% confidence interval [CI] 0.53-1.35; P = .49, I2 = 0%). The OR of the MACEs at 1 year was 0.61 (95% CI 0.36-1.05; P = .08, I2 = 0%). The OR of the MACEs at 5 years was 0.69 (95% CI 0.51-0.92; P = .01, I2 = 0%). Compared with the complex strategy, the simple strategy was associated with a lower incidence of MACEs at 5 years.
Conclusion: Compared to the complex stenting strategy, the simple stenting strategy can better reduce the occurrence of long-term MACEs for coronary bifurcation lesions.
背景:支架置入术仍然是冠状动脉分叉病变的一个挑战。虽然简单和复杂的支架植入策略都是可用的，但尚不清楚哪一种策略的临床效果更好。本荟萃分析旨在探讨两种支架植入术治疗后的长期预后。方法:从PubMed、EMBASE和Cochrane中央对照试验登记册中检索到的随机对照试验纳入本荟萃分析。将复杂支架置入策略确定为对照组，将简单支架置入策略确定为实验组。数据采用随机效应模型合成。采用Jadad量表评分评价随机对照试验的质量。分析6个月、1年和5年的临床终点。结果:共有11项随机对照试验符合纳入标准。本荟萃分析共纳入2494例患者。6个月时主要不良心脏事件(mace)的优势比[OR]为0.85(95%可信区间[CI] 0.53-1.35;p =。49, i2 = 0%)。1年时mace的OR为0.61 (95% CI 0.36-1.05;p =。08, I 2 = 0%)。5年时mace的OR为0.69 (95% CI 0.51-0.92;p =。01, i2 = 0%)。与复杂策略相比，简单策略与5年mace发生率较低相关。结论:与复杂支架置入术相比，简单支架置入术能更好地减少冠状动脉分叉病变长期mace的发生。
{"title":"Clinical Outcomes Following Simple or Complex Stenting for Coronary Bifurcation Lesions: A Meta-Analysis.","authors":"Qun Zhang, Hengshan Huan, Yu Han, Han Liu, Shukun Sun, Bailu Wang, Shujian Wei","doi":"10.1177/11795468221116842","DOIUrl":"https://doi.org/10.1177/11795468221116842","url":null,"abstract":"<p><strong>Background: </strong>Stent placement remains a challenge for coronary bifurcation lesions. While both simple and complex stenting strategies are available, it is unclear which one results in better clinical outcomes. This meta-analysis aims to explore the long-term prognosis following treatment with the 2 stenting strategies.</p><p><strong>Method: </strong>Randomized controlled trials found from searches of the PubMed, EMBASE, and Cochrane Central Register of Controlled Trials were included in this meta-analysis. The complex stent placement strategy was identified as the control group, and the simple stent placement strategy was identified as the experimental group. Data were synthesized with a random effects model. The quality of the randomized controlled trials was assessed by Jadad scale scores. The clinical endpoints at 6 months, 1 year, and 5 years were analyzed.</p><p><strong>Results: </strong>A total of 11 randomized controlled trials met the inclusion criteria. A total of 2494 patients were included in this meta-analysis. The odds ratio [OR] of the major adverse cardiac events (MACEs) at 6 months was 0.85 (95% confidence interval [CI] 0.53-1.35; <i>P</i> = .49, <i>I</i> <sup>2</sup> = 0%). The OR of the MACEs at 1 year was 0.61 (95% CI 0.36-1.05; <i>P</i> = .08, <i>I</i> <sup>2</sup> = 0%). The OR of the MACEs at 5 years was 0.69 (95% CI 0.51-0.92; <i>P</i> = .01, <i>I</i> <sup>2</sup> = 0%). Compared with the complex strategy, the simple strategy was associated with a lower incidence of MACEs at 5 years.</p><p><strong>Conclusion: </strong>Compared to the complex stenting strategy, the simple stenting strategy can better reduce the occurrence of long-term MACEs for coronary bifurcation lesions.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2022-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3a/55/10.1177_11795468221116842.PMC9379967.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40708643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fauzie Rahman, Melati Noormaulidya Putri, M. Syarif, I. Aflanie, Endah Labati S, Husnul Fatimah, Zuhrufa Wanna Yolanda
{"title":"What Does Comorbid Status Implication with the End Status of Corona Virus Disease (Covid-19) Patients","authors":"Fauzie Rahman, Melati Noormaulidya Putri, M. Syarif, I. Aflanie, Endah Labati S, Husnul Fatimah, Zuhrufa Wanna Yolanda","doi":"10.52845/cmi/2022-3-3-2","DOIUrl":"https://doi.org/10.52845/cmi/2022-3-3-2","url":null,"abstract":"","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2022-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73650414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Treatment of Cancers with a Novel Combination of Re-PurposedPharmaceuticals and Some Nutriceuticals","authors":"R. Marsh, T. Itinteang","doi":"10.52845/cmi/2022-3-3-1","DOIUrl":"https://doi.org/10.52845/cmi/2022-3-3-1","url":null,"abstract":"","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2022-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77862301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sacroiliitis in patients with low backache with Normal Lumbosacral spine MRI","authors":"Dr. Bushra Mohsen Abdulla","doi":"10.52845/cmi/2022-3-2-1","DOIUrl":"https://doi.org/10.52845/cmi/2022-3-2-1","url":null,"abstract":"","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73041324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Charecteristics of Pressure Sore of Spinal Cord Injury Patients Attentded at Crp","authors":"Mahbub Hossain","doi":"10.52845/cmi/2022-3-2-5","DOIUrl":"https://doi.org/10.52845/cmi/2022-3-2-5","url":null,"abstract":"","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78528454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prevalence and Determinants of Retinopathy among Patients with Diabetes Mellitus: Thiqar 2022","authors":"Wajida Saa'd Bunyan","doi":"10.52845/cmi/2022-3-2-4","DOIUrl":"https://doi.org/10.52845/cmi/2022-3-2-4","url":null,"abstract":"","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72759157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Clinical Outcome Of Corona Virus Disease-19 Patients In An Infectious Disease Center, Olodo, Ibadan, Oyo State, Nigeria","authors":"O. Alonge","doi":"10.52845/cmi/2022-3-2-2","DOIUrl":"https://doi.org/10.52845/cmi/2022-3-2-2","url":null,"abstract":"","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74474142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Lakey, Adam P Good, A. Wells, Ben Katz, Michael Alexander, D. Klokol, Mike K. S. Chan, M. Wong, D. Cox
{"title":"Maldi-Tof Analysis of Mitochondrial Peptides","authors":"J. Lakey, Adam P Good, A. Wells, Ben Katz, Michael Alexander, D. Klokol, Mike K. S. Chan, M. Wong, D. Cox","doi":"10.52845/cmi/2022-3-2-3","DOIUrl":"https://doi.org/10.52845/cmi/2022-3-2-3","url":null,"abstract":"","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85590684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-28eCollection Date: 2022-01-01DOI: 10.1177/11795468221108211
Achmad Fauzi Yahya, Minsy Titi Sari, Aninka Saboe
Distal wire perforation is an infrequent percutaneous coronary intervention (PCI) complication, which may progress to one of the fearful conditions, cardiac tamponade, and rarely to iatrogenic pericarditis. We described 2 cases of acute pericarditis and cardiac tamponade following distal guidewire coronary artery perforation that was successfully managed with pericardiocentesis, anti-inflammatory agents, and meticulous follow-up. Although uncommon, acute traumatic pericarditis may also be considered as a complication after a complex PCI.
{"title":"Iatrogenic Pericarditis and Cardiac Tamponade Following Distal Wire Perforation: A Serial Case Report.","authors":"Achmad Fauzi Yahya, Minsy Titi Sari, Aninka Saboe","doi":"10.1177/11795468221108211","DOIUrl":"10.1177/11795468221108211","url":null,"abstract":"<p><p>Distal wire perforation is an infrequent percutaneous coronary intervention (PCI) complication, which may progress to one of the fearful conditions, cardiac tamponade, and rarely to iatrogenic pericarditis. We described 2 cases of acute pericarditis and cardiac tamponade following distal guidewire coronary artery perforation that was successfully managed with pericardiocentesis, anti-inflammatory agents, and meticulous follow-up. Although uncommon, acute traumatic pericarditis may also be considered as a complication after a complex PCI.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2022-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/23/86/10.1177_11795468221108211.PMC9247988.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40467816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: There is limited data on the impact of comorbidity burden on clinical outcomes of patients undergoing cardiac implantable electronic devices (CIED) implantation. Objectives: Our aim was to assess trends in CIED implantations and explore the relationship between comorbidity burden and outcomes in patients undergoing de novo implantations. Methods: Using the National Inpatient Sample database from 2000 to 2014, we identified adults ⩾18 years undergoing de novo CIED procedures. Comorbidity burden was assessed by Charlson comorbidity Index (CCI), and patients were classified into 4 categories based on their CCI scores (CCI = 0, CCI = 1, CCI = 2, CCI ⩾3). Annual implantation trends were evaluated. Logistic regression was conducted to measure the association between categorized comorbidity burden and outcomes. Results: A total of 3 103 796 de-novo CIED discharge records were identified from the NIS database. About 22.4% had a CCI score of 0, 28.2% had a CCI score of 1, 22% had a CCI score of 2, and 27.4 % had a CCI score ⩾3. Annual de-novo CIED implantations peaked in 2006 and declined steadily from 2010 to 2014. Compared to CCI 0, CCI ⩾3 was independently associated with increased odds of in-hospital mortality, bleeding, pericardial, and cardiac complications (all P < .05). Length of stay and hospital charges increased with increasing comorbidity burden. Conclusions: CCI is a significant predictor of adverse outcomes after CIED implantation. Therefore, comorbidity burden needs to be considered in the decision-making process for CIED implant candidates.
背景:关于合并症负担对心脏植入式电子装置(CIED)植入术患者临床结果影响的数据有限。目的:我们的目的是评估CIED植入的趋势，并探讨接受重新植入的患者的合并症负担和结果之间的关系。方法:使用2000年至2014年的国家住院患者样本数据库，我们确定了接受新生CIED手术的未满18岁的成年人。通过Charlson合并症指数(CCI)评估合并症负担，并根据其CCI评分将患者分为4类(CCI = 0, CCI = 1, CCI = 2, CCI大于或等于3)。评估年度种植趋势。采用逻辑回归来衡量分类共病负担与结局之间的关系。结果:在NIS数据库中共检索到3 103 796例重新诊断的CIED出院记录。约22.4%的CCI得分为0,28.2%的CCI得分为1,22%的CCI得分为2,27.4%的CCI得分大于或等于3。每年重新植入的CIED在2006年达到顶峰，从2010年到2014年稳步下降。与CCI 0相比，CCI小于3与院内死亡率、出血、心包和心脏并发症的几率增加独立相关(所有P结论:CCI是CIED植入后不良结果的重要预测因子。因此，在选择CIED种植体候选人时，需要考虑合并症负担。
{"title":"Impact of Comorbidity Burden on Cardiac Implantable Electronic Devices Outcomes.","authors":"Temitope Ajibawo, Oluwatimilehin Okunowo, Adeniyi Okunade","doi":"10.1177/11795468221108212","DOIUrl":"https://doi.org/10.1177/11795468221108212","url":null,"abstract":"Background: There is limited data on the impact of comorbidity burden on clinical outcomes of patients undergoing cardiac implantable electronic devices (CIED) implantation. Objectives: Our aim was to assess trends in CIED implantations and explore the relationship between comorbidity burden and outcomes in patients undergoing de novo implantations. Methods: Using the National Inpatient Sample database from 2000 to 2014, we identified adults ⩾18 years undergoing de novo CIED procedures. Comorbidity burden was assessed by Charlson comorbidity Index (CCI), and patients were classified into 4 categories based on their CCI scores (CCI = 0, CCI = 1, CCI = 2, CCI ⩾3). Annual implantation trends were evaluated. Logistic regression was conducted to measure the association between categorized comorbidity burden and outcomes. Results: A total of 3 103 796 de-novo CIED discharge records were identified from the NIS database. About 22.4% had a CCI score of 0, 28.2% had a CCI score of 1, 22% had a CCI score of 2, and 27.4 % had a CCI score ⩾3. Annual de-novo CIED implantations peaked in 2006 and declined steadily from 2010 to 2014. Compared to CCI 0, CCI ⩾3 was independently associated with increased odds of in-hospital mortality, bleeding, pericardial, and cardiac complications (all P < .05). Length of stay and hospital charges increased with increasing comorbidity burden. Conclusions: CCI is a significant predictor of adverse outcomes after CIED implantation. Therefore, comorbidity burden needs to be considered in the decision-making process for CIED implant candidates.","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2022-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bf/f6/10.1177_11795468221108212.PMC9247999.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40467815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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