Post coronary artery bypass graft surgery
Post coronary artery bypass graft surgery
Post coronary artery bypass graft surgery
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Predictors of the major adverse cardiac events (MACE) after<br />
percutaneous <strong>coronary</strong> intervention- a single center registry<br />
Salarifar M, Kassaian SE, Alidoosti M, Haji Zeinali AM, Paydari N and Sharafi<br />
Tehran Heart Center, Medical Sciences/University of Tehran, Tehran, Iran<br />
Abstract<br />
Objective: To propose a model for predicting the risk of MACE. MACE was defined as<br />
nonfatal MI, target vessel revascularization and cardiac death.<br />
Methods: The data of all patients undergoing PCI between March 2003 and March 2005,<br />
(n=2614) were analyzed in this prospective registry. The only exclusion criteria was dropout<br />
from the 9 month follow-up plan (n=434, 16.6%). All characteristics of the patients who had<br />
MACE (n=122, 4.7%) were compared with the others (NonMACE group). All significant<br />
factors entered in the model for multivariate analysis. Time of developing MACE (MACE<br />
time) and MACE hazard evaluated by the Cox regression.<br />
Results: Univariate ORs were revealed in the table 1. Although in univariate analysis Intraaortic<br />
balloon pump, cardiogenic shock and PCI on the left main, were strong predictors for<br />
the MACE they were not entered in the model (due to small sample size). Multivariate<br />
analysis reveals that EF lower than 40%, Unstable Angina or acute <strong>coronary</strong> syndrome and<br />
Dissection were predictors for the MACE.<br />
Median for MACE time was 5±0.49 month (SEM). Unsmoothed graph in Graph<br />
1(Hazard function) shows that the frequency of the MACE increased in the fourth and<br />
tenth month in the first year after PCI. Also It reveals that the frequency of the MACE<br />
increase in the 14 and 15 month.<br />
Conclusion: we propose that the follow up plan could cover the most dangerous time<br />
(4th, 10th, 15th month) after the PCI. So we recommend 18 month follow up plan (1, 4,<br />
9, 12, 18 and yearly after that). Our study reveals that in the current era of interventional<br />
cardiology, the best outcome achieve in the patients presenting by stable angina, having<br />
good EF and have been treated by experienced hands(to prevent dissection).<br />
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