BACKGROUND Acute myocardial infarction(AMI)is a major cause of mortality worldwide.The stress hyperglycemia ratio(SHR),which integrates glucose and glycated hemoglobin A1c levels,better reflects acute metabolic stress...BACKGROUND Acute myocardial infarction(AMI)is a major cause of mortality worldwide.The stress hyperglycemia ratio(SHR),which integrates glucose and glycated hemoglobin A1c levels,better reflects acute metabolic stress.This study assessed the SHR and longterm prognosis of patients with AMI.METHODS This study was a post-hoc analysis based on the prospective,multicenter OPTIMAL registry(http://www.clinicaltrials.gov,NCT number:NCT03084991).A total of 3384 consecutive patients who underwent percutaneous coronary intervention(PCI)at Department of Cardiology,The 2nd Affiliated Hospital of Harbin Medical University,Harbin,China were included in the present analysis after exclusions.Patients were stratified into quartiles according to the SHR.The primary endpoint was cardiovascular death,with all-cause death and major adverse cardiovascular events as secondary endpoints.The median follow-up duration was 24.1 months,with a completion rate of 99.5%.RESULTS Kaplan-Meier survival curves showed progressively worse survival across SHR quartiles(log-rank P<0.001),with patients in Q4(SHR≥1.34)experiencing the highest risk.Multivariate Cox regression analysis confirmed that the SHR was an independent predictor of cardiovascular death[hazard ratio(HR)=1.56],all-cause death(HR=1.48),and major adverse cardiovascular events(HR=1.34)for Q4(SHR≥1.34)versus Q2(SHR:0.93–1.11).Restricted cubic spline analysis revealed a J-shaped association between SHR and outcomes,with the lowest risk observed at an SHR of approximately 1.0.CONCLUSIONS The SHR is an independent predictor of long-term adverse outcomes in patients with AMI undergoing PCI,supporting its use for early risk stratification and glycemic management.展开更多
Colorectal cancer(CRC)is one of the most common malignancies in the world.Despite significant improvements in surgical technique,postoperative complications still occur in a fair percentage of patients undergoing colo...Colorectal cancer(CRC)is one of the most common malignancies in the world.Despite significant improvements in surgical technique,postoperative complications still occur in a fair percentage of patients undergoing colorectal surgery.The most feared complication is anastomotic leakage.It negatively affects shortterm prognosis,with increased post-operative morbidity and mortality,higher hospitalization time and costs.Moreover,it may require further surgery with the creation of a permanent or temporary stoma.While there is no doubt about the negative impact of anastomotic dehiscence on the short-term prognosis of patients operated on for CRC,still under discussion is its impact on the long-term prognosis.Some authors have described an association between leakage and reduced overall survival,disease-free survival,and increased recurrence,while other Authors have found no real impact of dehiscence on long term prognosis.The purpose of this paper is to review all the literature about the impact of anastomotic dehiscence on long-term prognosis after CRC surgery.The main risk factors of leakage and early detection markers are also summarized.展开更多
Objective To investigate the correlation between the hemodynamic pattern of non-culprit vessel stenosis and long-term vessel-oriented composite outcome(VOcO)in patients with acute ST-segment elevation myocardial infar...Objective To investigate the correlation between the hemodynamic pattern of non-culprit vessel stenosis and long-term vessel-oriented composite outcome(VOcO)in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods From January 2019 to December 2021,233 consecutive patients with STEMI and non-culprit vessel stenosis were prospectively enrolled at Shanghai East Hospital.The median followup duration was 3.9 years.The 367 non-culprit vessels of the 233 patients were divided into the VOCO group(33 vessels,9.0%)and the non-VOCO group(334 vessels,91.0%).Parameters pertaining to the hemodynamic pattern of non-culprit vessel stenosis between the two groups were compared.Receiver operating characteristic(ROC)curvesswereused to assess the correlation between hemodynamic pattern and VoCO,and Cox multivariate regression and logistic multivariate regression analyses were applied to identify independent predictors of VOCO.Results The 233 enrolled patients were aged(62.5±12.9)years,with 193 males(82.8%).In the VOCO group,the maximum quantitative flow ratio(QFR)decreased within 20 mm of the QFR-assessed segment,the difference in QFR across the entire vessel,the length of functionally significant vessel,and the maximum gradient of QFR decrease(dQFR/dsmax)were significantly greater than those in the non-VOCO group.ROC curve analysis showed that the optimal threshold for predicting VOCO using dQFR/dsmax was 0.0096(area under the curve:0.691,95%CI:0.606-0.775,P<0.001).Multivariable Cox regression analysis revealed that dQFR/dsmax was an independent predictor of VOCO(HR=1.199,95%CI:1.070-1.343,P=0.002).When anatomical and functional stenosis severities were included in the model,a high pullback pressure gradient(PPG)index(HR=1.572,95%CI:1.052-2.351,P=0.027)emerged as an independent predictor of VOCO.Multivariable logistic regression analysis revealed that a low PPG index(OR=2.851,95%CI:1.945-4.178,P<0.001)was an independent predictor of QFR≤0.80 without long-term VOCO.Conclusion In patients with STEMI,localized hemodynamic patterns of coronary artery stenosis,characterized by high dQFR/dsmax and high PPG index,are associated with longterm VOCO.展开更多
Objective To investigate the long-term prognostic factors of acute pulmonary embolism(APE)among internal medicine inpatients with type 2 diabetes mellitus(T2DM),and establish a prediction model of long-term prognosis....Objective To investigate the long-term prognostic factors of acute pulmonary embolism(APE)among internal medicine inpatients with type 2 diabetes mellitus(T2DM),and establish a prediction model of long-term prognosis.Methods This study included 156 internal medicine inpatients with T2DM and APE(T2DM+APE group)admitted to internal medicine of Xinjiang 474 Hospital and The Fifth Affiliated Hospital of Xinjiang Medical University from July 2019 to June 2022.At the same time,156 inpatients with APE from the department of hematology were selected as APE group.All patients were followed up for 1 year to evaluate the prognosis.Patients in T2DM+APE group were divided into good prognosis subgroup(n=108)and poor prognosis subgroup(n=48).The risk factors for poor prognosis were analyzed and a prediction model was established.Results The incidence of adverse events in T2DM+APE group was higher than that in APE group(P<0.05).Logisticregressionanalysis found that N-terminal precursor of B-type natriuretic peptide(NT-proBNP),cardiac troponin T(c-TnT),heart-type fatty acid binding protein(H-FABP)and simplified Pulmonary Embolism Severity Index(sPESI)score were risk factors for poor long-term prognosis of T2DM complicated with APE.The area under the curve(AUC),sensitivity and specificity of this model for predicting poor prognosis of T2DM complicated with APE were 0.938,83.3%and 96.3%,which were higher than those of prediction with single indicator.Conclusion Patients with T2DM and APE have worse long-term prognosis than those with simple APE.The establishment of a prediction model is helpful for clinical evaluation of long-term prognosis.展开更多
Objective To investigate the impact of receptorinteracting protein kinase 3(RIPK3)on major adverse cardiovascular events(MACE)in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(P...Objective To investigate the impact of receptorinteracting protein kinase 3(RIPK3)on major adverse cardiovascular events(MACE)in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI),as well as the predictive performance of RIPK3 combined with traditional cardiovascular risk factors.MethodsThisstudyywasasingle-center prospective cohort study.It included patients with AMI who underwent PCI at Peking Union Medical College Hospital between September 2017 and November 2017.Baseline clinical data were collected,and plasma samples were obtained 6 hours after PCI to measure RIPK3 levels.Follow-up was conducted via outpatient visits or phone calls to record the occurrence of MACE,including cardiovascular death,hospitalization for heart failure,and vascular events(recurrent AMI or stroke).The predictiveperformance of RIPK3,traditional cardiovascular risk factors and their combination for MACE was compared using receiveroperating characteristic(ROC)curves.Patients were divided into low-and high-RIPK3 level groups based on the optimal cutoff value of RIPK3.Multivariate Cox proportional hazards regression analysis was used to assess the impact of RIPK3 levels on MACE after PCI in AMI patients.Kaplan-Meier survival curves were plotted,and the logrank test was used to compare MACE incidence between the low-and high-RIPK3 groups.Results A total of 103 AMI patients who underwent PCI were included,aged 63.0(56.0,69.0)years,and 83(80.6%)were male.The follow-up time was 5.17(2.81,5.17)years,during which 44 patients(42.7%)experienced MACE.The ROC curve analysis showed that the area under the curve(AUC)for traditional cardiovascular risk factors was 0.68(95%CI:0.58-0.78),while the AUC for plasma RIPK3 was 0.72(95%CI:0.62-0.82).The combined AUC for traditional risk factors and RIPK3 was 0.75(95%CI:0.65-0.85).MultivariateeCox proportional hazards regression analysis indicate1d that plasma RIPK3 level is greater than or equal to the optimal cutoff value of 440.9μg/L(HR=3.31,95%CI:1.53-8.30,P=0.005)was an independent risk factor for MACE in AMI patients after PCI.Kaplan-Meier survival analysis demonstrated that the high-RIPK3 group had a significantly higher risk of MACE after PCI compared to the low-RIPK3 group(log-rank P=0.006).Conclusion Elevated plasmaRIPK3level is an independent risk factor for MACE in AMI patients after PCI.Plasma RIPK3 combined with traditional cardiovascular risk factors can more effectively predict the occurrence of MACE in AMI patients after PCI.AMI patients with RIPK3≥440.9μg/L have a higher risk of MACE after PCI.展开更多
Objective To investigate the impact of the deeplearning-based CT fractional flow reserve(CT-FFR)on clinical decision-making and long-term prognosisin patients withobstructive coronaryyheartdisease.Methods In this sing...Objective To investigate the impact of the deeplearning-based CT fractional flow reserve(CT-FFR)on clinical decision-making and long-term prognosisin patients withobstructive coronaryyheartdisease.Methods In this single-center retrospective cohort study,consecutive patients with obstructive coronary heart disease(with at least one stenosis≥50%)on their first coronary computed tomography angiography(CCTA)in Beijing Anzhen Hospital from February 2017 to July 2018 were included.Baseline clinical and CT characteristics were collected.Deep-learning-based CT-FFR and Leiden CCTA risk score were calculated.All patients enrolled were followed up for at least 5 years.The study endpoint was major adverse cardiovascular events(MACE),defined as the composite of cardiac death,nonfatal myocardial infarction,unstable angina requiring hospitalization,and unplanned revascularization.Receiver operating characteristic(ROC)curves were drawn to define the optimal cut-off point of the Leiden score in predicting the 5-year MACE,and survival analysis and Cox regression were performed to explore the related factors of MACE.Results A total of 622 patients,aged 61(54,66)years with 407(65.4%)males,were included.Diagnostic coronary angiography was performed in 78 patients after their baseline CCTA,and 34(43.6%)patients had CT-FFR>0.80.During a follow-up time of 2181(2093,2355)days,155 patients(24.9%)suffered from MACE.Optimal cut-off point of Leiden score for predicting MACE was 15.48.Survival analysis found that male patients,Leiden risk score>15 and CT-FFR≤0.80 had worse prognosis.Multivariate Cox regression analysis identified CT-FFR≤0.80 as a robust and independent predictor of MACE(HR=4.98,95%CI 3.15-7.86,P<0.001).Conclusion Deep-learning-based CT-FFR aids in clinical decision-making and the evaluation of long-term prognosis in patients with obstructive coronary heart disease.展开更多
INTRODUCTION Cardiovascular system involvement is an important determinant of long-term prognosis in patients with systemic lupus erythematosus(SLE).Aneurysmal dilatation of the aortic root combined with Stanford type...INTRODUCTION Cardiovascular system involvement is an important determinant of long-term prognosis in patients with systemic lupus erythematosus(SLE).Aneurysmal dilatation of the aortic root combined with Stanford type A aortic dissection(TAAD)is a highly catastrophic complication in these patients.展开更多
Objective To investigate the impact of coronary angiography-derived index of microcirculatory resistance(caIMR) on the long-term prognosis of patients with coronary heart disease (CHD) undergoing elective percutaneous...Objective To investigate the impact of coronary angiography-derived index of microcirculatory resistance(caIMR) on the long-term prognosis of patients with coronary heart disease (CHD) undergoing elective percutaneous coronary intervention(PCI).展开更多
Objective To examine long term efficacy of percutaneous transluminal coronary angioplasty (PTCA),coronary stenting and to assess the factors affecting its efficacy Methods A total of 790 patients who underwent su...Objective To examine long term efficacy of percutaneous transluminal coronary angioplasty (PTCA),coronary stenting and to assess the factors affecting its efficacy Methods A total of 790 patients who underwent successful PTCA and PTCA+stent in this hospital were followed by direct interview or letter The rate of follow up was 84 2% and the period of follow up was 0 9-12 7 (3 5±2 4) years Results During follow up, 4 (0 5%) patients died, 22 (2 8%) had nonfatal acute myocardial infarction, 10 (1 3%) had coronary artery bypass surgery, and 98 (12 4%) had repeat PTCA The rate of recurrent angina pectoris was 31 1% The cardiac event free survival rate calculated by the Kaplan Meier method was 88 2% at 1 year and 80 6% at 12 7 years Cox regression analysis showed that there was a positive correlation between AMI history, stent implantation and the risk of cardiac events, and there was a negative correlation between the number of diseased arteries and the risk of cardiac events Compared to the PTCA group, patients with PTCA+stent had significantly lower rates of total cardiac events Conclusion The long term efficacy of PTCA, especially PTCA + stent in Chinese patients was very satisfactory, suggesting that PTCA+stent therapy should be the major treatment for revascularization in patients with coronary heart disease展开更多
基金supported by the National Natural Science Foundation of China(No.62135002)the Key Research and Development Program of Heilongjiang Province(No.2022ZX01A28).
文摘BACKGROUND Acute myocardial infarction(AMI)is a major cause of mortality worldwide.The stress hyperglycemia ratio(SHR),which integrates glucose and glycated hemoglobin A1c levels,better reflects acute metabolic stress.This study assessed the SHR and longterm prognosis of patients with AMI.METHODS This study was a post-hoc analysis based on the prospective,multicenter OPTIMAL registry(http://www.clinicaltrials.gov,NCT number:NCT03084991).A total of 3384 consecutive patients who underwent percutaneous coronary intervention(PCI)at Department of Cardiology,The 2nd Affiliated Hospital of Harbin Medical University,Harbin,China were included in the present analysis after exclusions.Patients were stratified into quartiles according to the SHR.The primary endpoint was cardiovascular death,with all-cause death and major adverse cardiovascular events as secondary endpoints.The median follow-up duration was 24.1 months,with a completion rate of 99.5%.RESULTS Kaplan-Meier survival curves showed progressively worse survival across SHR quartiles(log-rank P<0.001),with patients in Q4(SHR≥1.34)experiencing the highest risk.Multivariate Cox regression analysis confirmed that the SHR was an independent predictor of cardiovascular death[hazard ratio(HR)=1.56],all-cause death(HR=1.48),and major adverse cardiovascular events(HR=1.34)for Q4(SHR≥1.34)versus Q2(SHR:0.93–1.11).Restricted cubic spline analysis revealed a J-shaped association between SHR and outcomes,with the lowest risk observed at an SHR of approximately 1.0.CONCLUSIONS The SHR is an independent predictor of long-term adverse outcomes in patients with AMI undergoing PCI,supporting its use for early risk stratification and glycemic management.
文摘Colorectal cancer(CRC)is one of the most common malignancies in the world.Despite significant improvements in surgical technique,postoperative complications still occur in a fair percentage of patients undergoing colorectal surgery.The most feared complication is anastomotic leakage.It negatively affects shortterm prognosis,with increased post-operative morbidity and mortality,higher hospitalization time and costs.Moreover,it may require further surgery with the creation of a permanent or temporary stoma.While there is no doubt about the negative impact of anastomotic dehiscence on the short-term prognosis of patients operated on for CRC,still under discussion is its impact on the long-term prognosis.Some authors have described an association between leakage and reduced overall survival,disease-free survival,and increased recurrence,while other Authors have found no real impact of dehiscence on long term prognosis.The purpose of this paper is to review all the literature about the impact of anastomotic dehiscence on long-term prognosis after CRC surgery.The main risk factors of leakage and early detection markers are also summarized.
文摘Objective To investigate the correlation between the hemodynamic pattern of non-culprit vessel stenosis and long-term vessel-oriented composite outcome(VOcO)in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods From January 2019 to December 2021,233 consecutive patients with STEMI and non-culprit vessel stenosis were prospectively enrolled at Shanghai East Hospital.The median followup duration was 3.9 years.The 367 non-culprit vessels of the 233 patients were divided into the VOCO group(33 vessels,9.0%)and the non-VOCO group(334 vessels,91.0%).Parameters pertaining to the hemodynamic pattern of non-culprit vessel stenosis between the two groups were compared.Receiver operating characteristic(ROC)curvesswereused to assess the correlation between hemodynamic pattern and VoCO,and Cox multivariate regression and logistic multivariate regression analyses were applied to identify independent predictors of VOCO.Results The 233 enrolled patients were aged(62.5±12.9)years,with 193 males(82.8%).In the VOCO group,the maximum quantitative flow ratio(QFR)decreased within 20 mm of the QFR-assessed segment,the difference in QFR across the entire vessel,the length of functionally significant vessel,and the maximum gradient of QFR decrease(dQFR/dsmax)were significantly greater than those in the non-VOCO group.ROC curve analysis showed that the optimal threshold for predicting VOCO using dQFR/dsmax was 0.0096(area under the curve:0.691,95%CI:0.606-0.775,P<0.001).Multivariable Cox regression analysis revealed that dQFR/dsmax was an independent predictor of VOCO(HR=1.199,95%CI:1.070-1.343,P=0.002).When anatomical and functional stenosis severities were included in the model,a high pullback pressure gradient(PPG)index(HR=1.572,95%CI:1.052-2.351,P=0.027)emerged as an independent predictor of VOCO.Multivariable logistic regression analysis revealed that a low PPG index(OR=2.851,95%CI:1.945-4.178,P<0.001)was an independent predictor of QFR≤0.80 without long-term VOCO.Conclusion In patients with STEMI,localized hemodynamic patterns of coronary artery stenosis,characterized by high dQFR/dsmax and high PPG index,are associated with longterm VOCO.
文摘Objective To investigate the long-term prognostic factors of acute pulmonary embolism(APE)among internal medicine inpatients with type 2 diabetes mellitus(T2DM),and establish a prediction model of long-term prognosis.Methods This study included 156 internal medicine inpatients with T2DM and APE(T2DM+APE group)admitted to internal medicine of Xinjiang 474 Hospital and The Fifth Affiliated Hospital of Xinjiang Medical University from July 2019 to June 2022.At the same time,156 inpatients with APE from the department of hematology were selected as APE group.All patients were followed up for 1 year to evaluate the prognosis.Patients in T2DM+APE group were divided into good prognosis subgroup(n=108)and poor prognosis subgroup(n=48).The risk factors for poor prognosis were analyzed and a prediction model was established.Results The incidence of adverse events in T2DM+APE group was higher than that in APE group(P<0.05).Logisticregressionanalysis found that N-terminal precursor of B-type natriuretic peptide(NT-proBNP),cardiac troponin T(c-TnT),heart-type fatty acid binding protein(H-FABP)and simplified Pulmonary Embolism Severity Index(sPESI)score were risk factors for poor long-term prognosis of T2DM complicated with APE.The area under the curve(AUC),sensitivity and specificity of this model for predicting poor prognosis of T2DM complicated with APE were 0.938,83.3%and 96.3%,which were higher than those of prediction with single indicator.Conclusion Patients with T2DM and APE have worse long-term prognosis than those with simple APE.The establishment of a prediction model is helpful for clinical evaluation of long-term prognosis.
文摘Objective To investigate the impact of receptorinteracting protein kinase 3(RIPK3)on major adverse cardiovascular events(MACE)in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI),as well as the predictive performance of RIPK3 combined with traditional cardiovascular risk factors.MethodsThisstudyywasasingle-center prospective cohort study.It included patients with AMI who underwent PCI at Peking Union Medical College Hospital between September 2017 and November 2017.Baseline clinical data were collected,and plasma samples were obtained 6 hours after PCI to measure RIPK3 levels.Follow-up was conducted via outpatient visits or phone calls to record the occurrence of MACE,including cardiovascular death,hospitalization for heart failure,and vascular events(recurrent AMI or stroke).The predictiveperformance of RIPK3,traditional cardiovascular risk factors and their combination for MACE was compared using receiveroperating characteristic(ROC)curves.Patients were divided into low-and high-RIPK3 level groups based on the optimal cutoff value of RIPK3.Multivariate Cox proportional hazards regression analysis was used to assess the impact of RIPK3 levels on MACE after PCI in AMI patients.Kaplan-Meier survival curves were plotted,and the logrank test was used to compare MACE incidence between the low-and high-RIPK3 groups.Results A total of 103 AMI patients who underwent PCI were included,aged 63.0(56.0,69.0)years,and 83(80.6%)were male.The follow-up time was 5.17(2.81,5.17)years,during which 44 patients(42.7%)experienced MACE.The ROC curve analysis showed that the area under the curve(AUC)for traditional cardiovascular risk factors was 0.68(95%CI:0.58-0.78),while the AUC for plasma RIPK3 was 0.72(95%CI:0.62-0.82).The combined AUC for traditional risk factors and RIPK3 was 0.75(95%CI:0.65-0.85).MultivariateeCox proportional hazards regression analysis indicate1d that plasma RIPK3 level is greater than or equal to the optimal cutoff value of 440.9μg/L(HR=3.31,95%CI:1.53-8.30,P=0.005)was an independent risk factor for MACE in AMI patients after PCI.Kaplan-Meier survival analysis demonstrated that the high-RIPK3 group had a significantly higher risk of MACE after PCI compared to the low-RIPK3 group(log-rank P=0.006).Conclusion Elevated plasmaRIPK3level is an independent risk factor for MACE in AMI patients after PCI.Plasma RIPK3 combined with traditional cardiovascular risk factors can more effectively predict the occurrence of MACE in AMI patients after PCI.AMI patients with RIPK3≥440.9μg/L have a higher risk of MACE after PCI.
文摘Objective To investigate the impact of the deeplearning-based CT fractional flow reserve(CT-FFR)on clinical decision-making and long-term prognosisin patients withobstructive coronaryyheartdisease.Methods In this single-center retrospective cohort study,consecutive patients with obstructive coronary heart disease(with at least one stenosis≥50%)on their first coronary computed tomography angiography(CCTA)in Beijing Anzhen Hospital from February 2017 to July 2018 were included.Baseline clinical and CT characteristics were collected.Deep-learning-based CT-FFR and Leiden CCTA risk score were calculated.All patients enrolled were followed up for at least 5 years.The study endpoint was major adverse cardiovascular events(MACE),defined as the composite of cardiac death,nonfatal myocardial infarction,unstable angina requiring hospitalization,and unplanned revascularization.Receiver operating characteristic(ROC)curves were drawn to define the optimal cut-off point of the Leiden score in predicting the 5-year MACE,and survival analysis and Cox regression were performed to explore the related factors of MACE.Results A total of 622 patients,aged 61(54,66)years with 407(65.4%)males,were included.Diagnostic coronary angiography was performed in 78 patients after their baseline CCTA,and 34(43.6%)patients had CT-FFR>0.80.During a follow-up time of 2181(2093,2355)days,155 patients(24.9%)suffered from MACE.Optimal cut-off point of Leiden score for predicting MACE was 15.48.Survival analysis found that male patients,Leiden risk score>15 and CT-FFR≤0.80 had worse prognosis.Multivariate Cox regression analysis identified CT-FFR≤0.80 as a robust and independent predictor of MACE(HR=4.98,95%CI 3.15-7.86,P<0.001).Conclusion Deep-learning-based CT-FFR aids in clinical decision-making and the evaluation of long-term prognosis in patients with obstructive coronary heart disease.
文摘INTRODUCTION Cardiovascular system involvement is an important determinant of long-term prognosis in patients with systemic lupus erythematosus(SLE).Aneurysmal dilatation of the aortic root combined with Stanford type A aortic dissection(TAAD)is a highly catastrophic complication in these patients.
文摘Objective To investigate the impact of coronary angiography-derived index of microcirculatory resistance(caIMR) on the long-term prognosis of patients with coronary heart disease (CHD) undergoing elective percutaneous coronary intervention(PCI).
文摘Objective To examine long term efficacy of percutaneous transluminal coronary angioplasty (PTCA),coronary stenting and to assess the factors affecting its efficacy Methods A total of 790 patients who underwent successful PTCA and PTCA+stent in this hospital were followed by direct interview or letter The rate of follow up was 84 2% and the period of follow up was 0 9-12 7 (3 5±2 4) years Results During follow up, 4 (0 5%) patients died, 22 (2 8%) had nonfatal acute myocardial infarction, 10 (1 3%) had coronary artery bypass surgery, and 98 (12 4%) had repeat PTCA The rate of recurrent angina pectoris was 31 1% The cardiac event free survival rate calculated by the Kaplan Meier method was 88 2% at 1 year and 80 6% at 12 7 years Cox regression analysis showed that there was a positive correlation between AMI history, stent implantation and the risk of cardiac events, and there was a negative correlation between the number of diseased arteries and the risk of cardiac events Compared to the PTCA group, patients with PTCA+stent had significantly lower rates of total cardiac events Conclusion The long term efficacy of PTCA, especially PTCA + stent in Chinese patients was very satisfactory, suggesting that PTCA+stent therapy should be the major treatment for revascularization in patients with coronary heart disease
