Ng Seng, Loong
(2008)
Prevalence of major adversecardiovascular events (MACEs) post angioplasty-HUSM Experience.
Masters thesis, Universiti Sains Malaysia.
Abstract
The primary objective of this study was to determine the prevalence of major
adverse cardiovascular events (MACEs) in patients undergoing PCI in our cardiology
unit in Hospital Universiti Sains Malaysia (HUSM). The second objective was to have a baseline demographic and angiographic data of the patients who had undergone PCI aswell as comparison of association between independent variables with MACEs. Risk
factor control in terms of diabetic and lipid control was also analysed during clinic
follow-up A total of 240 patients who underwent coronary angioplasty with stent
placements were recruited into this prospective cohort study 21 patients (8.9 %) had MACEs post PCI. 5 patients had drop out from the study
during follow-up. 2 variables were significantly associated with MACEs post PCI using
Chi-Square test including two vessel residual disease (p<O.OO 1) and right coronary artery
disease(RCA) involvement (p=0.004). Multivariate analysis maintained the association of
the 2 variables including two vessel residual disease (p=0.052, adjusted OR 2.55 95% Cl
0.99-6.58) and RCA involvement (p=0.026, adjusted OR 5.53 95% CI 1.22-24.96) Multivariate analysis also identified higher HbAl C had significant association with
MACEs (p=O.Oll, adjusted OR 1.93~ 95% Cl1.16-3.20) Patients who were diabetics or had high LDL-Cholesterol (LDL-C) prior to coronary
angioplasty had significant improvement in metabolic risk control including reduction in
HbAIC (p=0.002) and LDL-C (p<O.OOI). Furthermore, 55.7% of our hyperlipidaemic
patients managed to achieve targeted LDL-C of <2.6mmol/l Conclusion: This study has shown that the prevalence of MACEs in patients undergoing
PCI was not high in HUSM. Residual two vessel disease, RCA involvement and higher
HbAl C were highly predictive of increased risk for MACEs post PCI. This group of
patients may benefit from earlier reangiographic studies, staged revascularization
therapies and more aggressive control of metabolic risk factors.
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