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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Predictors of outcome in patients undergoing PCI. Results of the RIVIERA study
International Journal of Cardiology, Volume 129, No. 3, Year 2008
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Description
Background: Limited information is available about clinical outcomes following routine percutaneous coronary intervention (PCI) in the current era. This study aimed to identify predictors of adverse clinical or angiographic complications following PCI in patients from many different countries. Methods: RIVIERA is a multinational, prospective, observational study in patients undergoing elective or primary PCI. Consecutive patients (n = 7962) were enrolled in 144 hospitals from 23 countries in four different continents. Primary outcome was death or myocardial infarction (MI). The mean age of the patients was 59 years and 77% were men; 92% of patients underwent elective and 8% primary PCI. Results: The rate of in-hospital outcomes was low: death 0.3%, MI 1%, any bleeding 3.4%. Angiographic complications occurred in 8.7% of patients, mainly coronary dissection (3.7%) and no reflow (2%). After multivariable analysis, the strongest independent predictors of death or MI were clinical presentation with non-ST-segment elevation acute coronary syndrome or ST-segment elevation myocardial infarction and administration of a glycoprotein (GP) IIb/IIIa inhibitor. Radial access, thienopyridine pretreatment and anticoagulation with enoxaparin were associated with a lower risk of death or MI. Female gender, PCI of coronary artery bypass graft, administration of a GP IIb/IIIa inhibitor and combined use of enoxaparin and unfractionated heparin were significantly associated with more bleeding. Radial access was the only variable associated with less bleeding. Conclusions: Routine PCI appears to be a relatively safe revascularization procedure. Many of the variables identified as predictors of adverse cardiac outcomes confirm results obtained in recent randomized PCI trials and are modifiable, suggesting that further improvements can be made. © 2007.
Authors & Co-Authors
Montalescot, Gilles
France, Paris
Hôpital Universitaire Pitié Salpêtrière
Öngen, Zeki
Turkey, Istanbul
İstanbul University-cerrahpaşa Cerrahpaşa Faculty of Medicine
Guindy, Ramez
Egypt, Cairo
Cairo General Hospital
Sousa, Amanda Guerra De Moraes Rego
Brazil, Sao Paulo
Instituto Dante Pazzanese de Cardiologia
Lu, Shu Zheng
China, Beijing
Beijing Anzhen Hospital, Capital Medical University
Pahlajani, Dev B.
India, Mumbai
Breach Candy Hospital
Pellois, André
France, Gentilly
Sanofi S.a.
Vicaut, Éric
France, Paris
Hôpital Lariboisiere Ap-hp
Statistics
Citations: 91
Authors: 8
Affiliations: 8
Identifiers
Doi:
10.1016/j.ijcard.2007.07.127
ISSN:
01675273
Research Areas
Health System And Policy
Noncommunicable Diseases
Study Design
Randomised Control Trial
Cohort Study
Participants Gender
Male
Female