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ȣ - 510594 84 |
| Impact of Canadian Cardiac Society Classification of Angina on the Mid-term Outcomes in Patients Undergoing Percutaneous Coronary Intervention |
| 고려대학교 구로병원 순환기내과 |
| Kang-yin Chen, 나승운, Zhe Jin, Yoshiyasu Minami,김지훈, 나진오,서순용, 최철웅,김진원,김응주,박창규,서홍석,오동주 |
Background:Canadian cardiac society classification (CCSC) is a practical clinical method to classify the severity of angina.However, whether it has a predictive value for the angiographic and clinical outcomes of the PCI remain unknown.Method:A total of 678 pts who had diagnoses of angina and underwent PCI with drug-eluting stent (DES) were enrolled.Pts were divided into 4 classes:Class I(n=151 pts,247 lesions),Class II (n=255 pts,407 lesions),Class III(n=133 pts,193 lesions) and Class IV(n=139 pts,205 lesions) according to CCSC.Angiographic and clinical outcomes at 6 months were evaluated.Result:Base line characteristics were similar among 4 groups.The follow-up data showed that pts with advanced CCSC showed higher angiographic binary restenosis and percent restenosis at 6 months.However,4 groups according to CCSC did not show difference in clinical outcomes including death,Q-wave MI,TLR,TVR and MACE (table).Multivariate analysis showed that the CCSC was associated with binary restenosis[adjusted OR:1.47(1.11-1.95),P=0.007].Conclusion:CCS classification of angina can be an independent risk factor of ISR after PCI with DES but was not translated into worse clinical outcomes.Because pts with more advanced CCS class showed higher incidence of ISR, special care may need to minimize the angiographic restenosis during the procedure and follow up.
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Table:
Angiographic and clinical outcomes at 6 months
|
Variable, n
(%) |
Class I
(n=151 pts) |
Class II
(n=255 pts) |
Class III
(n=133 pts) |
Class IV
(n=139 pts) |
P value |
|
Binary
restenosis |
11 (4.5) |
21 (5.2) |
17 (8.8) |
23 (11.2) |
0.010 |
|
%
Restenosis |
21.91±18.63 |
27.82±21.73 |
30.27±23.90 |
30.02±25.38 |
0.018 |
|
Late loss,
mm |
0.55±0.60 |
0.57±0.58 |
0.61±0.68 |
0.77±0.79 |
0.147 |
|
Cardiac death
|
4 (2.6) |
4 (1.6) |
2 (1.5) |
4 (2.9) |
0.747 |
|
Total death
|
6 (4.0) |
5 (2.0) |
6 (4.5) |
7 (5.0) |
0.358 |
|
Q-wave MI
|
0 (0) |
0 (0) |
0 (0) |
0 (0) |
-- |
|
TLR
|
3 (2.0) |
2 (0.8) |
0 (0) |
0 (0) |
0.155 |
|
TVR
|
3 (2.0) |
2 (0.8) |
0 (0) |
0 (0) |
0.155 |
|
TVR-MACE
|
9 (6.0) |
7 (2.7) |
6 (4.5) |
7 (5.0) |
0.437 |
|
Stent thrombosis |
1 (0.7) |
0 (0) |
1 (0.8) |
3 (2.2) |
0.125 |
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