An observational study to assess the outcomes of treatment of patients with stable angina after planned percutaneous coronary intervention: baseline patient characteristics

Aim. To describe the characteristics of patients who were invited in observational, prospective study on a value-based approach to assess the outcomes of treatment of patients with stable coronary artery disease (CAD) by percutaneous coronary intervention (PCI).

Material and methods. We analyzed the baseline characteristics of patients with stable CAD enrolled in a planned PCI with stenting at Almazov National Medical Research Center in 2017. Statistical processing of the results was carried out using Statistica 6.0 (Statsoft Russia) and Microsoft Excel 2017. All registered patients were included in the statistical analysis. Based on the initial clinical characteristics of the patients included in the study, descriptive statistical parameters were calculated. For continuous variables, the mean value and standard deviation were calculated, for the categorical variables — the frequency of characteristic occurrence.

Results. From January 1, 2017 to December 31, 2017, were performed 1740 PCI operations with stenting in 1458 patients aged 63,8±9,6 years (men — 1008 (69,1%)). At the time of admission to the hospital, the body mass index was 29,4±5,2 kg/m2, BP=132,3±15,1/79,6±8,5 mm Hg; HR=69,4±8,3 beats per minute. PCI of one coronary artery was performed in 75,6%, multivascular — in 16,6%, in chronic occlusions — in 4,6% and in bifurcation lesions — in 3,2% of patients, respectively. Type 4a myocardial infarction as a complication of PCI was registered in 2,9% of patients. The average duration of inpatient treatment was 5,5±3,4 days.

Conclusion. Patients with stable CAD who underwent PCI are a representative sample which allows the assessment of treatment outcomes, an objective assessment of the intervention and the calculation of pharmacoeconomic parameters. An observational study will help identifying the factors affecting the efficiency of surgery and getting knowledge of patients’ opinions about this method.

1. Dickersin K, Schnaper L. Reinventing medical research. In: Moss KL, editor. Man-made medicine: women’s health, public policy, and reform. Durham: Duke University Press; 1996

2. Nilsen ES, Myrhaug HT, Johansen M, et al. Methods of consumer involvement in developing healthcare policy and research, clinical practice guidelines and patient information material. Cochrane Database Syst Rev. 2006;3:CD004563. https://doi.org/10.1002/14651858.CD004563.pub2

3. Deshpande P.R., Rajan S., Sudeepthi B.L., Nazir A.C.P. Patient-reported outcomes: A new era in clinical research. Perspect Clin Res 2011; 2: 137-44.

4. Al-Abri R, Al-Balushi A. Patient satisfaction survey as a tool towards quality improvement. Oman Med J. 2014;29(1):3-7.

5. Bjertnaes OA, Sjetne IS, Iversen HH. Overall patient satisfaction with hospitals: Effects of patient-reported experiences and fulfilment of expectations. BMJ Qual Saf. 2012;21(1):39-46

6. Boulding W, Glickman SW, Manary MP, Schulman KA, Staelin R. Relationship between patient satisfaction with inpatient care and hospital readmission within 30 days. Am J Manag Care. 2011;17(1):41-8

7. Neumann F.J., Sousa-Uva M., Ahlsson A., et al. 2018 ESC/EACTS Guidelines on myocardial revascularization. European Heart Journal, ehy394, https://doi.org/10.1093/eurheartj/ehy394

8. Ilic S., Ilic M.D., Petrovic D. et al. Silent myocardial ischemia in asymptomatic patients with multiple coronary risk factors. Medicine and Biology. 2004; 11(3): 107–112

9. Manzella D., Paolisso G. Cardiac autonomic activity and Type II diabetes mellitus. ClinSci (Lond). 2005; 108(2): 93—99.

10. DeLuca A.J., Saulle L.N., Aronow W.S., еt al. Prevalence of silent myocardial ischemia in persons with diabetes mellitus or impaired glucose tolerance and association of hemoglobin A1c with prevalence of silent myocardial ischemia. Amer. J. Cardiology. 2005; 95(12): 1472—1474.

11. Montalescot G., Sechtem U., Achenbach S., et al. 2013 ESC guidelines on the management of stable coronary artery disease. Eur Heart J 2013;34:2949–3003 - doi:10.1093/eurheartj/eht296

12. Kini AS, Lee P, Marmur JD, et al. Correlation of postpercutaneous coronary intervention creatine kinase-MB and troponin I elevation in predicting mid-term mortality. Am J Cardiol. 2004;93:18-23 7.

13. Cavallini C, Savonitto S, Violini R, et al. Impact of the elevation of biochemical markers of myocardial damage on long-103term mortality after percutaneous coronary intervention: results of the CK-MB and PCI study. Eur Heart J. 2005;26:1494-8.

14. Fuchs S, Kornowski R, Mehran R, et al. Prognostic value of cardiac troponin-I levels following catheter-based coronary interventions. Am J Cardiol. 2000;85:1077-82.

15. Novack V, Pencina M, Cohen DJ, et al. Troponin criteria for myocardial infarction after percutaneous coronary intervention. Arch. Intern. Med. 2012; 172: 502-8.