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Prognosis of Patients with Crohn's Disease and Ulcerative Colitis Following Percutaneous Coronary Intervention Procedures

Jill Savren Lotker, Ariel Roguin, Arthur Kerner, Erez Marcusohn, Ofer Kobo

ISRAEL MEDICAL ASSOCIATION JOURNAL(2024)

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摘要
Background: Patients with inflammatory bowel disease (IBD) are at increased risk after percutaneous coronary intervention (PCI). Objectives: To compare the clinical outcomes within 30 days, one year, and five years of undergoing PCI. Methods: We conducted a retrospective cohort study of adult patients with IBD who underwent PCI in a tertiary care center from January 2009 to December 2019. Results: We included 44 patients, 26 with Crohn's disease (CD) and 18 with ulcerative colitis (UC), who underwent PCI. Patients with CD underwent PCI at a younger age compared to UC (57.8 vs. 68.9 years, P < 0.001) and were more likely to be male (88.46% of CD vs. 61.1% of UC, P < 0.03). CD patients had a higher rate of non -steroidal treatment compared to UC patients (50% vs. 5.56%, P < 0.001). Acute coronary syndromes (ACS) and/or the need for revascularization (e.g., PCI) were the most common clinical events to occur following PCI, in both groups. Of patients who experienced ACS and/or unplanned revascularization within 5 years, 25% of UC vs. 40% of CD had target lesion failure (TLF) due to in-stent restenosis and 10% of CD had TLF due to stent thrombosis. Conclusions: We observed higher rates of TLF in IBD patients compared to the general population as well as differences in clinical outcomes between UC and CD patients. A better understanding of the prognostic factors and pathophysiology of these differences may have clinical importance in tailoring the appropriate treatment or type of revascularization for this high -risk group.
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关键词
inflammatory bowel disease (IBD),percutaneous coronary intervention (PCI),stent thrombosis,in-stent restenosis (ISR),target lesion failure (TLF)
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