Yapay Zeka Hızlı Bakış & Çıkarımlar
AI InsightA multipleCox hazards analysis showed that OMT was a protective predictor of MACCE (hazard ratio, 0.19; 95% confidence interval, 0.04–0.88, p=0.03).Conclusion: This study demonstrated a significant association between the serial measurement of endothelial function with OMT and the clinicaloutcome in patients after PCI.
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Özet
Objective: Previous studies have demonstrated the importance of intensive optimal medical therapy (OMT) in patients with coronary arterydisease (CAD). To investigate our hypothesis that patients with and without OMT achievement differed with respect to the risk of future cardiacevents, we investigated the endothelial function in patients with CAD who underwent percutaneous coronary intervention (PCI) and contemporarymedical therapy.Methods: We conducted a prospective longitudinal cohort study to evaluate the endothelial function in 96 consecutive patients at 12 h afteradmission and 3 months at <12 h after admission and at 3 months after discharge by measuring the brachial artery dilatation after 5 min of forearmischemia flow-mediated dilation (FMD). OMT achievement was defined as systolic blood pressure of ≤130 mm Hg, low-density lipoproteincholesterol of ≤100 mg/dl, and hemoglobin A1c level of ≤7.0%. The primary endpoint was the incidence of composite major adverse cardiac orcerebrovascular events (MACCE) at 36 months.Results: Forty-nine (51%) patients achieved all three risk factor targets at 3 months. Although baseline FMD values did not differ between theOMT achievement and non-achievement groups, the 3-month FMD significantly improved in the OMT achievement group (6.6±3.5 vs. 5.2±2.9,p=0.03). Patients with improved FMD at 3 months had a lower rate of 36-month MACCE than those with persistently impaired FMD. A multipleCox hazards analysis showed that OMT was a protective predictor of MACCE (hazard ratio, 0.19; 95% confidence interval, 0.04–0.88, p=0.03).Conclusion: This study demonstrated a significant association between the serial measurement of endothelial function with OMT and the clinicaloutcome in patients after PCI.