We use cookies to understand how you use our site and to improve your experience. This includes personalizing content and advertising. To learn more, click here. By continuing to use our site, you accept our use of cookies. Cookie Policy.

Features Partner Sites Information LinkXpress
Sign In
Advertise with Us
Sekisui Diagnostics UK Ltd.

Download Mobile App




Preventive PCI for High-Risk Coronary Plaques Reduces Cardiac Events

By HospiMedica International staff writers
Posted on 09 Apr 2024
Print article
Image: Preventive percutaneous coronary intervention for high-risk coronary plaques shows substantial benefits over medications alone (Photo courtesy of Shutterstock)
Image: Preventive percutaneous coronary intervention for high-risk coronary plaques shows substantial benefits over medications alone (Photo courtesy of Shutterstock)

Plaques building up in the heart’s arteries that comprise fats, cholesterol, and other substances, can lead to heart attacks and serious cardiac events if they break off and travel through the blood vessel to cause a blockage. Percutaneous coronary intervention (PCI) is used to open blocked arteries for treating myocardial ischemia, a condition where the heart muscle fails to receive enough oxygenated blood. During PCI, a stent is inserted through a catheter into the blocked artery from the groin or arm, which not only keeps the artery open for blood to flow freely but also releases medications to prevent further plaque buildup. The concept of preventive PCI is based on the view that a stent could stabilize high-risk plaque lesions, thus lowering the chance of rupture and a potential heart attack. Now, a new study has found that individuals with a buildup of fatty atherosclerotic plaque in the heart’s arteries considered at risk of rupturing can benefit significantly from PCI, reducing the likelihood of severe cardiac events compared to treatment with medication alone.

The findings of the new research presented at the American College of Cardiology’s Annual Scientific Session by the University of Ulsan (Seoul, South Korea) suggest that individuals having high-risk plaques that are likely to rupture stand to benefit from preventive PCI instead of waiting for a heart attack or other serious reduction in blood flow to happen. The PREVENT trial is notably the most extensive study on preventive PCI to date as it focuses on patients with non-symptomatic or non-ischemic blockages that typically wouldn't warrant PCI under current care standards. It is also the first study with a large enough sample size to examine the clinical outcomes of using preventive PCI for treating vulnerable plaques. The trial found that, after two years, participants who underwent preventive PCI had an 89% lower risk of experiencing serious cardiac outcomes such as cardiac death, heart attack in the targeted vessel, revascularization due to ischemia in the target vessel, or hospitalization for unstable or progressive chest pain, compared to those on medication alone.

The study involved 1,606 coronary artery disease patients from 15 centers across four countries, all with plaques identified as vulnerable to rupture through intravascular imaging but not significantly obstructing blood flow. Participants, averaging 64 years old, were either assigned to PCI combined with medical therapy or to medical therapy only, which included lifestyle changes and intensive pharmacologic treatment per secondary prevention guidelines, with a strong emphasis on high-dose statin therapy for both groups. Two years into the study, the composite primary endpoint occurred in three patients who underwent PCI (0.4% of the PCI group) and in 27 patients who were administered only medications (3.4% of the controls), marking an 89% lower risk of the composite primary endpoint among those who received PCI. The cumulative incidence of this composite endpoint was found to be significantly lower in the PCI group through long-term follow-up over a median of 4.4 years (maximum up to 7.9 years), with patients receiving PCI demonstrating a 46% lower risk of the composite endpoint across this period. Additionally, the rates for each component of the composite primary endpoint were also found to be lower in the PCI group, in line with the composite rate of death from any cause or heart attack in the target vessel or any revascularization.

“PREVENT has now shown that preventive PCI may reduce the two-year and long-term risks of major cardiac events arising from vessels containing vulnerable plaques,” said Seung-Jung Park, MD, the study’s lead author. “These findings demonstrate that the focal treatment of high-risk vulnerable plaques may improve patient prognosis beyond optimal medical therapy alone.”

Related Links:
University of Ulsan 

Gold Member
Solid State Kv/Dose Multi-Sensor
AGMS-DM+
Gold Member
12-Channel ECG
CM1200B
Silver Member
Wireless Mobile ECG Recorder
NR-1207-3/NR-1207-E
New
Ultrasound Color LCD
U156W

Print article

Channels

Surgical Techniques

view channel
Image: Ureteral electrothermal injury is visible via histology ex vivo (Photo courtesy of Long et al., doi 10.1117/1.BIOS.1.1.015001)

Minimally Invasive Imaging Technique to Revolutionize Ureteral Injury Detection

Electrothermal ureteral injuries are a frequent complication during pelvic surgery. The ureters, which are delicate tubes carrying urine from the kidneys to the bladder, are especially at risk due to their... Read more

Patient Care

view channel
Image: The portable, handheld BeamClean technology inactivates pathogens on commonly touched surfaces in seconds (Photo courtesy of Freestyle Partners)

First-Of-Its-Kind Portable Germicidal Light Technology Disinfects High-Touch Clinical Surfaces in Seconds

Reducing healthcare-acquired infections (HAIs) remains a pressing issue within global healthcare systems. In the United States alone, 1.7 million patients contract HAIs annually, leading to approximately... Read more

Health IT

view channel
Image: First ever institution-specific model provides significant performance advantage over current population-derived models (Photo courtesy of Mount Sinai)

Machine Learning Model Improves Mortality Risk Prediction for Cardiac Surgery Patients

Machine learning algorithms have been deployed to create predictive models in various medical fields, with some demonstrating improved outcomes compared to their standard-of-care counterparts.... Read more

Point of Care

view channel
Image: The Quantra Hemostasis System has received US FDA special 510(k) clearance for use with its Quantra QStat Cartridge (Photo courtesy of HemoSonics)

Critical Bleeding Management System to Help Hospitals Further Standardize Viscoelastic Testing

Surgical procedures are often accompanied by significant blood loss and the subsequent high likelihood of the need for allogeneic blood transfusions. These transfusions, while critical, are linked to various... Read more
Copyright © 2000-2024 Globetech Media. All rights reserved.