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Left ventricular hypertrophy (LVH) is associated with increased risk for vascular events and mortality. This study investigated 8-year clinical outcomes of hypertensive patients with LVH who underwent percutaneous coronary intervention (PCI) with drug-eluting stents (DES) compared with hypertensive patients without LVH.A total of 1704 consecutive hypertensive patients who underwent PCI from 2004 to 2014 were enrolled. We classified them into either the LVH group (n = 406) or the control group (without LVH, n = 1298). LVH was defined by LV mass index > 115 g/m in men and > 95 g/m in women. After propensity score matched (PSM) analysis, 2 PSM groups (366 pairs, n = 732, c-statistic = 0.629) were generated.For up to 8 years, the LVH group showed a higher incidence of cardiac death (4.4% vs 1.2%, log-rank P = .023, hazard ratio: 3.371, 95% confidence interval: 1.109-10.25; P = .032) compared with the control group. However, there were no significant differences between the 2 groups in the incidence of total death, myocardial infarction, revascularization, and major adverse cardiac events up to 8 years.LVH in hypertensive patients who underwent successful PCI with DES was associated with higher incidence of cardiac death up to 8 years of follow-up. More careful managements and clinical follow-up are needed and treatment strategies should specifically focus to target prevention and reversal of LVH in hypertensive patients.

Purpose: Many recent studies have reported that successful percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) for chronic total occlusion (CTO) has more beneficial effects than failed CTO-PCI; however, there are only limited data available from comparisons of successful CTO-PCI with medical therapy (MT) in the Korean population., Materials and Methods: A total of 840 consecutive CTO patients who underwent diagnostic coronary angiography, receiving either PCI with DESs or MT, were enrolled. Patients were divided into two groups according to the treatment assigned. To adjust for potential confounders, propensity score matching (PSM) analysis was performed using logistic regression. Individual major clinical outcomes and major adverse cardiac events, a composite of total death, myocardial infarction (MI), stroke, and revascularization, were compared between the two groups up to 5 years., Results: After PSM, two propensity-matched groups (265 pairs, n=530) were generated, and the baseline characteristics were balanced. Although the PCI group showed a higher incidence of target lesion and vessel revascularization on CTO, the incidence of MI tended to be lower [hazard ratio (HR): 0.339, 95% confidence interval (CI): 0.110 to 1.043, p=0.059] and the composite of total death or MI was lower (HR: 0.454, 95% CI: 0.224 to 0.919, p=0.028), compared with the MT group up to 5 years., Conclusion: In this study, successful CTO PCI with DESs was associated with a higher risk of repeat PCI for the target vessel, but showed a reduced incidence of death or MI., Competing Interests: The authors have no financial conflicts of interest., (© Copyright: Yonsei University College of Medicine 2018.)

Aims: The usefulness of routine angiographic follow-up (RAF) and clinical follow-up (CF) after percutaneous coronary intervention (PCI) in patients with diabetes is not well understood. We compare 3-year clinical outcomes of RAF and CF in diabetic patients underwent PCI with drug-eluting stents (DES)., Methods: A total of 843 patients with diabetes who underwent PCI with DES were enrolled. RAF was performed at 6-9 months after PCI (n = 426). Rest of patients were medically managed and clinically followed (n = 417); symptom-driven events were captured. After propensity score matched analysis, 2 propensity-matched groups (262 pairs, n = 524, C-statistic = 0.750) were generated. The primary endpoint was major adverse cardiac events (MACE), the composite of total death, non-fatal myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), non-target vessel revascularization (Non-TVR)., Results: During the 3-year follow-up period, the cumulative incidence of target lesion revascularization [TLR: hazard ratio (HR), 4.07; 95% confidence interval (CI), 1.18-9.34; p = 0.001], target vessel revascularization (TVR: HR, 4.02; 95% CI, 1.93-8.40; p < 0.001), non-TVR (HR, 4.92; 95% CI, 1.68-14.4; p = 0.004) and major adverse cardiac events (MACE: HR, 2.53; 95% CI, 1.60-4.01, p < 0.001) were significantly higher in the RAF group. However, the incidence of total death, non-fatal MI were similar between the two groups., Conclusions: RAF following index PCI with DES in patients with diabetes was associated with increased incidence of revascularization and MACE without changes of death or re-infarction rates and increased TLR and TVR rates in both first- and second-generation DES., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Background: Diabetes mellitus (DM) is a major predictor of cardiovascular morbidity and mortality. However, there are limited data on the impact of DM in patients who have chronic total occlusion (CTO) lesion on long-term outcomes., Patients and Methods: A total of 822 CTO patients who underwent coronary angiography, treated by either percutaneous coronary intervention or optimal medical therapy, were enrolled and divided into two groups: (i) diabetic group (n=363) and (ii) nondiabetic group (n=459). Individual and composite major clinical outcomes were compared up to 5 years., Results: Propensity score matching analysis was carried out generating two groups (298 pairs, n=596, C-statistic=0.655) with balanced baseline characteristics. Up to 5 years, the DM group showed a higher trend toward revascularization (19.5 vs. 13.5%, P=0.051) and major adverse cardiovascular events (MACE) (24.7 vs. 19.1%, P=0.097) compared with the nondiabetic group. However, there was no difference in the incidence of death and myocardial infarction between the two groups. Subgroup analysis showed that the chronic kidney disease (CKD) subgroup was associated with a higher incidence of all-cause death, cardiac death, myocardial infarction, revascularization, and MACE in comparison with diabetic patients without CKD and nondiabetic patients, respectively (total MACE: 39 vs. 20.5 vs. 19.2% , P=0.001). Insulin-dependent diabetic patients had a significantly higher incidence of MACE (hazard ratio=1.58; 95% confidence interval: 1.04-2.40; P=0.03) compared with the nondiabetic patients., Conclusion: Diabetic patients with CTO were associated with a trend toward a higher incidence of revascularization and total MACE up to 5 years. Insulin-dependent and diabetic patients with CKD subgroups had a significantly higher incidence of total MACE.