Related Experiment Video
Updated: Aug 16, 2026
Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
Prognosis of non-ST-segment elevation acute coronary syndrome in patients with prior percutaneous coronary
José Ferreira Santos1, Jorge Ferreira, Carlos Aguiar
1Serviço de Cardiologia do Hospital de Santa Cruz, Carnaxide, Portugal.
Insights
A prior history of percutaneous coronary intervention (PCI) within four months predicts adverse outcomes in non-ST-segment elevation acute coronary syndromes (ACS) patients. Restenosis is a frequent culprit lesion in this high-risk group.
Area of Science:
- Cardiology
- Interventional Cardiology
- Clinical Outcomes Research
Background:
- Disagreement exists on the prognostic significance of prior percutaneous coronary intervention (PCI) in non-ST-segment elevation acute coronary syndromes (ACS).
- Characterizing patients with prior PCI and assessing its impact on prognosis is crucial for risk stratification.
Purpose of the Study:
- To investigate the prognostic value of a prior history of PCI in patients presenting with ACS.
- To evaluate the impact of the time interval between prior PCI and the index ACS event on patient outcomes.
Main Methods:
- A cohort of 448 ACS patients admitted between 1998 and 2000 was analyzed.
- Patients with prior PCI were compared to those without regarding baseline characteristics.
- One-year follow-up assessed the composite endpoint of death or myocardial infarction.
Main Results:
- 134 patients (30%) had a history of prior PCI.
- Prior PCI was not an independent predictor of one-year adverse events overall.
- However, PCI within 117 days prior to admission was an independent predictor of adverse outcome (adjusted OR 4.81; p=0.006).
- Restenosis was the most frequent culprit lesion in patients with recent prior PCI (60% vs 30%; p=0.003).
Conclusions:
- A history of PCI within the preceding four months is an independent predictor of adverse one-year outcomes in ACS patients.
- Recent PCI may indicate a higher risk subgroup, potentially due to restenosis.
Background:
There is disagreement concerning the prognostic value of a prior history of percutaneous coronary intervention (PCI) in patients with non-ST-segment elevation acute coronary syndromes (ACS). This study characterizes these patients and investigates the impact of prior PCI on their prognosis.
Methods:
448 consecutive patients admitted due to ACS between 1998 and 2000 were evaluated. Patients with prior PCI were compared to the others with regard to baseline demographic and clinical features. The study endpoint was death or myocardial infarction at one-year follow-up. The impact of prior PCI on the outcome was analyzed. In patients with prior PCI, the prognostic value of the time interval between PCI and current admission was assessed. In those patients who underwent coronary angiography during the index hospitalization, the culprit lesion features were evaluated.
Results:
134 patients (30%) with prior PCI were identified. Overall ACS patients had an event rate of 19% at one year. A history of prior PCI was not an independent predictor of outcome, but in the 44 patients with PCI performed during the 117 days before the index hospitalization, the event rate was significantly higher (30% versus 13%). Prior PCI in the previous 117 days was an independent risk predictor (adjusted OR 4.81; 95% CI, 1.57-14.71; p = 0.006). In these patients restenosis was the most frequent culprit lesion (60% versus 30%; p = 0.003).
Conclusions:
In ACS patients, a history of PCI in the previous four months is an independent predictor of adverse outcome at one-year follow-up.
Related Concept Videos
01:30Acute Coronary Syndrome I: Introduction
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:27Angina II: Classification
01:27Coronary Artery Disease V: Interprofessional Care