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Published on: January 28, 2020

Major adverse noncardiac events after PCI as predictors of long-term mortality

Kishore Harjai1, Chetan Shenoy, Amol Raizada

  • 1Guthrie Clinic, One Guthrie Square, Sayre, PA 18840, USA. harjai_kishore@guthrie.org

Journal of Interventional Cardiology
|August 19, 2008
PubMed

Insights

Major adverse noncardiac events (MANE) are more common than major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI). MANE significantly impacts long-term survival and mortality, necessitating their monitoring in clinical trials.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Clinical Outcomes Research

Background:

  • Major adverse cardiovascular events (MACE) are standard outcomes after percutaneous coronary intervention (PCI), but major adverse noncardiac events (MANE) are not.
  • MANE, including bleeding and contrast nephropathy, significantly affect patient survival post-PCI.
  • This study investigates the feasibility and prognostic value of a composite MANE endpoint.

Purpose of the Study:

  • To assess the incidence and prognostic impact of in-hospital MACE and MANE following PCI.
  • To evaluate the long-term survival implications of MANE compared to MACE.

Main Methods:

  • A cohort of 985 consecutive patients undergoing PCI was analyzed.
  • In-hospital MACE (MI, target vessel revascularization, stroke) and MANE (bleeding, contrast nephropathy) were recorded.
  • Long-term survival was tracked for up to 4.0 years post-PCI.

Main Results:

  • MANE occurred over six times more frequently than MACE (9.5% vs 1.5%).
  • MANE, unlike MACE, demonstrated a significant association with long-term mortality (40% vs 15% deaths).
  • MANE independently predicted increased long-term mortality (aHR=1.72) and myocardial infarction (aHR=3.43).

Conclusions:

  • Major adverse noncardiac events are frequent after PCI and carry significant long-term prognostic weight.
  • Monitoring and reporting MANE alongside MACE is crucial for comprehensive assessment in PCI trials.
  • MANE should be considered a critical endpoint in evaluating PCI outcomes.
Abstract

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