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The Predictive Value of ΣΔST/ΔHR Index for Restenosis after Percutaneous Coronary Intervention
1Department of Rehabilitation Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul 139-707, Korea.
Insights
The ΣΔST/ΔHR index effectively predicts restenosis after percutaneous coronary intervention (PCI), demonstrating higher sensitivity and negative predictive value than the ΣΔST index for cardiac rehabilitation patients.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Rehabilitation
Background:
- Percutaneous coronary intervention (PCI) is a common procedure for acute coronary syndrome (ACS).
- Restenosis remains a significant complication after PCI, necessitating effective monitoring strategies.
- Cardiac rehabilitation (CR) programs offer a structured approach for post-PCI patients.
Purpose of the Study:
- To evaluate the predictive value of the ΣΔST/ΔHR index for restenosis following PCI.
- To compare the predictive performance of the ΣΔST/ΔHR index against the ΣΔST index in patients undergoing CR after PCI.
Main Methods:
- Patients in a CR program post-PCI for ACS underwent exercise tolerance tests (ETT).
- ETT parameters included the sum of ST depression (ΣΔST index) and the ΣΔST/ΔHR index.
- Coronary angiography (CAG) was performed at baseline and nine months post-PCI to assess restenosis.
Main Results:
- The ΣΔST/ΔHR index showed a sensitivity of 85% and a negative predictive value of 92% for restenosis.
- In contrast, the ΣΔST index had a sensitivity of 69% and a negative predictive value of 82%.
- The ΣΔST/ΔHR index was significantly higher in the restenosis group (13.7±5.2) compared to the patent group (9.3±5.6, p=0.017).
Conclusions:
- The ΣΔST/ΔHR index is a valuable predictor of restenosis after PCI.
- This index demonstrates superior sensitivity and negative predictive value compared to the ΣΔST index.
- Utilizing the ΣΔST/ΔHR index in ETT may improve the detection of restenosis in post-PCI patients within CR programs.
Objective:
To find out the predictive value of the ΣΔST/ΔHR index for restenosis after percutaneous coronary intervention (PCI).
Method:
Subjects of this research were patients who participated in a cardiac rehabilitation (CR) program as six to eight weeks of a hospital-based program after receiving PCI to treat acute coronary syndrome (ACS). The patients received coronary angiography (CAG) at the onset of the ACS and nine months after that, and also received an exercise tolerance test (ETT) at the start of the CR program and several days before receiving a follow-up CAG. In ETT, we used the sum of the ST depression (ΣΔST index) of leads II, III, aVF, V(4-6) as well as the sum of the ΔST/ΔHR (heart rate) (ΣΔST/ΔHR index) in the same leads and the sum of the ΔST/ΔRPP (rate pressure product) (ΣΔST/ΔRPP index) in the same leads. We compared the predictive power of each index of ETT for restenosis after PCI.
Results:
The sensitivity, specificity, positive predictive value, and negative predictive value of ΣΔST index were 69%, 47%, 31%, and 82%. The ΣΔST/ΔHR index was 13.7±5.2 in the restenosis group and 9.3±5.6 in the patent group (p=0.017). The sensitivity, specificity, positive predictive value, and negative predictive value of this index were 85%, 63%, 44%, and 92%. The ΣΔST/ΔRPP index were 0.10±0.08 in the restenosis group and 0.06±0.04 in the patent group (p=0.016). The sensitivity, specificity, positive predictive value, and negative predictive value of this index were 54%, 76%, 44%, and 83%.
Conclusion:
The ΣΔST/ΔHR index showed a much higher sensitivity and negative predictive value for restenosis after PCI compared to the ΣΔST index.
