Altitude and prognosis after PCI: A propensity score-matched analysis

Area of Science:

• Cardiology
• Environmental Health
• Clinical Research

Background:

• Coronary artery disease (CAD) management often involves percutaneous coronary intervention (PCI).
• The influence of environmental factors like altitude on post-PCI outcomes requires further investigation.
• Previous research has not fully elucidated the impact of altitude on CAD patient prognosis.

Purpose of the Study:

• To investigate the association between living at different altitudes and the prognosis of patients after PCI.
• To determine if altitude is an independent predictor of major adverse cardiovascular events (MACE) in post-PCI patients.
• To analyze the 2-year outcomes of patients with CAD following PCI based on their residential altitude.

Main Methods:

• A post hoc analysis of 5453 patients who underwent PCI was performed.
• Patients were categorized into medium-altitude and low-altitude groups.
• Propensity score matching was utilized to control for confounding variables, followed by a 2-year follow-up to assess endpoint events.

Main Results:

• Patients residing at medium altitude showed a significantly lower risk of MACE (cardiovascular mortality, myocardial infarction, revascularization, stroke) compared to those at low altitude (HR, 0.781; P=0.025).
• A reduced risk of heart-related adverse events (HRAE) was also observed in the medium-altitude group, even after excluding stroke (HR, 0.794; P=0.042).
• No significant differences were found in the incidence of individual MACE components between the altitude groups.

Conclusions:

• Living at medium altitude is associated with a reduced risk of 2-year MACE in patients post-PCI.
• Altitude may play a role in the long-term prognosis of patients with coronary artery disease after PCI.
• Further research is warranted to confirm these findings and explore underlying mechanisms.