title stringlengths 1 1.19k | keywords stringlengths 0 668 | concept stringlengths 0 909 | paragraph stringlengths 0 61.8k | PMID stringlengths 10 11 |
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PBMC isolation | SEPARATION | After blood sampling in EDTA tubes, PBMCs were isolated from the whole blood by density gradient centrifugation (Lymphocyte Separation Medium, CMSMSL0101, Eurobio) with SepMate tubes (85460, STEMCELL Technologies). Whole blood was transferred into SepMate tubes at a rate of 17 ml of whole blood per tube and then centri... | PMC10427431 | |
Cytometry analysis | At each blood sample, before or during the patient’s treatment, we performed immunophenotyping by flow cytometry. | PMC10427431 | ||
Blood count analysis | anti-CD15-PacificBlue | FLUOR, LYSIS | Antibodies for blood count analysis: multi-color flow cytometry was performed using Beckman Coulter’s custom design service and its dry coating technology, and custom tubes containing anti-CD16-FITC (clone 3G8), anti-CD56-PE (clone N901), anti-CD19-PE-Cy5.5 (clone J3-119), anti-CD14-PE-Cy7 (clone RMO52), anti-CD4-APC (... | PMC10427431 |
Immune cell populations identification | anti-PD1-PE-Cy7, anti-CD15-PacificBlue | FLUOR, LYSIS | To decipher the peripheral immune system, we performed five panels to identify and characterize the different lymphocyte and myeloid subpopulations.Antibodies for T cell analysis (first panel): using Beckman Coulter’s custom design service and its dry coating technology, custom tubes containing anti-CD183-FITC (clone G... | PMC10427431 |
Lymphocyte function analysis | FLUOR | Using Beckman Coulter’s custom design service and its dry coating technology, custom tubes containing anti-IFN-γ-FITC (clone 45.15), anti-CD25-PE (clone B1.49.9), anti-CD4-PE-Cy5.5 (clone 13B8.2), anti-IL-4-PE-Cy7 (clone MP4-25D2), anti-Foxp3-Alexa Fluor 647 (clone 259D), anti-TNF-α-Alexa Fluor 700 (clone IPM2), anti-C... | PMC10427431 | |
DNA and RNA extraction | tumor, Tumor | BLOOD, TUMOR, TUMOR | After the evaluation of the tumor cell content in FFPE tumor specimens by a pathologist, samples were macro-dissected to obtain at least 80% tumor cell content for nucleic acid extraction. DNA was isolated from tumor tissue using the Maxwell 16 FFPE Plus LEV DNA Purification Kit (Promega). DNA from whole blood (germlin... | PMC10427431 |
Whole-exome capture and sequencing | Two hundred nanograms of genomic DNA was used for library preparation, using the Agilent SureSelectXT Reagent Kit. The totality of the enriched library was used in the hybridization and captured with SureSelect All Exon v5 or v6 (Agilent) baits. After hybridization, the captured libraries were purified according to the... | PMC10427431 | ||
RNA-seq | RNA depleted of ribosomal RNA was used for the library preparation with a NEBNext Ultra II RNA Directional Library Prep Kit for Illumina according to the manufacturer’s instructions (New England Biolabs). RNA-seq was performed on a NextSeq 500 device (Illumina). The libraries were sequenced with 76-bp paired-end reads. | PMC10427431 | ||
scRNA-seq | tumor, Tumor | TUMOR, TUMOR | This analysis was performed on one patient with complete response. Fresh tumor tissue was collected on the day of surgery for this patient. Tumor was mechanically and enzymatically dissociated using a human tumor dissociation kit, according to the manufacturer’s instructions (130-095-929, Miltenyi Biotec). In brief, tu... | PMC10427431 |
Immunohistology procedure | tumor | TUMOR, PATHOLOGY | Biopsies were collected before study entry (archival materials), at baseline or during treatment and were fixed after collection in paraformaldehyde and embedded in paraffin by the pathology laboratory. Four-micron slices were cut from FFPE tumor samples. The tissues embedded in paraffin were cut on a Leica rotary micr... | PMC10427431 |
Imaging mass cytometry | PMC10427431 | |||
Antibodies and metal conjugation | Antibodies other than provided ready to use by Standard BioTools were conjugated to purified lanthanide metals and eluted in antibody stabilizer buffer (CANDOR Bioscience) using the Maxpar X8 Antibody Labeling Kit according to the manufacturer’s instructions (PRD002 Rev 14, Fluidigm, Standard BioTools). CD15 was labele... | PMC10427431 | ||
Antibody staining | SECONDARY | After deparaffinization and antigen retrieval using Dako Target Retrieval Solution at pH 9 (S236784-2, Agilent) in a water bath (96 °C for 30 min), 3-µm tissue sections were encircled with a Dako Pen and incubated with SuperBlock (37515, Thermo Fisher Scientific) at room temperature for 45 min and then with FcR Blockin... | PMC10427431 | |
Data acquisition | Images were acquired with the Hyperion Imaging System (Fluidigm, Standard BioTools) according to the manufacturer’s instructions. After choosing the region of interest (ROI) in the section, the ROI was ablated with a UV laser at 200 Hz. Data were exported as .mcd files and visualized using Fluidigm MCD viewer 1.0.560.6... | PMC10427431 | ||
Imaging mass cytometry data pre-processing and cell segmentation | The raw data (.mcd files) were processed with the Steinbock pipeline (version 0.15.0) | PMC10427431 | ||
Cytokine measurement | tumor necrosis | TUMOR NECROSIS | Forty-five analytes were quantified in the plasma using Human XL Cytokine Magnetic 45-plex Luminex Assay (898855, R&D Systems) according to the manufacturer’s instructions: C-C motif chemokine ligand 2 (CCL2), CCL3, CCL4, CCL5, CCL11, CCL19, CCL20, CD40 ligand, fractalkine, C-X-C motif chemokine ligand 1 (CXCL1), CXCL2... | PMC10427431 |
ELISpot assay | tumor | TUMOR | Circulating tumor-specific T cell responses were assessed by IFN-γ ELISpot after short-term in vitro stimulation of PBMCs with a mixture of eight TERT-derived MHC class II-binding peptides (pool of HLA-DR and HLA-DP-restricted TERT peptidesThe same experiment was conducted after synthesis of 14 neopeptides identified f... | PMC10427431 |
Whole-exome sequencing data analysis | Cancer | MUTANT, CANCER | Reads in the FASTQ format were aligned to the reference human genome GRCh37 using the Burrows–Wheeler aligner (BWA version 0.7.17). Local realignment was performed using the Genome Analysis Toolkit (GATK version 4.13.0). Duplicate reads were removed using Picard version 2.5. In case of matched tumor-normal samples, som... | PMC10427431 |
RNA-seq data analysis | Raw FASTQ data were pseudo-aligned, and gene counts as well as transcripts per kilobase million (TPM) were quantified using Kallisto softwareTumor microenvironment (TME)-associated transcriptomic elements were quantified using MCP-counter, ImmuCellAI and tools, following respective guidelines. The MCP-counterThe CMScal... | PMC10427431 | ||
Single-cell data analysis | Cell Ranger (version 3.1.0) was used for raw data pre-processing. Each library was aligned to an indexed hg19 genome using Cell Ranger count. Output from Cell Ranger was loaded into R and further analyzed using the Seurat pipeline (version 3.1.2). Dimensional reduction, clustering and differential expression analysis o... | PMC10427431 | ||
TCR sequence analysis | TCR sequencing was used to count clonotypes detected in more than two cells per sample. A cell’s clonotype was defined as the combined alpha and beta chain CDR3 nucleotide sequences for that cell. As it was not possible to deduce beta and alpha chain pairing for partitions with multiple beta chains, these partitions we... | PMC10427431 | ||
Statistical analysis | death | DISEASE PROGRESSION, EVENT, METASTASIS | The efficacy population included all participants who met the eligibility criteria and who received at least one complete or two incomplete treatment cycles. All enrolled patients who initiated the study treatment were included in the safety analysis.PFS was defined as the time from the date of metastasis diagnosis to ... | PMC10427431 |
Reporting summary | Further information on research design is available in the | PMC10427431 | ||
Online content | Any methods, additional references, Nature Portfolio reporting summaries, source data, extended data, supplementary information, acknowledgements, peer review information; details of author contributions and competing interests; and statements of data and code availability are available at 10.1038/s41591-023-02497-z. | PMC10427431 | ||
Supplementary information |
Supplementary Figs. 1–8, Supplementary Tables 1–8, Protocol Clinical Study and CONSORT 2010 Checklist.Reporting Summary | PMC10427431 | ||
Source data |
Statistical source data.Statistical source data.Statistical source data.Statistical source data.Statistical source data.Statistical source data.Statistical source data.Statistical source data.Statistical source data.Statistical source data.Statistical source data.Statistical source data.Statistical source data.Statist... | PMC10427431 | ||
Extended data | PMC10427431 | |||
Extended data | is available for this paper at 10.1038/s41591-023-02497-z. | PMC10427431 | ||
Supplementary information | The online version contains supplementary material available at 10.1038/s41591-023-02497-z. | PMC10427431 | ||
Acknowledgements | Cancer | CANCER | We acknowledge O. Jaen (Beckman Coulter) for the help with flow cytometry panel design. We thank the GenomEast platform, a member of the ‘France Génomique’ consortium (ANR-10-INBS- 0009) for scRNA-seq and RNA-seq. We also thank the Cytometry platform (IGBMC, Strasbourg) for the sorting experiments related to scRNA-seq.... | PMC10427431 |
Author contributions | RECRUITMENT | F.G. was the coordinating investigator of the study and was responsible for study conception and design and acquisition of funding and approvals. He also contributed as an investigator and medical monitor and to patient recruitment, data collection and data interpretation. The paper was written by F.G., M.T. and C.T., ... | PMC10427431 | |
Peer review | PMC10427431 | |||
Data availability | The RNA-seq and single-cell data generated in this study have been deposited in the Gene Expression Omnibus database under accession number | PMC10427431 | ||
Competing interests | Pierre, J.B. | ONCOLOGY | F.G. received fees for oral communication from Eli Lilly, Sanofi, Bristol Myers Squibb, AstraZeneca and Amgen, received funding for clinical trials from AstraZeneca, received travel grants from Roche France, Amgen and Servier and is an advisory board member for Merck Serano, Amgen, Roche France and Sanofi, all outside ... | PMC10427431 |
References | PMC10427431 | |||
Abstract | Serban Stoica and Helena J M Smartt contributed equally to this work.
| PMC10097434 | ||
OBJECTIVES | COLD | Intermittent cold blood cardioplegia is commonly used in children, whereas intermittent warm blood cardioplegia is widely used in adults. We aimed to compare clinical and biochemical outcomes with these 2 methods. | PMC10097434 | |
METHODS | A single-centre, randomized controlled trial was conducted to compare the effectiveness of warm (≥34 | PMC10097434 | ||
RESULTS | deaths | COLD | 97 participants with median age of 1.2 years were randomized (49 to warm, 48 to cold cardioplegia); 59 participants (61%) had a risk-adjusted congenital heart surgery score of 3 or above. There were no deaths and 92 participants were followed to 3-months. Troponin release was similar in both groups [geometric mean rati... | PMC10097434 |
CONCLUSIONS | arrest | ARREST | Warm blood cardioplegia is a safe and reproducible technique but does not provide superior myocardial protection in paediatric heart surgery.Myocardial protection is typically achieved via cardioplegic arrest. | PMC10097434 |
INTRODUCTION | low cardiac output syndrome, arrest | DEL, ARREST, COMPLICATIONS, LOW CARDIAC OUTPUT SYNDROME | Myocardial protection is typically achieved via cardioplegic arrest. Several variables affect myocardial protection, including the type of crystalloid solution, mixing with blood, dose and frequency of delivery, and temperature. Sound protection and a technically adequate repair are cornerstones of surgery. Minimizing ... | PMC10097434 |
MATERIALS AND METHODS | PMC10097434 | |||
Ethical approval | Ethical approval was granted by the London—Central Ethics Service Committee (reference 18/LO/0205, 7 March 2018). Patients and/or parents/guardians provided written informed consent for randomization and use of their data. | PMC10097434 | ||
Trial design | Thermic-3 is a single-centre, parallel-group RCT. Participants were allocated in a 1:1 ratio to receive either antegrade ICBC or IWBC. Participants were followed-up for 3 months after randomization. Details of the study rationale and design are reported elsewhere [ | PMC10097434 | ||
Participants and setting | arrest, atrial septal defect | CIRCULATORY ARREST, ARREST | Patients aged ≤18 years undergoing congenital heart surgery requiring CPB and cardioplegic arrest at the Bristol Royal Hospital for Children, a regional congenital cardiac surgery centre in the UK, were screened for eligibility. Patients weighing <3 kg, those requiring emergency surgery or secundum atrial septal defect... | PMC10097434 |
Interventions | electromechanical arrest of the heart | STERILE | Participants received either IWBC (blood cardioplegia at the same temperature as the body, ≥34°C) or ICBC (blood cardioplegia at 4–6°C) during surgery.The route of cardioplegia infusion for both groups was usually into the aortic root, or selectively into the coronary arteries. All surgeons used the same established ca... | PMC10097434 |
Outcomes | The primary outcome was cardiac troponin T (cTnT) over the 1st 48 postoperative hours. Secondary outcomes were cardiac function (left and right ventricular function by echocardiography), circulatory function [central venous saturations (CVS), arterial saturations, base deficit, blood lactate], blood gas and blood sampl... | PMC10097434 | ||
Sample size | The sample size was 94 patients (47/group), which provided 80% power to detect a difference of 0.46 standard deviations in cTnT, assuming correlations between pre- and post-surgery measures of 0.3 and between the post-surgery measures of 0.5, 5% statistical significance (2-tailed) and allowing for up to 15% missing dat... | PMC10097434 | ||
Randomization | HEART | Randomization was stratified by surgical complexity [Risk Adjustment for Congenital Heart Surgery (RACHS) score <3 vs ≥3]. Random allocations were computer-generated using blocks with varying sizes, prepared by a statistician independent of the study team. Allocations were concealed until a patient was recruited and re... | PMC10097434 | |
Blinding | Staff providing postoperative care were blinded to the participants’ allocation. Documents containing allocation information (e.g. anaesthetic and perfusion charts) were placed in a sealed envelope within the medical notes. Staff accessing the contents of the sealed envelope were asked to record their name and reason f... | PMC10097434 | ||
Statistical methods | REGRESSION, EVENT | Analyses were based on a pre-specified statistical analysis plan and performed on an intention-to-treat basis. Continuous outcomes were compared using linear regression, time to event outcomes using Cox regression, categorical/ordinal outcomes using logistic regression and continuous longitudinal outcomes using linear ... | PMC10097434 | |
RESULTS | PMC10097434 | |||
Recruitment | MAY | Between May 2018 and April 2020, 479 patients were screened for inclusion and 234 (49%) were eligible (There were 29 protocol deviations (12 ICBC versus 17 IWBC, | PMC10097434 | |
Baseline data | mitral valve replacement, tricuspid valve repair and right ventricular, ventricular septal defect, Ebstein’s repair, pulmonary and tricuspid valve, atrioventricular septal defect | HEART, COLD | The median age was 1.2 years (range <1 month to 16.3 years): patients allocated IWBC were, on average, 7 months older than those allocated ICBC (median 11 and 18 months, respectively; Table Demography and intraoperative detailsData missing for 1 patient (ICBC).Other procedures were: ICBC group—double outlet right ventr... | PMC10097434 |
Operative details | Operative characteristics were similar in the 2 groups; the median duration of cross-clamp and CPB was 70 min and 100 min respectively, with 3- and 5-min difference between groups. The overall median duration of surgery was 225 min and blood product use was similar (Table | PMC10097434 | ||
Primary outcome | cTnT concentrations are illustrated in Fig. ( | PMC10097434 | ||
Secondary outcomes | BLOOD | The median postoperative chest drain loss was 75 ml in both groups (GMR 1.04; 95% CI 0.82–1.32; Electrical activity is shown in Cardiac function data are shown in Figs Blood gas levels over time. Geometric mean and 95% CI at each time point and GMR and 95% CI for the effect of IWBC versus ICBC on lactate ( | PMC10097434 | |
Complications and hospital readmissions | death, low cardiac output, stroke, Low cardiac output, neurological defects, paraplegia, Hirschsprung’s disease, disability | TRANSIENT ISCHAEMIC ATTACK, STROKE, RECURRENT LARYNGEAL NERVE PALSY, PARAPLEGIA, COLD, COMPLICATIONS, COMPLICATIONS | In the period from surgery to hospital discharge, there were 185 complications reported (69 ICBC, 116 IWBC), of which 30 (5 ICBC vs 25 IWBC) were classified as serious (Table Complications following surgeryComplications that were life-threatening or that caused hospitalization, increased length of hospital admission, p... | PMC10097434 |
DISCUSSION | Cardiac and renal function | EVENTS, COMPLICATIONS | Our results show that there is no difference in myocardial protection in the 1st 48 h when ICBC and IWBC are used, as evidenced by the similar cTnT profiles in the 2 groups. Cardiac and renal function were also comparable. However, participants in the IWBC group had on average a longer stay in PICU and experienced more... | PMC10097434 |
Strengths and limitations | myocardial damage | SEPARATION, COLD | This is one of few adequately powered RCTs focused on paediatric myocardial protection. Strengths are: inclusivity of the eligibility criteria; concealed allocation to minimize selection bias; objective outcomes and blinding to minimize detection bias, and minimal attrition. Stratification by RACHS score ensured the mo... | PMC10097434 |
CONCLUSION | In this single-centre trial of myocardial protection with St Thomas’ solution and normothermic bypass, IWBC is a safe and reproducible technique, but it does not provide superior myocardial protection to ICBC. Whether IWBC is advantageous for the most complex patients is uncertain as they are not represented in suffici... | PMC10097434 | ||
Supplementary Material | Click here for additional data file. | PMC10097434 | ||
ACKNOWLEDGEMENTS | We thank the research nurses, intensive care unit staff, anaesthetists, cardiologists and perfusionists who supported this research. | PMC10097434 | ||
SUPPLEMENTARY MATERIAL | PMC10097434 | |||
Funding | HEART | This work was supported by the British Heart Foundation (PG/15/33/31394/BHF, CH/1992027/7163/BHF, CH/17/1/32804/BHF) and the National Institute for Health Research (NIHR) Bristol Biomedical Research Centre. The funders played no role in the design, collection, analysis and interpretation of data. This trial was designe... | PMC10097434 | |
DATA AVAILABILITY | SECONDARY | Anonymized individual patient data will be made available upon request to the corresponding author for secondary research, conditional on assurance from the secondary researcher that the proposed use of the data is compliant with the Medical Research Council Policy on Data Sharing regarding scientific quality, ethical ... | PMC10097434 | |
Author contributions | PMC10097434 | |||
Reviewer information | European Journal of Cardio-Thoracic Surgery thanks Rodrigo Soto and the other anonymous reviewer(s) for their contribution to the peer review process of this article. | PMC10097434 | ||
MAY, THORACIC | Presented at the American Association of Thoracic Surgery 102nd Annual Meeting, Boston, MA, USA, 14–17 May 2022. | PMC10097434 | ||
REFERENCES | PMC10097434 | |||
ABBREVIATIONS | HEART | Confidence intervalsCardiopulmonary bypassCardiac troponin TCentral venous saturationsGeometric mean ratioHazard ratioIntermittent cold blood cardioplegiaIntermittent warm blood cardioplegiaPaediatric Intensive Care UnitRisk Adjustment for Congenital Heart SurgeryRandomized controlled trialsVasoactive-inotrope score | PMC10097434 | |
Key Points | PMC10687657 | |||
Question | chronic kidney disease | Is intravascular imaging beneficial in patients with complex coronary lesions and chronic kidney disease? | PMC10687657 | |
Findings | vessel failure, cardiac death, chronic kidney disease | MYOCARDIAL INFARCTION, CARDIAC DEATH | In this prespecified cohort substudy of the RENOVATE-COMPLEX-PCI trial with 1639 patients with or without chronic kidney disease, intravascular imaging–guided revascularization was associated with significantly lower incidence of the target vessel failure (a composite of cardiac death, myocardial infarction, or target ... | PMC10687657 |
Meaning | coronary artery lesions, vessel failure | These findings suggest that in patients with complex coronary artery lesions, intravascular imaging–guided revascularization was superior to angiography-guided revascularization in reducing the risk of target vessel failure, regardless of kidney function. | PMC10687657 | |
Importance | coronary lesions, CKD, chronic kidney disease | As patients with chronic kidney disease (CKD) are more likely to have complex coronary lesions, intravascular imaging guidance in percutaneous coronary intervention (PCI) for this population could be potentially beneficial. | PMC10687657 | |
Objectives | CKD | To investigate whether the outcomes of intravascular imaging–guided procedural optimization would be different according to the presence of CKD. | PMC10687657 | |
Design, Setting, and Participants | CKD | MAY | This was a prespecified substudy of RENOVATE-COMPLEX-PCI, a recently published multicenter randomized clinical trial in Korea studying the benefits of intravascular imaging for complex coronary lesions. Patients with complex coronary lesions, with or without CKD, were enrolled between May 2018 and May 2021. Data were a... | PMC10687657 |
Interventions | PCI in each group was done either under the guidance of intravascular imaging or angiography alone. | PMC10687657 | ||
Main Outcomes and Measures | vessel failure, TVF | MYOCARDIAL INFARCTION, CARDIAC DEATH | The primary end point was target vessel failure (TVF) at the 3-year point, defined as a composite of cardiac death, target vessel–related myocardial infarction, or clinically driven target vessel revascularization. | PMC10687657 |
Results | CKD, non-CKD | A total of 1639 patients (1300 male [79.3%]) treated with PCI for complex coronary lesions were stratified into CKD (296 participants) and non-CKD (1343 participants) groups. The mean (SD) age of each group was 70.3 (9.4) and 64.5 (10.1) years, and mean (SD) estimated serum creatinine was 2.9 (5.3) and 0.8 (0.2) mg/dL ... | PMC10687657 | |
Conclusions and Relevance | CKD | In this prespecified cohort substudy of the Randomized Controlled Trial of Intravascular Imaging Guidance versus Angiography-Guidance on Clinical Outcomes After Complex Percutaneous Coronary Intervention trial, intravascular imaging guidance showed clinical benefit over angiography guidance in reducing the risk of TVF,... | PMC10687657 | |
Trial Registration | ClinicalTrials.gov Identifier: | PMC10687657 | ||
Introduction | AIDS, CHRONIC KIDNEY DISEASE (CKD), CARDIOVASCULAR MORBIDITY | Chronic kidney disease (CKD) is a prevalent condition associated with increased cardiovascular morbidity and mortality.Intravascular imaging tools, such as intravascular ultrasound (IVUS) and optical coherence tomography (OCT), are useful aids in optimizing stent implantation and securing positive clinical outcomes. | PMC10687657 | |
Methods | PMC10687657 | |||
Trial Design and Patient Selection | The RENOVATE-COMPLEX-PCI was an investigator-initiated, randomized, open-label, multicenter, superiority trial at 20 sites in Korea. The design and primary results have been described previously. | PMC10687657 | ||
Randomization and Treatment | coronary artery lesions | Eligible patients with amenable complex coronary artery lesions were randomized in a 2:1 ratio to the intravascular imaging–guided PCI group or the angiography-guided PCI group. Randomization was performed by a web-based program run by an independent organization and stratified according to clinical presentation and pa... | PMC10687657 | |
Definitions and End Points | CKD | MAY | CKD was defined if the patient previously received a diagnosis of CKD (supported either by medical record or history-taking) or if the estimated glomerular filtration rate (GFR) was below 60mL/min/1.73mPatient follow-up was conducted at 1, 6, and 12 months and annually thereafter. The clinical follow-up was completed i... | PMC10687657 |
Statistical Analysis | The full statistical analysis plan and sample size calculation of the RENOVATE-COMPLEX-PCI were previously described in detail. | PMC10687657 | ||
Results | PMC10687657 | |||
Baseline Demographics | CKD | Of the 1639 patients (1300 male [79.3%]) enrolled in this trial, 296 patients (mean [SD] age, 70.3 [9.4] years) had CKD (203 patients undergoing imaging-guided PCI and 93 patients undergoing angiography-guided PCI) and 1343 patients (mean [SD] age, 64.5 [10.1] years) did not have CKD (889 patients undergoing imaging-gu... | PMC10687657 | |
Baseline Characteristics Stratified by Presence of Chronic Kidney Disease (CKD) and Allocation Group | Abbreviations: GFR, glomerular filtration rate; LV, left ventricle; PCI, percutaneous coronary intervention.SI conversion factor: To convert creatinine to micromoles per liter, multiply by 76.25.Of the total 1639 patients, 104 (6.3%) had no LV ejection fraction. | PMC10687657 | ||
Angiographic and Procedural Characteristics | CKD, non-CKD | A comparison of angiographic and procedural characteristics between CKD and non-CKD groups is shown in eTable 2 in Angiographic characteristics and lesion complexity between the 2 randomly assigned strategies were generally well balanced, regardless of the presence of CKD (In lesion-level analysis, the location of the ... | PMC10687657 | |
Comparison of Primary End Points According to Chronic Kidney Disease (CKD) and Glomerular Filtration Rate (GFR) | vessel failure, CKD, diabetes | HYPERTENSION, DYSLIPIDEMIA, ACUTE CORONARY SYNDROME, DIABETES | A, The Kaplan-Meier curve shows the cumulative incidence of target vessel failure in patients with (orange line) or without (blue line) CKD who underwent complex percutaneous coronary intervention. B, Continuous association of GFR with cumulative hazard of the target vessel failure is presented. Adjusted variables incl... | PMC10687657 |
Primary and Secondary End Points in Patients With Chronic Kidney Disease | MYOCARDIAL INFARCTION, ACUTE CORONARY SYNDROME | Abbreviations: HR, hazard ratio; MI, myocardial infarction; NA, not applicable.Percentages are 3-year Kaplan-Meier estimates.Adjusted variables for multivariable analysis were age, sex, acute coronary syndrome, history of percutaneous coronary intervention, 3 or more complex coronary lesions, use of adjunctive noncompl... | PMC10687657 | |
Comparison of Target Vessel Failure Between Imaging-Guided and Angiography-Guided Percutaneous Coronary Intervention (PCI), Stratified by the Presence of Chronic Kidney Disease (CKD) | vessel failure | The Kaplan-Meier curve shows the cumulative incidence of target vessel failure in intravascular imaging-guided PCI (orange line) and angiography-guided PCI (blue line) for patients with (A) or without (B) CKD.Among the non-CKD population, the primary end point occurred in 54 of 889 patients in the intravascular imaging... | PMC10687657 | |
Primary and Secondary End Points in Patients Without Chronic Kidney Disease | MYOCARDIAL INFARCTION, ACUTE CORONARY SYNDROME | Abbreviations: HR, hazard ratio; MI, myocardial infarction; NA, not applicable.Percentages are 3-year Kaplan-Meier estimates.Adjusted variables for multivariable analysis were age, sex, acute coronary syndrome, history of percutaneous coronary intervention, 3 or more complex coronary lesions, and use of adjunctive nonc... | PMC10687657 | |
Outcome Differences Between Intravascular Imaging- and Angiography-Guided PCI According to GFR | eFigure 5 in | PMC10687657 | ||
Discussion | coronary artery lesions, cardiac death, CKD, uremia | CARDIAC DEATH, ISCHEMIC HEART DISEASE, UREMIA | In this prespecified substudy of the RENOVATE-COMPLEX-PCI, we aimed to investigate whether the benefit of intravascular imaging–guided PCI differs according to the presence of CKD. A summary of the findings is as follows. First, patients with CKD had a 2-fold higher risk of TVF than those without CKD after PCI for comp... | PMC10687657 |
Limitations | bleeding, CKD | EVENT, BLEEDING | This study has several limitations. First, an uneven proportion of choice for intravascular imaging devices resulted in only a small fraction of OCT, and its benefit and harm could not be accurately compared with IVUS or angiography alone. A relatively small CKD population also limits interpretation from the comparison... | PMC10687657 |
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