Key result
Preprocedural TIMI flow 0-I is linked to ~131% higher 1-month MACCE risk after PCI.
Why the study?
Identifying predictors of short- and long-term MACCE after PCI in specific populations such as the Iranian cohort can aid in improving outcomes.
Cohort (n=1,921)
No
Hazard Ratio: 2.31 (95% CI 1.53–3.49)
May aid short-term risk stratification after PCI for ACS; leaves open whether targeted interventions reduce MACCE.
Background and Aims Major adverse cardiac and cerebrovascular events (MACCE) are significant complications following percutaneous coronary intervention (PCI). Identifying the predictors of these events can aid in improving outcomes, especially in specific populations such as the Iranian cohort. This study aims to investigate the incidence and predictors of short‐ and long‐term MACCE after PCI in patients from the National Persian Registry of Cardiovascular Disease (N‐PROVE). Methods We conducted a cohort study involving 1921 patients who underwent PCI for acute coronary syndrome at Razi Hospital, Birjand, Iran. Data on demographics, medical history, procedural details, and follow‐up outcomes were collected. The primary endpoint was the occurrence of MACCE, including all‐cause mortality, myocardial infarction (MI), cerebrovascular accident (CVA), and target‐vessel revascularization (TVR), at 1‐, 6‐, and 12‐months post‐PCI. Predictors of MACCE were identified using univariate and multivariate Cox proportional hazards models. Results MACCE occurred in 8.5% of patients at 1 month, 13.7% at 6 months, and 17.9% at 12 months post‐PCI. Independent predictors of MACCE included age ≥ 75 years, female sex, diabetes mellitus (DM), multi‐vessel disease (MVD), and poor TIMI flow. Multivariate analysis confirmed DM (HR 1.52, 95% CI 1.07–2.23), 2VD (HR 1.59, 95% CI 1.05–2.42), 3VD (HR 1.55, 95% CI 1.01–2.75), and TIMI flow 0‐I (HR 2.31, 95% CI 1.53–3.49) as significant predictors. Conclusions The study highlights key predictors of MACCE, particularly age, sex, DM, and TIMI flow. These findings underscore the need for tailored interventions for high‐risk groups, especially elderly patients and those with MVD, to improve long‐term outcomes following PCI.
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Azdaki et al. (2026) conducted a cohort in Acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) (n=1,921). Preprocedural TIMI flow 0-I vs. TIMI flow III was evaluated on Major adverse cardiac and cerebrovascular events (MACCE) at 1 month (HR 2.31, 95% CI 1.53-3.49). Preprocedural TIMI flow 0-I (HR 2.31), diabetes mellitus (HR 1.52), and multi-vessel disease were identified as significant independent predictors of major adverse cardiac and cerebrovascular events at 1 month following percutaneous coronary intervention.
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