Men demonstrated a significant survival advantage compared with women (841% versus 821%, P<0.001), and survival was directly proportional to the level of LV dysfunction present at the time of index procedure (LV grade 1 or 2 2, 861%; grade 3, 712%; and grade 4, 4945%, P<0.001). of all cases. The all-cause mortality rate at seven years follow-up was 10.6%. Repeat PCI occurred in 14.2% of patients, and coronary artery bypass grafting in 4.2%. Men showed a significant unadjusted survival advantage compared with women. Procedural characteristics such as incomplete revascularization and residual stenosis, in addition to established risk factors, were predictors of poorer long-term outcomes. Cardiogenic shock was the strongest predictor of late mortality. == CONCLUSION: == In the present large registry of all-comers for PCI, long-term major adverse cardiac event rates were low and consistent with outcomes from randomized controlled trials. These data reflect a large cohort in real-world clinical practice, and may help clinicians further characterize and better treat high-risk patients who are undergoing PCI. Keywords:Clinical outcomes, Mortality, PCI == Abstract == == HISTORIQUE : == Des essais contrls et randomiss font tat des rsultats court et moyen terme des interventions coronariennes percutanes (ICP), mais leur applicabilit la population gnrale est inconnue. On dispose de trop peu de donnes sur lissue clinique long terme chez les patients qui subissent une ICP. == OBJECTIF : == Dterminer lissue long terme de lICP chez tous les patients qui y ont t soumis dans un grand centre de soins cardiaques tertiaires. == MTHODE : == En tout, on a recens 12 662 patients conscutifs soumis une premire intervention qui ont t inscrits au registre prospectif du Rseau universitaire de sant (Toronto, Ontario) entre avril 2000 Acetoacetic acid sodium salt et septembre 2007. Les auteurs ont valu lissue perhospitalire. Ils ont obtenu des donnes de suivi auprs dun registre provincial intgr. Ils ont effectu une analyse de Kaplan-Meier pour calculer les taux de survie non ajusts et lanalyse de rgression multiple de Cox a permis de dgager des prdicteurs indpendants de mortalit tardive, de complications cardiaques majeures et de complications cardiovasculaires, tous types confondus. == RSULTATS : == La population comprenait une cohorte de patients risque relativement lev, dont 19 % avaient plus de 75 ans, 28 % souffraient de diabte, 61 %, de maladie plurivasculaire et 1,3 %, de choc cardiognique. Les interventions taient urgentes dans 53 % de tous les cas. Le taux de mortalit de toutes causes aprs sept ans de suivi tait de 10,6 %; 14,2 % des patients ont subi une autre ICP, tandis que 4,2 % ont subi un pontage coronarien. Les hommes ont prsent un avantage significatif sur le plan de la survie non ajuste, comparativement aux femmes. Les caractristiques des interventions, comme revascularisation incomplte et stnose rsiduelle, en plus des facteurs de risque tablis se sont rvles des prdicteurs dun pitre pronostic long terme. Le choc cardiognique a t le plus important prdicteur de mortalit tardive. == CONCLUSIONS : == Dans ce volumineux registre de tous les patients soumis une ICP, les taux de complications cardiaques majeures long terme ont t faibles et ont concord avec les rsultats des essais randomiss et contrls. Ces donnes sont le reflet de la pratique clinique concrte auprs dune importante cohorte et Acetoacetic acid sodium salt pourraient aider les cliniciens caractriser davantage et traiter plus efficacement les patients haut risque qui doivent subir une ICP. The introduction of coronary stent implantation heralded a major advance in percutaneous coronary intervention (PCI), with dramatically improved in-hospital mortality and morbidity compared with plain old balloon angioplasty for the treatment of coronary artery disease. Several randomized controlled trials (RCTs) have established the superior long-term safety and efficacy of bare-metal stenting (BMS) compared with Acetoacetic acid sodium salt plain old balloon angioplasty (13). The introduction of drug-eluting stents (DES) resulted in a further significant reduction in restenosis, and has been associated with improved procedural outcomes in a more complex subset of patients and lesions (47). Thus, coronary stenting using bare-metal or drug-eluting platforms Rabbit polyclonal to YY2.The YY1 transcription factor, also known as NF-E1 (human) and Delta or UCRBP (mouse) is ofinterest due to its diverse effects on a wide variety of target genes. YY1 is broadly expressed in awide range of cell types and contains four C-terminal zinc finger motifs of the Cys-Cys-His-Histype and an unusual set of structural motifs at its N-terminal. It binds to downstream elements inseveral vertebrate ribosomal protein genes, where it apparently acts positively to stimulatetranscription and can act either negatively or positively in the context of the immunoglobulin k 3enhancer and immunoglobulin heavy-chain E1 site as well as the P5 promoter of theadeno-associated virus. It thus appears that YY1 is a bifunctional protein, capable of functioning asan activator in some transcriptional control elements and a repressor in others. YY2, a ubiquitouslyexpressed homologue of YY1, can bind to and regulate some promoters known to be controlled byYY1. YY2 contains both transcriptional repression and activation functions, but its exact functionsare still unknown has become the cornerstone of PCI, and the indications for PCI have vastly expanded beyond those originally proposed. Pooled data from randomized DES trials have shown acceptable rates of all-cause mortality, myocardial infarction (MI) and revascularization in extended follow-up, up to four years (8). Although RCTs have excellent internal validity, direct extrapolation of their findings to the general population has been problematic due to their restrictive inclusion and.