1.Alcohol associated liver cirrhotics have higher mortality after index hospitalization: Long-term data of 5,138 patients
Priyanka JAIN ; Saggere Muralikrishna SHASTHRY ; Ashok Kumar CHOUDHURY ; Rakhi MAIWALL ; Guresh KUMAR ; Ankit BHARADWAJ ; Vinod ARORA ; Rajan VIJAYARAGHAVAN ; Ankur JINDAL ; Manoj Kumar SHARMA ; Vikram BHATIA ; Shiv Kumar SARIN
Clinical and Molecular Hepatology 2021;27(1):175-185
Background/Aims:
Liver cirrhosis is an important cause of morbidity and mortality globally. Every episode of decompensation and hospitalization reduces survival. We studied the clinical profile and long-term outcomes comparing alcohol-related cirrhosis (ALC) and non-ALC.
Methods:
Cirrhosis patients at index hospitalisation (from January 2010 to June 2017), with ≥1 year follow-up were included.
Results:
Five thousand and one hundred thirty-eight cirrhosis patients (age, 49.8±14.6 years; male, 79.5%; alcohol, 39.5%; Child-A:B:C, 11.7%:41.6%:46.8%) from their index hospitalization were analysed. The median time from diagnosis of cirrhosis to index hospitalization was 2 years (0.2–10). One thousand and seven hundred seven patients (33.2%) died within a year; 1,248 (24.3%) during index hospitalization. 59.5% (2,316/3,890) of the survivors, required at least one readmission, with additional mortality of 19.8% (459/2,316). ALC compared to non-ALC were more often (P<0.001) male (97.7% vs. 67.7%), younger (40–50 group, 36.2% vs. 20.2%; P<0.001) with higher liver related complications at baseline, (P<0.001 for each), sepsis: 20.3% vs. 14.9%; ascites: 82.2% vs. 65.9%; spontaneous bacterial peritonitis: 21.8% vs. 15.7%; hepatic encephalopathy: 41.0% vs. 25.0%; acute variceal bleeding: 32.0% vs. 23.7%; and acute kidney injury 30.5% vs. 19.6%. ALC patients had higher Child-Pugh (10.6±2.0 vs. 9.0±2.3), model for end-stage liver-disease scores (21.49±8.47 vs. 16.85±7.79), and higher mortality (42.3% vs. 27.3%, P<0.001) compared to non-ALC.
Conclusions
One-third of cirrhosis patients die in index hospitalization. 60% of the survivors require at least one rehospitalization within a year. ALC patients present with higher morbidity and mortality and at a younger age.
2.Multi-link Vision and MiniVision stent registry in Asian patients with coronary artery disease: a prospective, multi-center study.
Ya-Wei XU ; Yi-Dong WEI ; Kai TANG ; Yan-Qing CHEN ; Wei-Ming LI ; Xue-Jing YU ; Yong-Wen QIN ; Guo-Xian QI ; Peng QU ; Yu-Qing HOU ; Ashok JAIN ; Parvez GRANT ; Gudapati RAMESH ; Basavappa RAMESH ; Chumpol PIAMSOMBOON ; Srun KUANPRASERT ; Hyeon-Cheol GWON ; Yoon Haeng CHO ; Haizal Haroon KAMAR ; Cong-Xin HUANG
Chinese Medical Journal 2007;120(12):1093-1096
BACKGROUNDRecent studies have showed that the fine mesh stents are associated with a significant reduction in both clinical and angiographic re-stenosis of the coronary arteries. To maintain a very satisfactory radio-opacity using the stents, Guidant of the USA has designed a new type of bare metal stents (BMS)-Multi-link (ML) Vision/ML MiniVision stents. The clinical outcomes of Asian patients with coronary artery disease (CAD) after implanting the Multi-link Vision or MiniVision stent were investigated in this study.
METHODSAn observational, prospective, multi-center, non-randomized post marketing registry was conducted to demonstrate the efficacy of the BMS-ML Vision/ML MiniVision stents. The primary end point of the registry was clinical target lesion revascularization (TLR) at a 6-month follow-up. The major secondary end points included the rate of major adverse cardiac events (MACE) and serious adverse events (SAE) in hospital and at 6 months; and the rate of clinical TLR as a function of the type of angina. A total of 429 Asian people with 449 lesions from 14 centers were selected for this study. The average reference diameter of the lesions was (3.0 +/- 0.5) mm, and the mean length was (15.7 +/- 5.0) mm.
RESULTSThe successful rate of the procedure was 99.3%. Twenty-five percent of the lesions were treated by direct stenting without pre-dilation. Eighty-six percent of the lesions were implanted with ML Vision stent. After the 6-month follow-up, the rate of clinical TLR was 1.4%. The MACE, SAE and target vessel revascularization (TVR) were 6.8%, 3.5% and 1.4% respectively.
CONCLUSIONThe current registry showed the excellent 6-month clinical outcomes of ML Vision/ML MiniVision stents in Asian patients with CAD.
Aged ; Angioplasty, Balloon, Coronary ; methods ; Chromium Alloys ; Coronary Disease ; therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prospective Studies ; Registries ; Stents