Predictors of Short- and Long-Term Major Adverse Cardiac and Cerebrovascular Events (MACCE) After Percutaneous Coronary Intervention: A Cohort Study on the Data of National Persian Registry of Cardiovascular Disease (N-PROVE)

Abstract

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.