BACKGROUND: Little is known about the impact of technological and pharmacological advances on long-term outcome after percutaneous coronary intervention in general clinical practice. METHODS AND RESULTS: We analyzed in-hospital and long-term outcome of 24,410 percutaneous coronary interventions among 18,575 unique patients who underwent percutaneous coronary intervention at Mayo Clinic over 25 years. The study population was divided into group 1 (n=3708), coronary interventions from 1979 to 1989; group 2 (n=7020), interventions from 1990 to 1996; group 3 (n=10,952), interventions from 1996 to 2003; and group 4 (n=2730), interventions from 2003 to 2004. Despite the fact that patients in groups 3 and 4 were significantly older, sicker, and had greater prevalence of comorbid conditions, heart failure, and previous revascularization than those in groups 1 and 2, procedural success in groups 3 and 4 improved significantly (94%) versus groups 2 (89%) and 1 (78%) (P<0.001). Significant reduction in in-hospital mortality (groups 4 to 1: 1.8%, 1.7%, 2.6%, 3.0%; P<0.001) and need for emergency bypass surgery (groups 4 to 1: 0.4%, 0.5%, 1.6%, 5%; P<0.001) was noted in groups 3 and 4 compared with groups 1 and 2. Better adherence to currently recommended evidence-based medications for secondary prevention was seen in the recent time periods. After adjustment, significant reduction in follow-up mortality (hazard ratio, 0.81 and 0.74 for groups 3 and 4, respectively); death or myocardial infarction (hazard ratio, 0.80 and 0.75 for groups 3 and 4, respectively); death, myocardial infarction, or revascularization (hazard ratio, 0.76 and 0.58 for groups 3 and 4, respectively) was noted in recent time periods. CONCLUSIONS: Despite higher-risk profiles of patients who underwent percutaneous coronary intervention in recent time periods, procedural success as well as in-hospital and long-term outcomes improved significantly over the last 25 years.
BACKGROUND: Little is known about the impact of technological and pharmacological advances on long-term outcome after percutaneous coronary intervention in general clinical practice. METHODS AND RESULTS: We analyzed in-hospital and long-term outcome of 24,410 percutaneous coronary interventions among 18,575 unique patients who underwent percutaneous coronary intervention at Mayo Clinic over 25 years. The study population was divided into group 1 (n=3708), coronary interventions from 1979 to 1989; group 2 (n=7020), interventions from 1990 to 1996; group 3 (n=10,952), interventions from 1996 to 2003; and group 4 (n=2730), interventions from 2003 to 2004. Despite the fact that patients in groups 3 and 4 were significantly older, sicker, and had greater prevalence of comorbid conditions, heart failure, and previous revascularization than those in groups 1 and 2, procedural success in groups 3 and 4 improved significantly (94%) versus groups 2 (89%) and 1 (78%) (P<0.001). Significant reduction in in-hospital mortality (groups 4 to 1: 1.8%, 1.7%, 2.6%, 3.0%; P<0.001) and need for emergency bypass surgery (groups 4 to 1: 0.4%, 0.5%, 1.6%, 5%; P<0.001) was noted in groups 3 and 4 compared with groups 1 and 2. Better adherence to currently recommended evidence-based medications for secondary prevention was seen in the recent time periods. After adjustment, significant reduction in follow-up mortality (hazard ratio, 0.81 and 0.74 for groups 3 and 4, respectively); death or myocardial infarction (hazard ratio, 0.80 and 0.75 for groups 3 and 4, respectively); death, myocardial infarction, or revascularization (hazard ratio, 0.76 and 0.58 for groups 3 and 4, respectively) was noted in recent time periods. CONCLUSIONS: Despite higher-risk profiles of patients who underwent percutaneous coronary intervention in recent time periods, procedural success as well as in-hospital and long-term outcomes improved significantly over the last 25 years.
Authors: Melissa M Farmer; Maggie A Stanislawski; Mary E Plomondon; Bevanne Bean-Mayberry; Nataria T Joseph; Lauren E Thompson; Jessica L Zuchowski; Stacie L Daugherty; Elizabeth M Yano; P Michael Ho Journal: J Womens Health (Larchmt) Date: 2017-05-12 Impact factor: 2.681
Authors: Sunil V Rao; Connie N Hess; David Dai; Cynthia L Green; Eric D Peterson; Pamela S Douglas Journal: Am Heart J Date: 2013-07-01 Impact factor: 4.749
Authors: Mandeep Singh; Bernard J Gersh; Ryan J Lennon; Henry H Ting; David R Holmes; Brendan J Doyle; Charanjit S Rihal Journal: Mayo Clin Proc Date: 2009-06 Impact factor: 7.616
Authors: Lakshmi Venkitachalam; Kevin E Kip; Faith Selzer; Robert L Wilensky; James Slater; Suresh R Mulukutla; Oscar C Marroquin; Peter C Block; David O Williams; Sheryl F Kelsey Journal: Circ Cardiovasc Interv Date: 2008-12-15 Impact factor: 6.546
Authors: Keun-Ho Park; Myung Ho Jeong; Youngkeun Ahn; Sang Sik Jung; Moo Hyun Kim; Hyoung-Mo Yang; Junghan Yoon; Seung Woon Rha; Keum Soo Park; Kyoo Rok Han; Byung Ryul Cho; Kwang Soo Cha; Byung Ok Kim; Min Soo Hyon; Won-Yong Shin; Hyunmin Choe; Jang-Whan Bae; Hee Yeol Kim Journal: J Korean Med Sci Date: 2013-08-28 Impact factor: 2.153
Authors: Ki Hong Lee; Myung Ho Jeong; Cho Yun Chung; Donghan Kim; Min Goo Lee; Keun-Ho Park; Doo Sun Sim; Nam Sik Yoon; Hyun Ju Yoon; Kye Hun Kim; Young Joon Hong; Ju Han Kim; Youngkeun Ahn; Jeong Gwan Cho; Jong Chun Park; Jung Chaee Kang Journal: Korean Circ J Date: 2012-05-24 Impact factor: 3.243