BACKGROUND: Randomized controlled trials report short- and medium- term outcomes following percutaneous coronary intervention (PCI), but their applicability to the general population is not known. Data regarding the long-term clinical outcomes of patients undergoing PCI are lacking. OBJECTIVE: To determine the long-term outcomes of 'all-comers' undergoing PCI at a large-volume tertiary cardiac referral centre. METHODS: A total of 12,662 consecutive patients undergoing an index procedure and entered into the University Health Network's (Toronto, Ontario) prospective registry between April 2000 and September 2007 were identified. In-hospital outcomes were assessed. Follow-up data were obtained through linkage to a provincial registry. Kaplan-Meier analysis was performed to calculate unadjusted survival rates, and Cox multiple regression analysis identified independent predictors of late mortality, major adverse cardiac events and all cardiovascular events. RESULTS: The population included a relatively high-risk patient cohort, with 19% older than 75 years of age, 28% with diabetes, 61% with multivessel disease and 1.3% in cardiogenic shock. Urgent procedures comprised 53% 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, longterm 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.
BACKGROUND: Randomized controlled trials report short- and medium- term outcomes following percutaneous coronary intervention (PCI), but their applicability to the general population is not known. Data regarding the long-term clinical outcomes of patients undergoing PCI are lacking. OBJECTIVE: To determine the long-term outcomes of 'all-comers' undergoing PCI at a large-volume tertiary cardiac referral centre. METHODS: A total of 12,662 consecutive patients undergoing an index procedure and entered into the University Health Network's (Toronto, Ontario) prospective registry between April 2000 and September 2007 were identified. In-hospital outcomes were assessed. Follow-up data were obtained through linkage to a provincial registry. Kaplan-Meier analysis was performed to calculate unadjusted survival rates, and Cox multiple regression analysis identified independent predictors of late mortality, major adverse cardiac events and all cardiovascular events. RESULTS: The population included a relatively high-risk patient cohort, with 19% older than 75 years of age, 28% with diabetes, 61% with multivessel disease and 1.3% in cardiogenic shock. Urgent procedures comprised 53% 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, longterm 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.
Authors: Gregg W Stone; Cindy L Grines; David A Cox; Eulogio Garcia; James E Tcheng; John J Griffin; Giulio Guagliumi; Thomas Stuckey; Mark Turco; John D Carroll; Barry D Rutherford; Alexandra J Lansky Journal: N Engl J Med Date: 2002-03-28 Impact factor: 91.245
Authors: K M Anderson; R M Califf; G W Stone; F J Neumann; G Montalescot; D P Miller; J J Ferguson; J T Willerson; H F Weisman; E J Topol Journal: J Am Coll Cardiol Date: 2001-06-15 Impact factor: 24.094
Authors: F Kiemeneij; P W Serruys; C Macaya; W Rutsch; G Heyndrickx; P Albertsson; J Fajadet; V Legrand; P Materne; J Belardi; U Sigwart; A Colombo; J J Goy; C M Disco; M A Morel Journal: J Am Coll Cardiol Date: 2001-05 Impact factor: 24.094
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Authors: Issam Moussa; Martin B Leon; Donald S Baim; William W O'Neill; Jeffery J Popma; Maurice Buchbinder; Jay Midwall; Charles A Simonton; Emily Keim; Patrick Wang; Richard E Kuntz; Jeffrey W Moses Journal: Circulation Date: 2004-05-03 Impact factor: 29.690
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Authors: Jeffrey W Moses; Martin B Leon; Jeffrey J Popma; Peter J Fitzgerald; David R Holmes; Charles O'Shaughnessy; Ronald P Caputo; Dean J Kereiakes; David O Williams; Paul S Teirstein; Judith L Jaeger; Richard E Kuntz Journal: N Engl J Med Date: 2003-10-02 Impact factor: 91.245
Authors: Matthias Leschke; Vo Thanh Nhan; Matthias Waliszewski; Vicente Palacios; Iván Horváth; Vladimir A Ivanov; Damras Tresukosol; Panicos Avraamides; André Schneider; Martin Unverdorben Journal: Indian Heart J Date: 2012-08-27
Authors: Josef Veselka; Miloslav Špaček; Martin Horváth; Cyril Štěchovský; Ingrid Homolová; Petra Zimolová; Petr Hájek Journal: Arch Med Sci Date: 2016-07-01 Impact factor: 3.318
Authors: Vinayak Nagaraja; Sze-Yuan Ooi; James Nolan; Adrian Large; Mark De Belder; Peter Ludman; Rodrigo Bagur; Nick Curzen; Takashi Matsukage; Fuminobu Yoshimachi; Chun Shing Kwok; Colin Berry; Mamas A Mamas Journal: J Am Heart Assoc Date: 2016-12-16 Impact factor: 5.501