Literature DB >> 34913000

Impact of completeness of revascularisation on long-term outcomes in patients with multivessel disease undergoing PCI: CR versus IR outcomes in multivessel CAD.

Pravin Goel1, Ankit Sahu1, Manas Layek1, Roopali Khanna1, Prabhakar Mishra2.   

Abstract

AIMS: We aimed to study long-term clinical outcomes in patients with multivessel disease (MVD) undergoing percutaneous coronary intervention (PCI) over the last 10 years with respect to the completeness of revascularisation at a tertiary care hospital. METHODS AND
RESULTS: A total of 2,960 consecutive MVD patients taken for PCI between 2008 to 2017 were enrolled in the study with baseline demographic, procedural, and follow-up details retrieved from custom-made departmental software. Of those, 2,598 patients with follow-up details constituted the study cohort. Complete revascularisation (CR) was achieved in 1,854 (71.4%) and incomplete revascularisation (IR) in 744 (28.6%) patients. Propensity matching was performed and 740 matched pairs identified in the two groups. The primary endpoint was survival free of any major adverse cardiovascular events (MACE) with each individual MACE event being a secondary endpoint. IR occurred more often in patients with acute coronary syndrome (64.1% vs 58.3%, p=0.003), complex lesion intervention (40.7% vs 29.6%, p<0.001) and in those with mean stent length ≥38 mm per vessel intervened (21.0% vs 13.5%, p<0.001). Median follow-up was 54 months (interquartile range: 31-84 months). After propensity matching, CR resulted in a better survival free of all adverse events, i.e., 86.4% vs 81.1% (HR 1.52, CI: 1.21-2.02; p<0.01). Individual MACE endpoints were, however, not statistically different between the groups.
CONCLUSIONS: In MVD patients undergoing PCI, CR results in better survival free of all adverse events including all-cause mortality, non-fatal MI, repeat revascularisation and recurrent angina.

Entities:  

Year:  2021        PMID: 34913000      PMCID: PMC8670570          DOI: 10.4244/AIJ-D-21-00005

Source DB:  PubMed          Journal:  AsiaIntervention        ISSN: 2426-3958


  36 in total

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Review 3.  Complete myocardial revascularization confers a larger clinical benefit when performed with state-of-the-art techniques in high-risk patients with multivessel coronary artery disease: A meta-analysis of randomized and observational studies.

Authors:  Marco Zimarino; Fabrizio Ricci; Mattia Romanello; Marta Di Nicola; Alessandro Corazzini; Raffaele De Caterina
Journal:  Catheter Cardiovasc Interv       Date:  2015-04-02       Impact factor: 2.692

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Journal:  Circulation       Date:  2012-09-11       Impact factor: 29.690

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6.  Incidence, predictors and outcomes of incomplete revascularization after percutaneous coronary intervention and coronary artery bypass grafting: a subgroup analysis of 3-year SYNTAX data.

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Authors:  Mineok Chang; Jung-Min Ahn; Nayoung Kim; Pil Hyung Lee; Jae-Hyung Roh; Sung-Han Yoon; Soo-Jin Kang; Seung-Whan Lee; Young-Hak Kim; Cheol Whan Lee; Seong-Wook Park; Duk-Woo Park; Seung-Jung Park
Journal:  Am Heart J       Date:  2016-07-07       Impact factor: 4.749

8.  Complete versus incomplete revascularization in patients with multivessel disease undergoing percutaneous coronary intervention with drug-eluting stents.

Authors:  Corrado Tamburino; Dominick J Angiolillo; Piera Capranzano; Konstantinos Dimopoulos; Alessio La Manna; Rossella Barbagallo; Francesco Tagliareni; Sarah Mangiafico; Luis A Guzman; Alfredo R Galassi; Theodore A Bass
Journal:  Catheter Cardiovasc Interv       Date:  2008-10-01       Impact factor: 2.692

9.  World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects.

Authors: 
Journal:  JAMA       Date:  2013-11-27       Impact factor: 56.272

10.  Randomized trial of complete versus lesion-only revascularization in patients undergoing primary percutaneous coronary intervention for STEMI and multivessel disease: the CvLPRIT trial.

Authors:  Anthony H Gershlick; Jamal Nasir Khan; Damian J Kelly; John P Greenwood; Thiagarajah Sasikaran; Nick Curzen; Daniel J Blackman; Miles Dalby; Kathryn L Fairbrother; Winston Banya; Duolao Wang; Marcus Flather; Simon L Hetherington; Andrew D Kelion; Suneel Talwar; Mark Gunning; Roger Hall; Howard Swanton; Gerry P McCann
Journal:  J Am Coll Cardiol       Date:  2015-03-17       Impact factor: 24.094

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