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Start Over Descriptor "Percutaneous Coronary Intervention/statistics & numerical data" Topic 030204 cardiovascular system & hematology
4 results on '"Percutaneous Coronary Intervention/statistics & numerical data"'

1. Impact of COVID-19 Pandemic on Mechanical Reperfusion for Patients With STEMI

Author

Giuseppe De Luca, Pierre Deharo, Pierfrancesco Agostoni, Gabriele Gabrielli, Francisco Bosa Ojeda, Ylitalo Antti, Lisette Okkels Jensen, Bor Wilbert, Luigi Vignali, Fortunato Scotto Di Uccio, Dariusz Dudek, Marco Boccalatte, Monica Verdoia, Edouard Benit, Gianni Casella, Heidi Lehtola, Alessandra Scoccia, Tim Kinnaird, Massimo Siviglia, Raul Moreno, Vladimir Ganyukov, Arpad Lux, Mika Laine, Adrian P. Banning, Santiago Camacho-Freiere, Guido Parodi, José Moreu, Michał Kidawa, Miha Cercek, Victor Becerra, Stephane Manzo, Elvin Kedhi, Marija Vavlukis, Filippo Zilio, Ciro De Simone, Nikola Bakraceski, Xavier Carrillo, Giuseppe Uccello, Maurizio Menichelli, Gerard Rourai Ferrer, Dimitrios Alexopoulos, Benjamin Faurie, Jurriën M. ten Berg, Lucia Marinucci, Juan Sanchis Forés, Giovanni Amoroso, Sébastien Levesque, Bernardo Tuccillo, Enrico Fabris, Peter Ludman, Rui Campante Teles, Wojtek Wojakowski, Leonardo Spedicato, Lucian Calmac, Yves Cottin, Maurits T. Dirksen, Petr Kala, Thomas W Johnson, Xacobe Flores Rios, Gianluca Caiazzo, Clemens van Birgelen, Francesco Versaci, Alexander Ijsselmuiden, Luca Donazzan, Kees-Jan Royaards, Adriaan O. Kraaijeveld, Alejandro Gutierrez Barrios, Gennaro Galasso, Vincenzo Guiducci, Julinda Mehilli, Giuseppe Cirrincione, Andrea Santucci, Giuliana Cortese, José Luis Díez Gil, Iñigo Lozano Martínez-Luengas, Bruno Scheller, Periklis Davlouros, Tomas Kovarnik, Arturo García-Touchard, Pieter C. Smits, De Luca, G., Verdoia, M., Cercek, M., Jensen, L. O., Vavlukis, M., Calmac, L., Johnson, T., Ferrer, G. R., Ganyukov, V., Wojakowski, W., Kinnaird, T., van Birgelen, C., Cottin, Y., Ijsselmuiden, A., Tuccillo, B., Versaci, F., Royaards, K. -J., Berg, J. T., Laine, M., Dirksen, M., Siviglia, M., Casella, G., Kala, P., Diez Gil, J. L., Banning, A., Becerra, V., De Simone, C., Santucci, A., Carrillo, X., Scoccia, A., Amoroso, G., Lux, A., Kovarnik, T., Davlouros, P., Mehilli, J., Gabrielli, G., Rios, X. F., Bakraceski, N., Levesque, S., Cirrincione, G., Guiducci, V., Kidawa, M., Spedicato, L., Marinucci, L., Ludman, P., Zilio, F., Galasso, G., Fabris, E., Menichelli, M., Garcia-Touchard, A., Manzo, S., Caiazzo, G., Moreu, J., Fores, J. S., Donazzan, L., Vignali, L., Teles, R., Benit, E., Agostoni, P., Bosa Ojeda, F., Lehtola, H., Camacho-Freiere, S., Kraaijeveld, A., Antti, Y., Boccalatte, M., Deharo, P., Martinez-Luengas, I. L., Scheller, B., Alexopulos, D., Moreno, R., Kedhi, E., Uccello, G., Faurie, B., Gutierrez Barrios, A., Di Uccio, F. S., Wilbert, B., Smits, P., Cortese, G., Parodi, G., Dudek, D., banning, adrian/0000-0002-2842-7861, GUIDUCCI, VINCENZO/0000-0002-0833-2785, vavlukis, marija/0000-0002-4479-6691, Bor, Willem L/0000-0002-3253-5961, DAVLOUROS, PERIKLIS/0000-0002-1439-1992, Uccello, Giuseppe/0000-0002-6163-8468, Kidawa, Michal/0000-0002-5000-6561, [De Luca, Giuseppe] Univ Piemonte Orientale, Div Cardiol, Azienda Osped Univ Maggiore Carita, Novara, Italy, [Verdoia, Monica] Osped Inferm Biella, ASL Biella, Div Cardiol, Biella, Italy, [Cercek, Miha] Univ Med Ctr, Ctr Intens Internal Med, Ljubljana, Slovenia, [Jensen, Lisette Okkels] Odense Univ Hosp, Div Cardiol, Odense, Denmark, [Vavlukis, Marija] Ss Cyril & Methodius Univ, Med Fac, Univ Clin Cardiol, Skopje, North Macedonia, [Calmac, Lucian] Clin Emergency Hosp Bucharest, Bucharest, Romania, [Johnson, Tom] Univ Hosp Bristol NHSFT, Bristol Heart Inst, Div Cardiol, Bristol, Avon, England, [Johnson, Tom] Univ Bristol, Bristol, Avon, England, [Ferrer, Gerard Rourai] Hosp Univ Bellvitge, Heart Dis Inst, Intervent Cardiol Unit, Barcelona, Spain, [Ganyukov, Vladimir] State Res Inst Complex Issues Cardiovasc Dis, Div Cardiol, Kemerovo, Russia, [Wojakowski, Wojtek] Med Univ Silezia, Div Cardiol, Katowice, Poland, [Kinnaird, Tim] Univ Hosp Wales, Div Cardiol, Cardiff, Wales, [van Birgelen, Clemens] Thoraxctr Twente, Dept Cardiol, Med Spectrum Twente, Enschede, Netherlands, [Cottin, Yves] Univ Hosp, Div Cardiol, Dijon, France, [IJsselmuiden, Alexander] Amphia Hosp, Div Cardiol, Breda, Netherlands, [Tuccillo, Bernardo] Osped Mare, Div Cardiol, Naples, Italy, [Di Uccio, Fortunato Scotto] Osped Mare, Div Cardiol, Naples, Italy, [Versaci, Francesco] Osped Santa Maria Goretti, Div Cardiol, Latina, Italy, [Royaards, Kees-Jan] Maasstad Ziekenhuis, Div Cardiol, Rotterdam, Netherlands, [Smits, Pieter] Maasstad Ziekenhuis, Div Cardiol, Rotterdam, Netherlands, [Ten Berg, Jurrien] St Antonius Hosp, Div Cardiol, Nieuwegein, Netherlands, [Wilbert, Bor] St Antonius Hosp, Div Cardiol, Nieuwegein, Netherlands, [Laine, Mika] Helsinki Univ Cent Hosp, Div Cardiol, Helsinki, Finland, [Dirksen, Maurits] Northwest Clin, Div Cardiol, Alkmaar, Netherlands, [Siviglia, Massimo] Osped Riuniti Reggio Calabria, Div Cardiol, Reggio Di Calabria, Italy, [Casella, Gianni] Osped Maggiore Bologna, Div Cardiol, Bologna, Italy, [Kala, Petr] Masaryk Univ, Univ Hosp Brno, Med Fac, Brno, Czech Republic, [Diez Gil, Jose Luis] H Univ & Politecn La Fe, Valencia, Spain, [Banning, Adrian] John Radcliffe Hosp, Oxford, England, [Becerra, Victor] Hosp Clin Univ Virgen Victoria, Malaga, Spain, [De Simone, Ciro] Clin Villa Fiori, Div Cardiol, Acerra, Italy, [Santucci, Andrea] Osped Santa Maria Misericordia, Perugia, Italy, [Carrillo, Xavier] Hosp Germans Triasi Pujol, Badalona, Spain, [Scoccia, Alessandra] Osped St Anna, Div Cardiol, Ferrara, Italy, [Amoroso, Giovanni] Onze Lieve Vrouwe Gasthuis OLVG, Amsterdam, Netherlands, [Lux, Arpad] Mastricht Univ, Med Ctr, Maastricht, Netherlands, [Kovarnik, Tomas] Charles Univ Hosp, Prague, Czech Republic, [Davlouros, Periklis] Patras Univ Hosp, Invas Cardiol & Congenital Heart Dis, Patras, Greece, [Mehilli, Julinda] Ludwig Maximilians Univ Munchen, Univ Hosp Munich, Munich, Germany, [Gabrielli, Gabriele] Azienda Osped Univ, Intervent Cardiol Unit, Osped Riuniti, Ancona, Italy, [Rios, Xacobe Flores] Complexo Hosp Univ La Coruna, La Coruna, Spain, [Bakraceski, Nikola] Ctr Cardiovasc Dis, Ohrid, North Macedonia, [Levesque, Sebastien] CHU Poitiers, Univ Hosp, Poitiers, France, [Cirrincione, Giuseppe] Osped Civ Arnas, Div Cardiol, Palermo, Italy, [Guiducci, Vincenzo] AUSL IRCCS, Reggio Emilia, Italy, [Kidawa, Michal] Med Univ Lodz, Cent Hosp, Lodz, Poland, [Spedicato, Leonardo] Osped Santa Maria Misericordia, Div Cardiol, Udine, Italy, [Marinucci, Lucia] Osped Riuniti Marche Nord, Div Cardiol, Azienda Osped, Pesaro, Italy, [Ludman, Peter] Univ Hosp Birmingham, Birmingham, W Midlands, England, [Zilio, Filippo] Osped Santa Chiara, Trento, Italy, [Galasso, Gennaro] Osped San Giovanni Dio Ruggi Aragona, Div Cardiol, Salerno, Italy, [Fabris, Enrico] Univ Ospedali Riuniti, Azienda Osped, Trieste, Italy, [Menichelli, Maurizio] Osped F Spaziani, Div Cardiol, Frosinone, Italy, [Garcia-Touchard, Arturo] Hosp Puerta Hierro, Div Cardiol, Majadahonda, Spain, [Manzo, Stephane] Paris 07 Univ, CHU Lariboisiere, AP HP, Div Cardiol,INSERM,UMRS 942, Paris, France, [Caiazzo, Gianluca] Osped G Moscati, Div Cardiol, Aversa, Italy, [Moreu, Jose] Complejo Hosp Toledo, Div Cardiol, Toledo, Spain, [Sanchis Fores, Juan] Hosp Clin Univ Valencia, Div Cardiol, Valencia, Spain, [Donazzan, Luca] Osped S Maurizio Bolzano, Div Cardiol, Bolzano, Italy, [Vignali, Luigi] Azienda Osped Sanitaria, Intervent Cardiol Unit, Parma, Italy, [Teles, Rui] Hosp Santa Cruz, Div Cardiol, CHLO Carnaxide, Lisbon, Portugal, [Benit, Edouard] Jessa Ziekenhuis, Div Cardiol, Hasselt, Belgium, [Agostoni, Pierfrancesco] Ziekenhuis Netwerk Antwerpen ZNA Middelheim, Div Cardiol, Antwerp, Belgium, [Bosa Ojeda, Francisco] Hosp Univ Canarias, Div Cardiol, Santa Cruz De Tenerife, Spain, [Lehtola, Heidi] Oulu Univ Hosp, Div Cardiol, Oulu, Finland, [Camacho-Freiere, Santiago] Juan Ramon Jimenez Hosp, Div Cardiol, Huelva, Spain, [Kraaijeveld, Adriaan] UMC Utrecht, Div Cardiol, Utrecht, Netherlands, [Antti, Ylitalo] Univ Hosp, Heart Ctr, Div Cardiol, Turku, Finland, [Boccalatte, Marco] Osped Santa Maria Grazie, Div Cardiol, Pozzuoli, Italy, [Deharo, Pierre] Aix Marseille Univ, CHU Timone, Div Cardiol, Marseille, France, [Lozano Martinez-Luengas, Inigo] Hosp Cabuenes, Div Cardiol, Gijon, Spain, [Scheller, Bruno] Univ Saarland, Div Cardiol Clin & Expt Intervent Cardiol, Homburg, Germany, [Alexopoulos, Dimitrios] Attikon Univ Hosp, Div Cardiol, Athens, Greece, [Moreno, Raul] Hosp Paz, Div Cardiol, Madrid, Spain, [Kedhi, Elvin] St Jan Hosp, Div Cardiol, Brugge, Belgium, [Uccello, Giuseppe] Osped A Manzoni Lecco, Div Cardiol, Lecce, Italy, [Faurie, Benjamin] Grp Hosp Mutualiste Grenoble, Div Cardiol, Grenoble, France, [Gutierrez Barrios, Alejandro] Hosp Puerta Mar, Div Cardiol, Cadiz, Spain, [Cortese, Giuliana] Univ Padua, Dept Stat Sci, Padua, Italy, [Parodi, Guido] Azienda Osped Univ Sassari, Sassari, Italy, [Dudek, Dariusz] Jagiellonian Univ Med Coll, Inst Cardiol, Krakow, Poland, RS: Carim - H01 Clinical atrial fibrillation, and Cardiologie

Subjects
Male, Internationality, medical decision-making, medicine.medical_treatment, 030204 cardiovascular system & hematology, Rate ratio, COVID-19 (coronavirus), Settore MED/06, 0302 clinical medicine, Pandemic, Percutaneous Coronary Intervention/statistics & numerical data, Medicine, Viral, 030212 general & internal medicine, Myocardial infarction, Registries, Acute myocardial-infarction, Original Investigation, STEMI, ST-segment elevation myocardial infarction, Middle Aged, 3. Good health, Europe, fibrinolysis, Female, COVID-19, primary angioplasty, STEMI, Aged, Humans, Percutaneous Coronary Intervention, Retrospective Studies, ST Elevation Myocardial Infarction, Coronavirus Infections, Pandemics, Pneumonia, Viral, Cardiology and Cardiovascular Medicine, Editorial Comment, ACUTE MYOCARDIAL-INFARCTION, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Primary angioplasty, IRR, incidence rate ratio, Europe/epidemiology, 03 medical and health sciences, Betacoronavirus, cardiovascular diseases, Mortality, PCI, percutaneous coronary intervention, DES, drug-eluting stent(s), business.industry, ST Elevation Myocardial Infarction/mortality, PPCI, primary PCI, SARS-CoV-2, MORTALITY, Percutaneous coronary intervention, Retrospective cohort study, Pneumonia, medicine.disease, Confidence interval, ST-segment elevation myocardial infarction, CI, confidence interval, Emergency medicine, COVID-19, STEMI, primary angioplasty, ACS, acute coronary syndrome, business
Abstract

Background The fear of contagion during the coronavirus disease-2019 (COVID-19) pandemic may have potentially refrained patients with ST-segment elevation myocardial infarction (STEMI) from accessing the emergency system, with subsequent impact on mortality. Objectives The ISACS-STEMI COVID-19 registry aims to estimate the true impact of the COVID-19 pandemic on the treatment and outcome of patients with STEMI treated by primary percutaneous coronary intervention (PPCI), with identification of “at-risk” patient cohorts for failure to present or delays to treatment. Methods This retrospective registry was performed in European high-volume PPCI centers and assessed patients with STEMI treated with PPPCI in March/April 2019 and 2020. Main outcomes are the incidences of PPCI, delayed treatment, and in-hospital mortality. Results A total of 6,609 patients underwent PPCI in 77 centers, located in 18 countries. In 2020, during the pandemic, there was a significant reduction in PPCI as compared with 2019 (incidence rate ratio: 0.811; 95% confidence interval: 0.78 to 0.84; p, Central Illustration

Published
2020
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2. Fractional flow reserve-guided percutaneous coronary intervention vs. medical therapy for patients with stable coronary lesions: meta-analysis of individual patient data

Author

Peter Jüni, Bernard De Bruyne, Dan Eik Høfsten, Henning Kelbæk, Martina Rothenbühler, Nils P. Johnson, Thomas Engstrøm, Stephane Fournier, Mohamed Abdel-Wahab, William F. Fearon, Panagiotis Xaplanteris, Lars Køber, Elmir Omerovic, Pim A.L. Tonino, Emanuele Barbato, Nico H.J. Pijls, Pieter C. Smits, Bianca M. Boxma-de Klerk, Frederik M. Zimmermann, Cardiovascular Biomechanics, Zimmermann, Frederik M, Omerovic, Elmir, Fournier, Stephane, Kelbæk, Henning, Johnson, Nils P, Rothenbühler, Martina, Xaplanteris, Panagioti, Abdel-Wahab, Mohamed, Barbato, Emanuele, Høfsten, Dan Eik, Tonino, Pim A L, Boxma-de Klerk, Bianca M, Fearon, William F, Køber, Lar, Smits, Pieter C, De Bruyne, Bernard, Pijls, Nico H J, Jüni, Peter, and Engstrøm, Thomas

Subjects
Male, medicine.medical_specialty, Acute coronary syndrome, medicine.medical_treatment, Myocardial Infarction, 610 Medicine & health, Fractional flow reserve, Coronary Artery Disease, 030204 cardiovascular system & hematology, law.invention, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Percutaneous Coronary Intervention, Randomized controlled trial, 360 Social problems & social services, Interquartile range, law, Internal medicine, medicine, Humans, Myocardial infarction, Randomized Controlled Trials as Topic, business.industry, Percutaneous coronary intervention, 030229 sport sciences, Middle Aged, medicine.disease, Prognosis, Fractional Flow Reserve, Myocardial, Conventional PCI, Cardiology, Coronary Artery Disease/diagnosis, Coronary Artery Disease/mortality, Coronary Artery Disease/therapy, Female, Fractional Flow Reserve, Myocardial/physiology, Percutaneous Coronary Intervention/adverse effects, Percutaneous Coronary Intervention/mortality, Percutaneous Coronary Intervention/statistics & numerical data, Cardiology and Cardiovascular Medicine, business
Abstract

Aims To assess the effect of fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) with contemporary drug-eluting stents on the composite of cardiac death or myocardial infarction (MI) vs. medical therapy in patients with stable coronary lesions. Methods and results We performed a systematic review and meta-Analysis of individual patient data (IPD) of the three available randomized trials of contemporary FFR-guided PCI vs. medical therapy for patients with stable coronary lesions: FAME 2 (NCT01132495), DANAMI-3-PRIMULTI (NCT01960933), and Compare-Acute (NCT01399736). FAME 2 enrolled patients with stable coronary artery disease (CAD), while the other two focused on non-culprit lesions in stabilized patients after acute coronary syndrome. A total of 2400 subjects were recruited from 54 sites world-wide with 1056 randomly assigned to FFR-guided PCI and 1344 to medical therapy. The pre-specified primary outcome was a composite of cardiac death or MI. We included data from extended follow-ups for FAME 2 (up to 5.5 years follow-up) and DANAMI-3-PRIMULTI (up to 4.7 years follow-up). After a median follow-up of 35 months (interquartile range 12-60months), a reduction in the composite of cardiac death or MI was observed with FFR-guided PCI as compared with medical therapy (hazard ratio 0.72, 95% confidence interval 0.54-0.96; P= 0.02). The difference between groups was driven by MI. Conclusion In this IPD meta-Analysis of the three available randomized controlled trials to date, FFR-guided PCI resulted in a reduction of the composite of cardiac death or MI compared with medical therapy, which was driven by a decreased risk of MI.

Published
2018
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3. Severity of ischemic heart disease and presenting rhythm in patients with out-of-hospital cardiac arrest

Author

Kasper Adelborg, Steen Møller Hansen, Asger Granfeldt, Erika Frischknecht Christensen, Mads Wissenberg, Lars W. Andersen, Christian Fynbo Christiansen, and Christian Torp-Pedersen

Subjects
Male, Emergency Medical Services, medicine.medical_treatment, Denmark, Myocardial Ischemia/complications, Myocardial Ischemia, Disease, Cardiovascular Agents/therapeutic use, 030204 cardiovascular system & hematology, Emergency Nursing, Logistic regression, Coronary Angiography, Severity of Illness Index, 0302 clinical medicine, Heart Rate, Percutaneous Coronary Intervention/statistics & numerical data, Myocardial infarction, Registries, education.field_of_study, Medication use, Middle Aged, Cardiac arrest, surgical procedures, operative, Shockable rhythm, Electric Countershock/methods, Emergency Medicine, Cardiology, Female, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Ischemic heart disease, Population, Electric Countershock, Acute myocardial infarction, Chronic disease, 03 medical and health sciences, Percutaneous Coronary Intervention, Internal medicine, medicine, Humans, cardiovascular diseases, Cardiopulmonary resuscitation, education, Aged, Out-of-Hospital Cardiac Arrest/etiology, business.industry, Percutaneous coronary intervention, Emergency Medical Services/methods, 030208 emergency & critical care medicine, Cardiovascular Agents, Odds ratio, medicine.disease, Denmark/epidemiology, Non-shockable rhythm, Conventional PCI, Coronary Angiography/statistics & numerical data, business, Out-of-Hospital Cardiac Arrest
Abstract

INTRODUCTION: Ischemic heart disease (IHD) is associated with a shockable rhythm in out-of-hospital cardiac arrest (OHCA). However, the impact of IHD severity on first recorded rhythm is unknown. We hypothesized that the strength of the association between IHD and shockable rhythm increases with increasing IHD severity.METHODS: OHCA patients were identified in the Danish Cardiac Arrest Registry (2001-2014). Population-based registries were used to identify chronic diseases, drug prescriptions and cardiac procedures such as coronary angiography (CAG), percutaneous coronary intervention (PCI), and coronary artery bypass grafting (CABG). Severity of IHD was categorized as 1) No diagnosis of IHD, 2) IHD without previous CAG, PCI or CABG, 3) IHD with CAG, 4) IHD with PCI, and 5) IHD with CABG. Adjusted odds ratios (ORs) for a shockable rhythm was computed using multivariable logistic regression.RESULTS: Of 34,749 patients with OHCA, 6325 (18.2%) patients had a diagnosis of IHD. The prevalence of a shockable rhythm was higher for patients with a previous diagnosis of IHD (25.6%) and for those with previous CAG (33.3%), PCI (36.4%) or CABG (34.0%) when compared to patients without IHD (21.2%). IHD was associated with shockable rhythm (OR = 1.69, 95%CI 1.55-1.85) when compared to patients without IHD. The association with shockable rhythm was higher for patients with a history of CAG (OR = 1.92, 95%CI 1.67-2.20) and PCI (OR = 1.93, 95%CI 1.67-2.23), but similar in patients with CABG (OR = 1.69, 95%CI 1.37-2.10).CONCLUSION: IHD was associated with a shockable rhythm, with a moderate increase in the association in patients with a CAG or PCI procedure.

Published
2018
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4. Adverse events while awaiting myocardial revascularization: a systematic review and meta-analysis

Author

Adam Witkowski, Patrick Schauerte, Günther Laufer, Stephan Windecker, Miguel Sousa-Uva, Fernando Alfonso, Peter Clemmensen, Dimitrios J. Richter, William Wijns, Franz-Josef Neumann, Juhani Knuuti, Giulio G. Stefanini, Volkmar Falk, Ulf Landmesser, Berend Beumer, Christian W. Hamm, Adnan Kastrati, Marco Valgimigli, Gerasimos Filippatos, Peter Jüni, Jochen Cremer, Lucia Torracca, Philippe Kolh, Jean-Philippe Collet, Bruno R. da Costa, A. Pieter Kappetein, Stuart J. Head, David P. Taggart, and Cardiothoracic Surgery

Subjects
Male, medicine.medical_treatment, Myocardial Infarction, Coronary artery bypass grafting, Time-to-Treatment/statistics & numerical data, 030204 cardiovascular system & hematology, Emergency revascularization, Percutaneous coronary intervention, Waiting, Waiting Lists/mortality, Angina, Coronary artery bypass surgery, 0302 clinical medicine, Myocardial Revascularization, Percutaneous Coronary Intervention/statistics & numerical data, Medicine, Myocardial Revascularization/statistics & numerical data, 030212 general & internal medicine, Myocardial infarction, 610 Medicine & health, Delay, General Medicine, Middle Aged, Death, Cardiology, Female, Cardiology and Cardiovascular Medicine, Wait list, 360 Social problems & social services, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Waiting Lists, Revascularization, Time-to-Treatment, 03 medical and health sciences, Percutaneous Coronary Intervention, Internal medicine, Humans, Adverse effect, Myocardial Infarction/mortality, Aged, business.industry, medicine.disease, Myocardial revascularization, Relative risk, Conventional PCI, Surgery, business
Abstract

OBJECTIVES The aim of the current study was to estimate adverse event rates while awaiting myocardial revascularization and review criteria for prioritizing patients. METHODS A PubMed search was performed on 19 January 2015, to identify English-language, original, observational studies reporting adverse events while awaiting coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI). Rates of death, non-fatal myocardial infarction (MI) and emergency revascularization were calculated as occurrence rates per 1000 patient-weeks and pooled using random-effects models. RESULTS The search yielded 1323 articles, of which 22 were included with 66 410 patients and 607 675 patient-weeks on the wait list. When awaiting CABG, rates per 1000 patient-weeks were 1.1 [95% confidence interval 0.9-1.3] for death, 1.0 [0.6-1.6] for non-fatal MI and 1.8 [0.8-4.1] for emergency revascularization. Subgroup analyses demonstrated consistent outcomes, and sensitivity analyses demonstrated comparable event rates with low heterogeneity. Higher urgency of revascularization was based primarily on angiographic complexity, angina severity, left ventricular dysfunction and symptoms on stress testing, and such patients with a semi-urgent status had a higher risk of death than patients awaiting elective revascularization (risk ratio at least 2.8). Individual studies identified angina severity and left ventricular dysfunction as most important predictors of death when awaiting CABG. Adverse rates per 1000 patient-weeks for patients awaiting PCI were 0.1 [95% confidence interval 0.0-0.4] for death, 0.4 [0.1-1.2] for non-fatal MI and 0.7 [0.4-1.4] for emergency revascularization but were based on only a few old studies. CONCLUSIONS Rates of death, non-fatal MI and emergency revascularization when awaiting myocardial revascularization are infrequent but higher in specific patients. Countries that not yet have treatment recommendations related to waiting times should consider introducing a maximum to limit adverse events, particularly when awaiting CABG.

Published
2017
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