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Long-Term Outcome of Incomplete Revascularization After Percutaneous Coronary Intervention in SCAAR (Swedish Coronary Angiography and Angioplasty Registry).
- Source :
-
JACC. Cardiovascular interventions [JACC Cardiovasc Interv] 2016 Feb 08; Vol. 9 (3), pp. 207-215. - Publication Year :
- 2016
-
Abstract
- Objectives: The aim of this study was to describe current practice regarding completeness of revascularization in patients with multivessel disease undergoing percutaneous coronary intervention (PCI) and to investigate the association of incomplete revascularization (IR) with death, repeat revascularization, and myocardial infarction (MI) in a large nationwide registry.<br />Background: The benefits of multivessel PCI are controversial.<br />Methods: Between 2006 and 2010 we identified 23,342 patients with multivessel disease in the SCAAR (Swedish Coronary Angiography and Angioplasty Registry) and merged data with official Swedish health data registries. IR was defined as any nontreated significant (60%) stenosis in a coronary artery supplying >10% of the myocardium.<br />Results: Patients with IR (n = 15,165) were older, had more extensive coronary disease, and more often had ST-segment elevation MI at presentation than those with complete revascularization (CR) (n = 8,177). All-cause 1-year mortality, MI, and repeat revascularization were higher in IR than CR: 7.1% versus 3.8%, 10.4% versus 6.0%, and 20.5% versus 8.5%, respectively. Propensity score methodology was used in the adjusted analyses. Adjusted hazard ratio (HR) for the composite of death, MI, or repeat revascularization at 1 year was higher in IR than CR: 2.12 (95% confidence interval [CI]: 1.98 to 2.28; p < 0.0001). Adjusted HR for death and the combination of death/MI were 1.29 (95% CI: 1.12 to 1.49; p = 0.0005) and 1.42 (95% CI: 1.30 to 1.56; p < 0.0001), respectively.<br />Conclusions: Incomplete revascularization at the time of hospital discharge in patients with multivessel disease undergoing PCI is associated with a high risk of recurrent 1-year adverse cardiac events.<br /> (Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Age Factors
Aged
Coronary Artery Disease mortality
Female
Humans
Male
Myocardial Infarction epidemiology
Propensity Score
Registries
Retreatment statistics & numerical data
Severity of Illness Index
Stents
Sweden epidemiology
Coronary Artery Disease therapy
Coronary Stenosis therapy
Percutaneous Coronary Intervention
Subjects
Details
- Language :
- English
- ISSN :
- 1876-7605
- Volume :
- 9
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- JACC. Cardiovascular interventions
- Publication Type :
- Academic Journal
- Accession number :
- 26847112
- Full Text :
- https://doi.org/10.1016/j.jcin.2015.10.034