Document Detail

Increased incidence of periprocedural complications among patients with peripheral vascular disease undergoing myocardial revascularization in the bypass angioplasty revascularization investigation.
MedLine Citation:
PMID:  10402447     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Risks of coronary artery bypass graft surgery (CABG) or percutaneous transluminal coronary angioplasty (PTCA) may be different in the presence of peripheral vascular disease (PVD). METHODS AND RESULTS: We analyzed outcomes of 550 patients with PVD enrolled in the Bypass Angioplasty Revascularization Investigation randomized trial and registry. Compared with 1770 patients without PVD, those with PVD were older and had a greater prevalence of medical comorbid conditions. No significant differences in coronary anatomy or PTCA success rates were found. The risk of any major complication (death, myocardial infarction, stroke, coma, or emergency revascularization) after PTCA was significantly higher among patients with PVD (11.7% versus 7.8%, P=0.027). In multivariate analysis, this represented a 50% increase in the odds of having any major complication (multivariate odds ratio, 1.5; P=0. 032). Among patients undergoing CABG, the risk of major complications was found to be markedly higher for patients with PVD (12%) than those without (6.1%, P=0.003) even after controlling for baseline differences (multivariate odds ratio, 1.8; P=0.018). Major differences between the PTCA and CABG groups were related primarily to a higher risk of neurological complications in PVD patients who had CABG (multivariate odds ratio, 2.8; P<0.001). CONCLUSIONS: We conclude that patients with PVD are at high risk for periprocedural complications after myocardial revascularization, in particular neurological events.
C S Rihal; K Sutton-Tyrrell; P Guo; N M Keller; R Jandova; M A Sellers; H V Schaff; D R Holmes
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Circulation     Volume:  100     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  1999 Jul 
Date Detail:
Created Date:  1999-07-27     Completed Date:  1999-07-27     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  171-7     Citation Subset:  AIM; IM    
Mayo Clinic and Mayo Foundation, Rochester, MN, USA.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary*
Coronary Artery Bypass*
Intraoperative Complications / epidemiology*
Middle Aged
Myocardial Revascularization*
Nervous System Diseases / epidemiology,  etiology
Postoperative Complications / epidemiology*
Regression Analysis
Vascular Diseases / surgery,  therapy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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