| Late outcomes following percutaneous coronary interventions: results from a large, observational registry. | |
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MedLine Citation:
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PMID: 20847967 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Clare E Appleby; Karen Mackie; Vladimír Dzavík; Joan Ivanov |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The Canadian journal of cardiology Volume: 26 ISSN: 1916-7075 ISO Abbreviation: Can J Cardiol Publication Date: 2010 Aug-Sep |
Date Detail:
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Created Date: 2010-09-17 Completed Date: 2010-10-15 Revised Date: 2011-08-03 |
Medline Journal Info:
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Nlm Unique ID: 8510280 Medline TA: Can J Cardiol Country: Canada |
Other Details:
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Languages: eng Pagination: e218-24 Citation Subset: IM |
Affiliation:
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University Health Network, University of Toronto, Ontario. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angioplasty, Balloon, Coronary* / mortality Cohort Studies Coronary Artery Bypass / mortality Coronary Artery Disease / diagnosis, mortality, surgery, therapy* Drug-Eluting Stents / statistics & numerical data Female Follow-Up Studies Hospitals, University Humans Kaplan-Meier Estimate Male Medical Records Middle Aged Predictive Value of Tests Proportional Hazards Models Prospective Studies Regression Analysis Risk Factors Stents* / statistics & numerical data Survival Analysis Treatment Outcome |
| Comments/Corrections | |
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