Document Detail


Long-term clinical outcome after percutaneous coronary intervention in grafts vs native vessels in patients with previous coronary artery bypass grafting.
MedLine Citation:
PMID:  22019279     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The long-term clinical outcome of patients with previous coronary artery bypass grafting (CABG), undergoing percutaneous coronary intervention (PCI) is not clear.
METHODS: Observational, retrospective study of post-CABG patients, who underwent PCI in either a graft or a native vessel.
RESULTS: Out of 221 consecutive patients, those with PCI in both native vessel and graft (N=16) and missing follow-up data (N=15) were excluded. Out of the remaining 190 patients (age 67.9±9.6 years; 90.0% men), the graft-PCI group (N=88) had more occluded native vessels (2.1±0.8 vs 1.6±0.8; P<0.001), and fewer totally occluded grafts (0.55±0.6 vs 0.75±0.8; P=0.05) compared with the native vessel-PCI group (N=102). On follow-up (median duration 28 months), the incidence of major adverse cardiac events (MACEs), cardiac death, and repeat revascularization was higher in graft-PCI group compared with native vessel-PCI group (43.2% vs 19.6%, log-rank P<0.001; 19.3% vs 6.9%, log-rank P=0.008; and 23.9% vs 12.7%, log-rank P=0.02, respectively). Graft-PCI was independently associated with higher risk for major adverse cardiac events (hazard ratio [HR], 2.84; 95% confidence interval [CI], 1.45-5.57; P=0.002), cardiac death (HR, 3.44; 95% CI, 1.16-10.22; P=0.03) and repeat revascularization (HR, 2.41; 95% CI, 1.02-5.72; P=0.046).
CONCLUSIONS: Post-CABG patients, undergoing graft compared with native vessel-PCI, have worse long-term clinical outcome. Prospective studies are needed to elucidate the optimal revascularization strategy for such patients.
Authors:
Ioanna Xanthopoulou; Periklis Davlouros; Grigorios Tsigkas; Aggeliki Panagiotou; Georgios Hahalis; Dimitrios Alexopoulos
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2011-10-22
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  27     ISSN:  1916-7075     ISO Abbreviation:  Can J Cardiol     Publication Date:    2011 Nov-Dec
Date Detail:
Created Date:  2011-11-28     Completed Date:  2012-01-19     Revised Date:  2012-02-28    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  716-24     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
Affiliation:
Patras University Hospital, Cardiology Department, Patras, Greece. jxanthop@yahoo.gr
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Balloon, Coronary / methods*
Coronary Artery Bypass*
Coronary Restenosis / epidemiology,  etiology,  therapy*
Coronary Stenosis / surgery*
Electrocardiography
Female
Follow-Up Studies
Graft Occlusion, Vascular / complications,  epidemiology,  therapy*
Humans
Incidence
Male
Prognosis
Retrospective Studies
Survival Rate / trends
Time Factors

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


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