Document Detail


Repeat intervention after invasive treatment of coronary arteries.
MedLine Citation:
PMID:  18926714     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Patients who undergo successful revascularisation either with coronary artery bypass grafting (CABG) or with percutaneous coronary intervention (PCI) may subsequently require repeat invasive procedures. METHODS: A cohort of 662 coronary artery diseased (CAD) patients was retrospectively reviewed. Follow-up was 36 months. RESULTS: Thirty-day mortality was 1.0% in the CABG group (n=302) and 0% in the PCI group (n=360) (p=0.094). Overall 3-year survival for the cohort was 95.0% (NS). In addition to repeat angiographies (cumulative frequency 57.7% for PCI vs 4.3% for CABG, p<0.001) patients underwent both repeat PCI (20.7% vs 3.2%, p<0.001) and repeat CABG (6.9% vs 0.7%, p<0.001) during the follow-up. In Cox regression analysis hazard ratio (HR) for repeat PCI after initial PCI was 8.5, 95% confidence interval (CI) 3.7-19.5, p<0.001 and for repeat CABG 9.5, CI 2.2-40.0, p=0.002 in comparison to initial CABG. In-stent restenosis and progression of atherosclerotic plaques in native vessels were reasons for repeat intervention among the PCI patients. Complications with bypass grafts together with progression of the underlying disease were factors for re-interventions after CABG. CONCLUSIONS: PCI is far less invasive and may have lower in-hospital mortality rates than CABG. However, the highly likely need for repeat invasive procedures and revascularisation has to be taken into consideration when choosing an invasive approach for multi vessel CAD patients.
Authors:
Pertti Loponen; Kari Korpilahti; Michael Luther; Heini Huhtala; Matti R Tarkka
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-10-15
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  35     ISSN:  1873-734X     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2008-12-22     Completed Date:  2009-11-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  43-7     Citation Subset:  IM    
Affiliation:
Department of Thoracic and Vascular Surgery, Vaasa Central Hospital, Vaasa, Finland.
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Distribution
Aged
Aged, 80 and over
Angioplasty, Transluminal, Percutaneous Coronary* / adverse effects
Coronary Angiography
Coronary Artery Bypass* / adverse effects
Coronary Artery Disease / surgery,  therapy*
Coronary Restenosis / radiography,  surgery,  therapy
Epidemiologic Methods
Female
Humans
Male
Middle Aged
Reoperation

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


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