Clinical Characteristics and Outcomes From Percutaneous Coronary Intervention of Last Remaining Coronary Artery: An Analysis From the British Cardiovascular Intervention Society Database.

Shoaib, Ahmad; Rashid, Muhammad; Kontopantelis, Evangelos; Sharp, Andrew; Fahy, Eoin F.; Nolan, James; Townend, John; Ludman, Peter; Ratib, Karim; Azam, Ziyad A.; Ahmad, Ayesha; McEntegart, Margaret; Mohamed, Mohamed; Kinnaird, Tim; Mamas, Mamas A.

doi:10.1161/CIRCINTERVENTIONS.120.009049

Clinical Characteristics and Outcomes From Percutaneous Coronary Intervention of Last Remaining Coronary Artery: An Analysis From the British Cardiovascular Intervention Society Database.

Shoaib, Ahmad; Rashid, Muhammad; Kontopantelis, Evangelos; Sharp, Andrew; Fahy, Eoin F.; Nolan, James; Townend, John; Ludman, Peter; Ratib, Karim; Azam, Ziyad A.; Ahmad, Ayesha; McEntegart, Margaret; Mohamed, Mohamed; Kinnaird, Tim; Mamas, Mamas A.

Authors

Ahmad Shoaib

Muhammad Rashid m.rashid@keele.ac.uk

Evangelos Kontopantelis

Andrew Sharp

Eoin F. Fahy

James Nolan j.nolan@keele.ac.uk

John Townend

Peter Ludman

Karim Ratib

Ziyad A. Azam

Ayesha Ahmad

Margaret McEntegart

Mohamed Mohamed

Tim Kinnaird

Mamas Mamas m.mamas@keele.ac.uk

Abstract

BACKGROUND: Patients with complex high-risk coronary anatomy, such as those with a last remaining patent vessel (LRPV), are increasingly revascularized with percutaneous coronary intervention (PCI) in contemporary practice. There are limited data on the outcomes of these high-risk procedures. METHODS: We analyzed a large longitudinal PCI cohort (2007-2014, n=501?841) from the British Cardiovascular Intervention Society database. Clinical, demographic, procedural, and outcome data were analyzed by dividing patients into 2 groups; LRPV group (n=2432) and all other PCI groups (n=506?691). RESULTS: Patients in the LRPV PCI group were older, had more comorbidities, and higher prevalence of moderate-severe left ventricular systolic dysfunction. Mortality was higher in the LRPV PCI group during hospital admission (12 % versus 1.5 %, P<0.001), at 30 days (15% versus 2%, P<0.001), and at one-year (24% versus 5%, P<0.001). In a propensity score matching analysis the adjusted risk of mortality during index admission (odds ratio, 2.05 [95% CI, 1.65-2.44], P<0.001), at 30 days (odds ratio, 2.13 [95% CI, 1.78-2.5], P<0.001), at 1 year (odds ratio, 1.81 [95% CI, 1.59-2.03], P<0.001), and in-hospital major adverse cardiovascular events (odds ratio, 1.8 [95% CI, 1.42-2.19], P<0.001) were higher in LRPV PCI group as compared to control group. In sensitivity analyses, similar clinical outcomes were observed irrespective of which major epicardial coronary artery was treated. CONCLUSIONS: In this contemporary cohort, patients who had PCI to their LRPV had a higher-risk profile and more adverse clinical outcomes, irrespective of the vessel treated.

Journal Article Type	Article
Acceptance Date	Jun 16, 2020
Publication Date	Sep 2, 2020
Journal	Circulation: Cardiovascular Interventions
Print ISSN	1941-7640
Publisher	American Heart Association
Peer Reviewed	Peer Reviewed
Volume	13
Issue	9
Article Number	e009049
DOI	https://doi.org/10.1161/CIRCINTERVENTIONS.120.009049
Keywords	percutaneous coronary intervention; mortality; myocardial infarction; prevalence
Publisher URL	https://www.ahajournals.org/doi/10.1161/CIRCINTERVENTIONS.120.009049