Ahmad Shoaib
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
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 |
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LRPV Manuscript Ref .docx
(15.2 Mb)
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Publisher Licence URL
https://creativecommons.org/licenses/by-nc/4.0/
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