Abstract 3059: Impact of Complete Revascularization on Long-term Outcome after Percutaneous Coronary Intervention in the Bare Metal Stent Era: From the Coronary Revascularization Demonstrating Outcomes in Kyoto (CREDO-Kyoto)
Background: In the real world, complete revascularization of ischemic heart disease was difficult to definite and little was known its outcomes. This study was evaluated efficacy of complete revascularization and clinical outcomes.
Methods: CREDO-kyoto was multi-center registry of Japan, underwent first revascularization from Jan.2000 to Dec.2002. Clinical data and outcome were obtained from 30 institution, total 9086 patients were enrolled cardiac revascularization. Total 3516 patients were treated by percutaneous coronary intervention for multi-vessel coronary disease. We divided 2 groups, CR (n=1830) was defined as success revascularization at least of proximal lesions (AHA classification 1,2,3,5,6,7,11), and IR (n=1686) was incomplete revascularization.
Results: Baseline clinical characteristics were as follows (CR vs IR): male (71.4% vs 68.4%, P<0.01), age (67.4 years vs 68.9 years, P<0.01), chronic total occlusion (16.0% vs 28.2%, P<0.01), old myocardial infarction (22.2% vs 29.0%, P<0.01), congestive heart failure (13.0% vs 17.5%, P<0.01), diabetes (40.7% vs 45.0%, P<0.01), renal dysfunction (serum creatinin>1.5mg/dl) (7.1% vs 11.8%, P<0.01), and reduced left ventricular function. (LVEF<40%) (7.0% vs %, 10.1%, P<0.01) Clinical outcomes were shown in table 1⇓. With a median follow-up time of 2.5+-1.3 years, survival rate at 3 years was 92.7% in CR group and 86.7% in IR group. (log-rank P<0.01) In multivariate analysis, compare adjusted relative risk between CR and IR, relative risk of all death was 1.10 (0.96–1.27) P=0.17. In <75 age subgroup, relative risk was 0.98 (0.80–1.22) P=0.92. In >= 75 age subgroup, relative risk was 1.21 (1.00–1.48) P=0.05.
Conclusions: Complete revascularization was associated with better survival. However, in multivariate analysis, complete revascularization in <75 age group was no difference adjusted relative risk of death. In >=75 age, complete revascularization was associate with better survival.