Abstract 3524: Does Complete Revascularization in Patients with Multivessel Coronary Artery Disease Reduce the Rate of Death or Myocardial Infarction?
Background: Complete revascularization (CR) of multivessel coronary artery disease (CAD) has been shown to improve short term outcomes. Whether CR reduces the long term risk of death/myocardial infarction (D/MI) to a degree similar to patients with non-obstructive CAD is not known. We tested the hypothesis that CR is associated with improved outcomes (similar to patients with non-obstructive CAD).
Methods: This is a prospective study of consecutive patients presenting to a tertiary care center cath lab. Patients were divided into four groups whether they had non-obstructive CAD, complete, incomplete or no revascularization. Patients were prospectively followed up for three year. Univariate and multivariate predictors of D/MI were identified.
Results: A total of 1233 patients were included. Univariate predictors of D/MI are shown in the table⇓ below. After a follow-up duration of three years, Patients with CR has similar D/MI rate compared to patients with non-obstructive CAD, which was better than patients with incomplete or no revascularization. After adjusting for confounding variables, advanced age, diabetes, hypertension and ejection fraction but not the degree of revascularization were the independent predictors of D/MI.
Conclusions: CR is associated with improved long term outcomes. However, this is a reflection of the increased burden of CAD and does not infer causality.