Abstract 16535: Incomplete Revascularization Is Associated with Higher Long-Term Mortality Following Coronary Stenting
Background: Previous studies have reported that incomplete revascularization of coronary stenting for multivessel disease is associated higher risk of adverse outcomes compared to complete revascularization during short- and intermediate-term follow-up. Our previous studies have found that incomplete revascularization was associated with higher risk of mortality after stenting for multivessel disease during follow-up of up to 3 years. However, there is little data on the impact of incomplete revascularization on longer-term mortality.
Objective: To test the hypothesis that incomplete revascularization is related to increased risk of long-term (8-year) mortality following stenting for multivessel disease.
Methods: The study population consists of 13,016 patients with multivessel disease who had undergone stenting procedures with bare-metal stents in 1999 and 2000 in New York. The patients' demographic variables, pre-procedural risk factors, and procedural information were recorded in the New York State's Percutaneous Coronary Intervention Reporting System. The vital status of these patients was followed until the end of 2007 using the National Death Index. A propensity-matched analysis was conducted to evaluate the impact of incomplete revascularization on long-term survival during the follow-up period of 8 years on average.
Results: A total of 9,213 (70.8%) patients had received stenting with incomplete revascularization, and 3,803 (29.2%) patients received complete revascularization. Each of the patients who received stenting with complete revascularization was propensity-matched to a patient with incomplete revascularization. Using the propensity matched data, Kaplan-Meir survival analysis showed that the respective 8-year survival rates were 80.8% and 76.4% for complete and incomplete revascularization (P<0.0001). Cox-proportional hazards regression modeling showed that compared to complete revascularization, the risk of death was 29% higher for incomplete revascularization (hazard ratio = 1.29, 95% confidence interval: 1.16 to 1.44, P<0.0001).
Conclusions: Incomplete revascularization is associated with higher long-term mortality following stenting with bare-metal stents for multivessel disease.
- Percutaneous coronary intervention
- Interventional cardiology
- Coronary artery disease
- Follow-up studies
- © 2010 by American Heart Association, Inc.