Abstract 14695: Long-Term Outcome of Incomplete Revascularization After Percutaneous Coronary Intervention in the Swedish Coronary Angiography and Angioplasty Registry
Objectives: Whilst complete revascularization (CR) in patients with multivessel disease undergoing percutaneous coronary intervention (PCI) may increase the risk for procedure-related complications and long-term risk for late stent thrombosis, incomplete revascularization (IR) may be associated with events related to untreated lesions. The aim of this study was to determine current practice regarding completeness of revascularization in patients with multivessel disease, and to investigate the association of IR with death, repeat PCI and myocardial infarction (MI) in a large contemporary population-based registry.
Methods: Data on consecutive patients from every Swedish PCI-centre (2006-2010) from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR) were merged with the Swedish Official Registries for In-patient Care, Cause of Death and Prescribed Drugs. IR was defined as any non-treated significant (50%) stenosis in a coronary artery supplying >10 % of the myocardium. Patients with single-vessel disease or coronary by-pass grafts were excluded.
Results: Of 26 224 patients included in the study, 17 371 (66 %) had IR following PCI. At baseline, patients with IR were older, had more extensive coronary disease, and were more likely to have had an ST-elevation myocardial infarction than patients with CR. One year mortality was 9.3 % vs. 4.1%, the rate of MI 10.7 % vs. 6.1 % and repeat PCI 19.5% vs. 9.0% in the IR and CR group, respectively.
Unadjusted hazard ratio for the composite endpoint of death, MI or repeat PCI at one year was 2.6 (95 % CI 2.4 - 2.7) for the IR group compared to the CR group. Data adjusted for differences in baseline characteristics will be presented.
Conclusion: Incomplete revascularization is common after PCI in patients with multivessel disease and these patients have a high risk of death, MI and repeat PCI. Further studies exploring alternative strategies in the treatment of patients with incomplete revascularization are warranted.
- Coronary artery disease
- Interventional cardiology
- Myocardial revascularization
- Percutaneous coronary intervention
- © 2013 by American Heart Association, Inc.