Single-Centre Registry Analysis of Patients Who Underwent Percutaneous Coronary Intervention on Their Coronary Bypass Grafts

The study assessed the outcomes of patients undergoing percutaneous coronary intervention (PCI) to bypass grafts, focusing on all-cause mortality and target vessel failure (TVF) rates. A single-centre registry analysis included 364 patients who underwent PCI on coronary bypass grafts between 2008 an...

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Veröffentlicht in:CJC open (Online) 2024-03, Vol.6 (3), p.548-555
Hauptverfasser: Kim, Wan Cheol, Hirsch, Gregory, Kells, Catherine, Quraishi, Ata-Ur-Rehman, Bishop, Helen, Kidwai, Bakhtiar, Title, Lawrence, Beydoun, Hussein, Sandila, Navjot, Sumaya, Wael, Elkhateeb, Osama
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Sprache:eng
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Zusammenfassung:The study assessed the outcomes of patients undergoing percutaneous coronary intervention (PCI) to bypass grafts, focusing on all-cause mortality and target vessel failure (TVF) rates. A single-centre registry analysis included 364 patients who underwent PCI on coronary bypass grafts between 2008 and 2019. The study analyzed all-cause mortality and TVF, which encompassed target lesion revascularization, target vessel revascularization, and medically treated occluded target graft post-PCI. The median age of the patients was 71 years (interquartile range: [IQR] 65-78), with 82.1% being male. Most patients (94.8%) received PCI on saphenous vein grafts, and the median graft age was 13.0 years (IQR: 8.4-17.6). Drug-eluting stents were used more frequently (54.4%) than bare-metal stents (45.6%), with a median stent diameter of 3.5 mm (IQR: 3-4) and length of 19 mm (IQR: 18-28). Outcome differences were not significant for PCI sites (aorto-ostial, graft body, anastomosis), use of drug-eluting stents, or use of protection devices. The 1-year mortality rate was 3.3%, whereas the combined rate of TVF or death was 20.3%. After 5 years, the mortality rate increased to 14.9%, and the combined TVF or death rate rose to 40.3%. Multivariable analyses revealed that chronic kidney disease was independently associated with mortality (hazard ratio [HR] 1.74, 95% confidence interval [CI] 1.16-2.61, P = 0.007), whereas hypertension (HR 2.42, 95% CI 1.32-4.42, P = 0.004) and increased stent length (HR 1.01, 95% CI 1.00-1.02, P = 0.007) were independently associated with the TVF-or-mortality outcome. Patients undergoing PCI to bypass grafts experience considerable adverse outcomes over a 5-year period, highlighting the need for further strategies in managing this high-risk population. L’étude visait à évaluer l’issue des patients ayant subi une intervention coronarienne percutanée (ICP) sur un greffon coronarien, en mettant l’accent sur le taux de mortalité toutes causes confondues et le taux d’échecs de revascularisation du vaisseau cible (EVC). Une analyse du registre d’un seul établissement a porté sur 364 patients ayant subi une ICP sur un greffon coronarien de 2008 à 2019. L’étude a analysé la mortalité toutes causes confondues et les EVC, qui comprenaient la revascularisation de la lésion cible, la revascularisation du vaisseau cible et le traitement médical de l’occlusion du greffon coronarien cible après l’ICP. L’âge médian des patients était de 71 ans (intervalle interqu
ISSN:2589-790X
2589-790X
DOI:10.1016/j.cjco.2023.11.005