Comparison of clinical outcomes in patients presenting with an acute coronary syndrome due to stent thrombosis or saphenous vein graft occlusion and undergoing percutaneous coronary intervention. 

 -  2015 
<br/><br/>Available in print through MWHC library: 2002 - present 
<br/><br/> BACKGROUND: Patients presenting with ST or SVG occlusion are at increased risk of adverse outcomes. There is limited literature comparing the outcome of such patients.  CONCLUSIONS: As compared to patients undergoing NC-PCI, patients with ST have greater rates of in-hospital mortality and major bleeding as well as 30-day MACE rate. The 1-year MACE rate is similar in patients with ST and SVG occlusion who undergo PCI.Copyright (c) 2015. Published by Elsevier Inc.  METHODS: A cohort of 415 consecutive patients presenting to the MedStar Washington Hospital Center undergoing percutaneous coronary intervention (PCI) for an acute coronary syndrome secondary to ST (n=136) or SVG occlusion (n=279) was studied. The SVG group was subdivided into patients who underwent PCI in the occluded SVG (SVG-PCI: n=75) or in the subtended native coronary artery (NC-PCI: n=204). The analyzed clinical parameters were in-hospital complications as well as 30-day and 1-year major adverse cardiac events (MACE). MACE was defined as all-cause mortality, Q-wave myocardial infarction, or target vessel revascularization.  OBJECTIVE: To compare the clinical outcomes of patients undergoing percutaneous intervention for stent thrombosis (ST) or saphenous vein graft (SVG) occlusion.  RESULTS: The rates of death, major bleeding, and length of hospital stay were significantly different between the ST and NC-PCI groups. The SVG-PCI group had a shorter hospital stay. The 30-day MACE rate was significantly different in the ST and NC-PCI groups (18.9% vs. 7.5%; risk ratio=0.40, 95% CI=0.20-0.81, p=0.03) but not in the ST and SVG-PCI groups (18.9% vs. 15.1%; p=0.55, risk ratio=0.80, 95% CI=0.38-1.68). There were no differences in the 1-year MACE rate. 
<br/><br/><br/>English 
<br/><br/><label>ISSN: </label>1878-0938 
<br/><br/><label>Subjects--Topical Terms: </label><br/>*Acute Coronary Syndrome/th [Therapy]<br/>*Coronary Artery Bypass/ae [Adverse Effects]<br/>*Coronary Restenosis/co [Complications]<br/>*Drug-Eluting Stents/ae [Adverse Effects]<br/>*Graft Occlusion, Vascular/co [Complications]<br/>*Percutaneous Coronary Intervention/mt [Methods]<br/>Academic Medical Centers<br/>Acute Coronary Syndrome/di [Diagnosis]<br/>Acute Coronary Syndrome/et [Etiology]<br/>Acute Coronary Syndrome/mo [Mortality]<br/>Aged<br/>Aged, 80 and over<br/>Analysis of Variance<br/>Cause of Death<br/>Chi-Square Distribution<br/>Cohort Studies<br/>Coronary Artery Bypass/mt [Methods]<br/>Coronary Restenosis/ra [Radiography]<br/>Coronary Restenosis/th [Therapy]<br/>District of Columbia<br/>Female<br/>Graft Occlusion, Vascular/ra [Radiography]<br/>Graft Occlusion, Vascular/th [Therapy]<br/>Hospital Mortality/td [Trends]<br/>Humans<br/>Kaplan-Meier Estimate<br/>Male<br/>Middle Aged<br/>Percutaneous Coronary Intervention/mo [Mortality]<br/>Prognosis<br/>Retrospective Studies<br/>Risk Assessment<br/>Saphenous Vein/tr [Transplantation]<br/>Survival Analysis<br/>Treatment Outcome
<br/><br/><label>Subjects--Geographic Terms: </label><br/>MedStar Washington Hospital Center<br/>MedStar Washington Hospital Center<br/>MedStar Washington Hospital Center<br/>MedStar Washington Hospital Center<br/>MedStar Washington Hospital Center<br/>MedStar Washington Hospital Center<br/>MedStar Washington Hospital Center<br/>MedStar Washington Hospital Center
<br/><br/><label>Index Terms--Occupation: </label><br/>MedStar Heart Institute<br/>MedStar Heart Institute<br/>MedStar Heart Institute<br/>MedStar Heart Institute<br/>MedStar Heart Institute<br/>MedStar Heart Institute<br/>MedStar Heart Institute<br/>MedStar Heart Institute
<br/><br/><label>Index Terms--Function: </label><br/>Comparative Study<br/>Journal Article