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.
Citation: Cardiovascular Revascularization Medicine. 16(8):441-6, 2015 Dec.PMID: 26704310Institution: MedStar Washington Hospital Center | MedStar Washington Hospital Center | MedStar Washington Hospital Center | MedStar Washington Hospital Center | MedStar Washington Hospital Center | MedStar Washington Hospital Center | MedStar Washington Hospital Center | MedStar Washington Hospital CenterDepartment: MedStar Heart Institute | MedStar Heart Institute | MedStar Heart Institute | MedStar Heart Institute | MedStar Heart Institute | MedStar Heart Institute | MedStar Heart Institute | MedStar Heart InstituteForm of publication: Journal ArticleMedline article type(s): Comparative Study | Journal ArticleSubject headings: *Acute Coronary Syndrome/th [Therapy] | *Coronary Artery Bypass/ae [Adverse Effects] | *Coronary Restenosis/co [Complications] | *Drug-Eluting Stents/ae [Adverse Effects] | *Graft Occlusion, Vascular/co [Complications] | *Percutaneous Coronary Intervention/mt [Methods] | Academic Medical Centers | Acute Coronary Syndrome/di [Diagnosis] | Acute Coronary Syndrome/et [Etiology] | Acute Coronary Syndrome/mo [Mortality] | Aged | Aged, 80 and over | Analysis of Variance | Cause of Death | Chi-Square Distribution | Cohort Studies | Coronary Artery Bypass/mt [Methods] | Coronary Restenosis/ra [Radiography] | Coronary Restenosis/th [Therapy] | District of Columbia | Female | Graft Occlusion, Vascular/ra [Radiography] | Graft Occlusion, Vascular/th [Therapy] | Hospital Mortality/td [Trends] | Humans | Kaplan-Meier Estimate | Male | Middle Aged | Percutaneous Coronary Intervention/mo [Mortality] | Prognosis | Retrospective Studies | Risk Assessment | Saphenous Vein/tr [Transplantation] | Survival Analysis | Treatment OutcomeYear: 2015Local holdings: Available in print through MWHC library: 2002 - presentISSN:- 1878-0938
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 26704310 | Available | 26704310 |
Available in print through MWHC library: 2002 - present
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.
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