PCI With Incomplete Revascularization in Certain Vessels May Increase Mortality Risk
Mortality risk was higher in patients with incomplete revascularization in a vessel with ≥90% stenosis.
HealthDay News — The risk of mortality is increased for certain patients undergoing percutaneous coronary intervention (PCI) with incomplete revascularization (IR), according to a study published online in JAMA Cardiology.
Edward L. Hannan, PhD, from the University at Albany in New York, and colleagues examined the correlation between coronary vessel characteristics and outcomes in patients with PCI with IR. Data were included for 41,639 New York residents with multivessel coronary artery disease undergoing PCI from 2010 through 2012.
The researchers found that incomplete revascularization was common (78% among patients with ST-elevation myocardial infarction and 71% among other patients). Risk of mortality was higher for patients with IR in a vessel with at least 90% stenosis than in other patients with IR; this was significant only among patients without STEMI (adjusted hazard ratio, 1.15).
Patients with IR in 2 or more vessels had higher mortality than patients with complete revascularization and compared to other patients with IR (adjusted hazard ratio, 1.35 and 1.17 for patients with and without STEMI, respectively). Mortality was also higher for patients with proximal left anterior descending artery vessel IR vs other patients with IR (adjusted hazard ratios, 1.31 and 1.11 for patients with and without STEMI, respectively).
"Patients with IR are at higher risk of mortality if they have IR with at least 90% stenosis, IR in 2 or more vessels, or proximal left anterior descending IR," the authors wrote.
Several authors disclosed financial ties to the pharmaceutical industry.
Hannan EL, Zhong Y, Berger PB, et al. Association of coronary vessel characteristics with outcome in patients with percutaneous coronary interventions with incomplete revascularization [published online December 27, 2017]. JAMA Cardiol. doi:10.1001/jamacardio.2017.4787