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Percutaneous coronary intervention for acute coronary syndrome due to graft failure: use of bare-metal and drug-eluting stents and subsequent long-term clinical outcome.
Catheter Cardiovasc Interv. 2014 Feb; 83(2):203-9.CC

Abstract

OBJECTIVES

To describe clinical outcome after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) due to graft failure.

BACKGROUND

Limited data are available on outcome after PCI for graft failure-induced ACS in the drug-eluting stent (DES) era.

METHODS

Patients were identified who underwent PCI either with DES or BMS for ACS due to graft failure between January 2003 and December 2008. Follow-up was performed at 1 year and April 2011. The primary endpoint was the composite of death, myocardial infarction (MI), or target vessel revascularization (TVR). Kaplan-Meier estimates were calculated at 1 and 5-year follow-up. Predictors were identified by backward selection in Cox proportional hazards models.

RESULTS

A total of 92 patients underwent PCI, of which 77 were treated with bare metal stents (BMS) and 15 with DES. Patient and procedural characteristics were similar in both groups. Mean follow-up was 3.2 years. Five-year composite event rate was 65.9% after BMS vs. 43.4% after DES implantation (P = 0.17). Individual endpoints were comparable in both groups. Recurrence of angina, hospitalization, and repeat interventions were similar. After multivariable adjustment, the use of DES was not associated with a significant reduction in the primary endpoint (HR = 0.44, 0.18-1.04, p = 0.06).

CONCLUSION

In patients presenting with ACS due to acute graft failure, long-term outcomes remain poor. In a nonrandomized comparison with BMS, DES use was not associated with significant improved long-term clinical outcomes.

Authors+Show Affiliations

Department of Cardiology, Academic Medical Center-University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

22508617

Citation

Harskamp, Ralf E., et al. "Percutaneous Coronary Intervention for Acute Coronary Syndrome Due to Graft Failure: Use of Bare-metal and Drug-eluting Stents and Subsequent Long-term Clinical Outcome." Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions, vol. 83, no. 2, 2014, pp. 203-9.
Harskamp RE, Kuijt WJ, Damman P, et al. Percutaneous coronary intervention for acute coronary syndrome due to graft failure: use of bare-metal and drug-eluting stents and subsequent long-term clinical outcome. Catheter Cardiovasc Interv. 2014;83(2):203-9.
Harskamp, R. E., Kuijt, W. J., Damman, P., Beijk, M. A., Grundeken, M. J., Woudstra, P., Tijssen, J. G., & de Winter, R. J. (2014). Percutaneous coronary intervention for acute coronary syndrome due to graft failure: use of bare-metal and drug-eluting stents and subsequent long-term clinical outcome. Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions, 83(2), 203-9. https://doi.org/10.1002/ccd.24441
Harskamp RE, et al. Percutaneous Coronary Intervention for Acute Coronary Syndrome Due to Graft Failure: Use of Bare-metal and Drug-eluting Stents and Subsequent Long-term Clinical Outcome. Catheter Cardiovasc Interv. 2014;83(2):203-9. PubMed PMID: 22508617.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Percutaneous coronary intervention for acute coronary syndrome due to graft failure: use of bare-metal and drug-eluting stents and subsequent long-term clinical outcome. AU - Harskamp,Ralf E, AU - Kuijt,Wichert J, AU - Damman,Peter, AU - Beijk,Marcel A, AU - Grundeken,Maik J, AU - Woudstra,Pier, AU - Tijssen,Jan G, AU - de Winter,Robbert J, Y1 - 2013/10/21/ PY - 2011/10/04/received PY - 2012/04/01/accepted PY - 2012/4/18/entrez PY - 2012/4/18/pubmed PY - 2014/9/30/medline KW - bare metal stent KW - clinical outcome KW - drug eluting stent KW - graft failure SP - 203 EP - 9 JF - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JO - Catheter Cardiovasc Interv VL - 83 IS - 2 N2 - OBJECTIVES: To describe clinical outcome after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) due to graft failure. BACKGROUND: Limited data are available on outcome after PCI for graft failure-induced ACS in the drug-eluting stent (DES) era. METHODS: Patients were identified who underwent PCI either with DES or BMS for ACS due to graft failure between January 2003 and December 2008. Follow-up was performed at 1 year and April 2011. The primary endpoint was the composite of death, myocardial infarction (MI), or target vessel revascularization (TVR). Kaplan-Meier estimates were calculated at 1 and 5-year follow-up. Predictors were identified by backward selection in Cox proportional hazards models. RESULTS: A total of 92 patients underwent PCI, of which 77 were treated with bare metal stents (BMS) and 15 with DES. Patient and procedural characteristics were similar in both groups. Mean follow-up was 3.2 years. Five-year composite event rate was 65.9% after BMS vs. 43.4% after DES implantation (P = 0.17). Individual endpoints were comparable in both groups. Recurrence of angina, hospitalization, and repeat interventions were similar. After multivariable adjustment, the use of DES was not associated with a significant reduction in the primary endpoint (HR = 0.44, 0.18-1.04, p = 0.06). CONCLUSION: In patients presenting with ACS due to acute graft failure, long-term outcomes remain poor. In a nonrandomized comparison with BMS, DES use was not associated with significant improved long-term clinical outcomes. SN - 1522-726X UR - https://www.unboundmedicine.com/medline/citation/22508617/Percutaneous_coronary_intervention_for_acute_coronary_syndrome_due_to_graft_failure:_use_of_bare_metal_and_drug_eluting_stents_and_subsequent_long_term_clinical_outcome_ L2 - https://doi.org/10.1002/ccd.24441 DB - PRIME DP - Unbound Medicine ER -