Single-session versus staged procedures for elective multivessel percutaneous coronary intervention
| Autor: | Takao Kato, Yoshihisa Nakagawa, Koh Ono, Kazushige Kadota, Yutaka Furukawa, Satoshi Shizuta, Kenji Ando, Naritatsu Saito, Toshiaki Toyota, Kyohei Yamaji, Shuichiro Kaji, Minoru Horie, Takeshi Morimoto, Hiroki Shiomi, Takeshi Kimura |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Reoperation medicine.medical_specialty Acute coronary syndrome medicine.medical_treatment Contrast Media Coronary Artery Disease 030204 cardiovascular system & hematology Coronary Angiography Coronary artery disease 03 medical and health sciences 0302 clinical medicine Percutaneous Coronary Intervention Postoperative Complications Japan Recurrence Internal medicine medicine Humans cardiovascular diseases 030212 general & internal medicine Myocardial infarction Registries Non-ST Elevated Myocardial Infarction Stroke Aged business.industry Graft Occlusion Vascular Percutaneous coronary intervention medicine.disease Surgery Treatment Outcome Heart failure Conventional PCI Cardiology Female Kidney Diseases Stents Cardiology and Cardiovascular Medicine business Kidney disease |
| Zdroj: | Heart (British Cardiac Society). 104(11) |
| ISSN: | 1468-201X |
| Popis: | ObjectivesTo clarify the effect of single-session multivessel percutaneous coronary intervention (PCI) strategy relative to the staged multivessel strategy on clinical outcomes in patients with stable coronary artery disease (CAD) or non-ST-elevation acute coronary syndrome.MethodsIn the Coronary REvascularisation Demonstrating Outcome Study in Kyoto PCI/coronary artery bypass grafting registry cohort-2, there were 2018 patients who underwent elective multivessel PCI. Primary outcome measure was composite of all-cause death, myocardial infarction and stroke at 5-year follow-up.ResultsSingle-session multivessel PCI and staged multivessel PCI were performed in 707 patients (35.0%) and 1311 patients (65.0%), respectively. The cumulative 5-year incidence of and adjusted risk for the primary outcome measure were not significantly different between the single-session and staged groups (26.7% vs 23.0%, p=0.45; HR 0.91, 95% CI 0.72 to 1.16, p=0.47). The 30-day incidence of all-cause death was significantly higher in the single-session group than in the staged group (1.1% vs 0.2%, p=0.009). However, the causes of death in 11 patients who died within 30 days were generally not related to the procedural complications, but related to the serious clinical status before PCI. For the subgroup analyses including age, gender, extent of CAD, severe chronic kidney disease and heart failure, there was no significant interaction between the subgroup factors and the effect of the single-session strategy relative to the staged strategy for the primary outcome measure.ConclusionsThe single-session multivessel PCI strategy was associated with at least comparable 5-year clinical outcomes compared with the staged multivessel PCI, although the prevalence of the single-session strategy was low in the present study. |
| Databáze: | OpenAIRE |
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