Clinical outcomes of percutaneous coronary intervention in high‐risk patients turned down for surgical revascularization

Autor: Mohamed Farag, Ayman Al‐Atta, Ibrahem Abdalazeem, Tarik Salim, Mohammad Alkhalil, Mohaned Egred
Rok vydání: 2022
Předmět:
Zdroj: Catheterization and Cardiovascular Interventions. 100:360-366
ISSN: 1522-726X
1522-1946
DOI: 10.1002/ccd.30318
Popis: There are limited data on outcomes of PCI in surgical turndown patientsespecially in those presenting with ACS.A retrospective analysis of prospectively collected data of patients who were turned down for CABG and had PCI between 2013 and 2020. All consecutive patients (449), ACS (n = 245) and no-ACS (n = 204) were included. In-hospital complications occurred in 28 patients (6.2%). At 30 days, 27 patients (6.0%) died (18 patients in the ACS group [7.3%] vs. 9 patients in the no-ACS group [4.4%], p = 0.23). Following multivariate analysis, no significant difference in long-term mortality was observed between the two groups (median follow-up of 4 [2-6] years, hazard ratio [HR]: 1.08, 95% confidence interval [CI]: 0.75-1.58, p = 0.667). In propensity score-matched analysis, the adjusted mortality risk was also not different between the groups (HR: 0.74, 95% CI: 0.25-1.26, p = 0.374). Independent predictors of mortality included chronic kidney disease stage ≥ 3 (HR: 1.64, 95% CI: 1.13-2.39, p = 0.009), high European System for Cardiac Operative Risk Evaluation II (HR: 1.02, 95% CI: 1.00-1.05, p = 0.035), and laser atherectomy use (HR: 3.35, 95% CI: 1.32-8.54, p = 0.011).PCI in surgical patients turndown patients appears safe. ACSpresentation was associated with more comorbid illnesses; however, afteradjustment, ACS did not independently confer additional risk of mortality.
Databáze: OpenAIRE
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