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

Hideaki Ota, Michael Mahmoudi, Thibault Lhermusier, Marco A. Magalhaes, Rebecca Torguson, Lowell F. Satler, William O. Suddath, Augusto D. Pichard, Ron Waksman

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

Objective: To compare the clinical outcomes of patients undergoing percutaneous intervention for stent thrombosis (ST) or saphenous vein graft (SVG) occlusion. 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. 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. 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. 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.

Original languageEnglish
Pages (from-to)441-446
Number of pages6
JournalCardiovascular Revascularization Medicine
Volume16
Issue number8
DOIs
Publication statusPublished - 01-12-2015
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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