HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Pertti Loponen Michael Luther Matti R. Tarkka Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Loponen, P. Articles by Tarkka, M. R. Search for Related Content PubMed Articles by Loponen, P. Articles by Tarkka, M. R. Related Collections Cardiac - other

Repeat intervention after invasive treatment of coronary arteries

^a Department of Thoracic and Vascular Surgery, Vaasa Central Hospital, Vaasa, Finland
^b Department of Cardiology, Vaasa Central Hospital, Vaasa, Finland
^c School of Public Health, University of Tampere, Tampere, Finland
^d Department of Cardiothoracic Surgery, Heart Centre, Tampere University Hospital, Tampere, Finland

Received 25 April 2008; received in revised form 21 August 2008; accepted 27 August 2008.

^_* Corresponding author. Tel.: +358 50 527 3830. (Email: pertti.loponen{at}pp.inet.fi).

Objective: Patients who undergo successful revascularisation either with coronary artery bypass grafting (CABG) or with percutaneous coronary intervention (PCI) may subsequently require repeat invasive procedures. Methods: A cohort of 662 coronary artery diseased (CAD) patients was retrospectively reviewed. Follow-up was 36 months. Results: Thirty-day mortality was 1.0% in the CABG group (n = 302) and 0% in the PCI group (n = 360) (p = 0.094). Overall 3-year survival for the cohort was 95.0% (NS). In addition to repeat angiographies (cumulative frequency 57.7% for PCI vs 4.3% for CABG, p < 0.001) patients underwent both repeat PCI (20.7% vs 3.2%, p < 0.001) and repeat CABG (6.9% vs 0.7%, p < 0.001) during the follow-up. In Cox regression analysis hazard ratio (HR) for repeat PCI after initial PCI was 8.5, 95% confidence interval (CI) 3.7–19.5, p < 0.001 and for repeat CABG 9.5, CI 2.2–40.0, p = 0.002 in comparison to initial CABG. In-stent restenosis and progression of atherosclerotic plaques in native vessels were reasons for repeat intervention among the PCI patients. Complications with bypass grafts together with progression of the underlying disease were factors for re-interventions after CABG. Conclusions: PCI is far less invasive and may have lower in-hospital mortality rates than CABG. However, the highly likely need for repeat invasive procedures and revascularisation has to be taken into consideration when choosing an invasive approach for multi vessel CAD patients.

Key Words: CABG • PCI • Repeat intervention • Clinical outcomes

This article has been cited by other articles:

				R. Bhindi, G. A. Figtree, J. L. Edwards, R. J.L. Brereton, M. Misfeld, D. E. Ross, A. B. Shil, T. Aung, M. P. Strohm, R. F. Bonvini, et al. Percutaneous coronary intervention versus coronary-artery bypass grafting. N. Engl. J. Med., June 18, 2009; 360(25): 2672 - 2673. [Full Text] [PDF]