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dc.contributor.authorBarringhaus, Kurt G.
dc.contributor.authorPark, Kay Lee
dc.contributor.authorMcManus, David D.
dc.contributor.authorSteg, Phillippe Gabriel
dc.contributor.authorMontalescot, Gilles
dc.contributor.authorVan de Werf, Frans
dc.contributor.authorLopez-Sendon, Jose
dc.contributor.authorFitzGerald, Gordon
dc.contributor.authorGore, Joel M.
dc.date2022-08-11T08:08:08.000
dc.date.accessioned2022-08-23T15:44:03Z
dc.date.available2022-08-23T15:44:03Z
dc.date.issued2011-04-21
dc.date.submitted2011-09-23
dc.identifier.citationCatheter Cardiovasc Interv. 2011 Apr 1;77(5):617-22. <a href="http://dx.doi.org/10.1002/ccd.22784">Link to article on publisher's site</a>
dc.identifier.issn1522-1946 (Linking)
dc.identifier.doi10.1002/ccd.22784
dc.identifier.pmid20853369
dc.identifier.urihttp://hdl.handle.net/20.500.14038/27231
dc.description.abstractBACKGROUND: CABG and PCI are effective means for revascularization of patients with multi-vessel coronary artery disease, but previous studies have not focused on treatment of patients that first undergo primary PCI. METHODS: Among patients enrolled in the global registry of acute coronary events (GRACE), clinical outcomes for patients presenting with STEMI treated with primary PCI were compared according to whether residual stenoses were treated medically, surgically, or with staged PCI. Clinical characteristics and data pertaining to major adverse cardiac events during hospitalization and 6 months after discharge were collected. RESULTS: Of the 1,705 patients included, 1,345 (79%) patients were treated medically, 303 (18%) underwent staged PCI, and 57 (3.3%) underwent CABG following primary PCI. Hospital mortality was lowest among patients treated with staged PCI (Medical = 5.7%; PCI = 0.7%; CABG = 3.5%; P < 0.001 [PCI vs. Medical]), a finding that persisted after risk adjustment (Odds Ratio PCI vs. Medical 5 0.16, [0.04-0.68]; P 5 0.01). Six month postdischarge mortality likewise was lowest in the staged PCI group (Medical = 3.1%; PCI = 0.8%; CABG = 4.0%; P = 0.04 [PCI vs. Medical]). Patients revascularized surgically were rehospitalized less frequently (Medical = 20%; PCI = 19%; CABG = 6.3%; P < 0.05) and underwent fewer unscheduled procedures (Medical 5 9.8%; PCI = 10.0%; CABG = 0.0%; P < 0.02). CONCLUSIONS: The results of this multinational registry demonstrate that hospital mortality in patients who undergo staged percutaneous revascularization of multivessel coronary disease following primary PCI is very low. Patients undergoing CABG following primary PCI are hospitalized less frequently and undergo fewer unplanned catheter-based procedures.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=20853369&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1002/ccd.22784
dc.subjectAged
dc.subjectAngioplasty, Balloon, Coronary
dc.subjectAustralia
dc.subjectCardiovascular Agents
dc.subjectCoronary Artery Bypass
dc.subjectCoronary Stenosis
dc.subjectEurope
dc.subjectFemale
dc.subjectHospital Mortality
dc.subjectHumans
dc.subjectLogistic Models
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectMyocardial Infarction
dc.subjectNew Zealand
dc.subjectNorth America
dc.subjectOdds Ratio
dc.subjectPatient Selection
dc.subjectRegistries
dc.subjectRisk Assessment
dc.subjectRisk Factors
dc.subjectSouth America
dc.subjectTime Factors
dc.subjectTreatment Outcome
dc.subjectHealth Services Research
dc.titleOutcomes from patients with multi-vessel disease following primary PCI: staged PCI imparts very low mortality
dc.typeJournal Article
dc.source.journaltitleCatheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography and Interventions
dc.source.volume77
dc.source.issue5
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/cor_grace/5
dc.identifier.contextkey2254923
html.description.abstract<p>BACKGROUND: CABG and PCI are effective means for revascularization of patients with multi-vessel coronary artery disease, but previous studies have not focused on treatment of patients that first undergo primary PCI.</p> <p>METHODS: Among patients enrolled in the global registry of acute coronary events (GRACE), clinical outcomes for patients presenting with STEMI treated with primary PCI were compared according to whether residual stenoses were treated medically, surgically, or with staged PCI. Clinical characteristics and data pertaining to major adverse cardiac events during hospitalization and 6 months after discharge were collected.</p> <p>RESULTS: Of the 1,705 patients included, 1,345 (79%) patients were treated medically, 303 (18%) underwent staged PCI, and 57 (3.3%) underwent CABG following primary PCI. Hospital mortality was lowest among patients treated with staged PCI (Medical = 5.7%; PCI = 0.7%; CABG = 3.5%; P < 0.001 [PCI vs. Medical]), a finding that persisted after risk adjustment (Odds Ratio PCI vs. Medical 5 0.16, [0.04-0.68]; P 5 0.01). Six month postdischarge mortality likewise was lowest in the staged PCI group (Medical = 3.1%; PCI = 0.8%; CABG = 4.0%; P = 0.04 [PCI vs. Medical]). Patients revascularized surgically were rehospitalized less frequently (Medical = 20%; PCI = 19%; CABG = 6.3%; P < 0.05) and underwent fewer unscheduled procedures (Medical 5 9.8%; PCI = 10.0%; CABG = 0.0%; P < 0.02).</p> <p>CONCLUSIONS: The results of this multinational registry demonstrate that hospital mortality in patients who undergo staged percutaneous revascularization of multivessel coronary disease following primary PCI is very low. Patients undergoing CABG following primary PCI are hospitalized less frequently and undergo fewer unplanned catheter-based procedures.</p>
dc.identifier.submissionpathcor_grace/5
dc.contributor.departmentDepartment of Medicine, Division of Cardiovascular Medicine
dc.contributor.departmentCenter for Outcomes Research
dc.source.pages617-22


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