Angiographic Complete versus Clinical Selective Incomplete Percutaneous Revascularization in Heart Failure Patients with Multivessel Coronary Disease
Background. Patients with multivessel disease (MVD) often pursue complete revascularization (CR) during percutaneous coronary intervention (PCI) to improve prognosis. However, angiographic CR is not always feasible and is associated with some procedure-related complications in heart failure (HF) pat...
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| Format: | Article |
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Wiley
2020-01-01
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| Series: | Journal of Interventional Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2020/9506124 |
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| author | Chieh-Yu Chang Chun-Chi Chen I-Chang Hsieh Ming-Jer Hsieh Cheng-Hung Lee Dong-Yi Chen Ming-Lung Tsai Ming-Yun Ho Jih-Kai Yeh Yu-Chang Huang Yu-Ying Lu Chao-Yung Wang Shang-Hung Chang Ming-Shien Wen |
| author_facet | Chieh-Yu Chang Chun-Chi Chen I-Chang Hsieh Ming-Jer Hsieh Cheng-Hung Lee Dong-Yi Chen Ming-Lung Tsai Ming-Yun Ho Jih-Kai Yeh Yu-Chang Huang Yu-Ying Lu Chao-Yung Wang Shang-Hung Chang Ming-Shien Wen |
| author_sort | Chieh-Yu Chang |
| collection | DOAJ |
| description | Background. Patients with multivessel disease (MVD) often pursue complete revascularization (CR) during percutaneous coronary intervention (PCI) to improve prognosis. However, angiographic CR is not always feasible and is associated with some procedure-related complications in heart failure (HF) patients with MVD. Clinical selective incomplete revascularization (IR) may be reasonable for these high-risk patients, but its role in long-term outcomes remains uncertain. Methods. Six hundred patients with HF and MVD submitted to PCI were enrolled. Major adverse cardiac events (MACEs) were defined as a composite of recurrent myocardial infarction, any revascularization, and all-cause mortality at 5 years. Results. During a mean follow-up period of 3.7 ± 1.9 years, there was no significant difference in 5-year MACEs between selective IR and successful angiographic CR in HF patients with MVD. However, patients who failed CR had a significantly greater incidence of 5-year MACEs than those in the other two groups (failed CR: 46.4% vs. selective IR: 27.7% vs. successful CR: 27.8%, p<0.001). Conclusions. Long-term outcomes of selective IR were comparable with those of successful angiographic CR in HF patients with MVD. However, patients that failed CR showed 2.53-fold increased risk of MACEs compared to patients undergoing either selective IR or successful angiographic CR. A more comprehensive planning strategy should be devised before PCI in HF patients with MVD. |
| format | Article |
| id | doaj-art-9e769b83b37245c8a5d7253a04787a53 |
| institution | Kabale University |
| issn | 0896-4327 1540-8183 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Interventional Cardiology |
| spelling | doaj-art-9e769b83b37245c8a5d7253a04787a532025-02-03T00:58:44ZengWileyJournal of Interventional Cardiology0896-43271540-81832020-01-01202010.1155/2020/95061249506124Angiographic Complete versus Clinical Selective Incomplete Percutaneous Revascularization in Heart Failure Patients with Multivessel Coronary DiseaseChieh-Yu Chang0Chun-Chi Chen1I-Chang Hsieh2Ming-Jer Hsieh3Cheng-Hung Lee4Dong-Yi Chen5Ming-Lung Tsai6Ming-Yun Ho7Jih-Kai Yeh8Yu-Chang Huang9Yu-Ying Lu10Chao-Yung Wang11Shang-Hung Chang12Ming-Shien Wen13Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Address: No. 5, Fu-Hsing Street, Kwei-Shan, Taoyuan, TaiwanDivision of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Address: No. 5, Fu-Hsing Street, Kwei-Shan, Taoyuan, TaiwanDivision of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Address: No. 5, Fu-Hsing Street, Kwei-Shan, Taoyuan, TaiwanDivision of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Address: No. 5, Fu-Hsing Street, Kwei-Shan, Taoyuan, TaiwanDivision of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Address: No. 5, Fu-Hsing Street, Kwei-Shan, Taoyuan, TaiwanDivision of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Address: No. 5, Fu-Hsing Street, Kwei-Shan, Taoyuan, TaiwanDivision of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Address: No. 5, Fu-Hsing Street, Kwei-Shan, Taoyuan, TaiwanDivision of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Address: No. 5, Fu-Hsing Street, Kwei-Shan, Taoyuan, TaiwanDivision of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Address: No. 5, Fu-Hsing Street, Kwei-Shan, Taoyuan, TaiwanDivision of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Address: No. 5, Fu-Hsing Street, Kwei-Shan, Taoyuan, TaiwanDivision of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Address: No. 5, Fu-Hsing Street, Kwei-Shan, Taoyuan, TaiwanDivision of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Address: No. 5, Fu-Hsing Street, Kwei-Shan, Taoyuan, TaiwanDivision of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Address: No. 5, Fu-Hsing Street, Kwei-Shan, Taoyuan, TaiwanDivision of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Address: No. 5, Fu-Hsing Street, Kwei-Shan, Taoyuan, TaiwanBackground. Patients with multivessel disease (MVD) often pursue complete revascularization (CR) during percutaneous coronary intervention (PCI) to improve prognosis. However, angiographic CR is not always feasible and is associated with some procedure-related complications in heart failure (HF) patients with MVD. Clinical selective incomplete revascularization (IR) may be reasonable for these high-risk patients, but its role in long-term outcomes remains uncertain. Methods. Six hundred patients with HF and MVD submitted to PCI were enrolled. Major adverse cardiac events (MACEs) were defined as a composite of recurrent myocardial infarction, any revascularization, and all-cause mortality at 5 years. Results. During a mean follow-up period of 3.7 ± 1.9 years, there was no significant difference in 5-year MACEs between selective IR and successful angiographic CR in HF patients with MVD. However, patients who failed CR had a significantly greater incidence of 5-year MACEs than those in the other two groups (failed CR: 46.4% vs. selective IR: 27.7% vs. successful CR: 27.8%, p<0.001). Conclusions. Long-term outcomes of selective IR were comparable with those of successful angiographic CR in HF patients with MVD. However, patients that failed CR showed 2.53-fold increased risk of MACEs compared to patients undergoing either selective IR or successful angiographic CR. A more comprehensive planning strategy should be devised before PCI in HF patients with MVD.http://dx.doi.org/10.1155/2020/9506124 |
| spellingShingle | Chieh-Yu Chang Chun-Chi Chen I-Chang Hsieh Ming-Jer Hsieh Cheng-Hung Lee Dong-Yi Chen Ming-Lung Tsai Ming-Yun Ho Jih-Kai Yeh Yu-Chang Huang Yu-Ying Lu Chao-Yung Wang Shang-Hung Chang Ming-Shien Wen Angiographic Complete versus Clinical Selective Incomplete Percutaneous Revascularization in Heart Failure Patients with Multivessel Coronary Disease Journal of Interventional Cardiology |
| title | Angiographic Complete versus Clinical Selective Incomplete Percutaneous Revascularization in Heart Failure Patients with Multivessel Coronary Disease |
| title_full | Angiographic Complete versus Clinical Selective Incomplete Percutaneous Revascularization in Heart Failure Patients with Multivessel Coronary Disease |
| title_fullStr | Angiographic Complete versus Clinical Selective Incomplete Percutaneous Revascularization in Heart Failure Patients with Multivessel Coronary Disease |
| title_full_unstemmed | Angiographic Complete versus Clinical Selective Incomplete Percutaneous Revascularization in Heart Failure Patients with Multivessel Coronary Disease |
| title_short | Angiographic Complete versus Clinical Selective Incomplete Percutaneous Revascularization in Heart Failure Patients with Multivessel Coronary Disease |
| title_sort | angiographic complete versus clinical selective incomplete percutaneous revascularization in heart failure patients with multivessel coronary disease |
| url | http://dx.doi.org/10.1155/2020/9506124 |
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