Long‐Term Outcome of Consecutive Patients With Previous Coronary Bypass Surgery, Treated With Newer‐Generation Drug‐Eluting Stents
BackgroundPercutaneous coronary intervention (PCI) in patients with previous coronary artery bypass grafting (CABG) is associated with adverse clinical events. Although newer generation drug‐eluting stents showed favorable short‐term safety profiles, there is a lack of long‐term outcome data. We eva...
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| Format: | Article |
| Language: | English |
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Wiley
2018-02-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.117.007212 |
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| author | Liefke C. van der Heijden Marlies M. Kok Paolo Zocca Hanim Sen Marije M. Löwik Silvia Mariani Frits H. A. F. de Man Marc Hartmann Martin G. Stoel K. Gert van Houwelingen J. (Hans) W. Louwerenburg Gerard C. M. Linssen Carine J. M. Doggen Jan G. Grandjean Clemens von Birgelen |
| author_facet | Liefke C. van der Heijden Marlies M. Kok Paolo Zocca Hanim Sen Marije M. Löwik Silvia Mariani Frits H. A. F. de Man Marc Hartmann Martin G. Stoel K. Gert van Houwelingen J. (Hans) W. Louwerenburg Gerard C. M. Linssen Carine J. M. Doggen Jan G. Grandjean Clemens von Birgelen |
| author_sort | Liefke C. van der Heijden |
| collection | DOAJ |
| description | BackgroundPercutaneous coronary intervention (PCI) in patients with previous coronary artery bypass grafting (CABG) is associated with adverse clinical events. Although newer generation drug‐eluting stents showed favorable short‐term safety profiles, there is a lack of long‐term outcome data. We evaluated the impact of previous CABG on 5‐year clinical outcomes of patients treated with PCI using newer‐generation drug‐eluting stents. Methods and ResultsIn this patient‐level pooled analysis of the prospective TWENTE (The Real‐World Endeavor Resolute versus Xience V Drug‐Eluting Stent Study in Twente) trial and nonenrolled TWENTE registry, we assessed a consecutive series of patients who underwent PCI with newer‐generation drug‐eluting stents for non–ST‐segment–elevation acute coronary syndromes or stable angina. Of all 1709 patients, 202 (11.8%) had a history of CABG. Patients with previous CABG had significantly higher 5‐year rates of cardiac death (10.4% versus 4.3%; P<0.001) and target vessel revascularization (25.0% versus 8.1%; P<0.001). These differences remained statistically significant after adjustment for differences in baseline characteristics. Landmark analysis revealed that from 1‐ to 5‐year follow‐up, the rates of cardiac death (8.1% versus 3.2%; P<0.001) and target vessel revascularization (17.1% versus 5.9%; P<0.001) were significantly higher in patients with previous CABG. Among patients with a history of CABG, PCI of an obstructed vein graft was associated with a higher rate of 5‐year target vessel revascularization (P=0.003). ConclusionsAt 5‐year follow‐up after PCI with newer‐generation drug‐eluting stents, the risk of cardiac death and target vessel revascularization was significantly higher in patients with previous CABG. The target vessel revascularization rate was highest in patients who underwent PCI of obstructed vein grafts. |
| first_indexed | 2024-12-22T21:43:18Z |
| format | Article |
| id | doaj.art-d4b839f1a07e48468123d10dda03d38a |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-22T21:43:18Z |
| publishDate | 2018-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-d4b839f1a07e48468123d10dda03d38a2022-12-21T18:11:34ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802018-02-017310.1161/JAHA.117.007212Long‐Term Outcome of Consecutive Patients With Previous Coronary Bypass Surgery, Treated With Newer‐Generation Drug‐Eluting StentsLiefke C. van der Heijden0Marlies M. Kok1Paolo Zocca2Hanim Sen3Marije M. Löwik4Silvia Mariani5Frits H. A. F. de Man6Marc Hartmann7Martin G. Stoel8K. Gert van Houwelingen9J. (Hans) W. Louwerenburg10Gerard C. M. Linssen11Carine J. M. Doggen12Jan G. Grandjean13Clemens von Birgelen14Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, the NetherlandsDepartment of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, the NetherlandsDepartment of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, the NetherlandsDepartment of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, the NetherlandsDepartment of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, the NetherlandsDepartment of Cardiothoracic Surgery, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, the NetherlandsDepartment of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, the NetherlandsDepartment of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, the NetherlandsDepartment of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, the NetherlandsDepartment of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, the NetherlandsDepartment of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, the NetherlandsDepartment of Cardiology, Ziekenhuisgroep Twente, Almelo and Hengelo, the NetherlandsDepartment of Health Technology and Services Research, MIRA—Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, the NetherlandsDepartment of Cardiothoracic Surgery, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, the NetherlandsDepartment of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, the NetherlandsBackgroundPercutaneous coronary intervention (PCI) in patients with previous coronary artery bypass grafting (CABG) is associated with adverse clinical events. Although newer generation drug‐eluting stents showed favorable short‐term safety profiles, there is a lack of long‐term outcome data. We evaluated the impact of previous CABG on 5‐year clinical outcomes of patients treated with PCI using newer‐generation drug‐eluting stents. Methods and ResultsIn this patient‐level pooled analysis of the prospective TWENTE (The Real‐World Endeavor Resolute versus Xience V Drug‐Eluting Stent Study in Twente) trial and nonenrolled TWENTE registry, we assessed a consecutive series of patients who underwent PCI with newer‐generation drug‐eluting stents for non–ST‐segment–elevation acute coronary syndromes or stable angina. Of all 1709 patients, 202 (11.8%) had a history of CABG. Patients with previous CABG had significantly higher 5‐year rates of cardiac death (10.4% versus 4.3%; P<0.001) and target vessel revascularization (25.0% versus 8.1%; P<0.001). These differences remained statistically significant after adjustment for differences in baseline characteristics. Landmark analysis revealed that from 1‐ to 5‐year follow‐up, the rates of cardiac death (8.1% versus 3.2%; P<0.001) and target vessel revascularization (17.1% versus 5.9%; P<0.001) were significantly higher in patients with previous CABG. Among patients with a history of CABG, PCI of an obstructed vein graft was associated with a higher rate of 5‐year target vessel revascularization (P=0.003). ConclusionsAt 5‐year follow‐up after PCI with newer‐generation drug‐eluting stents, the risk of cardiac death and target vessel revascularization was significantly higher in patients with previous CABG. The target vessel revascularization rate was highest in patients who underwent PCI of obstructed vein grafts.https://www.ahajournals.org/doi/10.1161/JAHA.117.007212coronary artery bypass graftdrug‐eluting stentpercutaneous coronary interventionResoluteXience V |
| spellingShingle | Liefke C. van der Heijden Marlies M. Kok Paolo Zocca Hanim Sen Marije M. Löwik Silvia Mariani Frits H. A. F. de Man Marc Hartmann Martin G. Stoel K. Gert van Houwelingen J. (Hans) W. Louwerenburg Gerard C. M. Linssen Carine J. M. Doggen Jan G. Grandjean Clemens von Birgelen Long‐Term Outcome of Consecutive Patients With Previous Coronary Bypass Surgery, Treated With Newer‐Generation Drug‐Eluting Stents Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease coronary artery bypass graft drug‐eluting stent percutaneous coronary intervention Resolute Xience V |
| title | Long‐Term Outcome of Consecutive Patients With Previous Coronary Bypass Surgery, Treated With Newer‐Generation Drug‐Eluting Stents |
| title_full | Long‐Term Outcome of Consecutive Patients With Previous Coronary Bypass Surgery, Treated With Newer‐Generation Drug‐Eluting Stents |
| title_fullStr | Long‐Term Outcome of Consecutive Patients With Previous Coronary Bypass Surgery, Treated With Newer‐Generation Drug‐Eluting Stents |
| title_full_unstemmed | Long‐Term Outcome of Consecutive Patients With Previous Coronary Bypass Surgery, Treated With Newer‐Generation Drug‐Eluting Stents |
| title_short | Long‐Term Outcome of Consecutive Patients With Previous Coronary Bypass Surgery, Treated With Newer‐Generation Drug‐Eluting Stents |
| title_sort | long term outcome of consecutive patients with previous coronary bypass surgery treated with newer generation drug eluting stents |
| topic | coronary artery bypass graft drug‐eluting stent percutaneous coronary intervention Resolute Xience V |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.117.007212 |
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