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Favorable Long-Term Survival in Patients Undergoing Multivessel-PCI Compared to Predicted Prognosis of CABG Estimated by EuroSCORE: Procedural and Clinical Determinants of Long-Term Outcome

Lookup NU author(s): Professor Ioakim Spyridopoulos

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Abstract

Results: The patients were suffering from 2.5 +/- 0.6 diseased vessels, and 2.8 +/- 1.0 lesions were stented (32% of patients received at least one drug-eluting stent [DES]; 20% of lesions were treated with DES). Forty-seven percent of patients were treated for acute coronary syndrome (ACS) (N = 176 ST-elevation myocardial infarction [STEMI]; N = 140 non-ST-elevation myocardial infarction [NSTEMI]). The EuroSCORE was significantly higher in ACS patients compared to stable patients (logistic: STEMI 16.3 +/- 17.2; NSTEMI 13.6 +/- 13.0; stable CAD 3.9 +/- 4.2). The observed in-hospital mortality (STEMI 13.0%; NSTEMI 2.9%; stable CAD 1.7%, P < 0.001) was far lower than the estimated 30-day mortality. Cox regression analysis identified an elevated logistic EuroSCORE (HR per quartile 2.7, P = 0.003), severely reduced left ventricular ejection fraction (HR 2.7, P < 0.001), elevated C-reactive protein (HR 1.8, P = 0.012), and chronic renal failure (HR 2.8, P = 0.001) as independent predictors of long-term mortality. Conclusions: The EuroSCORE, which is routinely used to estimate the perioperative risk of patients undergoing CABG, also predicts short- and long-term prognosis of patients undergoing MV-PCI. The observed mortality of patients undergoing MV-PCI seems to be much lower than the estimated mortality of CABG. (J Interven Cardiol 2009;22:511-519).


Publication metadata

Author(s): Lehmann R, Fichtlscherer S, Schachinger V, Held L, Hobler C, Baier G, Zeiher AM, Spyridopoulos I

Publication type: Article

Publication status: Published

Journal: Journal of Interventional Cardiology

Year: 2009

Volume: 22

Issue: 6

Pages: 511-519

ISSN (print): 0896-4327

ISSN (electronic): 1540-8183

Publisher: Wiley-Blackwell

URL: http://dx.doi.org/10.1111/j.1540-8183.2009.00498.x

DOI: 10.1111/j.1540-8183.2009.00498.x


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