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Clinical outcomes of percutaneous coronary intervention in high-risk patients turned down for surgical revascularization

Lookup NU author(s): Dr Ayman Al-atta, Dr Mohammad Alkhalil, Dr Mohaned Egred

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Abstract

© 2022 Wiley Periodicals LLC. Aims: There are limited data on outcomes of PCI in surgical turndown patientsespecially in those presenting with ACS. Methods and Results: A retrospective analysis of prospectively collected data of patients who were turned down for CABG and had PCI between 2013 and 2020. All consecutive patients (449), ACS (n = 245) and no-ACS (n = 204) were included. In-hospital complications occurred in 28 patients (6.2%). At 30 days, 27 patients (6.0%) died (18 patients in the ACS group [7.3%] vs. 9 patients in the no-ACS group [4.4%], p = 0.23). Following multivariate analysis, no significant difference in long-term mortality was observed between the two groups (median follow-up of 4 [2–6] years, hazard ratio [HR]: 1.08, 95% confidence interval [CI]: 0.75–1.58, p = 0.667). In propensity score-matched analysis, the adjusted mortality risk was also not different between the groups (HR: 0.74, 95% CI: 0.25–1.26, p = 0.374). Independent predictors of mortality included chronic kidney disease stage ≥ 3 (HR: 1.64, 95% CI: 1.13–2.39, p = 0.009), high European System for Cardiac Operative Risk Evaluation II (HR: 1.02, 95% CI: 1.00–1.05, p = 0.035), and laser atherectomy use (HR: 3.35, 95% CI: 1.32–8.54, p = 0.011). Conclusions: PCI in surgical patients turndown patients appears safe. ACSpresentation was associated with more comorbid illnesses; however, afteradjustment, ACS did not independently confer additional risk of mortality.


Publication metadata

Author(s): Farag M, Al-Atta A, Abdalazeem I, Salim T, Alkhalil M, Egred M

Publication type: Article

Publication status: Published

Journal: Catheterization and Cardiovascular Interventions

Year: 2022

Volume: 100

Issue: 3

Pages: 360-366

Print publication date: 01/09/2022

Online publication date: 01/07/2022

Acceptance date: 11/06/2022

ISSN (print): 1522-1946

ISSN (electronic): 1522-726X

Publisher: John Wiley and Sons Inc.

URL: https://doi.org/10.1002/ccd.30318

DOI: 10.1002/ccd.30318


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