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Titolo:
Long-term clinical outcome and predictors of major adverse cardiac events after percutaneous interventions on saphenous vein grafts
Autore:
Keeley, EC; Velez, CA; ONeill, WW; Safian, RD;
Indirizzi:
William Beaumont Hosp, Dept Internal Med, Div Cardiovasc, Royal Oak, MI 48073 USA William Beaumont Hosp Royal Oak MI USA 48073 asc, Royal Oak, MI 48073 USA
Titolo Testata:
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
fascicolo: 3, volume: 38, anno: 2001,
pagine: 659 - 665
SICI:
0735-1097(200109)38:3<659:LCOAPO>2.0.ZU;2-W
Fonte:
ISI
Lingua:
ENG
Soggetto:
TRANSLUMINAL EXTRACTION ATHERECTOMY; LASER CORONARY ANGIOPLASTY; PREVIOUS BYPASS-SURGERY; BALLOON ANGIOPLASTY; LESIONS; SURVIVAL; THROMBUS; REGISTRY; FATE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
31
Recensione:
Indirizzi per estratti:
Indirizzo: Safian, RD William Beaumont Hosp, Dept Internal Med, Div Cardiovasc, 3601 W 13 Mile Rd, Royal Oak, MI 48073 USA William Beaumont Hosp 3601 W 13 Mile Rd Royal Oak MI USA 48073
Citazione:
E.C. Keeley et al., "Long-term clinical outcome and predictors of major adverse cardiac events after percutaneous interventions on saphenous vein grafts", J AM COL C, 38(3), 2001, pp. 659-665

Abstract

OBJECTIVES The purpose of this study was to examine the long-term clinicaloutcome after percutaneous intervention of saphenous vein grafts (SVG) andto identify the predictors of major adverse cardiac events (MACE). BACKGROUND Percutaneous interventions of SVGS have been associated with more procedural complications and higher restenosis rates compared with interventions on native vessels. METHODS From 1993 to 1997, 1,062 patients underwent percutaneous intervention on 1,142 SVG lesions. Procedural, in-hospital and long-term clinical outcomes were recorded in a database and analyzed. RESULTS In-hospital MACE occurred in 137 patients (13%) including death (8%), Q-wave myocardial infarction (MI) (2%) and coronary artery bypass surgery (3%). Late MACE occurred in 565 patients (54%) including death (9%), Q-wave MI (9%) and target vessel revascularization (36%). Any MACE occurred in457 (43%) patients. Follow-up was available in 1,056 (99%) patients at 3 +/- 1 year. Univariate predictors were restenotic lesion (odds ratio [OR]: 2.47, confidence interval [CI]: 1.13 to 3.85, p = 0.0003), unstable angina (OR: 1.99, CI: 1.27 to 2.91, p = 0.04) and congestive heart failure (CHF) (OR: 1.97, CI: 1.14 to 3.24, p = 0.02) for in-hospital MACE, and peripheral vascular disease (PVD) (OR: 2.18, CI: 1.34 to 3.44, p = 0.002), intra-aorticballoon pump placement (OR: 2.08, CI: 1.13 to 3.85, p = 0.02) and previousMI (OR: 1.97, CI: 1.14 to 3.25, p = 0.007) for late MACE. Independent multivariate predictors for late MACE were restenotic lesion (relative risk [RR] 1.33, p = 0.02), PVD (RR: 1.31, p = 0.01), CHF (RR: 1.42, p = 0.01) and multiple stents (RR: 1.47, p = 0.004). Angiographic follow-up was available for 422 patients. Angiographic restenosis occurred in 122 (29%) of stented SVGS and 181 (43%) of nonstented SVGS (p = 0.04). Stent implantation did not confer a survival benefit. CONCLUSIONS Despite the use of new interventional devices, SVG interventions are associated with significant morbidity and mortality; SVG stenting isnot associated with better three-year event-free survival. This may be dueto progressive disease at nonstented sites. (C) 2001 by the American College of Cardiology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/01/20 alle ore 03:13:15