Impact of Incomplete Revascularization on Disease Recurrence after Percutaneous Coronary Intervention

Artem Komkov ¹, Vladimir Mazaev ², Svetlana Ryazanova ²

¹ Moscow City Clinical Hospital 67, Msocow, Russia; ² National Research Centre for Preventive Medicine, Moscow, Russia;

Date, time and location: 2018.05.26 15:30, Congress Hall, 2F–A

Abstract

Objective. Incomplete revascularization (ICR) is one of the main reasons of recurrent coronary artery disease. Purpose of our study was to obtain information of influence of ICR on main clinical and angiographic outcomes in long follow up period after percutaneous coronary interventions (PCI).

Methods. 155 patients with ischemic heart disease were included in our study after BMS and DES implantation. Repeated coronary angiography (CAG) was administered to all patients according to clinical indications. Everybody took appropriate antithrombotic and lipid-lowering therapy. Main cardiovascular risk factors were observed: age, sex, arterial hypertension, dyslipidemia, diabetes mellitus (DM) including insulin dependence, current or former smoker, physical inactivity, obesity, alcohol abuse, cardiovascular family anamnesis, weight, body mass index, stable angina, previous myocardial infarction (MI), acute coronary syndrome (ACS): acute MI or unstable angina; chronic kidney disease, stent type, restenosis. We did statistical analysis with proportional hazard models (Cox) and logistic regression. Risk ratio (RR), odds ratio (OR) and confidence intervals (CI) 95% are presented.

Results. Average follow-up time was 367 days (Me 195 [78;523]), longest was 6,17 years. Patients were separated into 2 groups in suggestion of neoatherosclerosis development (<9 months and >9months from index-PCI to follow up coronary angiography, 90 and 65 patientsrespectively). ICR in <9 months group had OR 0.399 (CI 95%; 0,121-1,321; p=0.133) and in >9 months group had OR 2.504 (CI 95%; 0,757-8,285; p=0.133). Follow-up restenosis due to ICR had RR 1,322 (CI 95%; 0,926-1,887; p=0.124). Multistage PCI also had no reliable influence on ICR 0,336 (CI 95%; 0,042-2,703; p=0.305).

Conclusion. We had not find reliable risk factors of ICR as well as decision on multistage and deferred revascularization was managed not only angiographic but clinical and functional assessment.