J Transcat Intervent.2018;26:eA0016.
Clinical, angiographic profile and predictors of in-hospital mortality in percutaneous treatment of lesions in saphenous vein grafts
DOI: 10.31160/JOTCI2018;26(1)A0016
ABSTRACT
Background
The angiographic characteristics associated with saphenous vein graft degeneration and the high-risk profile of these patients increase the probability of adverse outcomes during and after percutaneous coronary intervention. This study set out to analyze the clinical and angiographic profile of patients, procedural characteristics, and hospital outcomes of percutaneous coronary intervention performed in saphenous vein grafts, and to investigate predictors of in-hospital mortality in this group.
Methods
A retrospective, observational study based on records kept by
Central Nacional de Intervenções Cardiovasculares
(CENIC) between 2006 and 2016. A comparative analysis of the adverse outcomes – periprocedural acute myocardial infarction, need for urgent coronary artery bypass grafting, and all-cause mortality – was performed according to different time periods (2006-2008, 2009-2011 and 2012-2016).
Results
A total of 2,361 patients were included in the analysis. The prevalence of periprocedural acute myocardial infarction and mortality did not differ between time periods. No patient in this sample required urgent coronary artery bypass grafting. Simple logistic regression analysis revealed the following in-hospital mortality predictors: advanced age, ST-segment elevation acute myocardial infarction, Killip class 3/4, long lesions, thrombi-containing lesions, three-vessel disease and periprocedural acute myocardial infarction. According to multiple logistic regression analysis, age (OR 1.07; 95%CI 1.02-1.13; p=0.01), smoking (OR 3.26; 95%CI 1.13 – 9.39; p=0.03), ST-segment elevation acute myocardial infarction (OR 10.36; 95%CI 3.96-27.07; p<0.01) and periprocedural acute myocardial infarction (OR 86.08; 95%CI 15.81-468.63; p<0.01) were correlated with mortality outcomes.
Conclusion
Identification of in-hospital mortality predictors may contribute to improve procedural planning for adverse events prevention in patients undergoing percutaneous coronary intervention of saphenous vein grafts.
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