Impact of repeat revascularization within 5 years on 10-year mortality after percutaneous or surgica...
Impact of repeat revascularization within 5 years on 10-year mortality after percutaneous or surgical revascularization
About this item
Full title
Author / Creator
Wang, Rutao , Lunardi, Mattia , Hara, Hironori , Gao, Chao , Ono, Masafumi , Davierwala, Piroze M. , Holmes, David R. , Mohr, Friedrich W. , Curzen, Nick , Burzotta, Francesco , van Geuns, Robert-Jan , Kappetein, Arie Pieter , Head, Stuart J. , Thuijs, Daniel J. F. M. , Tao, Ling , Garg, Scot , Onuma, Yoshinobu , Wijns, William and Serruys, Patrick W.
Publisher
Berlin/Heidelberg: Springer Berlin Heidelberg
Journal title
Language
English
Formats
Publication information
Publisher
Berlin/Heidelberg: Springer Berlin Heidelberg
Subjects
More information
Scope and Contents
Contents
Background
The SYNTAX trial demonstrated negative impact of repeat revascularization (RR) on 5-year outcomes following PCI/CABG in patients with three-vessel(3VD) and/or left main coronary artery disease(LMCAD). We aimed to investigate the impact of RR within 5 years, on 10-year mortality in patients with 3VD and/or LMCAD after PCI/CABG.
Methods
The SYNTAXES study evaluated the vital status out to 10 years of patients with 3VD and/or LMCAD. Patients were stratified by RR within 5 years and randomized treatment. The association between RR within 5 years and 10-year mortality was assessed.
Results
A total of 330 out of 1800 patients (18.3%) underwent RR within 5 years. RR occurred more frequently after initial PCI than after initial CABG (25.9% vs. 13.7%,
p <
0.001). Overall, 10-year mortality was comparable between patients undergoing RR and those not (28.2% vs. 26.1%, adjusted HR: 1.17, 95%CI 0.93–1.48,
p =
0.187). In the PCI arm, RR was associated with a trend toward higher 10-year mortality (adjusted HR: 1.29, 95%CI 0.97–1.72,
p =
0.075), while in the CABG arm, the trend was opposite (adjusted HR: 0.74, 95%CI 0.46–1.20,
p =
0.219). Among patients requiring RR, those who underwent PCI as initial revascularization had a higher risk of 10-year mortality compared to initial CABG (33.5% vs. 17.6%, adjusted HR: 2.09, 95%CI 1.21–3.61,
p =
0.008).
Conclusion
In the SYNTAXES study, RR within 5 years had no impact on 10-year all-cause death in the population overall. Among patients requiring any repeat procedures, 10-year mortality was higher after initial treatment with PCI than after CABG. These exploratory findings should be investigated with larger populations in future studies.
Trial registration
URL:
https://www.clinicaltrials.gov
; SYNTAXES Unique identifier: NCT03417050. URL:
https://www.clinicaltrials.gov
; SYNTAX Unique identifier: NCT00114972.
Graphical abstract...
Alternative Titles
Full title
Impact of repeat revascularization within 5 years on 10-year mortality after percutaneous or surgical revascularization
Authors, Artists and Contributors
Author / Creator
Lunardi, Mattia
Hara, Hironori
Gao, Chao
Ono, Masafumi
Davierwala, Piroze M.
Holmes, David R.
Mohr, Friedrich W.
Curzen, Nick
Burzotta, Francesco
van Geuns, Robert-Jan
Kappetein, Arie Pieter
Head, Stuart J.
Thuijs, Daniel J. F. M.
Tao, Ling
Garg, Scot
Onuma, Yoshinobu
Wijns, William
Serruys, Patrick W.
Identifiers
Primary Identifiers
Record Identifier
TN_cdi_proquest_journals_2856645879
Permalink
https://devfeature-collection.sl.nsw.gov.au/record/TN_cdi_proquest_journals_2856645879
Other Identifiers
ISSN
1861-0684
E-ISSN
1861-0692
DOI
10.1007/s00392-023-02211-6
