Incidence, Characteristics, Predictors, and Outcomes of Repeat Revascularization After Percutaneous Coronary Intervention and Coronary Artery Bypass Grafting

Abstract Objectives The study sought to determine the incidence, predictors, characteristics, and outcomes of repeat revascularization during 5-year follow-up of the SYNTAX (Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery) trial. Background Limited in-depth long-ter...

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Bibliographic Details
Published in:JACC. Cardiovascular interventions 2016-12, Vol.9 (24), p.2493-2507
Main Authors: Parasca, Catalina A., MD, Head, Stuart J., MD, PhD, Milojevic, Milan, MD, MSc, Mack, Michael J., MD, Serruys, Patrick W., MD, PhD, Morice, Marie-Claude, MD, Mohr, Friedrich W., MD, PhD, Feldman, Ted E., MD, Colombo, Antonio, MD, Dawkins, Keith D., MD, Holmes, David R., MD, Kappetein, Pieter A., MD, PhD
Format: Article
Language:English
Subjects:
Cardiovascular
coronary artery bypass grafting
percutaneous coronary intervention
repeat revascularization
SYNTAX
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Summary:Abstract Objectives The study sought to determine the incidence, predictors, characteristics, and outcomes of repeat revascularization during 5-year follow-up of the SYNTAX (Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery) trial. Background Limited in-depth long-term data on repeat revascularization are available from randomized trials comparing percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). Methods Incidence and timing of repeat revascularization and its relation to the long-term composite safety endpoint of death, stroke, and myocardial infarction were analyzed in the SYNTAX trial (n = 1,800) using Kaplan-Meier analysis. Results At 5 years, repeat revascularization occurred more often after initial PCI than after initial CABG (25.9% vs. 13.7%, respectively; p < 0.001), and more often consisted of multiple repeat revascularizations (9.0% vs. 2.8%, respectively; p = 0.022). Significantly more repeat PCI procedures were performed on de novo lesions in patients after initial PCI than initial CABG (33.3% vs. 13.4%, respectively; p < 0.001). At 5-year follow-up, patients who underwent repeat revascularization versus patients not undergoing repeat revascularization had significantly higher rates of the composite safety endpoint of death, stroke, and myocardial infarction after initial PCI (33.8% vs. 16.6%, respectively; p 
ISSN:1936-8798
DOI:10.1016/j.jcin.2016.09.044