Long-term outcomes in surgically ineligible patients managed with percutaneous coronary revascularization or medical therapy

• Published in: Cardiovascular intervention and therapeutics 2019-07, Vol.34 (3), p.249-259
• Main Authors: Danson, Edward James Frazer, Sapontis, James, Kaura, Amit, Hill, Jonathan Michael, Dworakowski, Rafal, MacCarthy, Philip, Melikian, Narbeh, Webb, Ian, Shah, Ajay, Byrne, Jonathan
• Format: Article
• Language: English
• Subjects: Cardiology; Interventional Radiology; Medicine; Medicine & Public Health; Original Article
• ISSN: 1868-4300; 1868-4297
• DOI: 10.1007/s12928-018-0554-5

The objective of the study was to report clinical outcomes of patients unsuitable for surgical coronary revascularization (CABG) treated with percutaneous revascularization (PCI) or medical therapy alone (MT). The decision to revascularize patients referred for CABG but who are unsuitable should be made at Heart Team meetings. The clinical outcomes in this important patient subset are not known, and while cases are considered individually, these decisions are not guided by robust data. Clinical data were analyzed for patients referred to the Heart Team for consideration of CABG over a 4-year period in a UK tertiary referral center. Outcome data for those managed with urgent PCI or MT were considered over a further 3-year period. 133 patients were treated with PCI and 117 with MT. MACE at 30 days were no different between groups (MT 10.3% versus PCI 12.2%); however, at 1 year MACE were higher in the MT group (MT 39.3% versus PCI 26.7%, P