Myocardial revascularization failure among patients requiring cardiac catheterization and secondary revascularization in contemporary clinical practice: Results of the REVASEC multicenter registry

BackgroundMyocardial revascularization failure (MRF) and Secondary revascularization (SR) are contemporary interventional cardiology challenges.AimTo investigate the characteristics, management, and prognosis of patients with myocardial revascularization failure (MRF) and need for secondary revascul...

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Published in:Catheterization and cardiovascular interventions 2023-10, Vol.102 (4), p.608-619
Main Authors: Salinas, Pablo, García‐Camarero, Tamara, Jimenez‐Kockar, Marcelo, Regueiro, Ander, García‐Blas, Sergio, Gomez‐Menchero, Antonio E., Ojeda, Soledad, Vilchez‐Tschischke, Jean Paul, Amat‐Santos, Ignacio, Díez‐Gil, Jose Luis, Rondán, Juan, Lozano Ruiz‐Poveda, Fernando, de Miguel Castro, Antonio, Manzano, Maria C., Pascual‐Tejerina, Virginia, Cruz‐González, Ignacio, García Perez‐Velasco, Javier, Fernández‐Diaz, Jose A., Escaned, Javier
Format: Article
Language:English
Subjects:
Angina
Angiography
Cardiac catheterization
Graft rejection
Heart diseases
Implants
Medical imaging
Multivariate analysis
Myocardial infarction
Patients
Prognosis
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Summary:BackgroundMyocardial revascularization failure (MRF) and Secondary revascularization (SR) are contemporary interventional cardiology challenges.AimTo investigate the characteristics, management, and prognosis of patients with myocardial revascularization failure (MRF) and need for secondary revascularization (SR) in contemporary practice.MethodsThe REVASEC study is a prospective registry (NCT03349385), which recruited patients with prior revascularization referred for coronary angiography at 19 centers. The primary endpoint is a patient‐oriented composite (POCE) at 1 year, including death, myocardial infarction, or repeat revascularization.ResultsA total of 869 patients previously revascularized by percutaneous intervention (83%) or surgery (17%) were recruited. MRF was found in 83.7% (41.1% stent/graft failure, 32.1% progression of coronary disease, and 10.5% residual disease). SR was performed in 70.1%, preferably by percutaneous intervention (95%). The POCE rate at 1 year was 14% in the overall cohort, with 6.4% all‐cause death. In the multivariate analysis, lower POCE rates were found in the groups without MRF (9.4%) and with disease progression (11%) compared with graft/stent failure (17%) and residual disease (18%), hazard ratio 0.67 (95% confidence interval: 0.45–0.99), p = 0.043. At 1 year, the SR group had less chronic persistent angina (19% vs. 34%, p 
ISSN:1522-1946
1522-726X
DOI:10.1002/ccd.30804