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Title: Outcomes in patients with peripheral vascular disease following percutaneous coronary intervention.
Austin Authors: Ramzy, John;Andrianopoulos, Nick;Roberts, Louise;Duffy, Stephen J;Clark, David J ;Teh, Andrew W ;Ajani, Andrew E;Reid, Christopher M;Brennan, Angela;Freeman, Melanie
Affiliation: Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, Victoria, Australia
School of Public Health, Curtin University, Perth, Western Australia, Australia
Department of Cardiology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
Department of Cardiology, Austin Health, Heidelberg, Victoria, Australia
Department of Cardiology, Box Hill Hospital, Melbourne, Victoria, Australia
Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
Centre of Cardiovascular Research and Education in Therapeutics (CCRE), Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
Issue Date: 21-Oct-2019 2019-02-21
Publication information: Catheterization and Cardiovascular Interventions 2019; 94(4): 588-597
Abstract: To evaluate the clinical characteristics and outcomes of patients with peripheral vascular disease (PVD) undergoing percutaneous coronary intervention (PCI) in a contemporary setting, and to determine whether use of drug-eluting stents (DESs) improves outcomes. PVD was an independent risk factor for adverse outcomes following PCI in the bare-metal stent (BMS) era. It is not known whether outcomes in these patients have improved with advances in interventional techniques and stent technology, as they have for the general population. Eighteen thousand three hundred and eighty patients undergoing PCI from an Australian registry between 2005 and 2013 were studied. Clinical and procedural data, 30-day and 12-month outcomes were compared in those with and without a reported history of PVD. Outcomes were also compared between patients with PVD who received DES and those who received BMS. Long-term mortality was compared using Australian National Death Index (NDI) linkage. Patients with PVD (n = 1,251, 6.8%) were older and had more prevalent diabetes, hypertension, cerebrovascular disease, heart failure, renal impairment, ostial lesions, left main, and multi-vessel disease (p < 0.001). Patients with PVD had significantly higher rates of major adverse cardiovascular events (MACEs) compared with those without PVD, in-hospital (5.7% vs. 4.1%, p < 0.008), at 30-days (8.6% vs. 5.8%, p < 0.001) and at 12-months (24.6% vs. 13.2%, p < 0.001). At 4.9 ± 2.6 years follow-up, there was significantly greater mortality in the PVD group. PVD patients who received DES experienced significantly less MACE than PVD patients treated with BMS at 30-days (4.8 vs. 10.1%, p < 0.001) and 12-months (19.4 vs. 26.4%, p < 0.005). PVD is an independent predictor of adverse outcomes in patients undergoing PCI. PVD patient who received DES had improved outcomes compared with those receiving BMS.
DOI: 10.1002/ccd.28145
ORCID: 0000-0001-8910-3863
PubMed URL: 30790432
Type: Journal Article
Subjects: coronary artery disease
peripheral arterial disease
Appears in Collections:Journal articles

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