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Complex Percutaneous Coronary Intervention in Patients Unable to Undergo Coronary Artery Bypass Grafting During the COVID-19 Pandemic: Insights From the UK-ReVasc Registry

Lookup NU author(s): Dr Mohaned Egred

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Abstract

© 2024 HMP Global. All Rights Reserved.Objectives. Cardiac surgery for coronary artery disease was dramatically reduced during the first wave of the COVID-19 pandemic. Many patients with disease ordinarily treated with coronary artery bypass grafting (CABG) instead underwent percutaneous coronary intervention (PCI). We sought to describe 12-month outcomes following PCI in patients who would typically have undergone CABG. Methods. Between March 1, 2020 and July 31, 2020, patients who received revascularization with PCI when CABG would have been the primary choice of revascularization were enrolled in the prospective, multicenter UK-ReVasc Registry. We evaluated the following major adverse cardiovascular events at 12 months: all-cause mortality, myocardial infarction (MI), repeat revascularization, stroke, major bleeding, and stent thrombosis. Results. A total of 215 patients were enrolled across 45 PCI centers in the United Kingdom. Twelve-month follow-up data were obtained for 97% of the cases. There were 9 deaths (4.3%), 5 MIs (2.4%), 12 repeat revascularizations (5.7%), 1 stroke (0.5%), 3 major bleeds (1.4%), and no cases of stent thrombosis. No difference in the primary endpoint was observed between patients who received complete vs incomplete revascularization (residual SYNTAX score <=8 vs > 8) (P = .22). Conclusions. In patients with patterns of coronary disease in whom CABG would have been the primary therapeutic choice outside of the pandemic, PCI was associated with acceptable outcomes at 12 months of follow-up. Contemporary randomized trials that compare PCI to CABG in such patient cohorts may be warranted.


Publication metadata

Author(s): Kite TA, Chase A, Owens CG, Shaukat A, Mozid AM, O'Kane P, Routledge H, Perera D, Jain AK, Palmer N, Hoole SP, Egred M, Sinha MK, Cahill TJ, Anantharam B, Byrne J, Morris PD, Kean S, Sabra A, Aetesam-Ur-Rahman M, Mailey J, Demir O, Mouyis K, Abdalwahab A, Terentes-Printzios D, Kanyal R, Curzen N, Berry C, Gershlick AH, Ladwiniec A

Publication type: Article

Publication status: Published

Journal: Journal of Invasive Cardiology

Year: 2024

Volume: 36

Issue: 7

Print publication date: 01/07/2024

Online publication date: 06/03/2024

Acceptance date: 02/04/2023

ISSN (print): 1042-3931

ISSN (electronic): 1557-2501

Publisher: Cliggott Publishing Co.

URL: https://doi.org/10.25270/jic/24.00030

DOI: 10.25270/jic/24.00030


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