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

Fecha de publicación: Fecha Ahead of Print:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Salinas P
  • García-Camarero T
  • Jimenez-Kockar M
  • Regueiro A
  • García-Blas S
  • Gomez-Menchero AE
  • Ojeda S
  • Amat-Santos I
  • Rondán J
  • Lozano Ruiz-Poveda F
  • de Miguel Castro A
  • Manzano MC
  • Pascual-Tejerina V
  • Cruz-González I
  • García Perez-Velasco J
  • Fernández-Diaz JA
  • Escaned J
  • REVASEC working group (collaborators)

Grupos

Abstract

BACKGROUND: Myocardial revascularization failure (MRF) and Secondary revascularization (SR) are contemporary interventional cardiology challenges. AIM: To investigate the characteristics, management, and prognosis of patients with myocardial revascularization failure (MRF) and need for secondary revascularization (SR) in contemporary practice. METHODS: The 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. RESULTS: A 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 < 0.001), but a higher rate of repeat revascularization (9% vs. 2.9%, p < 0.001). CONCLUSION: MRF was found in 84% of patients with prior revascularization referred for coronary angiography. Stent/graft failure and residual coronary disease were associated with a worse prognosis. SR provided better symptom control at the expense of a higher rate of new revascularization.

© 2023 Wiley Periodicals LLC.

Datos de la publicación

ISSN/ISSNe:
1522-1946, 1522-726X

CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS  WILEY

Tipo:
Article
Páginas:
608-619
PubMed:
37582340
Enlace a otro recurso:
www.scopus.com
Factor de Impacto:
1,088 SCImago ℠
Cuartil:
Q1 SCImago ℠

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Keywords

  • graft failure; myocardial revascularization failure; recurrent angina; repeat revascularization; secondary revascularization; stent failure

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