Abstract
Background: Angiographic incomplete revascularization (IR) has been reported in 30-60% of cases following percutaneous coronary intervention (PCI). The extent to which IR contributes to the burden, timing & characteristics of angina & the role of angina in contributing to adverse outcomes has not been defined. Methods: A retrospective review of 200 patients with IR after PCI from 9 US cardiology practices was performed to determine the frequency of recurrent angina. All angiograms were reviewed for residual coronary artery disease by an independent core laboratory. IR was defined as residual diameter stenosis >50% by quantitative coronary angiography in any epicardial coronary or major side branch. Recurrent angina was defined as documented worsening of angina or initiation of either ranolazine or long-acting nitrates. Angina was assessed at 30 days, 3 months, 6 months, 9 months, 12 months, & greater than 12 months. We report an interim analysis. Results: In the overall population of 200 patients, patients were mostly male (62%) with a mean age of 63.7±13.3 years, & mean BMI of 30.2±6.4. There was a high prevalence of comorbidities including hypertension (93.4%), hyperlipidemia (88.5%), diabetes (52.5%), & prior MI (36.1%). Of the 200 patients, 61 (30%) patients developed recurrent angina at a mean follow-up time of 549 days. Among those with recurrent angina, 26% of patients developed recurrent angina within 30 days of the index PCI procedure. At 3-, 6-, 9, & 12-months, 46%, 62%, 67%, & 80% of patients, respectively, had recurrent angina. The remaining 20% of patients experienced post-PCI angina after 12 months. Baseline demographic factors associated with recurrent angina included hypertension, diabetes, history of angina, prior PCI, & African American ethnicity (See Table 1). Conclusions: Angiographically identified IR alone does not adequately identify patients at risk for the development of recurrent angina. Among a cohort of 200 patients with angiographically identified IR, only 30% of patients developed recurrent angina post-PCI. Almost half of patients with recurrent angina experienced it within 3 months of the index PCI procedure. Several common cardiovascular comorbidities including diabetes, hypertension & prior PCI were associated with recurrent angina post-PCI. Complete analysis will be presented.
Published Version
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