Long-term outcomes of patients treated with PCI: Comparison between stable angina and silent ischemia

Abstract

There are limited data on the long-term prognosis of patients with stable coronary artery disease (CAD) after revascularization including patients with silent ischemia (SI). To compare the long-term outcomes of patients with stable angina (SA) versus SI, and assess risk factors of Major Adverse Cardiac and Cerebrovascular events (MACCE) at 7 years. We conducted a single-center study on 545 consecutively-enrolled patients who underwent percutaneous coronary intervention (PCI) for CAD to analyse their prognosis after 7 years. We compared 309 patients with SA and 236 patients with SI. The primary endpoint was MACCE (death from cardiovascular causes, myocardial infarction (MI), stroke, and new target or vessel revascularisation). The secondary endpoint was death from cardiovascular causes. The follow-up rate was 98%. The rate of MACCE was high 51%. There were no significant differences between the 2 groups for MACCE and the secondary endpoint. The mortality rate from any cause was 22%, and from cardiovascular causes 13%. The rate of new revascularisation was 44%. Independent risk factors for MACCE were hypertension, previous PCI, chronic kidney disease, and multi-vessel disease. Drug-eluting stents reduced the risk of MACCE. Independent risk factors for secondary endpoint were diabetes, previous MI, chronic kidney disease and multi-vessel disease (Fig. 1). We found no difference of the long-term prognosis between patients with SA and SI after adjustment with clinical factors.