Predisposing factors for incomplete angiographic revascularization in patients with multivessel percutaneous coronary intervention

Abstract

ABSTRACT Background Complete anatomical myocardial revascularization is associated with better angina control and lower rates of cardiac events. However, in a significant number of patients treated by percutaneous coronary intervention (PCI), complete revascularization is not achieved. Thus, the aim of this study was to evaluate factors associated with incomplete myocardial revascularization (IMR) in multivessel PCI patients. Methods This was a cohort study involving 1,049 prospectively and consecutively revascularized patients through PCI with treatment of two or more vessels, between 2012 and 2014, divided into two groups: IMR (n = 324; 30.9%) and complete myocardial revascularization (n = 725; 69.1%). Results IMR was significantly associated with older age (66.5 years vs. 64.1 years; p = 0.003), arterial hypertension (92.2% vs. 86.0%; p = 0.006), chronic renal failure (36.4% vs. 26.0%; p p = 0.05), previous surgical revascularization (16.1% vs. 7.1%; p = 0.001), saphenous venous graft lesions (3.4% vs. 1.0%, p p = 0.005), as well as lower access to drug-eluting stents (57.8% vs. 64.8%; p = 0.002). In-hospital clinical outcomes did not differ between the groups. Conclusions IMR occurred in approximately one-third of treated cases, and a significant association was observed with a higher-risk clinical profile and with target lesion interventions commonly associated with lower procedure success. The degree of revascularization had no impact on in-hospital clinical outcomes.