Ten-year mortality risk of patients undergoing elective PCI: long-term follow-up of the GENetic Determinants of Restenosis (GENDER) study

Abstract

Although the death rates from cardiovascular diseases (CVD) have declined over the last decades, the burden of disease remains high and CVD remains one of the leading causes of morbidity and mortality in Western developed countries [1, 2] including the Netherlands. [3–6] Tremendous efforts worldwide are put into research and development of novel treatment modalities for CVD to further halt the disease burden, and frequent updates of primary and secondary prevention guidelines should result in the most optimal treatment of each patient with CVD. Besides major improvements in pharmacological treatment with for instance statins, beta-blockers, angiotensin-converting-enzyme inhibitors and antiplatelet agents, interventional treatment modalities such as percutaneous coronary intervention (PCI) have markedly improved the outcome of patients with coronary artery disease. An important complication of percutaneous coronary intervention (PCI) that is still present is coronary restenosis.[7] Coronary restenosis - the renarrowing of the treated obstruction - results in high morbidity [8] and is even reported to be associated with an increased risk of mortality.[9, 10] Data on long-term follow-up of patients with restenosis are, however, scarce. To explore the relation of restenosis development with long-term mortality, we analysed the 10-year survival of the patients included in the GENetic DEterminants of Restenosis (GENDER) study.[11] The second objective of this report was to investigate whether the treatment strategies after PCI, applied in daily clinical practice over the past 10 years, resulted in a shift in mortality rates and causes of death of these confirmed coronary artery disease (CAD) patients compared with the general population.