Outcomes of Primary Percutaneous Cardiac Intervention for ST Elevation Myocardial Infarction with a Saphenous Vein Graft Culprit – DocWire News

BACKGROUND:

Patients treated with primary percutaneous coronary intervention (pPCI) for ST elevationmyocardial infarction(STEMI) who have a history of coronary artery bypass grafting (CABG) are at high risk of adverse cardiovascular outcomes. Data on the risk of a saphenous vein graft (SVG)-infarct-related artery (IRA) compared to other culprit vessels are sparse.

The study was based on a prospectively collected registry of 2,405 consecutive patients with STEMI attending a tertiary medical center in 2001-2017. Patients with an SVG-IRA (n =172) were compared with patients with native vessel disease (n =2,333) for mortality and major adverse cardiac events (MACE), which included death,myocardial infarction(MI), target vessel revascularization (TVR), and coronary artery bypass surgery (CABG) at 1 month and 3years.

The SVG-IRA group was significantly older than the native vessel group (p =.05), with no between-group differences in rates of male patients (76 vs. 82%, p =.59), diabetes (24.2 vs. 26.2%, p =.73), and renal failure (18.8 vs. 9.2%, p =.25). Mortality was higher in the SVG-IRA group at 1 month (13.9 vs. 2.5%, p <.01) and 3years (23.9 vs. 7.4%, p <.01). At 3years, SVG-IRA was associated with the highest rates of MACE (55.6%), compared with native vessel disease. After correction for confounders, SVG-IRA remained an independent risk factor for MACE both at 1 month (HR-2.08, 95%CI 1.72-3.11, p <.01) and 3years (HR-2.01, 95%CI 1.28-3.09, p <.01).

Among patients treated with pPCI for STEMI, outcomes are worse when the culprit is an SVG.

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Outcomes of Primary Percutaneous Cardiac Intervention for ST Elevation Myocardial Infarction with a Saphenous Vein Graft Culprit - DocWire News