Five-year outcomes of staged percutaneous coronary intervention in the SYNTAX study

Stuart Watkins, Keith G. Oldroyd, Istvan Preda, David Holmes, Antonio Colombo, Marie Claude Morice, Katrin Leadley, Keith D. Dawkins, Friedrich W. Mohr, Patrick W. Serruys, Ted E. Feldman, Ran Kornowski

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Aims: The SYNTAX study compared PCI with TAXUS Express stents to CABG for the treatment of de novo 3-vessel and/or left main coronary disease. This study aimed to determine patient characteristics and five-year outcomes after a staged PCI strategy compared to single-session PCI. Methods and results: In the SYNTAX trial, staged procedures were discouraged but were allowed within 72 hours or, if renal insufficiency or contrast-induced nephropathy occurred, within 14 days (mean 9.8±18.1 days post initial procedure). A total of 125 (14%) patients underwent staged PCI. These patients had greater disease severity and/or required a more complex procedure. MACCE was significantly increased in staged patients (48.1% vs. 35.5%, p=0.004), as was the composite of death/stroke/MI (32.2% vs. 19%, p=0.0007). Individually, cardiac death and stroke occurred more frequently in the staged PCI group (p=0.03). Repeat revascularisation was significantly higher in staged patients (32.8% vs 24.8%, p=0.035), as was stent thrombosis (10.9% vs. 4.7%, p=0.005). Conclusions: There is a higher incidence of MACCE in patients undergoing staged compared to single-session PCI for 3-vessel and/or left main disease over the first five years of follow-up. However, these patients had more comorbidities and more diffuse disease.

Original languageEnglish (US)
Pages (from-to)1402-1408
Number of pages7
JournalEuroIntervention
Volume10
Issue number12
DOIs
StatePublished - Apr 1 2015

Keywords

  • Coronary artery disease
  • Percutaneous coronary intervention staged procedure
  • SYNTAX

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Watkins, S., Oldroyd, K. G., Preda, I., Holmes, D., Colombo, A., Morice, M. C., Leadley, K., Dawkins, K. D., Mohr, F. W., Serruys, P. W., Feldman, T. E., & Kornowski, R. (2015). Five-year outcomes of staged percutaneous coronary intervention in the SYNTAX study. EuroIntervention, 10(12), 1402-1408. https://doi.org/10.4244/EIJV10I12A244