Incomplete revascularization is associated with greater risk of long-term mortality after stenting in the era of first generation drug-eluting stents

Chuntao Wu, Anne Marie Dyer, Gary Walford, David Holmes, Spencer B. King, Nicholas J. Stamato, Samin Sharma, Alice K. Jacobs, Ferdinand J. Venditti, Edward L. Hannan

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

The association between incomplete revascularization (IR) and long-term mortality after stenting in the era of drug-eluting stents is not well understood. In the present study, we test the hypothesis that IR is associated with a greater risk of long-term (5-year) mortality after stenting for multivessel coronary disease. Using data from the Percutaneous Coronary Intervention Reporting System of New York State, 21,767 patients with multivessel disease who underwent stenting during October 2003 to December 2005 were identified. Complete revascularization (CR) was achieved in 6,844 patients (31.4%), and 14,923 patients (68.6%) were incompletely revascularized. The CR and IR patients were propensity matched on a 1:1 ratio on the number of diseased vessels, the presence of total occlusion, type of stents, and the probability of achieving CR estimated using a logistic model with established risk factors as independent variables. Patients were followed for vital status until December 31, 2008 using the National Death Index. Differences in survival between the matched CR and IR patients were compared. Among the 6,511 pairs of propensity-matched patients, the 5-year survival rate for IR was lower compared with CR (79.3% vs 81.4%, p < 0.004), and the risk of death during follow-up was 16% greater for IR compared with CR (hazard ratio 1.16, 95% confidence interval 1.06 to 1.27, p < 0.001). In addition, subgroup analyses demonstrated that the association between IR and long-term mortality was not dependent on major patient risk factors. In conclusion, IR is associated with an increased risk of long-term mortality after stenting for multivessel disease in the era of drug-eluting stents.

Original languageEnglish (US)
Pages (from-to)775-781
Number of pages7
JournalAmerican Journal of Cardiology
Volume112
Issue number6
DOIs
StatePublished - Sep 15 2013

Fingerprint

Drug-Eluting Stents
Mortality
Percutaneous Coronary Intervention
Stents
Coronary Disease
Survival Rate
Logistic Models
Confidence Intervals
Survival

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Incomplete revascularization is associated with greater risk of long-term mortality after stenting in the era of first generation drug-eluting stents. / Wu, Chuntao; Dyer, Anne Marie; Walford, Gary; Holmes, David; King, Spencer B.; Stamato, Nicholas J.; Sharma, Samin; Jacobs, Alice K.; Venditti, Ferdinand J.; Hannan, Edward L.

In: American Journal of Cardiology, Vol. 112, No. 6, 15.09.2013, p. 775-781.

Research output: Contribution to journalArticle

Wu, Chuntao ; Dyer, Anne Marie ; Walford, Gary ; Holmes, David ; King, Spencer B. ; Stamato, Nicholas J. ; Sharma, Samin ; Jacobs, Alice K. ; Venditti, Ferdinand J. ; Hannan, Edward L. / Incomplete revascularization is associated with greater risk of long-term mortality after stenting in the era of first generation drug-eluting stents. In: American Journal of Cardiology. 2013 ; Vol. 112, No. 6. pp. 775-781.
@article{51bd33edfd9843f7b04c782776975385,
title = "Incomplete revascularization is associated with greater risk of long-term mortality after stenting in the era of first generation drug-eluting stents",
abstract = "The association between incomplete revascularization (IR) and long-term mortality after stenting in the era of drug-eluting stents is not well understood. In the present study, we test the hypothesis that IR is associated with a greater risk of long-term (5-year) mortality after stenting for multivessel coronary disease. Using data from the Percutaneous Coronary Intervention Reporting System of New York State, 21,767 patients with multivessel disease who underwent stenting during October 2003 to December 2005 were identified. Complete revascularization (CR) was achieved in 6,844 patients (31.4{\%}), and 14,923 patients (68.6{\%}) were incompletely revascularized. The CR and IR patients were propensity matched on a 1:1 ratio on the number of diseased vessels, the presence of total occlusion, type of stents, and the probability of achieving CR estimated using a logistic model with established risk factors as independent variables. Patients were followed for vital status until December 31, 2008 using the National Death Index. Differences in survival between the matched CR and IR patients were compared. Among the 6,511 pairs of propensity-matched patients, the 5-year survival rate for IR was lower compared with CR (79.3{\%} vs 81.4{\%}, p < 0.004), and the risk of death during follow-up was 16{\%} greater for IR compared with CR (hazard ratio 1.16, 95{\%} confidence interval 1.06 to 1.27, p < 0.001). In addition, subgroup analyses demonstrated that the association between IR and long-term mortality was not dependent on major patient risk factors. In conclusion, IR is associated with an increased risk of long-term mortality after stenting for multivessel disease in the era of drug-eluting stents.",
author = "Chuntao Wu and Dyer, {Anne Marie} and Gary Walford and David Holmes and King, {Spencer B.} and Stamato, {Nicholas J.} and Samin Sharma and Jacobs, {Alice K.} and Venditti, {Ferdinand J.} and Hannan, {Edward L.}",
year = "2013",
month = "9",
day = "15",
doi = "10.1016/j.amjcard.2013.05.003",
language = "English (US)",
volume = "112",
pages = "775--781",
journal = "American Journal of Cardiology",
issn = "0002-9149",
publisher = "Elsevier Inc.",
number = "6",

}

TY - JOUR

T1 - Incomplete revascularization is associated with greater risk of long-term mortality after stenting in the era of first generation drug-eluting stents

AU - Wu, Chuntao

AU - Dyer, Anne Marie

AU - Walford, Gary

AU - Holmes, David

AU - King, Spencer B.

AU - Stamato, Nicholas J.

AU - Sharma, Samin

AU - Jacobs, Alice K.

AU - Venditti, Ferdinand J.

AU - Hannan, Edward L.

PY - 2013/9/15

Y1 - 2013/9/15

N2 - The association between incomplete revascularization (IR) and long-term mortality after stenting in the era of drug-eluting stents is not well understood. In the present study, we test the hypothesis that IR is associated with a greater risk of long-term (5-year) mortality after stenting for multivessel coronary disease. Using data from the Percutaneous Coronary Intervention Reporting System of New York State, 21,767 patients with multivessel disease who underwent stenting during October 2003 to December 2005 were identified. Complete revascularization (CR) was achieved in 6,844 patients (31.4%), and 14,923 patients (68.6%) were incompletely revascularized. The CR and IR patients were propensity matched on a 1:1 ratio on the number of diseased vessels, the presence of total occlusion, type of stents, and the probability of achieving CR estimated using a logistic model with established risk factors as independent variables. Patients were followed for vital status until December 31, 2008 using the National Death Index. Differences in survival between the matched CR and IR patients were compared. Among the 6,511 pairs of propensity-matched patients, the 5-year survival rate for IR was lower compared with CR (79.3% vs 81.4%, p < 0.004), and the risk of death during follow-up was 16% greater for IR compared with CR (hazard ratio 1.16, 95% confidence interval 1.06 to 1.27, p < 0.001). In addition, subgroup analyses demonstrated that the association between IR and long-term mortality was not dependent on major patient risk factors. In conclusion, IR is associated with an increased risk of long-term mortality after stenting for multivessel disease in the era of drug-eluting stents.

AB - The association between incomplete revascularization (IR) and long-term mortality after stenting in the era of drug-eluting stents is not well understood. In the present study, we test the hypothesis that IR is associated with a greater risk of long-term (5-year) mortality after stenting for multivessel coronary disease. Using data from the Percutaneous Coronary Intervention Reporting System of New York State, 21,767 patients with multivessel disease who underwent stenting during October 2003 to December 2005 were identified. Complete revascularization (CR) was achieved in 6,844 patients (31.4%), and 14,923 patients (68.6%) were incompletely revascularized. The CR and IR patients were propensity matched on a 1:1 ratio on the number of diseased vessels, the presence of total occlusion, type of stents, and the probability of achieving CR estimated using a logistic model with established risk factors as independent variables. Patients were followed for vital status until December 31, 2008 using the National Death Index. Differences in survival between the matched CR and IR patients were compared. Among the 6,511 pairs of propensity-matched patients, the 5-year survival rate for IR was lower compared with CR (79.3% vs 81.4%, p < 0.004), and the risk of death during follow-up was 16% greater for IR compared with CR (hazard ratio 1.16, 95% confidence interval 1.06 to 1.27, p < 0.001). In addition, subgroup analyses demonstrated that the association between IR and long-term mortality was not dependent on major patient risk factors. In conclusion, IR is associated with an increased risk of long-term mortality after stenting for multivessel disease in the era of drug-eluting stents.

UR - http://www.scopus.com/inward/record.url?scp=84886692877&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84886692877&partnerID=8YFLogxK

U2 - 10.1016/j.amjcard.2013.05.003

DO - 10.1016/j.amjcard.2013.05.003

M3 - Article

C2 - 23756548

AN - SCOPUS:84886692877

VL - 112

SP - 775

EP - 781

JO - American Journal of Cardiology

JF - American Journal of Cardiology

SN - 0002-9149

IS - 6

ER -