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Outcomes following PCI in CABG candidates during the COVID‐19 pandemic: The prospective multicentre UK‐ReVasc registry

Outcomes following PCI in CABG candidates during the COVID‐19 pandemic: The prospective multicentre UK‐ReVasc registry
Outcomes following PCI in CABG candidates during the COVID‐19 pandemic: The prospective multicentre UK‐ReVasc registry

Objectives: To describe outcomes following percutaneous coronary intervention (PCI) in patients who would usually have undergone coronary artery bypass grafting (CABG). Background: In the United Kingdom, cardiac surgery for coronary artery disease (CAD) was dramatically reduced during the first wave of the COVID-19 pandemic. Many patients with “surgical disease” instead underwent PCI. Methods: Between 1 March 2020 and 31 July 2020, 215 patients with recognized “surgical” CAD who underwent PCI were enrolled in the prospective UK-ReVasc Registry (ReVR). 30-day major cardiovascular event outcomes were collected. Findings in ReVR patients were directly compared to reference PCI and isolated CABG pre-COVID-19 data from British Cardiovascular Intervention Society (BCIS) and National Cardiac Audit Programme (NCAP) databases. Results: ReVR patients had higher incidence of diabetes (34.4% vs 26.4%, P =.008), multi-vessel disease with left main stem disease (51.4% vs 3.0%, P <.001) and left anterior descending artery involvement (94.8% vs 67.2%, P <.001) compared to BCIS data. SYNTAX Score in ReVR was high (mean 28.0). Increased use of transradial access (93.3% vs 88.6%, P =.03), intracoronary imaging (43.6% vs 14.4%, P <.001) and calcium modification (23.6% vs 3.5%, P <.001) was observed. No difference in in-hospital mortality was demonstrated compared to PCI and CABG data (ReVR 1.4% vs BCIS 0.7%, P =.19; vs NCAP 1.0%, P =.48). Inpatient stay was half compared to CABG (3.0 vs 6.0 days). Low-event rates in ReVR were maintained to 30-day follow-up. Conclusions: PCI undertaken using contemporary techniques produces excellent short-term results in patients who would be otherwise CABG candidates. Longer-term follow-up is essential to determine whether these outcomes are maintained over time.

COVID-19, coronary artery bypass grafting, percutaneous coronary intervention
1522-1946
Kite, Thomas A.
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Ladwiniec, Andrew
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Owens, Colum G.
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Chase, Alexander
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Shaukat, Aadil
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Mozid, Abdul M.
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O'kane, Peter
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Routledge, Helen
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Perera, Divaka
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Jain, Ajay K.
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Palmer, Nick
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Hoole, Stephen P.
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Egred, Mohaned
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Cahill, Thomas J.
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Candilio, Luciano
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Anantharam, Brijesh
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Byrne, Jonathan
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Walsh, Simon J
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Mcentegart, Margaret
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Kean, Sharon
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Siddique, Laraib
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Budgeon, Charley
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Curzen, Nick
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Berry, Colin
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Ludman, Peter
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Gershlick, Anthony H.
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Kite, Thomas A.
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Ladwiniec, Andrew
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Owens, Colum G.
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Chase, Alexander
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Shaukat, Aadil
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Routledge, Helen
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Perera, Divaka
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Jain, Ajay K.
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Palmer, Nick
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Candilio, Luciano
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Anantharam, Brijesh
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Walsh, Simon J
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Mcentegart, Margaret
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Kean, Sharon
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Siddique, Laraib
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Budgeon, Charley
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Curzen, Nick
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Berry, Colin
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Ludman, Peter
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Gershlick, Anthony H.
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Kite, Thomas A., Ladwiniec, Andrew, Owens, Colum G., Chase, Alexander, Shaukat, Aadil, Mozid, Abdul M., O'kane, Peter, Routledge, Helen, Perera, Divaka, Jain, Ajay K., Palmer, Nick, Hoole, Stephen P., Egred, Mohaned, Sinha, Manas K., Cahill, Thomas J., Candilio, Luciano, Anantharam, Brijesh, Byrne, Jonathan, Walsh, Simon J, Mcentegart, Margaret, Kean, Sharon, Siddique, Laraib, Budgeon, Charley, Curzen, Nick, Berry, Colin, Ludman, Peter and Gershlick, Anthony H. (2021) Outcomes following PCI in CABG candidates during the COVID‐19 pandemic: The prospective multicentre UK‐ReVasc registry. Catheterization and Cardiovascular Interventions. (doi:10.1002/ccd.29702).

Record type: Article

Abstract

Objectives: To describe outcomes following percutaneous coronary intervention (PCI) in patients who would usually have undergone coronary artery bypass grafting (CABG). Background: In the United Kingdom, cardiac surgery for coronary artery disease (CAD) was dramatically reduced during the first wave of the COVID-19 pandemic. Many patients with “surgical disease” instead underwent PCI. Methods: Between 1 March 2020 and 31 July 2020, 215 patients with recognized “surgical” CAD who underwent PCI were enrolled in the prospective UK-ReVasc Registry (ReVR). 30-day major cardiovascular event outcomes were collected. Findings in ReVR patients were directly compared to reference PCI and isolated CABG pre-COVID-19 data from British Cardiovascular Intervention Society (BCIS) and National Cardiac Audit Programme (NCAP) databases. Results: ReVR patients had higher incidence of diabetes (34.4% vs 26.4%, P =.008), multi-vessel disease with left main stem disease (51.4% vs 3.0%, P <.001) and left anterior descending artery involvement (94.8% vs 67.2%, P <.001) compared to BCIS data. SYNTAX Score in ReVR was high (mean 28.0). Increased use of transradial access (93.3% vs 88.6%, P =.03), intracoronary imaging (43.6% vs 14.4%, P <.001) and calcium modification (23.6% vs 3.5%, P <.001) was observed. No difference in in-hospital mortality was demonstrated compared to PCI and CABG data (ReVR 1.4% vs BCIS 0.7%, P =.19; vs NCAP 1.0%, P =.48). Inpatient stay was half compared to CABG (3.0 vs 6.0 days). Low-event rates in ReVR were maintained to 30-day follow-up. Conclusions: PCI undertaken using contemporary techniques produces excellent short-term results in patients who would be otherwise CABG candidates. Longer-term follow-up is essential to determine whether these outcomes are maintained over time.

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Cathet Cardio Intervent - 2021 - Kite - Outcomes following PCI in CABG candidates during the COVID%u201019 pandemic The - Version of Record
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Accepted/In Press date: 16 March 2021
e-pub ahead of print date: 4 May 2021
Keywords: COVID-19, coronary artery bypass grafting, percutaneous coronary intervention

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Local EPrints ID: 453797
URI: http://eprints.soton.ac.uk/id/eprint/453797
ISSN: 1522-1946
PURE UUID: 5697b8f7-7439-41ae-8401-835491a14ebd
ORCID for Nick Curzen: ORCID iD orcid.org/0000-0001-9651-7829

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Date deposited: 24 Jan 2022 17:50
Last modified: 17 Mar 2024 03:02

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Contributors

Author: Thomas A. Kite
Author: Andrew Ladwiniec
Author: Colum G. Owens
Author: Alexander Chase
Author: Aadil Shaukat
Author: Abdul M. Mozid
Author: Peter O'kane
Author: Helen Routledge
Author: Divaka Perera
Author: Ajay K. Jain
Author: Nick Palmer
Author: Stephen P. Hoole
Author: Mohaned Egred
Author: Manas K. Sinha
Author: Thomas J. Cahill
Author: Luciano Candilio
Author: Brijesh Anantharam
Author: Jonathan Byrne
Author: Simon J Walsh
Author: Margaret Mcentegart
Author: Sharon Kean
Author: Laraib Siddique
Author: Charley Budgeon
Author: Nick Curzen ORCID iD
Author: Colin Berry
Author: Peter Ludman
Author: Anthony H. Gershlick

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