Complex percutaneous coronary intervention in patients unable to undergo coronary artery bypass grafting during the COVID-19 pandemic: insights from the UK-ReVasc Registry
Complex percutaneous coronary intervention in patients unable to undergo coronary artery bypass grafting during the COVID-19 pandemic: insights from the UK-ReVasc Registry
Objectives: cardiac surgery for coronary artery disease was dramatically reduced during the first wave of the COVID-19 pandemic. Many patients with disease ordinarily treated with coronary artery bypass grafting (CABG) instead underwent percutaneous coronary intervention (PCI). We sought to describe 12-month outcomes following PCI in patients who would typically have undergone CABG.
Methods: between March 1, 2020 and July 31, 2020, patients who received revascularization with PCI when CABG would have been the primary choice of revascularization were enrolled in the prospective, multicenter UK-ReVasc Registry. We evaluated the following major adverse cardiovascular events at 12 months: all-cause mortality, myocardial infarction (MI), repeat revascularization, stroke, major bleeding, and stent thrombosis.
Results: a total of 215 patients were enrolled across 45 PCI centers in the United Kingdom. Twelve-month follow-up data were obtained for 97% of the cases. There were 9 deaths (4.3%), 5 MIs (2.4%), 12 repeat revascularizations (5.7%), 1 stroke (0.5%), 3 major bleeds (1.4%), and no cases of stent thrombosis. No difference in the primary endpoint was observed between patients who received complete vs incomplete revascularization (residual SYNTAX score <=8 vs > 8) (P = .22).
Conclusions: in patients with patterns of coronary disease in whom CABG would have been the primary therapeutic choice outside of the pandemic, PCI was associated with acceptable outcomes at 12 months of follow-up. Contemporary randomized trials that compare PCI to CABG in such patient cohorts may be warranted.
Bypass Grafting, COVID-19, Complex PCI, Coronary, Coronary Artery, Disease, Intervention, Multivessel, Percutaneous, Revascularization
Kite, Thomas A.
c3ef9168-ce43-4d47-86e6-be17fd1d6ef0
Chase, Alexander
12807f14-a27d-4352-a03e-6856fb71afad
Owens, Colum G.
0bd6b85b-f3f9-44e5-97c6-87cee66b6d9f
Curzen, Nick
70f3ea49-51b1-418f-8e56-8210aef1abf4
UK-ReVasc Registry Investigators
Kite, Thomas A.
c3ef9168-ce43-4d47-86e6-be17fd1d6ef0
Chase, Alexander
12807f14-a27d-4352-a03e-6856fb71afad
Owens, Colum G.
0bd6b85b-f3f9-44e5-97c6-87cee66b6d9f
Curzen, Nick
70f3ea49-51b1-418f-8e56-8210aef1abf4
UK-ReVasc Registry Investigators
(2024)
Complex percutaneous coronary intervention in patients unable to undergo coronary artery bypass grafting during the COVID-19 pandemic: insights from the UK-ReVasc Registry.
Journal of Invasive Cardiology, 36 (7).
(doi:10.25270/jic/24.00030).
Abstract
Objectives: cardiac surgery for coronary artery disease was dramatically reduced during the first wave of the COVID-19 pandemic. Many patients with disease ordinarily treated with coronary artery bypass grafting (CABG) instead underwent percutaneous coronary intervention (PCI). We sought to describe 12-month outcomes following PCI in patients who would typically have undergone CABG.
Methods: between March 1, 2020 and July 31, 2020, patients who received revascularization with PCI when CABG would have been the primary choice of revascularization were enrolled in the prospective, multicenter UK-ReVasc Registry. We evaluated the following major adverse cardiovascular events at 12 months: all-cause mortality, myocardial infarction (MI), repeat revascularization, stroke, major bleeding, and stent thrombosis.
Results: a total of 215 patients were enrolled across 45 PCI centers in the United Kingdom. Twelve-month follow-up data were obtained for 97% of the cases. There were 9 deaths (4.3%), 5 MIs (2.4%), 12 repeat revascularizations (5.7%), 1 stroke (0.5%), 3 major bleeds (1.4%), and no cases of stent thrombosis. No difference in the primary endpoint was observed between patients who received complete vs incomplete revascularization (residual SYNTAX score <=8 vs > 8) (P = .22).
Conclusions: in patients with patterns of coronary disease in whom CABG would have been the primary therapeutic choice outside of the pandemic, PCI was associated with acceptable outcomes at 12 months of follow-up. Contemporary randomized trials that compare PCI to CABG in such patient cohorts may be warranted.
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REVASC 12 month manuscript_final
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Accepted/In Press date: 1 March 2024
e-pub ahead of print date: 6 March 2024
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Kite TA, Chase A, Owens CG, Shaukat A, Mozid AM, O'Kane P, Routledge H, Perera D, Jain AK, Palmer N, Hoole SP, Egred M, Sinha MK, Cahill TJ, Anantharam B, Byrne J, Morris PD, Kean S, Sabra A, Aetesam-Ur-Rahman M, Mailey J, Demir O, Mouyis K, Abdalwahab A, Terentes-Printzios D, Kanyal R, Curzen N, Berry C, Gershlick AH, Ladwiniec A; UK-ReVasc Registry Investigators. Complex percutaneous coronary intervention in patients unable to undergo coronary artery bypass grafting during the COVID-19 pandemic: insights from the UK-ReVasc Registry. J Invasive Cardiol. 2024 Mar 6. doi: 10.25270/jic/24.00030. Online ahead of print. PMID: 38471155.
Keywords:
Bypass Grafting, COVID-19, Complex PCI, Coronary, Coronary Artery, Disease, Intervention, Multivessel, Percutaneous, Revascularization
Identifiers
Local EPrints ID: 492731
URI: http://eprints.soton.ac.uk/id/eprint/492731
ISSN: 1042-3931
PURE UUID: ba5a9767-16f0-42dc-ad19-27be906bc798
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Date deposited: 13 Aug 2024 16:35
Last modified: 28 Aug 2024 01:40
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Contributors
Author:
Thomas A. Kite
Author:
Alexander Chase
Author:
Colum G. Owens
Corporate Author: UK-ReVasc Registry Investigators
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