PMID- 30690850
OWN - NLM
STAT- MEDLINE
DCOM- 20200818
LR  - 20200818
IS  - 1522-726X (Electronic)
IS  - 1522-1946 (Linking)
VI  - 94
IP  - 3
DP  - 2019 Sep 1
TI  - Angiographic predictors of adverse outcomes after percutaneous coronary 
      intervention in patients with radiation associated coronary artery disease.
PG  - E104-E110
LID - 10.1002/ccd.28107 [doi]
AB  - OBJECTIVES: To determine procedural predictors of long-term outcomes for patients 
      with radiation associated coronary artery disease (CAD) treated with percutaneous 
      coronary intervention (PCI). BACKGROUND: Patients who develop CAD after external 
      beam radiation therapy (XRT) for cancer are at high-risk for adverse events 
      following PCI. It is unknown if specific angiographic features can predict 
      outcomes in this population. METHODS: This is an observational study of 157 
      patients with malignancy who received XRT prior to PCI. Rates of major adverse 
      cardiovascular and cerebrovascular events (MACCEs; all-cause mortality, 
      myocardial infarction, repeat revascularization, or stroke) were compared across 
      patient characteristics over time with the Cox proportional hazards and 
      Kaplan-Meier's analyses. RESULTS: During follow-up of 5.4 +/- 4.5 years, 91 (58%) 
      patients had MACCE. On Kaplan-Meier's analysis of angiographic characteristics, 
      MACCE was more frequent in patients with at least moderate target vessel 
      calcification (P = 0.023), ostial stenosis (P = 0.049), target vessel 
      diameter >/= 3.0 mm (P = 0.018), a SYNTAX score >/= the median of 11 (P = 0.014), or 
      bare metal stenting (BMS)/balloon angioplasty (BA) compared to drug-eluting 
      stenting (DES) (P = 0.006). Cardiac death was more frequent in patients with 
      SYNTAX score >/= 11 (P = 0.028) or BMS (P = 0.043). After multivariable adjustment 
      for both angiographic and clinical characteristics, independent predictors of 
      MACCE were BMS placement (P = 0.013), chronic kidney disease >/= stage 3 
      (P = 0.019), New York Heart Association (NYHA) heart failure class >/=3 
      (P = 0.034), and SYNTAX score >/= 11 (P = 0.041). CONCLUSIONS: In patients 
      previously exposed to XRT treated with PCI, independent angiographic predictors 
      of MACCE include SYNTAX score >/= 11 and BMS placement, suggestive that DES should 
      be preferred in this population.
CI  - (c) 2019 Wiley Periodicals, Inc.
FAU - Reed, Grant W
AU  - Reed GW
AD  - Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.
FAU - Rossi, Jeffrey E
AU  - Rossi JE
AUID- ORCID: 0000-0001-7616-208X
AD  - Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.
FAU - Masri, Ahmad
AU  - Masri A
AUID- ORCID: 0000-0002-6390-6526
AD  - Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.
FAU - Griffin, Brian P
AU  - Griffin BP
AD  - Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.
FAU - Ellis, Stephen G
AU  - Ellis SG
AD  - Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.
FAU - Kapadia, Samir R
AU  - Kapadia SR
AUID- ORCID: 0000-0002-0026-3391
AD  - Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.
FAU - Desai, Milind Y
AU  - Desai MY
AD  - Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20190128
PL  - United States
TA  - Catheter Cardiovasc Interv
JT  - Catheterization and cardiovascular interventions : official journal of the 
      Society for Cardiac Angiography & Interventions
JID - 100884139
RN  - 0 (Metals)
SB  - IM
MH  - Aged
MH  - *Coronary Angiography
MH  - Coronary Artery Disease/diagnostic imaging/mortality/*surgery
MH  - Drug-Eluting Stents
MH  - Female
MH  - Humans
MH  - Male
MH  - Metals
MH  - Middle Aged
MH  - Neoplasms/*radiotherapy
MH  - Percutaneous Coronary Intervention/*adverse effects/instrumentation/mortality
MH  - Predictive Value of Tests
MH  - Prosthesis Design
MH  - Radiation Injuries/diagnostic imaging/mortality/*surgery
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Stents
MH  - Time Factors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - XRT
OT  - external beam therapy
OT  - radiation heart disease
EDAT- 2019/01/29 06:00
MHDA- 2020/08/19 06:00
CRDT- 2019/01/29 06:00
PHST- 2018/08/15 00:00 [received]
PHST- 2018/12/04 00:00 [revised]
PHST- 2019/01/02 00:00 [accepted]
PHST- 2019/01/29 06:00 [pubmed]
PHST- 2020/08/19 06:00 [medline]
PHST- 2019/01/29 06:00 [entrez]
AID - 10.1002/ccd.28107 [doi]
PST - ppublish
SO  - Catheter Cardiovasc Interv. 2019 Sep 1;94(3):E104-E110. doi: 10.1002/ccd.28107. 
      Epub 2019 Jan 28.