Long-term outcome of consecutive patients with previous coronary bypass surgery, treated with newer-generation drug-eluting stents

Liefke C. van der Heijden, Marlies M. Kok, Paolo Zocca, Hanim Sen, Marije M. Löwik, Silvia Mariani, Frits H.A.F. de Man, Marc Hartmann, Martin G. Stoel, K. Gert van Houwelingen, J. (Hans) W. Louwerenburg, Gerard C.M. Linssen, Carine J.M. Doggen, Jan G. Grandjean, Clemens von Birgelen*

*Corresponding author for this work

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Abstract

Background - Percutaneous coronary intervention (PCI) in patients with previous coronary artery bypass grafting (CABG) is associated with adverse clinical events. Although newer generation drug-eluting stents showed favorable short-term safety profiles, there is a lack of long-term outcome data. We evaluated the impact of previous CABG on 5-year clinical outcomes of patients treated with PCI using newer-generation drug-eluting stents.

Methods and Results - In this patient-level pooled analysis of the prospective TWENTE (The Real-World Endeavor Resolute versus Xience V Drug-Eluting Stent Study in Twente) trial and nonenrolled TWENTE registry, we assessed a consecutive series of patients who underwent PCI with newer-generation drug-eluting stents for non-ST-segment-elevation acute coronary syndromes or stable angina. Of all 1709 patients, 202 (11.8%) had a history of CABG. Patients with previous CABG had significantly higher 5-year rates of cardiac death (10.4% versus 4.3%; P < 0.001) and target vessel revascularization (25.0% versus 8.1%; P < 0.001). These differences remained statistically significant after adjustment for differences in baseline characteristics. Landmark analysis revealed that from 1- to 5-year follow-up, the rates of cardiac death (8.1% versus 3.2%; P < 0.001) and target vessel revascularization (17.1% versus 5.9%; P < 0.001) were significantly higher in patients with previous CABG. Among patients with a history of CABG, PCI of an obstructed vein graft was associated with a higher rate of 5-year target vessel revascularization (P=0.003).

Conclusions - At 5-year follow-up after PCI with newer-generation drug-eluting stents, the risk of cardiac death and target vessel revascularization was significantly higher in patients with previous CABG. The target vessel revascularization rate was highest in patients who underwent PCI of obstructed vein grafts.

Original languageEnglish
Article numbere007212
JournalJournal of the American Heart Association
Volume7
Issue number3
DOIs
Publication statusPublished - 6 Feb 2018

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Drug-Eluting Stents
Coronary Artery Bypass
Percutaneous Coronary Intervention
Veins
Transplants
Stable Angina
Acute Coronary Syndrome
Registries
Safety

Keywords

  • Coronary artery bypass graft
  • Drug-eluting stent
  • Percutaneous coronary intervention
  • Resolute
  • Xience

Cite this

van der Heijden, Liefke C. ; Kok, Marlies M. ; Zocca, Paolo ; Sen, Hanim ; Löwik, Marije M. ; Mariani, Silvia ; de Man, Frits H.A.F. ; Hartmann, Marc ; Stoel, Martin G. ; Gert van Houwelingen, K. ; Louwerenburg, J. (Hans) W. ; Linssen, Gerard C.M. ; Doggen, Carine J.M. ; Grandjean, Jan G. ; von Birgelen, Clemens. / Long-term outcome of consecutive patients with previous coronary bypass surgery, treated with newer-generation drug-eluting stents. In: Journal of the American Heart Association. 2018 ; Vol. 7, No. 3.
@article{ba683ea6c97d4f8fb8a7ae1172e0c0cf,
title = "Long-term outcome of consecutive patients with previous coronary bypass surgery, treated with newer-generation drug-eluting stents",
abstract = "Background - Percutaneous coronary intervention (PCI) in patients with previous coronary artery bypass grafting (CABG) is associated with adverse clinical events. Although newer generation drug-eluting stents showed favorable short-term safety profiles, there is a lack of long-term outcome data. We evaluated the impact of previous CABG on 5-year clinical outcomes of patients treated with PCI using newer-generation drug-eluting stents.Methods and Results - In this patient-level pooled analysis of the prospective TWENTE (The Real-World Endeavor Resolute versus Xience V Drug-Eluting Stent Study in Twente) trial and nonenrolled TWENTE registry, we assessed a consecutive series of patients who underwent PCI with newer-generation drug-eluting stents for non-ST-segment-elevation acute coronary syndromes or stable angina. Of all 1709 patients, 202 (11.8{\%}) had a history of CABG. Patients with previous CABG had significantly higher 5-year rates of cardiac death (10.4{\%} versus 4.3{\%}; P < 0.001) and target vessel revascularization (25.0{\%} versus 8.1{\%}; P < 0.001). These differences remained statistically significant after adjustment for differences in baseline characteristics. Landmark analysis revealed that from 1- to 5-year follow-up, the rates of cardiac death (8.1{\%} versus 3.2{\%}; P < 0.001) and target vessel revascularization (17.1{\%} versus 5.9{\%}; P < 0.001) were significantly higher in patients with previous CABG. Among patients with a history of CABG, PCI of an obstructed vein graft was associated with a higher rate of 5-year target vessel revascularization (P=0.003).Conclusions - At 5-year follow-up after PCI with newer-generation drug-eluting stents, the risk of cardiac death and target vessel revascularization was significantly higher in patients with previous CABG. The target vessel revascularization rate was highest in patients who underwent PCI of obstructed vein grafts.",
keywords = "Coronary artery bypass graft, Drug-eluting stent, Percutaneous coronary intervention, Resolute, Xience",
author = "{van der Heijden}, {Liefke C.} and Kok, {Marlies M.} and Paolo Zocca and Hanim Sen and L{\"o}wik, {Marije M.} and Silvia Mariani and {de Man}, {Frits H.A.F.} and Marc Hartmann and Stoel, {Martin G.} and {Gert van Houwelingen}, K. and Louwerenburg, {J. (Hans) W.} and Linssen, {Gerard C.M.} and Doggen, {Carine J.M.} and Grandjean, {Jan G.} and {von Birgelen}, Clemens",
year = "2018",
month = "2",
day = "6",
doi = "10.1161/JAHA.117.007212",
language = "English",
volume = "7",
journal = "Journal of the American Heart Association",
issn = "2047-9980",
publisher = "Wiley-Blackwell",
number = "3",

}

van der Heijden, LC, Kok, MM, Zocca, P, Sen, H, Löwik, MM, Mariani, S, de Man, FHAF, Hartmann, M, Stoel, MG, Gert van Houwelingen, K, Louwerenburg, JHW, Linssen, GCM, Doggen, CJM, Grandjean, JG & von Birgelen, C 2018, 'Long-term outcome of consecutive patients with previous coronary bypass surgery, treated with newer-generation drug-eluting stents', Journal of the American Heart Association, vol. 7, no. 3, e007212. https://doi.org/10.1161/JAHA.117.007212

Long-term outcome of consecutive patients with previous coronary bypass surgery, treated with newer-generation drug-eluting stents. / van der Heijden, Liefke C.; Kok, Marlies M.; Zocca, Paolo; Sen, Hanim; Löwik, Marije M.; Mariani, Silvia; de Man, Frits H.A.F.; Hartmann, Marc; Stoel, Martin G.; Gert van Houwelingen, K.; Louwerenburg, J. (Hans) W.; Linssen, Gerard C.M.; Doggen, Carine J.M.; Grandjean, Jan G.; von Birgelen, Clemens.

In: Journal of the American Heart Association, Vol. 7, No. 3, e007212, 06.02.2018.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Long-term outcome of consecutive patients with previous coronary bypass surgery, treated with newer-generation drug-eluting stents

AU - van der Heijden, Liefke C.

AU - Kok, Marlies M.

AU - Zocca, Paolo

AU - Sen, Hanim

AU - Löwik, Marije M.

AU - Mariani, Silvia

AU - de Man, Frits H.A.F.

AU - Hartmann, Marc

AU - Stoel, Martin G.

AU - Gert van Houwelingen, K.

AU - Louwerenburg, J. (Hans) W.

AU - Linssen, Gerard C.M.

AU - Doggen, Carine J.M.

AU - Grandjean, Jan G.

AU - von Birgelen, Clemens

PY - 2018/2/6

Y1 - 2018/2/6

N2 - Background - Percutaneous coronary intervention (PCI) in patients with previous coronary artery bypass grafting (CABG) is associated with adverse clinical events. Although newer generation drug-eluting stents showed favorable short-term safety profiles, there is a lack of long-term outcome data. We evaluated the impact of previous CABG on 5-year clinical outcomes of patients treated with PCI using newer-generation drug-eluting stents.Methods and Results - In this patient-level pooled analysis of the prospective TWENTE (The Real-World Endeavor Resolute versus Xience V Drug-Eluting Stent Study in Twente) trial and nonenrolled TWENTE registry, we assessed a consecutive series of patients who underwent PCI with newer-generation drug-eluting stents for non-ST-segment-elevation acute coronary syndromes or stable angina. Of all 1709 patients, 202 (11.8%) had a history of CABG. Patients with previous CABG had significantly higher 5-year rates of cardiac death (10.4% versus 4.3%; P < 0.001) and target vessel revascularization (25.0% versus 8.1%; P < 0.001). These differences remained statistically significant after adjustment for differences in baseline characteristics. Landmark analysis revealed that from 1- to 5-year follow-up, the rates of cardiac death (8.1% versus 3.2%; P < 0.001) and target vessel revascularization (17.1% versus 5.9%; P < 0.001) were significantly higher in patients with previous CABG. Among patients with a history of CABG, PCI of an obstructed vein graft was associated with a higher rate of 5-year target vessel revascularization (P=0.003).Conclusions - At 5-year follow-up after PCI with newer-generation drug-eluting stents, the risk of cardiac death and target vessel revascularization was significantly higher in patients with previous CABG. The target vessel revascularization rate was highest in patients who underwent PCI of obstructed vein grafts.

AB - Background - Percutaneous coronary intervention (PCI) in patients with previous coronary artery bypass grafting (CABG) is associated with adverse clinical events. Although newer generation drug-eluting stents showed favorable short-term safety profiles, there is a lack of long-term outcome data. We evaluated the impact of previous CABG on 5-year clinical outcomes of patients treated with PCI using newer-generation drug-eluting stents.Methods and Results - In this patient-level pooled analysis of the prospective TWENTE (The Real-World Endeavor Resolute versus Xience V Drug-Eluting Stent Study in Twente) trial and nonenrolled TWENTE registry, we assessed a consecutive series of patients who underwent PCI with newer-generation drug-eluting stents for non-ST-segment-elevation acute coronary syndromes or stable angina. Of all 1709 patients, 202 (11.8%) had a history of CABG. Patients with previous CABG had significantly higher 5-year rates of cardiac death (10.4% versus 4.3%; P < 0.001) and target vessel revascularization (25.0% versus 8.1%; P < 0.001). These differences remained statistically significant after adjustment for differences in baseline characteristics. Landmark analysis revealed that from 1- to 5-year follow-up, the rates of cardiac death (8.1% versus 3.2%; P < 0.001) and target vessel revascularization (17.1% versus 5.9%; P < 0.001) were significantly higher in patients with previous CABG. Among patients with a history of CABG, PCI of an obstructed vein graft was associated with a higher rate of 5-year target vessel revascularization (P=0.003).Conclusions - At 5-year follow-up after PCI with newer-generation drug-eluting stents, the risk of cardiac death and target vessel revascularization was significantly higher in patients with previous CABG. The target vessel revascularization rate was highest in patients who underwent PCI of obstructed vein grafts.

KW - Coronary artery bypass graft

KW - Drug-eluting stent

KW - Percutaneous coronary intervention

KW - Resolute

KW - Xience

UR - http://www.scopus.com/inward/record.url?scp=85041653230&partnerID=8YFLogxK

U2 - 10.1161/JAHA.117.007212

DO - 10.1161/JAHA.117.007212

M3 - Article

AN - SCOPUS:85041653230

VL - 7

JO - Journal of the American Heart Association

JF - Journal of the American Heart Association

SN - 2047-9980

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M1 - e007212

ER -