title: Predictors of long term outcomes in 11,441 consecutive patients following percutaneous coronary interventions.
abstract: Given the vicissitudes of percutaneous coronary intervention (PCI) technology, epidemiology, and mode of practice, the aim of this study was to define contemporary outcome predictors in a very large consecutive patient cohort. Data from 11,441 consecutive patients who underwent PCI at a tertiary medical center from April 2004 to September 2013 are presented. A comprehensive database was built using various data sources, with outcome end points defined as all-cause mortality and as a composite of death or nonfatal myocardial infarction during follow-up. Candidate variables to influence outcome were chosen a priori and were tested using multivariate time-dependent models to estimate each interaction. Mean follow-up was 5.5 years (range 3 months to 9.5 years). The cohort consisted of 75% men, 42% patients with diabetes, and 61% patients who underwent PCI in acute coronary syndrome settings and 7.8% for ST-elevation myocardial infarction. Drug-eluting stents were used in 43.4% of patients, bare-metal stents in 52%, and balloon angioplasty alone in 4.6%. In multivariate analysis, in addition to already well-recognized predictors of death or myocardial infarction such as advanced age (hazard ratio [HR] 1.031, p <0.001), female gender (HR 1.23, p <0.001), urgent setting (HR 1.23, p <0.001) and diabetes mellitus (HR 1.28, p <0.001), we particularly noted previous anemia (HR 1.55 p <0.001), previous chronic kidney injury (HR 1.93, p <0.001) and previous moderate to severe left ventricular dysfunction (HR 2.29, p <0.001). Drug-eluting stent placement was associated with better outcomes (HR 0.70, p <0.001). In conclusion, this analysis confirms the effect of some known predictors of PCI outcomes. However, the extent of their effect is modest, while other predictors may have a greater influence on outcomes. Risk stratification of PCI patients should take into account kidney injury, anemia, and left ventricular function. Drug-eluting stents provide sustained benefit.
authors: Cardiology Department, Rabin Medical Center (Beilinson and Hasharon Hospitals), Petach-Tikva, Israel; The "Sackler" Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors: Uri
authors: U
authors: Landes
authors: Cardiology Department, Rabin Medical Center (Beilinson and Hasharon Hospitals), Petach-Tikva, Israel; The "Sackler" Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. Electronic address: ran.kornowski@gmail.com.
authors: Ran
authors: R
authors: Kornowski
authors: Cardiology Department, Rabin Medical Center (Beilinson and Hasharon Hospitals), Petach-Tikva, Israel; The "Sackler" Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors: Abid
authors: A
authors: Assali
authors: Cardiology Department, Rabin Medical Center (Beilinson and Hasharon Hospitals), Petach-Tikva, Israel; The "Sackler" Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors: Hana
authors: H
authors: Vaknin-Assa
authors: Cardiology Department, Rabin Medical Center (Beilinson and Hasharon Hospitals), Petach-Tikva, Israel; The "Sackler" Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors: Gabriel
authors: G
authors: Greenberg
authors: Cardiology Department, Rabin Medical Center (Beilinson and Hasharon Hospitals), Petach-Tikva, Israel; The "Sackler" Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors: Eli I
authors: EI
authors: Lev
authors: Cardiology Department, Rabin Medical Center (Beilinson and Hasharon Hospitals), Petach-Tikva, Israel; The "Sackler" Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors: Tamir
authors: T
authors: Bental
mesh_terms: D054058:Acute Coronary Syndrome / Q000401:mortality / Q000601:surgery*; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D009203:Myocardial Infarction / Q000401:mortality / Q000601:surgery*; D062645:Percutaneous Coronary Intervention; D011183:Postoperative Complications / Q000453:epidemiology*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors