title: Long-Term Outcome of Incomplete Revascularization After Percutaneous Coronary Intervention in SCAAR (Swedish Coronary Angiography and Angioplasty Registry).
abstract: OBJECTIVE
  The aim of this study was to describe current practice regarding completeness of revascularization in patients with multivessel disease undergoing percutaneous coronary intervention (PCI) and to investigate the association of incomplete revascularization (IR) with death, repeat revascularization, and myocardial infarction (MI) in a large nationwide registry.
  
  
  BACKGROUND
  The benefits of multivessel PCI are controversial.
  
  
  METHODS
  Between 2006 and 2010 we identified 23,342 patients with multivessel disease in the SCAAR (Swedish Coronary Angiography and Angioplasty Registry) and merged data with official Swedish health data registries. IR was defined as any nontreated significant (60%) stenosis in a coronary artery supplying >10% of the myocardium.
  
  
  RESULTS
  Patients with IR (n = 15,165) were older, had more extensive coronary disease, and more often had ST-segment elevation MI at presentation than those with complete revascularization (CR) (n = 8,177). All-cause 1-year mortality, MI, and repeat revascularization were higher in IR than CR: 7.1% versus 3.8%, 10.4% versus 6.0%, and 20.5% versus 8.5%, respectively. Propensity score methodology was used in the adjusted analyses. Adjusted hazard ratio (HR) for the composite of death, MI, or repeat revascularization at 1 year was higher in IR than CR: 2.12 (95% confidence interval [CI]: 1.98 to 2.28; p < 0.0001). Adjusted HR for death and the combination of death/MI were 1.29 (95% CI: 1.12 to 1.49; p = 0.0005) and 1.42 (95% CI: 1.30 to 1.56; p < 0.0001), respectively.
  
  
  CONCLUSIONS
  Incomplete revascularization at the time of hospital discharge in patients with multivessel disease undergoing PCI is associated with a high risk of recurrent 1-year adverse cardiac events.
authors: Department of Cardiology, Falun Hospital, Falun, Sweden; Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden. Electronic address: Kristina.hambraeus@ltdalarna.se.
authors: Kristina
authors: K
authors: Hambraeus
authors: Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.
authors: Karin
authors: K
authors: Jensevik
authors: Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden; Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.
authors: Bo
authors: B
authors: Lagerqvist
authors: Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden; Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.
authors: Bertil
authors: B
authors: Lindahl
authors: PCI Unit, Department of Cardiology, Central Hospital, Karlstad, Sweden.
authors: Roland
authors: R
authors: Carlsson
authors: Gilead Sciences, Inc., Foster City, California.
authors: Ramin
authors: R
authors: Farzaneh-Far
authors: Department of Cardiology, University Hospital, Örebro, Sweden.
authors: Thomas
authors: T
authors: Kellerth
authors: Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors: Elmir
authors: E
authors: Omerovic
authors: New York Presbyterian Hospital, Columbia University Medical Center, and the Cardiovascular Research Foundation, New York, New York.
authors: Gregg
authors: G
authors: Stone
authors: Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden; Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.
authors: Christoph
authors: C
authors: Varenhorst
authors: Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden; Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.
authors: Stefan
authors: S
authors: James
mesh_terms: D000367:Age Factors; D000368:Aged; D003324:Coronary Artery Disease / Q000401:mortality / Q000628:therapy*; D023921:Coronary Stenosis / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology; D062645:Percutaneous Coronary Intervention; D057216:Propensity Score; D012042:Registries; D019233:Retreatment / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D015607:Stents; D013548:Sweden / Q000453:epidemiology
keywords: PCI; incomplete revascularization; multivessel disease; registry study