Failed elective percutaneous transluminal coronary angioplasty requiring coronary artery bypass surgery. In-hospital and late clinical outcome at 5 years.
Key result
Prompt surgical revascularization after failed elective PTCA yielded excellent long-term outcomes, with 5-year cardiac survival of 94.9% in patients with ongoing ischemia and 96.2% without.
Why the study?
Does prompt CABG after failed elective PTCA provide favorable long-term survival in patients experiencing failed elective PTCA?
Population
430 patients who had a failed elective percutaneous transluminal coronary angioplasty and underwent coronary…
Design
Cohort
Follow-up
5 years
Authors
Discussion
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Member takes
Implication
May support CABG timing decisions after failed PTCA; leaves open randomized confirmation of survival benefits.
Study Design
Type
Cohort (n=430)
Multicenter
No
Structured PICO
Does prompt CABG after failed elective PTCA provide favorable long-term survival in patients experiencing failed elective PTCA?
P
Population
430 patients who had a failed elective percutaneous transluminal coronary angioplasty (PTCA) and underwent coronary artery bypass graft (CABG) surgery during their hospitalization (comprising 5.9% of 7,246 patients undergoing elective PTCA). Mean age 56 +/- 9 years, 76.3% male.
I
Intervention
Coronary artery bypass graft (CABG) surgery following failed elective PTCA
O
Outcome
In-hospital and late clinical outcome at 5 years (including survival, cardiac survival, and freedom from cardiac death or nonfatal myocardial infarction)hard clinical
Main Result
Absolute Event Rate: 94.9% vs 96.2%
Prompt successful surgical revascularization (CABG) after failed elective PTCA is associated with excellent 5-year survival and low long-term event rates, despite a significant incidence of periprocedural myocardial infarction.
Cite This Study
Talley et al. (1990) conducted a cohort in Failed elective percutaneous transluminal coronary angioplasty (PTCA) requiring CABG (n=430). CABG with ongoing myocardial ischemia vs. CABG without ischemia was evaluated on 5-year cardiac survival. Prompt surgical revascularization after failed elective PTCA yielded excellent long-term outcomes, with 5-year cardiac survival of 94.9% in patients with ongoing ischemia and 96.2% without.