Author + information
- Richard Cheng,
- Jignesh Patel,
- David Chang,
- Michelle Kittleson,
- Raj Makkar,
- Jon Kobashigawa and
- Babak Azarbal
Background: PCI for cardiac allograft vasculopathy (CAV) is associated with high restenosis rates. The impact of diabetes (DM) on stent and lesion patency is not established.
Methods: Pts who underwent PCI with EES for CAV were included. Surveillance angiography was performed 6-12 mo after PCI and as indicated. Survival, rates of binary restenosis (BR), and target lesion revascularization (TLR) are reported. Multivariate Cox proportional hazards regression was performed for predictors of BR and TLR.
Results: 48 pts were included, 21 (43.8%) had DM. Mean age at PCI and time after transplant were 62.5±12.8 and 9.9±5.1 yrs. 132 EES were implanted into 113 lesions. Mean stent length and diameter were 16.9±5.7 and 3.0±0.6 mm. 1, 2, 3-yr survival were 93.5 ± 3.6%, 91.0 ± 4.3%, and 83.8 ± 6.3%. 1, 2, 3-yr rates of BR were 3.0 ± 1.7%, 6.9 ± 3.2%, and 10.0 ± 4.3%. 1, 2, 3-yr rates of TLR were 5.1 ± 2.5%, 14.3 ± 4.6%, and 21.2 ± 6.3%. DM was associated with an increased hazard ratio (HR) for BR 27.90 (95% CI 1.91-407.52, p=0.015). Statin use was protective HR 0.04 (95% CI 0.00-0.46), p=0.011). DM and # of stents were associated with an increased HR for TLR 6.09 (95% CI 1.37-27.14, p=0.018) and 4.22 (95% CI 1.34-13.25, p=0.014). Statin use was protective, HR 0.05 (95% CI 0.01-0.29, p=0.001).
Conclusions: DM is strongly associated with increased BR and TLR but overall EES stent patency is high. Observed 3-yr survival of 83.8% mirrors the natural history of allograft survival, suggesting that PCI with EES for severe CAV may normalize survival.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Revascularization and Myocardial Preservation in Acute and Stable Ischemic Heart Disease
Abstract Category: 3. Acute and Stable Ischemic Heart Disease: Therapy
Presentation Number: 1165-304
- 2017 American College of Cardiology Foundation