Author + information
- Walid Barakea,b,
- Dat Trana,b,
- Diane Galbraitha,b,
- Colleen Norrisa,b,
- Merril L. Knudtsona,b,
- Padma Kaula,b,
- Finlay McAlistera,b and
- Roopinder Sandhua,b
Background: Prior work has shown patients undergoing percutaneous coronary intervention (PCI) are older with higher comorbidities recently, yet population-based data examining trends in cause-specific mortality after PCI are sparse.
Methods: Prospective cohort study using APPROACH which collects clinical and angiographic data on all patients undergoing an angiogram in Alberta to determine trends in cause-specific mortality based on death certificates for patients > 20 years who underwent PCI from 2005-2013.
Results: A total of 37,195 patients underwent PCI; mean age was 62.9 ± 11.9 years, and 23.2% were female. Over time, patients were older, had more cardiovascular comorbidities, and more of those undergoing PCI had an indication of STEMI or NSTEMI; however, there was no trend in mortality rates (Table 1). The most common mode of death was cardiac after PCI (cardiac: 30 days=82.5%, 1 year=63.9%, 2 years=55%; non-cardiac: 30 days=11.8%, 1 year=31.9%, 2 years=39.9%), with a decline in cardiac and an increase in non-cardiac causes as time from the PCI increased, p for trend=<.001). The major drivers for these opposite trends were fewer fatal myocardial infarctions (76.5% to 53.4%, p <.001) and more lung neoplasms (6.1% to 11.7% p=.011).
Conclusions: Although demographics have changed, total, cardiac, and non-cardiac mortality rates have not changed over years in this large, real-world registry. As patients survive longer after their PCI, the proportion of non-cardiac deaths increases.
Moderated Poster Contributions
Interventional Cardiology Moderated Poster Theater, Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-3:55 p.m.
Session Title: Percutaneous Coronary Intervention: Lessons From the Real World
Abstract Category: 19. Interventional Cardiology: Complex Patients/Comorbidities
Presentation Number: 1263M-03
- 2017 American College of Cardiology Foundation