Author + information
- Muthiah Vaduganathana,b,
- Robert Harringtona,b,
- Gregg Stonea,b,
- Philippe Stega,b,
- C. Michael Gibsona,b,
- Christian Hamma,b,
- Matthew Pricea,b,
- Efthymios Deliargyrisa,b,
- Jayne Pratsa,b,
- Kenneth Mahaffeya,b,
- Harvey Whitea,b and
- Deepak Bhatta,b
Background: Clinical trials employ various definitions of ischemic endpoints, but limited comparative data are available assessing their relative prognostic significance. We sought to determine the prognostic impact of different definitions of periprocedural MI on 30-day mortality in patients undergoing PCI.
Methods: This exploratory analysis used pooled, individual patient-level data from the mITT populations of the three phase-3 CHAMPION trials (n=24,881). All ischemic endpoints were independently adjudicated. Multiple logistic regression analyses were adjusted for propensity scores, calculated based on known predictors of adverse events.
Results: Within 48h, 840 patients (3.4%) in the three CHAMPION trials experienced MI (2nd universal definition used for PCI and PLATFORM, protocol definition for PHOENIX), and 81 patients (0.3%) experienced stent thrombosis (ST). Of patients who experienced MI, 56% had presented with stable angina, 42% with NSTE-ACS, and 2% with STEMI. In the pooled CHAMPION experience, periprocedural ischemic complications were independently associated with excess mortality at 30 days (ranging from adjusted OR 3.49 for the 2nd universal definition to 20.83 for ST; P<0.001 for all associations; Table).
Conclusions: Based on pooled patient-level data from ∼25,000 patients in a contemporary PCI trial program, periprocedural ischemic complications, especially MIs with large biomarker elevations and ST, independently predict subsequent 30-day mortality.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Coronary Angiography, Intra-Vascular Imaging, Revascularization and Outcomes
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1166-320
- 2017 American College of Cardiology Foundation