Please use this identifier to cite or link to this item: http://hdl.handle.net/11054/1848
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dc.contributorKoshy, A.en_US
dc.contributorDinh, D.en_US
dc.contributorFulcher, J.en_US
dc.contributorBrennan, A.en_US
dc.contributorMurphy, A.en_US
dc.contributorDuffy, S.en_US
dc.contributorReid, C.en_US
dc.contributorAjani, Andrewen_US
dc.contributorFreeman, M.en_US
dc.contributorHiew, C.en_US
dc.contributorOqueli, Ernestoen_US
dc.contributorFarouque, O.en_US
dc.contributorYudi, M.en_US
dc.contributorClark, D.en_US
dc.date.accessioned2022-01-27T04:06:50Z-
dc.date.available2022-01-27T04:06:50Z-
dc.date.issued2022-
dc.identifier.govdoc01861en_US
dc.identifier.urihttp://hdl.handle.net/11054/1848-
dc.description.abstractObjectives: Patients with stable ischemic heart disease (SIHD) may present with a variety of symptoms including typical angina, angina equivalents such as dyspnea or no symptoms. We sought to determine whether symptom status affects periprocedural safety and long-term mortality in patients undergoing PCI. Methods: Prospectively enrolled consecutive patients undergoing PCI for SIHD at six hospitals in Australia between 2005 to 2018 as part of the Melbourne Interventional Group registry. Symptom status was recorded at the time of PCI and patients undergoing staged PCI were excluded. Results: Overall, 11,730 patients with SIHD were followed up for a median period of 5 years (maximum 14.0 years, interquartile range 2.2-9.0 years) with 1,317 (11.2%) being asymptomatic. Asymptomatic patients were older, and more likely to be male, have triple-vessel disease, with multiple comorbidities including renal failure, diabetes and heart failure (all P < .01). These patients had significantly higher rates of periprocedural complications and major adverse cardiovascular events at 30-days. Long-term mortality was significantly higher in asymptomatic patients (27.2% vs 18.0%, P < .001). On cox regression for long-term mortality, after adjustment for more important clinical variables, asymptomatic status was an independent predictor (Hazard ratio (HR) 1.39 95% CI 1.16-1.66, P < .001). Conclusions: In a real-world cohort of patients undergoing revascularization for SIHD, absence of symptoms was associated with higher rates of periprocedural complications and, after adjustment for more important clinical variables, was an independent predictor of long-term mortality. As the primary goal of revascularization in SIHD remains angina relief, the appropriateness of PCI in the absence of symptoms warrants justification.en_US
dc.description.provenanceSubmitted by Gemma Siemensma (gemmas@bhs.org.au) on 2022-01-17T03:04:21Z No. of bitstreams: 0en
dc.description.provenanceApproved for entry into archive by Gemma Siemensma (gemmas@bhs.org.au) on 2022-01-27T04:06:50Z (GMT) No. of bitstreams: 0en
dc.description.provenanceMade available in DSpace on 2022-01-27T04:06:50Z (GMT). No. of bitstreams: 0 Previous issue date: 2022en
dc.titleLong-term mortality in asymptomatic patients with stable ischemic heart disease undergoing percutaneous coronary intervention.en_US
dc.typeJournal Articleen_US
dc.type.specifiedArticleen_US
dc.bibliographicCitation.titleAmerican Heart Journalen_US
dc.bibliographicCitation.volume244en_US
dc.bibliographicCitation.stpage77en_US
dc.bibliographicCitation.endpage85en_US
dc.subject.healththesaurusISCHEMIC HEART DISEASEen_US
dc.subject.healththesaurusHEART DISEASEen_US
dc.subject.healththesaurusPCIen_US
dc.subject.healththesaurusPERCUTANEOUS CORONARY INTERVENTIONen_US
dc.identifier.doihttps://doi.org/10.1016/j.ahj.2021.10.190en_US
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