Background
Percutaneous coronary intervention (PCI) of saphenous vein grafts (SVG) is associated with poor outcomes. Improvement in pharmacology and technologies might translate to better outcomes after SVG PCI. However, there are limited data informing if the current practice has translated in better outcomes after SVG PCI.
Results
Patients in group 2 presented more frequently with acute MI and have significantly higher rate of comorbidities than pts in group 1 ( Table 1 ). Additionally, pts in group 2 presented more vessel diseased and have more complex coronary disease, although more lesions were dilated in pts in group 1. Clinical success was achieved in 97.5% and 94.3% of pts in groups 2 and 1, respectively ( P <.001). Despite the more complex population/presentation, group 2 has less periprocedural MI (13.7% vs. 17.5%, P =.002) and developed less major bleeding complication (1.8% vs. 5.7%, P <.001). At 1-year follow-up, the mortality rate remained similar between the two groups; however, the rate of Q-wave MI and TLR was significantly lower in pts performed in the last decade ( Table 1 ).
| Group 1 1990–1999 ( n =1948) | Group 2 2000–2008 ( n =1769) | P value | |
|---|---|---|---|
| Clinical characteristics | |||
| Age | 67.1±9.6 | 68.8±12.5 | <.001 |
| Male gender | 1507 (77.6%) | 1302 (73.7%) | .007 |
| Diabetes | 674 (34.9%) | 821 (46.9%) | <.001 |
| Peripheral vascular disease | 370 (26.5%) | 512 (29.6%) | .06 |
| Chronic renal failure | 174 (12.4%) | 353 (20.3%) | <.001 |
| Prior MI | 1159 (61.6%) | 714 (45.9%) | <.001 |
| History of PCI | 685 (35.6%) | 674 (44.9%) | <.001 |
| Heart failure | 311 (22.4%) | 404 (24.0%) | .27 |
| Clinical presentation | |||
| Acute MI | 28 (1.5%) | 182 (10.4%) | <.001 |
| Unstable angina | 1490 (77.9%) | 963 (54.8%) | <.001 |
| Stable angina | 394 (20.6%) | 613 (34.9%) | <.001 |
| Cardiogenic shock | 32 (1.9%) | 51 (2.7%) | .41 |
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