TY - JOUR
T1 - Long-term mortality in patients with radiation-associated coronary artery disease treated with percutaneous coronary intervention
AU - Reed, Grant W.
AU - Masri, Ahmad
AU - Griffin, Brian P.
AU - Kapadia, Samir R.
AU - Ellis, Stephen G.
AU - Desai, Milind Y.
PY - 2016/6/1
Y1 - 2016/6/1
N2 - Background - The incidence and predictors of long-term mortality after percutaneous coronary intervention (PCI) for radiation-associated coronary artery disease are unknown. Methods and Results - In this observational study of 314 patients (age, 65.2±11.4 years; 233 [74%] women) treated with PCI, 157 patients with previous external beam radiation therapy (XRT) were matched 1:1 with 157 comparison patients with atherosclerotic coronary artery disease without previous XRT, based on age, sex, lesion artery, and PCI type. The primary end point was all-cause mortality, and the secondary end point was cardiovascular mortality. After follow-up of 6.6±5.5 years, there were 101 deaths; 59 in the XRT group and 42 in the comparison group (P=0.04). On Cox proportional hazards multivariable survival analysis, previous XRT remained an independent predictor of all-cause mortality (hazard ratio [HR] 1.85; 95% confidence interval [CI], 1.21-2.85; P=0.004) and cardiovascular mortality (HR, 1.70; 95% CI, 1.06-2.89; P=0.03). Additional independent predictors of increased all-cause mortality included balloon angioplasty or bare-metal stent placement compared with drug-eluting stent placement (HR, 2.50; 95% CI, 1.61-3.97; P
AB - Background - The incidence and predictors of long-term mortality after percutaneous coronary intervention (PCI) for radiation-associated coronary artery disease are unknown. Methods and Results - In this observational study of 314 patients (age, 65.2±11.4 years; 233 [74%] women) treated with PCI, 157 patients with previous external beam radiation therapy (XRT) were matched 1:1 with 157 comparison patients with atherosclerotic coronary artery disease without previous XRT, based on age, sex, lesion artery, and PCI type. The primary end point was all-cause mortality, and the secondary end point was cardiovascular mortality. After follow-up of 6.6±5.5 years, there were 101 deaths; 59 in the XRT group and 42 in the comparison group (P=0.04). On Cox proportional hazards multivariable survival analysis, previous XRT remained an independent predictor of all-cause mortality (hazard ratio [HR] 1.85; 95% confidence interval [CI], 1.21-2.85; P=0.004) and cardiovascular mortality (HR, 1.70; 95% CI, 1.06-2.89; P=0.03). Additional independent predictors of increased all-cause mortality included balloon angioplasty or bare-metal stent placement compared with drug-eluting stent placement (HR, 2.50; 95% CI, 1.61-3.97; P
KW - coronary artery disease
KW - mortality
KW - percutaneous coronary intervention
KW - radiation oncology
KW - survival
UR - http://www.scopus.com/inward/record.url?scp=84975764064&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84975764064&partnerID=8YFLogxK
U2 - 10.1161/CIRCINTERVENTIONS.115.003483
DO - 10.1161/CIRCINTERVENTIONS.115.003483
M3 - Article
C2 - 27313281
AN - SCOPUS:84975764064
SN - 1941-7640
VL - 9
JO - Circulation: Cardiovascular Interventions
JF - Circulation: Cardiovascular Interventions
IS - 6
M1 - e003483
ER -