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Updated: Feb 16, 2026
Analysis of Coronary Vessels in Cleared Embryonic Hearts
Published on: December 7, 2016
Association of Coronary Vessel Characteristics With Outcome in Patients With Percutaneous Coronary Interventions With
Edward L Hannan1, Ye Zhong1, Peter B Berger2
1University at Albany, State University of New York, Rensselaer.
Insights
Incomplete revascularization (IR) after percutaneous coronary interventions (PCI) increases mortality risk, especially with severe stenosis, multiple vessels, or left anterior descending artery involvement. These findings highlight specific IR characteristics associated with worse patient outcomes.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Health Outcomes Research
Background:
- Incomplete revascularization (IR) is common after percutaneous coronary interventions (PCI), but the impact of specific IR characteristics on patient outcomes is not well understood.
- Existing research primarily compares complete versus incomplete revascularization, with limited focus on the nature of IR itself.
Purpose of the Study:
- To investigate whether specific features of incomplete revascularization (IR) are associated with increased mortality risk in patients undergoing percutaneous coronary interventions (PCI).
- To identify particular coronary vessel characteristics that may predict worse outcomes following PCI with IR.
Main Methods:
- A multicenter study utilizing the New York PCI registry, including 41,639 patients with multivessel coronary artery disease undergoing PCI between 2010 and 2012.
- Analysis focused on medium-term mortality, examining the association with the number of incompletely revascularized vessels, degree of stenosis, and involvement of the proximal left anterior descending artery, controlling for other mortality factors.
- Study included patients with and without ST-elevation myocardial infarction (STEMI).
Main Results:
- Incomplete revascularization (IR) was prevalent, occurring in 78% of STEMI patients and 71% of non-STEMI patients.
- Patients with IR in a vessel with at least 90% stenosis, IR in two or more vessels, or IR involving the proximal left anterior descending artery demonstrated significantly higher mortality.
- Specifically, IR in 2+ vessels (AHR 1.35 for STEMI, 1.17 for non-STEMI) and proximal LAD IR (AHR 1.31 for STEMI, 1.11 for non-STEMI) were linked to increased mortality.
Conclusions:
- The nature of incomplete revascularization (IR) significantly impacts patient mortality after percutaneous coronary interventions (PCI).
- Specific high-risk characteristics for IR include severe stenosis (≥90%), involvement of multiple vessels, and involvement of the proximal left anterior descending artery.
- These findings underscore the importance of considering the specific features of IR when assessing patient risk and guiding treatment decisions post-PCI.
Importance:
Many studies have compared outcomes for incomplete revascularization (IR) among patients undergoing percutaneous coronary interventions (PCI), but little is known about whether outcomes are related to the nature of the IR.
Objective:
To determine whether some coronary vessel characteristics are associated with worse outcomes in patients with PCI with IR.
Design, Setting, And Participants:
New York's PCI registry was used to examine mortality (median follow-up, 3.4 years) as a function of the number of vessels that were incompletely revascularized, the stenosis in those vessels, and whether the proximal left anterior descending artery was incompletely revascularized after controlling for other factors associated with mortality for patients with and without ST-elevation myocardial infarction (STEMI). This was a multicenter study (all nonfederal PCI hospitals in New York State) that included 41 639 New York residents with multivessel coronary artery disease undergoing PCI in New York State between January 1, 2010, and December 31, 2012.
Exposures:
Percutaneous coronary interventions, with complete and incomplete revascularization.
Main Outcomes And Measures:
Medium-term mortality.
Results:
For patients with STEMI, the mean age was 62.8 years; 26.2% were women, 11.9% were Hispanic, and 81.5% were white. For other patients, the mean age was 66.6 years, 29.1% were women, 11.3% were Hispanic, and 79.1% were white. Incomplete revascularization was very common (78% among patients with STEMI and 71% among other patients). Patients with IR in a vessel with at least 90% stenosis were at higher risk than other patients with IR. This was not significant among patients with STEMI (17.18% vs 12.86%; adjusted hazard ratio [AHR], 1.16; 95% CI, 0.99-1.37) and significant among patients without STEMI (17.71% vs 12.96%; AHR, 1.15; 95% CI, 1.07-1.24). Similarly, patients with IR in 2 or more vessels had higher mortality than patients with completely revascularization and higher mortality than other patients with IR among patients with STEMI (20.37% vs 14.39%; AHR, 1.35; 95% CI, 1.15-1.59) and among patients without STEMI (20.10% vs 12.86%; AHR, 1.17; 95% CI, 1.09-1.59). Patients with proximal left anterior descending artery vessel IR had higher mortality than other patients with IR (20.09% vs 14.67%; AHR, 1.31; 95% CI, 1.04-1.64 for patients with STEMI and 20.78% vs 15.62%; AHR, 1.11; 95% CI, 1.01-1.23 for patients without STEMI). More than 20% of all PCI patients had IR of 2 or more vessels and more than 30% had IR with more than 90% stenosis.
Conclusions And Relevance:
Patients with IR are at higher risk of mortality if they have IR with at least 90% stenosis, IR in 2 or more vessels, or proximal left anterior descending IR.
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