Related Experiment Video
Updated: Jun 8, 2026
Minimally Invasive Establishment of Murine Orthotopic Bladder Xenografts
Published on: February 11, 2014
Complete revascularization in stable multivessel coronary artery disease: A real world analysis from the British
M Bilal Iqbal1,2,3, Peter T Moore1,2, Imad J Nadra1,2
1Victoria Heart Institute Foundation, Victoria, British Columbia, Canada.
Insights
Complete revascularization (CR) in patients with multivessel disease (MVD) undergoing percutaneous coronary intervention (PCI) significantly reduces long-term mortality. This survival benefit is particularly evident in higher-risk patient subgroups.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Medicine
Background:
- Multivessel disease (MVD) is common in patients undergoing percutaneous coronary intervention (PCI).
- The prognostic value of PCI in stable MVD patients is debated.
- Limited data exists on the benefit of complete revascularization (CR) in stable MVD.
Purpose of the Study:
- To investigate the prognostic benefit of CR versus incomplete revascularization (IR) in patients with stable MVD undergoing PCI.
- To identify patient subgroups that may benefit most from CR.
Main Methods:
- Retrospective analysis of 8,436 patients with MVD undergoing PCI.
- Comparison of CR versus IR, with all-cause mortality at 5 years as the primary outcome.
- Multivariable-adjusted analyses and propensity-matched cohort analyses were performed.
Main Results:
- CR was achieved in 17% of patients.
- CR was associated with significantly lower 5-year all-cause mortality (6.2% vs. 10.7%) and repeat revascularization rates (12.7% vs. 18.4%).
- Adjusted analyses confirmed CR as an independent predictor of lower mortality (HR=0.73) and repeat revascularization (HR=0.78).
Conclusions:
- CR is an independent predictor of long-term survival in stable patients with MVD undergoing PCI.
- The survival benefit of CR is pronounced in higher-risk patients, including older individuals, males, those with severe angina or heart failure symptoms, and greater coronary disease burden.
- CR may benefit selected stable MVD patients, warranting consideration in treatment planning.
Background:
More than half of patients undergoing percutaneous coronary intervention (PCI) have multivessel disease (MVD). The prognostic significance of PCI in stable patients has recently been debated, but little data exists about the potential benefit of complete revascularization (CR) in stable MVD. We investigated the prognostic benefit of CR in patients undergoing PCI for stable disease.
Methods:
We compared CR versus incomplete revascularization (IR) in 8,436 patients with MVD. The primary outcome was all-cause mortality at 5 years.
Results:
A total of 1,399 patients (17%) underwent CR during the index PCI procedure for stable disease. CR was associated with lower mortality (6.2 vs. 10.7%, p < .001) and lower repeat revascularization at 5 years (12.7 vs. 18.4%, p < .001). Multivariable-adjusted analyses indicated that CR was associated with lower mortality (HR = 0.73, 95% CI: 0.58-0.91, p = .005) and repeat revascularization at 5 years (HR = 0.78, 95% CI: 0.66-0.93, p = .005). These findings were also confirmed in propensity-matched cohorts. Subgroup analyses indicated that CR conferred survival in older patients, male patients, absence of renal disease, greater angina (CCS Class III-IV) and heart failure (NYHA Class III-IV) symptoms, and greater burden of coronary disease. In sensitivity analyses where patients with subsequent repeat revascularization events were excluded, CR remained a strong predictor for lower mortality (HR = 0.69, 95% CI: 0.54-0.89, p = .004).
Conclusions:
In this study of stable patients with MVD, CR was an independent predictor of long-term survival. This benefit was specifically seen in higher risk patient groups and indicates that CR may benefit selected stable patients with MVD.
More Related Videos
06:51Development of an Algorithm to Perform a Comprehensive Study of Autonomic Dysreflexia in Animals with High Spinal Cord Injury Using a Telemetry Device
Published on: July 29, 2016
02:09Multi-modal Pulmonary Imaging: Using Complementary Information from CT and Hyperpolarized 129Xe MRI to Evaluate Lung Structure-Function
Published on: April 12, 2024
Related Concept Videos
01:30Coronary Artery Disease I: Introduction
01:27Coronary Artery Disease V: Interprofessional Care
01:30Acute Coronary Syndrome III: Diagnostic Studies