Impact of multisite artery disease on clinical outcomes after percutaneous coronary intervention: an analysis from the e-Ultimaster registry

Ofer Kobo; Majdi Saada; Clemens Von Birgelen; Pim A.L. Tonino; Andres Íñiguez-Romo; Ole Fröbert; Majdi Halabi; Rohit M. Oemrawsingh; Jawed Polad; Alexander J.J. Ijsselmuiden; Marco Roffi; Adel Aminian; Mamas A. Mamas; Ariel Roguin

doi:10.1093/ehjqcco/qcac043

Impact of multisite artery disease on clinical outcomes after percutaneous coronary intervention: an analysis from the e-Ultimaster registry

Ofer Kobo, Majdi Saada, Clemens Von Birgelen, Pim A.L. Tonino, Andres Íñiguez-Romo, Ole Fröbert, Majdi Halabi, Rohit M. Oemrawsingh, Jawed Polad, Alexander J.J. Ijsselmuiden, Marco Roffi, Adel Aminian, Mamas A. Mamas, Ariel Roguin^*

^*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

5 Citations (Scopus)

Abstract

Background: Multisite artery disease is considered a 'malignant' type of atherosclerotic disease associated with an increased cardiovascular risk, but the impact of multisite artery disease on clinical outcomes after percutaneous coronary intervention (PCI) is unknown. Methods: Patients enrolled in the large, prospective e-Ultimaster study were grouped into (1) those without known prior vascular disease, (2) those with known single-territory vascular disease, and (3) those with known two to three territories (i.e coronary, cerebrovascular, or peripheral) vascular disease (multisite artery disease). The primary outcome was coronary target lesion failure (TLF), defined as the composite of cardiac death, target vessel-related myocardial infarction, and clinically driven target lesion revascularization at 1-year. Inverse propensity score weighted (IPSW) analysis was performed to address differences in baseline patient and lesion characteristics. Results: Of the 37 198 patients included in the study, 62.3% had no prior known vascular disease, 32.6% had single-territory vascular disease, and 5.1% had multisite artery disease. Patients with known vascular disease were older and were more likely to be men and to have more co-morbidities. After IPSW, the TLF rate incrementally increased with the number of diseased vascular beds (3.16%, 4.44%, and 6.42% for no, single, and multisite artery disease, respectively, P < 0.01 for all comparisons). This was also true for all-cause death (2.22%, 3.28%, and 5.29%, P < 0.01 for all comparisons) and cardiac mortality (1.26%, 1.91%, and 3.62%, P ≤ 0.01 for all comparisons). Conclusions: Patients with previously known vascular disease experienced an increased risk of adverse cardiovascular events and mortality post-PCI. This risk is highest among patients with multisite artery disease.: Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02188355.

Original language	English
Journal	European heart journal - Quality of care & clinical outcomes
Volume	9
Issue	4
Pages (from-to)	417-426
Number of pages	10
ISSN	2058-5225
DOIs	https://doi.org/10.1093/ehjqcco/qcac043
Publication status	Published - Jun 2023
Externally published	Yes

Keywords

clinical trial
human
percutaneous coronary intervention
Poly-vascular disease
vascular disease
Percutaneous Coronary Intervention/adverse effects
Drug-Eluting Stents
Prospective Studies
Humans
Risk Factors
Male
Treatment Outcome
Coronary Artery Disease
Arteries
Female
Registries

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10.1093/ehjqcco/qcac043Licence: CC BY-NC

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Kobo, O., Saada, M., Von Birgelen, C., Tonino, P. A. L., Íñiguez-Romo, A., Fröbert, O., Halabi, M., Oemrawsingh, R. M., Polad, J., Ijsselmuiden, A. J. J., Roffi, M., Aminian, A., Mamas, M. A., & Roguin, A. (2023). Impact of multisite artery disease on clinical outcomes after percutaneous coronary intervention: an analysis from the e-Ultimaster registry. European heart journal - Quality of care & clinical outcomes, 9(4), 417-426. https://doi.org/10.1093/ehjqcco/qcac043

@article{19674e071e3f4c2fa425bf3f001a53b8,

title = "Impact of multisite artery disease on clinical outcomes after percutaneous coronary intervention: an analysis from the e-Ultimaster registry",

abstract = "Background: Multisite artery disease is considered a 'malignant' type of atherosclerotic disease associated with an increased cardiovascular risk, but the impact of multisite artery disease on clinical outcomes after percutaneous coronary intervention (PCI) is unknown. Methods: Patients enrolled in the large, prospective e-Ultimaster study were grouped into (1) those without known prior vascular disease, (2) those with known single-territory vascular disease, and (3) those with known two to three territories (i.e coronary, cerebrovascular, or peripheral) vascular disease (multisite artery disease). The primary outcome was coronary target lesion failure (TLF), defined as the composite of cardiac death, target vessel-related myocardial infarction, and clinically driven target lesion revascularization at 1-year. Inverse propensity score weighted (IPSW) analysis was performed to address differences in baseline patient and lesion characteristics. Results: Of the 37 198 patients included in the study, 62.3% had no prior known vascular disease, 32.6% had single-territory vascular disease, and 5.1% had multisite artery disease. Patients with known vascular disease were older and were more likely to be men and to have more co-morbidities. After IPSW, the TLF rate incrementally increased with the number of diseased vascular beds (3.16%, 4.44%, and 6.42% for no, single, and multisite artery disease, respectively, P < 0.01 for all comparisons). This was also true for all-cause death (2.22%, 3.28%, and 5.29%, P < 0.01 for all comparisons) and cardiac mortality (1.26%, 1.91%, and 3.62%, P ≤ 0.01 for all comparisons). Conclusions: Patients with previously known vascular disease experienced an increased risk of adverse cardiovascular events and mortality post-PCI. This risk is highest among patients with multisite artery disease.: Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02188355.",

keywords = "clinical trial, human, percutaneous coronary intervention, Poly-vascular disease, vascular disease, Percutaneous Coronary Intervention/adverse effects, Drug-Eluting Stents, Prospective Studies, Humans, Risk Factors, Male, Treatment Outcome, Coronary Artery Disease, Arteries, Female, Registries",

author = "Ofer Kobo and Majdi Saada and {Von Birgelen}, Clemens and Tonino, {Pim A.L.} and Andres {\'I}{\~n}iguez-Romo and Ole Fr{\"o}bert and Majdi Halabi and Oemrawsingh, {Rohit M.} and Jawed Polad and Ijsselmuiden, {Alexander J.J.} and Marco Roffi and Adel Aminian and Mamas, {Mamas A.} and Ariel Roguin",

note = "Publisher Copyright: {\textcopyright} 2022 The Author(s). Published by Oxford University Press on behalf of the European Society of Cardiology.",

year = "2023",

month = jun,

doi = "10.1093/ehjqcco/qcac043",

language = "English",

volume = "9",

pages = "417--426",

journal = "European heart journal - Quality of care & clinical outcomes",

issn = "2058-5225",

publisher = "Oxford University Press",

number = "4",

}

Kobo, O, Saada, M, Von Birgelen, C, Tonino, PAL, Íñiguez-Romo, A, Fröbert, O, Halabi, M, Oemrawsingh, RM, Polad, J, Ijsselmuiden, AJJ, Roffi, M, Aminian, A, Mamas, MA & Roguin, A 2023, 'Impact of multisite artery disease on clinical outcomes after percutaneous coronary intervention: an analysis from the e-Ultimaster registry', European heart journal - Quality of care & clinical outcomes, vol. 9, no. 4, pp. 417-426. https://doi.org/10.1093/ehjqcco/qcac043

Impact of multisite artery disease on clinical outcomes after percutaneous coronary intervention: an analysis from the e-Ultimaster registry. / Kobo, Ofer; Saada, Majdi; Von Birgelen, Clemens et al.
In: European heart journal - Quality of care & clinical outcomes, Vol. 9, No. 4, 06.2023, p. 417-426.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Impact of multisite artery disease on clinical outcomes after percutaneous coronary intervention

T2 - an analysis from the e-Ultimaster registry

AU - Kobo, Ofer

AU - Saada, Majdi

AU - Von Birgelen, Clemens

AU - Tonino, Pim A.L.

AU - Íñiguez-Romo, Andres

AU - Fröbert, Ole

AU - Halabi, Majdi

AU - Oemrawsingh, Rohit M.

AU - Polad, Jawed

AU - Ijsselmuiden, Alexander J.J.

AU - Roffi, Marco

AU - Aminian, Adel

AU - Mamas, Mamas A.

AU - Roguin, Ariel

PY - 2023/6

Y1 - 2023/6

N2 - Background: Multisite artery disease is considered a 'malignant' type of atherosclerotic disease associated with an increased cardiovascular risk, but the impact of multisite artery disease on clinical outcomes after percutaneous coronary intervention (PCI) is unknown. Methods: Patients enrolled in the large, prospective e-Ultimaster study were grouped into (1) those without known prior vascular disease, (2) those with known single-territory vascular disease, and (3) those with known two to three territories (i.e coronary, cerebrovascular, or peripheral) vascular disease (multisite artery disease). The primary outcome was coronary target lesion failure (TLF), defined as the composite of cardiac death, target vessel-related myocardial infarction, and clinically driven target lesion revascularization at 1-year. Inverse propensity score weighted (IPSW) analysis was performed to address differences in baseline patient and lesion characteristics. Results: Of the 37 198 patients included in the study, 62.3% had no prior known vascular disease, 32.6% had single-territory vascular disease, and 5.1% had multisite artery disease. Patients with known vascular disease were older and were more likely to be men and to have more co-morbidities. After IPSW, the TLF rate incrementally increased with the number of diseased vascular beds (3.16%, 4.44%, and 6.42% for no, single, and multisite artery disease, respectively, P < 0.01 for all comparisons). This was also true for all-cause death (2.22%, 3.28%, and 5.29%, P < 0.01 for all comparisons) and cardiac mortality (1.26%, 1.91%, and 3.62%, P ≤ 0.01 for all comparisons). Conclusions: Patients with previously known vascular disease experienced an increased risk of adverse cardiovascular events and mortality post-PCI. This risk is highest among patients with multisite artery disease.: Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02188355.

AB - Background: Multisite artery disease is considered a 'malignant' type of atherosclerotic disease associated with an increased cardiovascular risk, but the impact of multisite artery disease on clinical outcomes after percutaneous coronary intervention (PCI) is unknown. Methods: Patients enrolled in the large, prospective e-Ultimaster study were grouped into (1) those without known prior vascular disease, (2) those with known single-territory vascular disease, and (3) those with known two to three territories (i.e coronary, cerebrovascular, or peripheral) vascular disease (multisite artery disease). The primary outcome was coronary target lesion failure (TLF), defined as the composite of cardiac death, target vessel-related myocardial infarction, and clinically driven target lesion revascularization at 1-year. Inverse propensity score weighted (IPSW) analysis was performed to address differences in baseline patient and lesion characteristics. Results: Of the 37 198 patients included in the study, 62.3% had no prior known vascular disease, 32.6% had single-territory vascular disease, and 5.1% had multisite artery disease. Patients with known vascular disease were older and were more likely to be men and to have more co-morbidities. After IPSW, the TLF rate incrementally increased with the number of diseased vascular beds (3.16%, 4.44%, and 6.42% for no, single, and multisite artery disease, respectively, P < 0.01 for all comparisons). This was also true for all-cause death (2.22%, 3.28%, and 5.29%, P < 0.01 for all comparisons) and cardiac mortality (1.26%, 1.91%, and 3.62%, P ≤ 0.01 for all comparisons). Conclusions: Patients with previously known vascular disease experienced an increased risk of adverse cardiovascular events and mortality post-PCI. This risk is highest among patients with multisite artery disease.: Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02188355.

KW - clinical trial

KW - human

KW - percutaneous coronary intervention

KW - Poly-vascular disease

KW - vascular disease

KW - Percutaneous Coronary Intervention/adverse effects

KW - Drug-Eluting Stents

KW - Prospective Studies

KW - Humans

KW - Risk Factors

KW - Male

KW - Treatment Outcome

KW - Coronary Artery Disease

KW - Arteries

KW - Female

KW - Registries

UR - http://www.scopus.com/inward/record.url?scp=85163849943&partnerID=8YFLogxK

U2 - 10.1093/ehjqcco/qcac043

DO - 10.1093/ehjqcco/qcac043

M3 - Journal article

C2 - 35876646

AN - SCOPUS:85163849943

SN - 2058-5225

VL - 9

SP - 417

EP - 426

JO - European heart journal - Quality of care & clinical outcomes

JF - European heart journal - Quality of care & clinical outcomes

IS - 4

ER -

Impact of multisite artery disease on clinical outcomes after percutaneous coronary intervention: an analysis from the e-Ultimaster registry

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