Long-Term Outcomes and Predictors of Death and MACE Following PCI: Insights From the MIG Registry

Concerns regarding long term development of pulmonary incompetence (PI) have subsequently been raised. Methods: One hundred and six patients who underwent balloon valvotomy for pulmonary stenosis since 1986 were included. We reviewed our patients’ clinical data and recent echocardiograms. Results: Fifty-eight patients were female. Associated cardiac defects included a patent foramen ovale (19%), atrial septal defect (11%), patent ductus arteriosus (11%) and ventricular septal defect (8%). The median age at intervention was 24 months with a median peak gradient of 50 mm Hg .The procedure was successful in 101 (95.2%) of patients. Five patients required surgical valvotomy. Seventy-nine patients (75%) had follow-up at a median interval of 60 months. Eleven patients (14%) required a repeat procedure for recurrent pulmonary stenosis. The median peak gradient at follow-up was 19 mm Hg. All patients remain asymptomatic in NYHA I. Fifty-one patients (63%) had trivial or mild PI only. Nineteen patients (24%) had moderate and ten patients (13%) had moderate to severe PI. No patients required pulmonary valve replacement. Conclusions: Due to excellent initial results patients easily become lost to follow-up. Redo balloon valvotomy is sometimes necessary. The development of pulmonary incompetence can be insidious and asymptomatic. However long term follow-up is essential to review the degree of PI and its effect on the right ventricle. doi:10.1016/j.hlc.2010.06.995 329 Long-Term Outcomes and Predictors of Death and MACE Following PCI: Insights From the MIG Registry L. Roberts 1,∗ , N. Andrianopoulos 2 , I. Harries 3 , M. Moore 1 , S. Duffy 4 , A. Black 5 , A. Ajani 3 , P. Loane 2 , A. Brennan 2 , S. Ching 1 , J. Sapontis 1 , W. Childs 1 , S. Parnham 1 , S. Sidharta 1 , G. New 1 1 Box

Hill Hospital, Australia Australia 3 Royal Melbourne Hospital, Australia 4 Alfred Hospital, Australia 5 Geelong Hospital, Australia 2 CCRE,

Background: There is a paucity of long-term follow-up data on PCI outcomes in Australia. Aim: To examine the long-term outcomes of patients undergoing PCI and to determine predictors of clinical events Methods: We collected baseline data and conducted long-term follow-up from individuals by telephone in a sub-group of the MIG Registry from 4 hospitals. Renal impairment was defined as creatinine >200 ␮mol/L. Urgent PCI was defined as non-elective or non-rescue PCI. Results: 1747 PCIs were followed up for a median of 42 ± 6 months. Mean age was 64 ± 12 years; 74% were male; 22% had diabetes. 26% were NSTEACS and 27% were

Abstracts

S139

STEMI. Cardiac deaths at 42-months numbered 120 (55.4% of all deaths). Outcomes

42-month, n = 1747

Death Myocardial Infarction Target vessel revascularization MACE

(220) 12.6% (220) 12.6% (277) 15.9% (580) 33.2%

Multivariate analysis revealed the predictors of 30-day MACE to be cardiogenic shock [OR(CI:95%)] 5.7 (3.2–10.4) and of 30-day mortality were cardiogenic shock 22.4 (9.2–45.3) and renal failure 5.9 (2.1–16.6). Predictors of 12month MACE were cardiogenic shock 5.1 (2.9–8.9), renal failure 3.5 (2.1–5.6), urgent PCI 1.6 (1.2–2.1), diabetes 1.4 (1.1–1.9) and hypertension 1.3 (1.1–1.7). The predictor of 12-month mortality was age 1.1 (1.03–1.07). Predictors of 42-month MACE were renal failure 4.3 (2.6–7.1), cardiogenic shock 3.4 (1.9–6.1), diabetes 1.5 (1.2–1.9) and urgent PCI 1.5 (1.1–1.9), and 42-month mortality was cardiogenic shock 7.43 (3.8–14.4), renal failure 5.4 (3.2–9.3) and age 1.05 (1.03–1.07). Conclusion: After 3.5 years follow-up, adverse outcomes were common with deaths being nearly as frequent as other MACE. The predictors of late events are similar to that of earlier outcomes. doi:10.1016/j.hlc.2010.06.996 330 Long-Term Predictors of Mortality after Percutaneous Coronary Intervention in the Era of Drug Eluting Stents W. Wilson 1,∗ , D. Clark 2 , N. Andrianopoulos 3 , S. Duffy 4 , A. Brennan 3 , E. Harries 1 , G. New 5 , T. Yip 6 , P. Loane 3 , C. Reid 3 , A. Ajani 1 1 Royal

Melbourne Hospital, Melbourne, Australia Hospital, Melbourne, Australia 3 Monash Centre of Cardiovascular Research and Education, Melbourne, Australia 4 Alfred Hospital, Melbourne, Australia 5 Box Hill Hospital, Melbourne, Australia 6 Geelong Hospital, Geelong, Australia 2 Austin

Aim: To examine the timing, causes and predictors of death during long-term follow up after contemporary percutaneous coronary intervention (PCI) utilizing a large multi-centre Australian registry. Methods: The cohort consisted of 10,682 consecutive patients from the Melbourne Interventional Group (MIG) registry undergoing PCI (2/2004–11/2009). For the first time, long-term mortality rates of the MIG cohort were defined by linkage to the National Death Index (NDI) database. All deaths were analysed in terms of timing, aetiology and mortality predictors with a mean follow up of 3.2 ± 0.5 years (yrs). Results: The cohort (mean age 64.4 ± 12.0 yrs) comprised 75.0% males, 64.6% hypertensives, 24.4% diabetics, 23.2% current smokers, 59.3% with multi-vessel disease (MVD), 4.4% with renal failure (RF), 25.2% ST elevation MI (STEMI), 2.5% with cardiogenic shock and 5.1%

ABSTRACTS

Heart, Lung and Circulation 2010;19S:S1–S268