Clinical Outcomes and Characteristics in PCI of LIMA Grafts

Percutaneous coronary intervention (PCI) of left internal mammary artery (LIMA) grafts are associated with a higher risk of mortality, according to research presented at TCT 2016.

Farnaz Azarbal, MD, et al., analyzed data from the NCDR CathPCI Registry of 12,824 participants who underwent PCI of a bypass graft to the left anterior descending artery (LAD) between July 2009 and December 2011, examining the clinical and procedural characteristics of the participants. Grafts included LIMA, saphenous vein grafts (SVG) and other arterial grafts.

The results of the analysis showed that at one year following LIMA intervention, there was a significantly increased risk of death, compared to SVG. PCI of LIMA was also associated with greater than 50 percent residual stenosis, repeat coronary artery bypass graft and in-hospital death. The patients who received LIMA intervention were more likely to be women, have no previous history of myocardial infarction and have insulin-dependent diabetes.

The authors note that “while LIMA conduits are preferred to SVG conduits for LAD bypass, subsequent need for PCI of a LIMA, compared to an SVG, is associated with a higher hazard of mortality both acutely and at one year.”

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