Background: Owing to the repeat criticism of use of PCI we sought to define outcomes and outcome predictors in a very large consecutive patient cohort.
Methods: We present data from 11441 consecutive patients who underwent PCI at the Rabin Medical Center between 4/2004 and 9/2013. A comprehensive database was built using various data sources.
Results: Mean follow up was 5.5 years (range 3 m to 9.5 years). The cohort consisted of 75% males, 42% diabetics, 61% having the PCI in an emergent setting (MI or ACS), and 7.8% for ST elevation MI. Drug eluting stents (DES) were used in 43.4% of patients, Bare Metal Stents(BMS) in 52% and Balloon angioplasty alone (POBA) in 4.6%. In multivariate Analysis, in addition to well-known predictors of death or MI such as age (HR=1.031 p<0.001), Female gender (HR=1.23 p<0.001), Diabetes Mellitus (HR=1.28 p<0.001), we particularly noted prior anemia (HR 1.55 p<0.001), prior renal failure (HR=1.93 p<0.001) and prior moderate-severe LV dysfunction (HR=2.29 p<0.001). An acute setting conferred a higher risk of adverse outcome (HR=1.23 p<0.001) whilst use of a DES provided better outcomes (HR=0.70 p<0.001).
Conclusions: This comprehensive analysis confirms the effect of known risk factors and predictors of adverse outcomes. However their effect size is modest while other predictors may have larger effect size on long term PCI outcomes. DES use provides a sustained long term benefit.
