Abstract 18687: Peripheral Artery Disease Predicts Adverse Outcomes In PCI-naive Patients but Not in Patients Undergoing Repeat Revascularization

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Abstract

Introduction: Previous studies showed that peripheral artery disease (PAD) is an independent predictor of poor in-hospital outcomes following PCI. This has been attributed to extensive underlying atherosclerosis. However, little is known about the in-hospital outcomes of patients with PAD undergoing PCI who have had previous coronary revascularization.

Methods: The Dartmouth Dynamic Registry was queried for all PCI’s between 2004 and 2015. Patients were divided into four groups based on the presence of PAD and whether they were PCI naïve (no prior CABG or PCI) or had previous history of revascularization (prior CABG or PCI). PAD was defined as symptomatic lower extremity claudication or critical limb ischemia. Baseline demographics and comorbidities were collected. Outcomes compared include: in-hospital mortality, bleeding requiring transfusion, access site hematoma >5cm, post-PCI MI, acute renal failure(ARF) requiring dialysis, cerebral vascular accident(CVA), and hypotension requiring vasopressors.

Results: Between 2004-2015, 13,496 patients underwent PCI (Table 1). Of these patients, 521 (3.86%) had symptomatic PAD. Outcome measures for all 4 groups are summarized in Table 2. Amongst patients undergoing incident PCI, patients with PAD had a higher risk of in-hospital mortality, bleeding requiring transfusion, ARF requiring dialysis, and hypotension requiring vasopressors. For patients undergoing repeat PCI, there are no statistically significant differences for in-hospital outcomes between those with PAD and those without.

Conclusion: In patients undergoing repeat PCI, the presence of PAD is not predictive of adverse in-hospital outcomes.

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