o:3466 Ten-year all-cause mortality following staged percutaneous revascularization in patients with complex coronary artery disease en BACKGROUND: Medical and/or economic reasons sometimes necessitate the staging of percutaneous coronary intervention (SPCI) procedures in patients with complex coronary artery disease; however, the impact of this on very long-term outcomes is unknown. The aim of the present study is to assess 10-year all-cause mortality in patients with the three-vessel disease (3VD) and/or left main disease (LM) undergoing SPCI. METHODS: This is a sub-analysis of patients undergoing SPCI in the SYNTAXES study, which investigated 10-year all-cause mortality in patients with 3VD and/or LM in the randomized SYNTAX trial, beyond its original 5-year follow-up. An SPCI was allowed within 72 h or, if renal insufficiency or contrast-induced nephropathy occurred, within 14 days of the index procedure. Mortality was compared between patients having SPCI versus those not having SPCI or undergoing CABG. PCI patients were further stratified according to 3VD or LM. RESULTS: In the SYNTAX PCI population (overall: n = 903, 3VD: n = 546, LM: n = 357), 125 (13.8%) patients underwent SPCI. Patients with SPCI had a higher 10-year mortality compared to those who didn't (40.0% vs 26.6%; hazard ratio [HR] 1.69; 95% confidence interval [CI] 1.23–2.32; p < 0.01) and those having CABG(40.0% vs 24.5%; HR 1.85; 95%CI 1.35–2.53; p < 0.01). Patients having SPCI with 3VD (n = 103) or LM (n = 22) had higher mortality than respective patients not having SPCI (3VD: 37.4% vs 27.1%; HR 1.52; 95%CI 1.05–2.21; p = 0.03 and LM: 51.8% vs 25.9%; HR 2.39; 95%CI 1.27–4.47; p = 0.01). CONCLUSIONS: At 10-year follow-up, SPCI was associated with higher mortality than single-session PCI, so that CABG may be preferable if a staged procedure is anticipated. Key words: percutaneous coronary intervention, staged procedure, coronary artery bypass grafting, SYNTAX, mortality 91552100 128613641 1552101 1553-8389 1552099 10.1016/j.carrev.2021.08.027 2023-12-01T20:39:55.247Z 44 yes 46 Hideyuki Kawashima 106259465 2022 46 Masafumi Ono 2022 46 Hironori Hara 46 Robbert J. De Winter 46 David R. Holmes 46 Daniel J.F.M. Thuijs 46 Milan Milojević 106163721 0000-0003-0984-9011 46 Scot Garg 46 Patrick W. Serruys 46 Yoshinobu Onuma 46 SYNTAX Extended Survival Investigators institution application/pdf 412068 https://unilib.phaidrabg.rs/o:3466 no yes 1 70 616.132.2‑089‑036.88 92000001 71A11 Cardiovascular revascularization medicine 38 124 126 2021