Six-month outcomes after single- and multi-lesion percutaneous coronary intervention

Results from the ROSETTA registry

Lorne E. Goldman, Karen Okrainec, Mark J. Eisenberg, David Schechter, Jeffrey Lefkovits, Evelyne Goudreau, Ubeydullah Deligonul, Koon Hou Mak, Michael Del Core, Robert Duerr, Thao Huynh, Mark Smilovitch, Steven Sedlis, David L. Brown, David Brieger

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: The American College of Cardiology/American Heart Association exercise testing guidelines suggest that routine functional testing may benefit patients at high risk of restenosis, such as those undergoing multi-lesion percutaneous coronary intervention (PCI). Objectives: To compare the six-month post-PCI clinical and procedural outcomes in patients following single- and multi-lesion PCI, and to examine the use of routine functional testing (ie, in all patients) versus selective functional testing (ie, only in those with recurrent symptoms) following multi-lesion PCI. Methods: Six-month outcomes among 562 patients after single-lesion PCI and 229 patients after multi-lesion PCI were examined. All patients were enrolled in the Routine versus Selective Exercise Treadmill Testing after Angioplasty (ROSETTA) registry, a prospective, multicentre registry examining the use of functional testing after successful PCI. Results: For single- versus multi-lesion PCI patients, respectively, rates of death (1.8% versus 2.2%, P=0.7) and myocardial infarction (0.7% versus 2.6%, P=0.03) were low in both groups. Rates of unstable angina (12.0% versus 11.7%, P=0.9) and the composite clinical end point of death, myocardial infarction or unstable angina (13.5% versus 13.9%, P=0.9) were similar. Multi-lesion PCI patients had a higher number of repeat PCI procedures (6.6% versus 13.4%, P=0.02) but there was no difference in the rates of coronary artery bypass graft surgery (3.0% versus 2.6%, P=0.7). A routine functional testing strategy was used in 28.0% of single-lesion and 31.6% of multi-lesion patients. In a multivariate analysis of the multi-lesion patients, routine functional testing was not associated with a significant reduction in the composite clinical event rate (odds ratio 0.5, 95% CI 0.2 to 1.7, P=0.27). Conclusions: During the six-month period following successful PCI, clinical event rates were similar among patients undergoing single- or multi-lesion PCI. Routine functional testing was not associated with a statistically significant benefit in patients after multi-lesion PCI. However, additional study is required to better define the role of routine functional testing in this subgroup of patients.

Original languageEnglish
Pages (from-to)608-612
Number of pages5
JournalCanadian Journal of Cardiology
Volume20
Issue number6
StatePublished - May 1 2004

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Percutaneous Coronary Intervention
Angioplasty
Registries
Exercise
Unstable Angina
Myocardial Infarction
Coronary Artery Bypass
Multivariate Analysis
Odds Ratio
Guidelines

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Goldman, L. E., Okrainec, K., Eisenberg, M. J., Schechter, D., Lefkovits, J., Goudreau, E., ... Brieger, D. (2004). Six-month outcomes after single- and multi-lesion percutaneous coronary intervention: Results from the ROSETTA registry. Canadian Journal of Cardiology, 20(6), 608-612.

Six-month outcomes after single- and multi-lesion percutaneous coronary intervention : Results from the ROSETTA registry. / Goldman, Lorne E.; Okrainec, Karen; Eisenberg, Mark J.; Schechter, David; Lefkovits, Jeffrey; Goudreau, Evelyne; Deligonul, Ubeydullah; Mak, Koon Hou; Del Core, Michael; Duerr, Robert; Huynh, Thao; Smilovitch, Mark; Sedlis, Steven; Brown, David L.; Brieger, David.

In: Canadian Journal of Cardiology, Vol. 20, No. 6, 01.05.2004, p. 608-612.

Research output: Contribution to journalArticle

Goldman, LE, Okrainec, K, Eisenberg, MJ, Schechter, D, Lefkovits, J, Goudreau, E, Deligonul, U, Mak, KH, Del Core, M, Duerr, R, Huynh, T, Smilovitch, M, Sedlis, S, Brown, DL & Brieger, D 2004, 'Six-month outcomes after single- and multi-lesion percutaneous coronary intervention: Results from the ROSETTA registry', Canadian Journal of Cardiology, vol. 20, no. 6, pp. 608-612.
Goldman LE, Okrainec K, Eisenberg MJ, Schechter D, Lefkovits J, Goudreau E et al. Six-month outcomes after single- and multi-lesion percutaneous coronary intervention: Results from the ROSETTA registry. Canadian Journal of Cardiology. 2004 May 1;20(6):608-612.
Goldman, Lorne E. ; Okrainec, Karen ; Eisenberg, Mark J. ; Schechter, David ; Lefkovits, Jeffrey ; Goudreau, Evelyne ; Deligonul, Ubeydullah ; Mak, Koon Hou ; Del Core, Michael ; Duerr, Robert ; Huynh, Thao ; Smilovitch, Mark ; Sedlis, Steven ; Brown, David L. ; Brieger, David. / Six-month outcomes after single- and multi-lesion percutaneous coronary intervention : Results from the ROSETTA registry. In: Canadian Journal of Cardiology. 2004 ; Vol. 20, No. 6. pp. 608-612.
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abstract = "Background: The American College of Cardiology/American Heart Association exercise testing guidelines suggest that routine functional testing may benefit patients at high risk of restenosis, such as those undergoing multi-lesion percutaneous coronary intervention (PCI). Objectives: To compare the six-month post-PCI clinical and procedural outcomes in patients following single- and multi-lesion PCI, and to examine the use of routine functional testing (ie, in all patients) versus selective functional testing (ie, only in those with recurrent symptoms) following multi-lesion PCI. Methods: Six-month outcomes among 562 patients after single-lesion PCI and 229 patients after multi-lesion PCI were examined. All patients were enrolled in the Routine versus Selective Exercise Treadmill Testing after Angioplasty (ROSETTA) registry, a prospective, multicentre registry examining the use of functional testing after successful PCI. Results: For single- versus multi-lesion PCI patients, respectively, rates of death (1.8{\%} versus 2.2{\%}, P=0.7) and myocardial infarction (0.7{\%} versus 2.6{\%}, P=0.03) were low in both groups. Rates of unstable angina (12.0{\%} versus 11.7{\%}, P=0.9) and the composite clinical end point of death, myocardial infarction or unstable angina (13.5{\%} versus 13.9{\%}, P=0.9) were similar. Multi-lesion PCI patients had a higher number of repeat PCI procedures (6.6{\%} versus 13.4{\%}, P=0.02) but there was no difference in the rates of coronary artery bypass graft surgery (3.0{\%} versus 2.6{\%}, P=0.7). A routine functional testing strategy was used in 28.0{\%} of single-lesion and 31.6{\%} of multi-lesion patients. In a multivariate analysis of the multi-lesion patients, routine functional testing was not associated with a significant reduction in the composite clinical event rate (odds ratio 0.5, 95{\%} CI 0.2 to 1.7, P=0.27). Conclusions: During the six-month period following successful PCI, clinical event rates were similar among patients undergoing single- or multi-lesion PCI. Routine functional testing was not associated with a statistically significant benefit in patients after multi-lesion PCI. However, additional study is required to better define the role of routine functional testing in this subgroup of patients.",
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T1 - Six-month outcomes after single- and multi-lesion percutaneous coronary intervention

T2 - Results from the ROSETTA registry

AU - Goldman, Lorne E.

AU - Okrainec, Karen

AU - Eisenberg, Mark J.

AU - Schechter, David

AU - Lefkovits, Jeffrey

AU - Goudreau, Evelyne

AU - Deligonul, Ubeydullah

AU - Mak, Koon Hou

AU - Del Core, Michael

AU - Duerr, Robert

AU - Huynh, Thao

AU - Smilovitch, Mark

AU - Sedlis, Steven

AU - Brown, David L.

AU - Brieger, David

PY - 2004/5/1

Y1 - 2004/5/1

N2 - Background: The American College of Cardiology/American Heart Association exercise testing guidelines suggest that routine functional testing may benefit patients at high risk of restenosis, such as those undergoing multi-lesion percutaneous coronary intervention (PCI). Objectives: To compare the six-month post-PCI clinical and procedural outcomes in patients following single- and multi-lesion PCI, and to examine the use of routine functional testing (ie, in all patients) versus selective functional testing (ie, only in those with recurrent symptoms) following multi-lesion PCI. Methods: Six-month outcomes among 562 patients after single-lesion PCI and 229 patients after multi-lesion PCI were examined. All patients were enrolled in the Routine versus Selective Exercise Treadmill Testing after Angioplasty (ROSETTA) registry, a prospective, multicentre registry examining the use of functional testing after successful PCI. Results: For single- versus multi-lesion PCI patients, respectively, rates of death (1.8% versus 2.2%, P=0.7) and myocardial infarction (0.7% versus 2.6%, P=0.03) were low in both groups. Rates of unstable angina (12.0% versus 11.7%, P=0.9) and the composite clinical end point of death, myocardial infarction or unstable angina (13.5% versus 13.9%, P=0.9) were similar. Multi-lesion PCI patients had a higher number of repeat PCI procedures (6.6% versus 13.4%, P=0.02) but there was no difference in the rates of coronary artery bypass graft surgery (3.0% versus 2.6%, P=0.7). A routine functional testing strategy was used in 28.0% of single-lesion and 31.6% of multi-lesion patients. In a multivariate analysis of the multi-lesion patients, routine functional testing was not associated with a significant reduction in the composite clinical event rate (odds ratio 0.5, 95% CI 0.2 to 1.7, P=0.27). Conclusions: During the six-month period following successful PCI, clinical event rates were similar among patients undergoing single- or multi-lesion PCI. Routine functional testing was not associated with a statistically significant benefit in patients after multi-lesion PCI. However, additional study is required to better define the role of routine functional testing in this subgroup of patients.

AB - Background: The American College of Cardiology/American Heart Association exercise testing guidelines suggest that routine functional testing may benefit patients at high risk of restenosis, such as those undergoing multi-lesion percutaneous coronary intervention (PCI). Objectives: To compare the six-month post-PCI clinical and procedural outcomes in patients following single- and multi-lesion PCI, and to examine the use of routine functional testing (ie, in all patients) versus selective functional testing (ie, only in those with recurrent symptoms) following multi-lesion PCI. Methods: Six-month outcomes among 562 patients after single-lesion PCI and 229 patients after multi-lesion PCI were examined. All patients were enrolled in the Routine versus Selective Exercise Treadmill Testing after Angioplasty (ROSETTA) registry, a prospective, multicentre registry examining the use of functional testing after successful PCI. Results: For single- versus multi-lesion PCI patients, respectively, rates of death (1.8% versus 2.2%, P=0.7) and myocardial infarction (0.7% versus 2.6%, P=0.03) were low in both groups. Rates of unstable angina (12.0% versus 11.7%, P=0.9) and the composite clinical end point of death, myocardial infarction or unstable angina (13.5% versus 13.9%, P=0.9) were similar. Multi-lesion PCI patients had a higher number of repeat PCI procedures (6.6% versus 13.4%, P=0.02) but there was no difference in the rates of coronary artery bypass graft surgery (3.0% versus 2.6%, P=0.7). A routine functional testing strategy was used in 28.0% of single-lesion and 31.6% of multi-lesion patients. In a multivariate analysis of the multi-lesion patients, routine functional testing was not associated with a significant reduction in the composite clinical event rate (odds ratio 0.5, 95% CI 0.2 to 1.7, P=0.27). Conclusions: During the six-month period following successful PCI, clinical event rates were similar among patients undergoing single- or multi-lesion PCI. Routine functional testing was not associated with a statistically significant benefit in patients after multi-lesion PCI. However, additional study is required to better define the role of routine functional testing in this subgroup of patients.

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