Outcomes of percutaneous coronary intervention and coronary artery bypass grafting in patients with Takayasu arteritis. (15th August 2017)

• Record Type: Journal Article
• Authors: Yang, Yankun; Tian, Tao; Yang, Kunqi; Zhang, Ying; Meng, Xu; Fan, Peng; Feng, Lei; Mu, Chaowei; Gao, Linggen; Zhou, Xianliang
• Is Part Of: International journal of cardiology. Volume 241(2017)
• Page Start: 64
• Page End: 69
• Publication Date: 2017-08-15
• Subjects: Takayasu arteritis -- Coronary artery stenosis -- Percutaneous coronary intervention -- Coronary artery bypass; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2017.02.041
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: Coronary artery involvement is not a rare presentation of Takayasu arteritis (TA) and the treatment is challenging. The optimal methods of revascularization, and prognosis of treatment have not been established. Objectives: To assess the long-term outcomes of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) in TA patients. Methods: Patients with coronary artery involved in TA who underwent either PCI or CABG were identified between February 2003 and December 2015. The primary outcome was long-term all-cause mortality. Secondary outcomes were myocardial infarction (MI), stroke, and repeat revascularization. Results: Thirty-one patients were enrolled (PCI = 19 vs. CABG = 12). Most of them were female (25, 80.6%) and the mean age was 42.6 ± 13.8 years (16–64 years). Angina pectoris was the most common initial symptom (26 cases, 83.9%) and concomitant aortic regurgitation was present in 8 (25.8%) patients. Both groups had a low rate of corticosteroids use [4/19 (21.1%) vs. 2/12 (16.7%)]. During the median follow-up of 101 months (10–384 months), PCI group had a significantly higher incidence of restenosis [12/19(63.2%) vs. 3/12(25%)]. Two patients with severe aortic regurgitation in PCI group suffered from cardiac death during follow-up. Conclusions: Coronary artery involvement should be suspected in TA patients with angina pectoris, especially young women. PCI had a very high rate of in-stent restenosis in patients without corticosteroids and CABG may be a preferred treatment option.