RESUMO
Objectives: The aim of the study was to investigate the in-hospital and one-year clinical outcome of patients treated with percutaneous coronary intervention [PCI] in a tertiary hospital in Oman
Methods: We conducted a retrospective, single-center, observational study looking at patients > 18 years old who underwent a PCI from 1 January to 31 December 2013. The primary end point was the occurrence of a major adverse cardiovascular event [MACE], defined as death, any myocardial infarction [MI], cerebrovascular accident [CVA], and target vessel revascularization [TVR] with either repeat PCI or coronary artery bypass surgery [CABG]. Secondary end-points included procedural success rate, angina status, stent thrombosis, and the rate of redo-PCI/CABG for in-stent restenosis
Results: A total of 1 045 consecutive patients were analyzed. The mean age of the cohort was 58.2 +/- 11.2 years. Hyperlipidemia [66.8%], hypertension [55.1%], and diabetes mellitus [45.9%] were the predominant risk factors. Stable angina, ST-elevation MI, non-ST-elevation MI, and post-acute coronary syndrome [ACS] were common indications [approximately 20.0% each]. The angiographic and procedural success rate was 95.0%. Forty-six percent of patients had single-vessel disease, 34.4% had double vessel disease, and triple vessel disease was seen in 19.1% of patients. Ninety-eight percent had balloon angioplasty with stenting, and only 1.9% of patients had balloon angioplasty without stenting. The majority of patients had single-vessel stenting [81.3%]. A drug-eluting stent was used in 88.4% of patients, and a bare-metal stent in 11.6%. Inhospital MACE was 3.6%. There were 19 in-hospital deaths [1.8%], and four patients [0.4%] had CVA/MI. Out of 1 026 patients discharged, 100 patients were lost to followup. Among the 926 patients followed-up, 673 patients [72.7%] were asymptomatic. Oneyear MACE was 17.0%, including 5.0% death and 6.0% MI. Repeat revascularization was performed in 53 patients [5.7%] for documented in-stent restenosis. Definite stent thrombosis was documented in 10 [1.1%] patients. At discharge, the majority of patients were on post-ACS evidence-based medications, aspirin [100%], clopidogrel [99.6%], statin [97.6%], beta-blocker [88.7%], and angiotensin-converting-enzyme inhibitors [83.9%]
Conclusions: Omani patients treated with PCI were much younger than Western patients with a high prevalence of risk factors. Successful PCI was achieved in a large percentage of patients with a low incidence of in-hospital complications and mortality. At one-year follow-up, the majority patients had a good clinical outcome