🚨 New Interventional Cardiology Trial Alert: PROCTOR Study Results

In patients with prior CABG and failing saphenous vein grafts (SVGs), the choice of which vessel to re-intervene on is a common dilemma. The just-published PROCTOR trial provides compelling evidence.

➡ The Study: Randomized 220 post-CABG patients with SVG failure to receive PCI either on the native coronary artery (108 pts) or on the saphenous vein graft itself (112 pts).

➡ Key Finding at 1 Year: PCI on the native artery was associated with worse outcomes than PCI on the SVG.

Major Adverse Cardiac Events: 34% (native) vs. 19% (SVG) | HR 2.14

Nonfatal MI: Significantly higher with native PCI | HR 2.12

Repeat Revascularization: Higher with native PCI | HR 2.19

PCI-Related MI: 13% (native) vs. 1% (SVG) | HR 14.85

Mortality: No significant difference.

Conclusion: In this population, SVG PCI produced significantly better one-year clinical outcomes than attempting native vessel PCI.

This challenges some conventional wisdom and underscores the complexity of managing post-CABG patients. It highlights that technical success in a native vessel does not always translate to better patient outcomes, possibly due to vessel quality, complexity, and collateral flow.

#Cardiology #InterventionalCardiology #CABG #PCI #ClinicalTrials #PROCTORTrial #CardioTwitter #MedEd

Acronym Definitions:

PCI: Percutaneous Coronary Intervention. A minimally invasive procedure to open blocked coronary arteries, typically using a balloon and stent.

SVG: Saphenous Vein Graft. A segment of the leg vein used during CABG surgery to bypass a blocked coronary artery.

CABG: Coronary Artery Bypass Grafting. Open-heart surgery to restore blood flow by grafting vessels to bypass coronary blockages.

MI: Myocardial Infarction. A heart attack, caused by a blockage of blood flow to the heart muscle.

HR: Hazard Ratio. A measure of how often an event happens in one group compared to another over time in a study. An HR >1.0 indicates a higher risk.

PROCTOR: (Trial Name) Likely an acronym related to the trial’s focus (e.g., PCI of Restenotic Occluded Coronary naTive arteries versus bypass grafts), though the full expansion is not standardized in the summary provided.