Revascularization in paraplegics best performed with PCI

WASHINGTON – When paraplegics and quadriplegics have an acute MI and are candidates for revascularization, they should be treated preferentially with a percutaneous coronary intervention, according to data presented at the 2018 Cardiovascular Research Technologies meeting.

When compared 30 days after revascularization, the rates of major adverse cardiovascular events (MACE) following coronary artery bypass grafting (CABG) were 22% in the group with paraplegia or quadriplegia versus only 3.5% in those without loss of limb function. For percutaneous coronary intervention (PCI), the rates were 6% versus 2%, respectively, reported Xuming Dai, MD, PhD, an interventional cardiologist and assistant professor at the University of North Carolina at Chapel Hill.

A study of revascularization outcomes in patients with paraplegia or quadriplegia was undertaken after Dr. Dai was faced with two such patients, of whom one was ultimately referred for CABG. Concerned at the time about the suitability of CABG for patients with the potential for risk factors different from ambulatory patients, Dr. Dai consulted the literature.

“There are no guidelines, no studies. I could not even find a case report,” Dr. Dai recounted.