Summary
PROCTOR is the first randomised controlled trial designed to compare invasive strategies of native coronary artery PCI versus saphenous vein graft PCI in patients with prior CABG presenting with graft failure. The multicentre trial will enrol 584 patients and evaluate clinical and angiographic outcomes over 5 years, with repeat coronary angiography performed at 3 years to assess graft patency. This addresses a significant evidence gap, as previous randomised comparisons of these revascularisation strategies in the post-CABG population are lacking.
Regional applicability
The trial is described as multicentre and international in scope, though specific participating countries are not detailed in the abstract. The findings will be directly applicable to United Kingdom cardiology practice, as PCI in post-CABG patients is a common clinical scenario managed in UK cardiac centres, and current evidence-based guidance on optimal revascularisation strategy in this population is limited.
Key measures
Primary endpoint: 3-year composite MACE (all-cause mortality, non-fatal target coronary territory MI, clinically driven target coronary territory revascularisation). Secondary endpoints: individual MACE components at 1, 3, 5 years; PCI-related MI; target vessel failure; target lesion revascularisation; renal failure requiring dialysis; angiographic outcomes; quality of life (Seattle Angina Questionnaire, Canadian Cardiovascular Society Grading Scale, Rose Dyspnea Scale).
Outcomes reported
The trial compares clinical and angiographic outcomes between native coronary artery PCI and saphenous vein graft PCI in post-CABG patients, with primary endpoint being 3-year major adverse cardiac events (all-cause mortality, non-fatal target coronary territory myocardial infarction, or clinically driven target coronary territory revascularisation).
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