Major Adverse Coronary Events Status Post Percutaneous Coronary Intervention in Veterans Exposed to Agent Orange Versus Non-Exposed

Veterans exposed to Agent Orange are high-risk cardiovascular patients with a higher prevalence and odds of CABG s/p PCI. The increased prevalence of hypertension, hyperlipidemia, obesity, severe obesity, and diabetes in Veterans exposed to Agent Orange s/p PCI suggests that Agent Orange may contribute to the development of these disease processes. Strengths include the quality and longevity of the data collected, the Promise to Address Comprehensive Toxics (PACT) Act supporting Agent Orange research, and the advanced age of the Veterans increases the likelihood of cardiovascular disease. Weaknesses include the inability to quantify and confirm Agent Orange exposure, the inability to determine causation, and the VHA registrar's office could have erroneously assigned the Agent Orange disability flag by not verifying the service location. This study impacts the care of the Veterans s/p PCI; providers should assess the comorbidities, coronary artery disease progression, number of vessels affected, tortuosity of the cardiac vessels, location of the coronary artery lesion(s), size of the lesion(s), and the number of stents needed to determine if repeat PCI is the preferred treatment over CABG. Future studies should include the newly categorized Veterans exposed to Agent Orange from the PACT Act screenings, the CABG outcomes, the characteristics of the coronary lesions, the type of stent(s), and the medications prescribed at the time of the original PCI.