Key result
Primary PCI for AMI after prior CABG is linked to markedly lower success and higher mortality.
Why the study?
The study aimed to analyze the in-hospital outcome of primary PCI for patients with AMI and prior CABG.
Does a history of prior CABG worsen in-hospital outcomes and PCI success rates in patients with acute myocardial infarction undergoing primary PCI?
Cohort (n=156)
Does a history of prior CABG worsen in-hospital outcomes and PCI success rates in patients with acute myocardial infarction undergoing primary PCI?
Effect estimate: OR 5.26 (age <65); OR 13.76 (age ≥65) (95% CI 1.69-16.47 (age <65); 2.72-69.75 (age ≥65))
Patients presenting with acute myocardial infarction and a history of prior CABG have poor in-hospital outcomes following primary PCI, characterized by lower procedural success rates and higher mortality compared to matched patients without prior CABG.
Heightened vigilance warranted for primary PCI in AMI with prior CABG; leaves open whether tailored strategies improve outcomes.
BACKGROUND: This study aims to analyze the in-hospital outcome of primary percutaneous coronary intervention (PCI) for patients with acute myocardial infarction (AMI) and prior coronary artery bypass grafting (CABG). METHODS: This was a retrospective study. From January 2011 to December 2018, the data of 78 consecutive patients (study group) with prior CABG, who received primary coronary angiography in the setting of ST-elevation myocardial infarction (STEMI) or non-ST-elevation myocardial infarction (NSTEMI), were screened. The study group was compared with another well-matched 78 patients without a history of CABG (control group). The information of the coronary angiograms and clinical data of both groups were analyzed. Multivariate conditional logistic regression models were constructed to test the association between PCI success rate and the prior CABG at age ≥65 and <65 years, respectively. RESULTS: . 2.5%, P=0.03). The multivariate logistic regression analysis indicated that the primary PCI success rate was significantly associated with the history of prior CABG both in young patients [age <65 years; odds ratio (OR) =5.26, 95% confidence interval (CI): 1.69-16.47] and elderly (age ≥65 years; OR =13.76, 95% CI: 2.72-69.75). CONCLUSIONS: The patients who receive primary PCI with AMI and prior CABG have poor in-hospital outcomes, with low PCI success rates and high mortality.
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Liu et al. (2021) conducted a cohort in Acute myocardial infarction (AMI) (n=156). Primary PCI in patients with prior CABG vs. Primary PCI in patients without prior CABG was evaluated on Primary PCI success rate (OR 5.26 (age <65); OR 13.76 (age ≥65), 95% CI 1.69-16.47 (age <65); 2.72-69.75 (age ≥65)). Primary PCI in patients with acute myocardial infarction and prior CABG was associated with lower procedural success rates (OR 5.26 for age <65; OR 13.76 for age ≥65) and higher mortality.
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