Key result
Among patients requiring percutaneous coronary intervention within 1 year of CABG, 55% presented urgently and 81% of procedures were performed in native coronary arteries.
Observational (n=203)
Patients requiring PCI within 1 year of CABG frequently present urgently and primarily require intervention in native coronary arteries due to graft failure, suggesting a potential role for planned hybrid revascularization strategies.
Highlights early native-vessel disease progression as a primary driver of post-CABG urgency;.
OBJECTIVES: The aim of this study was to examine the clinical and procedural outcomes of patients undergoing percutaneous coronary intervention (PCI) within 1 year of coronary artery bypass graft surgery (CABG). BACKGROUND: CABG is the preferred revascularization strategy for patients with complex coronary artery disease due to a lower rate of repeat revascularization. Despite advances in surgical technique and medical therapy, >5% of patients require repeat revascularization within 1 year of CABG. METHODS AND RESULTS: Patients who underwent PCI within 1 year of CABG were identified from a prospective registry with data on over 20,000 PCI procedures (April 2000-June 2011). 203 post-CABG patients underwent 228 PCI procedures on 390 lesions during this period. 45% of patients had elective PCI while 55% had PCI on an urgent basis. 81% of PCI was performed in native coronary arteries, usually following graft failure in a previously grafted vessel (60%) or in an ungrafted native vessel (21%). CONCLUSIONS: Patients who required PCI within 1 year of CABG were more likely to present on an urgent basis and have PCI performed in grafted native coronary vessels. However, nearly third of the patients had PCI to an ungrafted native vessel or to a lesion in the native vessel where the graft was still patent. Further studies are needed to determine whether the use of hybrid revascularization strategies (combination CABG and planned PCI) in appropriate patients could reduce the need for urgent PCI within the first year after CABG.
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Sharma et al. (2017) conducted an observational in Coronary artery disease requiring PCI within 1 year of CABG (n=203). Percutaneous coronary intervention within 1 year of CABG was evaluated on Clinical and procedural characteristics (urgency and vessel location). Among patients requiring percutaneous coronary intervention within 1 year of CABG, 55% presented urgently and 81% of procedures were performed in native coronary arteries.