Key result
A history of previous coronary stenting significantly increased the risk of overall immediate postoperative complications after CABG compared to no prior stenting (32.9% vs. 11.6%; OR 3.74).
Why the study?
Does a history of prior coronary stenting increase immediate postoperative complications in patients undergoing CABG?
Cohort (n=556)
No
Does a history of prior coronary stenting increase immediate postoperative complications in patients undergoing CABG?
Odds Ratio: 3.74 (95% CI 2.13–6.55)
Absolute Event Rate: 32.9% vs 11.6%
p-value: p=<0.001
A history of previous coronary stenting is independently associated with a significantly increased risk of immediate post-CABG complications.
Prior stenting was associated with higher post-CABG complications; hypothesis-generating and should not yet change practice.
INTRODUCTION: Approximately 15 to 30% of patients undergoing percutaneous coronary intervention (PCI) will require repeated revascularization. There is an ongoing debate concerning the impact of prior PCI on subsequent coronary artery bypass graft (CABG) surgery. This study sought to compare immediate post-CABG complications between patients with and without previous coronary stenting. METHODS: A total of 556 CABG candidates including 73 patients with previous coronary stenting and 483 patients without prior stenting were enrolled in this retrospective-prospective study. Demographic information, cardiac markers (CK-MB, Troponin T), and postoperative data including inotrope administration, intra-aortic balloon pump (IABP) use, bleeding, pathological electrocardiography (ECG) changes, and overall complications were compared between the two groups. RESULTS: The mean age of the patients in stented group was significantly higher than that in unstented group (63.49±7.71 vs. 61.37±9.80 years, p=0.05). The mean serum level of Troponin T 12 h postoperation was significantly higher in the same group (323.26±33.16 vs. 243.30±11.52 ng/dL; p=0.03). Comparing the stented and unstented groups, the rates of inotrope use (17.8% vs. 7.2%; p=0.003), significant bleeding (15.1% vs. 4.3%; p=0.001), and overall complications (32.9% vs. 11.6%; odds ratio: 3.74 with 95% confidence interval of 2.13-6.55, p<0.001) were significantly higher in the former group. The association between overall complications and prior stenting was independent (odd ratio: 3.06). No significant connections were found between postoperative complications and stent number or type. CONCLUSION: A positive history of previous coronary stenting significantly increases the risk of immediate post-CABG complications.
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Negargar et al. (2014) conducted a cohort in Coronary Artery Disease undergoing CABG (n=556). Prior coronary stenting vs. No prior coronary stenting was evaluated on Overall immediate postoperative complications (OR 3.74, 95% CI 2.13-6.55, p=<0.001). A history of previous coronary stenting significantly increased the risk of overall immediate postoperative complications after CABG compared to no prior stenting (32.9% vs. 11.6%; OR 3.74).
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