Key result
Prior percutaneous coronary intervention (present in 13.8% of 950 patients) did not influence 30-day mortality or major adverse cardiac events following first-time isolated CABG.
Why the study?
Does prior PCI increase 30-day mortality or MACE in low-risk patients undergoing first-time isolated CABG?
Cohort (n=950)
Does prior PCI increase 30-day mortality or MACE in low-risk patients undergoing first-time isolated CABG?
In low-risk patients undergoing first-time isolated CABG, a history of prior PCI does not appear to increase the risk of 30-day mortality or major adverse cardiac events.
Prior PCI may not elevate early CABG risk in low-risk patients; leaves open confirmation in prospective or higher-risk cohorts.
BACKGROUND AND AIMS: An increasing number of patients referred for coronary artery bypass grafting (CABG) have had prior percutaneous coronary intervention (PCI). We sought to determine whether a relationship exists between increased postoperative mortality and morbidity following CABG procedure in patients with prior PCI. METHODS: Over an 18-month period, 950 patients having first-time isolated CABG were divided into two groups based on absence (Group A, 819 patients--86.21%) or presence of a prior PCI (Group B, 131 patients--13.79%). RESULTS: In the prior PCI population, 74 patients (56.4%) had only one stent, and only 6.8% had multiple admissions for PCI. The overall incidence of three vessel disease in the entire patient population was only 65% and the average ejection fraction was 52%. Multivariate analysis demonstrated age (OR 1.080; 95% CI: 1.020 to 1.145; p = 0.009), left ventricular ejection fraction (OR 0.939; 95% CI: 0.901 to 0.978; p = 0.002), and emergency surgery (OR 0.138; 95% CI: 0.0.045 to 0.424; p = 0.001) as risk factors for 30-day mortality, while age (OR 1.059; 95% CI: 1.016 to 1.104; p = 0.007) and emergency surgery (OR 0.205; 95% CI: 0.078 to 0.537; p = 0.001) predicted major adverse cardiac events (MACE). Prior PCI did not influence mortality or MACE at 30 days. CONCLUSION: In this study involving low risk patients, a PCI prior to CABG did not increase morbidity or mortality.
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Velicki et al. (2013) conducted a cohort in First-time isolated coronary artery bypass grafting (CABG) (n=950). Prior percutaneous coronary intervention (PCI) vs. No prior PCI was evaluated on 30-day mortality and major adverse cardiac events (MACE). Prior percutaneous coronary intervention (present in 13.8% of 950 patients) did not influence 30-day mortality or major adverse cardiac events following first-time isolated CABG.
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