Why the study?
The number of PCIs performed before CABG has risen significantly, but how prior stenting affects postoperative outcomes in CABG patients requires clarification.
Does prior PCI worsen postoperative outcomes in patients undergoing CABG for multivessel disease?
Observational (n=60)
Does prior PCI worsen postoperative outcomes in patients undergoing CABG for multivessel disease?
Absolute Event Rate: 63.3% vs 20%
Prior percutaneous coronary intervention is associated with increased postoperative morbidity and longer ICU stays in patients subsequently undergoing coronary artery bypass grafting.
BackgroundDuring the past decade, the number of percutaneous coronary interventions (PCI) performed before coronary artery bypass grafting (CABG) has risen significantly. Patients with more serious coronary pathology are referred for CABG, which can affect the postoperative outcome.Patients and methodsOutcomes of 60 CABG patients, who were recruited in a prospective comparative study, were compared. Group A (n = 30) underwent primary CABG and group B (n = 30), had prior PCI before CABG.ResultsTotal morbidity was substantially higher in the second group than in the first, with six patients in group A (nonstent group) and 19 patients in group B being affected (stent group). Inotropes and intraaortic balloon pump were used more in the previous PCI community than in group A. Group B had a longer ICU stay (50.45 ± 33.49 h in group A vs. 79.56 ± 60.44 h in group B).ConclusionPrevious PCI can have a detrimental effect on the morbidity outcome of the subsequent CABG. However, postoperative mortality has not been affected significantly. Thus, percutaneous coronary revascularization should be carefully weighed against the increased risk of CABG afterward. The guidelines for intervention should be strictly followed, particularly in patients with complex coronary lesions who are more likely to be referred for CABG.
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Bakr et al. (2022) conducted an observational in Multivessel disease requiring CABG (n=60). Prior percutaneous coronary intervention (PCI) vs. Primary CABG (no prior PCI) was evaluated on Total morbidity.
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