BACKGROUND: A possible relationship between increased perioperative risk during coronary artery bypass grafting (CABG) and previous percutaneous coronary intervention (PCI) is debatable. We sought to determine the impact of previous PCI on patient outcome after elective CABG. METHODS AND RESULTS: Between January 2000 and January 2005, 2626 consecutive patients undergoing first-time isolated elective CABG as the primary revascularization procedure (group 1) were evaluated for in-hospital mortality and major adverse cardiac events (MACEs) and were compared with 360 patients after single PCI (group 2) and with 289 patients after multiple PCI sessions (group 3) before elective CABG. Unadjusted univariate and risk-adjusted multivariate logistic-regression analysis revealed previous multiple PCIs to be strongly associated with in-hospital mortality (odds ratio [OR], 2.24; 95% confidence interval [CI], 1.52 to 3.21; P<0.001) and MACEs (OR, 2.28; 95% CI, 1.38 to 3.59; P<0.001). To control for selection bias, a computed propensity-score matching based on 13 patient characteristics and preoperative risk factors was performed separately comparing group 1 versus 2 and group 1 versus 3. After propensity matching, conditional logistic-regression analysis confirmed previous multiple PCIs to be strongly associated with in-hospital mortality (OR, 3.01; 95% CI, 1.51 to 5.98; P<0.0017) and MACEs (OR, 2.31; 95% CI, 1.45 to 3.67; P<0.0004). CONCLUSIONS: In patients with a history of multiple PCI sessions, perioperative risk for in-hospital mortality and MACEs during subsequent elective CABG is increased.
BACKGROUND: A possible relationship between increased perioperative risk during coronary artery bypass grafting (CABG) and previous percutaneous coronary intervention (PCI) is debatable. We sought to determine the impact of previous PCI on patient outcome after elective CABG. METHODS AND RESULTS: Between January 2000 and January 2005, 2626 consecutive patients undergoing first-time isolated elective CABG as the primary revascularization procedure (group 1) were evaluated for in-hospital mortality and major adverse cardiac events (MACEs) and were compared with 360 patients after single PCI (group 2) and with 289 patients after multiple PCI sessions (group 3) before elective CABG. Unadjusted univariate and risk-adjusted multivariate logistic-regression analysis revealed previous multiple PCIs to be strongly associated with in-hospital mortality (odds ratio [OR], 2.24; 95% confidence interval [CI], 1.52 to 3.21; P<0.001) and MACEs (OR, 2.28; 95% CI, 1.38 to 3.59; P<0.001). To control for selection bias, a computed propensity-score matching based on 13 patient characteristics and preoperative risk factors was performed separately comparing group 1 versus 2 and group 1 versus 3. After propensity matching, conditional logistic-regression analysis confirmed previous multiple PCIs to be strongly associated with in-hospital mortality (OR, 3.01; 95% CI, 1.51 to 5.98; P<0.0017) and MACEs (OR, 2.31; 95% CI, 1.45 to 3.67; P<0.0004). CONCLUSIONS: In patients with a history of multiple PCI sessions, perioperative risk for in-hospital mortality and MACEs during subsequent elective CABG is increased.
Authors: Jose C Nicolau; Susanna R Stevens; Hussein R Al-Khalidi; Fabio B Jatene; Remo H M Furtado; Luis A O Dallan; Luiz A F Lisboa; Patrice Desvigne-Nickens; Haissam Haddad; E Marc Jolicoeur; Mark C Petrie; Torsten Doenst; Robert E Michler; E Magnus Ohman; Jyotsna Maddury; Imtiaz Ali; Marek A Deja; Jean L Rouleau; Eric J Velazquez; James A Hill Journal: Int J Cardiol Date: 2019-03-15 Impact factor: 4.164
Authors: Richard P Konstance; Eric L Eisenstein; Kevin J Anstrom; Linda K Shaw; Robert M Califf; Robert A Harrington; David B Matchar; Kevin A Schulman; David F Kong Journal: J Med Syst Date: 2008-04 Impact factor: 4.460
Authors: Pedro Silvio Farsky; Mario H Hirata; Renato Tambellini Arnoni; Antonio Flavio Sanches Almeida; Mario Issa; Paula Helena Ortiz Lima; Maria de Lourdes Higuchi; Hui T Lin-Wang Journal: Arq Bras Cardiol Date: 2018-07-16 Impact factor: 2.000
Authors: Fausto Biancari; Magnus Dalén; Vito G Ruggieri; Till Demal; Giuseppe Gatti; Francesco Onorati; Giuseppe Faggian; Antonino S Rubino; Daniele Maselli; Riccardo Gherli; Antonio Salsano; Matteo Saccocci; Giuseppe Santarpino; Francesco Nicolini; Tuomas Tauriainen; Marisa De Feo; Juhani Airaksinen; Stefano Rosato; Andrea Perrotti; Giovanni Mariscalco Journal: J Am Heart Assoc Date: 2018-10-16 Impact factor: 5.501