BACKGROUND: This multicenter study investigated the impact of previous percutaneous coronary interventions (PCI) on postoperative outcome and 5-year survival of subsequent coronary artery bypass grafting. METHODS: Among 7,855 patients who underwent isolated first-time coronary artery bypass grafting between January 2000 and December 2005, 6,834 (87%) had no previous PCI and 1,021 (13%) had previous PCI with stenting. Logistic multiple regression and propensity score analyses were used to assess the risk-adjusted impact of prior PCI on in-hospital mortality and major adverse cardiac events. The Cox regression model was used to assess the effect of prior PCI on 3-year and 5-year survival. RESULTS: After risk-adjusted multivariate analysis, age over 70 years, female sex, 3-vessel or 2-vessel plus left main coronary disease, multivessel PCI, ejection fraction 0.40 or less, diabetes mellitus, previous myocardial infarction, and chronic obstructive pulmonary disease were identified as independent predictors of both hospital mortality and major adverse cardiac events. After propensity score matching, conditional logistic regression analysis identified history of previous PCI as significantly associated with an increased risk for hospital mortality (odds ratio, 2.8; 95% confidence interval 1.4 to 4.8; p=0.003) and major adverse cardiac events (odds ratio 2.1; 95% confidence interval 1.2 to 3.6; p<0.001). Survival at 3 and 5 years was lower in patients with previous PCI compared with the no-PCI patients (97.4%±0.01% vs 96.5%±0.02% and 94.2%±0.03% vs 92.1%±0.05%; log-rank test: p=0.03). CONCLUSIONS: Our results provided further evidence that history of PCI before coronary artery bypass grafting increases risk of both operative death and perioperative complications, and decreases survival at 5 years follow-up.
BACKGROUND: This multicenter study investigated the impact of previous percutaneous coronary interventions (PCI) on postoperative outcome and 5-year survival of subsequent coronary artery bypass grafting. METHODS: Among 7,855 patients who underwent isolated first-time coronary artery bypass grafting between January 2000 and December 2005, 6,834 (87%) had no previous PCI and 1,021 (13%) had previous PCI with stenting. Logistic multiple regression and propensity score analyses were used to assess the risk-adjusted impact of prior PCI on in-hospital mortality and major adverse cardiac events. The Cox regression model was used to assess the effect of prior PCI on 3-year and 5-year survival. RESULTS: After risk-adjusted multivariate analysis, age over 70 years, female sex, 3-vessel or 2-vessel plus left main coronary disease, multivessel PCI, ejection fraction 0.40 or less, diabetes mellitus, previous myocardial infarction, and chronic obstructive pulmonary disease were identified as independent predictors of both hospital mortality and major adverse cardiac events. After propensity score matching, conditional logistic regression analysis identified history of previous PCI as significantly associated with an increased risk for hospital mortality (odds ratio, 2.8; 95% confidence interval 1.4 to 4.8; p=0.003) and major adverse cardiac events (odds ratio 2.1; 95% confidence interval 1.2 to 3.6; p<0.001). Survival at 3 and 5 years was lower in patients with previous PCI compared with the no-PCI patients (97.4%±0.01% vs 96.5%±0.02% and 94.2%±0.03% vs 92.1%±0.05%; log-rank test: p=0.03). CONCLUSIONS: Our results provided further evidence that history of PCI before coronary artery bypass grafting increases risk of both operative death and perioperative complications, and decreases survival at 5 years follow-up.
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: Victor Nauffal; Thomas A Schwann; Maroun B Yammine; Abdul-Karim M El-Hage-Sleiman; Mohamad H El Zein; Ameer Kabour; Milo C Engoren; Robert H Habib Journal: J Thorac Cardiovasc Surg Date: 2015-02-10 Impact factor: 5.209
Authors: Giuseppe Giugliano; Anna Sannino; Linda Brevetti; Cinzia Perrino; Gabriele Giacomo Schiattarella; Anna Franzone; Federica Serino; Marco Ferrone; Fernando Scudiero; Andreina Carbone; Michele De Paulis; Raffaele Izzo; Bruno Amato; Bruno Trimarco; Giovanni Esposito Journal: BMC Surg Date: 2012-11-15 Impact factor: 2.102
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