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Prognostic significance of multiple previous percutaneous coronary interventions in patients undergoing elective

Matthias Thielmann1, Rainer Leyh, Parwis Massoudy

  • 1Department of Thoracic and Cardiovascular Surgery, West German Heart Center Essen, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany. matthias.thielmann@uni-essen.de

Circulation
|July 6, 2006
PubMed

Insights

Patients with multiple previous percutaneous coronary interventions (PCI) face higher in-hospital mortality and major adverse cardiac events (MACEs) after coronary artery bypass grafting (CABG). This study confirms increased perioperative risk for those with a history of multiple PCI sessions.

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology

Background:

  • The impact of prior percutaneous coronary intervention (PCI) on outcomes following coronary artery bypass grafting (CABG) remains debated.
  • Assessing perioperative risk in patients undergoing CABG after PCI is crucial for clinical decision-making.

Purpose of the Study:

  • To investigate the association between previous PCI and patient outcomes after elective CABG.
  • To quantify the increased risk of mortality and major adverse cardiac events (MACEs) in patients with a history of multiple PCI sessions undergoing CABG.

Main Methods:

  • Retrospective analysis of 2626 patients undergoing first-time isolated elective CABG (Group 1) compared to 360 patients with single PCI (Group 2) and 289 patients with multiple PCI sessions (Group 3).
  • Unadjusted and risk-adjusted logistic regression analyses were performed.
  • Propensity-score matching was utilized to control for selection bias between groups.

Main Results:

  • Unadjusted and risk-adjusted analyses showed multiple PCIs were significantly associated with increased in-hospital mortality (OR, 2.24) and MACEs (OR, 2.28).
  • After propensity-score matching, multiple PCIs remained strongly associated with higher in-hospital mortality (OR, 3.01) and MACEs (OR, 2.31).

Conclusions:

  • A history of multiple PCI sessions significantly increases perioperative risk for in-hospital mortality and MACEs in patients undergoing elective CABG.
  • These findings highlight the heightened risk profile for patients with extensive prior PCI interventions.
Abstract

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