Impact of repeated percutaneous coronary intervention on long-term survival after subsequent coronary artery bypass...

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiac Surgery

Background:

• Aggressive repeated percutaneous coronary intervention (PCI) is increasingly common in the current stent era.
• The impact of prior repeated PCI on subsequent coronary artery bypass grafting (CABG) outcomes requires thorough investigation.

Purpose of the Study:

• To evaluate the clinical outcomes of coronary artery bypass grafting (CABG) in patients with a history of no, single, or multiple percutaneous coronary interventions (PCI).

Main Methods:

• A retrospective study of 894 patients undergoing first-time isolated elective CABG between 1990 and 2008.
• Patients were categorized into three groups: no PCI (n=515), single PCI (n=179), and multiple PCI (n=200).
• Comparison of early and late clinical results, including in-hospital mortality and long-term survival, was performed.

Main Results:

• Patients with multiple prior PCI procedures had a significantly smaller number of bypass grafts and a trend toward higher in-hospital mortality.
• Kaplan-Meier survival analysis indicated significantly lower freedom from all-cause death and cardiac death in the multiple PCI group.
• Multivariate analysis identified the number of previous PCI procedures as an independent risk factor for cardiac death.

Conclusions:

• Repeated percutaneous coronary intervention (PCI) significantly increases the risk for long-term adverse prognosis following coronary artery bypass grafting (CABG).
• A history of multiple PCI procedures negatively impacts long-term survival after subsequent CABG.