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CABG mortality is not influenced by prior PCI in low risk patients
Lazar Velicki1, Nada Cemerlic-Adjic, Gordana Panic
1Medical Faculty, University of Novi Sad, Novi Sad, Serbia. lvelicki@gmail.com
Insights
Prior percutaneous coronary intervention (PCI) before coronary artery bypass grafting (CABG) did not increase 30-day mortality or major adverse cardiac events in this low-risk patient cohort. These findings suggest PCI is safe before CABG.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Interventional Cardiology
Background:
- An increasing number of patients undergoing coronary artery bypass grafting (CABG) have had prior percutaneous coronary intervention (PCI).
- The potential impact of prior PCI on postoperative outcomes following CABG is not fully understood.
Purpose of the Study:
- To determine if a relationship exists between prior PCI and increased postoperative mortality and morbidity in patients undergoing CABG.
Main Methods:
- A cohort of 950 patients undergoing first-time isolated CABG was divided into two groups: those with prior PCI (131 patients) and those without (819 patients).
- Outcomes including 30-day mortality and major adverse cardiac events (MACE) were compared between the groups.
Main Results:
- Prior PCI was present in 13.79% of the study population.
- Multivariate analysis identified age, left ventricular ejection fraction, and emergency surgery as risk factors for 30-day mortality and MACE.
- Prior PCI was not found to be an independent predictor of increased 30-day mortality or MACE.
Conclusions:
- In this cohort of generally low-risk patients, undergoing CABG after prior PCI did not result in increased morbidity or mortality.
- These findings suggest that prior PCI does not adversely affect short-term outcomes following CABG.
Background And Aims:
An increasing number of patients referred for coronary artery bypass grafting (CABG) have had prior percutaneous coronary intervention (PCI). We sought to determine whether a relationship exists between increased postoperative mortality and morbidity following CABG procedure in patients with prior PCI.
Methods:
Over an 18-month period, 950 patients having first-time isolated CABG were divided into two groups based on absence (Group A, 819 patients--86.21%) or presence of a prior PCI (Group B, 131 patients--13.79%).
Results:
In the prior PCI population, 74 patients (56.4%) had only one stent, and only 6.8% had multiple admissions for PCI. The overall incidence of three vessel disease in the entire patient population was only 65% and the average ejection fraction was 52%. Multivariate analysis demonstrated age (OR 1.080; 95% CI: 1.020 to 1.145; p = 0.009), left ventricular ejection fraction (OR 0.939; 95% CI: 0.901 to 0.978; p = 0.002), and emergency surgery (OR 0.138; 95% CI: 0.0.045 to 0.424; p = 0.001) as risk factors for 30-day mortality, while age (OR 1.059; 95% CI: 1.016 to 1.104; p = 0.007) and emergency surgery (OR 0.205; 95% CI: 0.078 to 0.537; p = 0.001) predicted major adverse cardiac events (MACE). Prior PCI did not influence mortality or MACE at 30 days.
Conclusion:
In this study involving low risk patients, a PCI prior to CABG did not increase morbidity or mortality.
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