Outcomes of Primary Percutaneous Coronary Intervention for Patients with Previous Coronary Artery Bypass Grafting

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Pankaj Garg1, Hazlyna Kamaruddin1, Javaid Iqbal2

  • 1Department of Cardiology and Cardiothoracic Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital, Herries Road S5 7AU, UK.

The Open Cardiovascular Medicine Journal
|March 24, 2016
PubMed

Insights

Patients with prior coronary artery bypass grafting (CABG) undergoing primary percutaneous coronary intervention (PPCI) for ST-segment elevation myocardial infarction (STEMI) had poorer acute reperfusion. However, their short-term and long-term prognosis after PPCI was similar to those without prior CABG.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Acute Coronary Syndromes

Background:

  • Limited data exists on outcomes for ST-segment elevation myocardial infarction (STEMI) patients with prior coronary artery bypass grafting (CABG) undergoing primary percutaneous coronary intervention (PPCI).
  • Understanding outcomes in this specific patient group is crucial for optimizing treatment strategies.

Purpose of the Study:

  • To compare the outcomes of STEMI patients undergoing PPCI, stratified by the presence or absence of previous CABG surgery.
  • To evaluate the impact of prior CABG on reperfusion success and long-term prognosis following PPCI.

Main Methods:

  • An observational registry study was conducted at a UK cardiothoracic centre, including consecutive patients undergoing PPCI between 2007 and 2012.
  • Data were extracted from electronic records, with mortality data obtained from the Office of National Statistics.
  • Median follow-up was 1.7 years.

Main Results:

  • Among 2133 patients, 47 had a history of CABG.
  • The CABG cohort showed inferior post-revascularization TIMI flow (17% vs. 10%, p=0.012) and were less likely to achieve acute reperfusion (TIMI 0 in 9% vs. 3%, p=0.0012).
  • In-hospital, 30-day, 1-year, and overall median follow-up mortality were not significantly different between groups.

Conclusions:

  • Patients with STEMI and prior CABG undergoing PPCI experience worse angiographic outcomes and reduced acute reperfusion.
  • Despite these acute challenges, prior CABG patients do not appear to have a worse short-term or long-term prognosis after PPCI.
Abstract

Keywords:
Acute myocardial infarction/STEMIPrimary PCI.coronary bypass grafts

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