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Factors Associated with Early Adverse Events after Coronary Artery Bypass Grafting Subsequent to Percutaneous
Yasser Ali Kamal1, Yasser Shaban Mubarak1, Ashraf Ali Alshorbagy1
1Department of Cardiothoracic Surgery, Minia University Hospital.
Insights
Previous percutaneous coronary intervention (PCI) significantly increases major adverse events after coronary artery bypass grafting (CABG). This finding highlights a critical factor impacting patient outcomes post-cardiac surgery.
Area of Science:
- Cardiology
- Cardiac Surgery
- Interventional Cardiology
Background:
- Previous percutaneous coronary intervention (PCI) may influence outcomes in patients undergoing coronary artery bypass grafting (CABG).
- Comparing early postoperative outcomes in CABG patients with and without prior PCI is crucial for risk stratification.
Purpose of the Study:
- To compare early in-hospital postoperative outcomes between patients who underwent CABG with versus without previous PCI.
- To identify if prior PCI is a predictor of adverse events following CABG.
Main Methods:
- Retrospective analysis of 160 isolated elective on-pump CABG patients (January 2010 - December 2014).
- Comparison of 38 patients with previous PCI to 122 patients without prior PCI.
- Analysis of preoperative, operative, and early in-hospital postoperative data, including mortality and major adverse events.
Main Results:
- No significant differences in preoperative demographics, risk factors, or in-hospital mortality were observed between groups.
- Patients with previous PCI had a significantly higher incidence of in-hospital major adverse events (15.8% vs. 2.5%, p=0.002).
- Multivariate analysis identified previous PCI as a significant predictor of major adverse events (OR 0.16, p=0.01).
Conclusions:
- Previous PCI significantly impacts the incidence of early major adverse events after CABG.
- Further large-scale, long-term studies are recommended to validate these findings and explore management strategies.
Background:
A previous percutaneous coronary intervention (PCI) may affect the outcomes of patients who undergo coronary artery bypass grafting (CABG). The objective of this study was to compare the early in-hospital postoperative outcomes between patients who underwent CABG with or without previous PCI.
Methods:
The present study included 160 patients who underwent isolated elective on-pump CABG at the department of cardiothoracic surgery, Minia University Hospital from January 2010 to December 2014. Patients who previously underwent PCI (n=38) were compared to patients who did not (n=122). Preoperative, operative, and early in-hospital postoperative data were analyzed. The end points of the study were in-hospital mortality and postoperative major adverse events.
Results:
Non-significant differences were found between the study groups regarding preoperative demographic data, risk factors, left ventricular ejection fraction, New York Heart Association class, EuroSCORE, the presence of left main disease, reoperation for bleeding, postoperative acute myocardial infarction, a neurological deficit, need for renal dialysis, hospital stay, and in-hospital mortality. The average time from PCI to CABG was 13.9±5.4 years. The previous PCI group exhibited a significantly larger proportion of patients who experienced in-hospital major adverse events (15.8% vs. 2.5%, p=0.002). On multivariate analysis, only previous PCI was found to be a significant predictor of major adverse events (odds ratio, 0.16; 95% confidence interval, 0.03 to 0.71; p=0.01).
Conclusion:
Previous PCI was found to have a significant effect on the incidence of early major adverse events after CABG. Further large-scale and long-term studies are recommended.
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