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Previous Percutaneous Coronary Intervention Does Not Increase Adverse Events After Coronary Artery Bypass Surgery

Chikara Ueki1, Hiroaki Miyata2, Noboru Motomura2

  • 1Department of Cardiovascular Surgery, Shizuoka General Hospital, Shizuoka, Japan; Japan Cardiovascular Surgery Database Organization, Tokyo, Japan.

The Annals of Thoracic Surgery
|January 30, 2017
PubMed

Insights

A prior percutaneous coronary intervention (PCI) does not worsen early outcomes following coronary artery bypass grafting (CABG). This finding suggests that PCI history should not influence decisions regarding repeat coronary revascularization strategies.

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Health Outcomes Research

Background:

  • The impact of prior percutaneous coronary intervention (PCI) on outcomes after coronary artery bypass grafting (CABG) remains incompletely understood.
  • Evaluating early clinical outcomes after CABG in patients with a history of PCI is crucial for treatment planning.

Purpose of the Study:

  • To assess the effect of previous PCI on early mortality and morbidity following subsequent CABG.
  • To analyze data from a large national registry to provide robust evidence on this clinical question.

Main Methods:

  • Analysis of 48,051 patients undergoing primary, isolated, elective CABG from the Japan Adult Cardiovascular Surgery Database (2008-2013).
  • Comparison of early mortality and morbidity between patients with and without prior PCI (n=12,457 vs. n=35,594).
  • Utilized multivariate logistic regression and propensity score analysis for risk adjustment.

Main Results:

  • Operative mortality rates were similar between groups (1.2% for both).
  • Morbidity rates were also comparable (7.4% vs. 7.2%).
  • Risk-adjusted analyses confirmed that prior PCI was not a significant risk factor for operative mortality.

Conclusions:

  • Previous PCI does not appear to increase the risk of postoperative adverse events after subsequent CABG.
  • Treatment decisions for repeat coronary revascularization should be guided by clinical appropriateness, independent of prior PCI history.
Abstract

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