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Updated: Feb 7, 2026
Author Spotlight: Enhancing Coronary Artery Revascularization
Published on: September 15, 2023
Coronary Angiography and Revascularization Following Coronary Artery Bypass Grafting in British Columbia: Incidence,
Peter T Moore1, Christian Janssen2, Aengus Murphy3
1Victoria Heart Institute Foundation, Victoria, British Columbia, Canada.
Insights
Coronary artery bypass grafting (CABG) patients often need repeat procedures, but further revascularization is linked to better long-term survival. This study tracked outcomes for over 17,000 patients after CABG.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Health Outcomes Research
Background:
- Coronary artery bypass grafting (CABG) is a standard treatment for coronary artery disease (CAD).
- Long-term follow-up reveals disease progression in native vessels and grafts after CABG, potentially diminishing its benefits.
- Assessing long-term outcomes is crucial to understand the sustained efficacy of CABG.
Purpose of the Study:
- To evaluate longer-term outcomes after CABG.
- To determine rates of repeat coronary angiography, revascularization procedures, and survival post-CABG.
- To identify factors influencing long-term mortality and survival after CABG.
Main Methods:
- Retrieved data for 17,316 patients undergoing isolated CABG in British Columbia (2001-2009) with follow-up until 2013.
- Utilized Cox proportional hazard and competing risk regression for survival and subsequent cardiac procedures.
- Analyzed rates of repeat coronary angiography, percutaneous coronary intervention (PCI), and repeat CABG.
Main Results:
- At a median follow-up of 8.5 years, 18.4% of patients died, and 18.1% underwent repeat angiography or revascularization.
- Repeat revascularization was associated with improved survival (adjusted hazard ratio 0.76).
- Dialysis dependency and age >75 were strong predictors of mortality, while left internal mammary artery use and aspirin therapy were protective.
Conclusions:
- Repeat coronary angiography is common after CABG.
- While only a minority receive further revascularization, it is linked to improved longer-term survival.
- These findings highlight the importance of continued management and potential reintervention after CABG.
Background:
Coronary artery bypass grafting (CABG) is established treatment for subsets of coronary artery disease (CAD). Observational data have characterised significant progression of native coronary as well as graft vessel disease during longer-term follow-up, potentially reducing the benefit of CABG. We sought to assess longer-term outcomes following CABG by determining rates of repeat coronary angiography, revascularization procedures, and survival.
Methods:
Data for all patients undergoing isolated CABG in British Columbia between 2001 and 2009 inclusive, and with follow-up until the end of 2013, were retrieved from the British Columbia Cardiac Registry. Cox proportional hazard regression and competing risk regression were performed for survival and subsequent cardiac procedures (coronary angiography, percutaneous coronary intervention [PCI] or repeat CABG).
Results:
Data were available from 17,316 patients with a mean age at index CABG of 65.7 ± 9.8 years. At a median follow-up of 8.5 (range 4.0 to 12.9) years, 3185 patients (18.4%) had died, 3135 (18.1%) underwent repeat coronary angiography with or without PCI or repeat CABG, and 11,557 (66.7%) had survived without additional procedures. Of those who underwent angiography, 1459 patients (46.5%) underwent further revascularization. In multivariate analysis, the strongest predictors of long-term mortality were dialysis dependency and age >75, whereas left internal mammary artery utilization and aspirin therapy were protective. Repeat revascularization predicted survival (adjusted hazard ratio 0.76; 95% confidence interval, 0.63-0.92; P = 0.004), whereas angiography alone did not.
Conclusions:
Following CABG, patients frequently undergo repeat coronary angiography. Although only a minority of patients receive further revascularization, this appears to be associated with longer-term survival.
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