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Does Prior Percutaneous Coronary Intervention Influence the Outcomes of Coronary Artery Bypass Surgery?

Gade S V Miguel1, Alexandre G Sousa2, Gilmara S Silva3

  • 1Clínica Girassol Cardiothoracic Surgeon Luanda Angola Cardiothoracic Surgeon, Clínica Girassol, Luanda, Angola.

Brazilian Journal of Cardiovascular Surgery
|April 10, 2020
PubMed

Insights

Previous percutaneous coronary intervention (PCI) does not consistently impact outcomes for patients undergoing coronary artery bypass graft (CABG) surgery. This study found no significant differences in mortality or other key outcomes between patients with and without prior PCI.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Interventional Cardiology

Background:

  • Percutaneous coronary intervention (PCI) is increasingly used for coronary artery disease.
  • A significant percentage of patients undergoing coronary artery bypass graft (CABG) surgery have had prior PCI.
  • Previous studies on the impact of prior PCI on CABG outcomes have yielded conflicting results.

Purpose of the Study:

  • To evaluate the influence of previous percutaneous coronary intervention (PCI) on outcomes following coronary artery bypass graft (CABG) surgery.
  • To compare outcomes in patients with and without a history of PCI undergoing CABG.

Main Methods:

  • A cohort of 3007 patients undergoing CABG was analyzed, with 261 having prior PCI.
  • Comparisons were made between the 'previous PCI' group and 'primary CABG' group in both an original and a propensity score-matched cohort.
  • Outcomes including mortality, readmission, and composite events were assessed at 30 days, 1 year, and 5 years.

Main Results:

  • No statistically significant differences in mortality were observed between groups at any follow-up period.
  • While some differences in readmission and composite events were noted in the original cohort, these were not confirmed in the matched cohort.
  • Propensity score matching aimed to control for baseline differences between the groups.

Conclusions:

  • This study did not find a consistent negative influence of previous percutaneous coronary intervention (PCI) on coronary artery bypass graft (CABG) outcomes.
  • Despite some observed differences, rigorous statistical matching indicated no significant adverse effect of prior PCI on CABG results.
Abstract

Keywords:
Coronary Artery BypassCoronary Artery DiseasePatient ReadmissionPercutaneous Coronary IntervationPropensity ScoreRegistries

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