Related Experiment Video
Updated: Dec 5, 2025
Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
Published on: March 27, 2018
Effect of previous coronary stenting on subsequent coronary artery bypass grafting outcomes
Yu-Ting Cheng1, Dong-Yi Chen2, Victor Chien-Chia Wu2
1Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Chang Gung University, Taoyuan City, Taiwan.
Insights
Previous coronary stenting before coronary artery bypass graft (CABG) increases short-term mortality and late revascularization. However, it does not impact long-term survival rates for patients with multivessel coronary artery disease.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Interventional Cardiology
Background:
- The impact of prior coronary stenting on outcomes following coronary artery bypass graft (CABG) surgery remains unclear.
- An increasing trend in patients undergoing CABG with previous coronary stenting has been observed.
- The average number of stents per patient has also risen over time.
Purpose of the Study:
- To evaluate the effect of previous coronary stenting on subsequent coronary artery bypass graft outcomes.
- To assess short-term and long-term adverse events in patients who underwent CABG with and without prior stenting.
Main Methods:
- Retrospective analysis of Taiwan's National Health Insurance Database (2000-2013).
- Inclusion of 32,335 patients undergoing multivessel CABG, with 3028 having prior stenting.
- Propensity-score matching created comparable groups (2977 each) of patients with and without previous stenting.
Main Results:
- The percentage of patients with prior stenting before CABG increased steadily over the study period.
- The group with previous stenting showed a significantly higher 30-day mortality rate (7.2% vs. 5.0%).
- Patients with prior stenting experienced a higher rate of revascularization at 13-year follow-up (14.4% vs. 10.0%).
Conclusions:
- Previous coronary stenting before CABG is associated with increased 30-day mortality.
- Prior stenting does not appear to affect late survival after CABG.
- Patients with prior stenting undergoing CABG face a higher likelihood of revascularization events during late follow-up.
Objectives:
The effect of previous coronary stenting on subsequent coronary artery bypass graft is inconclusive.
Methods:
We used Taiwan's National Health Insurance Database to retrospectively evaluate patients with multivessel coronary artery bypass graft between January 2000 and December 2013. Overall, 32,335 patients who received coronary artery bypass graft were included, of whom 3028 had previous coronary stenting. Propensity-score matching yielded 2977 cases each for evaluation under the previous stenting and no stenting groups. The 30-day mortality and major adverse cardiac events, including all-cause mortality, acute myocardial infarction, and revascularization, were considered primary outcomes.
Results:
The number of coronary artery bypass grafts decreased per year. However, the percentage of patients who had previous coronary stent implantation before coronary artery bypass graft increased steadily (P for trend <.001), and the average number of stents implanted in a patient also increased per year (P for trend <.001). The previous stent group had a significantly greater 30-day mortality rate than did the no-stent group (7.2% vs 5.0%; odds ratio, 1.47; 95% confidence interval, 1.19-1.82). The previous stent group had a greater rate of revascularization (14.4% and 10.0%; subdistribution hazard ratio, 1.50; 95% confidence interval, 1.30-1.74) in the last follow-up at year 13.
Conclusions:
Previous coronary stenting before coronary artery bypass graft for multivessel coronary artery disease significantly increased 30-day mortality but did not affect late survival. However, patients who had coronary stenting before coronary artery bypass graft experienced more revascularization events during late follow-up.
Related Concept Videos
01:27Coronary Artery Disease V: Interprofessional Care
01:23Peripheral Artery Disease V: Postoperative Nursing Management