Related Experiment Video
Updated: Dec 1, 2025
Author Spotlight: Enhancing Coronary Artery Revascularization
Published on: September 15, 2023
Long-term survival in patients who had CABG with or without prior coronary artery stenting
Pratik Rai1, Rebecca Taylor2, Mohamad Nidal Bittar2
1Department of Cardiothoracic Surgery, Lancanshire Cardiac Center, Blackpool Victoria Hospital, Blackpool, UK blue.rai@hotmail.co.uk.
Insights
Prior percutaneous coronary intervention (PCI) does not impact long-term survival after coronary artery bypass graft (CABG) surgery. This large study found no significant difference in survival rates between patients who had PCI before CABG and those who did not.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Health Outcomes Research
Background:
- Prior percutaneous coronary intervention (PCI) is common in patients with coronary artery disease.
- The impact of prior PCI on long-term survival following coronary artery bypass graft (CABG) surgery remains incompletely understood.
Purpose of the Study:
- To investigate the effect of prior PCI on long-term survival in patients undergoing CABG.
- To identify factors influencing mortality risk in CABG patients.
Main Methods:
- Retrospective cohort study of 11,332 patients undergoing CABG (1999-2017).
- Propensity score matching used to compare patients with (n=1058) and without (n=1058) prior PCI.
- Kaplan-Meier estimates and Cox proportional hazards models assessed survival and risk factors.
Main Results:
- No significant differences in immediate postoperative outcomes or 30-day mortality.
- Similar 5-year (90.8% vs 87.9%), 10-year (76.5% vs 74.6%), and 15-year (64.4% vs 64.7%) survival rates between groups.
- Prior PCI was not a significant predictor of long-term mortality (CoxPH=1.03, p=0.75).
Conclusions:
- Prior PCI does not adversely affect long-term survival after CABG.
- Certain patient, preoperative, and intraoperative factors significantly influence mortality risk and warrant further investigation.
Objective:
To conduct a large-scale, single-centre retrospective cohort study to understand the impact of prior percutaneous coronary intervention (PCI) on long-term survival of patients who then undergo coronary artery bypass graft (CABG).
Methods:
Between 1999 and 2017, a total of 11 332 patients underwent CABG at a hospital in the UK. The patients were stratified into those who received PCI (n=1090) or no PCI (n=10 242) prior to CABG. A total of 1058 patients from each group were matched using propensity score matching. Kaplan-Meier estimates were used to assess risk-adjusted survival in patients with prior PCI. Cox proportional hazards (CoxPH) model was then used to assess the effect of prior PCI and other variables in patients undergoing CABG.
Results:
The immediate postoperative outcome showed no difference in number of grafts per patients, blood transfusion, hospital stay or 30 days mortality between the groups. There was no significant difference in 5 years (90.8% vs 87.9), 10-year (76.5% vs 74.6%) and 15-year (64.4% vs 64.7%) survival between the non-PCI versus PCI groups. The Cox proportional hazards model further supports the null hypothesis as the PCI variable was found to be non-significant (CoxPH=1.03, p=0.75, CI=0.87-1.22) implying there was no difference in hazard of death for CABG patients with or without previous PCI. However, the model did yield information on the covariates that do affect the hazard of death.
Conclusion:
There is no difference in 5-year, 10-year and 15-year survival between patients undergoing CABG with or without prior PCI. However, certain patient, preoperative and intraoperative risk factors were identified with high hazard of death which needs to be investigated further.
More Related Videos
Related Concept Videos
01:27Coronary Artery Disease V: Interprofessional Care
01:23Peripheral Artery Disease V: Postoperative Nursing Management
01:28Acute Coronary Syndrome IV: Interprofessional Care