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Long-term outcomes of percutaneous coronary interventions within coronary artery bypass grafts

Rafał Januszek1, Zbigniew Siudak2, Artur Dziewierz3,4

  • 1Department of Clinical Rehabilitation, University of Physical Education, Krakow, Poland.

Archives of Medical Science : AMS
|May 24, 2021
PubMed

Insights

Percutaneous coronary interventions (PCI) in bypasses have poor outcomes. PCI of two or more bypasses, post-dilatation, and no-reflow independently predict worse long-term clinical outcomes in these patients.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Surgery

Background:

  • Long-term outcomes of percutaneous coronary interventions (PCIs) in coronary artery bypasses are inferior to those in native coronary arteries.
  • Identifying predictors of adverse events after PCI in bypasses is crucial for improving patient management.

Purpose of the Study:

  • To assess predictors of long-term clinical outcomes following percutaneous coronary interventions (PCIs) of coronary artery bypasses.

Main Methods:

  • A cohort of 194 patients undergoing PCI of coronary artery bypasses was analyzed.
  • The primary endpoint included target-vessel revascularization, target-lesion revascularization, myocardial infarction, stroke, coronary artery bypass grafting, and death.
  • Multivariate analysis identified independent predictors of study endpoints during a mean follow-up of 964 days.

Main Results:

  • The primary endpoint occurred in 59.7% of patients.
  • Independent predictors of worse outcomes identified by Cox multivariate analysis included PCI of two or more bypasses (p < 0.01), post-dilatation (p < 0.05), and no-reflow (p < 0.05).
  • Anti-embolic protection devices showed no significant impact on long-term outcomes.

Conclusions:

  • Percutaneous coronary interventions involving two or more bypasses are associated with worse long-term outcomes.
  • Post-dilatation and no-reflow phenomena are significant predictors of adverse events after PCI in coronary bypass grafts.
  • These findings highlight key factors influencing the success of PCI in bypass grafts.
Abstract

Keywords:
clinical outcomescoronary artery bypassesdeterminantslong-term follow-uppercutaneous coronary intervention

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