open access

Vol 26, No 6 (2019)
Original articles — Interventional cardiology
Published online: 2018-04-17
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Predictors of periprocedural complications in patients undergoing percutaneous coronary interventions within coronary artery bypass grafts

Rafał A. Januszek, Artur Dziewierz, Zbigniew Siudak, Tomasz Rakowski, Dariusz Dudek, Stanisław Bartuś
DOI: 10.5603/CJ.a2018.0044
·
Pubmed: 29671862
·
Cardiol J 2019;26(6):633-644.

open access

Vol 26, No 6 (2019)
Original articles — Interventional cardiology
Published online: 2018-04-17

Abstract

Background: During the first decade following the coronary bypass grafting, at least ten percent of the patients require percutaneous coronary interventions (PCI) due to graft failure. Saphenous vein grafts (SVG) are innately at a higher risk of periprocedural complications. The present study aimed to investigate predictors of periprocedural complications of PCI within coronary artery bypass grafts. Methods: This study analyzed data gathered in the Polish National Registry (ORPKI) between January 2015 and December 2016. Of the 221,195 patients undergoing PCI, data on 2,616 patients after PCI of SVG and 442 patients after internal mammary artery (IMA) were extracted. The dissimilarities in periprocedural complications between the SVG, IMA and non-IMA/SVG groups and their predictors were investigated. Results: Patients in the SVG group were older (p < 0.001), with a higher burden of concomitant disease and differing clinical presentation. The rate of de-novo lesions was lower, while restenosis was higher at baseline in the SVG (p < 0.001). The rate of no-reflows (p < 0.001), perforations (p = 0.01) and all periprocedural complications (p < 0.01) was higher in the SVG group, while deaths were lower (p < 0.001). Among the predictors of no-reflows, it was found that acute coronary syndromes (ACS), thrombectomy and past cerebral stroke, while the complications included arterial hypertension, Thrombolysis in Myocardial Infarction (TIMI) flow before PCI and thrombectomy. Conclusions: Percutaneous coronary interventions of SVG is associated with increased risk of specific periprocedural complications. The ACS, slower TIMI flow before PCI and thrombectomy significantly increase the periprocedural complication rate in patients undergoing PCI of SVG.

Abstract

Background: During the first decade following the coronary bypass grafting, at least ten percent of the patients require percutaneous coronary interventions (PCI) due to graft failure. Saphenous vein grafts (SVG) are innately at a higher risk of periprocedural complications. The present study aimed to investigate predictors of periprocedural complications of PCI within coronary artery bypass grafts. Methods: This study analyzed data gathered in the Polish National Registry (ORPKI) between January 2015 and December 2016. Of the 221,195 patients undergoing PCI, data on 2,616 patients after PCI of SVG and 442 patients after internal mammary artery (IMA) were extracted. The dissimilarities in periprocedural complications between the SVG, IMA and non-IMA/SVG groups and their predictors were investigated. Results: Patients in the SVG group were older (p < 0.001), with a higher burden of concomitant disease and differing clinical presentation. The rate of de-novo lesions was lower, while restenosis was higher at baseline in the SVG (p < 0.001). The rate of no-reflows (p < 0.001), perforations (p = 0.01) and all periprocedural complications (p < 0.01) was higher in the SVG group, while deaths were lower (p < 0.001). Among the predictors of no-reflows, it was found that acute coronary syndromes (ACS), thrombectomy and past cerebral stroke, while the complications included arterial hypertension, Thrombolysis in Myocardial Infarction (TIMI) flow before PCI and thrombectomy. Conclusions: Percutaneous coronary interventions of SVG is associated with increased risk of specific periprocedural complications. The ACS, slower TIMI flow before PCI and thrombectomy significantly increase the periprocedural complication rate in patients undergoing PCI of SVG.

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Keywords

percutaneous coronary interventions, coronary artery by-passes, periprocedural complications, no-reflow, predictors

About this article
Title

Predictors of periprocedural complications in patients undergoing percutaneous coronary interventions within coronary artery bypass grafts

Journal

Cardiology Journal

Issue

Vol 26, No 6 (2019)

Pages

633-644

Published online

2018-04-17

DOI

10.5603/CJ.a2018.0044

Pubmed

29671862

Bibliographic record

Cardiol J 2019;26(6):633-644.

Keywords

percutaneous coronary interventions
coronary artery by-passes
periprocedural complications
no-reflow
predictors

Authors

Rafał A. Januszek
Artur Dziewierz
Zbigniew Siudak
Tomasz Rakowski
Dariusz Dudek
Stanisław Bartuś

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