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One-year outcomes of percutaneous coronary intervention in native coronary arteries versus saphenous vein grafts in patients with prior coronary artery bypass graft surgery

Amr Abdelrahman, Maciej Dębski, Ranjit More, Hesham K. Abdelaziz, Tawfiqur Choudhury, Jonas Eichhofer, Billal Patel
DOI: 10.5603/CJ.a2020.0131
·
Pubmed: 33001421

open access

Ahead of print
Original articles
Published online: 2020-09-28

Abstract

Background: Patients with prior coronary artery bypass graft (CABG) surgery often require percutaneous coronary intervention (PCI). Data are still limited in regards to the outcomes of native saphenous vein graft (SVG) PCI after CABG. Methods: We performed a retrospective study in a tertiary reference cardiac center of consecutive patients who underwent PCI after CABG. The data were collected for patients who underwent either native or graft PCI from January 2008 to December 2018. Arterial graft PCIs were excluded. Multivariable Cox regression analysis with propensity matching was performed, and major adverse cardiac events (MACE) outcomes including death or myocardial infarction (MI) or revascularization were assessed at 1-year after each index procedure. Results: A total of 435 PCI were performed in 401 patients (209 had native PCI and 192 had graft PCI). Target lesions were classified as following: 235 (54%) native coronary arteries and 200 (46%) SVG. Propensity matching resulted in 167 matched pairs. In multivariable Cox regression graft PCI relative to native PCI was an independent risk factor for MACE (hazard ratio [HR] 1.725, 95% confidence interval [CI] 1.049–2.837) which was primarily driven by increased incidence in revascularization (HR 2.218, 95% CI 1.193–4.122) and MI (HR 2.248, 95% CI 1.220–4.142) and with no significant difference in mortality (HR 1.118, 95% CI 0.435–2.870). Conclusions: Compared with native coronary PCI, bypass graft PCI was significantly associated with higher incidence of MACE at 1-year and this was mainly driven by MI and revascularization.

Abstract

Background: Patients with prior coronary artery bypass graft (CABG) surgery often require percutaneous coronary intervention (PCI). Data are still limited in regards to the outcomes of native saphenous vein graft (SVG) PCI after CABG. Methods: We performed a retrospective study in a tertiary reference cardiac center of consecutive patients who underwent PCI after CABG. The data were collected for patients who underwent either native or graft PCI from January 2008 to December 2018. Arterial graft PCIs were excluded. Multivariable Cox regression analysis with propensity matching was performed, and major adverse cardiac events (MACE) outcomes including death or myocardial infarction (MI) or revascularization were assessed at 1-year after each index procedure. Results: A total of 435 PCI were performed in 401 patients (209 had native PCI and 192 had graft PCI). Target lesions were classified as following: 235 (54%) native coronary arteries and 200 (46%) SVG. Propensity matching resulted in 167 matched pairs. In multivariable Cox regression graft PCI relative to native PCI was an independent risk factor for MACE (hazard ratio [HR] 1.725, 95% confidence interval [CI] 1.049–2.837) which was primarily driven by increased incidence in revascularization (HR 2.218, 95% CI 1.193–4.122) and MI (HR 2.248, 95% CI 1.220–4.142) and with no significant difference in mortality (HR 1.118, 95% CI 0.435–2.870). Conclusions: Compared with native coronary PCI, bypass graft PCI was significantly associated with higher incidence of MACE at 1-year and this was mainly driven by MI and revascularization.

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Keywords

acute coronary syndrome, coronary artery bypass graft, coronary artery disease, major adverse cardiac event, percutaneous coronary intervention

About this article
Title

One-year outcomes of percutaneous coronary intervention in native coronary arteries versus saphenous vein grafts in patients with prior coronary artery bypass graft surgery

Journal

Cardiology Journal

Issue

Ahead of print

Article type

Original Article

Published online

2020-09-28

DOI

10.5603/CJ.a2020.0131

Pubmed

33001421

Keywords

acute coronary syndrome
coronary artery bypass graft
coronary artery disease
major adverse cardiac event
percutaneous coronary intervention

Authors

Amr Abdelrahman
Maciej Dębski
Ranjit More
Hesham K. Abdelaziz
Tawfiqur Choudhury
Jonas Eichhofer
Billal Patel

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