Long-term Outcomes of Percutaneous Coronary Intervention in Patients with Prior Coronary Artery Bypass Grafting

Authors

  • Stephen T. Broughton, MD University of Pittsburgh Medical Center Heart and Vascular Institute, Pittsburgh, PA
  • Edgar Aranda-Michel, PhD VA Medical Center of Pittsburgh, Pittsburgh, PA
  • Ahmet Sezer, PhD University of Pittsburgh Medical Center Heart and Vascular Institute, Pittsburgh, PA
  • Suresh R. Mulukutla, MD University of Pittsburgh Department of Medicine Division of Cardiology, Pittsburgh, PA
  • Catalin Toma, MD University of Pittsburgh Medical Center Heart and Vascular Institute, Pittsburgh, PA
  • Dustin E. Kliner, MD University of Pittsburgh Department of Medicine Division of Cardiology, Pittsburgh, PA
  • Danny Chu, MD University of Pittsburgh Department of Cardiothoracic Surgery, Pittsburgh, PA
  • Ibrahim Sultan, MD University of Pittsburgh Department of Cardiothoracic Surgery, Pittsburgh, PA

DOI:

https://doi.org/10.1532/hsf.4457

Keywords:

Coronary Artery Bypass Grafting

Abstract

BACKGROUND Patients with a prior coronary artery bypass graft (CABG) may have a need for repeat revascularization, which is typically attempted first via percutaneous coronary intervention (PCI) of either a bypass graft or native vessel. Long-term outcomes of native vessel compared to graft PCI after CABG have not yet been explored in a large institution study.

METHODS Patients with history of prior CABG who underwent PCI at our institution during 2010-2018 were included. Baseline characteristics and long-term outcomes of up to 5 years were compared between native vessel and bypass graft PCI groups. Cox regression was used to adjust for significant covariates in estimation of risk and calculation of hazard ratios.

RESULTS During the study, 4,251 patients with a prior CABG underwent PCI. Native vessel PCI represented 67.1% (n=2,851) of the cohort. After adjusting for significant covariates, bypass graft PCI compared to native vessel PCI had a higher risk of overall mortality (HR 1.15; 95% CI, 1.04-1.29; p<0.05), all-cause readmission (HR 1.16; 95% CI, 1.1-1.3; p<0.05), readmission for PCI (HR 1.25; 95% CI, 1.13-1.38; p<0.05), readmission for heart failure (HR 1.16; 95% CI, 1.06-1.26; p<0.05), and composite of myocardial infarction and revascularization (HR 1.23; 95% CI, 1.12-1.35; p<0.05).

CONCLUSIONS Among patients with prior CABG, bypass graft PCI compared to native vessel PCI was associated with higher risk of adverse long-term outcomes.

References

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Published

2022-03-24

How to Cite

Broughton, S. T., Aranda-Michel, E., Sezer, A., Mulukutla, S. R., Toma, C., Kliner, D. E., Chu, D., & Sultan, I. (2022). Long-term Outcomes of Percutaneous Coronary Intervention in Patients with Prior Coronary Artery Bypass Grafting. The Heart Surgery Forum, 25(2), E232-E240. https://doi.org/10.1532/hsf.4457

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