Comparison of Short-Term Results between Patients Undergoing Coronary Artery Bypass Graft with a Stent-Placement History and Patients Undergoing Primary Coronary Artery Surgery

Abstract

Background: Percutaneous coronary intervention (PCI) has become the first-choice treatment strategy the world over for patients with chronic coronary artery disorders. This study compared the effects of previous PCI procedures on the short-term postoperative results of coronary artery bypass graft surgery (CABG).
 Methodsː This cross-sectional analytical study recruited 220 patients who underwent CABG in Afshar Hospital in the Iranian city of Yazd between March 2009 and February 2013. The mean postoperative morbidity and mortality rates, the mean postoperative left ventricular ejection fraction (LVEF), the mean hemorrhage volume, the mean serum urea level, and the mean length of stay in the intensive care unit (ICU) were compared between the PCI and non-PCI groups. 
 Results: Among the 220 participants, 147(66.8%) were male and 73(33.2%) were female. The mean age of the study population was 59.41±10.52 years. There was no significant difference in the risk of mortality between the 2 groups (P=0.369). The mean serum urea level was 21.14±6.52 mg/dL in the PCI group and 14.45±1.08 mg/dL in the non-PCI group (P=0.016). The mean postoperative LVEF was 43.19±8.81% in the PCI group and 45.51±8.15% in the non-PCI group (P=0.044). The mean length of stay in the ICU was 3.34±1.23 days in the PCI group and 2.22±0.56 days in the non-PCI group (P<0.001). The mean hemorrhage volume was 1113.01±428.13 mL in the PCI group and 961.42±228.31 mL in the non-PCI group (P=0.027).
 Conclusion: Previous PCI procedures did not affect the post-CABG mortality rate; however, some postoperative results were worse in the PCI group than in the non-PCI group, which should be considered before the selection of the revascularization method. 
 
 J Teh Univ Heart Ctr 2019;14(2):53-57
 
 This paper should be cited as: Hadadzadeh M, Mirahmadi M, Mirzaei M, Pedarzadeh A, Ghasemzadeh B, Rahimianfar AA. Comparison of Short-term Results between Patients Undergoing Coronary Artery Bypass Graft with a Stent-Placement History and Patients Undergoing Primary Coronary Artery Surgery. J Teh Univ Heart Ctr 2019;14(2):53-57.

Prior percutaneous coronary intervention and outcomes in patients after coronary artery bypass grafting: a meta-analysis of 308,284 patients

“…Demographic factors, CAD risk factors, comorbidities, coronary lesion characteristics, and perioperative characteristics were adjusted varyingly in most of the included studies, while nine studies with nonsignificant results on univariate analysis were also included. 7 , 12 , 15 , 20 , 28 , 29 , 33 , 36 , 37 Fifteen multivariate studies excluded patients with acute PCI failure. 8 , 9 , 11 , 13 , 17 – 19 , 21 , 23 , 25 , 27 , 34 , 35 , 38 , 41 Because four studies reported outcomes according to the times of prior PCI 11 , 17 , 35 , 41 or the duration of the gap between PCI and CABG, 21 multiple datasets were considered for these studies.…”

“… 6 However, previous studies evaluating the association between prior PCI and prognosis after CABG have shown inconsistent results. 7 – 42 Although a number of meta-analyses have been performed on this topic, the results of these studies were also inconsistent. Two early meta-analyses including 9 and 14 studies, respectively, concluded that prior PCI may be related to a higher incidence of postoperative mortality within 1 month, but not to midterm mortality up to 5 years after CABG.…”

“… 46 Notably, in that analysis, studies reporting early postoperative and long-term follow-up outcomes were combined, which may have confounded the results. Because a number of recently published studies have consistently shown that prior PCI did not affect mortality after CABG, 33 , 35 – 39 we included these studies in an updated meta-analysis to evaluate the potential influences of prior PCI on early and late clinical outcomes in patients undergoing CABG.…”

Нospital outcomes of coronary artery bypass grafting in patients with coronary heart disease with previous percutaneous coronary intervention

“…Характеристики и исходная терапия больных ИБС, перенесших КШ, с предшествующим ЧКВ с СКА или без такового Table 1 В литературе приводятся противоречивые данные о частоте госпитальных осложнений КШ среди пациентов с предшествующей коронарной ангиопластикой. Так, в исследованиях [1,11] не выявлено различий в госпитальной летальности и в частоте ССС после КШ между группами пациентов с предшествующим ЧКВ и без такового. Вместе с тем другие авторы указывают на более высокие показатели госпитальной смертности и частоты ССС среди пациентов с предшествующим ЧКВ с СКА [12][13][14].…”

“…Однако до настоящего времени остается недостаточно ясным, оказывают ли неблагоприятное влияние на ближайшие и отдаленные исходы КШ ранее выполненные ЧКВ и СКА. Результаты ранее проведенных исследований противоречивы [1][2][3].…”