Mid-term outcomes after off-pump coronary surgery in patients with prior intracoronary stent

Carnero-Alcázar, Manuel; Alswies, Ali; Medinilla, Enrique Villagrán; Maroto, Luis; Guisasola, J.A. Silva; Carnicer, Javier Cobiella; Sánchez, María T. Tejerina; Hernández, José E. Rodríguez

doi:10.1093/ejcts/ezr210

Cited by 6 publications

(6 citation statements)

References 21 publications

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“…Carnero-Alcázar et al. reported standard EuroSCORE scores of 4.31 and 4.77 in their study group [13] , compared to 3.52 and 3.39 in Velicki et al. 's study [12] .…”

Section: Discussionmentioning

confidence: 80%

Impact of prior coronary stenting on the outcome of subsequent coronary artery bypass grafting

et al. 2017

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BackgroundThe percentage of patients referred for coronary artery bypass grafting (CABG) who have previously undergone percutaneous coronary interventions (PCIs) is increasing. The purpose of this study was to review the outcomes of patients who had received coronary stenting before CABG, and to examine the validity of a mortality risk stratification system in this patient group.MethodsFrom 2010 to 2012, 439 patients who underwent isolated CABG at our medical center were reviewed. The patients were divided into two study groups: those who had previously received coronary artery stenting (97 patients, 24.7%), and those who had not (342 patients, 75.3%). The patients who received balloon angioplasty were excluded.ResultsThere were no significant differences in baseline characteristics. The prior stenting group had a lower risk of mortality, although the difference was not significant. The prior stenting group had fewer graft anastomoses (p = 0.005), and hence a significantly shorter cardiopulmonary bypass time (p = 0.045) and shorter aortic cross-clamping time. Surgical mortality was similar between the two groups. The durations of intensive care unit stay and hospitalization were also similar. The discriminatory power of the logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE) was lower in both group.ConclusionsPrior coronary stenting does not affect short-term mortality in patients subsequently undergoing CABG surgery. The EuroSCORE does not predict perioperative mortality well for the patients who undergo coronary stenting before CABG.

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“…Carnero-Alcázar et al. reported standard EuroSCORE scores of 4.31 and 4.77 in their study group [13] , compared to 3.52 and 3.39 in Velicki et al. 's study [12] .…”

Section: Discussionmentioning

confidence: 80%

Impact of prior coronary stenting on the outcome of subsequent coronary artery bypass grafting

et al. 2017

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“…Patients with stent showed an increased risk of MACEs (hazard ratio: 2.784) than unstented patients in a study by Carnero-Alcazar et al 28 on 1020 patients with CABG.…”

Section: Discussionmentioning

confidence: 96%

Immediate Postoperative Complications in Patients Undergoing CABG; Investigating the Role of Prior Coronary Stenting

Negargar

Anvari

Abbasi

et al. 2014

J Cardiovasc Thorac Res

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Introduction: Approximately 15 to 30% of patients undergoing percutaneous coronary intervention (PCI) will require repeated revascularization. There is an ongoing debate concerning the impact of prior PCI on subsequent coronary artery bypass graft (CABG) surgery. This study sought to compare immediate post-CABG complications between patients with and without previous coronary stenting. Methods: A total of 556 CABG candidates including 73 patients with previous coronary stenting and 483 patients without prior stenting were enrolled in this retrospective-prospective study. Demographic information, cardiac markers (CK-MB, Troponin T), and postoperative data including inotrope administration, intra-aortic balloon pump (IABP) use, bleeding, pathological electrocardiography (ECG) changes, and overall complications were compared between the two groups. Results: The mean age of the patients in stented group was significantly higher than that in unstented group (63.49±7.71 vs. 61.37±9.80 years, p=0.05). The mean serum level of Troponin T 12 h postoperation was significantly higher in the same group (323.26±33.16 vs. 243.30±11.52 ng/dL; p=0.03). Comparing the stented and unstented groups, the rates of inotrope use (17.8% vs. 7.2%; p=0.003), significant bleeding (15.1% vs. 4.3%; p=0.001), and overall complications (32.9% vs. 11.6%; odds ratio: 3.74 with 95% confidence interval of 2.13-6.55, p<0.001) were significantly higher in the former group. The association between overall complications and prior stenting was independent (odd ratio: 3.06). No significant connections were found between postoperative complications and stent number or type. Conclusion: A positive history of previous coronary stenting significantly increases the risk of immediate post-CABG complications.

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“…These recent papers all indicate a higher postoperative morbidity rate in patients having PCI before CABG surgery . Midterm results were not available in the large multicenter studies, but an increased myocardial infarction rate and a reduced reintervention‐free survival rate have already been reported for PCI prior CABG patients …”

Section: Discussionmentioning

confidence: 99%

“…4 Midterm results were not available in the large multicenter studies, but an increased myocardial infarction rate and a reduced reintervention-free survival rate have already been reported for PCI prior CABG patients. 5,6 Pretreated vessels, either by balloon angioplasties or stent deployments, may accelerate inflammatory endothelial proliferation and dysfunction. 7,8 An increased level of systemic inflammatory markers, indicating coronary vessel inflammation, and a rise of endothelial progenitor cell recruitment have been found immediately after PCI.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Coronary Interventions Prior to Coronary Artery Bypass Surgery

2015

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Mid-term outcomes after off-pump coronary surgery in patients with prior intracoronary stent

Abstract: Patients with intracoronary stents have a lower survival rate and a greater risk of death, MI or need for repeat revascularization during the mid-term follow-up after OP-CABG.

Cited by 6 publications

References 21 publications

Impact of prior coronary stenting on the outcome of subsequent coronary artery bypass grafting

Impact of prior coronary stenting on the outcome of subsequent coronary artery bypass grafting

Immediate Postoperative Complications in Patients Undergoing CABG; Investigating the Role of Prior Coronary Stenting

Percutaneous Coronary Interventions Prior to Coronary Artery Bypass Surgery

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