Percutaneous revascularization in patients with previous coronary artery bypass graft surgery. Immediate and 1-year clinical outcomes

Tejada, Julio García; Velázquez, Maite; Hernández, Felipe; Albarrán, Agustín; Gómez, I. Benítez; Rodríguez, Sergio; Andreu, Javier; Tascón, Juan

doi:10.1016/j.ijcard.2008.01.042

Cited by 13 publications

(11 citation statements)

References 25 publications

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“…In the above mentioned registry by Coolong et al [10], significant predictors of major adverse cardiac events (MACE) at 30 days of follow-up included a high degree of SVG degeneration (p < 0.0001), large atheroma volume (p < 0.0001), patient age (p < 0.01), and cigarette smoking (p = 0.03). In another study [23] that retrospectively evaluated 197 PCI in 91 patients after previous CABG, LVEF < 50% and PCI of more than 1 vessel were identified as significant predictors of MACE at 1 year of follow-up.…”

Section: 22mentioning

confidence: 98%

Outcomes of percutaneous coronary intervention in patients after previous coronary artery bypass surgery

et al. 2016

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A b s t r a c tBackground: Patients after previous coronary artery bypass grafting (CABG) often require repeat percutaneous revascularisation due to poor patency rates of saphenous vein grafts (SVG) and higher risk of re-CABG. Few data are available to evaluate different percutaneous revascularisation strategies in patients after previous CABG. Aim:To evaluate outcomes of percutaneous coronary intervention (PCI) in patients after previous CABG, including the effect of treatment on the quality of life and symptoms, and secondly to assess the relation between angiographic factors and treatment outcomesMethods: This was a prospective observational study which included 78 patients after previous CABG. Following coronary angiography, the patients were assigned to one of three groups: group A (n = 20), PCI of a SVG (PCI SVG); group B (n = 29), PCI of a native coronary artery (PCI NA); group C (n = 29), control group that received medical treatment (MT) only. Duration of follow-up was 12 months.Results: Compared to MT patients, patients treated with PCI had significantly higher Canadian Cardiovascular Society (CCS) class (2.75 vs. 2.41, p = 0.03) and more frequently had coronary angiography performed due to unstable angina (57% vs. 31%, p = 0.04). Patients in the PCI SVG group had significantly older SVG conduits compared to the PCI NA group (13.4 years vs. 8.2 years, p = 0.005). At 12 months of follow-up, we found a significant improvement in the EQ-5D index of the quality of life, and a significant reduction in CCS class in the PCI SVG group (0.66 vs. 0.7, p = 0.0003, and 2.75 vs. 1.9, p < 0.001, respectively) and in the PCI NA group (0.65 vs. 0.72, p < 0.001, and 2.75 vs. 2.17, p < 0.001, respectively), but no improvement in the MT group. Treatment outcomes did not differ significantly between the three groups (combined endpoint rate 20% vs. 13% vs. 27.5%, p = 0.37). In multivariate analysis, SVG age > 11 years was identified as a significant predictor of poor outcomes in patients treated with PCI after previous CABG.Conclusions: PCI in patients after previous CABG does not improve prognosis but significantly improves the quality of life and reduces symptom severity.

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Section: 22mentioning

confidence: 98%

Outcomes of percutaneous coronary intervention in patients after previous coronary artery bypass surgery

et al. 2016

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“…In patients with previous coronary artery bypass graft surgery (CABG), progression of atherosclerosis and degeneration of bypass grafts may lead to secondary revascularizationsin the majority of patients by means of percutaneous coronary intervention (PCI) [1,2]. So far, most PCI studies with comprehensive assessment of patients with a history of CABG were performed in the era of bare metal and early generation drug-eluting stents (DES) [3][4][5], while only limited data are available from second-generation DES.…”

Section: Introductionmentioning

confidence: 99%

Impact of previous coronary artery bypass surgery on clinical outcome after percutaneous interventions with second generation drug-eluting stents in TWENTE trial and Non-Enrolled TWENTE registry

Sen

Lam

Tandjung

et al. 2014

International Journal of Cardiology

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“…In the case of graft failure, repeat revascularization after either PCI or CABG is necessary in a certain number of patients, if appropriate. Nevertheless, in addition to increased operation difficulty, the patients undergoing re-CABG have a 2-to 4-fold higher mortality than in this operation than in the first operation, whereas PCI in patients previously treated with CABG is associated with worse acute and long-term outcomes than native artery PCI [30].…”

Section: Discussionmentioning

confidence: 99%

Second Generation Drug-Eluting Stent Implantation versus Coronary Artery Bypass Grafting in the Treatment of Young Patients with Left Main and/or Multivessel Coronary Disease

Chen

Zhang

Yan

et al. 2020

Journal of Interventional Cardiology

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Background. Many studies have compared the outcomes of coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) for complex coronary artery disease (CAD). However, no trials have focused on young patients (<45 years) with complex CAD. We conducted a retrospective evaluation to compare the outcomes of a second-generation drug-eluting stent (DES) and CABG in young patients with LM or three-vessel disease. Methods. In young patients with complex CAD who underwent PCI or CABG, a Kaplan-Meier analysis and Cox regression before and after propensity score matching were used to compare major adverse cardiac and cerebrovascular events (MACCE), including myocardial infarction (MI), stroke, death, and repeat revascularization. Results. During follow-up, MACCE occurred in 20.5% of patients in the PCI group and 8.6% of patients in the CABG group (hazard ratio (HR): 3.263, 95% confidence interval (CI): 1.379 to 7.722, p=0.007). Repeat revascularization occurred more frequently in the PCI group (18.9% vs. 3.7%, respectively, HR: 6.968, 95% CI: 2.036 to 23.842, p=0.002). There were no significant differences in the other endpoints. After propensity score matching, no conclusions were modified. Conclusions. In young patients with LM or three-vessel disease, PCI showed a higher incidence of MACCE, which was mainly driven by repeat revascularization. However, this did not translate into hard endpoint differences. Therefore, PCI is an alternative treatment to CABG in young patients with complex CAD.

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Percutaneous revascularization in patients with previous coronary artery bypass graft surgery. Immediate and 1-year clinical outcomes

Cited by 13 publications

References 25 publications

Outcomes of percutaneous coronary intervention in patients after previous coronary artery bypass surgery

Outcomes of percutaneous coronary intervention in patients after previous coronary artery bypass surgery

Impact of previous coronary artery bypass surgery on clinical outcome after percutaneous interventions with second generation drug-eluting stents in TWENTE trial and Non-Enrolled TWENTE registry

Second Generation Drug-Eluting Stent Implantation versus Coronary Artery Bypass Grafting in the Treatment of Young Patients with Left Main and/or Multivessel Coronary Disease

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