The Prognostic Value of Previous Coronary Stent Implantation in Patients Undergoing Myocardial Revascularization Surgery

Abstract

Background: Currently, there are studies underway to determine whether coronary stent implantation with percutaneous transluminal coronary angioplasty prior to a coronary artery bypass graft (CABG) influences the prognosis of surgery. The aim of this study was to assess both the need for future revascularisation or all-cause mortalityas composite endpoint after CABG surgery among patients with a previous stent implantation. Methods: A retrospective, non-randomised study was performed in 721 patients, who underwent CABGin our centre between 2012 and 2017.This single-centre study compared two groups: 1) the previous stent group, patients with previous stent implantation (n=144), and, 2) the non-previous stent group, patients without previous stent implantation (n=577). Results: After a median follow-up of 36 months, the previous stent group presented a decreased combined event-free survival at 1, 3 and 5 years compared with the non-previous stent group (67.4, 43.5 and 23.0%vs 91.0, 80.3 and 63.0%, respectively; p<0.01). There was also higher mortality in the previous stent groupthan in the non-previous stentgroup (96.1, 90.5 and 79.4 vs 91.9, 75.9 and 51.0, respectively; p=0.01). The multivariable analysis of demographics, baseline comorbidity and surgical data showed previous stent implantation as an independentpredictorof the composite endpoint (Hazard Ratio=3.00 and 95% confident interval=2.09-4.32; p<0.01). Conclusions: Patients with percutaneous coronary intervention prior to CABG present higher comorbidities and clinical eventsduring follow-up than those who do not undergo stenting.