Does Prior Percutaneous Coronary Intervention Adversely Affect Early and Mid-Term Survival After Coronary Artery Surgery?

Abstract

In this large registry study, prior PCI was not associated with increased short- or mid-term mortality after CABG. Good outcomes can be obtained in the group of patients undergoing CABG who have had previous PCI.

Impact of previous percutaneous coronary interventions on the course and clinical outcomes of coronary artery bypass grafting

“…Analogical findings were reported by Thielmann et al who analyzed a high-risk subset of patients with diabetes mellitus and triple-vessel disease [5,]. Yup et al noticed even shorter CCT and reduced duration of CPB in patients with prior PCI [10]. Undoubtedly, the influence of previous PCI on these intraoperative variables requires further studies, especially taking into account that they may contribute to several adverse postoperative complications [19] In the present study, compared to stent-naive subjects, higher long-term mortality in PCI patients was observed.…”

“…However, the vast majority of patients had a single PCI procedure before referral to CABG. Analogically, Yap et al observed no differences between PCI and non-PCI patients in terms of short-term and mid-term mortality after CABG [10]. In this cited paper, non-PCI patients were older, had higher EuroSCORE and more frequently a history of MI.…”

“…Studies on the impact of these procedures in patients undergoing surgical revascularization give conflicting results. Although, there is a large body of evidence indicating that previous PCI adversely affects clinical outcomes of CABG, this is not supported by other published data [5,6,7,8,9,10]. Some studies reported that patients with multiple PCI procedures have significantly increased risk for in-hospital mortality and major adverse cardiac events (MACE) compared with patients without or with only a single previous PCI [11,12].…”

Intervenção Coronariana Percutânea prévia como fator de risco para Revascularização Miocárdica

“…Some groups believe there is no correlation between previous PCI and subsequent CABG 14 . Others have found this correlation only in patients receiving multiple coronary interventions or in diabetic patients 9,[29][30][31] .…”

“…A significant inflammatory process and endothelial function abnormalities in the coronary arteries have been related to the treatment with stent, especially when drug-eluting stents were used [11][12][13] . However, the actual clinical impact of the presence of stents in the coronary artery in the prognosis of CABG has not been clearly established and it is controversy 14,15 . The increase in mortality is the main event that can influence changes in the guidelines.…”