For patients with prior coronary artery bypass grafting and recurrent myocardial ischemia, percutaneous coronary intervention on bypass graft or native coronary artery?—A 5‐year follow‐up cohort study

Abstract

Background: Real-world data on target vessel of percutaneous coronary intervention (PCI) for patients with prior coronary artery bypass grafting (CABG) was still limited.Hypothesis: A prospective cohort was examined to determine the frequency and outcomes of native coronary artery PCI versus bypass graft PCI in patients with prior CABG.Methods: A large-sample observational study enrolled a total of 10 724 patients with coronary artery disease (CAD) underwent PCI in 2013. Two-and five-year clinical outcomes were compared between graft PCI group and native artery PCI group in patients with prior CABG.Results: A total of 438 cases had CABG history in the total cohort. Graft PCI group and native artery PCI group accounted for 13.7% and 86.3%, respectively. The rates of 2-and 5-year all-cause death and major adverse cardiovascular and cerebral events (MACCE) showed no significant difference between the two groups (p > .05). Two-year revascularization risk was lower in graft PCI group than native artery PCI group (3.3% and 12.4%, p < .05), but 5-year myocardial infarction (MI) risk was higher (13.3% and 5.0%, p < .05). In multivariate COX regression models, graft PCI group was independently associated with lower 2-year revascularization risk (hazard ratio

BMSC‑derived exosome‑mediated miR‑25‑3p delivery protects against myocardial ischemia/reperfusion injury by constraining M1‑like macrophage polarization

“…However, reperfusion can further damage the ischemic myocardium, referred to as myocardial ischemia/reperfusion injury (MIRI) ( 5 ), which can affect the prognosis of patients. Currently, the main clinical treatment for myocardial ischemia is percutaneous artery intervention (PCI), however, this treatment only provides short-term relief and also leads to myocardial re-damage ( 6 ). Other current treatments, such as calcium channel blockers or hypoxia preconditioning, are used for MIRI but are not very effective, as multiple factors are involved in the pathophysiological process of MIRI ( 7 , 8 ), there is an urgent requirement to find more therapeutic solutions for MIRI.…”