Increased mortality and perioperative complications in patients with previous elective percutaneous coronary interventions undergoing coronary artery bypass surgery

Intervenção Coronariana Percutânea prévia como fator de risco para Revascularização Miocárdica

“…Bonaros et al 26 confirmed these data in study with 306 patients with previous PCI who were matched with similar group without PCI prior to CABG. Patients with previous PCI had higher inhospital mortality (4.4% vs. 2.4%, p<0.001).…”

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

“…Our findings are in agreement with common sense, but surprisingly they have not been confirmed in available studies. Many studies revealed no significant differences in CCT and duration of CPB between patients with prior PCI compared to non-PCI patients [6,7,18]. Analogical findings were reported by Thielmann et al who analyzed a high-risk subset of patients with diabetes mellitus and triple-vessel disease [5,].…”

“…In the study of Lisboa et al patients with previous PCI had higher in-hospital mortality after CABG and it was also comparable with EuroSCORE and 2000 Bernstein-Parsonnet risk score [7]. However, these findings are not consistent with the results of Bonaros et al who did not confirm the accuracy of EuroSCORE in patients after PCI [6].…”

“…Some of the studies also indicate that multiple PCIs are stronger predictor of the above-mentioned clinical endpoints compared to single previous PCI or no prior PCI [11,12]. Except for the impact of prior PCI on perioperative mortality, Bonaros et al reported higher perioperative morbidity (MACE, bleeding complications, acute renal failure, renal replacement therapy and the use of blood products) as well [6]. On the other hand, in the study of Mehta et al previous PCI was independent predictor of perioperative complications, longer hospitalizations and higher readmission rates, but the impact on mortality was not confirmed [18].…”

“…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].…”