Percutaneous Intervention Before Coronary Artery Bypass Surgery Does Not Unfavorably Impact Survival: A Single-Center Propensity-Matched Analysis

Luthra, Suvitesh; Juarez, Miguel M. Leiva; Senanayake, Eshan; Luckraz, Heyman; Billing, J. Stephen; Cotton, James; Norell, Michael S.

doi:10.1016/j.athoracsur.2016.07.046

Cited by 10 publications

(14 citation statements)

References 29 publications

(28 reference statements)

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“…In our patients assigned to CABG, we found a non-significant decrease in all-cause and CV mortality rates for those with prior PCI (HR=0.85 and 0.84, respectively) as compared with those without prior PCI, a finding similar to that of Luthra et al, who described higher survival rates for patients having CABG with prior PCI and LVEF<30%, but not for those with LVEF >30% (26). Finally, for CV hospitalization, we observed a higher rate (statistically significant in the model adjusted by baseline variables but not significant in the model adjusted for propensity for prior PCI) during the follow-up in patients with prior PCI.…”

Section: Accepted Manuscript Relationship Between Prisupporting

confidence: 86%

Does prior coronary angioplasty affect outcomes of surgical coronary revascularization? Insights from the STICH trial

Nicolau

Stevens

Al‐Khalidi

et al. 2019

International Journal of Cardiology

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Background The STICH trial showed superiority of coronary artery bypass plus medical treatment (CABG) over medical treatment alone (MED) in patients with left ventricular ejection fraction (LVEF) 35%. In previous publications, percutaneous coronary intervention (PCI) prior to CABG was associated with worse prognosis. Objectives The main purpose of this study was to analyse if prior PCI influenced outcomes in STICH. Methods and Results: Patients in the STICH trial (n=1212), followed for a median time of 9.8 years, were included in the present analyses. In the total population, 156 had a prior PCI (74 and 82, respectively, in the MED and CABG groups). In those with vs. without prior PCI, the adjusted hazard-ratios (aHRs) were 0.92 (95% CI=0.74-1.15) for all-cause mortality, 0.85 (95% CI=0.64-1.11) for CV mortality, and 1.43 (95% CI=1.15-1.77) for CV hospitalization. In the group randomized to CABG without prior PCI, the aHRs were 0.82 (95% CI=0.70-0.95) for allcause mortality, 0.75 (95% CI=0.62-0.90) for CV mortality and 0.67 (95% CI=0.56-0.80) for CV hospitalization. In the group randomized to CABG with prior PCI, the aHRs were 0.76 (95% CI=0.50-1.15) for all-cause mortality, 0.81 (95% CI=0.49-1.36) for CV mortality and 0.61 (95% CI=0.41-0.90) for CV hospitalization. There was no evidence of interaction between randomized treatment and prior PCI for any endpoint (all adjusted p>0.05). Conclusion In the STICH trial, prior PCI did not affect the outcomes of patients whether they were treated medically or surgically, and the superiority of CABG over MED remained unchanged regardless of prior PCI.

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Section: Accepted Manuscript Relationship Between Prisupporting

confidence: 86%

Does prior coronary angioplasty affect outcomes of surgical coronary revascularization? Insights from the STICH trial

Nicolau

Stevens

Al‐Khalidi

et al. 2019

International Journal of Cardiology

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“…Так, пожилой возраст пациентов повышал риск развития ГО в 1,3 раза, наличие СД в 1,5 раза, МФА в 1,8 раза, а ХПН в 2 раза. Следует учитывать, что возраст остается важным и не модифицируемым предиктором осложнений, при этом в дальнейшем возрастной ценз пациентов будет только расти, приводя к увеличения среднего возраста пациентов, подвергающихся ЧКВ или КШ [13,14].…”

Section: Discussionunclassified

Main predictors of in-hospital adverse outcomes in non-ST elevation acute coronary syndrome patients with multivessel disease

Неверова

Тарасов

Нагирняк

2018

Cardiovasc Ther Prev

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Aim. To evaluate the range of risk factors associated with adverse cardiovascular events onset in hospital period of follow-up in patients with non-ST elevation acute coronary syndrome (NSTEACS) with multivessel disease (MD).Material and methods. To the study, under the framework of prospective, single-center registry, the NSTEACS and MD patients were included. Depending on the strategy of revascularization, three groups were selected: staged PCI, coronary bypass (CBG) and PCI as the first with CBG as the second stage. As adverse cardiovascular events, the following were taken: death, myocardial infarction, stroke or transient cerebral ishemia, clinically significant bleeding by BARC, repeat nonscheduled revascularization of target vessel. Results. Analysis revealed the groups of factors increasing the probability of adverse cardiovascular events. Those are: (1) clinical and demographic — older age, diabetes, postinfarction cardiosclerosis, multifocal atherosclerosis, chronic renal failure; (2) coronary and surgical — left main stem lesion, severe atherosclerosis by SYNTAX Score, high surgical risk by EuroScore II, revascularization strategy; (3) predominance of low or moderate risk by GRACE comparing with high risk.Conclusion. The results have confirmed high predictional significance of clinical and demography and coronary factors for development of adverse cardiovascular diseases. A significant finding of the study was the fact that in a hospital with surgery and endovascular treatment available 24/7, the intermediate and low GRACE risk in NSTEACS and MD is a factor of adverse cardiovascular events development due to revascularization delays if the risk is not high.

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“…This means that most patients with prior PCI did not receive multiple repeated PCI procedures. The relatively small number of patients with multiple repeated PCI procedures might have reduced the adverse effect of a prior history of PCI in the study by Luthra and colleagues [1].…”

Section: Repeated Coronary Revascularization In the Era Of The Heart Teammentioning

confidence: 95%

“…However, previous studies that focused on multiple prior PCI suggested that CABG after multiple repeated PCI procedures led to increased mortality and morbidity [4,5]. Although Luthra and colleagues did not provide data on multiple repeated PCI, most of their patients with prior PCI (60.6%) received fewer than two stents [1]. This means that most patients with prior PCI did not receive multiple repeated PCI procedures.…”

Section: Repeated Coronary Revascularization In the Era Of The Heart Teammentioning

confidence: 99%

“…We read with great interest the article by Luthra and colleagues [1], who evaluated the clinical impact of prior percutaneous coronary intervention (PCI) in patients undergoing coronary artery bypass grafting (CABG). They showed that subsequent CABG after prior PCI could be performed without increased risk [1]. This result is consistent with recent studies that used a large dataset of a national database [2,3].…”

Section: Repeated Coronary Revascularization In the Era Of The Heart Teammentioning

confidence: 99%

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Repeated Coronary Revascularization in the Era of the Heart Team

Ueki

Sakaguchi

2017

The Annals of Thoracic Surgery

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The conclusion is still valid and appropriate in that TAR conferred a better prognosis on diabetic patients than did the "mixed" non-TAR procedure of single arterial graft (52.2%) and multiple grafts but not TAR (47.8%). However, this effect might have been even greater if one had strictly compared TAR with SITA plus VG. Other authors reviewing large numbers of diabetic patients undergoing multiple or TAR have also reported similar benefits [4,5].We can certainly go back and review these findings at a more in-depth level and perform a three-way analysis: TAR versus MAR (but not total arterial revascularization) versus SITA plus VG.

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Percutaneous Intervention Before Coronary Artery Bypass Surgery Does Not Unfavorably Impact Survival: A Single-Center Propensity-Matched Analysis

Abstract: The survival in matched cohorts did not show adverse outcomes with prior PCI at 1, 3, 5, 7, and 10 years. Prior PCI does not adversely impact survival after CABG.

Cited by 10 publications

References 29 publications

Does prior coronary angioplasty affect outcomes of surgical coronary revascularization? Insights from the STICH trial

Does prior coronary angioplasty affect outcomes of surgical coronary revascularization? Insights from the STICH trial

Main predictors of in-hospital adverse outcomes in non-ST elevation acute coronary syndrome patients with multivessel disease

Repeated Coronary Revascularization in the Era of the Heart Team

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