Abstract
Introduction. The number of patients with previous Percutaneous Coronary Interventions (PCI) referred to Coronary Artery Bypass Grafting (CABG) is continuously increasing. The relationship between previous elective PCI and the perioperative outcome after CABG remains undetermined. The aim of the study was to investigate whether patients referred to CABG after previous elective PCI have an increased perioperative risk. Methods. Between January 2002 and May 2007, 4412 consecutive patients underwent first-time open heart surgery at our department. After excluding patients with a history of emergent PCI, we isolated 306 patients after previous elective PCI during the last 24 months before CABG (Group 1). Those patients were compared to 452 consecutive patients without history of previous PCI, who underwent CABG during the same period and who were matched for age, gender and preoperative risk factors (Group 2). Both groups were compared in terms of 30-day mortality, Major Adverse Cardiac Events (MACEs), and perioperative complications. Results. Both groups were comparable concerning preoperative linear EuroSCORE (Group 1: 4.83±0.18, Group 2: 4.72±0.14, p=0.63). Patients with previous elective PCI before CABG had increased perioperative mortality (Group 1: 3.3% vs Group 2: 1.9%, p<0.001) and MACEs (Group 1: 7.9% vs 4.3%, p<0.001). This fact was associated with a worse logistic perioperative outcome (Group 1: 1.26±0.39, Group 2: 2.33, p=0.044). In addition, the incidence of bleeding complications (Group 1: 5.9% vs Group 2: 3.8%, p=0.017) and the number of blood products (Group 1: 1.70±0.31 vs 0.61±0.17, p<0.001) used were higher in patients of the Group 1. A higher incidence of acute renal failure (Group 1: 5.9% vs 2.7%, p=0.025) and renal replacement therapy (Group 1: 3.6% vs Group 2: 1.7%, p=0.03) was observed in patients of the same group. Conclusions. Patients with previous elective PCI before referral to CABG have a worse perioperative outcome in terms of mortality, MACE and perioperative complications as compared to patients with no history of PCI.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.