Abstract
Background: We have previously shown that multiple prior percutaneous coronary intervention (PCI) procedures adversely affect outcome after subsequent coronary artery bypass grafting (CABG). We were now interested to investigate this effect on a multicentric basis. Methods: Eight cardiac surgical centers from the German Federal State of North-Rhine-Westphalia provided outcome data of 37140 consecutive patients having undergone isolated first-time CABG between 01/2000 and 12/2005. Twenty-two patient characteristics and outcome variables, which are part of a collection of data claimed by the national medical quality-control commission, were retrieved from the individual databases. Three groups of patients were analyzed for overall in-hospital mortality and major adverse cardiac events (MACE): Patients without a previous PCI procedure, patients with 1 previous PCI procedure and patients with ≥2 previous PCI procedures before surgery. Unadjusted univariable and risk-adjusted multivariable logistic regression analysis were applied. Computed propensity-score matching was performed based on 15 patient major risk factors to correct for and minimize selection bias. Results: A total of 10.3% of patients had 1 previous PCI procedure, and 3.7% of patients had ≥2 previous PCI procedures. Risk-adjusted multivariable logistic regression analysis of ≥2 previous PCI significantly correlated with in-hospital mortality (odds ratio [OR], 2.0; confidence interval [CI], 1.4–3.0; P <0.0005) and MACE (OR, 1.5; CI, 1.2–1.9; P <0.0013). After propensity score matching, conditional logistic regression analysis confirmed the results of adjusted analysis. A history of ≥2 previous PCI procedures was significantly associated with in-hospital mortality (OR, 1.9; CI, 1.3–2.7; P =0.0016) and MACE (OR, 1.5; CI, 1.2–1.9; P =0.0019). Conclusions: This large multicentric trial supports earlier results of our single-center analysis, multiple previous PCI procedures significantly increased the event of in-hospital mortality and MACE after subsequent CABG.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: 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.
