Predictors of Intervention in Acute Coronary Syndrome Patients with pre-Existing Bypass Grafts

Abstract

Predictors of Intervention in Acute Coronary Syndrome Patients with pre-Existing Bypass Grafts T.A.C. Snow ∗, T. Watson, P.N. Ruygrok, M.W. Webster, J.T. Stewart Green Lane Cardiovascular Service, Auckland City Hospital, New Zealand Background: The majority of patients who present to hospital with an acute coronary syndrome (ACS) undergo angiography with a view to revascularisation. However a large proportion of those with pre-existing coronary artery bypass grafts (CABG) have little scope for further intervention and are consequently treated medically. We investigated predictors of ability to offer percutaneous coronary intervention (PCI) in this cohort of patients. Methods: Case notes for all patients with previous CABG who presented to our unit with an ACS between May 2010 and February 2012 were reviewed. Clinical predictors for repeat revascularisationwere establishedusing binary logistic regression analysis. Results: 160 patients (mean age 70.2± 9.3 years, 82.5% male)were identified. Themeanduration sinceCABGwas 12.1± 6.6 years. The median number of grafts was three (range1–7)perpatient (90.6%hada left internalmammary, 80.3% had one or more saphenous venous and 26.3% had one or more radial artery grafts). Following angiography, PCI was undertaken in 66 (41.3%), 33 (50%) to the native c n