Long-Term Outcomes of Percutaneous Coronary Intervention in Patients with Prior Coronary Artery Bypass Graft - A Retrospective Experience

• Published in: Indian heart journal
• Main Authors: Boddu, Anil Kumar, S, Bijulal, KM, Krishnamoorthy, VK, Ajit Kumar
• Format: Journal Article
• Language: English
• Published: Elsevier, a division of RELX India, Pvt. Ltd 27.08.2024
• Subjects: Coronary artery bypass graft; Drug-eluting stent; Major adverse cardiac event; Mortality; Percutaneous coronary intervention; Coronary artery bypass graft; Percutaneous coronary intervention; Mortality; Drug-eluting stent; Major adverse cardiac event
• ISSN: 0019-4832
• DOI: 10.1016/j.ihj.2024.07.009

To evaluate the long-term clinical outcomes of percutaneous coronary intervention (PCI) in patients who had previously undergone coronary artery bypass grafting (CABG). A total of 219 patients who had a history of CABG and underwent PCI at tertiary care centre were retrospectively enrolled in this study. Clinical endpoints such as major adverse cardiac events (MACE; cardiac death, non-fatal myocardial infarction [MI], and target vessel revascularization), any death, cardiac death, MI, target vessel revascularization (TVR), and target lesion revascularisation (TLR) were reported at long-term follow-up. About 66.6% patients were treated on the native vessel, and 24.2% on grafts vessel. In all, 360 stents [83.3% drug-eluting stent (DES) and 16.6% bare metal stent (BMS)] were implanted. Diabetes mellitus (p=0.03), LVEF<55% for PCI (p=0.04), stent type [BMS (p<0.001) and DES (p<0.001)] and chronic kidney disease [(CKD) p<0.01] were appeared to be the significant predictors of mortality. Age at CABG>50 years (p=0.04), stent type [BMS (p=0.03) and DES (p<0.01)] and CKD (p<0.01) as independent predictors for MACE. Higher event rate was reported in graft-vessel PCI group as compared to native-vessel PCI group: ISR (p<0.01), TLR (p=0.01), mortality (p=0.04), MACE (p<0.01) and MI (p=0.05). Mortality (p<0.001), MACE (p<0.001) and MI (p<0.001) were significantly lower in DES vs. BMS groups. Native-vessel PCI was associated with better clinical outcomes than graft-vessel PCI that also with the use of DES as the first choice in patients with a history of CABG.