[Correlation between previous coronary artery stenting and early mortality in patients undergoing coronary artery bypass graft surgery]

Abstract

Background: In this study, we examine the effect of previous percutaneous intervention on the rate of adverse perioperative outcome in patients undergoing coronary artery bypass graft surgery (CABG).

Methods: Outcomes of 240 CABG patients, collected consecutively in an observational study, were compared. Gp A (n=35) had prior PCI before CABG and Gp B (n=205) underwent primary CABG.

Results: Statistically significant results were obtained for the following preoperative criteria: previous myocardial infarction: 48.6% vs 36.6% (P=0.003), distribution of CAD (P=0.0001), unstable angina: 45.7% vs 39% (P=0.04). For intraoperative data, the total number of established bypasses was 2.6 (GpA) vs 2.07 (Gp B) (P=0.017), with the number of arterial bypass grafts being: 20% vs 13% (P=ns). Regarding the postoperative course, no significant difference in troponine I rate, 24-hour bleeding: 962 ml (Gp A) vs 798 ml (Gp B) (P=0.004), transfusion (PRBC unit): 3.63 (Gp A) vs 2.5 (Gp B) (P=0.006). Previous PCI emerged as an independent predictor of postoperative in-hospital mortality (OR 2.24, 95% CI [1.52-2.75], P<0.01).

Conclusion: Patients with prior PCI presented for CABG with more severe CAD. Thirty-day mortality and morbidity were significantly higher in patients with prior PCI.

Keywords: Angioplastie; Chirurgie coronarienne; Coronary artery bypass; Outcome; PCI; Résultats.