Evaluation of the Patients with Recurrent Angina After Coronary Artery Bypass Grafting

Braz J Cardiovasc Surg. 2024 May 15;39(4):e20230303. doi: 10.21470/1678-9741-2023-0303.

Abstract

Introduction: In this study, we aimed to evaluate the most common causes of recurrent angina after coronary artery bypass grafting (CABG) and our treatment approaches applied in these patients.

Methods: We included all patients who underwent CABG, with or without percutaneous coronary intervention after CABG, at our hospital from September 2013 to December 2019. Patients were divided into two groups according to the time of onset of anginal pain after CABG. Forty-five patients (58.16 ± 8.78 years) had recurrent angina in the first postoperative year after CABG and were specified as group I (early recurrence). Group II (late recurrence) comprised 82 patients (58.05 ± 8.95 years) with angina after the first year of CABG.

Results: The mean preoperative left ventricular ejection fraction was 53.22 ± 8.87% in group I, and 54.7 ± 8.58% in group II (P=0.38). No significant difference was registered between groups I and II regarding preoperative angiographic findings (P>0.05). Failed grafts were found in 27.7% (n=28/101) of the grafts in group I as compared to 26.8% (n=51/190) in group II (P>0.05). Twenty-four (53.3%) patients were treated medically in group I, compared with 54 (65.8%) patients in group II (P=0.098). There was a need for intervention in 46.6% (n=21) of group I patients, and in 34.1% (n=28) of group II patients.

Conclusion: Recurrent angina is a complaint that should not be neglected because most of the patients with recurrent angina are diagnosed with either native coronary or graft pathology in coronary angiography performed.

Keywords: Angina Pectoris; Coronary Artery Bypass; Percutaneous Coronary Intervention; Stroke Volume; Vascular Graft Occlusion.

MeSH terms

  • Aged
  • Angina Pectoris* / etiology
  • Angina Pectoris* / surgery
  • Coronary Angiography
  • Coronary Artery Bypass* / adverse effects
  • Female
  • Humans
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention
  • Postoperative Complications / etiology
  • Recurrence*
  • Retrospective Studies
  • Stroke Volume / physiology
  • Time Factors
  • Treatment Outcome