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Prognostic significance of multiple previous percutaneous coronary interventions in patients undergoing elective coronary artery bypass surgery.
Circulation. 2006 Jul 04; 114(1 Suppl):I441-7.Circ

Abstract

BACKGROUND

A possible relationship between increased perioperative risk during coronary artery bypass grafting (CABG) and previous percutaneous coronary intervention (PCI) is debatable. We sought to determine the impact of previous PCI on patient outcome after elective CABG.

METHODS AND RESULTS

Between January 2000 and January 2005, 2626 consecutive patients undergoing first-time isolated elective CABG as the primary revascularization procedure (group 1) were evaluated for in-hospital mortality and major adverse cardiac events (MACEs) and were compared with 360 patients after single PCI (group 2) and with 289 patients after multiple PCI sessions (group 3) before elective CABG. Unadjusted univariate and risk-adjusted multivariate logistic-regression analysis revealed previous multiple PCIs to be strongly associated with in-hospital mortality (odds ratio [OR], 2.24; 95% confidence interval [CI], 1.52 to 3.21; P<0.001) and MACEs (OR, 2.28; 95% CI, 1.38 to 3.59; P<0.001). To control for selection bias, a computed propensity-score matching based on 13 patient characteristics and preoperative risk factors was performed separately comparing group 1 versus 2 and group 1 versus 3. After propensity matching, conditional logistic-regression analysis confirmed previous multiple PCIs to be strongly associated with in-hospital mortality (OR, 3.01; 95% CI, 1.51 to 5.98; P<0.0017) and MACEs (OR, 2.31; 95% CI, 1.45 to 3.67; P<0.0004).

CONCLUSIONS

In patients with a history of multiple PCI sessions, perioperative risk for in-hospital mortality and MACEs during subsequent elective CABG is increased.

Authors+Show Affiliations

Department of Thoracic and Cardiovascular Surgery, West German Heart Center Essen, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany. matthias.thielmann@uni-essen.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article

Language

eng

PubMed ID

16820616

Citation

Thielmann, Matthias, et al. "Prognostic Significance of Multiple Previous Percutaneous Coronary Interventions in Patients Undergoing Elective Coronary Artery Bypass Surgery." Circulation, vol. 114, no. 1 Suppl, 2006, pp. I441-7.
Thielmann M, Leyh R, Massoudy P, et al. Prognostic significance of multiple previous percutaneous coronary interventions in patients undergoing elective coronary artery bypass surgery. Circulation. 2006;114(1 Suppl):I441-7.
Thielmann, M., Leyh, R., Massoudy, P., Neuhäuser, M., Aleksic, I., Kamler, M., Herold, U., Piotrowski, J., & Jakob, H. (2006). Prognostic significance of multiple previous percutaneous coronary interventions in patients undergoing elective coronary artery bypass surgery. Circulation, 114(1 Suppl), I441-7.
Thielmann M, et al. Prognostic Significance of Multiple Previous Percutaneous Coronary Interventions in Patients Undergoing Elective Coronary Artery Bypass Surgery. Circulation. 2006 Jul 4;114(1 Suppl):I441-7. PubMed PMID: 16820616.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prognostic significance of multiple previous percutaneous coronary interventions in patients undergoing elective coronary artery bypass surgery. AU - Thielmann,Matthias, AU - Leyh,Rainer, AU - Massoudy,Parwis, AU - Neuhäuser,Markus, AU - Aleksic,Ivan, AU - Kamler,Markus, AU - Herold,Ulf, AU - Piotrowski,Jarowit, AU - Jakob,Heinz, PY - 2006/7/6/pubmed PY - 2006/8/19/medline PY - 2006/7/6/entrez SP - I441 EP - 7 JF - Circulation JO - Circulation VL - 114 IS - 1 Suppl N2 - BACKGROUND: A possible relationship between increased perioperative risk during coronary artery bypass grafting (CABG) and previous percutaneous coronary intervention (PCI) is debatable. We sought to determine the impact of previous PCI on patient outcome after elective CABG. METHODS AND RESULTS: Between January 2000 and January 2005, 2626 consecutive patients undergoing first-time isolated elective CABG as the primary revascularization procedure (group 1) were evaluated for in-hospital mortality and major adverse cardiac events (MACEs) and were compared with 360 patients after single PCI (group 2) and with 289 patients after multiple PCI sessions (group 3) before elective CABG. Unadjusted univariate and risk-adjusted multivariate logistic-regression analysis revealed previous multiple PCIs to be strongly associated with in-hospital mortality (odds ratio [OR], 2.24; 95% confidence interval [CI], 1.52 to 3.21; P<0.001) and MACEs (OR, 2.28; 95% CI, 1.38 to 3.59; P<0.001). To control for selection bias, a computed propensity-score matching based on 13 patient characteristics and preoperative risk factors was performed separately comparing group 1 versus 2 and group 1 versus 3. After propensity matching, conditional logistic-regression analysis confirmed previous multiple PCIs to be strongly associated with in-hospital mortality (OR, 3.01; 95% CI, 1.51 to 5.98; P<0.0017) and MACEs (OR, 2.31; 95% CI, 1.45 to 3.67; P<0.0004). CONCLUSIONS: In patients with a history of multiple PCI sessions, perioperative risk for in-hospital mortality and MACEs during subsequent elective CABG is increased. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/16820616/Prognostic_significance_of_multiple_previous_percutaneous_coronary_interventions_in_patients_undergoing_elective_coronary_artery_bypass_surgery_ L2 - https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.105.001024?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -