TY - JOUR
T1 - Outcomes following PCI in patients with previous CABG
T2 - A multi centre experience
AU - Bundhoo, Shantu S.
AU - Kalla, Manish
AU - Anantharaman, Rajaram
AU - Morris, Keith
AU - Chase, Alexander
AU - Smith, David
AU - Anderson, Richard A.
AU - Kinnaird, Tim D.
PY - 2010/10/11
Y1 - 2010/10/11
N2 - Background: Limited data is available to guide operators as to the optimal revascularisation strategy in patients with previous CABG representing with angina. Method: Retrospective analysis of 161 patients with prior CABG undergoing PCI in two centres between September 2005 and April 2008. Results: 161 patients (132 male, 68 ± 8years) underwent PCI at 126 ± 65 months after index CABG. Clinical presentation of recurrent ischaemia was stable in 59.7% and as an acute coronary syndrome in 40.3% of patients. Mean follow-up after PCI was 13.5 ± 4.8 months. About 62.7% of patients underwent native vessel PCI, 32.9% had a graft only PCI, and 4.4% having a combination of both. Drug eluting stents were used in 84.9% of cases. There was one cardiac death and one case of redo CABG during follow-up. Mean CCS angina class decreased from 2.87 to 0.67 (P < 0.0001) in the follow-up group. About 13.6 % of all patients had a MACE at follow up. This was higher in the graft PCI group (21.6% vs. 8.9%, P = 0.048). About 12.4% of the total cohort underwent repeat PCI although 30% of these required PCI for a de-novo lesion. TVR rate was significantly higher in patients undergoing graft PCI than native vessel PCI (15% vs. 4.9%, P = 0.031). Graft PCI was an independent predictor (HR 3.73, 1.27-10.87 [95%CI], P = 0.016) of MACE in these patients. Conclusion: PCI significantly improved angina in these patients with low overall rates of TVR. However TVR rate was significantly higher in patients undergoing graft PCI than those undergoing native vessel PCI.
AB - Background: Limited data is available to guide operators as to the optimal revascularisation strategy in patients with previous CABG representing with angina. Method: Retrospective analysis of 161 patients with prior CABG undergoing PCI in two centres between September 2005 and April 2008. Results: 161 patients (132 male, 68 ± 8years) underwent PCI at 126 ± 65 months after index CABG. Clinical presentation of recurrent ischaemia was stable in 59.7% and as an acute coronary syndrome in 40.3% of patients. Mean follow-up after PCI was 13.5 ± 4.8 months. About 62.7% of patients underwent native vessel PCI, 32.9% had a graft only PCI, and 4.4% having a combination of both. Drug eluting stents were used in 84.9% of cases. There was one cardiac death and one case of redo CABG during follow-up. Mean CCS angina class decreased from 2.87 to 0.67 (P < 0.0001) in the follow-up group. About 13.6 % of all patients had a MACE at follow up. This was higher in the graft PCI group (21.6% vs. 8.9%, P = 0.048). About 12.4% of the total cohort underwent repeat PCI although 30% of these required PCI for a de-novo lesion. TVR rate was significantly higher in patients undergoing graft PCI than native vessel PCI (15% vs. 4.9%, P = 0.031). Graft PCI was an independent predictor (HR 3.73, 1.27-10.87 [95%CI], P = 0.016) of MACE in these patients. Conclusion: PCI significantly improved angina in these patients with low overall rates of TVR. However TVR rate was significantly higher in patients undergoing graft PCI than those undergoing native vessel PCI.
KW - GRFT-bypass grafts coronary
KW - outcomes
KW - percutaneous coronary intervention
UR - https://www.scopus.com/pages/publications/79960737633
U2 - 10.1002/ccd.22841
DO - 10.1002/ccd.22841
M3 - Article
C2 - 20939043
AN - SCOPUS:79960737633
SN - 1522-1946
VL - 78
SP - 169
EP - 176
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
IS - 2
ER -