Document Detail

Coronary artery bypass grafting after recent or remote percutaneous coronary intervention in the Commonwealth of Massachusetts.
MedLine Citation:
PMID:  20736447     Owner:  NLM     Status:  In-Process    
BACKGROUND: In this study, we sought to characterize the outcomes after isolated coronary artery bypass grafting (CABG) in patients with a history of remote (≥14 days), and recent (<14 days), percutaneous coronary intervention (PCI).
METHODS AND RESULTS: Patients with PCI within 5 years of CABG were identified among 12 591 primary isolated CABG reported in the mandatory Massachusetts Adult Cardiac Surgery Database. Patients were excluded if they were out-of-state (n=1043, 8%), had undergone primary PCI for acute myocardial infarction (n=401, 3%), had a PCI-CABG interval >5 years or unknown (n=136 and n=673, 1% and 5%). Patients with a history of remote and recent PCI were analyzed separately. Each CABG patient with PCI was matched to 3 patients without PCI using a propensity score. Outcomes were analyzed using generalized estimating equations and stratified proportional hazards models, with a mean follow-up of 4.1±1.2 years. There were 1117 CABG patients (9%) with prior PCI (n(remote)=823; n(recent)=294). In matched CABG patients with remote prior PCI, no differences were found in 30-day mortality (1.1% versus 1.5%; P=0.432), hospital morbidity (41% versus 40%; P=0.385) and overall survival (hazard ratio, [95% confidence interval] for death for prior PCI, 0.93 [0.74 to 1.18]; P=0.555). In matched CABG patients with recent prior PCI, hospital morbidity was higher (59% versus 45%; P<0.001), but no differences were found in 30-day mortality (3.5% versus 3.1%; P=0.754) and overall survival (HR, 1.18 [0.83 to 1.69]; P=0.353).
CONCLUSIONS: In patients undergoing CABG, remote prior PCI (≥14 days) was not associated with adverse outcomes at 30 days or during long-term follow-up.
Louis-Mathieu Stevens; Paul Khairy; Arvind K Agnihotri
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-08-24
Journal Detail:
Title:  Circulation. Cardiovascular interventions     Volume:  3     ISSN:  1941-7632     ISO Abbreviation:  Circ Cardiovasc Interv     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101499602     Medline TA:  Circ Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  460-7     Citation Subset:  IM    
Division of Cardiac Surgery, Centre Hospitalier Universitaire de Montréal, Montreal, Quebec, Canada.
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Grant Support
//Canadian Institutes of Health Research

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