Influence of prior percutaneous coronary intervention on outcome of coronary artery bypass grafting: A multi-center clinical study

Hongwei Jiang; Hang Zhang; Wen Chen; Fangjing Zheng; Yongfeng Shao; Yongxiang Qian; Guoxiang Wang; Mingqiu LI; Qingsheng You; Zhiyong Liu; Yong Wang; Zhenya Shen; Wei LI; Demin LI; Su Huang; Chongjun Zhong; Rui Wang; Xin Chen

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Influence of prior percutaneous coronary intervention on outcome of coronary artery bypass grafting: A multi-center clinical study

VernacularTitle:经皮冠状动脉介入史对冠状动脉旁路移植术结果影响的多中心临床研究
Author: Hongwei JIANG ¹ ; Hang ZHANG ¹ ; Wen CHEN ¹ ; Fangjing ZHENG ¹ ; Yongfeng SHAO ² ; Yongxiang QIAN ^{3
,

4} ; Guoxiang WANG ⁵ ; Mingqiu LI ^{6
,

7} ; Qingsheng YOU ⁸ ; Zhiyong LIU ⁹ ; Yong WANG ^{4
,

10
,

11} ; Zhenya SHEN ¹² ; Wei LI ¹³ ; Demin LI ¹⁴ ; Su HUANG ^{15
,

16} ; Chongjun ZHONG ^{17
,

18} ; Rui WANG ¹ ; Xin CHEN ¹
Author Information

1. Department of Cardiovascular Surgery, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing, 210006, P. R. China
2. Department of Cardiovascular Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, P. R. China
3. Department of Thoracic and Cardiac Surgery, The First People&rsquo
4. s Hospital of Changzhou, Changzhou, 213003, Jiangsu, P. R. China
5. Department of Thoracic and Cardiac Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221006, Jiangsu, P. R. China
6. Department of Cardiac Surgery, Wuxi People'
7. s Hospital, Wuxi, 214023, Jiangsu, P. R. China
8. Department of Thoracic and Cardiac Surgery, Affiliated Hospital of Nantong University, Nantong, 226001, Jiangsu, P. R. China
9. Department of Thoracic and Cardiac Surgery, Zhongda Hospital, Nanjing, 210009, P. R. China
10. Department of Thoracic and Cardiac Surgery, The Second
11. People&rsquo
12. Department of Cardiovascular Surgery, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu, P. R. China
13. Department of Cardiac Surgery, Xuzhou Central Hospital, Xuzhou, 221009, Jiangsu, P. R. China
14. Department of Thoracic and Cardiac Surgery, General Hospital of Eastern Theater Command, Nanjing, 210002, P. R. China
15. Department of Cardiovascular Surgery, Huaian First People&rsquo
16. s Hospital, Huaian, 223300, Jiangsu, P. R. China
17. Department of Thoracic and Cardiovascular Surgery, Nantong First People&rsquo
18. s Hospital, Nantong, 226001, Jiangsu, P. R. China
Publication Type:Journal Article
Keywords: Percutaneous coronary intervention; coronary artery bypass grafting; follow-up; clinical outcome; multi-center; clinical study
From: Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2022;29(11):1436-1441
CountryChina
Language:Chinese
Abstract: Objective To investigate the influence of prior percutaneous coronary intervention (PCI) on the outcome of coronary artery bypass grafting (CABG). Methods Clinical data of 5 216 patients from Jiangsu Province CABG registry who underwent primary isolated CABG from 2016 to 2019 were retrospectively analyzed. Patients were divided into a PCI group (n=673) and a non-PCI group (n=4 543) according to whether they had received PCI treatment. The PCI group included 491 males and 182 females, aged 62.6±8.2 years, and the non-PCI group included 3 335 males and 1 208 females, aged 63.7±8.7 years. Multivariable logistic regression and propensity score matching (PSM) were used to compare 30-day mortality, incidence of major complications and 1-year follow-up outcomes between the two groups. Results Both in original cohort and matched cohort, there was no statistical difference in the 30-day mortality [14 (2.1%) vs. 77 (1.7%), P=0.579; 14 (2.1%) vs. 11 (1.6%), P=0.686], or the incidence of major complications (myocardial infarction, stroke, mechanical ventilation≥24 h, dialysis for new-onset renal failure, deep sternal wound infection and atrial fibrillation) (all P>0.05). The rate of reoperation for bleeding in the PCI group was higher than that in the non-PCI group [19 (2.8%) vs. 67 (1.5%), P=0.016; 19 (2.8%) vs. 7 (1.0%), P=0.029]. Both in original cohort and matched cohort, there was no statistical difference in 1-year survival rate between the two groups [613 (93.1%) vs. 4 225 (94.6%), P=0.119; 613 (93.1%) vs. 630 (95.2%), P=0.124], while the re-admission rate in the PCI group was significantly higher than that in the non-PCI group [32 (4.9%) vs. 113 (2.5%), P=0.001; 32 (4.9%) vs. 17 (2.6%), P=0.040]. Conclusion This study shows that a history of PCI treatment does not significantly increase the perioperative mortality and major complications of CABG, but increases the rate of cardiogenic re-admission 1 year postoperatively.