title: The association between prior percutaneous coronary intervention and short-term outcomes after coronary artery bypass grafting.
abstract: BACKGROUND
  Increasingly, patients are being referred for coronary artery bypass grafting (CABG) for management of symptoms after prior percutaneous coronary intervention (PCI). In this study, we assessed the impact of prior PCI on inhospital mortality after CABG.
  
  
  METHODS
  Perioperative data were collected on patients who underwent first-time CABG at 2 surgical centers. Patients who underwent PCI and CABG during the same admission were excluded. Patients with prior PCI were compared with patients with no prior PCI, and the risk-adjusted impact of prior PCI on inhospital mortality after CABG was determined using both multivariate techniques and propensity score matching techniques.
  
  
  RESULTS
  Six thousand thirty-two patients met inclusion criteria. Patients with prior PCI were less likely to be between the ages of 70 and 80 (P < .0001), to have an ejection fraction <0.40 (P < .0001), and to have 3-vessel/left main disease (P < .0001). They were, however, more likely to have Canadian Cardiovascular Society class IV symptoms (P < .0001) and to have an urgent status (P = .02). Rates of inhospital mortality after CABG were higher in patients with prior PCI (3.6% vs 2.3%, P = .02). Using multivariate techniques, prior PCI emerged as an independent predictor of postoperative inhospital mortality (odds ratio 1.93, P = .003). When patients with prior PCI were matched to patients with no prior PCI using propensity scores, inhospital mortality remained higher among patients with prior PCI (3.6% vs 1.7%, P = .01).
  
  
  CONCLUSIONS
  Patients with prior PCI presented for CABG with less comorbidity and diminished coronary disease; yet, they had more advanced symptoms and greater urgency. After adjusting for these differences, prior PCI emerged as an independent predictor of inhospital mortality after CABG.
authors.affiliation: Division of Cardiac Surgery, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Ansar
authors.initials: A
authors.lastname: Hassan
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Buth
authors.forename: Roger J F
authors.initials: RJ
authors.lastname: Baskett
authors.forename: Imtiaz S
authors.initials: IS
authors.lastname: Ali
authors.forename: Andrew
authors.initials: A
authors.lastname: Maitland
authors.forename: John A P
authors.initials: JA
authors.lastname: Sullivan
authors.forename: William A
authors.initials: WA
authors.lastname: Ghali
authors.forename: Gregory M
authors.initials: GM
authors.lastname: Hirsch
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D001026:Coronary Artery Bypass; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome