title: Differences between early, intermediate, and late angioplasty after coronary artery bypass grafting.
abstract: The aim of the present study was to identify patients with recurrent ischemia after coronary artery bypass surgery (CABG) treated by percutaneous coronary intervention (PCI). Graft failure after CABG may be managed conservatively or treated by surgery or PCI. We thought to investigate clinical, angiographic, and procedural characteristics in relation to clinical outcome. This was a retrospective single-center study. Patients who underwent revascularization by PCI with a previous CABG were analyzed. Patients were divided in 3 groups, depending on interval between CABG and index PCI: group 1, interval <72 hours; group 2, interval between 72 hours and 1 year; group 3, interval >1 year. Two hundred twenty-one patients were studied. Clinical characteristics and survival curves were comparable in groups 2 and 3. Postoperative creatine kinase MB and troponin values were significantly higher in group 1 (P = 0.000). From group 1, significantly more patients (10.5%) required emergency CABG after the index PCI than compared with group 2 (2.1%) and group 3 (0%), (P = 0.003). There were more off-pump CABGs in group 1 than in the other 2 groups. Group 1 received less PCIs in native ungrafted vessels compared with the other 2 groups. Mortality in group 1 (18.4%) was higher than in the other 2 groups (7.4 and 4.5%, respectively; P < 0.05). Mortality in group 1 was higher in the acute phase of follow-up. PCI performed less than 72 hours after CABG is feasible but accompanied by a higher mortality and redo CABG. This outcome is probably related to the high-risk patient category.
authors.affiliation: Department of Cardiology, University Medical Centre Groningen, Groningen, The Netherlands.
authors.forename: Eng-Shiong
authors.initials: ES
authors.lastname: Tan
authors.forename: Gillian
authors.initials: G
authors.lastname: Jessurun
authors.forename: Wouter
authors.initials: W
authors.lastname: Deurholt
authors.forename: Pieter
authors.initials: P
authors.lastname: van der Vleuten
authors.forename: Ad
authors.initials: A
authors.lastname: van den Heuvel
authors.forename: Tjark
authors.initials: T
authors.lastname: Ebels
authors.forename: Felix
authors.initials: F
authors.lastname: Zijlstra
authors.forename: Rene
authors.initials: R
authors.lastname: Tio
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D015906:Angioplasty, Balloon, Coronary / Q000379:methods* / Q000401:mortality; D015331:Cohort Studies; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000379:methods; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome