title: Clinical outcomes with off-pump coronary surgery after angioplasty with stent.
abstract: OBJECTIVE
  The aim was to determine whether prior coronary stent implantation affects postoperative outcomes in patients undergoing coronary artery bypass grafting.
  
  
  METHODS
  Between January 2005 and April 2008, a retrospective analysis was carried out to evaluate the effect of prior coronary stent implantation in patients undergoing off-pump coronary surgery on the incidence of major cardiovascular events in the postoperative period (i.e. at 30 days or during postoperative hospitalization).
  
  
  RESULTS
  In total, 796 consecutive patients underwent coronary artery bypass grafting. Of these, 116 (14.6%) had a coronary stent at the time of surgery. Patients with and without stents had similar levels of risk (i.e. EuroSCORE). Multivariate analysis, adjusted for the presence of confounding variables (i.e. preoperative left ventricular ejection fraction <40%, critical preoperative state, age, history of cerebrovascular accident, recent acute myocardial infarction, number of diseased coronary vessels, incomplete revascularization and on-pump conversion), showed that the presence of a stent was significantly associated with increased risks of postoperative myocardial infarction (relative risk [RR]=3.13; 95% confidence interval [CI], 1.75-5.96), in-hospital cardiac mortality (RR=4.62; 95% CI, 1.76-12.11) and in-hospital all-cause mortality (RR=3.65; 95% CI, 1.60-8.34).
  
  
  CONCLUSIONS
  In our experience, coronary artery stent implantation prior to coronary surgery was associated with increased risks of postoperative myocardial infarction, cardiac mortality and all-cause mortality in the postoperative period.
authors.affiliation: Servicio de Cirugía Cardiaca, Hospital Clínico San Carlos, Madrid, Spain. manuelcarneroalcazar@hotmail.es
authors.forename: Manuel
authors.initials: M
authors.lastname: Carnero Alcázar
authors.forename: Ali
authors.initials: A
authors.lastname: Alswies
authors.forename: Jacobo A
authors.initials: JA
authors.lastname: Silva Guisasola
authors.forename: Luis F
authors.initials: LF
authors.lastname: Reguillo Lacruz
authors.forename: Luis C
authors.initials: LC
authors.lastname: Maroto Castellanos
authors.forename: Enrique
authors.initials: E
authors.lastname: Villagrán Medinilla
authors.forename: Luis F
authors.initials: LF
authors.lastname: O'Connor Vallejo
authors.forename: Javier
authors.initials: J
authors.lastname: Cobiella Carnicer
authors.forename: Alvaro
authors.initials: A
authors.lastname: González Rocafort
authors.forename: Victoria D
authors.initials: VD
authors.lastname: Alegría Landa
authors.forename: José L
authors.initials: JL
authors.lastname: Castañón Cristóbal
authors.forename: Manuel
authors.initials: M
authors.lastname: Gil Aguado
authors.forename: José E
authors.initials: JE
authors.lastname: Rodríguez Hernández
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D047549:Coronary Artery Bypass, Off-Pump; D003327:Coronary Disease / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors