Coronary artery bypass grafting in patients with relatively recent previous stent implantation: three years follow-up results.
BACKGROUND
An increasing number of patients who undergo coronary artery bypass grafting(CABG) have a history of coronary stent implantation. This study aims to assess perioperative and medium-term follow-up outcomes in patients in whom CABG was preceded by coronary stent implantation within two years before operation.


METHODS
One hundred and sixty two patients undergoing CABG after previous stent placement (PCI + CABG group) were compared to 149 who had CABG without PCI in the past (CABG group). Clinical, angiographic and perioperative outcome data were compared. The three year follow-up comprised data on number of deaths and the presence of anginal symptoms.


RESULTS
In both groups the extent of coronary artery disease was comparable, but more patients in the PCI + CABG group had a history of myocardial infarction. Perioperative outcome data did not differ between the groups except for a higher number of vessels considered infarct-related grafted in the CABG group. Patients operated on up to three months after PCI had more extensive coronary heart disease than those operated on later. They also had a significantly shorter operation time. This group also showed a trend towards less postoperative bleeding, less rethoracotomy and less low cardiac output syndrome. In a three year follow-up, 48 (30%) patients in the PCI + CABG group reported presence of angina compared to 28 (19%) in the CABG group (p = 0.04).


CONCLUSIONS
Previous PCI does not significantly influence the CABG outcome. In mediumterm follow-up, freedom from anginal symptoms is less likely in patients in whom CABG was preceded by stent implantation.
Gaszewska-Zurek
Ewa
E
Department of Cardiology, Silesian School of Medicine, Ziołowa 47,40-635 Katowice, Poland. ezurek@gmail.com
Zurek
Paweł
P
Kaźmierski
Maciej
M
Kargul
Tomasz
T
Duraj
Piotr
P
Jasiński
Marek
M
Woś
Stanisław
S
Tendera
Michał
M
D000368:Aged; D000787:Angina Pectoris / Q000401:mortality / Q000601:surgery / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000401:mortality / Q000601:surgery / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome