title: [The impact of prior revascularization procedures on outcome of percutaneous coronary intervention in ACS].
abstract: Development of interventional cadriology is cause of increasing number of acute coronary syndrome (ACS) patients with prior revascularization procedures in the past.
  
  
  OBJECTIVE
  To evaluate the clinical feature of ACS patients with and without prior revascularization procedures and to compare in-hospital and long-term outcome following percutaneous coronary intervention (PCI) in these groups.
  
  
  METHODS
  There were 325 ACS consecutive patients included to the study who underwent PCI procedures. There were 175 patients after PCI or coronary artery by-pass grafting in the past. Control group consisted of 150 subjects with ACS with no history of PCI procedures. We analyzed baseline characteristic as well as the inhospital, 30- and 180-day outcomes.
  
  
  RESULTS
  The baseline characteristic revealed higher rate of patients with heart failure in case-history (18.0% vs. 26.9%, p = 0.03), diabetes (16.0% vs. 25.1%, p = 0.04), and multi-vessels coronary disease (85.2% vs. 60.6%, p = 0.003) in the subgroup of prior revascularization. The rate of non-STEMI was higher (28.0% vs. 40.6%, p = 0.02) and the rate of STEMI was lower (47.4% vs. 63.3%, p = 0.004) as a form of ACS in previously revascularized subjects. The analysis of inhospital outcome revealed significantly longer time of hospitalization of the patients with prior revascularization (7.7 +/- 4.6 vs. 5.4 +/- 4.1, p < 0.0001). There were no significant differences in clinical characteristics at 6-months after ACS.
  
  
  CONCLUSIONS
  Patients undergoing PCI in ACS with prior revascularization procedures are characterized by a higher level of atherosclerosis risk factors, more advanced changes in coronary arteries and higher NSTEMI occurance than ACS patients without PCI history. Baseline and long-term results of revascularization, frequency and nature of complications are comparable in both groups, but length of hospitalization period and significantly longer in patients with revascularization in the past.
authors.affiliation: Slaski Uniwersytet Medyczny w Katowicach, Katedra i Klinika Kardiologii.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Walkowicz
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Gasior
authors.forename: Józefa
authors.initials: J
authors.lastname: Dabek
mesh_terms: D054058:Acute Coronary Syndrome / Q000453:epidemiology* / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006333:Heart Failure / Q000453:epidemiology; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D015995:Prevalence; D012008:Recurrence; D012307:Risk Factors; D016896:Treatment Outcome