title: Previous coronary stents do not increase early and long-term adverse outcomes in patients undergoing off-pump coronary artery bypass grafting: a propensity-matched comparison.
abstract: OBJECTIVE
  The aim of our study was to compare the early and long-term outcomes of patients undergoing off-pump coronary artery bypass grafting (CABG) with and without previous coronary stents.
  
  
  METHODS
  Between September 2004 and September 2011, 269 patients with previous stents underwent first-time isolated off-pump CABG. These patients were compared with 897 patients without previous stent. A propensity score-matching analysis was performed to compare early and late outcomes between the groups. Mean follow-up time was 43.4 months after surgery.
  
  
  RESULTS
  Patients with previous stents were more likely to be men (85.9% in the stent group vs 79.4% in the no-stent group; P=.022) and more likely to have prior myocardial infarction (60.2% vs 36.8%; P<.001). Mean number of anastomoses was lower in patients with previous stents than in patients without previous stents (4.0 vs 4.2; P=.037). There was no difference in the use of bilateral internal thoracic artery graft between the groups (88.8% vs 89.1%; P>.999). After propensity adjustment for preoperative characteristics, both operative death (0.7% vs 1.5%; P=.414) and the major complications rates (7.8% vs 7.5%; P=.869) were similar between the groups. The actuarial survival rate at 7 years was not different between the groups (87.2%±3.2% vs 84.8%±2.9%; P=.470). Furthermore, freedom from major adverse cardiac and cerebrovascular events at 7 years were similar between the groups (78.9%±3.8% vs 77.6%±3.3%; P=.811).
  
  
  CONCLUSIONS
  Previous coronary stents do not increase early and long-term morbidity or mortality in patients undergoing off-pump CABG.
authors.affiliation: Department of Cardiovascular Surgery, Sakakibara Heart Institute, Tokyo, Japan. Electronic address: tfukui.cvs@gmail.com.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Fukui
authors.affiliation: EBM Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Sachiko
authors.initials: S
authors.lastname: Tanaka
authors.affiliation: Department of Cardiovascular Surgery, Sakakibara Heart Institute, Tokyo, Japan.
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Takanashi
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects* / Q000401:mortality; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000295:instrumentation* / Q000401:mortality; D011183:Postoperative Complications / Q000401:mortality; D057216:Propensity Score; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome