title: Percutaneous coronary intervention strategies and prognosis for graft lesions following coronary artery bypass grafting.
abstract: The purpose of this study was to compare the prognosis of graft-percutaneous coronary intervention (PCI) and native vessel (NV)-PCI, drug-eluting stents (DESs) and bare-metal stents (BMSs) for the treatment of graft lesions following coronary artery bypass grafting (CABG), and to determine the risk factors for major adverse cardiac events (MACEs). A total of 289 patients who underwent PCI following CABG between August 2005 and March 2010 were retrospectively analyzed. The effects on survival were compared among patients who underwent NV- and graft-PCI, and DES and BMS implantation. Additionally, the risk factors for MACEs following PCI for graft lesions were analyzed. The findings showed that MACE-free and revascularization-free survival rates were significantly higher in the NV-PCI group compared with those in the graft-PCI group. There were 63 cases (29.0%) of MACEs in the DES group and 25 cases (52.1%) in the BMS group. In patients undergoing NV-PCI, the DES group had significantly fewer MACEs and less target vessel revascularization (TVR) than the BMS group. In patients undergoing graft-PCI, the DES group showed a tendency for fewer MACEs and a lower incidence of cardiac mortality, myocardial infarction and TVR compared with the BMS group. Diabetes, an age of >70 years and graft-PCI were independent risk factors for MACEs in patients post-PCI. It is concluded that NV-PCI has superior long-term outcomes compared with graft-PCI, and should therefore be considered as the first-line treatment for graft disease following CABG. Despite this, graft-PCI remains a viable option. DESs are the first choice for graft-PCI due to their safety and efficacy and their association with reduced mortality and MACE rate. Diabetes, older age and graft-PCI are independent risk factors for MACEs in patients post-CABG who are undergoing revascularization.
authors.affiliation: Department of Cardiology, Tianjin Chest Hospital, Tianjin 300051, P.R. China.
authors.forename: Yin
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Cardiology, Tianjin Chest Hospital, Tianjin 300051, P.R. China.
authors.forename: Xiujun
authors.initials: X
authors.lastname: Zhou
authors.affiliation: Department of Cardiology, Tianjin Chest Hospital, Tianjin 300051, P.R. China.
authors.forename: Hua
authors.initials: H
authors.lastname: Jiang
authors.affiliation: Department of Cardiology, Tianjin Chest Hospital, Tianjin 300051, P.R. China.
authors.forename: Mingdong
authors.initials: M
authors.lastname: Gao
authors.affiliation: Department of Cardiology, Tianjin Chest Hospital, Tianjin 300051, P.R. China.
authors.forename: Lin
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Cardiology, Tianjin Chest Hospital, Tianjin 300051, P.R. China.
authors.forename: Yutian
authors.initials: Y
authors.lastname: Shi
authors.affiliation: Cardiovascular Institute, Department of Cardiology, Tianjin Chest Hospital, Tianjin 300051, P.R. China.
authors.forename: Jing
authors.initials: J
authors.lastname: Gao
keywords: coronary artery bypass grafting; follow-up; multivariate risk factors; percutaneous coronary intervention; prognosis