title: Percutaneous Intervention Before Coronary Artery Bypass Surgery Does Not Unfavorably Impact Survival: A Single-Center Propensity-Matched Analysis.
abstract: BACKGROUND
  This retrospective propensity-matched study investigated the impact of prior percutaneous coronary intervention (PCI) on short-term and long-term survival after coronary artery bypass graft surgery (CABG).
  
  
  METHODS
  A total of 4,634 patients underwent isolated first-time CABG between April 2004 and March 2014. Among these, 424 (9.2%) had PCI. Propensity score analysis yielded 1:1 risk-adjusted matched groups: PCI (330 patients) and non-PCI (330 patients). A Cox proportional hazards model was used among the matched groups to assess the impact of prior PCI among other variables. Kaplan-Meier survival curves were compared at 1, 2, 3, 5, 7, and 10 years using the log-rank test to assess differences in survival.
  
  
  RESULTS
  In-hospital 30-day mortality was 1.1% (non-PCI) versus 0.9% (prior PCI; p = 0.66). Overall survival at 10 years was 77.5% (non-PCI) versus 82.71% (prior PCI; p = 0.4). Cox regression analysis identified European System for Cardiac Operative Risk Evaluation, nonsinus rhythm, age, pulmonary disease, and urgent surgery as risk factors for increased mortality. Prior PCI was not an independent predictor for mortality (hazard ratio, 0.55; 95% confidence interval, 0.25 to 1.18; p = 0.123). Overall survival in matched cohorts, non-PCI versus prior PCI, was 96.02% versus 97.13% (p = 0.08) at 1 year, 92.64% versus 96.36% (p = 0.08) at 3 years, 90.01% versus 93.47% (p = 0.02) at 5 years, 83.33% versus 90.37% (p = 0.01) at 7 years, and 73.56% versus 90.27% (p = 0.004) at 10 years.
  
  
  CONCLUSIONS
  The survival in matched cohorts did not show adverse outcomes with prior PCI at 1, 3, 5, 7, and 10 years. Prior PCI does not adversely impact survival after CABG.
authors.affiliation: Division of Cardiac Surgery, Derriford Hospital, Plymouth, United Kingdom. Electronic address: drsl00@gmail.com.
authors.forename: Suvitesh
authors.initials: S
authors.lastname: Luthra
authors.affiliation: Department of Pulmonary Medicine, MD Anderson Cancer Center, Houston, Texas.
authors.forename: Miguel M
authors.initials: MM
authors.lastname: Leiva Juárez
authors.affiliation: Department of Cardiothoracic Surgery, New Cross Hospital, Wolverhampton, United Kingdom.
authors.forename: Eshan
authors.initials: E
authors.lastname: Senanayake
authors.affiliation: Department of Cardiothoracic Surgery, New Cross Hospital, Wolverhampton, United Kingdom.
authors.forename: Heyman
authors.initials: H
authors.lastname: Luckraz
authors.affiliation: Department of Cardiothoracic Surgery, New Cross Hospital, Wolverhampton, United Kingdom.
authors.forename: John S
authors.initials: JS
authors.lastname: Billing
authors.affiliation: Department of Cardiothoracic Surgery, New Cross Hospital, Wolverhampton, United Kingdom.
authors.forename: James
authors.initials: J
authors.lastname: Cotton
authors.affiliation: Department of Cardiothoracic Surgery, New Cross Hospital, Wolverhampton, United Kingdom.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Norell
mesh_terms: D001026:Coronary Artery Bypass / Q000706:statistics & numerical data; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data; D004630:Emergencies; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000453:epidemiology / Q000601:surgery; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D009203:Myocardial Infarction / Q000601:surgery*; D062645:Percutaneous Coronary Intervention / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000401:mortality; D057216:Propensity Score; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome