title: Previous Percutaneous Coronary Intervention Does Not Increase Adverse Events After Coronary Artery Bypass Surgery.
abstract: BACKGROUND
  Adverse effects of previous percutaneous coronary intervention (PCI) on clinical outcomes after coronary artery bypass grafting (CABG) are unclear. This study aimed to evaluate the effect of previous PCI on early outcomes after subsequent CABG by using data from the Japanese national database.
  
  
  METHODS
  This study analyzed data from 48,051 consecutive patients that were retrieved from the Japan Adult Cardiovascular Surgery Database. These patients underwent primary, isolated, elective CABG between January 2008 and December 2013. Early mortality and morbidity rates in patients with previous PCI (n = 12,457, 25.9%) were compared with those in patients with no PCI (n = 35,594, 74.1%) by using multivariate logistic regression analysis and propensity score analysis.
  
  
  RESULTS
  Operative mortality rates (no PCI, 1.2%; previous PCI, 1.2%; P = 0.970) and morbidity rates (no PCI, 7.4%; previous PCI, 7.2%; p = 0.436) were similar between the two groups. In risk-adjusted multivariate logistic-regression analysis, previous PCI (odds ratio [OR], 1.00; 95% confidence interval [CI], 0.82 to 1.22; p = 0.995) and morbidity (OR, 0.97; 95% CI, 0.89 to 1.05; p = 0.391) were not significant risk factors of operative mortality. Inverse probability of treatment weighting using the propensity score confirmed these results.
  
  
  CONCLUSIONS
  This study shows that a previous PCI procedure does not increase postoperative adverse events after subsequent CABG. In the setting of repeat coronary revascularization, the most appropriate method of revascularization should be selected by the heart team, without being affected by a history of a previous PCI procedure.
authors.affiliation: Department of Cardiovascular Surgery, Shizuoka General Hospital, Shizuoka, Japan; Japan Cardiovascular Surgery Database Organization, Tokyo, Japan. Electronic address: uekichikara@gmail.com.
authors.forename: Chikara
authors.initials: C
authors.lastname: Ueki
authors.affiliation: Japan Cardiovascular Surgery Database Organization, Tokyo, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Miyata
authors.affiliation: Japan Cardiovascular Surgery Database Organization, Tokyo, Japan.
authors.forename: Noboru
authors.initials: N
authors.lastname: Motomura
authors.affiliation: Department of Cardiovascular Surgery, Shizuoka General Hospital, Shizuoka, Japan; Japan Cardiovascular Surgery Database Organization, Tokyo, Japan.
authors.forename: Genichi
authors.initials: G
authors.lastname: Sakaguchi
authors.affiliation: Department of Cardiovascular Surgery, Shizuoka General Hospital, Shizuoka, Japan; Japan Cardiovascular Surgery Database Organization, Tokyo, Japan.
authors.forename: Takehide
authors.initials: T
authors.lastname: Akimoto
authors.affiliation: Japan Cardiovascular Surgery Database Organization, Tokyo, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Takamoto
mesh_terms: D000368:Aged; D001026:Coronary Artery Bypass / Q000379:methods*; D003324:Coronary Artery Disease / Q000401:mortality / Q000601:surgery*; D017558:Elective Surgical Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology*; D057216:Propensity Score; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome