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Outcomes Following Primary Percutaneous Coronary Intervention in Patients With Previous Coronary Artery Bypass Surgery

Lookup NU author(s): Dr Mark De Belder, Professor Azfar Zaman


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Background-There are limited data on outcomes of patients with previous coronary artery bypass grafting (CABG) presenting with ST-segment-elevation myocardial infarction (STEMI) and undergoing primary percutaneous coronary intervention (PPCI). We report outcomes in patients with STEMI undergoing PPCI with or without previous CABG surgery in a large real-world, all-comer population.Methods and Results-Clinical, demographic, procedural, and outcomes data were collected for all patients undergoing PPCI in England and Wales from January 2007 to December 2012. All-cause mortality at 30 days and 1 year were evaluated in the whole and a propensity-matched cohort. Of 79295 patients with STEMI studied, 2658 (3.4%) patients had prior CABG, of whom 44% (n=1168) underwent PPCI to native vessels and 56% (n=1490) to bypass grafts. There were significant differences in the demographic, clinical, and procedural characteristics of these groups. Patients with prior CABG (with primary PCI to native artery or graft) had higher mortality at 30 days (6.2% with PPCI to native artery, 6.1% with PPCI to bypass graft) than patients with no prior CABG (4.5%; P<0.001). However, after risk factor adjustments, there was no significant difference in outcomes. There were also no significant differences in 30-day mortality, in-hospital major adverse cardiovascular events, in-hospital stroke, and in-hospital bleeding in the propensity-matched population.Conclusions-A prior history of CABG in patients presenting with STEMI and undergoing PPCI does not independently confer additional risk of mortality, although it is a marker of other high-risk features.

Publication metadata

Author(s): Iqbal J, Kwok CS, Kontopantelis E, de Belder MA, Ludman PF, Giannoudi M, Gunning M, Zaman A, Mamas MA, British Cardiovascular Interventio, Natl Inst Cardiovascular Outcomes

Publication type: Article

Publication status: Published

Journal: Circulation: Cardiovascular Interventions

Year: 2016

Volume: 9

Issue: 4

Print publication date: 01/04/2016

Acceptance date: 26/02/2016

ISSN (print): 1941-7640

ISSN (electronic): 1941-7632

Publisher: Lippincott Williams & Wilkins, Ltd.


DOI: 10.1161/CIRCINTERVENTIONS.115.003151


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