TY - JOUR
T1 - Impact of prior coronary artery bypass graft surgery on chronic total occlusion revascularisation
T2 - Insights from a multicentre US registry
AU - Michael, Tesfaldet T.
AU - Karmpaliotis, Dimitri
AU - Brilakis, Emmanouil S.
AU - Abdullah, Shuaib M.
AU - Kirkland, Ben L.
AU - Mishoe, Katrina L.
AU - Lembo, Nicholas
AU - Kalynych, Anna
AU - Carlson, Harold
AU - Banerjee, Subhash
AU - Lombardi, William
AU - Kandzari, David E.
PY - 2013/10
Y1 - 2013/10
N2 - Objective To investigate the impact of prior coronary artery bypass graft (CABG) surgery on the outcomes of percutaneous coronary intervention (PCI) for chronic total occlusions (CTO). Design Observational retrospective study. Setting Three tertiary hospitals in the USA. Participants 1363 consecutive patients who underwent CTO PCI between 2006 and 2011. Main outcome measures Procedural success and inhospital complications, which were compared between patients with and without prior CABG. Results Compared to patients without prior CABG, those with prior CABG were older, had more comorbidities, were treated more frequently with the retrograde approach (46.7% vs 27.1%, p<0.001) and had lower technical success rates (79.7% vs 88.3%, p=0.015). Of the 24 (1.8%) major inhospital complications, 11 occurred in patients with prior CABG and 13 in patients without prior CABG (2.1% vs 1.5%, p=0.392). In multivariable analysis prior CABG was independently associated with lower technical success rate (OR 0.49, 95% CIs 0.35 to 0.70, p<0.001). Conclusions In a large multicentre registry, CTO PCI was frequently performed among patients with prior CABG, with higher use of the retrograde approach and similar complications but lower technical success rates compared to patients without prior CABG.
AB - Objective To investigate the impact of prior coronary artery bypass graft (CABG) surgery on the outcomes of percutaneous coronary intervention (PCI) for chronic total occlusions (CTO). Design Observational retrospective study. Setting Three tertiary hospitals in the USA. Participants 1363 consecutive patients who underwent CTO PCI between 2006 and 2011. Main outcome measures Procedural success and inhospital complications, which were compared between patients with and without prior CABG. Results Compared to patients without prior CABG, those with prior CABG were older, had more comorbidities, were treated more frequently with the retrograde approach (46.7% vs 27.1%, p<0.001) and had lower technical success rates (79.7% vs 88.3%, p=0.015). Of the 24 (1.8%) major inhospital complications, 11 occurred in patients with prior CABG and 13 in patients without prior CABG (2.1% vs 1.5%, p=0.392). In multivariable analysis prior CABG was independently associated with lower technical success rate (OR 0.49, 95% CIs 0.35 to 0.70, p<0.001). Conclusions In a large multicentre registry, CTO PCI was frequently performed among patients with prior CABG, with higher use of the retrograde approach and similar complications but lower technical success rates compared to patients without prior CABG.
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U2 - 10.1136/heartjnl-2013-303763
DO - 10.1136/heartjnl-2013-303763
M3 - Article
C2 - 23598543
AN - SCOPUS:84884540683
SN - 1355-6037
VL - 99
SP - 1515
EP - 1518
JO - Heart
JF - Heart
IS - 20
ER -