Percutaneous coronary intervention in native arteries versus bypass grafts in prior coronary artery bypass grafting patients: A report from the national cardiovascular data registry

Emmanouil S. Brilakis, Sunil V. Rao, Subhash Banerjee, Steven Goldman, Kendrick A. Shunk, David R. Holmes, Emily Honeycutt, Matthew T. Roe

Research output: Contribution to journalArticle

90 Citations (Scopus)

Abstract

Objectives: This study examined a large registry to determine the frequency, predictors, and outcomes of native coronary artery versus bypass graft percutaneous coronary intervention (PCI) in patients with prior coronary artery bypass graft surgery (CABG). Background: The PCI target vessel and corresponding outcomes in prior CABG patients are poorly studied. Methods: We analyzed the frequency and factors associated with native versus bypass graft PCI in prior CABG patients undergoing PCI between January 1, 2004, and June 30, 2009, in the National Cardiovascular Data Registry (NCDR) CathPCI Registry. Generalized estimating equations logistic regression modeling was used to generate independent variables associated with native versus bypass graft PCI and in-hospital mortality. Results: During the study period, PCI in prior CABG patients represented 17.5% of the total PCI volume (300,902 of 1,721,046). The PCI target was a native coronary artery in 62.5% and a bypass graft in 37.5%: saphenous vein graft (SVG) (104,678 [34.9%]), arterial graft (7,517 [2.5%]), or both arterial graft and SVG (718 [0.2%]). Compared with patients undergoing native coronary artery PCI, those undergoing bypass graft PCI had higher-risk characteristics and more procedural complications. On multivariable analysis, several parameters (including graft stenosis and longer interval from CABG) were associated with performing native coronary PCI, and bypass graft PCI was associated with higher in-hospital mortality (adjusted odds ratio: 1.22, 95% confidence interval: 1.12 to 1.32). Conclusions: Most PCIs performed in prior CABG patients are done in native coronary artery lesions. Compared with native coronary PCI, bypass graft PCI is independently associated with higher in-hospital mortality.

Original languageEnglish (US)
Pages (from-to)844-850
Number of pages7
JournalJACC: Cardiovascular Interventions
Volume4
Issue number8
DOIs
StatePublished - Aug 2011

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Percutaneous Coronary Intervention
Coronary Artery Bypass
Registries
Arteries
Transplants
Hospital Mortality
Coronary Vessels
Saphenous Vein

Keywords

  • bypass graft
  • coronary bypass graft surgery
  • percutaneous coronary intervention

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Percutaneous coronary intervention in native arteries versus bypass grafts in prior coronary artery bypass grafting patients : A report from the national cardiovascular data registry. / Brilakis, Emmanouil S.; Rao, Sunil V.; Banerjee, Subhash; Goldman, Steven; Shunk, Kendrick A.; Holmes, David R.; Honeycutt, Emily; Roe, Matthew T.

In: JACC: Cardiovascular Interventions, Vol. 4, No. 8, 08.2011, p. 844-850.

Research output: Contribution to journalArticle

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abstract = "Objectives: This study examined a large registry to determine the frequency, predictors, and outcomes of native coronary artery versus bypass graft percutaneous coronary intervention (PCI) in patients with prior coronary artery bypass graft surgery (CABG). Background: The PCI target vessel and corresponding outcomes in prior CABG patients are poorly studied. Methods: We analyzed the frequency and factors associated with native versus bypass graft PCI in prior CABG patients undergoing PCI between January 1, 2004, and June 30, 2009, in the National Cardiovascular Data Registry (NCDR) CathPCI Registry. Generalized estimating equations logistic regression modeling was used to generate independent variables associated with native versus bypass graft PCI and in-hospital mortality. Results: During the study period, PCI in prior CABG patients represented 17.5{\%} of the total PCI volume (300,902 of 1,721,046). The PCI target was a native coronary artery in 62.5{\%} and a bypass graft in 37.5{\%}: saphenous vein graft (SVG) (104,678 [34.9{\%}]), arterial graft (7,517 [2.5{\%}]), or both arterial graft and SVG (718 [0.2{\%}]). Compared with patients undergoing native coronary artery PCI, those undergoing bypass graft PCI had higher-risk characteristics and more procedural complications. On multivariable analysis, several parameters (including graft stenosis and longer interval from CABG) were associated with performing native coronary PCI, and bypass graft PCI was associated with higher in-hospital mortality (adjusted odds ratio: 1.22, 95{\%} confidence interval: 1.12 to 1.32). Conclusions: Most PCIs performed in prior CABG patients are done in native coronary artery lesions. Compared with native coronary PCI, bypass graft PCI is independently associated with higher in-hospital mortality.",
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T1 - Percutaneous coronary intervention in native arteries versus bypass grafts in prior coronary artery bypass grafting patients

T2 - A report from the national cardiovascular data registry

AU - Brilakis, Emmanouil S.

AU - Rao, Sunil V.

AU - Banerjee, Subhash

AU - Goldman, Steven

AU - Shunk, Kendrick A.

AU - Holmes, David R.

AU - Honeycutt, Emily

AU - Roe, Matthew T.

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N2 - Objectives: This study examined a large registry to determine the frequency, predictors, and outcomes of native coronary artery versus bypass graft percutaneous coronary intervention (PCI) in patients with prior coronary artery bypass graft surgery (CABG). Background: The PCI target vessel and corresponding outcomes in prior CABG patients are poorly studied. Methods: We analyzed the frequency and factors associated with native versus bypass graft PCI in prior CABG patients undergoing PCI between January 1, 2004, and June 30, 2009, in the National Cardiovascular Data Registry (NCDR) CathPCI Registry. Generalized estimating equations logistic regression modeling was used to generate independent variables associated with native versus bypass graft PCI and in-hospital mortality. Results: During the study period, PCI in prior CABG patients represented 17.5% of the total PCI volume (300,902 of 1,721,046). The PCI target was a native coronary artery in 62.5% and a bypass graft in 37.5%: saphenous vein graft (SVG) (104,678 [34.9%]), arterial graft (7,517 [2.5%]), or both arterial graft and SVG (718 [0.2%]). Compared with patients undergoing native coronary artery PCI, those undergoing bypass graft PCI had higher-risk characteristics and more procedural complications. On multivariable analysis, several parameters (including graft stenosis and longer interval from CABG) were associated with performing native coronary PCI, and bypass graft PCI was associated with higher in-hospital mortality (adjusted odds ratio: 1.22, 95% confidence interval: 1.12 to 1.32). Conclusions: Most PCIs performed in prior CABG patients are done in native coronary artery lesions. Compared with native coronary PCI, bypass graft PCI is independently associated with higher in-hospital mortality.

AB - Objectives: This study examined a large registry to determine the frequency, predictors, and outcomes of native coronary artery versus bypass graft percutaneous coronary intervention (PCI) in patients with prior coronary artery bypass graft surgery (CABG). Background: The PCI target vessel and corresponding outcomes in prior CABG patients are poorly studied. Methods: We analyzed the frequency and factors associated with native versus bypass graft PCI in prior CABG patients undergoing PCI between January 1, 2004, and June 30, 2009, in the National Cardiovascular Data Registry (NCDR) CathPCI Registry. Generalized estimating equations logistic regression modeling was used to generate independent variables associated with native versus bypass graft PCI and in-hospital mortality. Results: During the study period, PCI in prior CABG patients represented 17.5% of the total PCI volume (300,902 of 1,721,046). The PCI target was a native coronary artery in 62.5% and a bypass graft in 37.5%: saphenous vein graft (SVG) (104,678 [34.9%]), arterial graft (7,517 [2.5%]), or both arterial graft and SVG (718 [0.2%]). Compared with patients undergoing native coronary artery PCI, those undergoing bypass graft PCI had higher-risk characteristics and more procedural complications. On multivariable analysis, several parameters (including graft stenosis and longer interval from CABG) were associated with performing native coronary PCI, and bypass graft PCI was associated with higher in-hospital mortality (adjusted odds ratio: 1.22, 95% confidence interval: 1.12 to 1.32). Conclusions: Most PCIs performed in prior CABG patients are done in native coronary artery lesions. Compared with native coronary PCI, bypass graft PCI is independently associated with higher in-hospital mortality.

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