TY - JOUR
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.
N1 - Funding Information:
This research was supported by the American College of Cardiology Foundation's National Cardiovascular Data Registry (NCDR). The views expressed in this manuscript represent those of the author(s), and do not necessarily represent the official views of the NCDR or its associated professional societies identified at http://www.ncdr.com . Dr. Brilakis has received speaker honoraria from St. Jude Medical and Terumo; research support from Abbott Vascular and InfraReDx, and his spouse is an employee of Medtronic. Dr. Rao has received research funding from Cordis Corporation. Dr. Banerjee has received speaker honoraria from St. Jude Medical, Medtronic, and Johnson & Johnson; and research support from Boston Scientific and The Medicines Company. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
PY - 2011/8
Y1 - 2011/8
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.
KW - bypass graft
KW - coronary bypass graft surgery
KW - percutaneous coronary intervention
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U2 - 10.1016/j.jcin.2011.03.018
DO - 10.1016/j.jcin.2011.03.018
M3 - Article
C2 - 21851896
AN - SCOPUS:84860390346
SN - 1936-8798
VL - 4
SP - 844
EP - 850
JO - JACC: Cardiovascular Interventions
JF - JACC: Cardiovascular Interventions
IS - 8
ER -