Article Impact Level: HIGH Data Quality: STRONG Summary of Clinical Cardiology, clc.24021. https://doi.org/10.1002/clc.24021 Dr. Ru Liu et al.
Points
- The study investigated the frequency and outcomes of native coronary artery PCI versus bypass graft PCI in patients with prior coronary artery bypass grafting (CABG).
- The study enrolled 10,724 patients with coronary artery disease (CAD) who underwent PCI in 2013, of which 438 patients had a history of CABG.
- The study found that the rates of 2- and 5-year all-cause death and major adverse cardiovascular and cerebral events (MACCE) showed no significant difference between the graft PCI group and the native artery PCI group.
- The study found that the 2-year revascularization risk was lower in the graft PCI group than in the native artery PCI group. However, the 5-year myocardial infarction (MI) risk was higher in the graft PCI group than the native artery PCI group.
- In multivariate COX regression models, the graft PCI group was independently associated with a lower 2-year revascularization risk and a higher 5-year MI risk than the native artery PCI group.
Summary
The study enrolled a total of 10,724 patients with CAD who underwent PCI in 2013. Out of the total cohort, 438 patients had a history of CABG, accounting for 4.1% of the total population. The cohort’s mean age was 62.5 years, and most of the patients were men (70.7%). Among those with a CABG history, the mean age was 68.8 years, and the majority were men (78.1%).
The study also found that the baseline characteristics of patients in the graft PCI group and native artery PCI group were similar, except for the presence of diabetes, which was higher in the graft PCI group (46.5% vs. 38.6%, p < .05). The mean number of grafts per patient was 2.2. The mean time interval between CABG and PCI was 9.3 years.
Regarding clinical outcomes, the study found that the rates of cardiac and non-cardiac deaths were not significantly different between the two groups at both 2- and 5-year follow-ups. The rates of target and non-target vessel revascularization were significantly lower in the graft PCI group at a 2-year follow-up (3.3% vs. 12.4%, p < .05) but not at a 5-year follow-up. The rate of MI was significantly higher in the graft PCI group at 5-year follow-ups (13.3% vs. 5.0%, p < .05). The rate of MACCE was not significantly different between the two groups at both 2- and 5-year follow-ups.
In multivariate COX regression models, the study found that the graft PCI group was independently associated with a lower 2-year revascularization risk (hazard ratio [HR]: 0.21; 95% confidence interval [CI]: 0.05–0.88; p = .033) and a higher 5-year MI risk than the native artery PCI group (HR: 2.61; 95% CI: 1.03–6.57; p = .042).
Link to the article: https://onlinelibrary.wiley.com/doi/full/10.1002/clc.24021
References Liu, R., Liu, H., Yuan, D., Chen, Y., Tang, X., Zhang, C., Zhu, P., Yang, T., Zhang, Y., Li, H., Xu, O., Gao, R., Xu, B., & Yuan, J. (2023). For patients with prior coronary artery bypass grafting and recurrent myocardial ischemia, percutaneous coronary intervention on bypass graft or native coronary artery?—A 5‐year follow‐up cohort study. Clinical Cardiology, clc.24021. https://doi.org/10.1002/clc.24021
