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document
Percutaneous coronary intervention in patients with previous coronary artery bypass grafting ( from the j-Cypher Registry ) . A paucity of data is available from large-scale studies evaluating the long-term outcomes of percutaneous coronary intervention in patients who had previously undergone coronary artery bypass grafting ( CABG ) in the drug-eluting stent era . Of 12,812 patients who had undergone sirolimus-eluting stent implantation in the j-Cypher registry , 919 ( 7.2 % ) had a history of CABG and had significantly higher crude 5-year mortality ( 19.9 % vs 14.0 % , p < 0.001 ) . After adjusting for confounders , the excess risk of death was no longer significant ( hazard ratio 0.99 , 95 % confidence interval 0.83 to 1.18 , p = 0.90 ) , and the adjusted risk of target lesion revascularization was significantly higher in patients with previous CABG than in those without ( hazard ratio 1.25 , 95 % confidence interval 1.06 to 1.47 , p = 0.01 ) . Of the patients with previous CABG , those who had undergone ≥1 saphenous vein graft intervention had significantly higher adjusted risks of cardiac death ( hazard ratio 2.21 , 95 % confidence interval 1.26 to 3.76 , p = 0.01 ) , myocardial infarction ( hazard ratio 2.56 , 95 % confidence interval 1.10 to 5.60 , p = 0.03 ) , target lesion revascularization ( hazard ratio 2.65 , 95 % confidence interval 1.82 to 3.81 , p < 0.001 ) , and definite stent thrombosis ( hazard ratio 7.70 , 95 % confidence interval 1.99 to 29.1 , p = 0.004 ) compared with those who underwent percutaneous coronary intervention only for the native coronary artery . In conclusion , the adjusted mortality was similar between patients with and without previous CABG , despite a significantly different risk of target lesion revascularization . Among the patients with previous CABG , those with saphenous vein graft intervention using a first-generation drug-eluting stent had worse clinical outcomes than those with a native coronary artery target only .
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Intervention_Surgical
Percutaneous coronary intervention
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Intervention_Surgical
percutaneous coronary intervention
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Intervention_Surgical
coronary artery bypass grafting ( CABG )
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Outcome_Mortality
crude 5-year mortality