Previous percutaneous coronary intervention may increase symptom recurrence and adverse cardiac events following surgical revascularization.

OBJECTIVE

The number of percutaneous coronary interventions (PCI) is increasing. There is limited outcome data on patients with a history of PCI and subsequently required surgical revascularization.

METHODS

Overall 611 patients who survived 30 days after coronary artery bypass graft surgery (CABG) between 2001 and 2005 were evaluated. Mean follow-up was 29.4 +/- 11.3 months and 45% were female. The effect of preoperative PCI as a risk factor for symptom recurrence and adverse cardiovascular events and mortality was determined.

RESULTS

Preoperative PCI was an independent risk factor for symptom recurrence (p<0.0001), combined adverse cardiac events (p<0.0001) and slightly increased overall mortality (p<0.04). Comparison of patients with and without a prior PCI showed that former had significantly worse outcomes compared to the latter. Patients with history of at least one restenosis following a PCI developed significantly more adverse end points (p<0.0001).

CONCLUSION

In this study, patients with previous PCI were more likely to develop symptom recurrence and adverse cardiovascular events following CABG. This difference was more pronounced in patients who had at least one recurrent stenosis after a PCI.