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Risk of coronary surgery for hospital and early morbidity and mortality after initially successful percutaneous intervention

¹ Department of Cardiology, University Medical Center Nijmegen, St Radboud, The Netherlands
² Department of Thoracic and Cardiac Surgery, University Medical Center Nijmegen, St Radboud, The Netherlands

*Corresponding author: Department of Thoracic and Cardiac Surgery, University Medical Center Nijmegen, St Radboud, PO Box 9101, 6500 HB Nijmegen, The Netherlands. Tel.: +31-24-3613711; fax: +31-24-3540129 .

E-mail address: l.noyez{at}thorax.umcn.nl (L. Noyez).

This study examines the influence of a successful PCI upon preoperative patient profile, peroperative management and postoperative, including one-year follow-up, results. From January 1999 through December 2001, 1141 patients (91%) underwent coronary artery bypass grafting (CABG) as the primary intervention for myocardial revascularization (group A) and 113 patients (9%) underwent primary CABG after an initially successful PCI (group B). Patients undergoing CABG after a failed PCI were not included. Patients in group B were statistically significant younger (P=0.010), with more peripheral arterial vascular (P=0.015) and renal disease (P=0.036). Left main coronary artery stenosis was significantly lower in group B (P=0.004). The number of diseased vessels did not differ between the two groups. However, less distal anastomoses were performed in group B (P=0.001). Postoperatively there was no statistically significant differences, in the percentages of myocardial infarction, arrhythmias, reinterventions, neurological, renal and pulmonary complications, and hospital mortality. One-year follow-up did not show any statistically significant differences in cardiac related mortality (P=0.25) or recurrent ischemic events (P=0.27). Multivariate analysis did not identify a successful PCI as a risk factor for early and late adverse outcomes. Previous PCI does not seem to result in a higher postoperative mortality or morbidity after CABG.

Key Words: Myocardial revascularization; Percutaneous intervention; Mortality; Morbidity; Coronary

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