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Initial clinical impact of drug eluting stents on coronary artery bypass graft surgery

Department of Thoracic and Cardiovascular Surgery, Anjo Kosei Hospital, 28 Higashihirokute, Anjo-cho, Anjo, Aichi, 446-8602, Japan

*Corresponding author. Tel: +81-88-837-3000; fax: +81-88-837-6766.

E-mail address: skanemitsu70{at}yahoo.co.jp (S. Kanemitsu).

Drug eluting stents (DESs) reduce the incidence of restenosis after percutaneous coronary intervention (PCI) and have been predicted to decrease the number of patients referred for coronary artery bypass grafting (CABG). We studied about the impact of DESs on CABG. We compared our isolated CABG patients over two years (May 2002–April 2004) before the introduction of DESs (non DES term) with those over the two years (May 2004–April 2006) after the implementation of DESs (DES term). We studied a total of 136 CABG cases in the non DES term and 138 CABG cases in the DES term. In the non DES term, of 3650 coronary angiographies (CAGs), 794 (21.8%) underwent PCI, and 65 (1.9%) underwent CABG. In the DES term, of 4003 CAG, 1091 (27.3%) underwent PCI, and 70 (1.7%) underwent CABG. Among CABG patients, there was no significant difference in the age, sex, and ejection fraction. Patients in the DES term were more likely to have severe diabetes and severe renal failure. The clinical introduction of DESs was associated with a modest decrease in the percentage of CAG patients referred for CABG. Moreover, preoperative conditions have become more serious.

Key Words: Coronary artery bypass; Off-pump; Drug eluting stent; Angioplasty