Title:The Prognostic Value of Previous Coronary Stent Implantation in Patients
Undergoing Myocardial Revascularization Surgery
Volume: 21
Issue: 1
Author(s): Jose Manuel Villaescusa-Catalan*, Jorge Rodríguez-Capitán*, Cristina Isabel Sanz-Sánchez, Gemma Sánchez-Espín, José Luis Guerrero-Orriach, Francisco Javier Pavón Morón, Lourdes Fernández-Romero, José María Melero-Tejedor, Miguel Such-Martínez, Carlos Porras-Martín and Manuel Jiménez-Navarro
Affiliation:
- Unidad de Gestión Clínica de Cardiología y Cirugía Cardiovascular, Hospital Universitario Virgen de la Victoria,
Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
- Centro de Investigación
Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III. Madrid, Spain
- Unidad de Gestión Clínica de Cardiología y Cirugía Cardiovascular, Hospital Universitario Virgen de la Victoria,
Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
- Centro de Investigación
Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III. Madrid, Spain
Keywords:
Coronary artery disease, coronary artery bypass graft, revascularisation, stent implantation, survival analysis, percutaneous coronary intervention.
Abstract:
Background: Currently, studies are underway to determine whether coronary stent implantation
with percutaneous transluminal coronary angioplasty before a coronary artery bypass graft (CABG)
influences the prognosis of surgery. This study aimed to assess the need for future revascularisation or
all-cause mortality as a composite endpoint after CABG surgery among patients with previous stent
implantation.
Methods: A retrospective, non-randomised study was performed on 721 patients who underwent
CABGin our centre between 2012 and 2017. This single-centre study compared two groups: 1) the previous
stent group, patients with previous stent implantation (n=144), and 2) the non-previous stent
group, patients without previous stent implantation (n=577).
Results: After a median follow-up of 36 months, the previous stent group presented a decreased combined
event-free survival at 1, 3 and 5 years compared with the non-previous stent group (67.4, 43.5 and
23.0% vs. 91.0, 80.3 and 63.0%, respectively; p<0.01). There was also higher mortality in the previous
stent group than in the non-previous stent group (96.1, 90.5 and 79.4 vs. 91.9, 75.9 and 51.0, respectively;
p=0.01). The multivariable analysis of demographics, baseline comorbidity and surgical data showed
previous stent implantation as an independent predictor of the composite endpoint (Hazard Ratio=3.00
and 95% confident interval=2.09-4.32; p<0.01).
Conclusion: Patients with percutaneous coronary intervention before CABG present higher comorbidities
and clinical events during follow-up than those who do not undergo stenting.
