For patients with prior coronary artery bypass grafting and recurrent myocardial ischemia, percutaneous coronary intervention on bypass graft or native coronary artery?—A 5‐year follow‐up cohort study

Abstract

AbstractBackgroundReal‐world data on target vessel of percutaneous coronary intervention (PCI) for patients with prior coronary artery bypass grafting (CABG) was still limited.HypothesisA prospective cohort was examined to determine the frequency and outcomes of native coronary artery PCI versus bypass graft PCI in patients with prior CABG.MethodsA large‐sample observational study enrolled a total of 10 724 patients with coronary artery disease (CAD) underwent PCI in 2013. Two‐ and five‐year clinical outcomes were compared between graft PCI group and native artery PCI group in patients with prior CABG.ResultsA total of 438 cases had CABG history in the total cohort. Graft PCI group and native artery PCI group accounted for 13.7% and 86.3%, respectively. The rates of 2‐ and 5‐year all‐cause death and major adverse cardiovascular and cerebral events (MACCE) showed no significant difference between the two groups (p > .05). Two‐year revascularization risk was lower in graft PCI group than native artery PCI group (3.3% and 12.4%, p < .05), but 5‐year myocardial infarction (MI) risk was higher (13.3% and 5.0%, p < .05). In multivariate COX regression models, graft PCI group was independently associated with lower 2‐year revascularization risk (hazard ratio [HR]: 0.21; 95% confidence interval [CI]: 0.05–0.88; p = .033), but higher 5‐year MI risk than native artery PCI group (HR: 2.61; 95% CI: 1.03–6.57; p = .042). Five‐year all‐cause death and MACCE risk showed no difference between the two groups in model.ConclusionsIn patients with prior CABG underwent PCI, patients in graft PCI group had higher 5‐year MI risk than patients received native artery PCI. But, 5‐year mortality and MACCE was not significantly different between graft PCI group and native artery PCI group.