Prior Percutaneous Coronary Intervention and Mortality in Patients Undergoing Surgical Myocardial Revascularization

Giovanni Mariscalco, Stefano Rosato, Giuseppe F. Serraino, Daniele Maselli, Magnus Dalén, Juhani K.E. Airaksinen, Daniel Reichart, Marco Zanobini, Francesco Onorati, Marisa De Feo, Riccardo Gherli, Giuseppe Santarpino, Antonino S. Rubino, Giuseppe Gatti, Francesco Nicolini, Francesco Santini, Andrea Perrotti, Vito D. Bruno, Vito G. Ruggieri, Fausto Biancari

Research output: Contribution to journalArticle

Abstract

Background - The clinical impact of prior percutaneous coronary intervention (PCI) in patients requiring coronary artery bypass grafting (CABG) remains unsettled. We sought to determine whether prior PCI is associated with adverse outcome after CABG. Methods and Results - Data from the prospective E-CABG (European Multicenter Study on Coronary Artery Bypass Grafting) conducted between January 2015 and March 2016 at 16 European centres were analyzed using propensity weighted methodology to adjust for confounding. A parallel systematic review/meta-analysis (MEDLINE, Embase, SCOPUS, and Cochrane Library) through September 2017 was accomplished. Of a total of 3641 adult patients included in the E-CABG study, 685 (19%) patients had a history of PCI. At multivariable level, prior PCI was not associated with an increased hospital mortality in both unweighted and weighted patient groups (odds ratio, 0.73; 95% confidence interval, 0.29-1.38; P=0.33 and odds ratio, 0.90; 95% confidence interval, 0.39-2.08; P=0.81, respectively). Subgroup analyses confirmed that prior PCI had no impact on hospital mortality and morbidity, including reexploration for bleeding, blood transfusion, hospital resource use, and neurological, renal, and cardiac complications. The systematic review provided a total of 71 366 individuals and showed a trend toward higher in-hospital/30-day mortality (adjusted odds ratio, 1.30; 95% confidence interval, 0.99-1.70; I 2 =43.1%) in patients with prior PCI. Conclusions - Our prospective multicenter study showed that prior PCI was not associated with an increased risk of mortality or other adverse outcomes in patients undergoing CABG. In light of a trend toward increased mortality observed in the meta-analysis, further studies are needed to ascertain the prognostic impact of prior PCI in the outcome after CABG.

Original languageEnglish
Article numbere005650
JournalCirculation: Cardiovascular Interventions
Volume11
Issue number2
DOIs
Publication statusPublished - Feb 1 2018

Fingerprint

Myocardial Revascularization
Percutaneous Coronary Intervention
Coronary Artery Bypass
Mortality
Odds Ratio
Confidence Intervals
Hospital Mortality
Multicenter Studies
Meta-Analysis
MEDLINE
Blood Transfusion
Libraries
Prospective Studies
Hemorrhage
Morbidity
Kidney

Keywords

  • adult
  • coronary artery bypass grafting
  • mortality
  • prior coronary intervention
  • thoracic surgery

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Prior Percutaneous Coronary Intervention and Mortality in Patients Undergoing Surgical Myocardial Revascularization. / Mariscalco, Giovanni; Rosato, Stefano; Serraino, Giuseppe F.; Maselli, Daniele; Dalén, Magnus; Airaksinen, Juhani K.E.; Reichart, Daniel; Zanobini, Marco; Onorati, Francesco; De Feo, Marisa; Gherli, Riccardo; Santarpino, Giuseppe; Rubino, Antonino S.; Gatti, Giuseppe; Nicolini, Francesco; Santini, Francesco; Perrotti, Andrea; Bruno, Vito D.; Ruggieri, Vito G.; Biancari, Fausto.

In: Circulation: Cardiovascular Interventions, Vol. 11, No. 2, e005650, 01.02.2018.

Research output: Contribution to journalArticle

Mariscalco, G, Rosato, S, Serraino, GF, Maselli, D, Dalén, M, Airaksinen, JKE, Reichart, D, Zanobini, M, Onorati, F, De Feo, M, Gherli, R, Santarpino, G, Rubino, AS, Gatti, G, Nicolini, F, Santini, F, Perrotti, A, Bruno, VD, Ruggieri, VG & Biancari, F 2018, 'Prior Percutaneous Coronary Intervention and Mortality in Patients Undergoing Surgical Myocardial Revascularization', Circulation: Cardiovascular Interventions, vol. 11, no. 2, e005650. https://doi.org/10.1161/CIRCINTERVENTIONS.117.005650
Mariscalco, Giovanni ; Rosato, Stefano ; Serraino, Giuseppe F. ; Maselli, Daniele ; Dalén, Magnus ; Airaksinen, Juhani K.E. ; Reichart, Daniel ; Zanobini, Marco ; Onorati, Francesco ; De Feo, Marisa ; Gherli, Riccardo ; Santarpino, Giuseppe ; Rubino, Antonino S. ; Gatti, Giuseppe ; Nicolini, Francesco ; Santini, Francesco ; Perrotti, Andrea ; Bruno, Vito D. ; Ruggieri, Vito G. ; Biancari, Fausto. / Prior Percutaneous Coronary Intervention and Mortality in Patients Undergoing Surgical Myocardial Revascularization. In: Circulation: Cardiovascular Interventions. 2018 ; Vol. 11, No. 2.
@article{b14ad7741b4f46c08bcab392af720c74,
title = "Prior Percutaneous Coronary Intervention and Mortality in Patients Undergoing Surgical Myocardial Revascularization",
abstract = "Background - The clinical impact of prior percutaneous coronary intervention (PCI) in patients requiring coronary artery bypass grafting (CABG) remains unsettled. We sought to determine whether prior PCI is associated with adverse outcome after CABG. Methods and Results - Data from the prospective E-CABG (European Multicenter Study on Coronary Artery Bypass Grafting) conducted between January 2015 and March 2016 at 16 European centres were analyzed using propensity weighted methodology to adjust for confounding. A parallel systematic review/meta-analysis (MEDLINE, Embase, SCOPUS, and Cochrane Library) through September 2017 was accomplished. Of a total of 3641 adult patients included in the E-CABG study, 685 (19{\%}) patients had a history of PCI. At multivariable level, prior PCI was not associated with an increased hospital mortality in both unweighted and weighted patient groups (odds ratio, 0.73; 95{\%} confidence interval, 0.29-1.38; P=0.33 and odds ratio, 0.90; 95{\%} confidence interval, 0.39-2.08; P=0.81, respectively). Subgroup analyses confirmed that prior PCI had no impact on hospital mortality and morbidity, including reexploration for bleeding, blood transfusion, hospital resource use, and neurological, renal, and cardiac complications. The systematic review provided a total of 71 366 individuals and showed a trend toward higher in-hospital/30-day mortality (adjusted odds ratio, 1.30; 95{\%} confidence interval, 0.99-1.70; I 2 =43.1{\%}) in patients with prior PCI. Conclusions - Our prospective multicenter study showed that prior PCI was not associated with an increased risk of mortality or other adverse outcomes in patients undergoing CABG. In light of a trend toward increased mortality observed in the meta-analysis, further studies are needed to ascertain the prognostic impact of prior PCI in the outcome after CABG.",
keywords = "adult, coronary artery bypass grafting, mortality, prior coronary intervention, thoracic surgery",
author = "Giovanni Mariscalco and Stefano Rosato and Serraino, {Giuseppe F.} and Daniele Maselli and Magnus Dal{\'e}n and Airaksinen, {Juhani K.E.} and Daniel Reichart and Marco Zanobini and Francesco Onorati and {De Feo}, Marisa and Riccardo Gherli and Giuseppe Santarpino and Rubino, {Antonino S.} and Giuseppe Gatti and Francesco Nicolini and Francesco Santini and Andrea Perrotti and Bruno, {Vito D.} and Ruggieri, {Vito G.} and Fausto Biancari",
year = "2018",
month = "2",
day = "1",
doi = "10.1161/CIRCINTERVENTIONS.117.005650",
language = "English",
volume = "11",
journal = "Circulation: Cardiovascular Interventions",
issn = "1941-7640",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Prior Percutaneous Coronary Intervention and Mortality in Patients Undergoing Surgical Myocardial Revascularization

AU - Mariscalco, Giovanni

AU - Rosato, Stefano

AU - Serraino, Giuseppe F.

AU - Maselli, Daniele

AU - Dalén, Magnus

AU - Airaksinen, Juhani K.E.

AU - Reichart, Daniel

AU - Zanobini, Marco

AU - Onorati, Francesco

AU - De Feo, Marisa

AU - Gherli, Riccardo

AU - Santarpino, Giuseppe

AU - Rubino, Antonino S.

AU - Gatti, Giuseppe

AU - Nicolini, Francesco

AU - Santini, Francesco

AU - Perrotti, Andrea

AU - Bruno, Vito D.

AU - Ruggieri, Vito G.

AU - Biancari, Fausto

PY - 2018/2/1

Y1 - 2018/2/1

N2 - Background - The clinical impact of prior percutaneous coronary intervention (PCI) in patients requiring coronary artery bypass grafting (CABG) remains unsettled. We sought to determine whether prior PCI is associated with adverse outcome after CABG. Methods and Results - Data from the prospective E-CABG (European Multicenter Study on Coronary Artery Bypass Grafting) conducted between January 2015 and March 2016 at 16 European centres were analyzed using propensity weighted methodology to adjust for confounding. A parallel systematic review/meta-analysis (MEDLINE, Embase, SCOPUS, and Cochrane Library) through September 2017 was accomplished. Of a total of 3641 adult patients included in the E-CABG study, 685 (19%) patients had a history of PCI. At multivariable level, prior PCI was not associated with an increased hospital mortality in both unweighted and weighted patient groups (odds ratio, 0.73; 95% confidence interval, 0.29-1.38; P=0.33 and odds ratio, 0.90; 95% confidence interval, 0.39-2.08; P=0.81, respectively). Subgroup analyses confirmed that prior PCI had no impact on hospital mortality and morbidity, including reexploration for bleeding, blood transfusion, hospital resource use, and neurological, renal, and cardiac complications. The systematic review provided a total of 71 366 individuals and showed a trend toward higher in-hospital/30-day mortality (adjusted odds ratio, 1.30; 95% confidence interval, 0.99-1.70; I 2 =43.1%) in patients with prior PCI. Conclusions - Our prospective multicenter study showed that prior PCI was not associated with an increased risk of mortality or other adverse outcomes in patients undergoing CABG. In light of a trend toward increased mortality observed in the meta-analysis, further studies are needed to ascertain the prognostic impact of prior PCI in the outcome after CABG.

AB - Background - The clinical impact of prior percutaneous coronary intervention (PCI) in patients requiring coronary artery bypass grafting (CABG) remains unsettled. We sought to determine whether prior PCI is associated with adverse outcome after CABG. Methods and Results - Data from the prospective E-CABG (European Multicenter Study on Coronary Artery Bypass Grafting) conducted between January 2015 and March 2016 at 16 European centres were analyzed using propensity weighted methodology to adjust for confounding. A parallel systematic review/meta-analysis (MEDLINE, Embase, SCOPUS, and Cochrane Library) through September 2017 was accomplished. Of a total of 3641 adult patients included in the E-CABG study, 685 (19%) patients had a history of PCI. At multivariable level, prior PCI was not associated with an increased hospital mortality in both unweighted and weighted patient groups (odds ratio, 0.73; 95% confidence interval, 0.29-1.38; P=0.33 and odds ratio, 0.90; 95% confidence interval, 0.39-2.08; P=0.81, respectively). Subgroup analyses confirmed that prior PCI had no impact on hospital mortality and morbidity, including reexploration for bleeding, blood transfusion, hospital resource use, and neurological, renal, and cardiac complications. The systematic review provided a total of 71 366 individuals and showed a trend toward higher in-hospital/30-day mortality (adjusted odds ratio, 1.30; 95% confidence interval, 0.99-1.70; I 2 =43.1%) in patients with prior PCI. Conclusions - Our prospective multicenter study showed that prior PCI was not associated with an increased risk of mortality or other adverse outcomes in patients undergoing CABG. In light of a trend toward increased mortality observed in the meta-analysis, further studies are needed to ascertain the prognostic impact of prior PCI in the outcome after CABG.

KW - adult

KW - coronary artery bypass grafting

KW - mortality

KW - prior coronary intervention

KW - thoracic surgery

UR - http://www.scopus.com/inward/record.url?scp=85047191407&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85047191407&partnerID=8YFLogxK

U2 - 10.1161/CIRCINTERVENTIONS.117.005650

DO - 10.1161/CIRCINTERVENTIONS.117.005650

M3 - Article

AN - SCOPUS:85047191407

VL - 11

JO - Circulation: Cardiovascular Interventions

JF - Circulation: Cardiovascular Interventions

SN - 1941-7640

IS - 2

M1 - e005650

ER -