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Even after the introduction of drug–eluting stents, revascularization in patients with prior coronary artery bypass grafting (CABG) was still challenging, and the late clinical outcomes were unknown.
We conducted a secondary analysis of 5–year follow–up data of j–Cypher Registry. Of the 12812 patients (19662 lesions), 919 patients (7.2%) with 1369 lesions (7.0%) had a history of CABG and underwent PCI for lesions in the native vessel (1200 lesions [87.7%]) or the bypass graft (SVG, 144 lesions [10.5%]; and arterial graft [AG], 25 lesions [1.8%]).
Cumulative incidence of death at 5 years was significantly higher in patients with prior CABG than those without prior CABG (19.9% versus 14.0%, p < 0.001), whereas adjusted hazard ratio (HR [95%CI]) was similar (0.95 [0.79–1.14], p = 0.59). Cumulative incidences of target lesion revascularization (TLR) per vessel at 5 years were 41.9% in SVG, 21.5% in AG, 16.8% in native vessel in patients with prior CABG, and 13.2% in those without prior CABG, respectively (p < 0.001). Adjusted hazard ratios (95%CI) regarding TLR for lesions in SVG, AG, and native vessel were 4.51 (3.22–6.13, p< 0.001), 2.32 (0.83–5.02, p = 0.10), and 1.22 (1.02–1.45, p = 0.003), respectively, as compared with those in patients without prior CABG.
Although adjusted mortality was similar between patients with prior CABG and those without CABG, adjusted HR for TLR were significantly higher in SVG lesions and native vessels in patients with prior CABG.
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.–4:30 p.m.
Session Title: Complex Patients, Diabetes and Renal Insufficiency
Abstract Category: 43. TCT@ACC–i2: Complex Patients, Diabetes, Renal Insufficiency
Presentation Number: 2106–228
- 2013 American College of Cardiology Foundation