Abstract 1847: Prognostic Impact Of Previous Percutaneous Coronary Interventions On Coronary Artery Bypass Graft Surgery: A Multicentric Analysis FromThe German Federal State North-Rhine-Westphalia

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Titel: Abstract 1847: Prognostic Impact Of Previous Percutaneous Coronary Interventions On Coronary Artery Bypass Graft Surgery: A Multicentric Analysis FromThe German Federal State North-Rhine-Westphalia
Beteiligte: Massoudy, Parwis; Thielmann, Matthias; Lehmann, Nils; Marr, Anja; Kleikamp, Georg; Maleszka, Ariane; Zittermann, Armin; Körfer, Reiner; Radu, Miriam; Krian, Arno; Litmathe, Jens; Gams, Emmeran; Sezer, Ömer; Scheld, Hans; Schiller, Wolfgang; Welz, Armin; Dohmen, Guido; Autschbach, Rüdiger; Slottosch, Ingo; Wahlers, Thorsten; Neuhäuser, Markus; Remagen, Rhein Ahr Campus; Jöckel, Karl-Heinz; Jakob, Heinz
Erschienen: Ovid Technologies (Wolters Kluwer Health), 2007
Erschienen in: Circulation
Sprache: Englisch
DOI: 10.1161/circ.116.suppl_16.ii_395
ISSN: 0009-7322; 1524-4539
Schlagwörter: Physiology (medical) ; Cardiology and Cardiovascular Medicine
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Beschreibung: <jats:p> <jats:bold> <jats:italic>Background:</jats:italic> </jats:bold> We have previously shown that multiple prior percutaneous coronary intervention (PCI) procedures adversely affect outcome after subsequent coronary artery bypass grafting (CABG). We were now interested to investigate this effect on a multicentric basis. </jats:p> <jats:p> <jats:bold> <jats:italic>Methods:</jats:italic> </jats:bold> Eight cardiac surgical centers from the German Federal State of North-Rhine-Westphalia provided outcome data of 37140 consecutive patients having undergone isolated first-time CABG between 01/2000 and 12/2005. Twenty-two patient characteristics and outcome variables, which are part of a collection of data claimed by the national medical quality-control commission, were retrieved from the individual databases. Three groups of patients were analyzed for overall in-hospital mortality and major adverse cardiac events (MACE): Patients without a previous PCI procedure, patients with 1 previous PCI procedure and patients with ≥2 previous PCI procedures before surgery. Unadjusted univariable and risk-adjusted multivariable logistic regression analysis were applied. Computed propensity-score matching was performed based on 15 patient major risk factors to correct for and minimize selection bias. </jats:p> <jats:p> <jats:bold> <jats:italic>Results:</jats:italic> </jats:bold> A total of 10.3% of patients had 1 previous PCI procedure, and 3.7% of patients had ≥2 previous PCI procedures. Risk-adjusted multivariable logistic regression analysis of ≥2 previous PCI significantly correlated with in-hospital mortality (odds ratio [OR], 2.0; confidence interval [CI], 1.4–3.0; <jats:italic>P</jats:italic> <0.0005) and MACE (OR, 1.5; CI, 1.2–1.9; <jats:italic>P</jats:italic> <0.0013). After propensity score matching, conditional logistic regression analysis confirmed the results of adjusted analysis. A history of ≥2 previous PCI procedures was significantly associated with in-hospital mortality (OR, 1.9; CI, 1.3–2.7; <jats:italic>P</jats:italic> =0.0016) and MACE (OR, 1.5; CI, 1.2–1.9; <jats:italic>P</jats:italic> =0.0019). </jats:p> <jats:p> <jats:bold> <jats:italic>Conclusions:</jats:italic> </jats:bold> This large multicentric trial supports earlier results of our single-center analysis, multiple previous PCI procedures significantly increased the event of in-hospital mortality and MACE after subsequent CABG. </jats:p>
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