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Current Vascular Pharmacology

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ISSN (Print): 1570-1611
ISSN (Online): 1875-6212

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Cross-Sectional Study

The Prognostic Value of Previous Coronary Stent Implantation in Patients Undergoing Myocardial Revascularization Surgery

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

Volume 21, Issue 1, 2023

Published on: 02 November, 2022

Page: [59 - 68] Pages: 10

DOI: 10.2174/1570161120666220926102044

Price: $65

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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.

Keywords: Coronary artery disease, coronary artery bypass graft, revascularisation, stent implantation, survival analysis, percutaneous coronary intervention.

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