0 14

Cited 0 times in

Repeated Target Vessel Revascularization After Coronary Artery Bypass for In-Stent Restenosis

Authors
 Jung-Hwan Kim  ;  Seung Hyun Lee  ;  Hyun-Chel Joo  ;  Kyung-Jong Yoo  ;  Young-Nam Youn 
Citation
 Annals of Thoracic Surgery, Vol.104(4) : 1332-1339, 2017 
Journal Title
 Annals of Thoracic Surgery 
ISSN
 0003-4975 
Issue Date
2017
MeSH
Aged ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/etiology* ; Coronary Artery Bypass, Off-Pump/adverse effects* ; Coronary Artery Bypass, Off-Pump/mortality ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Percutaneous Coronary Intervention*/adverse effects ; Propensity Score ; Retreatment ; Stents* ; Survival Rate ; Treatment Outcome
Abstract
BACKGROUND: The purpose of this study was to examine the impact of previous percutaneous coronary intervention with stent on long-term outcomes after off-pump coronary artery bypass grafting (OPCAB). METHODS: Between January 2001 and December 2014, 1,668 patients with triple-vessel disease undergoing OPCAB were reviewed and divided into 2 groups. The no-stent group (n = 1,409) included patients who underwent OPCAB as a primary revascularization procedure and the stent group (n = 259) included patients with a history of percutaneous coronary intervention with stent. The mean follow-up duration was 5.32 ± 3.39 years. RESULTS: After propensity score matching, characteristics of both groups were comparable (n = 259 in each group). In-hospital mortality (n = 3 [1.2%] in both groups; p > 0.999) was similar. The 14-year overall survival rate (75.6% ± 6.6% in the no-stent group versus 71.9% ± 8.5% in the stent group; p = 0.917) and freedom from major adverse cardiac and cerebrovascular events (MACCEs) rate (68.3% ± 6.6% versus 54.6% ± 8.5%; p = 0.239) were also similar. However, freedom from target vessel revascularization (TVR) rate at 14 years was significantly higher in the no-stent group (97.2% ± 1.7% versus 76.9% ± 6.5%; p < 0.001). The independent risk factor for late TVR was in-stent restenosis (hazard ratio, 3.355; 95% confidence interval, 1.925 to 5.848; p < 0.001) and it also was a risk factor for MACCEs (hazard ratio, 1.645; 95% CI, 1.105 to 2.448; p = 0.014). CONCLUSIONS: Previous intracoronary stenting does not increase long-term mortality, but grafting to previously stented target vessels with in-stent restenosis increases the risk of repeat TVR and MACCEs.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/161017
DOI
10.1016/j.athoracsur.2017.03.034
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실)
Yonsei Authors
김정환(Kim, Jung Hwan) ; 유경종(Yoo, Kyung Jong) ; 윤영남(Youn, Young Nam) ; 이승현(Lee, Seung Hyun) ; 주현철(Joo, Hyun Chel)
사서에게 알리기
  feedback
Full Text
https://www.sciencedirect.com/science/article/pii/S0003497517304484
Export
RIS (EndNote)
XLS (Excel)
XML

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse