University of Oulu

Mariscalco, Giovanni, et al. “Prior Percutaneous Coronary Intervention and Mortality in Patients Undergoing Surgical Myocardial Revascularization: Results From the E-CABG (European Multicenter Study on Coronary Artery Bypass Grafting) With a Systematic Review and Meta-Analysis.” Circulation: Cardiovascular Interventions, vol. 11, no. 2, Feb. 2018. (Crossref), doi:10.1161/CIRCINTERVENTIONS.117.005650

Prior percutaneous coronary intervention and mortality in patients undergoing surgical myocardial revascularization results from the E-CABG (European Multicenter Study on Coronary Artery Bypass Grafting) with a systematic review and meta-analysis

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Author: Mariscalco, Giovanni1; Rosato, Stefano2; Serraino, Giuseppe F.1;
Organizations: 1Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Leicester, United Kingdom
2National Center for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, Rome, Italy
3Department of Cardiac Surgery, St. Anna Hospital, Catanzaro, Italy
4Department of Molecular Medicine and Surgery, Department of Cardiothoracic Surgery and Anesthesiology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
5Heart Center, Turku University Hospital, University of Turku, Turku, Finland
6Hamburg University Heart Center, Hamburg, Germany
7Department of Cardiac Surgery, Centro Cardiologico–Fondazione Monzino IRCCS, University of Milan, Italy
8Division of Cardiovascular Surgery, Verona University Hospital, Verona, Italy
9Division of Cardiac Surgery, Department of Cardiothoracic Sciences, Second University of Naples, Naples, Italy
10Department of Cardiovascular Sciences, Cardiac Surgery Unit, S. Camillo-Forlanini Hospital, Rome, Italy
11Cardiovascular Center, Paracelsus Medical University, Nuremberg, Germany
12Centro Clinico-Diagnostico “G.B. Morgagni”, Centro Cuore, Pedara, Italy
13Division of Cardiac Surgery, Ospedali Riuniti, Trieste, Italy
14Division of Cardiac Surgery, University of Parma, Parma, Italy
15Division of Cardiac Surgery, University of Genoa, Genoa, Italy
16Division of Cardiothoracic and Vascular Surgery, Pontchaillou University Hospital, Rennes, France
17Heart Centre, Bristol University, Bristol, United Kingdom
18Department of Thoracic and Cardio-Vascular Surgery, University Hospital Jean Minjoz, Besançon, France
19Department of Surgery, Oulu University Hospital, Oulu, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.9 MB)
Persistent link:
Language: English
Published: Wolters Kluwer, 2018
Publish Date: 2019-10-15


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; I²=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.

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Series: Circulation. Cardiovascular interventions
ISSN: 1941-7640
ISSN-E: 1941-7632
ISSN-L: 1941-7640
Volume: 11
Issue: 2
Article number: e005650
DOI: 10.1161/CIRCINTERVENTIONS.117.005650
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
Copyright information: © 2018 American Heart Association, Inc. The Definitive Version of Record can be found online at: