University of Oulu

Biancari F, Salsano A, Santini F, De Feo M, Dalén M, Zhang Q, Gatti G, Mazzaro E, Franzese I, Bancone C, et al. Late Myocardial Infarction and Repeat Revascularization after Coronary Artery Bypass Grafting in Patients with Prior Percutaneous Coronary Intervention. Journal of Clinical Medicine. 2022; 11(19):5755.

Late myocardial infarction and repeat revascularization after coronary artery bypass grafting in patients with prior percutaneous coronary intervention

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Author: Biancari, Fausto1,2,3; Salsano, Antonio4; Santini, Francesco4;
Organizations: 1Heart and Lung Center, Helsinki University Hospital, University of Helsinki, 00029 Helsinki, Finland
2Department of Medicine, South Karelia Central Hospital, University of Helsinki, 53130 Lappeenranta, Finland
3Department of Surgery, Oulu University Hospital, University of Oulu, 90570 Oulu, Finland
4Division of Cardiac Surgery, Ospedale Policlinico San Marino, University of Genoa, 16126 Genoa, Italy
5Department of Cardiothoracic Sciences, Monaldi Hospital, University of Campania “Luigi Vanvitelli”, 81100 Naples, Italy
6Department of Cardiac Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, 171 64 Solna, Stockholm, Sweden
7Division of Cardiac Surgery, Cardio-Thoracic and Vascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, 34148 Trieste, Italy
8Cardiovascular Department, IRCCS Centro Cardiologico Monzino, 20138 Milan, Italy
9Cardiac Surgery Unit, Poliambulanza Foundation, 25214 Brescia, Italy
10Division of Cardiac Surgery, University of Verona Medical School, 37129 Verona, Italy
11Istituto Superiore di Sanitá, 00161 Rome, Italy
12Department of Cardiovascular Sciences, Clinical Sciences Wing, Glenfield Hospital, University of Leicester, Leicester LE3 9QP, UK
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.7 MB)
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Language: English
Published: Multidisciplinary Digital Publishing Institute, 2022
Publish Date: 2023-06-30


Objectives: The aim of the present study was to evaluate the risk of late mortality and major adverse cardiovascular and cerebral events after coronary artery bypass grafting (CABG) in patients with prior percutaneous coronary intervention (PCI).

Methods: A total of 2948 patients undergoing isolated CABGs were included in a prospective multicenter registry. Outcomes were adjusted for multiple covariates in logistic regression, Cox proportional hazards analysis and competing risk analysis.

Results: In all, 2619 patients fulfilled the inclusion criteria of this analysis. Of them, 2199 (79.1%) had no history of PCI and 420 (20.9%) had a prior PCI. An adjusted analysis showed that a single prior PCI and multiple prior PCIs did not increase the risk of 30-day and 5-year mortality. Patients with multiple prior PCIs had a significantly higher risk of 5-year myocardial infarction (SHR 2.566, 95%CI 1.379–4.312) and repeat revascularization (SHR 1.774, 95%CI 1.140–2.763). Similarly, 30-day and 5-year mortality were not significantly increased in patients with prior PCI treatment of single or multiple vessels. Patients with multiple vessels treated with PCI had a significantly higher risk of 5-year myocardial infarction (SHR 2.640, 95%CI 1.497–4.658), repeat revascularization (SHR 1.648, 95%CI 1.029–2.638) and stroke (SHR 2.215, 95%CI 1.056–4.646) at 5-year. The risk for repeat revascularization was also increased with a prior single vessel PCI, but not for other outcomes.

Conclusions: Among patients undergoing CABGs, multiple prior PCIs seem to increase the risk of late myocardial infarction and the need for repeat revascularization, but not the risk of mortality.

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Series: Journal of clinical medicine
ISSN: 2077-0383
ISSN-E: 2077-0383
ISSN-L: 2077-0383
Volume: 11
Issue: 19
Article number: 5755
DOI: 10.3390/jcm11195755
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Copyright information: © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (