PROGNOSTIC IMPACT OF PREVIOUS STENTING ON OUTCOME OF CORONARY ARTERY BYPASS GRAFTING IN MULTIVESSEL DISEASE PATIENTS
Mahmoud F. El-Safty and Mohamed A. El-Badawy
National Heart Institute, Giza, Egypt
Background: Patients with prior percutaneous coronary intervention (PCI) are expected to be at greater risk of coronary artery bypass grafting (CABG). Only a few studies are accessible and conflicting, however. Initial PCI can complicate the procedure and may increase postoperative morbidity and mortality, some authors say. No distinction is defined by others. Aim of the work: The aim was to study the prognostic effect of previous stenting in patients with multivessel disease on the outcome of CABG. Patients and Methods: In the period between August 2015 and August 2017, one hundred patients underwent CABG in a prospective comparative study collected at the National Heart Institute. Patients were grouped into two groups: category I: 50 patients with non-stents (non-stent category) and category II: 50 patients with previous stents (stent group). Centered on whether or not they were subjected to previous PCI to discuss the prognostic impact of previous stenting on the outcome of CABG in patients with multi-vessel disease. Results: In group II (P=0.001), the mean age of group I was 57.20±8.52 vs 53.25±7.95. The echocardiography revealed minimal difference between the two classes in mean ESD, RSWMA or EF, but the mean EDD was higher in group II. In category I, the mean number of grafts was greater (3.12±0.73 vs 2.46±0.85, P=0.00001) (mean number of grafts). This was the same for venous grafts (1.89±0.74 vs 1.39±0.90, P=0.00001) and arterial grafts (Rima or radial artery) (1.24±0.54 vs 1.07±0.33, P=0.006). The use of inotropes was found to be greater in the previous PCI community than in community I (P=0.02). Conclusion: Previous PCI has a detrimental effect on morbidity outcomes in subsequent CABG. Any preoperative component, including diabetes, is not linked to this effect. There was, however, no difference in terms of postoperative mortality.