[MSB-19] Effects of Early Coronary Artery Bypass Grafting on Stent and Graft Patency Following Successful Stenting for Acute Coronary Syndromes.

Abstract

Objective: This study aimed to compare graft and stent patency in coronary stent implantation followed by early coronary artery bypass grafting (CABG) in patients with acute coronary syndrome (ACS).

Methods: Seventy-one patients who underwent coronary stenting for ACS followed by early CABG within 30 days were retrospectively evaluated between 2019 and 2022. The patients were divided into two groups: those who received bypass on the stented artery (n=39; mean age: 59.1±10.4 years) and the non-bypass group (n=32; mean age: 62.9±9.5 years).

Results: There was no significant difference in the mean ages of the two groups (p=0.114). The most frequently stented coronary artery was the right coronary artery (71.8%), and the most commonly used stent type was a drug-eluting stent (94%; p=0.414). In both groups, the most preferred dual antiplatelet regimen was acetylsalicylic acid+clopidogrel preoperatively (76.9% in the bypass group, 75% in the non-bypass group) and acetylsalicylic acid+clopidogrel postoperatively (79.5% in the bypass group, 87.5% in the non-bypass group). The mean follow-up time was 775.0±453.1 and 563.4±403.2 days in the non-bypass and bypass groups, respectively. The mortality rate was 7%. Coronary artery imaging was performed in 47 patients. In the nonbypass group, 86% of stents were patent, and 14% were occluded. In the bypass group, 81.8% of stents were patent, and 18.2% were occluded. In the bypass group, 81.8% of grafts were patent, and 18.2% were occluded. There was no significant difference in stent patency rates between the groups.

Conclusion: Continuing dual antiplatelet therapy in patients with patent stents before early CABG could be beneficial for achieving better outcomes. In our study, no significant statistical differences were observed between groups in terms of mortality and postoperative myocardial infarction rates.