The Prognostic Value of Previous Coronary Stent Implantation in Patients Undergoing Myocardial Revascularization Surgery.

IF 2.8 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Current vascular pharmacology Pub Date : 2023-01-01 DOI:10.2174/1570161120666220926102044

Jose Manuel Villaescusa-Catalan, Jorge Rodríguez-Capitán, Cristina Isabel Sanz-Sánchez, Gemma Sánchez-Espín, José Luis Guerrero-Orriach, Francisco Javier Pavón Morón, Lourdes Fernández-Romero, José María Melero-Tejedor, Miguel Such-Martínez, Carlos Porras-Martín, Manuel Jiménez-Navarro

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引用次数: 0

Abstract

Background: Currently, studies are underway to determine whether coronary stent implantation with percutaneous transluminal coronary angioplasty before a coronary artery bypass graft (CABG) influences the prognosis of surgery. This study aimed to assess the need for future revascularisation or all-cause mortality as a composite endpoint after CABG surgery among patients with previous stent implantation.

Methods: A retrospective, non-randomised study was performed on 721 patients who underwent CABGin our centre between 2012 and 2017. This single-centre study compared two groups: 1) the previous stent group, patients with previous stent implantation (n=144), and 2) the non-previous stent group, patients without previous stent implantation (n=577).

Results: After a median follow-up of 36 months, the previous stent group presented a decreased combined event-free survival at 1, 3 and 5 years compared with the non-previous stent group (67.4, 43.5 and 23.0% vs. 91.0, 80.3 and 63.0%, respectively; p<0.01). There was also higher mortality in the previous stent group than in the non-previous stent group (96.1, 90.5 and 79.4 vs. 91.9, 75.9 and 51.0, respectively; p=0.01). The multivariable analysis of demographics, baseline comorbidity and surgical data showed previous stent implantation as an independent predictor of the composite endpoint (Hazard Ratio=3.00 and 95% confident interval=2.09-4.32; p<0.01).

Conclusion: Patients with percutaneous coronary intervention before CABG present higher comorbidities and clinical events during follow-up than those who do not undergo stenting.

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既往冠脉支架置入术对心肌血管重建术患者的预后价值。

背景:目前，研究正在确定冠状动脉搭桥术(CABG)前经皮冠状动脉腔内成形术是否影响手术预后。本研究旨在评估既往支架植入术患者冠脉搭桥术后对未来血运重建的需求或全因死亡率作为复合终点。方法:对2012年至2017年在本中心接受cabi治疗的721例患者进行回顾性、非随机研究。这项单中心研究比较了两组:1)既往支架组，既往支架植入患者(n=144); 2)未既往支架组，既往未支架植入患者(n=577)。结果:中位随访36个月后，与未使用支架组相比，使用支架组在1年、3年和5年的联合无事件生存率下降(分别为67.4、43.5和23.0% vs 91.0、80.3和63.0%);结论:冠脉搭桥前行经皮冠状动脉介入治疗的患者在随访中比未行支架置入的患者存在更高的合并症和临床事件。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current vascular pharmacology 医学-外周血管病

CiteScore

9.20

自引率

4.40%

发文量

审稿时长

6-12 weeks

期刊介绍： Current Vascular Pharmacology publishes clinical and research-based reviews/mini-reviews, original research articles, letters, debates, drug clinical trial studies and guest edited issues to update all those concerned with the treatment of vascular disease, bridging the gap between clinical practice and ongoing research. Vascular disease is the commonest cause of death in Westernized countries and its incidence is on the increase in developing countries. It follows that considerable research is directed at establishing effective treatment for acute vascular events. Long-term treatment has also received considerable attention (e.g. for symptomatic relief). Furthermore, effective prevention, whether primary or secondary, is backed by the findings of several landmark trials. Vascular disease is a complex field with primary care physicians and nurse practitioners as well as several specialties involved. The latter include cardiology, vascular and cardio thoracic surgery, general medicine, radiology, clinical pharmacology and neurology (stroke units).