In-hospital outcome of primary PCI for patients with acute myocardial infarction and prior coronary artery bypass grafting

Yu Liu; Le-Feng Wang; Xin-Chun Yang; Pi-Xiong Su; Kui-Bao Li; Hong-Shi Wang; Mu-Lei Chen; Li Xu; Jiu-Chang Zhong

doi:10.21037/jtd-20-1813

In-hospital outcome of primary PCI for patients with acute myocardial infarction and prior coronary artery bypass grafting

J Thorac Dis. 2021 Mar;13(3):1737-1745. doi: 10.21037/jtd-20-1813.

Authors

Yu Liu¹, Le-Feng Wang¹, Xin-Chun Yang¹, Pi-Xiong Su¹, Kui-Bao Li¹, Hong-Shi Wang¹, Mu-Lei Chen¹, Li Xu¹, Jiu-Chang Zhong¹

Affiliation

¹ Heart Center & Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.

Abstract

Background: This study aims to analyze the in-hospital outcome of primary percutaneous coronary intervention (PCI) for patients with acute myocardial infarction (AMI) and prior coronary artery bypass grafting (CABG).

Methods: This was a retrospective study. From January 2011 to December 2018, the data of 78 consecutive patients (study group) with prior CABG, who received primary coronary angiography in the setting of ST-elevation myocardial infarction (STEMI) or non-ST-elevation myocardial infarction (NSTEMI), were screened. The study group was compared with another well-matched 78 patients without a history of CABG (control group). The information of the coronary angiograms and clinical data of both groups were analyzed. Multivariate conditional logistic regression models were constructed to test the association between PCI success rate and the prior CABG at age ≥65 and <65 years, respectively.

Results: The results revealed that the primary PCI success rate in the study group was significantly lower than in the control group (67.9% vs. 92.3%, P<0.001) and in-hospital mortality was significantly higher than in control group (11.5% vs. 2.5%, P=0.03). The multivariate logistic regression analysis indicated that the primary PCI success rate was significantly associated with the history of prior CABG both in young patients [age <65 years; odds ratio (OR) =5.26, 95% confidence interval (CI): 1.69-16.47] and elderly (age ≥65 years; OR =13.76, 95% CI: 2.72-69.75).

Conclusions: The patients who receive primary PCI with AMI and prior CABG have poor in-hospital outcomes, with low PCI success rates and high mortality.

Keywords: Acute myocardial infarction (AMI); coronary angiography; coronary artery bypass grafting (CABG); in-hospital outcomes; percutaneous coronary intervention (PCI).