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Long‐Term Outcome of Consecutive Patients With Previous Coronary Bypass Surgery, Treated With Newer‐Generation Drug‐Eluting Stents

Authors: van der Heijden, Liefke C.; Kok, Marlies M.; Zocca, Paolo; Sen, Hanim; Löwik, Marije M.; Mariani, Silvia; de Man, Frits H.A.F.; +8 Authors

Long‐Term Outcome of Consecutive Patients With Previous Coronary Bypass Surgery, Treated With Newer‐Generation Drug‐Eluting Stents

Abstract

Background Percutaneous coronary intervention ( PCI ) in patients with previous coronary artery bypass grafting ( CABG ) is associated with adverse clinical events. Although newer generation drug‐eluting stents showed favorable short‐term safety profiles, there is a lack of long‐term outcome data. We evaluated the impact of previous CABG on 5‐year clinical outcomes of patients treated with PCI using newer‐generation drug‐eluting stents. Methods and Results In this patient‐level pooled analysis of the prospective TWENTE (The Real‐World Endeavor Resolute versus Xience V Drug‐Eluting Stent Study in Twente) trial and nonenrolled TWENTE registry, we assessed a consecutive series of patients who underwent PCI with newer‐generation drug‐eluting stents for non– ST ‐segment–elevation acute coronary syndromes or stable angina. Of all 1709 patients, 202 (11.8%) had a history of CABG . Patients with previous CABG had significantly higher 5‐year rates of cardiac death (10.4% versus 4.3%; P <0.001) and target vessel revascularization (25.0% versus 8.1%; P <0.001). These differences remained statistically significant after adjustment for differences in baseline characteristics. Landmark analysis revealed that from 1‐ to 5‐year follow‐up, the rates of cardiac death (8.1% versus 3.2%; P <0.001) and target vessel revascularization (17.1% versus 5.9%; P <0.001) were significantly higher in patients with previous CABG . Among patients with a history of CABG , PCI of an obstructed vein graft was associated with a higher rate of 5‐year target vessel revascularization ( P =0.003). Conclusions At 5‐year follow‐up after PCI with newer‐generation drug‐eluting stents, the risk of cardiac death and target vessel revascularization was significantly higher in patients with previous CABG . The target vessel revascularization rate was highest in patients who underwent PCI of obstructed vein grafts.

Country
Netherlands
Related Organizations
Keywords

Male, Resolute, Time Factors, Xience V, Coronary Disease, Prosthesis Design, Risk Assessment, Percutaneous coronary intervention, Percutaneous Coronary Intervention, SDG 3 - Good Health and Well-being, coronary artery bypass graft, Risk Factors, Coronary artery bypass graft, drug‐eluting stent, Diseases of the circulatory (Cardiovascular) system, Humans, Registries, Coronary Artery Bypass, Xience, Original Research, Aged, Randomized Controlled Trials as Topic, percutaneous coronary intervention, Drug-Eluting Stents, Middle Aged, Treatment Outcome, RC666-701, Retreatment, Female, Drug-eluting stent

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    selected citations
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    This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    8
    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Average
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Average
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
8
Top 10%
Average
Average
Green
gold