Impact of previous coronary artery bypass surgery on clinical outcome after percutaneous interventions with second generation drug-eluting stents in TWENTE trial and Non-Enrolled TWENTE registry

Hanim Sen, Ming Kai Lam, Kenneth Tandjung, Marije M. Löwik, K. Gert van Houwelingen, Martin G. Stoel, Hans W. Louwerenburg, Frits H.A.F. de Man, Gerard C.M. Linssen, Jan G. Grandjean, Carine J.M. Doggen, Clemens von Birgelen

Research output: Contribution to journalArticleAcademicpeer-review

8 Citations (Scopus)

Abstract

Background: Patients with previous coronary artery bypass grafting (CABG) who underwent percutaneous coronary intervention (PCI) have an increased repeat revascularization rate, but data on contemporary second-generation drug-eluting stents (DES) are scarce.

Methods: We evaluated 1-year clinical outcome following secondary revascularization by PCI in patients of the TWENTE trial and non-enrolled TWENTE registry, and compared patients with previous CABG versus patients without previous CABG.

Results: Of all 1709 consecutive patients, 202 (11.8%) had previously undergone CABG (on average 11.2 ± 8.5 years ago). CABG patients were older (68.5 ± 9.4 years vs. 64.1 ± 10.7 years, P < 0.001) and more often had diabetes (28.7% vs. 20.9%, P = 0.01) and previous PCI (40.1% vs. 19.8%, P < 0.001) compared to patients without previous CABG. Nevertheless, a higher target vessel revascularization (TVR) rate following PCI in the CABG patients (9.4% vs. 2.3%, P < 0.001) was the only significant difference in clinical outcome at 1-year follow-up (available for 99.6%). Among CABG patients, the TVR rate was significantly higher in patients treated for graft lesions (n = 65; 95.4% in vein grafts) than in patients treated for native coronary lesions only (n = 137) (18.5% vs. 5.1%, P = 0.002). Among 1638 patients with PCI of native coronary lesions only, there was only a non-significant difference in TVR between patients with previous CABG versus patients without previous CABG (5.1% vs. 2.3%, P = 0.08).

Conclusions: Patients with previous CABG showed a favorable safety profile after PCI with second-generation DES. Nevertheless, their TVR rate was still much higher, driven by more repeat revascularizations after PCI of degenerated vein grafts. In native coronary lesions, there was no such difference

Original languageEnglish
Pages (from-to)885-890
Number of pages6
JournalInternational journal of cardiology
Volume176
Issue number3
DOIs
Publication statusPublished - 2014

Keywords

  • IR-91608
  • METIS-304792
  • Drug-eluting stent(s)
  • Percutaneous Coronary Intervention (PCI)
  • Previous coronary artery bypass grafting
  • TWENTE trial
  • Non-enrolled TWENTE registry

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