Safety and Efficacy of Percutaneous Coronary Intervention in Symptomatic Patients with the History of Prior Coronary Artery bypass Graft Surgery

After coronary artery bypass graft surgery (CABGs), repeat revascularization is often necessary due to progressive atherosclerosis of coronary arteries and grafts, poor patency, limited longevity, and higher risk of redo CABGs. However, data regarding percutaneous revascularization among post-CABGs patients are limited. In this cohort study, 83 subjects with a history of CABGs and recent percutaneous coronary intervention (PCI) at Ekbatan University Hospital were recruited, between January 2013 and January 2017. We followed them at 1-year intervals to evaluate the prevalence of major adverse cardiac events (MACE). The mean duration of follow-up was 28 months. The mean age of the patients was 63 years, and 75% were male. One hundred and three target vessels had undergone PCI with 109 stents, of which 90% were drug-eluting stents (DES). Procedural success was 90%. 19.6% of the procedures were performed on grafts. Mean angina class decreased by one during follow-up, from 2.94 to 1.8. Thirteen patients suffered MACE with 5 cardiac death, 4 nonfatal myocardial infarction (MI), and 8 repeat revascularization, of which 4 were target vessel revascularization. The rate of MACE at one, two, and three years was 17.5%, 25%, and 35%, respectively. Based on univariate analysis, graft PCI was an independent predictor of MACE. Cardiac death can be predicted by age, left ventricular ejection fraction (LVEF), and history of MI. For patients with a history of CABG and recurrence of symptoms, PCI is considered as an efficient and risk-free modality, which can be relied on to alleviate symptoms.