Immediate Postoperative Complications in Patients Undergoing CABG; Investigating the Role of Prior Coronary Stenting

Abstract

Introduction: Approximately 15 to 30% of patients undergoing percutaneous coronaryintervention (PCI) will require repeated revascularization. There is an ongoing debate concerningthe impact of prior PCI on subsequent coronary artery bypass graft (CABG) surgery. This studysought to compare immediate post-CABG complications between patients with and withoutprevious coronary stenting.Methods: A total of 556 CABG candidates including 73 patients with previous coronary stentingand 483 patients without prior stenting were enrolled in this retrospective-prospective study.Demographic information, cardiac markers (CK-MB, Troponin T), and postoperative dataincluding inotrope administration, intra-aortic balloon pump (IABP) use, bleeding, pathologicalelectrocardiography (ECG) changes, and overall complications were compared between the twogroups.Results: The mean age of the patients in stented group was significantly higher than that inunstented group (63.49±7.71 vs. 61.37±9.80 years, p=0.05). The mean serum level of TroponinT 12 h postoperation was significantly higher in the same group (323.26±33.16 vs. 243.30±11.52ng/dL; p=0.03). Comparing the stented and unstented groups, the rates of inotrope use (17.8% vs.7.2%; p=0.003), significant bleeding (15.1% vs. 4.3%; p=0.001), and overall complications (32.9%vs. 11.6%; odds ratio: 3.74 with 95% confidence interval of 2.13-6.55, p<0.001) were significantly higher in the former group. The association between overall complications and prior stenting was independent (odd ratio: 3.06). No significant connections were found between postoperative complications and stent number or type.Conclusion: A positive history of previous coronary stenting significantly increases the risk of immediate post-CABG complications.

Keywords: Percutaneous Coronary, Intervention, Coronary Artery Bypass Graft, Outcome