Coronary artery diseaseRequirement for Emergent Coronary Artery Bypass Surgery Following Percutaneous Coronary Intervention in the Stent Era
Section snippets
Methods
This was a single-center observational study. The study population consisted of 21,957 unselected patients who underwent PCI at Washington Hospital Center, Washington, DC, from August 1994 (Food and Drug Administration stent approval) to January 2008. These patients were entered into a prospective registry and subsequently followed up for clinical events. There were no specific exclusion criteria in the study. Patients who required emergent CABG were identified, and appropriate source
Results
In the overall study population, 90 patients (cumulative incidence 0.41%) required emergent CABG. Baseline clinical, angiographic, and procedural characteristics are listed in Table 1, Table 2. There were a number of baseline differences between groups. Patients who required emergent CABG were more likely to have had a previous MI and less previous CABG surgery. These patients presented less with stable angina and more with acute ST-segment elevation MI and cardiogenic shock. In addition,
Discussion
The present study assessed the risk, outcomes, and correlates of emergent CABG after PCI in a large referral medical center with on-site cardiothoracic surgery after stent approval by the US Food and Drug Administration in August 1994. The requirement for emergent CABG after PCI continues to be a relevant issue in interventional cardiology, and performance of PCI in centers without cardiothoracic surgery is still debated. In keeping with previous reports, emergent CABG after PCI was both
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