Original CommunicationPrevious percutaneous coronary intervention increases morbidity after coronary artery bypass grafting
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Data collection
The Virginia Cardiac Surgery Quality Initiative (VCSQI) is a voluntary consortium of 16 different cardiac surgical centers and hospitals within the Commonwealth of Virginia that collectively captures approximately 99% of Virginia's cardiac operative procedures. Data analyses were exempt from the University of Virginia Institutional Review Board because the VCSQI database has no patient identifiers. In addition, participating institutions were exempt from Health Insurance Portability and
Incidence of PCI has increased over time
A total of 34,316 patients underwent isolated CABG surgeries from 2001 to 2008. Of those, 4346 (12.7%) patients had previous PCI. Prior to 2004, <1% of patients undergoing CABG had previous PCI. Since 2004, the incidence of prior PCI among CABG patients significantly increased (7.8% in 2004, 21.5% in 2005, 23.4% in 2006, 25.3% in 2007, and 22.0% in 2008; P < .001; Fig 1).
Preoperative and intraoperative risk factors
Patient demographics and preoperative risk factors are presented in Table I. Patients with prior PCI were comparatively
Discussion
Using a multicenter, retrospective analysis from 16 different statewide cardiac centers, we demonstrate that the incidence of PCI in patients undergoing CABG has risen since the introduction of DES in 2004. The objective of the study was to investigate the independent effect of prior PCI in patients undergoing CABG. Although there was no relationship between prior PCI and mortality after CABG, we determined that the risk-adjusted in-hospital major morbidity is worse in patients with prior PCI.
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Supported by Award Number T32/HL007849 (DJL, CMB) from the National Heart, Lung, and Blood Institute and the Thoracic Surgery Foundation for Research and Education Research Grant (GA). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, and Blood Institute or the National Institutes of Health.