Previous coronary stents do not increase early and long-term adverse outcomes in patients undergoing off-pump coronary artery bypass grafting: a propensity-matched comparison

J Thorac Cardiovasc Surg. 2014 Nov;148(5):1843-9. doi: 10.1016/j.jtcvs.2014.02.004. Epub 2014 Feb 12.

Abstract

Objective: The aim of our study was to compare the early and long-term outcomes of patients undergoing off-pump coronary artery bypass grafting (CABG) with and without previous coronary stents.

Methods: Between September 2004 and September 2011, 269 patients with previous stents underwent first-time isolated off-pump CABG. These patients were compared with 897 patients without previous stent. A propensity score-matching analysis was performed to compare early and late outcomes between the groups. Mean follow-up time was 43.4 months after surgery.

Results: Patients with previous stents were more likely to be men (85.9% in the stent group vs 79.4% in the no-stent group; P=.022) and more likely to have prior myocardial infarction (60.2% vs 36.8%; P<.001). Mean number of anastomoses was lower in patients with previous stents than in patients without previous stents (4.0 vs 4.2; P=.037). There was no difference in the use of bilateral internal thoracic artery graft between the groups (88.8% vs 89.1%; P>.999). After propensity adjustment for preoperative characteristics, both operative death (0.7% vs 1.5%; P=.414) and the major complications rates (7.8% vs 7.5%; P=.869) were similar between the groups. The actuarial survival rate at 7 years was not different between the groups (87.2%±3.2% vs 84.8%±2.9%; P=.470). Furthermore, freedom from major adverse cardiac and cerebrovascular events at 7 years were similar between the groups (78.9%±3.8% vs 77.6%±3.3%; P=.811).

Conclusions: Previous coronary stents do not increase early and long-term morbidity or mortality in patients undergoing off-pump CABG.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Chi-Square Distribution
  • Coronary Artery Bypass, Off-Pump / adverse effects*
  • Coronary Artery Bypass, Off-Pump / mortality
  • Coronary Artery Disease / diagnosis
  • Coronary Artery Disease / mortality
  • Coronary Artery Disease / surgery
  • Coronary Artery Disease / therapy*
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Percutaneous Coronary Intervention / adverse effects*
  • Percutaneous Coronary Intervention / instrumentation*
  • Percutaneous Coronary Intervention / mortality
  • Postoperative Complications / mortality
  • Propensity Score
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Stents*
  • Time Factors
  • Treatment Outcome