Predictors of MACE following PPCI in patients with a prior history of CABG

Acta Cardiol. 2024 Apr;79(2):123-126. doi: 10.1080/00015385.2023.2256181. Epub 2023 Sep 28.

Abstract

Background: Evidence suggests patients undergoing Primary Percutaneous Coronary Intervention (PPCI) who have a prior history of Coronary Artery Bypass Grafting (CABG) are more likely to experience adverse cardiac events compared to patients without prior CABG. We aimed to study risk factors of one-year Major Adverse Cardiovascular Events (MACE) in patients undergoing PPCI with a prior history of CABG.

Methods: Patients with a history of CABG undergoing PPCI on Saphenous Vein Graft (SVG) were contacted one year after PPCI. One-year follow-up sought MACE, death, and cardiovascular hospitalisation.

Results: A total of 69 patients were included in this study of which 66 were followed-up. Within the one-year follow-up, 6 (8.7%) patients were hospitalised due to cardiovascular causes, and 20 (29%) developed MACE. Patients with prior PCI had a significantly higher one-year MACE rate compared to others. Among patients undergoing pre-dilation, patients who experienced MACE had a significantly higher pre-dilation diameter. Moreover, patients experiencing MACE had a significantly lower Ejection Fraction (EF). According to logistic regression models, prior PCI, pre-dilation, and EF were predictors of one-year MACE. Furthermore, The EF was an independent predictor of one-year MACE.

Conclusion: Higher pre-dilation diameter might be associated with a higher one-year MACE rate in patients undergoing PPCI on SVG with a prior history of CABG. Additionally, EF was an independent predictor of one-year MACE.

Keywords: CABG; mACE; pPCI; sVG.

MeSH terms

  • Coronary Artery Bypass / adverse effects
  • Coronary Artery Disease* / diagnosis
  • Coronary Artery Disease* / etiology
  • Coronary Artery Disease* / surgery
  • Humans
  • Percutaneous Coronary Intervention* / adverse effects
  • Risk Factors
  • Treatment Outcome