E-resources
-
Massoudy, Parwis, MD; Thielmann, Matthias, MD; Lehmann, Nils, PhD; Marr, Anja, PhD; Kleikamp, Georg, MD; Maleszka, Ariane, MD; Zittermann, Armin, MD; Körfer, Reiner, MD; Radu, Miriam, MD; Krian, Arno, MD; Litmathe, Jens, MD; Gams, Emmeran, MD; Sezer, Ömer, MD; Scheld, Hans, MD; Schiller, Wolfgang, MD; Welz, Armin, MD; Dohmen, Guido, MD; Autschbach, Rüdiger, MD; Slottosch, Ingo, MD; Wahlers, Thorsten, MD; Neuhäuser, Markus, PhD; Jöckel, Karl-Heinz, PhD; Jakob, Heinz, MD
Journal of thoracic and cardiovascular surgery/The Journal of thoracic and cardiovascular surgery/The journal of thoracic and cardiovascular surgery, 04/2009, Volume: 137, Issue: 4Journal Article
Objectives Do prior percutaneous coronary interventions adversely affect the outcome of subsequent coronary artery bypass grafting? We investigated this effect on a multicenter basis. Methods Eight cardiac surgical centers provided outcome data of 37,140 consecutive patients who underwent isolated first-time coronary bypass grafting between January 2000 and December 2005. Twenty-two patient characteristics and outcome variables were retrieved. Three groups of patients were analysed for in-hospital mortality and in-hospital major adverse cardiac events: patients without a previous percutaneous coronary intervention, with 1 previous intervention, and with 2 or more previous percutaneous coronary interventions before bypass grafting. A total of 29,928 patients with complete information for prior percutaneous coronary intervention underwent final analysis. Unadjusted univariate and risk-adjusted multivariate logistic regression analysis as well as computed propensity score matching were performed, based on 14 major risk factors to correct for and minimize selection bias. Results A total of 10.3% of patients had 1 previous percutaneous coronary intervention, and 3.7% of patients had 2 or more previous interventions. Risk-adjusted multivariate logistic regression analysis revealed a significant association of 2 or more previous percutaneous coronary interventions with in-hospital mortality (odds ratio OR, 2.0; confidence interval CI, 1.4–3.0; P = .0005) and major adverse cardiac events (OR, 1.5; CI, 1.2–1.9; P = .0013). After propensity score matching, conditional logistic regression analysis confirmed the results of adjusted analysis. A history of 2 or more previous percutaneous coronary interventions was significantly associated with in-hospital mortality (OR, 1.9; CI, 1.3–2.7; P = .0016) and major adverse cardiac events (OR, 1.5; CI, 1.2–1.9; P = .0019). Conclusions Multicenter analysis confirms that a history of multiple previous percutaneous coronary interventions increases in-hospital mortality and the incidence of major adverse cardiac events after subsequent coronary artery bypass grafting. Critical discussion of the treatment strategy in these patients is warranted.
Author
![loading ... loading ...](themes/default/img/ajax-loading.gif)
Shelf entry
Permalink
- URL:
Impact factor
Access to the JCR database is permitted only to users from Slovenia. Your current IP address is not on the list of IP addresses with access permission, and authentication with the relevant AAI accout is required.
Year | Impact factor | Edition | Category | Classification | ||||
---|---|---|---|---|---|---|---|---|
JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
Select the library membership card:
If the library membership card is not in the list,
add a new one.
DRS, in which the journal is indexed
Database name | Field | Year |
---|
Links to authors' personal bibliographies | Links to information on researchers in the SICRIS system |
---|
Source: Personal bibliographies
and: SICRIS
The material is available in full text. If you wish to order the material anyway, click the Continue button.