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

Toshihiro Fukui, Sachiko Tanaka, Shuichiro Takanashi
Journal of Thoracic and Cardiovascular Surgery 2014, 148 (5): 1843-9

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.

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