Takeshi Kinoshita, Tomoaki Suzuki, Osamu Nishimura, Hirohisa Ikegami, Atsushi Kambara, Keiji Matsubayashi, Tohru Asai.
Shiga University of Medical Science, Otsu, Japan.
OBJECTIVE: Since recent prevalence of percutaneous coronary intervention (PCI), the number of stent-loaded high-risk patients requiring coronary artery bypass grafting (CABG) is increasing. We assessed the impact of prior PCI on hospital mortality in patients with diabetes mellitus and multi-vessel disease undergoing off-pump CABG.
METHODS: Perioperative data were collected on 233 consecutive patients with diabetes mellitus and multi-vessel disease undergoing isolated off-pump CABG between January 1, 2002, and October 31, 2007. Patients with prior PCI (n=62, group 1) were compared with patients with no prior PCI (n=171, group 2), and the risk-adjusted impact of prior PCI on hospital mortality after off-pump CABG was determined using multivariate logistic regression analyses.
RESULTS: Patients in group 1 were more likely to have old myocardial infarction (53% vs 31%, p=0.002) and to receive hemodialysis (24% vs 8%, p=0.001). Other preoperative characteristics did not differ according to most of their demographics, cardiac factors, and non-cardiac factors. Hospital mortality was 6.5% in group 1 and 1.2% in group 2 (p=0.024). Risk-adjusted multivariate logistic regression analysis identified prior PCI (odds ratio, 12.0, p=0.031) and left ventricular ejection fraction < 40% (odds ratio, 8.25, p=0.030) as an independent factor in hospital mortality after off-pump CABG.
CONCLUSIONS: Prior PCI before off-pump CABG in patients with diabetes mellitus and multi-vessel disease independently increases the risk for hospital mortality.
Back to 2008 Annual Meeting
Back to Program Outline