الفهرس 
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Abstract
The number of percutaneous coronary interventions (PCI) prior to coronary artery bypass grafting (CABG) increased drastically during the last decade. Patients are referred for CABG with more severe coronary pathology, which may influence postoperative outcome.
Outcomes of 100 CABG patients, collected by a Prospective comparative randomized study, were compared. group A (n = 50, mean age 53.88 years, 8 women) underwent primary CABG and group B (n = 25, mean age 51.36, 7 women) had prior PCI before CABG.
Previous PCI has a negative impact on the early post-operative outcome of subsequent CABG regarding morbidity. Total morbidity was significantly higher in the previous PCI group than the first group where 10 patients in group A (non-stent group) were affected, while 26 patients were affected in group B (stent group). Inotropes were found to be used more with the previous PCI group rather than group A. ICU stay was longer for group B (53.68 ± 31.45 hrs. vs 72.56 ± 54.44 hrs.).
As regard two-year cardio-vascular mortality rates were 6% in the prior coronary stenting group (group B) versus 4% in the non-coronary stenting group (group A). It was showed that the PCI group had a significantly higher risk of experiencing MACCE after CABG surgery than the non-PCI group for all parameters except in stroke. The analysis done for each individual endpoint showed similar results, with the PCI group having, after surgery, significantly more coronary revascularization (1 for group A vs 7 patients for group B) and unstable angina requiring hospitalization (5 for group A vs 13 patients for group B), myocardial infarction (3 for group A vs 10 patients for group B), congestive heart failure (1 for group A vs 7 patients for group B). When focusing on the MACCE endpoints (death, MI, and coronary revascularization), MACCE were observed in 14 patients in the stent group and 5 patients in the non-stent group. Freedom from MACCE at 2 years was 72 % in the stent group and 80 % in the non-stent group.
Previous PCI has a negative impact on the outcome of subsequent CABG regarding morbidity. This effect is not related to any preoperative variable. However, there was no difference in the postoperative mortality. Percutaneous Coronary revascularization should be carefully considered against the higher risk it provides for subsequent CABG.