Medical Journal of Mashhad university of Medical Sciences

Medical Journal of Mashhad university of Medical Sciences

Evaluation of short-term (in-hospital) and long-term (6 months and one year) clinical results of patients with PCI on vein grafts referred to Shahid Rajaei Cardiovascular Hospital in 2017 to 2019

Document Type : Research Paper

Authors
elham ranjbari 1
zahra hosseini 2
mohammad mehdi peighambari 2
vahid ranjbari 3
1 Rajaie cardiovascular Medical and research center , school of medicine , Iran University of Medical Sciences , Tehran , Iran
2 Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
3 Iran University of Science and Technology, Tehran, Iran
10.22038/mjms.2023.69937.4149
Abstract
Introduction:Revascularization to treat coronary artery stenosis in two ways; Percutaneous intervention (PCI) and open surgery can be performed.For patients who were previously treated with open surgery and now have symptoms again, due to the higher mortality and morbidity of re-surgery, PCI is the preferred method of treatment.
Methods:This study is a cohort.The study population includes all patients without exit criteria who were subjected to PCI on SVG in Shahid Rajaei Hospital from October 2017 to 2019. In these patients, the short-term(in-hospital) and long-term(6 months and one year) clinical results were examined in terms of the incidence of MACE(major adverse cardiovascular events).
Findings: 216 patients aged 39 to 99 years with an average of 65.95±9.16 were included in the study. In-hospital MACE, we had only one case of stroke, one case of MI, and one case of vascular complications. During the first 6 months, there were 19 cases of mortality, 5 cases of MI, 2 cases requiring reperfusion on the same SVG, and 3 cases requiring PCI, It was seen on other SVGs of the patients. After one year, a total of 28 cases of mortality, 13 cases of MI, 7 cases requiring re-establishment of flow in the same SVG and 7 cases requiring PCI were seen on other SVGs of the patients. The relationship between the incidence of MACE with the age and chronic kidney disease was seen.
Conclusion: MACE occurred more in older patients and patients with a history of chronic kidney disease with GFR>30 (mild and moderate CKD).
Keywords
Key words: MACE
Revascularization
SVG
PCI
Subjects
  1. Zajac P, Zycinski P, Qawoq H, Jankowski L, Peruga J, Wcisło T,et al.(2016).Outcomes of percutaneous coronary intervention in patients after previous coronary artery bypass surgery. Kardiologiapolska,74(4),322-330.

  2. Leal S, Teles RC, Cale R, Sousa PJ, Brito J, Raposo L, et al.(2011).Percutaneous revascularization

    1. strategies in saphenous vein graft lesions: Long-term results.Rev Port Cardiol,31(1),11-18.
  3. Alidoosti M, Hosseini K, Sharafi A, Nematipour E, Salarifar M, Poorhoseini HR,et al.(2010).           Outcomes of Percutaneous Coronary Intervention on Saphenous Vein Graft and Native Coronary Vessels. Journal of Tehran University Heart Center,6(3),143-147.
  4. Parang P, Arora R.(2009).Coronary vein graft disease: pathogenesis and prevention.Can J Cardiol,25,57-62.
  5. Hiscock M, Oqueli E, Dick R.(2007).Percutaneous saphenous vein graft intervention: a review. Heart Lung Circ,16,51-5.
  6. Alexander JH, Hafley G, Harrington RA, et al.(2005).Efficacy and safety of edifoligide, an E2F transcription factor decoy for prevention of vein graft failure following coronary artery bypass graft surgery:PREVENT IV: a randomized controlled trial.JAMA,294,2446–2454.
  7. Barner HB, Bailey M, Guthrie TJ, et al.(2012).Radial artery free and T graft patency as coronary artery bypass conduit over a 15-year period. Circulation, 126 (11 suppl. 1),140–144.
  8. Weintraub WS, Jones EL, Morris DC, King SB, 3rd, Guyton RA,Craver JM.(1997).Outcome of reoperative coronary bypass surgery versus coronary angioplasty after previous bypass surgery. Circulation,95,868-877.
  9. Coolong A, Baim DS, Kuntz RE, et al.(2008). Saphenous vein graft stenting and major adverse cardiac events: a predictive model derived from a pooled analysis of 3958 patients.Circulation,117,790–797.
  10. de Jaegere PP, van Domburg RT, Feyter PJ, et al.(1996). Long-term clinical outcome after stent implantation in saphenous vein grafts. J Am Coll Cardiol, 28,89–96.
  11. De Feyter PJ.(2003). Percutaneous treatment of saphenous vein bypass graft obstructions: a continuing obstinate problem. Circulation,107,2284–2286.
  12. Otaa H, Mahmoudib M, Lhermusiera T, A.Magalhaesa M, Torgusona R, F.Satlera L, et al.(2015). Comparison of Clinical Outcomes in Patients Presenting With an Acute CoronarySyndrome Due to Stent Thrombosis or Saphenous Vein Graft Occlusion and Undergoing Percutaneous Coronary Intervention. Cardiovascular Revascularization Medicine,15, 1553-8389.
  13. Brilakis E, V.Rao S, Banerjee S, Goldman S, A.Shunk K, R.Holmes D, et al.(2011). Percutaneous Coronary Intervention in Native Arteries Versus Bypass Grafts in Prior Coronary Artery Bypass Grafting Patients. J A C C,4(8),844-850.
  14. Bansal D, Muppidi R, Singla S, Sukhija R, Zarich S, L.Mehta J, et al.(2008). Percutaneous Intervention on the Saphenous Vein Bypass Grafts—Long-Term Outcomes. medtronic, 71,58-61.
  15. Morrison, D. A., Sethi, G., Sacks, J., Henderson, W. G., Grover, F., Sedlis, S., ... & Investigators of the Department of Veterans Affairs Cooperative Study# 385, the Angina With Extremely Serious Operative Mortality Evaluation (AWESOME)*. (2002). Percutaneous coronary intervention versus repeat bypass surgery for patients with medically refractory myocardial ischemia: AWESOME randomized trial and registry experience with post-CABG patients. Journal of the American College of Cardiology, 40(11), 1951-1954.
  16. Peykar S, Angiolillo DJ, Bass TA, et al. Saphenous vein graft disease. Minerva Cardioangiol 2004;52:379–390.‏
  17. Brodie, B. R., VerSteeg, D. S., Brodie, M. M., Hansen, C., Richter, S. J., Stuckey, T. D., ... & Downey, W. (2005). Poor long‐term patient and graft survival after primary percutaneous coronary intervention for acute myocardial infarction due to saphenous vein graft occlusion. Catheterization and cardiovascular interventions, 65(4), 504-509.‏
  18. Pucelikova T, Mehran R, Kirtane AJ, et al. Short- and long-term outcomes after stent-assisted percutaneous treatment of saphenous vein grafts in the drug-eluting stent era. Am J Cardiol 2008; 101: 63–68.
  19. Wang, J. H., Liu, W., Du, X., Ma, C. S., & Wu, X. S. (2014). Long term outcomes of saphaneous vein graft intervention in elderly patients with prior coronary artery bypass graft. Journal of geriatric cardiology: JGC, 11(1), 26.‏
  20. Hakeem A, Helmy T, Munsif S, et al. Safety and efficacy of drug eluting stents compared with bare metal stents for saphenous vein graft interventions: A comprehensive metaanalysis of randomized trials and observational studies comprising 7,994 patients. Catheter Cardiovasc Interv 2011; 77: 343–355.
  21. Davis KB, Chaitman B, Ryan T, Bittner V, Kennedy JW. Comparison of 15-year survival for men and women after initial medical or surgical treatment for coronary artery disease. J Am Coll Cardiol. 1995;25:1000–9.
  22. Dangas GD, Farkouh ME, Sleeper LA, Yang M, Schoos MM, Macaya C, Abizaid A, Buller CE, Devlin G, Rodriguez AE, Lansky AJ, Siami FS, Domanski M, Fuster V, FREEDOM Investigators. Long-term outcome of PCI versus CABG in insulin and non-insulin-treated diabetic patients: results from the FREEDOM trial. J Am Coll Cardiol. 2014;64(12):1189–97.
  23. Greenland P, Knoll MD, Stamler J, et al. Major risk factors as antecedents of fatal and nonfatal coronary heart disease events. JAMA. 2003;290:891–7.
  24. Campeau L, Enjalbert M, Lespe´rance J, et al. The relation of risk factors to the development of atherosclerosis in saphenous-vein bypass grafts and the progression of disease in the native circulation. A study 10 years after aortocoronary bypass surgery. N Engl J Med. 1984;311:1329–32.
  25. Head SJ, Milojevic M, Daemen J, et al.Mortality after coronary artery bypass grafting versus percutaneous coronary intervention with stenting for coronary artery disease: a pooled analysis of individual patient data.Lancet2018;391:939-48. 10.1016/S0140-6736(18)30423-9
  26. Windecker S, Neumann FJ, Juni P, Sousa‐Uva M, Falk V. Considerations for the choice between coronary artery bypass grafting and percutaneous coronary intervention as revascularization strategies in major categories of patients with stable multivessel coronary artery disease: an accompanying article of the task force of the 2018 ESC/EACTS guidelines on myocardial revascularization. Eur Heart J. 2019;40:​204–212.
Medical Journal of Mashhad university of Medical Sciences
Volume 65, Issue 6
January and February 2023
Pages 2244-2236