Mohamed, MO ORCID: https://orcid.org/0000-0002-9678-5222, Shoaib, A ORCID: https://orcid.org/0000-0003-0513-8319, Gogas, B, Patel, T, Alraies, T, Velagapudi, P, Chugh, S, Sharma, K, Mohamed, W, Murphy, G, Kwok, CS ORCID: https://orcid.org/0000-0001-7047-1586, Rashid, M ORCID: https://orcid.org/0000-0001-9725-1583, Bagur, R ORCID: https://orcid.org/0000-0003-1888-9429 and Mamas, MA ORCID: https://orcid.org/0000-0001-9241-8890 (2020) Trends of repeat revascularization choice in patients with prior coronary artery bypass surgery. Catheterization and Cardiovascular Interventions.

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Abstract

Objective: To examine rates and predictors repeat revascularization strategies (percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG)) in patients with prior CABG.
Methods: Using the National Inpatient Sample, patients with a history of CABG hospitalized for revascularization by PCI or CABG from January 2004 through September 2015 were included. Regression analyses were performed to examine predictors of receipt of either revascularization strategy as well as in-hospital outcomes.
Results: The rate of redo-CABG doubled between 2004 (5.3%) and 2015 (10.3%). Patients who underwent redo-CABG were more comorbid and experienced significantly worse major adverse cardiovascular and cerebrovascular events (MACCE; odds ratio (OR): 5.36 95% CI 5.11-5.61), mortality (OR 2.84 95% CI 2.60,-3.11), bleeding (OR 5.97 95% CI 5.44-6.55) and stroke (OR 2.15 95% CI 1.92-2.41), but there was no difference in cardiac complications between groups. Thoracic complications were high in patients undergoing redo-CABG (8%), especially in females. Factors favoring receipt of redo-CABG compared to PCI included male sex, age<80 years, and absence of diabetes and renal failure.
Conclusion: Reoperation in patients with prior CABG has doubled in the United States over a twelve-year period. Patients undergoing redo-CABG are more complex and associated with worse clinical outcomes than those receiving PCI.

Item Type: Article
Additional Information: The final accepted manuscript and all relevant information regarding this article can be found online at; https://onlinelibrary.wiley.com/doi/abs/10.1002/ccd.29234
Uncontrolled Keywords: outcomes, percutaneous coronary intervention, redo CABG, reoperation, revascularization
Subjects: R Medicine > R Medicine (General)
R Medicine > RC Internal medicine > RC666 Diseases of the circulatory (Cardiovascular) system
R Medicine > RD Surgery
R Medicine > RD Surgery > RD32 Operative surgery. Technique of surgical operations
Divisions: Faculty of Medicine and Health Sciences > School of Primary, Community and Social Care
Depositing User: Symplectic
Date Deposited: 13 Aug 2020 15:21
Last Modified: 24 Sep 2020 14:36
URI: https://eprints.keele.ac.uk/id/eprint/8543

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