Cardiovascular revascularization medicine : including molecular interventions · 2026
Characteristics and outcomes of percutaneous coronary intervention among patients initially referred for CABG.
СтатьяНазвание и аннотация: Перевод в очереди
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Min Sugi, Kadiyala Vishnu, Has Phinnara, Elkaryoni Ahmed, Lu Frederick, Khetpal Vishal, Agyeman Harrison, Hyder Omar, Saad Marwan, Abbott J Dawn
Аннотация
BACKGROUND: Coronary artery bypass grafting (CABG) ineligibility is associated with increased mortality in patients undergoing PCI. Limited data exist about CABG-eligible patients who decline surgery and opt for PCI.
METHODS: National Cardiovascular Data Repository CathPCI data from 2018 to 2024 at two high-volume PCI centers was used to identify patients that had surgical consultation prior to PCI. Baseline characteristics and in-hospital outcomes were compared between patients who were turned down for surgery (CABG-ineligible) and those who were offered surgery but declined (CABG-eligible).
RESULTS: The cohort included 388 patients (313 CABG-ineligible and 75 CABG-eligible). CABG-ineligible patients were younger (70.4 vs 73.4 years; p = 0.01) and had higher rates of chronic lung disease, diabetes, and frailty, but with no difference in lesion complexity between the groups. PCI in the CABG-ineligible group was more likely urgent, emergent, or salvage, including STEMI and NSTEMI. Overall, PCI technical success was high, 92.9%, and in-hospital mortality was 4.8% in CABG-ineligible versus 2.7% in the CABG-eligible group (p = 0.54). There was no difference in bleeding, myocardial infarction, cardiogenic shock, cardiac arrest, or new-onset dialysis.
CONCLUSIONS: Among patients who underwent PCI after referral for CABG, technical success was high and in-hospital mortality was acceptable in patients who were deemed eligible or ineligible for CABG. Further study is warranted to examine long-term outcomes of PCI in CABG-ineligible patients versus those who decline CABG.
METHODS: National Cardiovascular Data Repository CathPCI data from 2018 to 2024 at two high-volume PCI centers was used to identify patients that had surgical consultation prior to PCI. Baseline characteristics and in-hospital outcomes were compared between patients who were turned down for surgery (CABG-ineligible) and those who were offered surgery but declined (CABG-eligible).
RESULTS: The cohort included 388 patients (313 CABG-ineligible and 75 CABG-eligible). CABG-ineligible patients were younger (70.4 vs 73.4 years; p = 0.01) and had higher rates of chronic lung disease, diabetes, and frailty, but with no difference in lesion complexity between the groups. PCI in the CABG-ineligible group was more likely urgent, emergent, or salvage, including STEMI and NSTEMI. Overall, PCI technical success was high, 92.9%, and in-hospital mortality was 4.8% in CABG-ineligible versus 2.7% in the CABG-eligible group (p = 0.54). There was no difference in bleeding, myocardial infarction, cardiogenic shock, cardiac arrest, or new-onset dialysis.
CONCLUSIONS: Among patients who underwent PCI after referral for CABG, technical success was high and in-hospital mortality was acceptable in patients who were deemed eligible or ineligible for CABG. Further study is warranted to examine long-term outcomes of PCI in CABG-ineligible patients versus those who decline CABG.