HOW PREVIOUS PERCUTANEOUS CORONARY INTERVENTION (PCI) INFLUENCE OUTCOMES IN PATIENTS UNDERGOING CORONARY ARTERY BYPASS GRAFTING (CABG)?

Aim: Benefits of CABG, over Percutaneous Coronary Interventions (PCI) has become more firmly established in patients with diabetes, multivessel disease and impaired ventricular function. Given the spread of PCI, it is increasingly common to find a patient requiring CABG with previuos PCI (up to 20%), Robust data in patients undergoing CABG with previuos PCI is weak. The aim of the study is to investigate the impact of a previous PCI on the outcome of CABG in the real word. Methods: We retrospective analysed 20337 CABG operations performed in an Italian Region, Lazio, using a regional administrative dataset. Follow up were 100% completed and certified. Results: Between 2008 and 2022, a total of 20.337 patients were enrolled: 19148 had no previous PCI and 1189 with previous PCI. At baseline patients with previous PCI were younger (64+10 vs 67+9.5 yo, p<0.05), with an higher risk profile: diabetes (27.25 vs 21.61%, p<0.0001), cholesterol disorders (28,7% vs 17.46%, p<0.0001), hypertension (53.99 vs 36.72.6%, p<0.0001), COPD (4.96 vs 3.78%, p<0.0001), heart failure (11.61 vs 7.35%, p>0.0001). These data could be explained considering the failed PCI and so a higher profile risk. Previous PCI was not associated with adverse outcomes in early and long term follow up, in all LVEF class. Long term results were remarkable in our series. Conclusions: Our data suggest that previous PCI, although the technical difficulties, could not be considered an independent for CABG that could guarantee a very low early and long term mortality, even in case of low LVEF.