Clinical outcome of patients with a history of CABG referred with acute coronary syndrome and undergoing coronary angioplasty

Abstract

The history of coronary artery bypass graft (CABG) surgery and coronary angioplasty is a critical and vital concern for patients with acute coronary syndrome (ACS), requiring careful monitoring and treatment. In this context, medical professionals, faced with challenges and potential risks for this group of patients, necessitate thorough examination and scientific research. This study aims to investigate the clinical outcomes of patients with a history of CABG presenting with acute coronary syndrome and undergoing coronary angioplasty. Methods: This cohort study was conducted at Shahid Madani Heart Medical Center in Tabriz, including patients diagnosed with ACS, admitted and underwent percutaneous coronary intervention (PCI) from the beginning of 2015 to the beginning of 2018. The documented files for mortality and cardiovascular events in the following three years were included for follow-up. A total of approximately 473 patients were enrolled in this study. The patients were categorized into two groups: those with a history of CABG and those without. The two groups were compared in terms of hospital and long-term cardiovascular complications. ACS in these two groups was further classified into two subgroups: STEACS/primary PCI and NSTEACS/PCI. Data analysis was performed using SPSS version 25. Long-term mortality comparison was conducted using Kaplan-Meier and Log-rank methods. Multivariate regression analysis was employed to determine the independent value of CABG on hospital and long-term complications. Results: Comparison of hospital and long-term events between the CABG group and the control group showed a significant difference only in cases of recurrent MI/ACS in long-term events (p=0.001). Additionally, the comparison of hospital and long-term events in the CABG group and the control group in STEACS and NSTEACS revealed a significant difference only in cases of recurrent MI/ACS in long-term events (p=0.05).