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General Thoracic and Cardiovascular Surgery

Published in:

01-08-2018 | Original Article

Multiple coronary stenting negatively affects myocardial recovery after coronary bypass grafting

Authors: Shin Yajima, Daisuke Yoshioka, Satsuki Fukushima, Koichi Toda, Shigeru Miyagawa, Yasushi Yoshikawa, Hiroki Hata, Shunsuke Saito, Keitaro Domae, Yoshiki Sawa

Published in: General Thoracic and Cardiovascular Surgery | Issue 8/2018

Abstract

Objectives

We aimed to elucidate the relationship between the magnitude of myocardial recovery after coronary artery bypass grafting (CABG) and the prognosis and to explore the predictors of myocardial non-recovery.

Methods

Eighty-one patients with a preoperative left ventricular ejection fraction (LVEF) ≤ 40% who underwent isolated CABG between 2002 and 2015 and had undergone echocardiographic follow-up (median follow-up, 3.1 years; interquartile range 1.2–6.0 years) were analyzed. The Recovery group comprised patients with LVEF improvement ≥ 10%, whereas the Non-recovery group comprised those with an LVEF improvement < 10%. Group differences in overall survival, freedom from major adverse cardiac events (MACEs), and readmission due to heart failure were evaluated. In addition, the risk factors for LVEF non-recovery were evaluated in a multivariate analysis.

Results

A total of 39 patients (48%) were in the Recovery group, whereas 42 patients (52%) were in the Non-recovery group. Although the survival and freedom from MACE rates were comparable, the rate of freedom from heart failure requiring hospitalization at 1, 5, and 8 years of follow-up was significantly lower in the Non-recovery group than in the Recovery group (p = 0.012). A history of percutaneous coronary intervention (PCI) was an exclusive independent risk factor for post-CABG myocardial non-recovery (odds ratio, 16.0; 95% confidence interval, 3.44–125). Furthermore, the number of coronary stents was negatively correlated with LVEF recovery (r = − 0.460, p = 0.024).

Conclusions

Great consideration should be taken when performing CABG in patients with left ventricular dysfunction and a history of PCI, particularly in those with multiple coronary stents.

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Title: Multiple coronary stenting negatively affects myocardial recovery after coronary bypass grafting
Authors: Shin Yajima
Daisuke Yoshioka
Satsuki Fukushima
Koichi Toda
Shigeru Miyagawa
Yasushi Yoshikawa
Hiroki Hata
Shunsuke Saito
Keitaro Domae
Yoshiki Sawa
Publication date: 01-08-2018
Publisher: Springer Japan
Published in: General Thoracic and Cardiovascular Surgery / Issue 8/2018
Print ISSN: 1863-6705
Electronic ISSN: 1863-6713
DOI: https://doi.org/10.1007/s11748-018-0937-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Multiple coronary stenting negatively affects myocardial recovery after coronary bypass grafting

Abstract

Objectives

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

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