Incidence and outcome of surgical procedures after coronary artery bypass grafting compared with those after percutaneous coronary intervention: a report from the Coronary Revascularization Demonstrating Outcome Study in Kyoto PCI/CABG Registry Cohort-2
Noncardiac surgery after percutaneous coronary intervention (PCI) has been reported to be carrying high risk for both ischemic and bleeding complications. However, there has been no report comparing the incidence and outcomes of surgical procedures after coronary artery bypass grafting (CABG) with t...
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| Veröffentlicht in: | Circulation. Cardiovascular interventions 2014-08, Vol.7 (4), p.482-491 |
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| creator | Tokushige, Akihiro Shiomi, Hiroki Morimoto, Takeshi Ono, Koh Furukawa, Yutaka Nakagawa, Yoshihisa Kadota, Kazushige Ando, Kenji Shizuta, Satoshi Tada, Tomohisa Tazaki, Junichi Kato, Yoshihiro Hayano, Mamoru Abe, Mitsuru Hamasaki, Shuichi Ohishi, Mitsuru Nakashima, Hitoshi Mitsudo, Kazuaki Nobuyoshi, Masakiyo Kita, Toru Imoto, Yutaka Sakata, Ryuzo Okabayashi, Hitoshi Hanyu, Michiya Shimamoto, Mitsuomi Nishiwaki, Noboru Komiya, Tatsuhiko Kimura, Takeshi |
| description | Noncardiac surgery after percutaneous coronary intervention (PCI) has been reported to be carrying high risk for both ischemic and bleeding complications. However, there has been no report comparing the incidence and outcomes of surgical procedures after coronary artery bypass grafting (CABG) with those after PCI.
Among 14 383 patients undergoing first coronary revascularization (PCI, n=12 207; CABG, n=2176) enrolled in the Coronary Revascularization Demonstrating Outcome Study in Kyoto (CREDO-Kyoto) PCI/CABG Registry Cohort-2, surgical procedures were performed more frequently after CABG (n=560) than after PCI (n=2398; cumulative 3-year incidence: 27% versus 22%; unadjusted P |
| doi_str_mv | 10.1161/CIRCINTERVENTIONS.113.001056 |
| format | Article |
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Among 14 383 patients undergoing first coronary revascularization (PCI, n=12 207; CABG, n=2176) enrolled in the Coronary Revascularization Demonstrating Outcome Study in Kyoto (CREDO-Kyoto) PCI/CABG Registry Cohort-2, surgical procedures were performed more frequently after CABG (n=560) than after PCI (n=2398; cumulative 3-year incidence: 27% versus 22%; unadjusted P<0.0001), particularly <6 months of coronary revascularization. The risk for the primary ischemic outcome measure (death/myocardial infarction) at 30-day postsurgical procedures was not significantly different between the CABG and PCI groups (cumulative incidence: 3.1% versus 3.2%; unadjusted P=0.9; adjusted hazard ratio, 0.97; 95% confidence interval, 0.47-1.89; P=0.9). The risk for the primary bleeding outcome measure (moderate or severe bleeding by Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries classification) was lower in the CABG groups than in the PCI group (cumulative incidence: 1.3% versus 2.6%; unadjusted P=0.07; adjusted hazard ratio, 0.36; 95% confidence interval, 0.12-0.87; P=0.02). There were no interactions between the timing of surgery and the types of coronary revascularization (CABG/PCI) for both ischemic and bleeding outcomes.
Surgical procedures were performed significantly more frequently after CABG than after PCI, particularly <6 months after coronary revascularization. Surgical procedures after CABG as compared with those after PCI were associated with similar risk for ischemic events and lower risk for bleeding events, regardless of the timing after coronary revascularization.</description><identifier>ISSN: 1941-7640</identifier><identifier>EISSN: 1941-7632</identifier><identifier>DOI: 10.1161/CIRCINTERVENTIONS.113.001056</identifier><identifier>PMID: 25074253</identifier><language>eng</language><publisher>United States</publisher><subject>Aged ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - mortality ; Cardiovascular Diseases - surgery ; Cohort Studies ; Coronary Artery Bypass ; Female ; Follow-Up Studies ; Humans ; Hypertension - epidemiology ; Hypertension - mortality ; Hypertension - surgery ; Incidence ; Japan ; Male ; Middle Aged ; Myocardial Infarction - epidemiology ; Myocardial Infarction - etiology ; Percutaneous Coronary Intervention ; Postoperative Hemorrhage - epidemiology ; Postoperative Hemorrhage - etiology ; Registries ; Retrospective Studies ; Risk ; Survival Analysis ; Treatment Outcome</subject><ispartof>Circulation. Cardiovascular interventions, 2014-08, Vol.7 (4), p.482-491</ispartof><rights>2014 American Heart Association, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c231t-3f122ea99aff4a88f80eb504d7310d0f07ba70af5058990d76cf27f59feb5cd73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,3685,27922,27923</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25074253$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tokushige, Akihiro</creatorcontrib><creatorcontrib>Shiomi, Hiroki</creatorcontrib><creatorcontrib>Morimoto, Takeshi</creatorcontrib><creatorcontrib>Ono, Koh</creatorcontrib><creatorcontrib>Furukawa, Yutaka</creatorcontrib><creatorcontrib>Nakagawa, Yoshihisa</creatorcontrib><creatorcontrib>Kadota, Kazushige</creatorcontrib><creatorcontrib>Ando, Kenji</creatorcontrib><creatorcontrib>Shizuta, Satoshi</creatorcontrib><creatorcontrib>Tada, Tomohisa</creatorcontrib><creatorcontrib>Tazaki, Junichi</creatorcontrib><creatorcontrib>Kato, Yoshihiro</creatorcontrib><creatorcontrib>Hayano, Mamoru</creatorcontrib><creatorcontrib>Abe, Mitsuru</creatorcontrib><creatorcontrib>Hamasaki, Shuichi</creatorcontrib><creatorcontrib>Ohishi, Mitsuru</creatorcontrib><creatorcontrib>Nakashima, Hitoshi</creatorcontrib><creatorcontrib>Mitsudo, Kazuaki</creatorcontrib><creatorcontrib>Nobuyoshi, Masakiyo</creatorcontrib><creatorcontrib>Kita, Toru</creatorcontrib><creatorcontrib>Imoto, Yutaka</creatorcontrib><creatorcontrib>Sakata, Ryuzo</creatorcontrib><creatorcontrib>Okabayashi, Hitoshi</creatorcontrib><creatorcontrib>Hanyu, Michiya</creatorcontrib><creatorcontrib>Shimamoto, Mitsuomi</creatorcontrib><creatorcontrib>Nishiwaki, Noboru</creatorcontrib><creatorcontrib>Komiya, Tatsuhiko</creatorcontrib><creatorcontrib>Kimura, Takeshi</creatorcontrib><creatorcontrib>CREDO-Kyoto PCI/CABG Registry Cohort-2 Investigators</creatorcontrib><title>Incidence and outcome of surgical procedures after coronary artery bypass grafting compared with those after percutaneous coronary intervention: a report from the Coronary Revascularization Demonstrating Outcome Study in Kyoto PCI/CABG Registry Cohort-2</title><title>Circulation. Cardiovascular interventions</title><addtitle>Circ Cardiovasc Interv</addtitle><description>Noncardiac surgery after percutaneous coronary intervention (PCI) has been reported to be carrying high risk for both ischemic and bleeding complications. However, there has been no report comparing the incidence and outcomes of surgical procedures after coronary artery bypass grafting (CABG) with those after PCI.
Among 14 383 patients undergoing first coronary revascularization (PCI, n=12 207; CABG, n=2176) enrolled in the Coronary Revascularization Demonstrating Outcome Study in Kyoto (CREDO-Kyoto) PCI/CABG Registry Cohort-2, surgical procedures were performed more frequently after CABG (n=560) than after PCI (n=2398; cumulative 3-year incidence: 27% versus 22%; unadjusted P<0.0001), particularly <6 months of coronary revascularization. The risk for the primary ischemic outcome measure (death/myocardial infarction) at 30-day postsurgical procedures was not significantly different between the CABG and PCI groups (cumulative incidence: 3.1% versus 3.2%; unadjusted P=0.9; adjusted hazard ratio, 0.97; 95% confidence interval, 0.47-1.89; P=0.9). The risk for the primary bleeding outcome measure (moderate or severe bleeding by Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries classification) was lower in the CABG groups than in the PCI group (cumulative incidence: 1.3% versus 2.6%; unadjusted P=0.07; adjusted hazard ratio, 0.36; 95% confidence interval, 0.12-0.87; P=0.02). There were no interactions between the timing of surgery and the types of coronary revascularization (CABG/PCI) for both ischemic and bleeding outcomes.
Surgical procedures were performed significantly more frequently after CABG than after PCI, particularly <6 months after coronary revascularization. Surgical procedures after CABG as compared with those after PCI were associated with similar risk for ischemic events and lower risk for bleeding events, regardless of the timing after coronary revascularization.</description><subject>Aged</subject><subject>Cardiovascular Diseases - epidemiology</subject><subject>Cardiovascular Diseases - mortality</subject><subject>Cardiovascular Diseases - surgery</subject><subject>Cohort Studies</subject><subject>Coronary Artery Bypass</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Hypertension - epidemiology</subject><subject>Hypertension - mortality</subject><subject>Hypertension - surgery</subject><subject>Incidence</subject><subject>Japan</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Myocardial Infarction - epidemiology</subject><subject>Myocardial Infarction - etiology</subject><subject>Percutaneous Coronary Intervention</subject><subject>Postoperative Hemorrhage - epidemiology</subject><subject>Postoperative Hemorrhage - etiology</subject><subject>Registries</subject><subject>Retrospective Studies</subject><subject>Risk</subject><subject>Survival Analysis</subject><subject>Treatment Outcome</subject><issn>1941-7640</issn><issn>1941-7632</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNplUVtv0zAUthCIjcFfQOeB12x2rg3iZWRlREwt6gqv0alz3AY1dmQ7Q-G_I-HSbjzwZPu7nWN9jL0T_FKIXFxV9aqqF-v56vt8sa6Xi_sAJ5ecC57lz9i5KFMRFXkSP3-6p_yMvXLuB-cBzuOX7CzOeJHGWXLOftdadi1pSYC6BTN6aXoCo8CNdttJ3MNgjaR2tOQAlScL0lij0U6ANjwn2EwDOgdbG-hObwPfD2iphZ-d34HfGUcn50BWjh41mdH9i-l04B5I-87o94BgaTDWg7KmD26C6lG4ogd0ctyj7X7hQQ031BvtvMW_g5en7e_92B5i4ctkvIGvVX1VXX-8Df5tF8RTSNyFCVH8mr1QuHf05nResG-f5uvqc3S3vK2r67tIxonwUaJEHBOWJSqV4mymZpw2GU_bIhG85YoXGyw4qoxns7LkbZFLFRcqK1WQyaC6YB-OudIa5yypZrBdH77UCN4cWm3-azXASXNsNdjfHu3DuOmpfTI_1pj8AcQfqZs</recordid><startdate>201408</startdate><enddate>201408</enddate><creator>Tokushige, Akihiro</creator><creator>Shiomi, Hiroki</creator><creator>Morimoto, Takeshi</creator><creator>Ono, Koh</creator><creator>Furukawa, Yutaka</creator><creator>Nakagawa, Yoshihisa</creator><creator>Kadota, Kazushige</creator><creator>Ando, Kenji</creator><creator>Shizuta, Satoshi</creator><creator>Tada, Tomohisa</creator><creator>Tazaki, Junichi</creator><creator>Kato, Yoshihiro</creator><creator>Hayano, Mamoru</creator><creator>Abe, Mitsuru</creator><creator>Hamasaki, Shuichi</creator><creator>Ohishi, Mitsuru</creator><creator>Nakashima, Hitoshi</creator><creator>Mitsudo, Kazuaki</creator><creator>Nobuyoshi, Masakiyo</creator><creator>Kita, Toru</creator><creator>Imoto, Yutaka</creator><creator>Sakata, Ryuzo</creator><creator>Okabayashi, Hitoshi</creator><creator>Hanyu, Michiya</creator><creator>Shimamoto, Mitsuomi</creator><creator>Nishiwaki, Noboru</creator><creator>Komiya, Tatsuhiko</creator><creator>Kimura, Takeshi</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>201408</creationdate><title>Incidence and outcome of surgical procedures after coronary artery bypass grafting compared with those after percutaneous coronary intervention: a report from the Coronary Revascularization Demonstrating Outcome Study in Kyoto PCI/CABG Registry Cohort-2</title><author>Tokushige, Akihiro ; Shiomi, Hiroki ; Morimoto, Takeshi ; Ono, Koh ; Furukawa, Yutaka ; Nakagawa, Yoshihisa ; Kadota, Kazushige ; Ando, Kenji ; Shizuta, Satoshi ; Tada, Tomohisa ; Tazaki, Junichi ; Kato, Yoshihiro ; Hayano, Mamoru ; Abe, Mitsuru ; Hamasaki, Shuichi ; Ohishi, Mitsuru ; Nakashima, Hitoshi ; Mitsudo, Kazuaki ; Nobuyoshi, Masakiyo ; Kita, Toru ; Imoto, Yutaka ; Sakata, Ryuzo ; Okabayashi, Hitoshi ; Hanyu, Michiya ; Shimamoto, Mitsuomi ; Nishiwaki, Noboru ; Komiya, Tatsuhiko ; Kimura, Takeshi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c231t-3f122ea99aff4a88f80eb504d7310d0f07ba70af5058990d76cf27f59feb5cd73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Aged</topic><topic>Cardiovascular Diseases - epidemiology</topic><topic>Cardiovascular Diseases - mortality</topic><topic>Cardiovascular Diseases - surgery</topic><topic>Cohort Studies</topic><topic>Coronary Artery Bypass</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Hypertension - epidemiology</topic><topic>Hypertension - mortality</topic><topic>Hypertension - surgery</topic><topic>Incidence</topic><topic>Japan</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Myocardial Infarction - epidemiology</topic><topic>Myocardial Infarction - etiology</topic><topic>Percutaneous Coronary Intervention</topic><topic>Postoperative Hemorrhage - epidemiology</topic><topic>Postoperative Hemorrhage - etiology</topic><topic>Registries</topic><topic>Retrospective Studies</topic><topic>Risk</topic><topic>Survival Analysis</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tokushige, Akihiro</creatorcontrib><creatorcontrib>Shiomi, Hiroki</creatorcontrib><creatorcontrib>Morimoto, Takeshi</creatorcontrib><creatorcontrib>Ono, Koh</creatorcontrib><creatorcontrib>Furukawa, Yutaka</creatorcontrib><creatorcontrib>Nakagawa, Yoshihisa</creatorcontrib><creatorcontrib>Kadota, Kazushige</creatorcontrib><creatorcontrib>Ando, Kenji</creatorcontrib><creatorcontrib>Shizuta, Satoshi</creatorcontrib><creatorcontrib>Tada, Tomohisa</creatorcontrib><creatorcontrib>Tazaki, Junichi</creatorcontrib><creatorcontrib>Kato, Yoshihiro</creatorcontrib><creatorcontrib>Hayano, Mamoru</creatorcontrib><creatorcontrib>Abe, Mitsuru</creatorcontrib><creatorcontrib>Hamasaki, Shuichi</creatorcontrib><creatorcontrib>Ohishi, Mitsuru</creatorcontrib><creatorcontrib>Nakashima, Hitoshi</creatorcontrib><creatorcontrib>Mitsudo, Kazuaki</creatorcontrib><creatorcontrib>Nobuyoshi, Masakiyo</creatorcontrib><creatorcontrib>Kita, Toru</creatorcontrib><creatorcontrib>Imoto, Yutaka</creatorcontrib><creatorcontrib>Sakata, Ryuzo</creatorcontrib><creatorcontrib>Okabayashi, Hitoshi</creatorcontrib><creatorcontrib>Hanyu, Michiya</creatorcontrib><creatorcontrib>Shimamoto, Mitsuomi</creatorcontrib><creatorcontrib>Nishiwaki, Noboru</creatorcontrib><creatorcontrib>Komiya, Tatsuhiko</creatorcontrib><creatorcontrib>Kimura, Takeshi</creatorcontrib><creatorcontrib>CREDO-Kyoto PCI/CABG Registry Cohort-2 Investigators</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Circulation. Cardiovascular interventions</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tokushige, Akihiro</au><au>Shiomi, Hiroki</au><au>Morimoto, Takeshi</au><au>Ono, Koh</au><au>Furukawa, Yutaka</au><au>Nakagawa, Yoshihisa</au><au>Kadota, Kazushige</au><au>Ando, Kenji</au><au>Shizuta, Satoshi</au><au>Tada, Tomohisa</au><au>Tazaki, Junichi</au><au>Kato, Yoshihiro</au><au>Hayano, Mamoru</au><au>Abe, Mitsuru</au><au>Hamasaki, Shuichi</au><au>Ohishi, Mitsuru</au><au>Nakashima, Hitoshi</au><au>Mitsudo, Kazuaki</au><au>Nobuyoshi, Masakiyo</au><au>Kita, Toru</au><au>Imoto, Yutaka</au><au>Sakata, Ryuzo</au><au>Okabayashi, Hitoshi</au><au>Hanyu, Michiya</au><au>Shimamoto, Mitsuomi</au><au>Nishiwaki, Noboru</au><au>Komiya, Tatsuhiko</au><au>Kimura, Takeshi</au><aucorp>CREDO-Kyoto PCI/CABG Registry Cohort-2 Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incidence and outcome of surgical procedures after coronary artery bypass grafting compared with those after percutaneous coronary intervention: a report from the Coronary Revascularization Demonstrating Outcome Study in Kyoto PCI/CABG Registry Cohort-2</atitle><jtitle>Circulation. Cardiovascular interventions</jtitle><addtitle>Circ Cardiovasc Interv</addtitle><date>2014-08</date><risdate>2014</risdate><volume>7</volume><issue>4</issue><spage>482</spage><epage>491</epage><pages>482-491</pages><issn>1941-7640</issn><eissn>1941-7632</eissn><abstract>Noncardiac surgery after percutaneous coronary intervention (PCI) has been reported to be carrying high risk for both ischemic and bleeding complications. However, there has been no report comparing the incidence and outcomes of surgical procedures after coronary artery bypass grafting (CABG) with those after PCI.
Among 14 383 patients undergoing first coronary revascularization (PCI, n=12 207; CABG, n=2176) enrolled in the Coronary Revascularization Demonstrating Outcome Study in Kyoto (CREDO-Kyoto) PCI/CABG Registry Cohort-2, surgical procedures were performed more frequently after CABG (n=560) than after PCI (n=2398; cumulative 3-year incidence: 27% versus 22%; unadjusted P<0.0001), particularly <6 months of coronary revascularization. The risk for the primary ischemic outcome measure (death/myocardial infarction) at 30-day postsurgical procedures was not significantly different between the CABG and PCI groups (cumulative incidence: 3.1% versus 3.2%; unadjusted P=0.9; adjusted hazard ratio, 0.97; 95% confidence interval, 0.47-1.89; P=0.9). The risk for the primary bleeding outcome measure (moderate or severe bleeding by Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries classification) was lower in the CABG groups than in the PCI group (cumulative incidence: 1.3% versus 2.6%; unadjusted P=0.07; adjusted hazard ratio, 0.36; 95% confidence interval, 0.12-0.87; P=0.02). There were no interactions between the timing of surgery and the types of coronary revascularization (CABG/PCI) for both ischemic and bleeding outcomes.
Surgical procedures were performed significantly more frequently after CABG than after PCI, particularly <6 months after coronary revascularization. Surgical procedures after CABG as compared with those after PCI were associated with similar risk for ischemic events and lower risk for bleeding events, regardless of the timing after coronary revascularization.</abstract><cop>United States</cop><pmid>25074253</pmid><doi>10.1161/CIRCINTERVENTIONS.113.001056</doi><tpages>10</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1941-7640 |
| ispartof | Circulation. Cardiovascular interventions, 2014-08, Vol.7 (4), p.482-491 |
| issn | 1941-7640 1941-7632 |
| language | eng |
| recordid | cdi_crossref_primary_10_1161_CIRCINTERVENTIONS_113_001056 |
| source | MEDLINE; American Heart Association Journals; EZB-FREE-00999 freely available EZB journals |
| subjects | Aged Cardiovascular Diseases - epidemiology Cardiovascular Diseases - mortality Cardiovascular Diseases - surgery Cohort Studies Coronary Artery Bypass Female Follow-Up Studies Humans Hypertension - epidemiology Hypertension - mortality Hypertension - surgery Incidence Japan Male Middle Aged Myocardial Infarction - epidemiology Myocardial Infarction - etiology Percutaneous Coronary Intervention Postoperative Hemorrhage - epidemiology Postoperative Hemorrhage - etiology Registries Retrospective Studies Risk Survival Analysis Treatment Outcome |
| title | Incidence and outcome of surgical procedures after coronary artery bypass grafting compared with those after percutaneous coronary intervention: a report from the Coronary Revascularization Demonstrating Outcome Study in Kyoto PCI/CABG Registry Cohort-2 |
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