The following is a summary of “Percutaneous Coronary Intervention in Men, Women, and Minorities With a Previous Coronary Artery Bypass Graft Surgery (from the Pooled PLATINUM Diversity and PROMUS Element Plus Registries),” published in the August 2023 issue of Cardiovascular Disease by Beerkens et al.

There is a lack of data regarding the outcomes of new-generation stents in patients with a history of coronary artery bypass graft (CABG), and the potential influence of gender and race/ethnicity on associated risks remains uncertain. Researchers conducted a study on the 1-year outcomes following the implantation of platinum chromium everolimus-eluting stents in a diverse population of men, women, and minorities who had previously undergone coronary artery bypass grafting (CABG). The data for this study was collected from the PLATINUM Diversity (NCT02240810) and PROMUS Element Plus (NCT01589978) registries. The primary outcome of the researcher’s research was major adverse cardiac events (MACE), which is a combination of all-cause death, myocardial infarction (MI), and target vessel revascularisation (TVR) occurring within one year after percutaneous coronary intervention (PCI). 

Secondary endpoints encompassed all-cause mortality, myocardial infarction (MI), target vessel revascularisation (TVR), target vessel failure, and stent thrombosis. A cumulative of 4,175 individuals were encompassed in the analysis, comprising 1,858 female patients (44.5%), 1,057 individuals from minority groups (25.3%), and 662 patients (15.9%) who had undergone previous coronary artery bypass grafting (CABG). Patients with a history of coronary artery bypass graft (CABG) surgery exhibited advanced age, a higher proportion of male individuals, and a greater prevalence of White patients. Additionally, these patients presented with an increased burden of co-existing medical conditions compared to those without a prior CABG procedure. At 1 year, individuals with a history of coronary artery bypass grafting (CABG) exhibited an increased susceptibility to major adverse cardiovascular events (MACE) compared to those without such a history (12.6% vs. 7.5%, hazard ratio 1.70, 95% confidence interval 1.32 to 2.19, P <0.001). 

Additionally, these individuals were more prone to experiencing adverse outcomes such as death/myocardial infarction (MI), target vessel revascularization (TVR), and target vessel failure. Following multivariate adjustment, no discernible disparities in Major Adverse Cardiovascular Events (MACE) (adjusted hazard ratio 1.11, 95% CI 0.82 to 1.49, P = 0.506) or any secondary outcome measures. No significant correlation was found between prior coronary artery bypass graft (CABG) surgery and gender or minority status. In summary, within a contemporary population undergoing percutaneous coronary intervention (PCI), individuals with a history of coronary artery bypass grafting (CABG) continue to exhibit a heightened risk for PCI due to their elevated risk profile. After adjustment, the previous coronary artery bypass graft (CABG) status did not show an independent association with adverse outcomes. Additionally, no interaction was observed between CABG status and gender or race/ethnicity.

Source: sciencedirect.com/science/article/abs/pii/S0002914923003119