Advances in Interventional Cardiology
eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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Original paper

Long-term survival in patients with acute coronary syndrome and prior coronary artery bypass grafting stratified by the number of significantly stenosed and occluded native coronary arteries

Michał Chyrchel
1
,
Natalia Ostruszka
2
,
Jacek Niedziela
3
,
Mateusz Kozioł
2
,
Damian Grzegorek
4
,
Julia Radzikowska
2
,
Wojciech Siłka
2
,
Andrzej Surdacki
1
,
Mateusz Gąsior
3
,
Rafał Januszek
5

  1. 2nd Department of Cardiology and Cardiovascular Interventions, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
  2. Jagiellonian University Medical College, Krakow, Poland
  3. Third Department of Cardiology, Silesian Center for Heart Diseases, Medical University of Silesia, Zabrze, Poland
  4. Department of Cardiology, John Paul II Provincial Hospital, Belchatow, Poland
  5. Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Cracow University, Krakow, Poland
Adv Interv Cardiol
DOI: https://doi.org/10.5114/aic.2025.155793
Online publish date: 2025/11/02
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Introduction
Patients with acute coronary syndrome (ACS) and prior coronary artery bypass grafting (CABG) are at high procedural risk. Among the risk factors determining the prognosis, it is assumed that the number of graft vessels may be an important aspect.

Aim
To assess the impact of number of significantly stenosed or occluded native arteries on prognosis in post-CABG patients treated with graft percutaneous coronary intervention (PCI) due to ACS.

Material and methods
This retrospective analysis covered 689 post-CABG patients undergoing PCI for the ACS, who were extracted from the PL-ACS registry from 2005 to 2020. They were stratified into three groups according to the number of significantly stenosed or occluded native arteries: one- (SVD), two- (2VD) and multi-vessel disease (MVD). Prognosis was assessed via Kaplan-Meier curves and multivariable Cox regression analyses.

Results
All-cause one-year mortality reached 14% in the SVD group, 12% in the 2VD group and 14% in the MVD group (p = 0.78), whereas in-hospital mortality occurred in 3.3%, 3.8%, and 6.2% of cases, respectively (p = 0.26). The incidence rates of periprocedural complications, including stroke, major bleeding, cardiac arrest, pulmonary oedema were comparable between the study groups. The multivariate analysis confirmed among significant predictors of overall mortality at one year: age, chronic heart failure, left ventricle ejection fraction, major bleeding and Killip-Kimball grade (p < 0.05).

Conclusions
The results of our study suggest that the number of occluded native arteries does not affect the prognosis of post-CABG patients undergoing PCI for ACS treatment, as in-hospital outcomes, one-year all-cause mortality, and periprocedural complications were comparable across all study groups.

keywords:

acute coronary syndrome, coronary artery bypass grafting, coronary artery disease, number of native vessels, percutaneous coronary interventions
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