Abstract 15051: The Impact of Percutaneous Coronary Intervention in Native Coronary Arteries versus Bypass Grafts on Health Status Outcomes
Background: Patients undergoing percutaneous coronary intervention (PCI) of a bypass graft are less likely to achieve TIMI flow grade 3 post-stenting and have higher complication rates than PCI to a native coronary artery. However, no data exists on the impact of bypass graft vs. native coronary PCI on health status outcomes after PCI.
Methods: In a 10-center US PCI registry, patients were assessed for angina frequency (AF), angina-related physical limitation (PL) and quality of life (QoL) at baseline and at 6 and 12 months after PCI using the Seattle Angina Questionnaire (SAQ). Patients with graft PCI were propensity score matched in a 1:2 ratio to patient with native coronary artery PCI, and then health status recovery was compared between groups using repeated measures analysis.
Results: Of 3267 PCI patients (71% male, 20% NSTEMI), 207 (6.3%) underwent bypass graft PCI of whom 200 were propensity matched to 396 similar patients with native coronary PCI. While patients with graft PCI had worse health status than those with native coronary PCI in the overall cohort, after propensity score matching, patients’ comorbidities and characteristics (including baseline SAQ health status; SAQ AF for bypass graft vs native coronary PCI: 64 ± 29 vs 65 ± 27) were well balanced. Repeated measures analysis showed that both groups increased SAQ AF scores by ~28 points over 1 year (SAQ AF for bypass graft vs native coronary PCI: 92 ± 17 vs 92 ± 16), with no significant difference in health status recovery over time between groups (Figure).
Conclusions: While patients with graft PCI had worse baseline health status, after accounting for these and other patients-level differences, we found that patients with graft PCI had similarly good health status recovery after PCI when compared to PCI in native coronary artery. Although technical considerations may influence an operator’s decision to perform PCI in a bypass graft, concerns about the potential health status benefits should not preclude PCI.
- Percutaneous coronary intervention (PCI)
- Angina pectoris
- Quality of life
- Coronary interventions
- Graft patency
Author Disclosures: M. Qintar: None. M. Omer: None. F. Tang: None. S.V. Arnold: None. J.A. Spertus: Research Grant; Modest; NHLBI, AHA, ACCF, Lilly, EvaHeart, Amorcyte. Honoraria; Modest; United Healthcare, Genentech, Amgen. Ownership Interest; Significant; Health Outcomes Sciences, the commercial entity distributing and supporting ePRISM,, Owns copyrights to the Seattle Angina Questionnaire. A.C. Salisbury: None.
- © 2016 by American Heart Association, Inc.