• Dewei Wang, Keyu Chen, Tinglin Xiong, Ling He, Wei Ni, and Haoyu Wang.
• Dewei Wang, Department of Cardiology, Nanchong Central Hospital, Nanchong Central Hospital 97, Renmin South Road, Nanchong, Sichuan Province, 637000, China.
• Pak J Med Sci. 2023 Jul 1; 39 (4): 115611651156-1165.

ObjectiveThis review assessed evidence on the impact of prior coronary artery bypass grafting (CABG) on outcomes of percutaneous coronary intervention (PCI) for chronic total occlusions (CTO).MethodsPubMed, CENTRAL, Embase, ScienceDirect, and Google Scholar databases were searched from 1st January 1980 up to 10th January 2022 for studies assessing outcomes of CTO-PCI in patients with and without prior-CABG.ResultsEight studies were included. The meta-analysis demonstrated significantly reduced odds of procedural success in patients with prior history of CABG (OR: 0.51 95% CI: 0.41, 0.64 I2=84% p<0.00001). There was a tendency of increased in-hospital mortality (OR: 1.72 95% CI: 0.97, 3.04 I2=26% p=0.06) and major adverse cardiac events (MACE) (OR: 1.30 95% CI: 0.99, 1.69 I2=0% p=0.05), along with a significantly increased risk of myocardial infarction (MI) (OR: 2.56 95% CI: 1.65, 3.97 I2=0% p<0.0001) and coronary perforation (OR: 1.52 95% CI: 1.03, 2.24 I2=70% p=0.04) in patients with history of CABG. There was no difference in the risk of stroke, pericardial tamponade, major bleeding, vascular access complications, and renal failure.ConclusionOur results suggest that patients with prior history of CABG undergoing PCI for CTO have a 49% reduced chance of procedural success. Such patients are at an increased risk of in-hospital mortality, MACE, MI, and coronary perforation.Copyright: © Pakistan Journal of Medical Sciences.

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