Is a Prior History of PCI a Predictor of MACE Within 1 Year of CABG, a Propensity‐Matched Analysis Using Optimal Matching

Background Percutaneous coronary intervention (PCI) is an effective option for myocardial revascularization, even for high‐risk patients. As a result, more patients who undergo coronary artery bypass grafting (CABG) have previously had PCI. This study aims to assess the impact of prior PCI on the occurrence of major adverse cardiac events (MACEs) within 1 year of CABG. Methods We performed a propensity‐matched analysis of adult patients who underwent isolated CABG at our institution from January 2018 to December 2023. We evaluated patient demographics, medication, laboratory results, previous PCI, and clinical data. Our main goal was to compare and predict any differences in MACE between patients with a history of PCI and those without. An optimal propensity score (OPS) matching technique was used to create matched groups based on patients’ preoperative characteristics and risk factors, thereby controlling for selection bias associated with prior PCI. Results Over 5 years, 375 patients received isolated CABG. Using 2:1 OPS, 219 patients were matched and included in the final analysis (58.4% of the original cohort). The average age was 62 years, and 82% were male. Of the studied group, 185 patients (84.5%) had diabetes; 59 patients (26.9%) experienced MACE; and 73 patients (33%) had previous PCI, with 53% of those undergoing PCI within 12 months of surgery. Factors such as age under 61 years, prior PCI, low hemoglobin levels (less than 12 g/dL), BMI below 30 kg/m 2 , ejection fraction less than 40%, and nonelective surgery were strongly associated with 1‐year MACE, as identified by stepwise multivariate logistic regression analyses. Conclusion In the current era, using propensity‐matched groups, a history of PCI before CABG has no direct impact on the risk of MACE within 1 year of CABG surgery. Lower LVEF and hemoglobin levels before CABG were significantly predictive of MACE within 1 year after the procedure. To maximize benefit and minimize harm, it is recommended to focus on optimizing patient status before surgery to achieve the best outcomes.