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?:abstract
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Background: Coronary angiography (CA) in patients with previous coronary artery bypass grafts (CABG) is technically more difficult and has been linked to higher in-hospital complications and mortality Our aim is to describe the characteristics, coronary angiography findings and percutaneous coronary interventional (PCI) management in patients with prior CABG undergoing coronary angiography post-ACS Methods: The All NZ Acute Coronary Syndrome Quality Improvement (ANZACS-QI) registry was used to identify patients admitted to NZ public hospitals with a first ACS event who underwent invasive CA between September 2014 and December 2018 We compared ACS patients with and without with prior CABG Results: Of 57,357 ACS patients, 3,573 (6%) had prior CABG Patients with prior CABG were older than those without CABG (71y vs 65y, p<0 01) and more likely to be male (82% vs 66%, p<0 01) The use of radial artery access for CA was lower in those with prior CABG than for those without prior CABG (50% vs 89%, p<0 01) PCI use was similar in both groups (35% vs 36%, p=0 04) Of the 1264 patients with prior CABG who were treated with PCI, 64% had PCI to the native coronary artery only, 31% had PCI to a coronary graft, and 61 (5%) had PCI to both native vessel and graft Conclusion: Half of patients with prior CABG were studied via the radial artery route A third of patients with prior CABG received a PCI, a rate similar to those without prior CABG, and of these, two-thirds received intervention to a native coronary artery
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