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Background  Percutaneous coronary intervention ( PCI ) in patients with previous coronary artery bypass grafting ( CABG ) is associated with adverse clinical events. Although newer generation drug‐eluting stents showed favorable short‐term safety profiles, there is a lack of long‐term outcome data. We evaluated the impact of previous  CABG  on 5‐year clinical outcomes of patients treated with  PCI  using newer‐generation drug‐eluting stents.    Methods and Results  In this patient‐level pooled analysis of the prospective TWENTE (The Real‐World Endeavor Resolute versus Xience V Drug‐Eluting Stent Study in Twente) trial and nonenrolled  TWENTE  registry, we assessed a consecutive series of patients who underwent  PCI  with newer‐generation drug‐eluting stents for non– ST ‐segment–elevation acute coronary syndromes or stable angina. Of all 1709 patients, 202 (11.8%) had a history of  CABG . Patients with previous  CABG  had significantly higher 5‐year rates of cardiac death (10.4% versus 4.3%;  P <0.001) and target vessel revascularization (25.0% versus 8.1%;  P <0.001). These differences remained statistically significant after adjustment for differences in baseline characteristics. Landmark analysis revealed that from 1‐ to 5‐year follow‐up, the rates of cardiac death (8.1% versus 3.2%;  P <0.001) and target vessel revascularization (17.1% versus 5.9%;  P <0.001) were significantly higher in patients with previous  CABG . Among patients with a history of  CABG ,  PCI  of an obstructed vein graft was associated with a higher rate of 5‐year target vessel revascularization ( P =0.003).    Conclusions  At 5‐year follow‐up after  PCI  with newer‐generation drug‐eluting stents, the risk of cardiac death and target vessel revascularization was significantly higher in patients with previous  CABG . The target vessel revascularization rate was highest in patients who underwent  PCI  of obstructed vein grafts.

Long‐Term Outcome of Consecutive Patients With Previous Coronary Bypass Surgery, Treated With Newer‐Generation Drug‐Eluting Stents