Comparison of Outcomes of Patients with vs without Previous Coronary Artery Bypass Graft Surgery Presenting with ST-Segment Elevation Acute Myocardial Infarction.
Aged
Aged, 80 and over
Coronary Artery Bypass
/ statistics & numerical data
Female
Hospital Mortality
Humans
Male
Middle Aged
Mortality
Myocardial Infarction
/ epidemiology
Percutaneous Coronary Intervention
Proportional Hazards Models
Registries
ST Elevation Myocardial Infarction
/ surgery
Stroke
/ epidemiology
Time-to-Treatment
/ statistics & numerical data
Journal
The American journal of cardiology
ISSN: 1879-1913
Titre abrégé: Am J Cardiol
Pays: United States
ID NLM: 0207277
Informations de publication
Date de publication:
01 09 2021
01 09 2021
Historique:
received:
15
03
2021
revised:
17
05
2021
accepted:
24
05
2021
pubmed:
11
7
2021
medline:
18
9
2021
entrez:
10
7
2021
Statut:
ppublish
Résumé
The outcomes of patients with previous coronary bypass graft surgery (CABG) presenting with ST-segment elevation acute myocardial infarction (STEMI) have received limited study. We compared the clinical and procedural characteristics and outcomes of STEMI patients with and without previous CABG in a contemporary multicenter STEMI registry between 2003 and 2020. The primary outcomes of the study were mortality and major cardiac adverse events (MACE: death, MI or stroke). Survival curves were derived using the Kaplan-Meier method and compared with the log-rank test. Of the 13,893 patients included in the analyses, 7.2% had previous CABG. Mean age was 62.4 ± 13.6 years, most patients (71%) were men and 22% had diabetes. Previous CABG patients were older (69.0 ± 11.7 vs 61.9 ± 13.6 years, p <0.001) and more likely to have diabetes (40% vs 21%, p <0.001) compared with patients without previous CABG. Previous CABG patients had higher mortality and MACE at 5 years (p <0.001). Outcomes were similar with saphenous vein graft vs native coronary culprits. Previous CABG remained associated with mortality from discharge to 18 months (p = 0.044) and from 18 months to 5 years (p <0.001) after adjusting for baseline characteristics. Long term outcomes after STEMI were worse among patients with previous CABG compared with patients without previous CABG, even after adjustment for baseline characteristics.
Identifiants
pubmed: 34243937
pii: S0002-9149(21)00520-8
doi: 10.1016/j.amjcard.2021.05.041
pii:
doi:
Types de publication
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
33-40Informations de copyright
Copyright © 2021 Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Competing Interest Dr. Garcia. Institutional research grants from Edwards Lifesciences, Medtronic, Abbott Vascular, Biotronik and BSCI. Consultant: Neochord, Abbott Vascular, Medtronic and BSCI. Proctor: Edwards Lifesciences. Dr. Burke: speaker for Opsens Medical; has served as a consultant for Abbott Vascular; and owns equity in Egg Medical and MHI Ventures. Dr. Brilakis: consulting/speaker honoraria from Abbott Vascular, American Heart Association (associate editor Circulation), Amgen, Asahi Intecc, Biotronik, Boston Scientific, Cardiovascular Innovations Foundation (Board of Directors), ControlRad, CSI, Elsevier, GE Healthcare, InfraRedx, Medicure, Medtronic, Opsens, Siemens, and Teleflex; owner, Hippocrates LLC; shareholder: MHI Ventures, Cleerly Healths. All other authors: declaration of interest: none.