Comparison of Outcomes of Patients with vs without Previous Coronary Artery Bypass Graft Surgery Presenting with ST-Segment Elevation Acute Myocardial Infarction.

Abstract

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.

• Authors: Judit Karacsonyi, Christian W Schmidt, Brynn K Okeson, Santiago Garcia, Timothy D Henry, Ilias Nikolakopoulos, Evangelia Vemmou, Iosif Xenogiannis, Scott Sharkey, Frank V Aguirre, Mark Tannenbaum, M Nicholas Burke, Mario Goessl, Paul Sorajja, Jay Traverse, Yale L Wang, Emmanouil S Brilakis
• Journal: The American journal of cardiology (Am J Cardiol) Vol. 154 Pg. 33-40 (09 01 2021) ISSN: 1879-1913 [Electronic] United States
• PMID: 34243937 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2021 Elsevier Inc. All rights reserved.

Topics

• 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)