Coronary artery bypass grafting within 30 days of an acute myocardial infarction

Kaul, Tej K; Fields, Barry L.; Riggins, Shefton L.; Dacumos, Guillermo C.; Wyatt, David A.; Jones, Christopher R.

doi:10.1016/0003-4975(95)00125-5

Cited by 48 publications

(37 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Mortality in patients with preoperative UA undergoing isolated CABG was 4.1 %, versus 6.1% in the group without acute event in this study. The death rate is similar to that presented by other authors as Kaul et al [18] (5.9%), Hochman et al [25] (4.3%), Howard et al [26] (4.3%) and Jatene et al [21] (4.1%), in the context of ACS. However, when we compared the mean death for periods, we observe that there is a significant difference when assessing the period 1996-2003 (4.3%) and 2004-2010 (7.3%) P=0.001, despite advances in treatment and management of ischemic patients undergoing CABG, with greater use of statins, beta-blockers, angiotensin-converting enzyme inhibitors and acetylsalicylic acid, which can be explained by the increased complexity of patients undergoing CABG, with more comorbidities, age and more complex pathologies.…”

Section: Discussionsupporting

confidence: 90%

“…Hasdai et al [17] assessed the outcome of 10,000 patients after ACS in relation to gender and observed in this record that females had older age, no association with increased mortality, lower use of antiplatelet agents (such as glycoprotein IIbIIIa) and less use of less beta blockers, antiplatelet and statin, and more diuretics and digoxin at discharge [17]. Although studies suggest female as a risk indicator for CABG and being part of the scores [18], others did not confirm this risk in the context of ACS [19][20][21], as well as the present study.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Unstable angina does not increase mortality in coronary artery bypass graft surgery

Sussenbach¹,

Guaragna²,

Castagnino³

et al. 2013

Revista Brasileira De Cirurgia Cardiovascular

View full text Add to dashboard Cite

391Rev Bras Cir Cardiovasc | Braz J Cardiovasc SurgRev Bras Cir Cardiovasc 2013;28(3):391- 392Rev Bras Cir Cardiovasc | Braz J Cardiovasc Surg Bras Cir Cardiovasc 2013;28(3):391-400 Sussenbach CP, et al. -Unstable angina does not increase mortality in coronary artery bypass graft surgery twenty minutes (if not interrupted by the nitroglycerin), 2) is described as an intense and frank pain and recent onset (less than 1 month), 3) occurs in a crescendo pattern (e.g., more intense, prolonged or frequent than previously), in the absence signs of myocardial necrosis (elevation of cardiac enzymes). On the ohter hand, the European System Risk in Cardiac Operations (EuroSCORE) defines UA as anginal pain at rest that requires treatment with intravenous nitroglycerin to the surgical procedure. For purposes of this study UA was defined as acute coronary syndrome without ST elevation (ACSST) and without enzyme and/or class IV angina [6,7]. RevAccording to current recommendations on UA, taking into account the patient's risk, CABG is indicated in cases of severe injury of the left main coronary artery, threevessel disease with impaired left ventricular function (left ventricular ejection fraction < 0.5 ); two-vessel lesion with involvement of the proximal left anterior descending artery or decreased left ventricular function or provoked ischemia. Life expectancy, associated diseases, symptom severity and amount of viable myocardium at risk are also important factors [5,8,9].

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Unstable angina does not increase mortality in coronary artery bypass graft surgery

Sussenbach¹,

Guaragna²,

Castagnino³

et al. 2013

Revista Brasileira De Cirurgia Cardiovascular

View full text Add to dashboard Cite

show abstract

“…Despite decades of experience, we have found studies showing increased mortality among patients operated on early after AMI ,6,15,16 and others reporting the safety of CABG at any time after AMI 17,25,29,30 . In our study, no relation was found between mortality and time from AMI to CABG.…”

Section: Discussionmentioning

confidence: 98%

Cirurgia de revascularização na fase aguda do infarto do miocárdio: análise dos fatores pré-operatórios preditores de mortalidade

Ladeira¹,

Jatene²,

Monteiro³

et al. 2006

Arq. Bras. Cardiol.

View full text Add to dashboard Cite

M a i l i n g A d d r e s s : OBJECTIVETo assess preoperative predictors of mortality in patients undergoing coronary artery bypass grafting (CABG) within the first 30 days of acute myocardial infarction (AMI). METHODSBetween March 1998 and July 2002, 753 AMI patients were consecutively and prospectively entered into a database, 135 (17.9%) of whom underwent isolated CABG and were enrolled in this study. The following prognostic factors were assessed by multivariate analysis: age, gender, diabetes, history of previous AMI, CABG or coronary angioplasty (PTCA), anterior infarct location, Q-wave AMI, the use of fibrinolytics, elapsed time from AMI to the procedure, and presence of complications in the preoperative period. RESULTSOverall in-hospital mortality was 6.7%, ranging from 12.5% in patients with preoperative complications to 1.4% in those with no complications. Only history of previous angioplasty (p = 0.037) and cardiogenic shock (p = 0.002) showed a statistically significant correlation with postoperative mortality. The use of thrombolytics, on the other hand, in the initial management of AMI showed a negative correlation with mortality (p = 0.035). CONCLUSIONCABG in the acute phase of MI is associated with distinct operative mortality, depending on the patient's preoperative clinical condition. Among those factors analyzed, preoperative cardiogenic shock and history of previous angioplasty were predictive of worse prognosis in this group of patients. KEY WORDSmortality, surgery, acute myocardial infarction.

show abstract

“…The interval between the onset of AMI and operation is a predictor of operative mortality, 14 which in previous reports has been high at 5.0-20%. 9,[15][16][17] Furthermore, the longer it took to CABG from the onset, the lower the mortality. On the other hand, Lee considered the interval between the onset and operation as crucial, regardless of revascularization.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4][5] Several authors have reported an approximately 20% mortality rate in patients with acute myocardial infarction (AMI) undergoing conventional coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB). [6][7][8][9][10][11] The purpose of this study was to evaluate OPCAB for patients with AMI within 14 days of infarction. …”

mentioning

confidence: 99%

Off-Pump Coronary Artery Bypass Grafting for Acute Myocardial Infarction

Takai

Kobayashi

Tagusari

et al. 2006

Circ J

View full text Add to dashboard Cite

urgical revascularization for ischemic heart disease has been an innovation of the past decade and now off-pump coronary artery bypass grafting (OPCAB) is widely accepted and considered to be safe and effective for myocardial revascularization. 1 In addition OPCAB is considered to be safe for high-risk patients. [2][3][4][5] Several authors have reported an approximately 20% mortality rate in patients with acute myocardial infarction (AMI) undergoing conventional coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB). [6][7][8][9][10][11] The purpose of this study was to evaluate OPCAB for patients with AMI within 14 days of infarction. MethodsThe diagnosis of AMI was based on continuous chest pain and changes in the conventional ECG and enzyme criteria (creatine kinase-myocardial band more than twice the normal value, which is <11 IU/L), and confirmed by coronary angiography that showed an occuluded vessel. The therapeutic starategy for AMI is firstly catheter intervention, followed up medically with intraaortic balloon pumping (IABP). The sustained elevation of enzymes, ST segment on ECG, sustained chest pain and hemodynamic instability (including cardiogenic shock) were indicators Circulation Journal Vol. 70, October 2006 for surgery.The strategy of OPCAB at the National Cardiovascular Center was described in 2002 12 and 2004. 13 Briefly, we usually use a radial artery (RA) composite graft in combination with 1 or both internal thoracic arteries (ITA) for revascularization of the total coronary system. In particular, single ITA and the RA as a composite graft are used for elderly patients with poor risks.The left ITA (LITA) is generally used for revascularization of the left anterior descending branch (LAD) or the blood source of the RA as various configurations of the composite graft. 13 From April 2000 through January 2005 of the 841 patients who underwent OPCAB, we examined 43 consecutive patients (5.1%), 33 of whom were male (Table 1). Three patients underwent OPCAB following unsuccessful percutaneous coronary intervention (PCI), and 1 underwent a re-do procedure 9 years after conventional CABG. Six patients (14%) were admitted to surgery in cardiogenic shock, 20 (47%) required preoperative IABP, and 18 (42%) required emergecy operation. Statistical AnalysisAll values are expressed as the mean ± standard deviation. The discrete variables were analyzed with chi-square test and Mann-Whitney U-test. All statistical analyses were performed using SPSS 10.0 for Windows (Chicago, IL, USA). The differences were considered statistically significant when the p-value was less than 0.05. Background The aim of this study was to evaluate the surgical results of off-pump coronary artery bypass grafting (OPCAB) for patients with acute myocardial infarction (AMI) within 14 days of the infarction. Methods and ResultsFrom April 2000 to January 2005 among 841 patients who underwent OPCAB, 43 consecutive patients (5.1%) were examined. Mean age at operation was 69.5 years and mean time from the onset of AM...

show abstract

Coronary artery bypass grafting within 30 days of an acute myocardial infarction

Cited by 48 publications

References 23 publications

Unstable angina does not increase mortality in coronary artery bypass graft surgery

Unstable angina does not increase mortality in coronary artery bypass graft surgery

Cirurgia de revascularização na fase aguda do infarto do miocárdio: análise dos fatores pré-operatórios preditores de mortalidade

Off-Pump Coronary Artery Bypass Grafting for Acute Myocardial Infarction

Contact Info

Product

Resources

About