Timing of Revascularization after Acute Myocardial Infarction

Abstract

The optimal timing of surgical revascularization after acute myocardial infarction remains controversial. Higher mortality after emergency coronary artery bypass has been documented. We retrospectively reviewed 278 patients who underwent coronary artery bypass between 2005 and 2007. The time from onset of myocardial infarction to surgical revascularization was the basis for dividing patients into 3 groups: surgery was performed within 24 h in group 1, at 24-72 h in group 2, and after 14 days in group 3. There was a definite relationship between the timing of revascularization and the outcome of surgery. Group 1 had a mortality rate of 11.7%, group 2 had 7% mortality, and group 3 had 2.5% mortality. Group 1 had the highest incidence of postoperative complications. Surgical revascularization within 24 h of acute myocardial infarction was associated with significantly higher risks of mortality and morbidity than procedures performed after 72 h.

Frequency of Arrhythmias in ST-Segment Elevation Myocardial Infarction Patients During Primary Percutaneous Coronary Intervention (PPCI) Till 48 hours Post PPCI in NICVD

“…Patients with STEMI needs to be revascularized within 90 minutes to reduce the incidence of mortality and post-MI complications. 3,4 Primary percutaneous coronary intervention is the gold standard treatment in patients with STEMI, unless contraindicated. STEMI patients who are unable to undergo invasive revascularization on time are more likely to develop post-MI complications.…”

Short Term Outcome of Urgent Coronary Artery Bypass Grafting (CABG) Surgery

“…Significant LM disease is defined as the lesion in the main stem of the LCA greater than 50 percent in the coronary angiography or ostial LAD and LCX involvement (equivalent LM) [4,5].…”

Pressure-Regulated Tepid Blood Reperfusion in Patients Undergoing Emergency Coronary Revascularization after Myocardial Infarction

“…Although it is much safer to perform CABG on an elective basis, some patients may not have such a delay due to ongoing or increasing ischemia and/or cardiogenic shock. 1,2 We would kindly like to comment on the myocardial protection technique that we prefer in patients who undergo emergency CABG after AMI: the pressure-regulated tepid blood reperfusion method. 2 Myocardial revascularization in the early phases of AMI while the cardiac enzymes still are elevated carries certain risks and increased mortality and morbidity rates.…”

“…2 Myocardial revascularization in the early phases of AMI while the cardiac enzymes still are elevated carries certain risks and increased mortality and morbidity rates. 1,2 There is an ongoing search for a better cardioprotective method to achieve improved results in this particular patient group; however, the literature lacks an established accepted methodology.…”

“…We read with great interest the manuscript entitled “Timing of Revascularization after Acute Myocardial Infarction” by Abd-Alaal and colleagues 1 in which they compared the results of myocardial revascularization after acute myocardial infarction (AMI) in patients who underwent coronary artery bypass grafting (CABG) at 3 different times: group 1 in the 1 st 24 h, group 2 between 24–72 h, and group 3 after 14 days. They concluded that myocardial revascularization performed within 24 h after ischemia is associated with significantly higher risks of mortality and morbidity than procedures performed beyond 72 h.…”