Timing of coronary artery bypass grafting after myocardial infarction influences late survival.
| Autor: | Patlolla SH; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn., Crestanello JA; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn., Schaff HV; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn., Pochettino A; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn., Stulak JM; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn., Daly RC; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn., Greason KL; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn., Dearani JA; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn., Saran N; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn. |
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| Jazyk: | angličtina |
| Zdroj: | JTCVS open [JTCVS Open] 2024 May 23; Vol. 20, pp. 40-48. Date of Electronic Publication: 2024 May 23 (Print Publication: 2024). |
| DOI: | 10.1016/j.xjon.2024.05.008 |
| Abstrakt: | Objectives: The role of timing of coronary artery bypass grafting after acute myocardial infarction on early and late outcomes remains uncertain. Methods: We reviewed 1631 consecutive adult patients who underwent isolated coronary artery bypass grafting with information on timing of acute myocardial infarction. Early and late mortality were compared between patients receiving coronary artery bypass grafting within 24 hours after acute myocardial infarction, between 1 and 7 days after acute myocardial infarction, and more than 7 days after acute myocardial infarction. Sensitivity analyses were performed in subgroups of patients with ST-segment elevation myocardial infarction or non-ST-segment elevation myocardial infarction, and other high-risk groups. Results: A total of 124 patients (5.7%) underwent coronary artery bypass grafting within 24 hours, 972 patients (51.2%) received coronary artery bypass grafting between 1 and 7 days after acute myocardial infarction, and 535 patients (43.2%) underwent coronary artery bypass grafting more than 7 days after acute myocardial infarction. Overall operative mortality was 2.7% with comparable adjusted early mortality among 3 groups. Over a median follow-up of 13.5 years (interquartile range, 8.9-17.1), compared with patients receiving coronary artery bypass grafting between 1 and 7 days after acute myocardial infarction, those receiving coronary artery bypass grafting at 7 days had greater adjusted risk for late overall mortality (hazard ratio, 1.39, 95% CI, 1.16-1.67; P < .001), whereas those receiving coronary artery bypass grafting within 24 hours had comparable risk of late overall mortality (hazard ratio, 1.12, 95% CI, 0.86-1.47; P = .39). Timing of coronary artery bypass grafting was associated with late mortality in patients with non-ST-segment elevation myocardial infarction (patients receiving coronary artery bypass grafting at >7 days had a higher risk of late mortality [hazard ratio, 1.38, 95% CI, 1.14-1.67, P < .001] compared with those receiving coronary artery bypass grafting between 1 and 7 days), but not in patients with ST-segment elevation myocardial infarction. Conclusions: Early revascularization through coronary artery bypass grafting within 7 days during the same hospitalization appears beneficial, especially for patients presenting with non-ST-segment elevation myocardial infarction. Competing Interests: The authors reported no conflicts of interest. The Journal policy requires editors and reviewers to disclose conflicts of interest and to decline handling or reviewing manuscripts for which they may have a conflict of interest. The editors and reviewers of this article have no conflicts of interest. (© 2024 The Author(s).) |
| Databáze: | MEDLINE |
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