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Timing of coronary artery bypass grafting after myocardial infarction influences late survivalCentral MessagePerspective

Authors :
Sri Harsha Patlolla, MBBS, MS
Juan A. Crestanello, MD
Hartzell V. Schaff, MD
Alberto Pochettino, MD
John M. Stulak, MD
Richard C. Daly, MD
Kevin L. Greason, MD
Joseph A. Dearani, MD
Nishant Saran, MBBS
Source :
JTCVS Open, Vol 20, Iss , Pp 40-48 (2024)
Publication Year :
2024
Publisher :
Elsevier, 2024.

Abstract

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 7 days had a higher risk of late mortality [hazard ratio, 1.38, 95% CI, 1.14-1.67, P

Details

Language :
English
ISSN :
26662736
Volume :
20
Issue :
40-48
Database :
Directory of Open Access Journals
Journal :
JTCVS Open
Publication Type :
Academic Journal
Accession number :
edsdoj.9c3b1cb0b6749f1bbb960f16091bc60
Document Type :
article
Full Text :
https://doi.org/10.1016/j.xjon.2024.05.008