A risk model derived from the National Registry of Myocardial Infarction 2 database for predicting mortality after coronary artery bypass grafting during acute myocardial infarction

Zaroff, Jonathan G.; diTommaso, Dante; Barron, Hal V.

doi:10.1016/s0002-9149(02)02375-5

Cited by 34 publications

(17 citation statements)

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“…S o m e p a t i e n t s r e q u i r e u r g e n t m y o c a r d i a l revascularization, such as those with mechanical complications associated with acute myocardial infarction 20 or patients with cardiogenic shock and left main coronary artery disease or three-vessel disease 21,22 . Yet, there are doubts regarding when to operate on patients who, despite their good clinical outcome following AMI, have multivessel disease or even isolated lesions of CABG, point to the following variables as risk factors for operative mortality: female gender, Q-wave AMI, age > 65, history of CHF and diabetes mellitus, previous CABG, and Killip's classification of AMI 11 .…”

Section: Discussionmentioning

confidence: 99%

“…Countless studies have been trying to identify which group of patients are at higher operative risk after AMI 9,10,11,16,22,26 . Data from the National Registry of Myocardial Infarction 2, which assessed 71,774 AMI patients who underwent between history of previous angioplasty and operative mortality is yet to be established, and other studies are needed to clarify this issue 31 .…”

Section: Ladeira E Cols Coronary Artery Bypass Grafting In Acute Myomentioning

confidence: 99%

“…Thus, surgery in this phase is reserved for patients who failed to improve with the above recanalization techniques or evolved to persistent angina or hemodynamic instability 10 . In another group of patients, recanalization is successful; nevertheless, the patient has major residual coronary obstructions requiring surgical intervention 11 . In clinically stable patients, operative mortality rates range from 2% to 4%, very similar to those of patients who undergo elective revascularization 10,11 .…”

mentioning

confidence: 99%

“…In another group of patients, recanalization is successful; nevertheless, the patient has major residual coronary obstructions requiring surgical intervention 11 . In clinically stable patients, operative mortality rates range from 2% to 4%, very similar to those of patients who undergo elective revascularization 10,11 . However, in patients with clinical or mechanical complications, mortality rates rise to 6%-26% [12][13][14] .…”

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confidence: 99%

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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.

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Ladeira E Cols Coronary Artery Bypass Grafting In Acute Myomentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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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.

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“…These patients are frequently haemodynamically unstable and require high-dose catecholamines. Since mortality in these patients is extremely high if myocardial blood flow can not be restored, coronary artery bypass surgery remains a final rescue therapy [18,19]. However, the mortality of these emergency operations is also high (41%) [20].…”

Section: Coronary Artery Bypass Surgerymentioning

confidence: 99%

Coronary artery angioplasty for treatment of peri‐operative myocardial ischaemia

et al. 2005

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SummaryIncreasing numbers of elderly patients with severe co-existing medical diseases undergo major surgery. With these patients there is also an accompanying risk of age-related cardiovascular complications such as life-threatening myocardial ischaemia. We present a patient who suffered a myocardial infarction after a hemicolectomy and suffered a cardiac arrest in the recovery room. The therapeutic options available (e.g. coronary artery bypass grafting, acute percutaneous coronary angioplasty and peri-operative thrombolysis) are discussed and the successful management of the case by coronary angioplasty and stent implantation is described. Peri-operative myocardial ischaemia is a serious clinical condition. In non-cardiac surgery, approximately 4% of all patients will experience peri-operative cardiac complications and 0.5% will suffer myocardial infarction [1]. Although most ischaemic episodes occur on the second and third postoperative day [2], in some patients myocardial ischaemia is apparent during surgery. If ST-segment elevations persist despite adequate treatment, mortality increases to 20-50% [3,4]. Consequently rapid and aggressive treatment is required to improve the survival rate of these patients.We present a case of near-fatal intra-and postoperative myocardial ischaemia after a hemicolectomy. The patient was treated by percutaneous transluminal coronary angioplasty and stent implantation within the first hour after surgery. Case reportA 76-year-old male patient (ASA physical status III, New York Heart Association class III, weighing 73 kg) was admitted for resection of a transverse colonic carcinoma. The patient had had a myocardial infarction less than 3 months previously. Additional cardiovascular risk factors were arterial hypertension and non-insulin dependent diabetes. Four years previously, the patient had had a cerebral vascular accident but made a full recovery. He was treated with a calcium-channel blocker, a thiazide diuretic, an angiotensin converting enzyme inhibitor and oral hypoglycaemic drugs (a biguanide and a sulphonylurea). Pre-operative blood chemistry was normal; the haemoglobin concentration was low at 9.7 g.dl ) and nitroglycerine (1.6 lg.kg )1 .min )1) were started. The mean blood pressure increased and was then maintained at 80 mm Hg until the end of the operation. Blood samples were collected for measurement of troponin T (positive threshold concentration 0

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Dreyer¹,

Velentgas²

2012

Pharmacoepidemiology

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A risk model derived from the National Registry of Myocardial Infarction 2 database for predicting mortality after coronary artery bypass grafting during acute myocardial infarction

Cited by 34 publications

References 14 publications

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

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

Coronary artery angioplasty for treatment of peri‐operative myocardial ischaemia

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