Can We Improve Outcomes in Patients With Previous Coronary Artery Bypass Surgery Admitted for Acute Coronary Syndrome?

Teixeira, Rogério; Lourenço, Carolina; António, Natália; Jorge, Elisabete; Baptista, Rui; Saraiva, Fátima; Mendes, Paulo; Monteiro, Sílvia; Gonçalves, Francisco; Monteiro, Pedro; Freitas, Mário; Providência, Luí­s A.

doi:10.1016/s1885-5857(10)70117-1

Cited by 7 publications

(12 citation statements)

References 36 publications

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“…this may probably be related to the dual circulation and the more common occlusion of secondary branches is due to the protection of the main coronary arteries by the bypass vessels. The case presented here might be of interest for the signifi cantly shorter time interval between the ACS and the prior CABG surgery than the interval varying between the median of 4-12.5 years, as reported in the previous study [5].…”

Section: Discussionsupporting

confidence: 50%

“…In the AWESOME RCT and registry, overall in-hospital mortality was higher with CABG than with PCI [7]. A new major coronary event after CABG surgery can be due to progression of atherosclerosis in native arteries and/or development of vascular disease in the graft [5]. Both events were true for this patient, especially with regard to ostial lesions.…”

Section: Discussionmentioning

confidence: 90%

“…Although data on percutaneous revascularization of saphenous venous grafts are still debated, studies showed no statistical difference in restenosis during a 6-month period, but with an improved clinical outcome for elective stenting [5]. Because of the initial higher mortality of redo CABG and the comparable long-term mortality, PCI is the preferred revascularization strategy in patients with patent left internal torasic artery (ITA) and amenable anatomy [4].…”

Section: Discussionmentioning

confidence: 99%

“…Ischemia after CABG may be due to new disease, progression beyond the bypass graft anastomosis, or disease in the graft itself [4]. Teixeira et al reported that a history of CABG was an independent predictor for a future readmission for unstable angina, and they found the time between CABG surgery and the acute coronary syndrome (ACS) to vary between a median of 4 to 12.5 years [5]. The present paper reports an ACS patient fi ve months after CABG surgery.…”

Section: Introductionmentioning

confidence: 99%

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Significant Restenosis of Multiple Saphenous Vein Grafts Early After Coronary Artery Bypass Graft Surgery: a Case Report

Cicek¹

2011

J Med Cases

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Section: Discussionsupporting

confidence: 50%

Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Significant Restenosis of Multiple Saphenous Vein Grafts Early After Coronary Artery Bypass Graft Surgery: a Case Report

Cicek¹

2011

J Med Cases

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“…Despite the indisputable benefit of CABG surgery in reducing morbidity and mortality [1], acute myocardial infarction (MI) still reported with an incidence of 3% to 8% annually following bypass graft surgery [2]. In patients with ACS, some of the previous reports suggested prior CABG as an independent risk factor for mortality [3], [4], while others reported equal or even more favorable prognosis when compared to non-BABG patients [5]–[9]. A recent global rising in the number of ACS was observed in patients with prior CABG [10], as a result of the worldwide increasing numbers of bypass surgeries performed annually [11], [12] and in the consequences of the angiographically recognized loss of vein graft after surgery (50% become diseased and 25% occluded) by 5 years [2].…”

Section: Introductionmentioning

confidence: 99%

Acute Coronary Syndrome in Patients with Prior Coronary Artery Bypass Surgery: Observations from a 20-Year Registry in a Middle-Eastern Country

et al. 2012

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ObjectivesClinical characteristics and trends in the outcome of acute coronary syndrome (ACS) in patients with prior coronary artery bypass graft surgery (CABG) are unclear. The aim of this study was to evaluate clinical characteristics, in-hospital treatment, and outcomes in patients presented with ACS with or without a history of prior CABG over 2 decades.MethodsData were derived from hospital-based study for collected data from 1991 through 2010 of patients hospitalized with ACS in Doha, Qatar. Data were analyzed according to their history of prior CABG. Baseline clinical characteristics, in-hospital treatment, and outcome were compared.ResultsA total 16,750 consecutive patients with ACS were studied, of which 693 (4.1%) had prior CABG. Patients with prior CABG were older (mean 60.5±11 vs. 53±12 years; P = 0.001), more likely to be females and have more cardiovascular risk factors than the non-CABG group. Prior CABG patients had larger infarct size, were less likely to receive reperfusion therapy, early invasive therapy and more likely to receive evidence-based therapies when compared to non-CABG patients. In-hospital mortality and stroke rates were comparable between the 2 groups. Over 2 decades, there was reduction in the in-hospital mortality rates and stroke rates in both groups (CABG, death; 13.2% to 4%, stroke; 1.9% to 0.0%, non-CABG, death; 10% to 3.2%, stroke 1.0% to 0.1%; all, p = 0.001).ConclusionSignificant reduction in-hospital morbidity and mortality among ACS patients with prior CABG over a 20-year period.

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Clinical Characteristics, Management Strategies and Outcomes of Acute Myocardial Infarction Patients With Prior Coronary Artery Bypass Grafting

Shoaib

Mohamed

Rashid

et al. 2021

Mayo Clinic Proceedings

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Objective: To investigate the management strategies, temporal trends, and clinical outcomes of patients with a history of coronary artery bypass graft (CABG) surgery and presenting with acute myocardial infarction (MI). Patients and Methods: We undertook a retrospective cohort study using the National Inpatient Sample database from the United States (January 2004eSeptember 2015), identified all inpatient MI admissions (7,250,768 records) and stratified according to history of CABG (group 1, CABG-naive [94%]; group 2, prior CABG [6%]). Results: Patients in group 2 were older, less likely to be female, had more comorbidities, and were more likely to present with non-ST-elevation myocardial infarction compared with group 1. More patients underwent coronary angiography (68% vs 48%) and percutaneous coronary intervention (PCI) (44% vs 26%) in group 1 compared with group 2. Following multivariable logistic regression analyses, the adjusted odd ratio (OR) of in-hospital major adverse cardiovascular and cerebrovascular events (OR, 0.98; 95% CI, 0.95 to 1.005; P¼.11), all-cause mortality (OR, 1; 95% CI, 0.98 to 1.04; P¼.6) and major bleeding (OR, 0.99; 95% CI, 0.94 to 1.03; P¼.54) were similar to group 1. Lower adjusted odds of in-hospital major adverse cardiovascular and cerebrovascular events (OR, 0.64; 95% CI, 0.57 to 0.72; P<.001), all-cause mortality (OR, 0.45; 95% CI, 0.38 to 0.53; P<.001), and acute ischemic stroke (OR, 0.71; 95% CI, 0.59 to 0.86; P<.001) were observed in group 2 patients who underwent PCI compared with those managed medically without any increased risk of major bleeding (OR, 1.08; 95% CI, 0.94 to 1.23; P¼.26). Conclusions: In this national cohort, MI patients with prior-CABG had a higher risk profile, but similar in-hospital adverse outcomes compared with CABG-naive patients. Prior-CABG patients who received PCI had better in-hospital clinical outcomes compared to those who received medical management.

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Can We Improve Outcomes in Patients With Previous Coronary Artery Bypass Surgery Admitted for Acute Coronary Syndrome?

Cited by 7 publications

References 36 publications

Significant Restenosis of Multiple Saphenous Vein Grafts Early After Coronary Artery Bypass Graft Surgery: a Case Report

Significant Restenosis of Multiple Saphenous Vein Grafts Early After Coronary Artery Bypass Graft Surgery: a Case Report

Acute Coronary Syndrome in Patients with Prior Coronary Artery Bypass Surgery: Observations from a 20-Year Registry in a Middle-Eastern Country

Clinical Characteristics, Management Strategies and Outcomes of Acute Myocardial Infarction Patients With Prior Coronary Artery Bypass Grafting

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