Characteristics, management and outcomes of patients with acute coronary syndrome and prior coronary artery bypass surgery: findings from the second Gulf Registry of Acute Coronary Events

Al-Aqeedi, Rafid Fayadh; Sulaiman, Kadhim; Suwaidi, Jassim Al; AlHabib, Khalid F.; El‐Menyar, Ayman; Panduranga, Prashanth; Alshiekh-Ali, Alawi; Saif, Shukri Al

doi:10.1510/icvts.2011.274571

Cited by 14 publications

(15 citation statements)

References 24 publications

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“…Likewise, the predominance of men in both groups. Females were significantly more prevalent in our population with prior CABG, a similar finding was reported in previous studies conducted on same Middle-eastern population [28], [29]. This female preponderance with prior CABG was not reported in Western population.…”

Section: Discussionsupporting

confidence: 91%

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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Section: Discussionsupporting

confidence: 91%

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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“…4 Post-CABG patients presenting with acute myocardial infarction (MI) have been shown to be older, with a greater proportion of diabetes, heart failure, and previous MI. 5,6 Nonetheless it has been demonstrated that they usually have smaller infarcts and a lower incidence of Q-wave MIs. 7,8 Therefore it has been hypothesized that a prior CABG could exert a protective effect, as a result of the double coronary circulation and ischemic preconditioning.…”

Section: Introductionmentioning

confidence: 99%

Prognosis following acute coronary syndromes according to prior coronary artery bypass grafting: Meta-analysis

Teixeira

Vieira

Ribeiro

et al. 2014

European Heart Journal: Acute Cardiovascular Care

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Purpose: Conduct a meta-analysis to study the prognostic influence of a previous coronary artery bypass grafting (CABG) in patients admitted for an acute coronary syndrome (ACS). Methods: A systematic review of the literature was performed using electronic reference databases through January 2013 (MEDLINE, Cochrane Library, Web of Knowledge, Google Scholar and references cited in other studies). Studies in which ACS outcomes with a previous history of CABG were compared with ACS outcomes with no history of previous CABG were considered for inclusion. The main endpoints of interest were mortality and non-fatal acute myocardial infarction. Data was aggregated at three follow-up times using random-effects meta-analysis models. Results: Twenty-four studies were included which provided 387,181 patients for analysis. Previous CABG ACS patients were older, more diabetic and had a more frequent history of a previous myocardial infarction. Pooled in-hospital mortality was higher for the previous CABG ACS patients (OR 1.22 [1.04–1.44], p<0.01, I2 88%). The pooled adjusted OR showed no significant differences for the two groups (adjusted OR 1.13 [0.93–1.37], p=0.22, I2 92%). Previous CABG ACS patient had a higher pooled 30-day mortality (OR 1.28 [1.05–1.55], p=0.02, I2 74%); a higher non-adjusted (OR 1.61 [1.38–1.88], p<0.01, I2 70%) and adjusted (adjusted OR 1.37 [1.15–1.65], p<0.01, I2 0%) long-term mortality. Both the in-hospital and the long-term re-infarction rates were higher for the previous CABG ACS patients. Conclusions: According to our data, ACS patients with previous CABG history had a higher risk for short- and long-term adverse events.

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“… 9 Furthermore, Arab patients presenting with acute coronary syndrome (ACS) with prior coronary artery bypass graft (CABG) were observed to have more severe left ventricular dysfunction but with a less prominent surge of cardiac biomarkers as compared to patients from other regions. 10 In Saudi Arabia, hypertension is present in more than 80% of patients with heart failure, making it the single strongest predictor of CHF. 11 This was later confirmed from a recent study by Assiri, indicating that both hypertension and ischemic heart disease are the major causes of heart failure among elderly Saudis.…”

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confidence: 99%

Characteristics of Saudi patients with congestive heart failure and adherence to management guidelines in a tertiary hospital in Riyadh

Alqahtani

Alanazi

Binsalih

et al. 2012

Annals of Saudi Medicine

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BACKGROUND AND OBJECTIVESThere is limited data available on the characteristics of local Saudi patients diagnosed with congestive heart failure (CHF) and on their adherence to guidelines for managing the disease. This study aimed to fill this gap.DESIGN AND SETTINGRetrospective study of patients treated at King Abdulaziz Medical City from 2002–2008.SUBJECTS AND METHODSThe records were reviewed of subjects admitted secondary to heart failure (defined as systolic heart failure [ejection fraction <55%] and/or heart failure with preserved ejection fraction diagnosed either clinically and/or by echocardiogram and/or cardiac catheterization) or who visited the outpatient department for the same complaint.RESULTSOf 392 CHF cases, the mean age was 67.8 (12.8) years and the majority were males (53.1%). Hypertension was the predominant comorbid illness, accounting for 84.9% of cases, followed by diabetes mellitus type 2 and hyperlipidemia. Almost three-fourths (73.7%) of the subjects had mild to severe left ventricular dysfunction, with 68.5% of the cases having right ischemic cardiomyopathy. Spironolactone, exercise and vaccination were the the least least adhered to recommendations (30.0%, 20.5% and 15.2%, respectively).CONCLUSIONSThe study highlights the need for proper education of patients and caregivers to increase compliance to medications. Physicians are also encouraged to undergo continuing medical education and training courses to properly implement current recommendations in the management of heart failure. Further studies are needed on a larger scale in order to formulate an effective management scheme that will address the current challenges faced by both clinicians and CHF patients.

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Characteristics, management and outcomes of patients with acute coronary syndrome and prior coronary artery bypass surgery: findings from the second Gulf Registry of Acute Coronary Events

Cited by 14 publications

References 24 publications

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

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

Prognosis following acute coronary syndromes according to prior coronary artery bypass grafting: Meta-analysis

Characteristics of Saudi patients with congestive heart failure and adherence to management guidelines in a tertiary hospital in Riyadh

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