Outcome of acute myocardial infarction versus stable coronary artery disease patients treated with coronary bypass surgery

Abstract

Objective: To study the long-term outcome differences between acute myocardial infarction (MI) and stable coronary artery disease (CAD) patients treated with coronary artery bypass grafting (CABG). Methods: We studied retrospectively patients with MI (n ¼ 1882) or stable CAD (n ¼ 13117) treated with isolated CABG between 2004 and 2014. Inverse propensity probability weight adjustment for baseline features was used. Median follow-up was 7.9 years. Results: In-hospital mortality (8.6% vs. 1.6%; OR 5.94; p < .0001) and re-sternotomy (5.5% vs. 2.7%; OR 2.07; p < .0001) were more common in MI patients compared to stable CAD patients. Hospital surviving MI patients had higher all-cause mortality (28.2% vs. 22.2%; HR 1.37; p ¼ .002) and MACE rate (34.4% vs. 27.4%; HR 1.22; CI 1.00-1.50; p ¼ .049) at 10-year follow-up. Cardiovascular mortality (15.9% vs. 12.7%; HR 1.36; p ¼ .017) and rate of new myocardial infarction (12.0% vs. 9.8%; HR 1.40; p ¼ .034) were also higher in MI patients during follow-up. In follow-up of stabilized first-year survivors, the difference in all-cause (26.5% vs. 20.7%; HR 1.40; p ¼ .003) and cardiovascular (14.2% vs. 11.4%; HR 1.37; p ¼ .027) mortality continued to increase between MI and stable CAD patients. Conclusion: MI patients have poorer short-and long-term outcomes compared to stable CAD patients after CABG and risk difference continues to increase with time. KEY MESSAGES 1. Patients with myocardial infarction have poorer short-and long-term outcomes compared to stable coronary artery disease patients after coronary artery bypass grafting (CABG). 2. Higher risk of death continues also in stabilized first-year myocardial infarct survivors. 3. The importance of efficient secondary prevention and follow-up highlights in post-myocardial infarct population after CABG.

Surgical aortic valve replacement and infective endocarditis

“…Patients with prior history of IE or IE as auxiliary diagnosis were excluded from controls. Co‐morbidities were recognized from the CRHF and the nationwide Finnish Cancer Registry using ICD codes as previously described 10 . Outcomes are defined in the supplement.…”

“…Co-morbidities were recognized from the CRHF and the nationwide Finnish Cancer Registry using ICD codes as previously described. 10 Outcomes are defined in the supplement. Hospital transfers after SAVR were combined in calculating admission duration.…”

Digoxin use and outcomes after myocardial infarction in patients with atrial fibrillation

“…11 To improve the balancing, patients with non-overlapping propensity scores (1 in the digoxin group and 32 in the control group) were excluded, and IPTWs were stabilized. 14 Separate propensity scoring and IPTW calculations were performed for subgroups of patients with and without diagnosed HF up until the time of index MI admission. Unmeasured confounding was estimated by calculating the E value.…”

Association between glucose-to-lymphocyte ratio and in-hospital mortality in acute myocardial infarction patients

“…Marenzi et al [28] indicated that renal replacement therapy use was associated with a significant increase in in-hospital mortality and a more complicated clinical course in AMI patients. Malmberg et al [29] also found the in-hospital mortality to be significantly higher when CABG was performed for patients with AMI, compared with patients with stable coronary artery disease. However, another study indicated that β blockers might not be related to the all-cause mortality in patients with AMI [30].…”