Document Detail


Can we improve outcomes in patients with previous coronary artery bypass surgery admitted for acute coronary syndrome?
MedLine Citation:
PMID:  20450849     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION AND OBJECTIVES: Prognosis and in-hospital management of patients with acute coronary syndrome (ACS) and a history of coronary artery bypass graft (CABG) surgery are still debated. The objective of this study was to characterize ACS patients with a CABG and to compare their in-hospital and postdischarge outcomes with those of patients without a CABG. METHODS: This ongoing prospective observational study included 1,495 consecutive patients admitted for ACS to a coronary care unit and followed up for a mean of 19 months. There were two groups: group A (n=73), with CABGs; and group B (n=1,223), without CABGs. RESULTS: Group A patients were more often male (86.3% versus 69.1%; P=.002), and more frequently had a history of diabetes, myocardial infarction and heart failure. Group B patients more frequently had ST-elevation myocardial infarction, and had a higher median ejection fraction (53% [interquartile range, 47%-60%] vs. 50% [42%-55%]; P< .01) and peak troponin-I concentration. There was no difference in the use of invasive techniques. Regarding medication, Group B patients were more likely to receive dual antiplatelet therapy at discharge. No significant difference was observed in in-hospital mortality (9.5% versus 5.9%; P=.2) or mortality at 1 month, 6 months or 1 year (9.8% versus 9.1%; log-rank test, P=.87) and the cumulative major adverse cardiac event rate was equally low in both groups. The presence of a CABG was associated with more readmissions for unstable angina (11.3% vs. 3.1%; P< .01). CONCLUSIONS: In our ACS patients, the presence of a CABG had no significant influence on short- or medium-term outcomes, such as all-cause mortality and adverse cardiac events.
Authors:
Rogério Teixeira; Carolina Lourenço; Natália António; Elisabete Jorge; Rui Baptista; Fátima Saraiva; Paulo Mendes; Sílvia Monteiro; Francisco Gonçalves; Pedro Monteiro; Mario Freitas; Luís A Providência
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Revista española de cardiología     Volume:  63     ISSN:  1579-2242     ISO Abbreviation:  Rev Esp Cardiol     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-10     Completed Date:  2010-08-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0404277     Medline TA:  Rev Esp Cardiol     Country:  Spain    
Other Details:
Languages:  eng     Pagination:  554-63     Citation Subset:  IM    
Affiliation:
Unidad de Cuidados Coronarios, Hospital Universitario, Coimbra, Portugal. rogeriopteixeira@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Acute Coronary Syndrome / etiology*,  mortality,  therapy*
Aged
Coronary Artery Bypass / adverse effects*
Electrocardiography
Female
Follow-Up Studies
Hospital Mortality
Humans
Kaplan-Meiers Estimate
Male
Middle Aged
Postoperative Complications / therapy*
Prospective Studies
Risk Factors
Treatment Outcome
Troponin / blood
Chemical
Reg. No./Substance:
0/Troponin
Comments/Corrections
Comment In:
Rev Esp Cardiol. 2010 May;63(5):516-7   [PMID:  20450844 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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