Document Detail


Early coronary artery bypass grafting for complicated acute myocardial infarction.
MedLine Citation:
PMID:  3262108     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The occurrence of unstable angina or cardiogenic shock after an acute myocardial infarction characterizes a subgroup of patients with increased morbidity and mortality. To assess the efficacy of surgical revascularization in this cohort, 96 patients who underwent coronary artery bypass grafting within 6 weeks of an acute myocardial infarction were compared to 485 patients who underwent myocardial revascularization without recent infarction. Fourteen (15%) of the patients with acute infarction were in cardiogenic shock and 82 (85%) patients had unstable angina at the time of surgery. Preoperatively, the patients with acute infarction compared to the patients without acute infarction were older (+3.5 years), had an increased incidence of congestive heart failure (21% vs 13%), and had a lower mean ejection fraction (4% vs 65%). Preoperative intraaortic balloon support was used in 9 patients (65%) with cardiogenic shock, and in 16 patients (19%) with unstable angina. Mean interval to surgery from time of infarction was 14.9 days. Overall operative mortality was 7.3% (7 patients) for the acute infarction group 28% for patients with cardiogenic shock and 3.7% for patients with unstable angina compared to 3.7% for the group of patients without recent infarction. Earlier surgical intervention did not result in a significant increase in operative mortality. Discriminant analysis of the recent infarction cohort demonstrated that preoperative ejection fraction less than 45% and age greater than 70 were the most significant predictors of early mortality. Of the 89 patients surviving surgery, actuarial survival was 97% at 3 years with no late infarctions. At follow-up 95% of survivors were NYHA Class I or II.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
M W Connolly; J S Gelbfish; D M Rose; J J Jacobowitz; D Sorvino; P Cappabianco; A J Acinapura; J N Cunningham
Related Documents :
16777508 - Update and rationale for ongoing acute myocardial infarction trials: combination therap...
11061368 - Cardiogenic shock due to acute left main coronary artery occlusion: successful treatmen...
6838398 - Assisted circulation in cardiac and respiratory insufficiency.
10688308 - Graded response and restitution hypotheses of ventricular vulnerability to fibrillation...
9781788 - The use of an implantable left ventricular assist device in a patient with cardiogenic ...
6653588 - Short-term responses to cardiac rehabilitation after acute myocardial infarction. cardi...
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of cardiovascular surgery     Volume:  29     ISSN:  0021-9509     ISO Abbreviation:  J Cardiovasc Surg (Torino)     Publication Date:    1988 Jul-Aug
Date Detail:
Created Date:  1988-10-17     Completed Date:  1988-10-17     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0066127     Medline TA:  J Cardiovasc Surg (Torino)     Country:  ITALY    
Other Details:
Languages:  eng     Pagination:  375-82     Citation Subset:  IM    
Affiliation:
Department of Surgery, Maimonides Medical Center, Brooklyn, NY.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Angina, Unstable / etiology,  mortality
Assisted Circulation
Coronary Artery Bypass*
Female
Humans
Male
Middle Aged
Myocardial Infarction / complications,  mortality,  surgery*
Shock, Cardiogenic / etiology,  mortality
Stroke Volume
Time Factors

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


Previous Document:  Lanolin and epidermal growth factor in healing of partial-thickness pig wounds.
Next Document:  Hemodynamic effects of nifedipine in coronary surgery.