Document Detail


Increased rehospitalization rate after coronary bypass operation for acute coronary syndrome: a prospective study in 200 patients.
MedLine Citation:
PMID:  19766799     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Patients with acute coronary syndrome (ACS) run increased risk of cardiac death or myocardial infarction after coronary artery bypass grafting (CABG). Long-term survival is similar in ACS patients and patients with stable angina pectoris. This study analyzed the cardiac rehospitalization rate up to 10 years after CABG for ACS and stable angina. METHODS: CABG was done in 200 patients, 100 with ACS and 100 with stable angina. Troponin-T levels were assayed and the severity of the unstable symptoms was classified according to Braunwald. Early outcome, long-term survival, and freedom from cardiac rehospitalization were analyzed. RESULTS: Three ACS patients died early and 12 died late. In the control group, there were no early and 19 late deaths. The cumulative long-term survival was 85% for the ACS patients and 81% for the stable patients (p = 0.75). Postoperative myocardial infarction occurred in 5 unstable patients and 1 stable patient (p = 0.01). At 3 years after the operation, freedom from cardiac rehospitalization was significantly higher in the stable patients (9 vs 27, p = 0.001). In the end of the follow-up, there were no differences in the rehospitalization rate. CONCLUSIONS: Similar and excellent long-term survival was found in both ACS and stable patients long-term after CABG. In patients with ACS, variables such as elevated troponin-T and angina at rest herald an increased risk of perioperative myocardial infarction. Freedom from cardiac rehospitalization is significantly higher in stable patients compared with ACS patients during the first postoperative years, indicating recurrent ischemia.
Authors:
Staffan Bjessmo
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  88     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-09-21     Completed Date:  2009-10-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1148-52     Citation Subset:  AIM; IM    
Affiliation:
Cardiothoracic Surgery Unit, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. staffan.bjessmo@karolinska.se
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MeSH Terms
Descriptor/Qualifier:
Acute Coronary Syndrome / surgery*
Adult
Aged
Aged, 80 and over
Coronary Artery Bypass / methods*
Death, Sudden, Cardiac / epidemiology*,  etiology,  prevention & control
Female
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Myocardial Infarction / epidemiology*,  etiology,  therapy
Patient Readmission / trends*
Postoperative Complications
Prospective Studies
Risk Factors
Survival Rate / trends
Sweden / epidemiology

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


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