| Myocardial revascularisation after acute myocardial infarction. | |
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MedLine Citation:
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PMID: 10549845 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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One hundred and twenty-three patients had coronary artery bypass grafting (CABG) within 30 days of acute myocardial infarction (AMI) from May 1992 to November 1997. Commonest infarct was anterior transmural (61.8%) and commonest indication of surgery was post-infarct persistent or recurrent angina (69.1%). Ten patients were operated within 48 h and 36 between 48 h to 2 weeks of having MI. Out of these, nine patients were having infarct extension and cardiogenic shock at the time of surgery. Pre-operatively fourteen patients were on inotropes of which six also had intra-aortic balloon pump (IABP) support. All patients had complete revascularisation with 3.8+/-1.2 distal anastomoses per patient. By multivariate analysis, we found that independent predictors of post-operative morbidity [inotropes >48 h, use of IABP, ventilation >24 h, ICU stay >5 days] and complications [re-exploration, arrhythmias, pulmonary complications, wound infection, cerebrovascular accident (CVA)] were left ventricular ejection fraction (LVEF) <30%, Q-wave MI, surgery <48 h after AMI, presence of pre-operative cardiogenic shock and age >60 years (P < or = 0.01). Mortality at 30 days was 3.3%. LVEF <30%, Q-wave MI, surgery <48 h after AMI, presence of pre-operative cardiogenic shock and age >60 years were found to be independent predictors of 30 days mortality (P < or = 0.01). Ninety patients were followed up for a mean duration of 33 months (1 to 65 months). There were three late deaths and five patients developed recurrence of angina. To conclude, CABG can be carried out with low risk following AMI in stable patients for post-infarct angina. Patients who undergo urgent or emergent surgery and who have pre-operative cardiogenic shock, IABP, poor left ventricular functions, age >60 years and Q-wave MI are at increased risk. |
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Authors:
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A Bana; O P Yadava; R Ghadiok; N Selot |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: International journal of cardiology Volume: 69 ISSN: 0167-5273 ISO Abbreviation: Int. J. Cardiol. Publication Date: 1999 May |
Date Detail:
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Created Date: 1999-12-07 Completed Date: 1999-12-07 Revised Date: 2006-07-12 |
Medline Journal Info:
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Nlm Unique ID: 8200291 Medline TA: Int J Cardiol Country: IRELAND |
Other Details:
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Languages: eng Pagination: 209-16 Citation Subset: IM |
Affiliation:
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Department of Cardiac Surgery, Sir Ganga Ram Hospital Marg, Rajinder Nagar, New Delhi, India. gangaram@giasdl01.vsnl.net.in |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Age Factors Angina Pectoris / etiology Coronary Artery Bypass* / methods Female Follow-Up Studies Humans Male Middle Aged Multivariate Analysis Myocardial Infarction / complications, mortality, surgery* Postoperative Complications / epidemiology Recurrence Risk Factors |
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