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Prognosis following acute coronary syndromes according to prior coronary artery bypass grafting: Meta-analysis.
MedLine Citation:
PMID:  25293725     Owner:  NLM     Status:  Publisher    
PURPOSE: Conduct a meta-analysis to study the prognostic influence of a previous coronary artery bypass grafting (CABG) in patients admitted for an acute coronary syndrome (ACS).
METHODS: A systematic review of the literature was performed using electronic reference databases through January 2013 (MEDLINE, Cochrane Library, Web of Knowledge, Google Scholar and references cited in other studies). Studies in which ACS outcomes with a previous history of CABG were compared with ACS outcomes with no history of previous CABG were considered for inclusion. The main endpoints of interest were mortality and non-fatal acute myocardial infarction. Data was aggregated at three follow-up times using random-effects meta-analysis models.
RESULTS: Twenty-four studies were included which provided 387,181 patients for analysis. Previous CABG ACS patients were older, more diabetic and had a more frequent history of a previous myocardial infarction. Pooled in-hospital mortality was higher for the previous CABG ACS patients (OR 1.22 [1.04-1.44], p<0.01, I(2) 88%). The pooled adjusted OR showed no significant differences for the two groups (adjusted OR 1.13 [0.93-1.37], p=0.22, I(2) 92%). Previous CABG ACS patient had a higher pooled 30-day mortality (OR 1.28 [1.05-1.55], p=0.02, I(2) 74%); a higher non-adjusted (OR 1.61 [1.38-1.88], p<0.01, I(2) 70%) and adjusted (adjusted OR 1.37 [1.15-1.65], p<0.01, I(2) 0%) long-term mortality. Both the in-hospital and the long-term re-infarction rates were higher for the previous CABG ACS patients.
CONCLUSIONS: According to our data, ACS patients with previous CABG history had a higher risk for short- and long-term adverse events.
Rogério Teixeira; Maria J Vieira; Miguel A Ribeiro; Lino Gonçalves; Bernard J Gersh
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-10-7
Journal Detail:
Title:  European heart journal. Acute cardiovascular care     Volume:  -     ISSN:  2048-8734     ISO Abbreviation:  Eur Heart J Acute Cardiovasc Care     Publication Date:  2014 Oct 
Date Detail:
Created Date:  2014-10-8     Completed Date:  -     Revised Date:  2014-10-9    
Medline Journal Info:
Nlm Unique ID:  101591369     Medline TA:  Eur Heart J Acute Cardiovasc Care     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© The European Society of Cardiology 2014.
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