Document Detail

Timing of coronary artery bypass graft surgery following acute myocardial infarction: a critical literature review.
MedLine Citation:
PMID:  12269518     Owner:  NLM     Status:  MEDLINE    
Despite more than 30 years' experience with coronary artery bypass surgery, controversy still exists about the optimal timing of surgical revascularization following acute myocardial infarction. To review the published information on this topic, a Medline search of the literature published between 1984 and October 2000 was performed. After reviews and individual case reports we re excluded, 11 retrospective and prospective studies remained for analysis. Pervasive heterogeneity with respect to inclusion criteria, outcome measurement, definitions, variance among studies of measured time between myocardial infarction (MI) and coronary artery bypass graft (CABG), differences in study endpoints, and evolution of surgical techniques and medical regimens over this time precluded formal meta-analysis. Although prospective randomized trials are lacking, the preponderance of data from the 11 retrospective and prospective observational studies suggests that timing of bypass surgery after infarction is not an independent predictor of outcome and that delaying coronary bypass surgery for an arbitrary period of time following acute MI is unwarranted. Rather, ventricular function, post-infarction ischemia, noncardiac comorbid conditions, and the urgency of the surgery itself constitute the important predictors of perioperative mortality, and these clinical factors should be used to estimate perioperative risk and decide upon the risk:benefit relationship for CABG in this patient population.
Arthur W Crossman; Harry J D'Agostino; Stephen A Geraci
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Clinical cardiology     Volume:  25     ISSN:  0160-9289     ISO Abbreviation:  Clin Cardiol     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-09-24     Completed Date:  2003-02-24     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  406-10     Citation Subset:  IM    
Department of Internal Medicine, University of Florida Health Sciences Center, Jacksonville 32209, USA.
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MeSH Terms
Coronary Artery Bypass*
Myocardial Infarction / surgery*
Outcome Assessment (Health Care)
Time Factors

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

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