The following is a summary of the “Coronary artery bypass grafting after acute ST-elevation myocardial infarction,” published in the February 2023 issue of Thoracic and cardiovascular surgery by Elbadawi et al.
This study used a nationwide database to characterize the evolution and results of coronary artery bypass grafting performed for ST-elevation myocardial infarction. Patients hospitalized with ST-elevation myocardial infarction and those treated with coronary artery bypass grafting alone were identified by searching the National Inpatient Sample database we accessed between 2002 and 2016. Here, they present findings on CABG’s early (2002-2010) and late (2011-2016) cohorts regarding temporal trends, predictors, and outcomes. About 7.7% of the 3,347,470 patients admitted with ST-elevation myocardial infarction underwent coronary artery bypass grafting alone.
In patients with ST-elevation myocardial infarction, the rate of isolated coronary artery bypass grafting has decreased over time (from 9.2% in 2002 to 5.5% in 2016; Ptrend .001), while the rate of perioperative crude in-hospital mortality has remained stable (5.1 % in 2002 to 4.2 % in 2016; Ptrend =.66) despite an increase in the prevalence of comorbidities. Isolated coronary artery bypass grafting, mechanical support devices, and pre-coronary artery bypass grafting percutaneous coronary intervention have all increased on hospital days three and beyond. Higher in-hospital mortality was observed in the initial cohort following coronary artery bypass grafting performed on days 1 and 2.
Acute kidney injury, ischemic stroke, ventricular arrhythmia, and length of hospital stay were all lower in the recent cohort for CABG performed on day two compared to day three or later. According to this study, coronary artery bypass grafting has decreased nationwide after ST-elevation myocardial infarction. Sicker patients underwent isolated coronary artery bypass grafting on day 1, associated with higher in-hospital mortality than coronary artery bypass grafting performed on day three or later. According to the most recent cohort study, the in-hospital mortality rate for coronary artery bypass grafting performed on day 2 was comparable to those performed on day three or later.
Source: sciencedirect.com/science/article/abs/pii/S0022522321005626
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