title: Characteristics, management and outcome of patients with prior coronary bypass surgery presenting with acute myocardial infarction.
abstract: We compared the characteristics, management and outcome of patients with or without prior coronary artery bypass graft surgery (CABG) presenting with AMI to any coronary care unit in Israel, from four national surveys performed during 1992-1998. Of 5,396 patients, 171 (3.2%) had prior CABG, 39 of whom received thrombolysis. Thrombolysis was administered less often in patients with prior CABG, but the utilization of coronary angiography was similar. Mortality rates were higher in patients with prior CABG, particularly among those given thrombolysis. The use of coronary angiography was a strong independent predictor of survival, but its utilization was similar in patients with or without prior CABG. Patients with prior CABG constitute a small minority among current AMI patients. They are sicker and their mortality is higher compared to patients without prior surgery, especially among those given thrombolysis. Coronary angiography is associated with improved outcome in these patients but is currently used to the same extent as in patients without prior surgery.
authors.affiliation: Soroka Medical Center, Beer Sheva, Israel.
authors.forename: Doron
authors.initials: D
authors.lastname: Zahger
authors.forename: Solomon
authors.initials: S
authors.lastname: Behar
authors.forename: David
authors.initials: D
authors.lastname: Harpaz
authors.forename: Jonathan
authors.initials: J
authors.lastname: Leor
authors.forename: A Teddy
authors.initials: AT
authors.lastname: Weiss
authors.forename: Shmuel
authors.initials: S
authors.lastname: Gottlieb
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D015331:Cohort Studies; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D019468:Disease Management; D004562:Electrocardiography; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007557:Israel; D008297:Male; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D010343:Patient Admission; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors / Q000627:therapeutic use; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015912:Thrombolytic Therapy; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D019039:Platelet Glycoprotein GPIIb-IIIa Complex