title: Coronary artery bypass grafting within 30 days after treatment of acute myocardial infarctions with angioplasty or fibrinolysis - a surgical substudy of DANAMI-2.
abstract: OBJECTIVE
  To calculate the incidence and analyse the indications and outcome after surgical revascularization within the first 30 days after randomization of 1572 patients with acute myocardial infarction (MI) associated with ST-segment elevation (STEMI).
  
  
  METHODS
  Data regarding the patients undergoing heart surgery within the first 30 days after randomization were collected.
  
  
  RESULTS
  Three patients (0.2%) with acute STEMI and randomized to percutaneous coronary intervention (PCI) underwent emergent coronary artery bypass grafting (CABG). A total of 50 patients (3.2%), 30 in the PCI group and 20 in the fibrinolysis group were revascularized by surgery within the first 30 days after randomization. The most frequent indication for surgery in both groups was unstable angina pectoris, followed by left main stenosis. The incidence of postoperative complications was higher compared with the outcome after elective CABG.
  
  
  CONCLUSIONS
  The incidence of emergency CABG in this study was low (0.2%) after treatment of acute MI with either PCI or fibrinolysis. The overall incidence within 30 days was 3.2%, however, the mortality is increased with a 30-day mortality of 10% in this high-risk patient group.
authors.affiliation: Department of Cardiothoracic Surgery, Gentofte Hospital, Hellerup, Denmark. hekja@gentoftehosp.kbhamt.dk
authors.forename: Henrik
authors.initials: H
authors.lastname: Kjaergard
authors.forename: Per Hostrup
authors.initials: PH
authors.lastname: Nielsen
authors.forename: Jan Jesper
authors.initials: JJ
authors.lastname: Andreasen
authors.forename: Daniel
authors.initials: D
authors.lastname: Steinbrüchel
authors.forename: Lars Ib
authors.initials: LI
authors.lastname: Andersen
authors.forename: Klaus
authors.initials: K
authors.lastname: Rasmussen
authors.forename: Henning Rud
authors.initials: HR
authors.lastname: Andersen
authors.forename: Torsten Toftegaard
authors.initials: TT
authors.lastname: Nielsen
mesh_terms: D000208:Acute Disease; D000368:Aged; D000800:Angioplasty, Balloon; D001026:Coronary Artery Bypass / Q000401:mortality / Q000706:statistics & numerical data*; D004562:Electrocardiography; D005260:Female; D005342:Fibrinolysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D009204:Myocardial Revascularization / Q000401:mortality / Q000706:statistics & numerical data*; D018579:Patient Selection; D016896:Treatment Outcome