Coronary artery bypass grafting within the first year after treatment of large acute myocardial infarctions with angioplasty or fibrinolysis.
OBJECTIVE
To calculate the incidence and analyse and outcome after coronary artery bypass grafting (CABG) within the first year after randomisation of 1,572 patients with acute myocardial infarctions with ST-segment elevation (STEMI) to either percutaneous coronary intervention (PCI) or fibrinolysis.


METHODS
The study includes 131 patients: 108 male and 23 female with a mean age 62 years.


RESULTS
The total 30-day mortality after CABG was 4.6% (7.5% in the PCI group and 2.6% in the fibrinolysis group). The 30-day mortality was 9.8% after CABG within the first 30-days and 1.3% after CABG within 31-365 days. The patients who were operated early had a reduced EF to 43% as compared to 50% in patients who were not operated or patients having CABG after 30-days (p=0.002).


CONCLUSIONS
CABG was performed within the first year after STEMI in 10% of patients randomised to fibrinolysis and in 6.7% of patients randomised to PCI. Patients having CABG within the first 30-days after treatment of STEMI had an increased mortality of 9.8%.
Kjaergard
Henrik K
HK
Department of Cardiothoracic Surgery, Gentofte Hospital, 2900 Hellerup, Denmark. hekja@gentoftehosp.kbhamt.dk
Nielsen
Per Hostrup
PH
Andreasen
Jan Jesper
JJ
Steinbrüchel
Daniel
D
Andersen
Lars Ib
LI
Rasmussen
Klaus
K
Andersen
Henning Rud
HR
Nielsen
Torsten Toftegaard
TT
Mortensen
Leif Spange
LS
D015906:Angioplasty, Balloon, Coronary; D001026:Coronary Artery Bypass / Q000401:mortality / Q000706:statistics & numerical data; D023903:Coronary Restenosis / Q000601:surgery*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D013318:Stroke Volume; D016019:Survival Analysis; D013997:Time Factors
D005343:Fibrinolytic Agents