Optimal timing for surgical revascularization in survivors of acute coronary syndromes eligible for elective coronary artery bypass graft surgery.
BACKGROUND
Several patients with acute coronary syndrome (ACS) are discharged home after the acute phase of ACS and are suitable for elective coronary artery bypass graft (CABG) surgery. The aim of the study was to assess the optimal timing for surgical revascularization and its effect on 12-month outcome in patients discharged from hospital after ACS and referred for elective CABG surgery.


METHODS
The analysis involved 2028 patients enrolled into the ongoing Polish Registry of Acute Coronary Syndromes (PL-ACS) who were discharged from hospital with the intention to undergo elective CABG surgery.


CONCLUSIONS
Among 2028 patients 1216 (60.0%) underwent surgery during 12months of follow-up. Patients who underwent surgical revascularization had a lower prevalence of mortality (5.7% vs 11.5%, p<0.0001). Patients who underwent surgery within the first month had a significantly higher prevalence of mortality than those who did not undergo surgery (5.7% vs 1.6%, p<0.0001). By the third month, the two cumulative mortalities were similar (4.2% vs 4.6%, p=0.65). From the beginning of the fourth month, the cumulative mortality was significantly higher among patients who did not undergo surgery.
Zembala
Marian
M
Department of Cardiac Surgery and Transplantology, Silesian Center for Heart Diseases, Zabrze, Poland.
Trzeciak
Przemysław
P
Gąsior
Mariusz
M
Gierlotka
Marek
M
Hudzik
Bartosz
B
Tajstra
Mateusz
M
Bochenek
Andrzej
A
Woś
Stanisław
S
Poloński
Lech
L
D054058:Acute Coronary Syndrome / Q000601:surgery*; D000368:Aged; D001026:Coronary Artery Bypass / Q000379:methods*; D017558:Elective Surgical Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000379:methods*; D010351:Patient Discharge / Q000639:trends; D011446:Prospective Studies; D012042:Registries; D017741:Survivors; D013997:Time Factors; D016896:Treatment Outcome