title: Acute coronary syndrome in patients with prior coronary artery bypass surgery: observations from a 20-year registry in a middle-eastern country.
abstract: OBJECTIVE
  Clinical characteristics and trends in the outcome of acute coronary syndrome (ACS) in patients with prior coronary artery bypass graft surgery (CABG) are unclear. The aim of this study was to evaluate clinical characteristics, in-hospital treatment, and outcomes in patients presented with ACS with or without a history of prior CABG over 2 decades.
  
  
  METHODS
  Data were derived from hospital-based study for collected data from 1991 through 2010 of patients hospitalized with ACS in Doha, Qatar. Data were analyzed according to their history of prior CABG. Baseline clinical characteristics, in-hospital treatment, and outcome were compared.
  
  
  RESULTS
  A total 16,750 consecutive patients with ACS were studied, of which 693 (4.1%) had prior CABG. Patients with prior CABG were older (mean 60.5±11 vs. 53±12 years; P = 0.001), more likely to be females and have more cardiovascular risk factors than the non-CABG group. Prior CABG patients had larger infarct size, were less likely to receive reperfusion therapy, early invasive therapy and more likely to receive evidence-based therapies when compared to non-CABG patients. In-hospital mortality and stroke rates were comparable between the 2 groups. Over 2 decades, there was reduction in the in-hospital mortality rates and stroke rates in both groups (CABG, death; 13.2% to 4%, stroke; 1.9% to 0.0%, non-CABG, death; 10% to 3.2%, stroke 1.0% to 0.1%; all, p = 0.001).
  
  
  CONCLUSIONS
  Significant reduction in-hospital morbidity and mortality among ACS patients with prior CABG over a 20-year period.
authors: Department of Cardiology and Cardiovascular Surgery, Heart Hospital Hamad Medical Corporation (HMC), Doha, Qatar.
authors: Rafid
authors: R
authors: Al-Aqeedi
authors: Nidal
authors: N
authors: Asaad
authors: Awad
authors: A
authors: Al-Qahtani
authors: Rajvir
authors: R
authors: Singh
authors: Hajar A
authors: HA
authors: Al Binali
authors: Abdul Wahid
authors: AW
authors: Al Mulla
authors: Jassim
authors: J
authors: Al Suwaidi
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery*; D001026:Coronary Artery Bypass; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data; D011780:Qatar / Q000453:epidemiology; D012042:Registries