title: [The effect of surgical revascularization on different timing after ST-elevation myocardial infarction on patients with ischemic heart disease and left ventricular dysfunction].
abstract: OBJECTIVE
  To analysis the influence of surgical revascularization on different timing after ST-elevation myocardial infarction (STEMI) on patients with coronary artery disease and left ventricular dysfunction.
  
  
  METHODS
  Clinical data of 225 patients admitted from January 2003 to July 2012 with history of STEMI and left ventricular dysfunction (ejection faraction<50%) who underwent isolated coronary artery bypass grafting was retrospectively reviewed. There were 186 male and 39 female patients. According to the timing of surgical revascularization after STEMI, the patients were divided into early revascularization group (ER group, <21 days), mid-term revascularization group (MR group, 21 to 90 days) and late revascularization group (LR group, >90 days). There were 20 male and 9 female patients in ER group with mean age of (63 ± 10) years, 48 male and 16 female in MR group with mean age of (63 ± 8) years, 118 male and 14 female in LR group with mean age of (62 ± 10) years, respectively. Thirty-day post-operative mortality and major complications were determined as the endpoints to evaluate the early results of operation.
  
  
  RESULTS
  The 30-day post-operative mortality were 3.4%,0 and 2.3% among three groups respectively and there was no statistic difference between groups (χ(2) = 2.137, P = 0.330).Low cardiac output syndrome mortality were 13.8%, 3.1% and 2.3% among three groups respectively and there was statistic difference between groups (χ(2) = 8.344, P = 0.015). The ejection fractions was significantly improved in all the three groups from 42% ± 6%, 41% ± 6% and 42% ± 6% preoperatively to 46% ± 7%, 45% ± 10% and 45% ± 9% postoperatively (t = -3.378 to -2.339, all P < 0.05). The left ventricular end diastolic dimension were significantly reduced in MR group and LR group from (54 ± 6) mm and (55 ± 6) mm preoperatively to (47 ± 8) mm and (49 ± 9) mm postoperatively (t = 5.634, 5.885; P = 0.000). There was no significant change in ER group pre- and postoperatively ((51 ± 6) mm vs.(49 ± 7) mm, t = 1.524, P = 0.133).
  
  
  CONCLUSIONS
  The patients with coronary artery disease and left ventricular dysfunction can benefit from surgical revascularization on different timing after STEMI, presenting as the reverse of left ventricle remodeling and the improvement of left ventricle function. The short-term results are mainly determined by the patients' condition, surgical technique and the level of perioperative management.It is recommended for this patient cohort to accept surgical revascularization three weeks after STEMI.
authors.affiliation: Department of Cardiovascular Surgery, Peoples' Liberation Army General Hospital, Institute of Cardiac Surgery of People's Liberation Army, Beijing 100853, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Wang
authors.affiliation: Department of Cardiovascular Surgery, Peoples' Liberation Army General Hospital, Institute of Cardiac Surgery of People's Liberation Army, Beijing 100853, China. Email: gaochq301@yahoo.com.
authors.forename: Changqing
authors.initials: C
authors.lastname: Gao
authors.affiliation: Department of Cardiovascular Surgery, Peoples' Liberation Army General Hospital, Institute of Cardiac Surgery of People's Liberation Army, Beijing 100853, China.
authors.forename: Cangsong
authors.initials: C
authors.lastname: Xiao
authors.affiliation: Department of Cardiovascular Surgery, Peoples' Liberation Army General Hospital, Institute of Cardiac Surgery of People's Liberation Army, Beijing 100853, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Wu
authors.affiliation: Department of Cardiovascular Surgery, Peoples' Liberation Army General Hospital, Institute of Cardiac Surgery of People's Liberation Army, Beijing 100853, China.
authors.forename: Chonglei
authors.initials: C
authors.lastname: Ren
authors.affiliation: Department of Cardiovascular Surgery, Peoples' Liberation Army General Hospital, Institute of Cardiac Surgery of People's Liberation Army, Beijing 100853, China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Cardiovascular Surgery, Peoples' Liberation Army General Hospital, Institute of Cardiac Surgery of People's Liberation Army, Beijing 100853, China.
authors.forename: Guopeng
authors.initials: G
authors.lastname: Liu
authors.affiliation: Department of Cardiovascular Surgery, Peoples' Liberation Army General Hospital, Institute of Cardiac Surgery of People's Liberation Army, Beijing 100853, China.
authors.forename: Zhiyun
authors.initials: Z
authors.lastname: Gong
authors.affiliation: Department of Cardiovascular Surgery, Peoples' Liberation Army General Hospital, Institute of Cardiac Surgery of People's Liberation Army, Beijing 100853, China.
authors.forename: Mingyan
authors.initials: M
authors.lastname: Wang
authors.affiliation: Department of Cardiovascular Surgery, Peoples' Liberation Army General Hospital, Institute of Cardiac Surgery of People's Liberation Army, Beijing 100853, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Sheng
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000601:surgery*; D003327:Coronary Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000601:surgery*; D017202:Myocardial Ischemia; D012189:Retrospective Studies; D013997:Time Factors; D018487:Ventricular Dysfunction, Left; D016277:Ventricular Function, Left