title: Timing of coronary artery bypass surgery in patients with non-ST-segment elevation myocardial infarction and postoperative outcomes.
abstract: BACKGROUND
  The aim of the study was to assess whether a cardiac troponin T (cTnT) level 1 ng/ml or below threshold is safe and to evaluate mid-term follow-up results in stable patients with non-ST-segment elevation after acute myocardial infarction.
  
  
  METHODS
  Among cTnT positive patients who presented to the emergency unit with chest pain and received coronary angiography, 100 patients who underwent isolated coronary artery bypass grafting (CABG) constituted the study group (group 1). The same number of patients (n = 100) who were cTnT negative and underwent an isolated CABG operation under elective conditions were selected as the control group (group 2).
  
  
  RESULTS
  Among preoperative criteria, group 1 had significantly higher smoking rates (74% vs. 41%, p = 0.0001), and significantly lower ejection fraction values (47.1 ±8.25, 54.69 ±8.73, p = 0.0001). There were no significant differences between the groups with respect to operative parameters. Postoperative follow-up periods were significantly longer in group 1 (23.25 ±14 vs. 17.55 ±7.95 months, p = 0.001). Average waiting time for cTnT to drop below the 1 ng/ml threshold value was 5.73 ±2.95 (1-12) days. Intra-aortic balloon pump use in Groups 1 and 2 was 3% and 1%, respectively. There were no hospital mortalities in either group. Mortality rates at mid term were 6% in both groups.
  
  
  CONCLUSIONS
  This study compared two groups positive and negative for preoperative cTnT. The findings show that it is safe to wait until cTnT levels decrease to the 1 ng/ml threshold value in cTnT positive patients having a stable course. This waiting period is not very long, which is significant with respect to potential complications.
authors.affiliation: Cardiovascular Surgery Department, Gaziosmanpasa Hospital, Istanbul, Turkey.
authors.forename: Ismail Cihan
authors.initials: IC
authors.lastname: Ozbek
authors.affiliation: Cardiovascular Surgery Department, Gaziosmanpasa Hospital, Istanbul, Turkey.
authors.forename: Kenan
authors.initials: K
authors.lastname: Sever
authors.affiliation: Thoracic Surgery Department, Istanbul Bilim University, Istanbul, Turkey.
authors.forename: Ozkan
authors.initials: O
authors.lastname: Demirhan
authors.affiliation: Cardiovascular Surgery Department, Gaziosmanpasa Hospital, Istanbul, Turkey.
authors.forename: Denyan
authors.initials: D
authors.lastname: Mansuroglu
authors.affiliation: Anesthesiology Department, Gaziosmanpasa Hospital, Istanbul, Turkey.
authors.forename: Muslum
authors.initials: M
authors.lastname: Cicek
authors.affiliation: Cardiology Department, Gaziosmanpasa Hospital, Istanbul, Turkey.
authors.forename: Ebubekir Emre
authors.initials: EE
authors.lastname: Men
authors.affiliation: Cardiology Department, Gaziosmanpasa Hospital, Istanbul, Turkey.
authors.forename: Fusun
authors.initials: F
authors.lastname: Gunesdogdu
authors.affiliation: Department of Cardiovascular Surgery, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Ugurlucan
authors.affiliation: Department of Cardiovascular Surgery, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Basaran
authors.affiliation: Cardiology Department, Gaziosmanpasa Hospital, Istanbul, Turkey.
authors.forename: Nuri
authors.initials: N
authors.lastname: Kurtoglu
keywords: coronary artery bypass grafting; myocardial infarction; non-ST-segment elevation; timing; troponin-T