Javaid Iqbal1, Chun Shing Kwok1, Evangelos Kontopantelis1, Mark A de Belder1, Peter F Ludman1, Marilena Giannoudi1, Mark Gunning1, Azfar Zaman1, Mamas A Mamas2. 1. From the Manchester Heart Centre, Manchester Royal Infirmary, Manchester, UK (J.I.); Keele Cardiovascular Research Group, Keele University, Stoke-on-Trent, UK (C.S.K., M.A.M.); Department of Cardiology, Royal Stoke Hospital, University Hospital North Midlands NHS Trust, UK (C.S.K., M.G., M.A.M.); Farr Institute, University of Manchester, Manchester, UK (E.K., M.A.M.); Department of Cardiology, The James Cook University Hospital, Middlesbrough, UK (M.A.d.B.); Department of Cardiology, Queen Elizabeth Hospital, Birmingham, UK (P.F.L.); and Department of Cardiology, Freeman Hospital and Institute of Cellular Medicine, Newcastle University, Newcastle-upon-Tyne, UK (M.G., A.Z.). 2. From the Manchester Heart Centre, Manchester Royal Infirmary, Manchester, UK (J.I.); Keele Cardiovascular Research Group, Keele University, Stoke-on-Trent, UK (C.S.K., M.A.M.); Department of Cardiology, Royal Stoke Hospital, University Hospital North Midlands NHS Trust, UK (C.S.K., M.G., M.A.M.); Farr Institute, University of Manchester, Manchester, UK (E.K., M.A.M.); Department of Cardiology, The James Cook University Hospital, Middlesbrough, UK (M.A.d.B.); Department of Cardiology, Queen Elizabeth Hospital, Birmingham, UK (P.F.L.); and Department of Cardiology, Freeman Hospital and Institute of Cellular Medicine, Newcastle University, Newcastle-upon-Tyne, UK (M.G., A.Z.). mamasmamas1@yahoo.co.uk.
Abstract
BACKGROUND: There are limited data on outcomes of patients with previous coronary artery bypass grafting (CABG) presenting with ST-segment-elevation myocardial infarction (STEMI) and undergoing primary percutaneous coronary intervention (PPCI). We report outcomes in patients with STEMI undergoing PPCI with or without previous CABG surgery in a large real-world, all-comer population. METHODS AND RESULTS: Clinical, demographic, procedural, and outcomes data were collected for all patients undergoing PPCI in England and Wales from January 2007 to December 2012. All-cause mortality at 30 days and 1 year were evaluated in the whole and a propensity-matched cohort. Of 79 295 patients with STEMI studied, 2658 (3.4%) patients had prior CABG, of whom 44% (n=1168) underwent PPCI to native vessels and 56% (n=1490) to bypass grafts. There were significant differences in the demographic, clinical, and procedural characteristics of these groups. Patients with prior CABG (with primary PCI to native artery or graft) had higher mortality at 30 days (6.2% with PPCI to native artery, 6.1% with PPCI to bypass graft) than patients with no prior CABG (4.5%; P<0.001). However, after risk factor adjustments, there was no significant difference in outcomes. There were also no significant differences in 30-day mortality, in-hospital major adverse cardiovascular events, in-hospital stroke, and in-hospital bleeding in the propensity-matched population. CONCLUSIONS: A prior history of CABG in patients presenting with STEMI and undergoing PPCI does not independently confer additional risk of mortality, although it is a marker of other high-risk features.
BACKGROUND: There are limited data on outcomes of patients with previous coronary artery bypass grafting (CABG) presenting with ST-segment-elevation myocardial infarction (STEMI) and undergoing primary percutaneous coronary intervention (PPCI). We report outcomes in patients with STEMI undergoing PPCI with or without previous CABG surgery in a large real-world, all-comer population. METHODS AND RESULTS: Clinical, demographic, procedural, and outcomes data were collected for all patients undergoing PPCI in England and Wales from January 2007 to December 2012. All-cause mortality at 30 days and 1 year were evaluated in the whole and a propensity-matched cohort. Of 79 295 patients with STEMI studied, 2658 (3.4%) patients had prior CABG, of whom 44% (n=1168) underwent PPCI to native vessels and 56% (n=1490) to bypass grafts. There were significant differences in the demographic, clinical, and procedural characteristics of these groups. Patients with prior CABG (with primary PCI to native artery or graft) had higher mortality at 30 days (6.2% with PPCI to native artery, 6.1% with PPCI to bypass graft) than patients with no prior CABG (4.5%; P<0.001). However, after risk factor adjustments, there was no significant difference in outcomes. There were also no significant differences in 30-day mortality, in-hospital major adverse cardiovascular events, in-hospital stroke, and in-hospital bleeding in the propensity-matched population. CONCLUSIONS: A prior history of CABG in patients presenting with STEMI and undergoing PPCI does not independently confer additional risk of mortality, although it is a marker of other high-risk features.
Authors: Krishnaraj S Rathod; Anne-Marie Beirne; Richard Bogle; Sam Firoozi; Pitt Lim; Jonathan Hill; Miles C Dalby; Ajay K Jain; Iqbal S Malik; Anthony Mathur; Sundeep Singh Kalra; Ranil DeSilva; Simon Redwood; Philip A MacCarthy; Andrew Wragg; Elliot J Smith; Daniel A Jones Journal: J Am Heart Assoc Date: 2020-06-01 Impact factor: 5.501
Authors: Samir B Pancholy; Purveshkumar Patel; Gaurav A Patel; Dhara D Patel; Neil R Patel; Elizabeth A Pattara; Tejas M Patel Journal: Int J Cardiol Heart Vasc Date: 2021-09-22
Authors: Liefke C van der Heijden; Marlies M Kok; Paolo Zocca; Hanim Sen; Marije M Löwik; Silvia Mariani; Frits H A F de Man; Marc Hartmann; Martin G Stoel; K Gert van Houwelingen; J Hans W Louwerenburg; Gerard C M Linssen; Carine J M Doggen; Jan G Grandjean; Clemens von Birgelen Journal: J Am Heart Assoc Date: 2018-01-30 Impact factor: 5.501