A total of 2.616 patients with acute coronary syndrome were analyzed from the from the North-Rhine-Westphalia surgical myocardial infarction registry. In-hospital all-cause mortality and major adverse cardio-cerebral event were the primary end points. The mean age of the patients was 68±11 years. These patients had 80.4% of 3-vessel and 45.3% of left main-stem disease, presenting a logistic EuroSCORE of 15.1% in unstable angina, 20.3% in non-ST-segment-elevation myocardial infarction, and 23.5% in ST-segment-elevation myocardial infarction. 36.2% of patients had a history of PCI. PCI was performed within 24 hours before surgery in 5.2% in unstable angina, 5.9% in non-ST-segment-elevation myocardial infarction, and 16.1% in ST-segment-elevation myocardial infarction. PCI failed in 5.3% in unstable angina, 6.8% in non-ST-segment-elevation myocardial infarction and 17.2% in ST-segment-elevation myocardial infarction. Patients presented with cardiogenic shock were 28.8%. In-hospital mortality without PCI was 7.4%, but increased to 8.7% with prior PCI >24 hours, 14.5% with prior PCI <24 hours, and 14.1% with failed PCI (P<0.003). Without PCI, the in-hospital major adverse cardio-cerebral event rate was 16.4%, 17.4% with prior PCI >24 hours, 25.6% with prior PCI <24 hours, and 41.3% with failed PCI (P=0.014). Prior PCI (P=0.039), as well as failed PCI (P=0.001) were shown to be predictors for in-hospital all-cause mortality and major adverse cardio-cerebral event using multivariable logistic regression.  

High perioperative risk, cardiogenic shock, and increased illnesses and deaths are associated with immediately prior or failed percutaneous coronary intervention before coronary artery bypass grafting in acute coronary syndromes.  

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Keywords

Disease Condition,Therapeutic Modality,Coronary Artery Disease,Interventional Cardiology,Acute Coronary Syndrome,Percutaneous Coronary Intervention

Source

https://pubmed.ncbi.nlm.nih.gov/34514809/

Tags

Disease Condition ,Therapeutic Modality ,Coronary Artery Disease,Interventional Cardiology,Acute Coronary Syndrome,Percutaneous Coronary Intervention