Emergent coronary artery bypass grafting for cardiogenic shock caused by very late drug-eluting stent thrombosis

2009 ◽  
Vol 57 (11) ◽  
pp. 609-611 ◽  
Author(s):  
Massimo Boffini ◽  
Fabrizio Ceresa ◽  
Fabrizio Sansone ◽  
Marco Ribezzo ◽  
Chiara Comoglio ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Cardiogenic Shock ◽  
Coronary Artery Bypass ◽  
Stent Thrombosis ◽  
Artery Bypass ◽  
Drug Eluting Stent ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Drug Eluting

Abstract 16253: Temporal Trends and Outcomes of Coronary Artery Bypass Grafting After Acute St-elevation Myocardial Infarction

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ayman Elbadawi ◽  
Mohammed Elzeneini ◽  
Islam Y Elgendy ◽  
Mohamed Omer ◽  
Gbolahan O Ogunbayo ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Blood Transfusion ◽  
Hospital Mortality ◽  
Cardiogenic Shock ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

Introduction: There is paucity of data on the outcomes of coronary artery bypass grafting (CABG) among patients presenting with ST-segment elevation myocardial infarction (STEMI). Methods: We queried the National Inpatient Sample database (2002-2016) for patients with STEMI who underwent CABG. We reported the trends in utilization of CABG for STEMI, and the associated in-hospital outcomes. Using multivariable analysis, we compared in-hospital outcomes in patients undergoing CABG on hospitalization day 1 vs. day 2 vs. day ≥3 , in the early (2002 to 2009) and contemporary cohorts (2012 to 2016). Results: Our analysis yielded 2,910,960 patients with STEMI, of whom 7.6% underwent CABG (9.6% in 2002 versus 3.9% in 2016, P trend <0.001). There was an increase in in-hospital mortality (5.8% in 2002 versus 7.6% in 2016, P trend <0.001) which corresponded to an increase in comorbidities burden among patients undergoing CABG. There was a rising trend in performing CABG on hospitalization day ≥ 3 corresponding to an increase in the utilization of MCS and pre-CABG PCI during the study years. CABG was more likely to be performed on admission day 1 in patients with anterior STEMI, cardiogenic shock or mechanical complications. In the early cohort, CABG on day 1 and day 2 was associated with higher in-hospital mortality, while in the contemporary cohort only CABG on day 1 was associated with higher in-hospital mortality compared with CABG on day ≥ 3. CABG on day 1 was associated with higher rate of cardiac arrest, hemorrhagic stroke, blood transfusion and cardiac tamponade in the earlier cohort, while in the more contemporary cohort it was associated with higher blood transfusion. Conclusions: There was a downtrend in performing CABG for STEMI, and an uptrend in in-hospital mortality after CABG. Patients undergoing emergent CABG on day 1 were more likely to have mechanical complications and cardiogenic shock and were associated with higher in-hospital mortality.

scholarly journals Does the use of paclitaxel or rapamycin-eluting stent decrease further need for coronary-artery bypass grafting when compared with bare-metal stent?

2007 ◽  
Vol 125 (4) ◽  
pp. 242-245 ◽  
Author(s):  
Hernani Pinto de Lemos Júnior ◽  
Álvaro Nagib Atallah
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Drug Eluting Stents ◽  
Metal Stents ◽  
Bypass Grafting ◽  
Bare Metal ◽  
Artery Bypass Grafting ◽  
Drug Eluting

CONTEXT AND OBJECTIVE: The safety and efficacy of drug-eluting stents reduce the need for surgical revascularization. The objective of the present study was to investigate whether paclitaxel or rapamycin-eluting stent are effective in avoiding the need for coronary-artery bypass grafting. METHODS: This was a systematic review of the literature using the methodology of the Cochrane Collaboration. The type of study considered was controlled randomized trials; the type of intervention was drug-eluting or bare-metal stents; and the main outcome investigated was coronary-artery bypass grafting. RESULTS: The ten studies included in this systematic review did not show any statistically significant difference between the drug-eluting stents and the bare-metal stents with regard to the outcome of coronary-artery bypass grafting (confidence interval: 0.31 to 1.42). CONCLUSION: The surgical revascularization rate was not reduced by the use of drug-eluting stents.

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