Review finds early invasive therapy may improve outcomes in unstable angina and non-ST-segment elevation myocardial infarctionAbstracted from: Bavry AA, Kumbhani DJ, Quiroz R, et al. Invasive therapy along with glycoprotein IIb/IIIa inhibitors and intracoronary stents improves survival in non ST-segment elevation acute coronary syndromes: a meta-analysis and review of the literature. Am J Cardiol 2004; 93: 830–5.

2004 ◽  
Vol 8 (3) ◽  
pp. 276-277
Keyword(s):  
Unstable Angina ◽  
Acute Coronary Syndromes ◽  
Meta Analysis ◽  
Review Of The Literature ◽  
Invasive Therapy ◽  
St Segment Elevation ◽  
St Segment ◽  
Coronary Syndromes

scholarly journals Surgical revascularization for acute coronary syndromes: a report from the North Rhine-Westphalia surgical myocardial infarction registry

2020 ◽  
Vol 58 (6) ◽  
pp. 1137-1144
Author(s):  
Oliver J Liakopoulos ◽  
Ingo Slottosch ◽  
Daniel Wendt ◽  
Hendryk Welp ◽  
Wolfgang Schiller ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Unstable Angina ◽  
Acute Coronary Syndromes ◽  
Left Ventricular Ejection ◽  
Logistic Euroscore ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Coronary Syndromes ◽  
St Elevation

Abstract OBJECTIVES The aim of this was to analyse current outcomes in patients referred to coronary artery bypass grafting (CABG) for acute coronary syndromes (ACSs), including ST-elevation or non-ST-elevation ACS (non-ST-segment elevation myocardial infarction) or unstable angina. METHODS Patients (n = 2432) undergoing CABG for ACS between January 2010 and December 2017 were prospectively entered into a surgical myocardial infarction registry in North Rhine-Westphalia, Germany. Key end points were in-hospital all-cause mortality (IHM) and major adverse cardio-cerebral events (MACCE). Predictors for IHM and MACCE were analysed by multivariable logistic regression. RESULTS Patients (78% males) were referred for CABG for unstable angina (25%), non-ST-segment elevation myocardial infarction (50%), and ST-segment elevation myocardial infarction (25%). The mean patient age was 68 ± 11 years, logistic EuroSCORE was 19 ± 18% and three-vessel and left main stem diseases were diagnosed in 81% and 45% of patients, respectively. On-pump CABG with cardiac arrest or beating heart was performed in 92% and 2%, respectively, with only 6% off-pump surgery and 6% multiple arterial revascularization (3.1 ± 1.0 grafts, 93% left internal thoracic artery). Emergency CABG was performed in 23% of patients (42% in ST-segment elevation myocardial infarction; P < 0.001). The total IHM and MACCE rates were 8.1% and 17.5% and were highest in ST-segment elevation myocardial infarction patients with 12.6% and 28.5%, respectively (P < 0.001). Key predictors for IHM and MACCE were female gender, elevated troponin, left ventricular ejection fraction, inotropic support, logistic EuroSCORE, cardiopulmonary bypass and aortic clamp time and the need for emergency CABG. CONCLUSIONS Surgical myocardial revascularization in patients with ACS is still linked to substantial in-hospital mortality. Emergency CABG for patients with ACS was associated with poorer outcomes.

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