Angiographic Findings and Revascularization Success in Patients With Acute Myocardial Infarction and Previous Coronary Bypass Grafting
Blachutzik F, Achenbach S, Tröbs M, Röther J, Nef H, Hamm C, Schlundt C (2016)
Publication Type: Journal article
Publication year: 2016
Journal
Book Volume: 118
Pages Range: 473-6
Journal Issue: 4
DOI: 10.1016/j.amjcard.2016.05.040
Abstract
Current guidelines recommend invasive coronary angiography and interventional revascularization in ST-elevation and Non-ST-elevation myocardial infarction (STEMI and NSTEMI). The aim of this study was to analyze culprit lesions and percutaneous coronary intervention (PCI) success in patients with previous coronary artery bypass grafting (CABG). We analyzed the data of 121 consecutive patients in whom coronary angiography was performed in the setting of STEMI or NSTEMI and who had previous CABG. Coronary angiograms were reviewed, and clinical data were evaluated. The culprit vessel was identified by means of electrocardiographic findings, echocardiography, and coronary angiography. A bypass graft was the culprit vessel in 86% of patients with STEMI and 68% of patients with NSTEMI. Venous grafts were culprit vessels significantly more frequently than arterial grafts (81 of 260 venous grafts vs 4 of 65 arterial grafts, p <0.001). Attempted acute PCI was successful in 97% of native arteries (31 of 32 patients) but only in 81% of bypass grafts (68 of 84 patients, p = 0.031). Overall in-hospital mortality was 13% (STEMI: 25%, NSTEMI: 10%, p <0.001) and was significantly higher after failed acute PCI (6 of 11 patients; 55%) compared with successful acute PCI (7 of 110 patients; 6%; p = 0.006). In conclusion, the culprit lesion in patients with previous CABG who present with STEMI or NSTEMI is more often located in bypass grafts than in native arteries. Successful PCI is more likely in native arteries compared with bypass grafts.
Authors with CRIS profile
Stephan Achenbach
Department of Medicine 2 – Cardiology and Angiology
Monique Tröbs
Department of Medicine 2 – Cardiology and Angiology
Jens Röther
Department of Medicine 2 – Cardiology and Angiology
Christian Schlundt
Department of Medicine 2 – Cardiology and Angiology
Involved external institutions
Germany (DE)How to cite
APA:
Blachutzik, F., Achenbach, S., Tröbs, M., Röther, J., Nef, H., Hamm, C., & Schlundt, C. (2016). Angiographic Findings and Revascularization Success in Patients With Acute Myocardial Infarction and Previous Coronary Bypass Grafting. American Journal of Cardiology, 118(4), 473-6. https://doi.org/10.1016/j.amjcard.2016.05.040
MLA:
Blachutzik, Florian, et al. "Angiographic Findings and Revascularization Success in Patients With Acute Myocardial Infarction and Previous Coronary Bypass Grafting." American Journal of Cardiology 118.4 (2016): 473-6.
BibTeX: Download