Author + information
- Sahil Agrawal,
- Manyoo Agarwal,
- Lohit Garg,
- Aakash Garg,
- Abhishek Sharma,
- Nirmanmoh Bhatia,
- Divyanshu Mohananey,
- Amitoj Singh,
- Peter Puleo,
- John Kostis and
- Jamshid Shirani
Background: Trends of utilization of emergent coronary artery bypass graft (CABG) surgery in setting of ST-segment elevation myocardial infarction (STEMI) and related outcomes have not been well studied.
Methods: We utilized the Nationwide Inpatient Sample database to identify adults (age ≥ 18 years) admitted with STEMI who underwent emergent (day 0 or 1) CABG from years 2003-2013.
Results: Of the 2,632,247 patients admitted with STEMI, 212,014 (8%) underwent CABG during index hospitalization; 71,195 (34%) of which were emergent. Clinical characteristics of patients undergoing CABG are shown and compared in Table 1. While annual rates of CABG surgery decreased from 2003-2013, proportion of emergent CABG surgeries showed a significant rise [28% in 2003 vs. 43% in 2013, adjusted odds ratio (OR) per year 1.095, 95% confidence interval (CI) 1.091-1.099; p<0.001]. The use of an internal mammary artery graft increased from 69% in 2003 to 85% in 2013 (OR per year 1.08, 95%CI 1.07- 1.09, p<0.01). Risk-adjusted in-hospital mortality did not change significantly (7.6% in 2003 vs. 8.0% in 2013, OR per year 1.0, 95% CI 0.99- 1.01, p=0.6) while rates of acute ischemic stroke, acute kidney injury requiring dialysis and blood transfusion increased (p<0.001 for all).
Conclusion: Use of emergent CABG for revascularization in STEMI has increased substantially in recent years. This has not been associated with an increase in risk-adjusted in-hospital mortality while several morbidities showed an increased rate.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Revascularization and Myocardial Preservation in Acute and Stable Ischemic Heart Disease
Abstract Category: 3. Acute and Stable Ischemic Heart Disease: Therapy
Presentation Number: 1165-303
- 2017 American College of Cardiology Foundation