Incidence, predictors, and outcomes of early acute myocardial infarction following coronary artery bypass grafting
The American Journal of Cardiology Jul 20, 2019
Alkhouli M, et al. - Via the National-Readmission-Database (2015-2016), the researchers recognized subjects who underwent coronary artery bypass grafting (CABG) between January 1 and June 31 in order to determine the incidence, predictors, and outcomes of early acute myocardial infarction (AMI) post-CABG. Out of the 203,760 included subjects, 3,829 were readmitted for AMI. Those with AMI were younger, had more females, and higher prevalence of hypertension, diabetes, obstructive lung disease, anemia, vascular disease, renal insufficiency, and liver cirrhosis, but less atrial fibrillation in comparison with subjects without readmissions for AMI. Female sex, heart failure, dialysis, cirrhosis, non-elective CABG, perioperative mechanical circulatory support, low-volume centers, and non-home discharge following CABG were the most powerful predictors of post-CABG AMI readmission. Among the subjects who were readmitted for AMI, 86.3% and 13.7% had non-ST-elevation AMI and ST-elevation-AMI, respectively. Coronary angiography was done in 2,096 subjects, out of those, 63.5% and 1.7% received a percutaneous coronary intervention and had redo-CABG, respectively. Readmissions for AMI were correlated with important in-hospital mortality, acute kidney injury, and new dialysis. Moreover, the median length-of-stay was 3 days, and the mean hospital cost was $22,207±29,071.
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