Effects of revascularization within 14 days of hospital admission due to acute coronary syndrome on 1-year mortality in patients with previous coronary artery bypass graft surgery
2007 (English)In: European Heart Journal, ISSN 0195-668X, Vol. 28, no 3, 316-325 p.Article in journal (Refereed) Published
Aims: To determine whether revascularization within 14 days reduces 1-year mortality in patients with a previous CABG admitted for non-ST-elevation ACS. Current guidelines for patients with acute coronary syndrome (ACS) include early revascularization. The evidence is derived from studies, in which patients with previous coronary artery by-pass graft (CABG) surgery often were excluded and thus insufficient to support a similar strategy in these high-risk patients in whom coronary interventions are associated with lower success and higher complication rates. Methods and results: A cohort of 10 469 patients < 80 years old from a national registry, admitted to coronary care units in Sweden, was studied. We obtained 1-year mortality data from the Swedish National Cause of Death Registry. Relative risk (RR) in patients undergoing revascularization within 14 days (n = 4269) of admission compared to those who did not (n = 6200) was calculated by using multivariable logistic regression analyses and propensity scores for the likelihood of early revascularization. At 1-year, unadjusted mortality was 5.4% in the revascularized group and 13.1% in the conservatively treated group. In multiple regression analyses, revascularization was associated with a reduction of 1-year mortality (RR 0.67, 95% CI, 0.56-0.81, P < 0.001). Conclusion: In patients with a previous CABG admitted for ACS, revascularization within 14 days of hospital admission was associated with a marked reduction in 1-year mortality, supporting an early invasive approach also in this subset of patients. © The European Society of Cardiology 2007. All rights reserved.
Place, publisher, year, edition, pages
2007. Vol. 28, no 3, 316-325 p.
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:liu:diva-40766DOI: 10.1093/eurheartj/ehl471Local ID: 54067OAI: oai:DiVA.org:liu-40766DiVA: diva2:261615