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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
Karolinska University Hospital.
Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
2007 (English)In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 28, no 3, 316-325 p.Article in journal (Refereed) Published
Abstract [en]

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.
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Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-40766DOI: 10.1093/eurheartj/ehl471Local ID: 54067OAI: oai:DiVA.org:liu-40766DiVA: diva2:261615
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13

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Stenestrand, Ulf

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