PMID- 20211314
OWN - NLM
STAT- MEDLINE
DCOM- 20100402
LR  - 20100309
IS  - 1097-6744 (Electronic)
IS  - 0002-8703 (Linking)
VI  - 159
IP  - 3
DP  - 2010 Mar
TI  - Timing of nonemergent coronary artery bypass grafting and mortality after non-ST 
      elevation acute coronary syndrome.
PG  - 490-6
LID - 10.1016/j.ahj.2010.01.002 [doi]
AB  - BACKGROUND: The purpose of this study was to determine the association between 
      time to coronary artery bypass grafting (CABG) and mortality among patients 
      admitted with non-ST elevation acute coronary syndrome (NSTEACS). Patients are 
      increasingly being referred for CABG soon after NSTEACS, although few data exist 
      to guide the optimal timing of bypass surgery. METHODS: We identified a cohort of 
      all patients who underwent nonemergent CABG within 60 days of hospitalization for 
      NSTEACS in the province of Alberta, Canada, from 2000 to 2004. Time from 
      admission to CABG was categorized as early (2-7 days), intermediate (8-14 days), 
      or late (15-60 days-reference group). The primary outcome was mortality occurring 
      within 30 days of surgery. RESULTS: Of the total cohort of 1,454 patients, 213 
      (14.6%) underwent early, 637 (43.8%) underwent intermediate, and 707 (48.6%) 
      underwent late CABG surgery. In the final adjusted model time to CABG was not 
      statistically significant as an independent predictor of short-term mortality. 
      Compared to late CABG, there was a nonsignificant increased risk of mortality for 
      those undergoing early (hazard ratio 2.36, 95% CI 0.72-7.76) and intermediate 
      (hazard ratio 1.68, 95% CI 0.76-3.72) CABG surgery. CONCLUSIONS: Time from 
      admission to CABG was not associated with an increased risk of short-term 
      mortality. However, there was a trend toward increased mortality with early CABG, 
      and this study does not exclude the presence of a modest risk association between 
      timing of CABG and short-term mortality.
FAU - Deyell, Marc W
AU  - Deyell MW
AD  - University of British Columbia, Vancouver, Canada.
FAU - Ghali, William A
AU  - Ghali WA
FAU - Ross, David B
AU  - Ross DB
FAU - Zhang, Jianguo
AU  - Zhang J
FAU - Hemmelgarn, Brenda R
AU  - Hemmelgarn BR
CN  - Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease 
      (APPROACH) Investigators
LA  - eng
GR  - Canadian Institutes of Health Research/Canada
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
SB  - IM
MH  - Acute Coronary Syndrome/diagnosis/*mortality/*surgery
MH  - Aged
MH  - Cohort Studies
MH  - *Coronary Artery Bypass
MH  - *Electrocardiography
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Proportional Hazards Models
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Time Factors
EDAT- 2010/03/10 06:00
MHDA- 2010/04/03 06:00
CRDT- 2010/03/10 06:00
PHST- 2009/09/30 00:00 [received]
PHST- 2010/01/06 00:00 [accepted]
PHST- 2010/03/10 06:00 [entrez]
PHST- 2010/03/10 06:00 [pubmed]
PHST- 2010/04/03 06:00 [medline]
AID - S0002-8703(10)00056-6 [pii]
AID - 10.1016/j.ahj.2010.01.002 [doi]
PST - ppublish
SO  - Am Heart J. 2010 Mar;159(3):490-6. doi: 10.1016/j.ahj.2010.01.002.