PMID- 32558440
OWN - NLM
STAT- MEDLINE
DCOM- 20200702
LR  - 20200702
IS  - 1565-1088 (Print)
VI  - 22
IP  - 6
DP  - 2020 Jun
TI  - Long-Term Outcomes in ST Elevation Myocardial Infarction Patients Undergoing 
      Coronary Artery Bypass Graft Versus Primary Percutaneous Coronary Intervention.
PG  - 352-356
AB  - BACKGROUND: Coronary artery bypass grafting (CABG) for primary reperfusion in 
      patients with ST elevation myocardial infarction (STEMI) has largely been 
      superseded byf primary percutaneous coronary intervention (PCI) and is estimated 
      to be performed in </= 5% of STEMI cases. OBJECTIVES: To compare early CABG (within 
      30 days following admission) and primary PCI outcomes following STEMI. METHODS: 
      We analyzed a retrospective cohort of patients hospitalized with acute STEMI for 
      early reperfusion therapy between January 2008 and June 2016. Short- and 
      long-term outcomes were assessed for patients with STEMI undergoing primary PCI 
      vs. early CABG as reperfusion therapy. RESULTS: The study comprised 1660 STEMI 
      patients, 38 of whom (2.3%) underwent CABG within 30 days of presentation. 
      Unadjusted 30-day mortality was more than twice as high in the CABG group (7.5%) 
      than in the PCI group (3.3%); however, it did not reach statistical significance. 
      Similar results were demonstrated for mortality rates beyond 30 days (22% vs. 
      14%, P = 0.463). All patients undergoing CABG beyond 72 hours following admission 
      survived past 2 years. Multivariate analysis found no differences between the two 
      groups in long-term mortality risk. propensity score matched long-term mortality 
      comparison (30 days-2 years) yielded a 22% mortality rate in the CABG groups 
      compared with 14% in the PCI group (P < 0.293). CONCLUSIONS: Early CABG was 
      performed in only a minority of STEMI patients. This high-risk patient population 
      demonstrated worse outcomes compared to patients undergoing PCI. Performing 
      surgery beyond 72 hours following admission may be associated with lower risk.
FAU - Merdler, Ilan
AU  - Merdler I
AD  - Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, affiliated 
      with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Gabarin, Mustafa
AU  - Gabarin M
AD  - Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, affiliated 
      with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Loewenstein, Itamar
AU  - Loewenstein I
AD  - Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, affiliated 
      with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Letourneau, Sivan
AU  - Letourneau S
AD  - Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, affiliated 
      with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Zahler, David
AU  - Zahler D
AD  - Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, affiliated 
      with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Hochstadt, Aviram
AU  - Hochstadt A
AD  - Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, affiliated 
      with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Szekely, Yishay
AU  - Szekely Y
AD  - Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, affiliated 
      with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Banai, Shmuel
AU  - Banai S
AD  - Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, affiliated 
      with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Shacham, Yacov
AU  - Shacham Y
AD  - Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, affiliated 
      with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - Israel
TA  - Isr Med Assoc J
JT  - The Israel Medical Association journal : IMAJ
JID - 100930740
SB  - IM
MH  - Aged
MH  - *Coronary Artery Bypass
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Percutaneous Coronary Intervention
MH  - Retrospective Studies
MH  - ST Elevation Myocardial Infarction/mortality/*surgery
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2020/06/20 06:00
MHDA- 2020/07/03 06:00
CRDT- 2020/06/20 06:00
PHST- 2020/06/20 06:00 [entrez]
PHST- 2020/06/20 06:00 [pubmed]
PHST- 2020/07/03 06:00 [medline]
PST - ppublish
SO  - Isr Med Assoc J. 2020 Jun;22(6):352-356.