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DOI: 10.1055/s-2007-967390
Is CABG in acute myocardial infarction justified?
Aims: Nowadays, PCI represents the treatment of choice in acute myocardial infarction (AMI). In a selected group of patients, either after failed intervention or if coronary morphology remains unsuitable for PCI, emergent CABG is performed. Aim of the study was the evaluation of results in this high-risk patient group.
Methods: Out of 128 patients undergoing isolated CABG with acute infarction up to 5 days. Mean age was 66.3±10.8 years (median: 68.7 years), 74.2% were male.
Results: Since patients with AMI are presenting differently, two groups were built (group 1– acute cardiogenic shock (n=19.14.8%), group 2– no acute cardiogenic shock (n=109.85.2%). 30-day mortality differed significantly between the groups (42.1% vs.7.3%). STEMI occurred in group 1 in 36%, in group 2 in 30.3%. The number of peripheral anastomoses was 2.6±0.7 in group 1 and 2.9±0.9 in group 2. LV function was evaluated using a scale from 1–3 (good, mid, bad). The mean improvement was 0.6 in patients of group 1 and 0.4 in patients of group 2.
Conclusion: CABG in patients with AMI turns out to be a beneficial approach even in patients presenting with cardiogenic shock. Seem the extreme patient selection, the results justify surgical treatment even in desperate cases.