Predictors of long-term mortality in acute ST-elevation myocardial infarction patients undergoing emergent coronary artery bypass graft surgery. 2021

Begüm Uygur, and Ömer Çelik, and Ali Rıza Demir, and Gökhan Demirci, and Taner İyigün, and Anıl Şahin, and Ömer Taşbulak, and Yalçın Avcı, and Mehmet Ertürk
Department of Cardiology, University of Health Sciences Turkey İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey.

Coronary artery bypass graft (CABG) surgery as a primary treatment for acute ST-elevation myocardial infarction (STEMI) is still debated. This study aimed to evaluate the predictors of long-term mortality in STEMI patients undergoing emergent CABG. To the best of our knowledge, this is the first study to evaluate the long-term mortality predictors in patients with STEMI revascularized by primary CABG. This retrospective study included 88 consecutive patients with STEMI, who did not qualify for primary percutaneous intervention and required emergent CABG between 2010 and 2017. The study population was divided into the following 2 groups: survivors and nonsurvivors. The 2 groups were compared in terms of demographics, preoperative, intraoperative, and postoperative characteristics. 23 of the 88 patients, died during the median 92.8 (69.0-105.1) months of follow-up. Data were evaluated with univariate and multivariate analyses. Killip class (p<0.001) was found to be an independent predictor of long-term all-cause mortality in patients with STEMI revascularized by CABG, and mortality rates increased significantly as Killip class increased (log-rank test, p<0.001). Moreover, age (p=0.044) was found to be an independent predictor of long-term mortality. Left ventricular ejection fraction, glomerular filtration rate, glucose levels, and left anterior descending artery to the left internal mammary artery graft usage (p=0.001, p=0.009, p<0.001, and p=0.039, respectively) were significantly associated with long-term all-cause mortality for our study population. Killip class was found to be an independent predictor of long-term all-cause mortality in patients with STEMI who underwent emergent CABG. The patients' admission status may give valuable information about long-term mortality.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D002423 Cause of Death Factors which produce cessation of all vital bodily functions. They can be analyzed from an epidemiologic viewpoint. Causes of Death,Death Cause,Death Causes
D004630 Emergencies Situations or conditions requiring immediate intervention to avoid serious adverse results. Emergency
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D005919 Glomerular Filtration Rate The volume of water filtered out of plasma through glomerular capillary walls into Bowman's capsules per unit of time. It is considered to be equivalent to INULIN clearance. Filtration Rate, Glomerular,Filtration Rates, Glomerular,Glomerular Filtration Rates,Rate, Glomerular Filtration,Rates, Glomerular Filtration
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000072657 ST Elevation Myocardial Infarction A clinical syndrome defined by MYOCARDIAL ISCHEMIA symptoms; persistent elevation in the ST segments of the ELECTROCARDIOGRAM; and release of BIOMARKERS of myocardial NECROSIS (e.g., elevated TROPONIN levels). ST segment elevation in the ECG is often used in determining the treatment protocol (see also NON-ST ELEVATION MYOCARDIAL INFARCTION). ST Elevated Myocardial Infarction,ST Segment Elevation Myocardial Infarction,STEMI
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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