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Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
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Increased rehospitalization rate after coronary bypass operation for acute coronary syndrome: a prospective study in

Staffan Bjessmo1

  • 1Cardiothoracic Surgery Unit, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. staffan.bjessmo@karolinska.se

The Annals of Thoracic Surgery
|September 22, 2009
PubMed

Insights

Patients undergoing coronary artery bypass grafting (CABG) show similar long-term survival regardless of acute coronary syndrome (ACS) or stable angina. However, ACS patients face higher early risks and rehospitalization rates post-CABG.

Area of Science:

  • Cardiology
  • Cardiac Surgery

Background:

  • Patients with acute coronary syndrome (ACS) face elevated risks of cardiac death or myocardial infarction post-coronary artery bypass grafting (CABG).
  • Long-term survival rates after CABG are comparable between ACS patients and those with stable angina pectoris.

Purpose of the Study:

  • To analyze and compare cardiac rehospitalization rates up to 10 years post-CABG in patients with ACS versus stable angina.
  • To evaluate long-term survival and early outcomes in these patient groups.

Main Methods:

  • A cohort of 200 patients (100 with ACS, 100 with stable angina) underwent CABG.
  • Troponin-T levels were measured, and unstable symptoms were classified using the Braunwald criteria.
  • Analysis included early outcomes, long-term survival, and freedom from cardiac rehospitalization.

Main Results:

  • Long-term survival was similar (85% for ACS, 81% for stable; p=0.75).
  • Postoperative myocardial infarction occurred more frequently in ACS patients (5 vs 1; p=0.01).
  • Stable patients had significantly higher freedom from cardiac rehospitalization at 3 years (p=0.001), though rates equalized by the end of follow-up.

Conclusions:

  • CABG offers similar excellent long-term survival for both ACS and stable angina patients.
  • Elevated troponin-T and rest angina in ACS patients predict increased perioperative myocardial infarction risk.
  • ACS patients experience higher early cardiac rehospitalization post-CABG, suggesting recurrent ischemia.
Abstract

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