[Direct myocardial revascularization after 6, 12 and 24 hours of acute coronary syndrome]

Area of Science:

• Cardiology
• Cardiac Surgery
• Acute Coronary Syndromes

Background:

• Acute coronary syndrome (ACS) necessitates timely intervention.
• Coronary artery bypass grafting (CABG) is a critical treatment for severe coronary artery disease.
• The optimal timing for revascularization in ACS remains a subject of investigation.

Purpose of the Study:

• To evaluate the outcomes of direct myocardial revascularization performed within 72 hours of ACS onset.
• To assess the safety and efficacy of urgent CABG in ACS patients with high SYNTAX scores.

Main Methods:

• Retrospective analysis of 48 patients with coronary artery disease undergoing urgent CABG between 2011-2019.
• Patients were stratified into three groups based on surgery timing: within 6 hours, 6-24 hours, and 24-72 hours post-admission.
• All patients had a SYNTAX Score >22, indicating complex coronary artery disease.

Main Results:

• Myocardial damage markers were comparable across groups at 1 and 2 days post-surgery (p>0.05).
• In-hospital mortality was low (3.84% in group 1, 6.6% in group 2, 0% in group 3).
• One-year survival rates were 80.8%, 100%, and 100% for groups 1, 2, and 3, respectively, with overall 5-year survival reaching 100%.

Conclusions:

• Early active open revascularization is recommended for ACS patients with clear surgical indications.
• Timely CABG within 72 hours of ACS manifestation is associated with favorable long-term outcomes.
• Urgent surgical intervention can be safely performed in selected ACS patients.