Is It Safe to Use Arterial Grafts in Patients with Acute Myocardial Infarction? Short-Mid-Term Propensity Analysis

Area of Science:

• Cardiovascular Surgery
• Cardiac Surgery Outcomes
• Myocardial Infarction Treatment

Background:

• The optimal arterial graft strategy for acute myocardial infarction (AMI) patients undergoing coronary artery bypass grafting (CABG) remains debated.
• Multiple arterial grafts (MAGs) may offer survival benefits, but their use in the acute phase of AMI requires further investigation.

Purpose of the Study:

• To compare the short- to mid-term clinical outcomes of AMI patients treated with CABG using single arterial grafts (SAGs) versus MAGs.
• To evaluate the safety and efficacy of MAGs in the acute setting of myocardial infarction.

Main Methods:

• A cross-sectional cohort study of 4,053 patients from the REPLICCAR II registry.
• Propensity score matching (PSM) was used to compare 35 patients receiving MAGs with a matched cohort receiving SAGs for AMI (n=238), with 70 patients evaluated post-PSM.
• Clinical follow-up assessed readmission, new AMI, reoperation, and mortality.

Main Results:

• Surgery duration was longer in the MAG group (median 4.78 hours) compared to the SAG group (median 4.11 hours) (P=0.040).
• Bilateral internal thoracic artery was the most common MAG configuration (62.86%).
• No significant differences in clinical outcomes were observed between MAG and SAG groups up to five years post-CABG.

Conclusions:

• The use of MAGs in patients with AMI undergoing CABG was not associated with adverse clinical outcomes in the mid-term follow-up.
• These findings suggest that MAGs are a safe and viable option for revascularization in AMI patients.