Related Experiment Video
Updated: Jul 16, 2026
Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
Examining the Outcomes of Hybrid Coronary Revascularization in Acute ST-Elevation Myocardial Infarction (STEMI)
Fraz Ahmad1, Alamgir Aslam Khan2, Ameer Aslam3
1Cardiology, Shalamar Hospital, Lahore, PAK.
Insights
Hybrid coronary revascularization (HCR) effectively treats acute ST-segment elevation myocardial infarction (STEMI) in complex cases. This approach combines percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG), showing promising one-year outcomes.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Surgery
Background:
- Acute ST-segment elevation myocardial infarction (STEMI) necessitates prompt restoration of coronary blood flow.
- Percutaneous coronary intervention (PCI) is standard but often insufficient for complex coronary anatomy.
- Hybrid coronary revascularization (HCR), combining PCI and coronary artery bypass grafting (CABG), presents an alternative for complex STEMI cases.
Purpose of the Study:
- To evaluate the efficacy and safety of HCR in acute STEMI patients.
- To assess outcomes in patients with high-risk features like multivessel disease or left main coronary artery involvement.
Main Methods:
- A prospective cohort study involving 342 acute STEMI patients at Shalamar Hospital, Lahore.
- Patients underwent HCR, including PCI with drug-eluting stents and minimally invasive CABG.
- Outcomes measured were one-year major adverse cardiovascular events (MACE), six-month graft patency, and procedural success.
Main Results:
- The one-year MACE rate was 14.6%, including myocardial infarction (6.1%), repeat revascularization (4.4%), and cardiac death (4.1%).
- Six-month graft patency was high at 94.7%, with an overall procedural success rate of 98.2%.
- One-year survival was 95.3%.
Conclusions:
- HCR is a safe and effective strategy for acute STEMI, especially with complex coronary anatomy.
- HCR balances reduced invasiveness with improved patient outcomes.
- Further multicenter studies are recommended to validate findings and establish HCR guidelines.
Background:
Acute ST-segment elevation myocardial infarction (STEMI) is a critical cardiovascular condition requiring timely intervention to restore coronary blood flow and minimize myocardial damage. While percutaneous coronary intervention (PCI) remains the gold standard, it is often insufficient for patients with complex coronary anatomy, such as multivessel disease or left main coronary artery involvement. Hybrid coronary revascularization (HCR), which combines PCI and coronary artery bypass grafting (CABG), offers a novel approach to managing these complex cases.
Objective:
The primary objective of this study was to evaluate the outcomes of HCR in patients presenting with acute STEMI, particularly those with high-risk features such as multivessel disease or left main coronary artery involvement.
Methods:
This prospective cohort study was conducted at Shalamar Hospital, a tertiary care center in Lahore, Pakistan. The study enrolled 342 patients diagnosed with acute STEMI between January 1, 2023, and December 31, 2023. Participants underwent HCR, consisting of PCI with drug-eluting stents and minimally invasive CABG. Key outcomes included the incidence of major adverse cardiovascular events (MACE) within one year, graft patency at six months, and overall procedural success. Data were collected through patient records and follow-up assessments, and statistical analysis was performed using SPSS Statistics version 26.0 (IBM Corp. Released 2019. IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp.).
Results:
The one-year MACE rate was 14.6%, with 6.1% of patients experiencing myocardial infarction, 4.4% requiring repeat revascularization, and 4.1% experiencing cardiac death. Graft patency at six months was 94.7%, and the overall procedural success rate was 98.2%. One-year survival was observed in 95.3% of the patients.
Conclusion:
HCR is a safe and effective strategy for managing acute STEMI, particularly in patients with complex coronary anatomy. It offers a balanced approach by reducing the need for invasive procedures and improving patient outcomes. Further multicenter studies are necessary to confirm these findings and establish standardized guidelines for HCR.
Related Concept Videos
01:30Acute Coronary Syndrome I: Introduction
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:28Acute Coronary Syndrome IV: Interprofessional Care