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Impact of Previous Coronary Artery Bypass Grafting on Clinical Outcomes in Patients With Acute Myocardial Infarction:

Mullapudi Lokesh1, Anastasia Postoev2, Loiy Naser Alsarkhi3

  • 1Medicine and Surgery, Gomel State Medical University, Gomel, BLR.

Cureus
|October 17, 2025
PubMed

Insights

Previous coronary artery bypass grafting (CABG) did not significantly impact overall acute myocardial infarction (AMI) mortality. However, prior CABG was linked to a higher mortality risk in ST-segment elevation myocardial infarction (STEMI) patients.

Area of Science:

  • Cardiology
  • Clinical Research
  • Public Health

Background:

  • Coronary artery bypass grafting (CABG) is a common intervention for coronary artery disease.
  • The impact of prior CABG on outcomes in patients with acute myocardial infarction (AMI) requires further clarification.
  • Understanding these outcomes is crucial for guiding treatment strategies and patient management.

Purpose of the Study:

  • To systematically review and meta-analyze the clinical outcomes of patients with AMI who have a history of previous CABG compared to those without.
  • To investigate the association between prior CABG and mortality and major adverse cardiac events (MACE) in the overall AMI population and specific subgroups (STEMI and NSTEMI).

Main Methods:

  • A comprehensive literature search was conducted in major databases (PubMed/MEDLINE, Embase, CENTRAL, Web of Science) from January 2010 to August 2025.
  • Nine observational studies were included, with data extracted and quality assessed by two independent reviewers.
  • Random-effects models were used for meta-analysis, with meta-regression to explore heterogeneity.

Main Results:

  • Previous CABG was not significantly associated with all-cause mortality in the overall AMI population (RR: 1.06, 95% CI: 0.97-1.16), despite high heterogeneity.
  • Subgroup analysis indicated a 16% higher mortality risk in STEMI patients with prior CABG (RR: 1.16, 95% CI: 1.12-1.20).
  • No significant difference in MACE was observed between groups (RR: 0.98, 95% CI: 0.85-1.12).

Conclusions:

  • Prior CABG may increase mortality risk specifically in patients with STEMI.
  • The findings for NSTEMI patients were not statistically significant, and overall results showed considerable heterogeneity.
  • Larger, targeted investigations are needed to confirm these subgroup findings due to limited study numbers.

Keywords:
coronary artery bypass graftingmeta-analysismortalitymyocardial infarctionstemi

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