Evaluation of Emergency Coronary Artery Bypass Grafting within 2 Weeks of Acute Myocardial Infarction

概要

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Fifty-seven AMI patients underwent emergency coronary artery bypass grafting (CABG) within 2 weeks after the onset of infarction to relieve myocardial ischemia. Eight (14%) patients died shortly after CABG and 4 (7%) died later. Among 34 patients undergoing CABG for post-infarction angina, early death only occurred in 1 (2.9%), and the mortality rate was not different from that of 801 patients who underwent elective CABG (2.8%). Among 12 patients undergoing CABG within 6 hr after the onset of AMI, 3 patients with cardiogenic shock died but the others survived. Cardiac function was preserved in these patients, although myocardial enzymes increased in the early postoperative period. Based on these results, CABG was concluded to be beneficial for preventing the extension of infarction. The following 4 factors were significantly associated with postoperative cardiac death : (1) Cardiogenic shock, especially requiring cardiopulmonary resuscitation (p<0.005), (2) AMI evoked by PTCA or CAG (p<0.005), (3) CABG within 24 hrs after the onset of AMI (p<0.05), and (4) transmural infarction (p<0.05). In 45 patients surviving long-term, the postoperative clinical status was good and emergency CABG was obviously beneficial in the treatment of AMI.
北里大学の論文
1998-10-31