PMID: 22572233May 11, 2012Paper

Results of emergency coronary artery bypass grafting for acute myocardial infarction: importance of intraoperative and postoperative cardiac medical therapy

Annals of Thoracic and Cardiovascular Surgery : Official Journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
Akira SezaiMotomi Shiono

Abstract

The results of emergency coronary artery bypass grafting (CABG) for acute myocardial infarction (AMI) are less than satisfactory, and readmission for cardiac events is common. 105 patients underwent emergency CABG for AMI. We examined the long-term results of emergency CABG for AMI from the viewpoints of preoperative, intraoperative, and postoperative factors. The operative mortality rate was 11.4%. Risk factors for early death were age ≥80 years, shock, veno-arterial bypass, creatine kinase isoenzyme Mb ≥100 U/L, non-use of a left internal thoracic artery graft and an extracorporeal circulation time ≥120 min. Risk factors for late cardiac events were ejection fraction <40%, non-use of human atrial natriuretic peptide (hANP) therapy, angiotensin II receptor blockers (ARB) and aldosterone blockers, and a 3-month postoperative brain natriuretic peptide level ≥200 pg/ml. Early results of this study are similar to those seen in previous reports, whereas late phase results yield some new and interesting findings. We suggest that intraoperative hANP, and postoperative aldosterone blocker and ARB, following CABG for AMI, will, through control of the renin-angiotensin-aldsterone system, inhibit left ventricular remodelling, reduce the ...Continue Reading

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Citations

Oct 20, 2015·Journal of cardiology·Akira Sezai, Motomi Shiono
May 26, 2015·Annals of Thoracic and Cardiovascular Surgery : Official Journal of the Association of Thoracic and Cardiovascular Surgeons of Asia·Akira SezaiMotomi Shiono
Nov 20, 2015·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Tomas A AxelssonTomas Gudbjartsson
Mar 21, 2015·Journal of Cardiothoracic and Vascular Anesthesia·Fausto BiancariGiovanni Mariscalco
Apr 19, 2016·Annals of Thoracic and Cardiovascular Surgery : Official Journal of the Association of Thoracic and Cardiovascular Surgeons of Asia·Akira SezaiHisakuni Sakino
Jun 16, 2016·Texas Heart Institute Journal·Erin M SchumerMark S Slaughter
Apr 5, 2018·The New England Journal of Medicine·Steffen DeschHolger Thiele
Aug 22, 2014·Annals of Thoracic and Cardiovascular Surgery : Official Journal of the Association of Thoracic and Cardiovascular Surgeons of Asia·Akira Sezai, Motomi Shiono
Apr 6, 2018·The New England Journal of Medicine·Koen AmelootNicolas Van Mieghem

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