Emergency coronary artery bypass surgery for percutaneous coronary interventions: changes in the incidence, clinical characteristics, and indications from 1979 to 2003
The purpose of the current study was to evaluate the changes in incidence, clinical characteristics, and indications for emergency coronary artery bypass grafting (CABG) in patients undergoing percutaneous coronary intervention (PCI) from 1979 to 2003. Emergency CABG after PCI is associated with sig...
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| Veröffentlicht in: | Journal of the American College of Cardiology 2005-12, Vol.46 (11), p.2004-2009 |
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| container_issue | 11 |
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| container_title | Journal of the American College of Cardiology |
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| creator | Yang, Eric H Gumina, Richard J Lennon, Ryan J Holmes, Jr, David R Rihal, Charanjit S Singh, Mandeep |
| description | The purpose of the current study was to evaluate the changes in incidence, clinical characteristics, and indications for emergency coronary artery bypass grafting (CABG) in patients undergoing percutaneous coronary intervention (PCI) from 1979 to 2003.
Emergency CABG after PCI is associated with significant morbidity and mortality.
Data from 23,087 patients who underwent PCI at Mayo Clinic from 1979 to 2003 were analyzed. Patients were divided into three groups: the "pre-stent" era, 1979 to 1994 (n = 8,905); the "initial stent era," 1995 to 1999 (n = 7,605); and the "current stent era," 2000 to 2003 (n = 6,577).
Although patients undergoing PCI in the recent time periods had more high-risk features, there was a significant decrease in the incidence of emergency CABG from 2.9% to 0.7% to 0.3% across the groups (p < 0.001). Patients requiring emergency surgery in the recent time periods had a higher prevalence of hypertension, prior revascularization, and left ventricular dysfunction (ejection fraction |
| doi_str_mv | 10.1016/j.jacc.2005.06.083 |
| format | Article |
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Emergency CABG after PCI is associated with significant morbidity and mortality.
Data from 23,087 patients who underwent PCI at Mayo Clinic from 1979 to 2003 were analyzed. Patients were divided into three groups: the "pre-stent" era, 1979 to 1994 (n = 8,905); the "initial stent era," 1995 to 1999 (n = 7,605); and the "current stent era," 2000 to 2003 (n = 6,577).
Although patients undergoing PCI in the recent time periods had more high-risk features, there was a significant decrease in the incidence of emergency CABG from 2.9% to 0.7% to 0.3% across the groups (p < 0.001). Patients requiring emergency surgery in the recent time periods had a higher prevalence of hypertension, prior revascularization, and left ventricular dysfunction (ejection fraction <40%), as well as more complex coronary lesions. Fewer patients in the current stent era had coronary artery dissections and abrupt vessel closure requiring emergency CABG. The in-hospital mortality rate for emergency CABG patients remains unchanged and ranges from 10% to 14%.
The current study demonstrates that despite the increase in high-risk patients undergoing PCI, there has been a marked decrease in the incidence of patients requiring emergency CABG. However, the in-hospital mortality rate for those requiring emergency CABG remains high and unchanged.</description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/j.jacc.2005.06.083</identifier><identifier>PMID: 16325032</identifier><language>eng</language><publisher>United States: Elsevier Limited</publisher><subject>Aged ; Angioplasty, Balloon, Coronary ; Cardiology ; Cause of Death ; Coronary Artery Bypass - mortality ; Coronary Artery Bypass - statistics & numerical data ; Coronary Disease - epidemiology ; Coronary Disease - therapy ; Coronary vessels ; Diabetic Angiopathies - surgery ; Emergency Treatment ; Female ; Heart attacks ; Hospital Mortality ; Humans ; Hypertension - epidemiology ; Male ; Middle Aged ; Platelet Glycoprotein GPIIb-IIIa Complex - therapeutic use ; Respiratory distress syndrome ; Retrospective Studies ; Stents ; Stroke Volume ; Treatment Failure ; Ventricular Dysfunction, Left - epidemiology</subject><ispartof>Journal of the American College of Cardiology, 2005-12, Vol.46 (11), p.2004-2009</ispartof><rights>Copyright Elsevier Limited Dec 6, 2005</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27922,27923</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16325032$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yang, Eric H</creatorcontrib><creatorcontrib>Gumina, Richard J</creatorcontrib><creatorcontrib>Lennon, Ryan J</creatorcontrib><creatorcontrib>Holmes, Jr, David R</creatorcontrib><creatorcontrib>Rihal, Charanjit S</creatorcontrib><creatorcontrib>Singh, Mandeep</creatorcontrib><title>Emergency coronary artery bypass surgery for percutaneous coronary interventions: changes in the incidence, clinical characteristics, and indications from 1979 to 2003</title><title>Journal of the American College of Cardiology</title><addtitle>J Am Coll Cardiol</addtitle><description>The purpose of the current study was to evaluate the changes in incidence, clinical characteristics, and indications for emergency coronary artery bypass grafting (CABG) in patients undergoing percutaneous coronary intervention (PCI) from 1979 to 2003.
Emergency CABG after PCI is associated with significant morbidity and mortality.
Data from 23,087 patients who underwent PCI at Mayo Clinic from 1979 to 2003 were analyzed. Patients were divided into three groups: the "pre-stent" era, 1979 to 1994 (n = 8,905); the "initial stent era," 1995 to 1999 (n = 7,605); and the "current stent era," 2000 to 2003 (n = 6,577).
Although patients undergoing PCI in the recent time periods had more high-risk features, there was a significant decrease in the incidence of emergency CABG from 2.9% to 0.7% to 0.3% across the groups (p < 0.001). Patients requiring emergency surgery in the recent time periods had a higher prevalence of hypertension, prior revascularization, and left ventricular dysfunction (ejection fraction <40%), as well as more complex coronary lesions. Fewer patients in the current stent era had coronary artery dissections and abrupt vessel closure requiring emergency CABG. The in-hospital mortality rate for emergency CABG patients remains unchanged and ranges from 10% to 14%.
The current study demonstrates that despite the increase in high-risk patients undergoing PCI, there has been a marked decrease in the incidence of patients requiring emergency CABG. However, the in-hospital mortality rate for those requiring emergency CABG remains high and unchanged.</description><subject>Aged</subject><subject>Angioplasty, Balloon, Coronary</subject><subject>Cardiology</subject><subject>Cause of Death</subject><subject>Coronary Artery Bypass - mortality</subject><subject>Coronary Artery Bypass - statistics & numerical data</subject><subject>Coronary Disease - epidemiology</subject><subject>Coronary Disease - therapy</subject><subject>Coronary vessels</subject><subject>Diabetic Angiopathies - surgery</subject><subject>Emergency Treatment</subject><subject>Female</subject><subject>Heart attacks</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Hypertension - epidemiology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Platelet Glycoprotein GPIIb-IIIa Complex - therapeutic use</subject><subject>Respiratory distress syndrome</subject><subject>Retrospective Studies</subject><subject>Stents</subject><subject>Stroke Volume</subject><subject>Treatment Failure</subject><subject>Ventricular Dysfunction, Left - epidemiology</subject><issn>0735-1097</issn><issn>1558-3597</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkc1q3DAQx0VJaDZpX6CHIgj0FLsjy5Kt3sqStIFALunZyONxVostbSU7sE_U16yapBR6-jMzv_lm7IOAUoDQn_fl3iKWFYAqQZfQyjdsI5RqC6lMc8I20EhVCDDNGTtPaQ8AuhXmLTsTWlYKZLVhv65nio_k8cgxxOBtPHIbF8rSHw82JZ7WHM_mGCI_UMR1sZ7Cmv7xzmf-ifzigk9fOO6sf6SU3XzZURZ0Q25AVxwn5x3a6Q8SLeYslxaH6YpbP2RwyMHnInyMYebCNIYvgecF5Tt2Otop0ftXvWA_bq4ftt-Lu_tvt9uvd8WuauRSCE1a0wBjIyxBPQiNo6qVtY0VOEo1Ul8bwLrVILAZjZaqN7qyZKhvlUF5wT691D3E8HOltHSzS0jT9LJ0p9uMybbO4OV_4D6s0efZOqFAC63bGjL18ZVa-5mG7hDdnE_W_X2A_A3P3Iu9</recordid><startdate>20051206</startdate><enddate>20051206</enddate><creator>Yang, Eric H</creator><creator>Gumina, Richard J</creator><creator>Lennon, Ryan J</creator><creator>Holmes, Jr, David R</creator><creator>Rihal, Charanjit S</creator><creator>Singh, Mandeep</creator><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7T5</scope><scope>7TK</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20051206</creationdate><title>Emergency coronary artery bypass surgery for percutaneous coronary interventions: changes in the incidence, clinical characteristics, and indications from 1979 to 2003</title><author>Yang, Eric H ; Gumina, Richard J ; Lennon, Ryan J ; Holmes, Jr, David R ; Rihal, Charanjit S ; Singh, Mandeep</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-h273t-16e66ed0f71ae04d16cf545aa7a1cf35feb490c48601c7f9635b962ae9eb859c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Aged</topic><topic>Angioplasty, Balloon, Coronary</topic><topic>Cardiology</topic><topic>Cause of Death</topic><topic>Coronary Artery Bypass - mortality</topic><topic>Coronary Artery Bypass - statistics & numerical data</topic><topic>Coronary Disease - epidemiology</topic><topic>Coronary Disease - therapy</topic><topic>Coronary vessels</topic><topic>Diabetic Angiopathies - surgery</topic><topic>Emergency Treatment</topic><topic>Female</topic><topic>Heart attacks</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Hypertension - epidemiology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Platelet Glycoprotein GPIIb-IIIa Complex - therapeutic use</topic><topic>Respiratory distress syndrome</topic><topic>Retrospective Studies</topic><topic>Stents</topic><topic>Stroke Volume</topic><topic>Treatment Failure</topic><topic>Ventricular Dysfunction, Left - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yang, Eric H</creatorcontrib><creatorcontrib>Gumina, Richard J</creatorcontrib><creatorcontrib>Lennon, Ryan J</creatorcontrib><creatorcontrib>Holmes, Jr, David R</creatorcontrib><creatorcontrib>Rihal, Charanjit S</creatorcontrib><creatorcontrib>Singh, Mandeep</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American College of Cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yang, Eric H</au><au>Gumina, Richard J</au><au>Lennon, Ryan J</au><au>Holmes, Jr, David R</au><au>Rihal, Charanjit S</au><au>Singh, Mandeep</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Emergency coronary artery bypass surgery for percutaneous coronary interventions: changes in the incidence, clinical characteristics, and indications from 1979 to 2003</atitle><jtitle>Journal of the American College of Cardiology</jtitle><addtitle>J Am Coll Cardiol</addtitle><date>2005-12-06</date><risdate>2005</risdate><volume>46</volume><issue>11</issue><spage>2004</spage><epage>2009</epage><pages>2004-2009</pages><issn>0735-1097</issn><eissn>1558-3597</eissn><abstract>The purpose of the current study was to evaluate the changes in incidence, clinical characteristics, and indications for emergency coronary artery bypass grafting (CABG) in patients undergoing percutaneous coronary intervention (PCI) from 1979 to 2003.
Emergency CABG after PCI is associated with significant morbidity and mortality.
Data from 23,087 patients who underwent PCI at Mayo Clinic from 1979 to 2003 were analyzed. Patients were divided into three groups: the "pre-stent" era, 1979 to 1994 (n = 8,905); the "initial stent era," 1995 to 1999 (n = 7,605); and the "current stent era," 2000 to 2003 (n = 6,577).
Although patients undergoing PCI in the recent time periods had more high-risk features, there was a significant decrease in the incidence of emergency CABG from 2.9% to 0.7% to 0.3% across the groups (p < 0.001). Patients requiring emergency surgery in the recent time periods had a higher prevalence of hypertension, prior revascularization, and left ventricular dysfunction (ejection fraction <40%), as well as more complex coronary lesions. Fewer patients in the current stent era had coronary artery dissections and abrupt vessel closure requiring emergency CABG. The in-hospital mortality rate for emergency CABG patients remains unchanged and ranges from 10% to 14%.
The current study demonstrates that despite the increase in high-risk patients undergoing PCI, there has been a marked decrease in the incidence of patients requiring emergency CABG. However, the in-hospital mortality rate for those requiring emergency CABG remains high and unchanged.</abstract><cop>United States</cop><pub>Elsevier Limited</pub><pmid>16325032</pmid><doi>10.1016/j.jacc.2005.06.083</doi><tpages>6</tpages></addata></record> |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present); EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Aged Angioplasty, Balloon, Coronary Cardiology Cause of Death Coronary Artery Bypass - mortality Coronary Artery Bypass - statistics & numerical data Coronary Disease - epidemiology Coronary Disease - therapy Coronary vessels Diabetic Angiopathies - surgery Emergency Treatment Female Heart attacks Hospital Mortality Humans Hypertension - epidemiology Male Middle Aged Platelet Glycoprotein GPIIb-IIIa Complex - therapeutic use Respiratory distress syndrome Retrospective Studies Stents Stroke Volume Treatment Failure Ventricular Dysfunction, Left - epidemiology |
| title | Emergency coronary artery bypass surgery for percutaneous coronary interventions: changes in the incidence, clinical characteristics, and indications from 1979 to 2003 |
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