Predictors of long-term mortality in acute ST-elevation myocardial infarction patients undergoing emergent coronary artery bypass graft surgery [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2021; 49(3): 191-197 | DOI: 10.5543/tkda.2021.79059

Predictors of long-term mortality in acute ST-elevation myocardial infarction patients undergoing emergent coronary artery bypass graft surgery

Begüm Uygur1, Ömer Çelik1, Ali Rıza Demir1, Gökhan Demirci1, Taner İyigün2, Anıl Şahin1, Ömer Taşbulak1, Yalçın Avcı1, Mehmet Ertürk1
1Department of Cardiology, University of Health Sciences Turkey İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
2Department of Cardiovascular Surgery, University of Health Sciences Turkey İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey


OBJECTIVE
Coronary artery bypass graft (CABG) surgery as a primary treatment for acute ST-elevation myocardial infarction (STEMI) is still debated. This study aimed to evaluate the predictors of long-term mortality in STEMI patients undergoing emergent CABG. To the best of our knowledge, this is the first study to evaluate the long-term mortality predictors in patients with STEMI revascularized by primary CABG.

METHODS
This retrospective study included 88 consecutive patients with STEMI, who did not qualify for primary percutaneous intervention and required emergent CABG between 2010 and 2017. The study population was divided into the following 2 groups: survivors and nonsurvivors. The 2 groups were compared in terms of demographics, preoperative, intraoperative, and postoperative characteristics.

RESULTS
23 of the 88 patients, died during the median 92.8 (69.0-105.1) months of follow-up. Data were evaluated with univariate and multivariate analyses. Killip class (p<0.001) was found to be an independent predictor of long-term all-cause mortality in patients with STEMI revascularized by CABG, and mortality rates increased significantly as Killip class increased (log-rank test, p<0.001). Moreover, age (p=0.044) was found to be an independent predictor of long-term mortality. Left ventricular ejection fraction, glomerular filtration rate, glucose levels, and left anterior descending artery to the left internal mammary artery graft usage (p=0.001, p=0.009, p<0.001, and p=0.039, respectively) were significantly associated with long-term all-cause mortality for our study population.

CONCLUSION
Killip class was found to be an independent predictor of long-term all-cause mortality in patients with STEMI who underwent emergent CABG. The patients’ admission status may give valuable information about long-term mortality.

Keywords: Emergent CABG, Long term mortality, ST-elevation myocardial infarction

How to cite this article
Begüm Uygur, Ömer Çelik, Ali Rıza Demir, Gökhan Demirci, Taner İyigün, Anıl Şahin, Ömer Taşbulak, Yalçın Avcı, Mehmet Ertürk. Predictors of long-term mortality in acute ST-elevation myocardial infarction patients undergoing emergent coronary artery bypass graft surgery. Turk Kardiyol Dern Ars. 2021; 49(3): 191-197

Corresponding Author: Begüm Uygur, Türkiye
© Copyright 2021 Archives of the Turkish Society of Cardiology
LookUs & Online Makale