Outcomes of Urgent Coronary Artery Bypass Graft Surgery Following Non-ST Elevation Myocardial Infarction
Abdelhamid Fathi Sherif *
Department of Cardiothoracic Surgery, Faculty of Medicine, Benha University, Egypt.
Mahmoud Mohamed Ghalwash
Department of Cardiothoracic Surgery, Faculty of Medicine, Benha University, Egypt.
*Author to whom correspondence should be addressed.
Abstract
Background: Non-ST elevation myocardial infarction (NSTEMI) significantly reduces patient survival, a condition that is essential for the optimization of results and the restoration of effective vascular flow multivessel coronary artery disease, Emergency coronary artery bypass grafting (CABG) is frequently contemplated. In the aftermath of NSTEMI, the objective of this investigation is to assess the results of urgent CABG, to prioritize risk stratification through the use of the Global Registry of Acute Coronary Events (GRACE) score
Methods: An analysis of 60 consecutive patients who underwent emergent CABG following NSTEMI was conducted retrospectively. Data on patients were obtained from a prospectively compiled database, and the GRACE score was implemented to evaluate the probability of mortality. Patients were divided into three risk categories: low (<10%), intermediate (10-19%), and high (≥20%), based on their predicted mortality percentages.
Results: Patients in the high-risk group (Group 3) exhibited significantly lower Euro Scores and ejection fractions (EF) than those in the low and intermediate groups, as demonstrated by the study. Additionally, the cross-clamp time was notably longer in Group 3, highlighting the urgency of intervention in this population The postoperative complications' overall incidence did not differ significantly between the groups. Even though Group 3 exhibited an increased in-hospital mortality rate.
Conclusions: The findings underscore the importance of timely intervention and tailored management strategies for NSTEMI patients, more specifically, the individuals who have been classified as high-risk by the GRACE score. This study contributes to the growing body of literature supporting urgent CABG as a lifesaving procedure and emphasizes the need for further research to optimize outcomes in this vulnerable patient population. The results advocate for a multidisciplinary approach to enhance perioperative care and improve survival rates among NSTEMI patients undergoing CABG.
Keywords: Non-ST elevation myocardial infarction, Coronary artery bypass grafting, acute coronary events score, multivessel coronary artery disease, postoperative complications, urgent intervention, patient outcomes