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Clinical Characteristics and Outcomes of Patients with Acute Coronary Syndrome and Prior Coronary Artery Bypass Grafting in a Large Middle Eastern Cohort

BACKGROUND: Acute Coronary Syndrome (ACS) can occur in patients with prior coronary artery bypass grafting (CABG). In the Gulf Registry of acute coronary events (Gulf RACE), we identified the clinical characteristics and in-hospital outcomes of these patients. METHODS: Clinical characteristics and i...

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Autores principales: Alanbaei, Muath, Alsheikh-Ali, Alawi A, Aleinati, Tareq, Zubaid, Mohammad, Ridha, Mustafa, Alenezi, Fahad, Al-Mahmeed, Wael, Sulaiman, Kadhim, Al-Lawati, Jawad, Amin, Haitham, Al Suwaidi, Jassim, Al-Motarreb, Ahmed
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Bentham Open 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3170976/
https://www.ncbi.nlm.nih.gov/pubmed/21915225
http://dx.doi.org/10.2174/1874192401105010196
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author Alanbaei, Muath
Alsheikh-Ali, Alawi A
Aleinati, Tareq
Zubaid, Mohammad
Ridha, Mustafa
Alenezi, Fahad
Al-Mahmeed, Wael
Sulaiman, Kadhim
Al-Lawati, Jawad
Amin, Haitham
Al Suwaidi, Jassim
Al-Motarreb, Ahmed
author_facet Alanbaei, Muath
Alsheikh-Ali, Alawi A
Aleinati, Tareq
Zubaid, Mohammad
Ridha, Mustafa
Alenezi, Fahad
Al-Mahmeed, Wael
Sulaiman, Kadhim
Al-Lawati, Jawad
Amin, Haitham
Al Suwaidi, Jassim
Al-Motarreb, Ahmed
author_sort Alanbaei, Muath
collection PubMed
description BACKGROUND: Acute Coronary Syndrome (ACS) can occur in patients with prior coronary artery bypass grafting (CABG). In the Gulf Registry of acute coronary events (Gulf RACE), we identified the clinical characteristics and in-hospital outcomes of these patients. METHODS: Clinical characteristics and in-hospital outcomes for 461 ACS patients with prior CABG are compared to 7715 ACS patients without prior CABG enrolled from 64 hospitals in 6 Gulf countries over a 6-month period. RESULTS: The overall incidence of ACS with prior CABG was 5.6% out of 8176 patients. The ACS with prior CABG were older (63 vs 55 years, P<0.0001), had more history of diabetes (62.3 vs 37.6%, P <0.0001), dyslipidemia (70.3 vs 29.5%, P<0.0001), and hypertension (75.7 vs 47.8%, P<0.0001) compared with the non-CABG group. They presented more frequently with dyspnea (14.8 vs 9.5%, P<0.0005), non-ST segment elevation myocardial infarction (41.4 vs 31.6%, P<0.0001) and echocardiographic evidence of left ventricular dysfunction (49.4 vs 29.8%, P<0.0001) than ACS without prior CABG. They had a complicated in-hospital course with more recurrent ischemia (13.9 vs 9.3%, P=0.0011), heart failure (24.1 vs 15.7%), and stroke (2.2 vs 0.6%) compared with those without CABG. The in-hospital mortality rate was 5.6% in the CABG group compared with 3.5% in the ACS without prior CABG group. After adjusting for confounders, prior CABG was independently associated with recurrent ischemia and shock, more in patients presenting with ST elevation than non-ST elevation ACS. CONCLUSIONS: Patients with ACS and prior CABG are a high-risk group with poor outcomes irrespective of their older age and comorbidities. They should be identified and treated differently to improve their outcomes.
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spelling pubmed-31709762011-09-13 Clinical Characteristics and Outcomes of Patients with Acute Coronary Syndrome and Prior Coronary Artery Bypass Grafting in a Large Middle Eastern Cohort Alanbaei, Muath Alsheikh-Ali, Alawi A Aleinati, Tareq Zubaid, Mohammad Ridha, Mustafa Alenezi, Fahad Al-Mahmeed, Wael Sulaiman, Kadhim Al-Lawati, Jawad Amin, Haitham Al Suwaidi, Jassim Al-Motarreb, Ahmed Open Cardiovasc Med J Article BACKGROUND: Acute Coronary Syndrome (ACS) can occur in patients with prior coronary artery bypass grafting (CABG). In the Gulf Registry of acute coronary events (Gulf RACE), we identified the clinical characteristics and in-hospital outcomes of these patients. METHODS: Clinical characteristics and in-hospital outcomes for 461 ACS patients with prior CABG are compared to 7715 ACS patients without prior CABG enrolled from 64 hospitals in 6 Gulf countries over a 6-month period. RESULTS: The overall incidence of ACS with prior CABG was 5.6% out of 8176 patients. The ACS with prior CABG were older (63 vs 55 years, P<0.0001), had more history of diabetes (62.3 vs 37.6%, P <0.0001), dyslipidemia (70.3 vs 29.5%, P<0.0001), and hypertension (75.7 vs 47.8%, P<0.0001) compared with the non-CABG group. They presented more frequently with dyspnea (14.8 vs 9.5%, P<0.0005), non-ST segment elevation myocardial infarction (41.4 vs 31.6%, P<0.0001) and echocardiographic evidence of left ventricular dysfunction (49.4 vs 29.8%, P<0.0001) than ACS without prior CABG. They had a complicated in-hospital course with more recurrent ischemia (13.9 vs 9.3%, P=0.0011), heart failure (24.1 vs 15.7%), and stroke (2.2 vs 0.6%) compared with those without CABG. The in-hospital mortality rate was 5.6% in the CABG group compared with 3.5% in the ACS without prior CABG group. After adjusting for confounders, prior CABG was independently associated with recurrent ischemia and shock, more in patients presenting with ST elevation than non-ST elevation ACS. CONCLUSIONS: Patients with ACS and prior CABG are a high-risk group with poor outcomes irrespective of their older age and comorbidities. They should be identified and treated differently to improve their outcomes. Bentham Open 2011-08-30 /pmc/articles/PMC3170976/ /pubmed/21915225 http://dx.doi.org/10.2174/1874192401105010196 Text en © Alanbaei et al.; Licensee Bentham Open. http://creativecommons.org/licenses/by-nc/3.0/ This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.
spellingShingle Article
Alanbaei, Muath
Alsheikh-Ali, Alawi A
Aleinati, Tareq
Zubaid, Mohammad
Ridha, Mustafa
Alenezi, Fahad
Al-Mahmeed, Wael
Sulaiman, Kadhim
Al-Lawati, Jawad
Amin, Haitham
Al Suwaidi, Jassim
Al-Motarreb, Ahmed
Clinical Characteristics and Outcomes of Patients with Acute Coronary Syndrome and Prior Coronary Artery Bypass Grafting in a Large Middle Eastern Cohort
title Clinical Characteristics and Outcomes of Patients with Acute Coronary Syndrome and Prior Coronary Artery Bypass Grafting in a Large Middle Eastern Cohort
title_full Clinical Characteristics and Outcomes of Patients with Acute Coronary Syndrome and Prior Coronary Artery Bypass Grafting in a Large Middle Eastern Cohort
title_fullStr Clinical Characteristics and Outcomes of Patients with Acute Coronary Syndrome and Prior Coronary Artery Bypass Grafting in a Large Middle Eastern Cohort
title_full_unstemmed Clinical Characteristics and Outcomes of Patients with Acute Coronary Syndrome and Prior Coronary Artery Bypass Grafting in a Large Middle Eastern Cohort
title_short Clinical Characteristics and Outcomes of Patients with Acute Coronary Syndrome and Prior Coronary Artery Bypass Grafting in a Large Middle Eastern Cohort
title_sort clinical characteristics and outcomes of patients with acute coronary syndrome and prior coronary artery bypass grafting in a large middle eastern cohort
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3170976/
https://www.ncbi.nlm.nih.gov/pubmed/21915225
http://dx.doi.org/10.2174/1874192401105010196
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