In-hospital and long-term prognosis after myocardial infarction in patients with prior coronary artery bypass surgery; 19-year experience.
In-hospital and long-term prognosis after myocardial infarction in patients with prior coronary artery bypass surgery; 19-year experience.
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DOI：
10.1100/tsw.2009.114
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发表时间：
2009-10-01
影响因子：
--
通讯作者：
Ostojic M
中科院分区：
文献类型：
--
作者：
Mitrovic PM;Stefanovic B;Vasiljevic Z;Radovanovic M;Radovanovic N;Krljanac G;Novakovic A;Ostojic M
为了总结19年来急性心肌梗死（AMI）患者既往冠状动脉搭桥手术（CABS）的预后，我们分析了748例既往冠状动脉搭桥术后AMI患者（搭桥后组）和1080例无CABS的AMI患者的对照组。搭桥后组梗死面积各项指标均降低。搭桥后组有更多的心室颤动。住院死亡率相似（p = 0.3675）。在随访期间，搭桥术后患者比对照组患者有更多的心力衰竭、复发性CABS、再梗死和不稳定型心绞痛。对照组的累积生存期优于旁路治疗组（p = 0.0403）。多元logistic回归模型显示既往心绞痛（p = 0.0005）、糖尿病（p = 0.0058）、年龄（p = 0.0102）是影响生存率的独立预测因素。洋地黄和利尿剂的使用以及既往心绞痛也会影响生存率（p = 0.0092），男性、老年患者和糖尿病也会影响生存率（p = 0.0420）。先前CABS后的AMI患者有较小的梗死，但更多的再梗死、再手术、心力衰竭和心绞痛。既往心绞痛、糖尿病和年龄，以及洋地黄和利尿剂合并心绞痛、男性、老年患者和糖尿病共同影响这些患者较差的生存率。
To present a 19-year experience of the prognosis of patients with acute myocardial infarction (AMI) and prior coronary artery bypass surgery (CABS), 748 patients with AMI after prior CABS (postbypass group) and a control group of 1080 patients with AMI, but without prior CABS, were analyzed. All indexes of infarct size were lower in the postbypass group. There was more ventricular fibrillation in the postbypass group. In-hospital mortality was similar (p = 0.3675). In the follow-up period, postbypass patients had more heart failure, recurrent CABS, reinfarction, and unstable angina than did control patients. Cumulative survival was better in the control group than in the postbypass group (p = 0.0403). Multiple logistic regression model showed that previous angina (p = 0.0005), diabetes (p = 0.0058), and age (p = 0.0102) were independent predictor factors for survival. Use of digitalis and diuretics, together with previous angina, also influenced survival (p = 0.0092), as well as male gender, older patients, and diabetes together (p = 0.0420). Patients with AMI after prior CABS had smaller infarct, but more reinfarction, reoperation, heart failure, and angina. Previous angina, diabetes, and age, independently, as well as use of digitalis and diuretics together with angina, and male gender, older patients, and diabetes together, influenced a worse survival rate in these patients.
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DOI：
10.1016/0735-1097(88)90447-0
发表时间：
1988-10-01
影响因子：
24
作者：
WISEMAN, A;WATERS, DD;THEROUX, P
通讯作者：
THEROUX, P
影响因子：
158.5
作者：
CAMPEAU, L;ENJALBERT, M;SNIDERMAN, A
通讯作者：
SNIDERMAN, A
影响因子：
2.8
作者：
DITTRICH, HC;GILPIN, E;ROSS, J
通讯作者：
ROSS, J
影响因子：
2.8
作者：
GRINES, CL;BOOTH, DC;DEMARIA, AN
通讯作者：
DEMARIA, AN
影响因子：
37.8
作者：
CREAN, PA;WATERS, DD;THEROUX, P
通讯作者：
THEROUX, P